To compare self-reported (SR) medication use and pharmacy data for major psychoactive medications and three classes of medications used for different indications, and to determine the socio-economic factors associated with the congruence.
Postal questionnaire data collected in 1997 were compared with the register of the Social Insurance Institution of Finland on the reimbursed prescriptions purchased during 1997. Altogether 7625 subjects were included in this study. Drugs were categorized according to the Anatomical Therapeutic Chemical (ATC) system.
Kappa values were 0.77, 0.68, 0.84, 0.92 and 0.55 for antipsychotics, antidepressants, antiepileptics, antidiabetics and beta-blocking agents, respectively. Prevalence-adjusted and bias-adjusted kappa values were almost perfect (0.98-1.00). Reliability of antipsychotics use was better for married subjects than for those who were not married; and of antidepressants use for highly educated and married subjects than for those who were less educated and were not married. Altogether 414 (5.4%) responders and 285 (7.1%) non-responders had used at least one of the selected medications.
Agreement between the SR and pharmacy data was moderate for psychoactive medication use. Even though data collected by postal questionnaire may underestimate the prevalence of medication use due to non-participation it can be assumed accurate enough for study purposes.
The authors elaborated a medical and ecologic questionnaire for specific history. The questionnaire was applied to express-evaluation of public health state and environmental factors in the certain settlement. The health state was proved to be influenced significantly by occupational conditions, hardiness and intensity of work, psychologic climate. The most hazardous environmental factors are: unsatisfactory quality of drinkable water, air pollution and traffic noise. The lifestyle of the population examined is strongly associated with bad habits (smoking, short sleep, alcohol abuse).
Structured diagnostic inter- views include items that evaluate physical etiologies for mood and anxiety disorders. The objective of this article was to assess the impact of such items.
A mental health survey in Canada collected data from n = 36,984 household residents. The lifetime prevalence of mood and anxiety disorders was calculated with and without exclusions due to physical causes.
Approximately 10% of subjects with a lifetime depressive disorder reported that all of their episodes were due to one or more physical cause. Many of the reported etiologies were implausible given the DSM-IV requirement that the disturbance be a "direct physiological consequence" of the physical cause. The results were similar for manic episodes and anxiety disorders.
Structured diagnostic interviews assess physical etiologies in ways that are subject to inconsistency and inaccuracy. Physical etiology items may bias estimates by introducing etiological opinions into the assessment of disorder frequency.
Medical records are considered the gold standard for information on cancer treatments and prognosis. We compared survivor self-report and medical records for agreement on key treatment and prognostic characteristics.
A population-based study was conducted in Quebec assessing work experience among breast cancer survivors aged /=4, unknown) was slightly lower (0.85) but was still excellent. When accepting answers +/-1 month of the medical record date, >/=89% of women correctly reported different treatment dates.
These results provide evidence of the validity of summary treatment and prognostic data reported by breast cancer survivors 3 years after diagnosis. Survivors can likely accurately describe the treatment trajectory and key prognostic information when medical record review is unfeasible. These findings may need replication among older women.
Over the last 20 years, the Canadian Blood Services' (CBS) Donor Health Assessment Questionnaire (DHAQ), used to screen prospective blood donors to determine their eligibility, has grown in complexity and length. Its growth is inextricably linked to the evolution of the environment within which CBS operates from unregulated collection and distribution of labile blood products to a fully regulated environment and to the need to satisfy both Health Canada and US Food and Drug Administration (FDA) requirements. Within this context, the development of the CBS DHAQ has been characterized by addition of questions and items without any periodic reevaluation of the need for retaining existing questions and/or items. In this review, we apply principles from cognitive science relating to how people think when answering questionnaires to the situation of blood donors completing the DHAQ. We show that some items that were added at different times in separate questions, for reasons that were historically relevant, could be now asked more simply with a single question. The historical development of the DHAQ, resulting in the condensing of many items into lists, the use of complex wording, and the sheer number of items included in the questionnaire make accurate retrieval of information from the donor's memory difficult. Thus, we believe that redesigning the DHAQ will improve the quality and accuracy of the donors' answers to screening questions.
From 1 July 1990 to 31 December 1991, all patients referred to the Allergy Section of the ENT Department, University Hospital, Lund, Sweden, (n = 678) answered a 134-item questionnaire presented on the screen of a personal computer by pressing Y (for yes) or N (for no) on the keyboard. The objective of this study was to compare the questionnaire responses from patients with allergic rhinitis (AR) with those of patients with perennial nonallergic rhinitis or vasomotor rhinitis (VMR). Nasal blockage was the predominant symptom in the VMR group, whereas the AR patients mainly suffered from eye irritation, sneezing, and, to some extent, rhinorrhea. Concomitant asthma was more prevalent in the AR group than in the VMR group, whose histories were characterized by symptoms associated with airway infections. About 60% of both groups reported problems with such nonspecific airway irritants as cigarette smoke and perfumes. With respect to the diagnostic reliability of the history, in the AR group the order of accuracy (according to the skin prick test results) of reported hypersensitivity to allergens was as follows: cat > timothy > birch > dust mite > mugwort. A history of hypersensitivity to molds as a cause of symptoms was of no diagnostic value. The findings suggest that there are several differences in the medical histories of AR and VMR patients that merit further investigation.
