Utility of the Infantile Hemangioma Referral Score (IHReS) as a decision-making tool for referral to treatment

BackgroundThe general paediatricians and primary care physicians sometimes face immense difficulty in referral judgements regarding which infantile hemangiomas (IHs) require referrals and when is the appropriate time to refer IHs for treatment. This resulted in the treatment being delayed beyond IHs’ critical timeframe. The Infantile Hemangioma Referral Score (IHReS) has been recently developed, with the aim to solve this problem.ObjectivesThe objective of the present study is to evaluate the reliability of IHReS and to assess the possibility of using this instrument in our country where a similar problem of delaying treatment of IHs is currently existing.MethodsThe present study was a prospective, cross-sectional study. Thirteen selected clinical cases were used to assess the reliability of IHReS among physicians who may have had the chance to deal with patients with IHs. The target physicians across the country were asked to participate in the study via an online platform (Google Forms) to decide whether to refer patients with IHs for treatment or observe. There were 3 steps of assessment: step 1, usual practice evaluation; step 2, using IHReS; step 3, retesting by using IHReS.ResultsSubstantial agreement was observed after using IHReS (step 2) for interrater reliability, with Fleiss’ Kappa values of 0.80 and 0.78 among IH experts and non-expert physicians, respectively. Regarding repeatability, in the test–retest assessments, Cohen’s Kappa coefficient values revealed almost perfect agreement in intrarater repeatability for both experts and non-expert physicians (1.00).ConclusionIHReS is a simple, easy-to-assess tool for non-expert physicians. The benefit in the increase of interrater agreement was found in both IH experts and non-expert physicians. It has had the reliability to be used in making referral decisions regarding patients with IH for treatment among Thai physicians. Using IHReS can improve clinical outcomes by identifying which patient needs early intervention to minimise the possible complications.

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Concordance and accuracy Of Teledermatology using mobile phones in the outpatient clinic Of Jose R. Reyes Memorial Medical Center: A Cross-sectional study (Preprint)

10.2196/preprints.32546 ◽

2021 ◽

Author(s):

Ivan Arni Caballero Preclaro ◽

Zharlah Gulmatico-Flores ◽

Elizabeth Amelia Velasco Tianco

Keyword(s):

Mobile Phones ◽

Final Diagnosis ◽

Cross Sectional Study ◽

Sectional Study ◽

Substantial Agreement ◽

Perfect Agreement ◽

Cross Sectional ◽

Face To Face ◽

The Third ◽

Store And Forward

BACKGROUND Dermatologists rely on visual findings, thus teledermatology is uniquely compatible to provide dermatologic care. The use of mobile phones in a store-and-forward approach, where gathered data is sent to a distant health provider for later review, may be a potential bridge to seek dermatologic care. OBJECTIVE To determine the agreement between face-to-face consult and teledermatologic consult through the store-and-forward approach using mobile phone, and its accuracy compared to histopathologic diagnosis. METHODS The study design is a cross-sectional study of participants consecutively recruited from dermatology patients who presented with skin or mucosal complaint and without prior dermatologist consultation. Photographs were taken using a standard phone (iPhone 6s plus) and a 4-mm skin punch biopsy was taken on each patient, the gold standard to which the study result was compared to. The photographs were sent to three consultant dermatologists using a store-and-forward approach, for independent diagnosis and treatment plan. RESULTS A total of 64 patients were included, with a median age of 41 years old. There was moderate to almost perfect agreement in terms of final diagnosis between face to face dermatologic diagnosis and teledermatologic diagnoses. The third teledermatologist had the highest agreement with the clinical dermatologist in terms of final diagnosis (kappa = 0.84; p <.001). Between the three dermatologists, there was moderate to almost perfect agreement as well. Agreement between pairs of teledermatologists ranges from 0.45 to 0.84. The three teledermatologists had moderate to substantial agreement with the biopsy results, with the third teledermatologist having the highest accuracy (kappa = 0.77; p < .001). Overall, there was a moderate agreement in the diagnosis of patients across raters. CONCLUSIONS Teledermatology is a viable alternative to face-to-face consultations. Our results show moderate to substantial agreement in diagnoses from face-to-face consultation and store-and-forward teledermatology.

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Knowledge, attitude and practice of evidence-based medicine among primary care practitioners in Malaysia: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2020-044372 ◽

2021 ◽

Vol 11 (6) ◽

pp. e044372

Author(s):

Mat Nawi Zanaridah ◽

Mohd Noor Norhayati ◽

Zakaria Rosnani

Keyword(s):

Primary Care ◽

Evidence Based Medicine ◽

Primary Care Physicians ◽

Cross Sectional Study ◽

Evidence Based ◽

Sectional Study ◽

Primary Care Practitioner ◽

Cross Sectional ◽

Primary Care Practitioners ◽

Based Medicine

ObjectivesTo determine the level of knowledge and practice of evidence-based medicine (EBM) and the attitudes towards it and to identify the factors associated with its practice among primary care practitioners in Selangor, Malaysia.SettingThis cross-sectional study was conducted in randomly selected health clinics in Selangor. Data were collected from primary care physicians using self-administered questionnaires on knowledge, practice and attitudes regarding EBM.ParticipantsThe study included 225 respondents working in either government or private clinics. It excluded house officers and those working in public and private universities or who were retired from practice.ResultsA total of 32.9% had a high level of EBM knowledge, 12% had a positive attitude towards EBM and 0.4% had a good level of its practice. The factors significantly associated with EBM practice were ethnicity, attitude, length of work experience as a primary care practitioner and quick access to online reference applications on mobile phones.ConclusionsAlthough many physicians have suboptimal knowledge of EBM and low levels of practising it, majority of them have a neutral attitude towards EBM practice. Extensive experience as a primary care practitioner, quick access to online references on a mobile phone and good attitude towards EBM were associated with its practice.

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A cross-sectional study reporting concussion exposure, assessment and management in Western Australian general practice

BMC Family Practice ◽

10.1186/s12875-021-01384-1 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Elizabeth Thomas ◽

HuiJun Chih ◽

Belinda Gabbe ◽

Melinda Fitzgerald ◽

Gill Cowen

Keyword(s):

General Practice ◽

Cross Sectional Study ◽

Limited Information ◽

Sectional Study ◽

Cross Sectional ◽

Usual Practice ◽

Exact Test ◽

Concussion Management ◽

Practice Knowledge ◽

Western Australian

Abstract Background General Practitioners (GPs) may be called upon to assess patients who have sustained a concussion despite limited information being available at this assessment. Information relating to how concussion is actually being assessed and managed in General Practice is scarce. This study aimed to identify characteristics of current Western Australian (WA) GP exposure to patients with concussion, factors associated with GPs’ knowledge of concussion, confidence of GPs in diagnosing and managing patients with concussion, typical referral practices and familiarity of GPs with guidelines. Methods In this cross-sectional study, GPs in WA were recruited via the RACGP WA newsletter and shareGP and the consented GPs completed an electronic survey. Associations were performed using Chi-squared tests or Fisher’s Exact test. Results Sixty-six GPs in WA responded to the survey (response rate = 1.7%). Demographics, usual practice, knowledge, confidence, identification of prolonged recovery as well as guideline and resource awareness of GPs who practised in regional and metropolitan areas were comparable (p > 0.05). Characteristics of GPs were similar between those who identified all symptoms of concussion and distractors correctly and those who did not (p > 0.05). However, 84% of the respondents who had never heard of concussion guidelines were less likely to answer all symptoms and distractors correctly (p = 0.039). Whilst 78% of the GPs who were confident in their diagnoses had heard of guidelines (p = 0.029), confidence in managing concussion was not significantly associated with GPs exposure to guidelines. It should be noted that none of the respondents correctly identified signs of concussion and excluded the distractors. Conclusions Knowledge surrounding concussion guidelines, diagnosis and management varied across GPs in WA. Promotion of available concussion guidelines may assist GPs who lack confidence in making a diagnosis. The lack of association between GPs exposure to guidelines and confidence managing concussion highlights that concussion management may be an area where GPs could benefit from additional education and support.