The Ontario Familial Breast Cancer Registry (OFBCR) is one of six international sites of the Cooperative Familial Registry for Breast Cancer Studies collecting family history, epidemiologic information, and blood samples from families (with various patterns of familial risk) for the purpose of studying the etiology of breast cancer. To invite 2361 female breast cancer patients residing in Ontario to take part in the Registry, a package was sent that included a Family History Questionnaire. Several variations of mailing and follow-up strategies were employed. Overall, the response rate was 67%. The best response (74%) was achieved by following up our introductory package of information with a postcard 10 days later and a telephone call several weeks thereafter. Given the design of the project, which involves a considerable commitment on the part of both patients and their family members, we are impressed by the positive response of these women.
Subarachnoid haemorrhage (SAH) reduces health-related quality of life (HRQoL) and increases the risk of psychiatric sequels such as depression and posttraumatic stress disorder. Especially those with a psychiatric history and those using maladaptive coping strategies are at risk for such sequels. The extent to which HRQoL after SAH was related to a history of psychiatric morbidity and to the use of various coping strategies was assessed.
Patients admitted to the Uppsala University Hospital with aneurysmal SAH (n = 59) were investigated prospectively. Seven months after SAH, data were collected using the Structured Clinical Interview for DSM-IV axis I disorders, the Short Form-36 (SF-36) Health Survey and the Jalowiec Coping Scale.
Patients with SAH had lower HRQoL than the general Swedish population in all eight domains of the SF-36. The lower HRQoL was almost entirely in the subgroup with a psychiatric history. HRQoL was also strongly correlated to the use of coping. Physical domains of SF-36 were less affected than mental domains. Those with a psychiatric history used more coping than the remainder with respect to all emotional coping scales. Coping and the presence of a psychiatric history were more strongly related to mental than to physical components of HRQoL.
A psychiatric history and the use of maladaptive emotional coping were related to worse HRQoL, more to mental than to physical aspects.
To compare discrepancies in drug histories among patients acutely admitted to different hospital wards, classify the discrepancies according to their potential clinical impact and identify appropriate selection criteria for patients that should be subject to a detailed drug history at admission.
Two gastrointestinal surgery wards and one geriatric ward at St Olav's University Hospital in Trondheim and two general internal medicine wards at Ålesund Hospital in Ålesund, Norway.
All patients acutely admitted to these wards during a period of three?months were asked to participate in the study. A total of 168 patients were included. For each patient, drug information available at admission was compared with information from drug lists obtained from the general practitioner and (if applicable) the home care services/the nursing home.
Number of patients with one or more discrepancies in their drug history. Type and clinical impact of the discrepancies found. Selection criteria for patients that should be subject to a detailed drug history.
In total, 83% had at least one discrepancy in their drug history. Omission of a drug accounted for 72% of the discrepancies, whereas a difference in dosing was the cause of the remaining 28%. 9% of the discrepancies had the potential to cause severe harm or discomfort. We found no significant differences in the number of discrepancies between hospital wards, genders, ages or levels of care.
This study demonstrates the importance of collecting drug information from all available sources when a patient is admitted to hospital. As we found no significant differences in discrepancies between subgroups of patients, we suggest that medication reconciliation should be performed for all patients.
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A comprehensive pedigree, usually provided by the counselee and verified by medical records, is essential for risk assessment in cancer genetic counseling. Collecting the relevant information is time-consuming and sometimes impossible. We studied the use of electronically ascertained pedigrees (EGP). The study group comprised women (n?=?1352) receiving HBOC genetic counseling between December 2006 and December 2016 at Landspitali in Iceland. EGP's were ascertained using information from the population-based Genealogy Database and Icelandic Cancer Registry. The likelihood of being positive for the Icelandic founder BRCA2 pathogenic variant NM_000059.3:c.767_771delCAAAT was calculated using the risk assessment program Boadicea. We used this unique data to estimate the optimal size of pedigrees, e.g., those that best balance the accuracy of risk assessment using Boadicea and cost of ascertainment. Sub-groups of randomly selected 104 positive and 105 negative women for the founder BRCA2 PV were formed and Receiver Operating Characteristics curves compared for efficiency of PV prediction with a Boadicea score. The optimal pedigree size included 3° relatives or up to five generations with an average no. of 53.8 individuals (range 9-220) (AUC 0.801). Adding 4° relatives did not improve the outcome. Pedigrees including 3° relatives are difficult and sometimes impossible to generate with conventional methods. Pedigrees ascertained with data from pre-existing genealogy databases and cancer registries can save effort and contain more information than traditional pedigrees. Genetic services should consider generating EGP's which requires access to an accurate genealogy database and cancer registry. Local data protection laws and regulations have to be addressed.