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Sources of psychological distress among primary care physicians during the COVID-19 pandemic’s first wave in Spain: a cross-sectional study

Primary Health Care Research & Development ◽

10.1017/s1463423621000566 ◽

2021 ◽

Vol 22 ◽

Author(s):

Ana Cebrián-Cuenca ◽

José Joaquín Mira ◽

Elena Caride-Miana ◽

Antonio Fernández-Jiménez ◽

Domingo Orozco-Beltrán

Keyword(s):

Primary Care ◽

Psychological Distress ◽

Primary Care Physicians ◽

Linear Regression Analysis ◽

Cross Sectional Study ◽

Multivariate Linear Regression Analysis ◽

Sectional Study ◽

Rt Pcr ◽

Cross Sectional ◽

Protective Measures

Abstract Background: The COVID-19 pandemic is affecting people worldwide. In Spain, the first wave was especially severe. Objectives: This study aimed to identify sources and levels of distress among Spanish primary care physicians (PCPs) during the first wave of the pandemic (April 2020). Methods: A cross-sectional study was conducted using a survey that included sociodemographic data, a description of working conditions related to distress [such as gaps in training in protective measures, cleaning, and hygiene procedures in work setting, unavailability of personal protective equipments (PPEs) and COVID-19 RT-PCR test, and lack of staff due to be infected] and a validated scale, the ‘Self-applied Acute Stress Scale’ (EASE). The survey was answered by a non-probability sampling of PCPs working in family healthcare centres from different regions of Spain. Analysis of variance and multivariate linear regression analysis were performed. Results: In all, out of 518 PCP participants, 123 (23.7%) obtained high psychological distress scores. Only half of them had received information about the appropriate use of PPE. PCP characteristics associated with higher levels of distress include female gender [1.69; 95% confidence interval (CI) 0.54, 2.84]; lack of training in protective measures (1.96; 95% CI 0.94, 2.99); unavailable COVID-19 RT-PCR for health care workers after quarantine or COVID-19 treatment (−0.77 (−1.52, −0.02). Reinforcing disinfection of the work environment (P < 0.05), availability of PPEs (P < 0.05), and no healthcare professional was infected (P < 0.05) were related to the lowest distress score. Conclusions: A better understanding of the sources of distress among PCPs could prevent its effect on future outbreaks.

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Loneliness and internet addiction in doctors and medical students: a cross-sectional study

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20181746 ◽

2018 ◽

Vol 6 (5) ◽

pp. 1502

Author(s):

Cüneyt Ardiç ◽

Sibel İnecikli ◽

Celile Hatipoğlu

Keyword(s):

Internet Addiction ◽

Primary Care Physicians ◽

Descriptive Study ◽

Cross Sectional Study ◽

The Internet ◽

Sectional Study ◽

School Students ◽

Cross Sectional ◽

Factors Affecting ◽

Spare Time

Background: Our aim in this study is to determine the level of internet addiction in medical school students and primary care physicians and the factors affecting them.Methods: A 68 physicians and 167 students participated in this descriptive study. The participants were administered the young ınternet addiction test, UCLA loneliness scale and asked to respond to survey questions about their ssociodemographic characteristics, and the relations were evaluated with appropriate statistical methods.Results: It has been identified that playing games online, surfing the internet aimlessly and loneliness score affected internet addiction regardless of other variables (p<0.05). A statistically significant correlation between addiction level and age (r= (-0.341), p<0,001), loneliness score (r=0,284, p<0,001) and online time (r=0,387, p<0,001) has been discovered.Conclusions: In this study, it was found statistically significant that students with internet addiction stayed online for long periods of time and it seemed in line with the criteria observed in substance use disorders such as longer duration of use than intended and not being able to spare time for other activities.

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Variation in colorectal cancer testing between primary care physicians: a cross-sectional study in Switzerland

International Journal of Public Health ◽

10.1007/s00038-019-01259-4 ◽

2019 ◽

Vol 64 (7) ◽

pp. 1075-1083 ◽

Cited By ~ 3

Author(s):

Alexander Leonhard Braun ◽

Emanuele Prati ◽

Yonas Martin ◽

Charles Dvořák ◽

Kali Tal ◽

...

Keyword(s):

Colorectal Cancer ◽

Primary Care ◽

Primary Care Physicians ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional

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Diabetes care knowledge and practice among primary care physicians in Southeast Nigeria: a cross-sectional study

BMC Family Practice ◽

10.1186/s12875-020-01202-0 ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Ejiofor Ugwu ◽

Ekenechukwu Young ◽

Marcellinus Nkpozi

Keyword(s):

Primary Care ◽

Diabetes Care ◽

Primary Care Physicians ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Knowledge And Practice

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Nutrition competence of primary care physicians in Saudi Arabia: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2019-033443 ◽

2020 ◽

Vol 10 (1) ◽

pp. e033443 ◽

Cited By ~ 1

Author(s):

Osamah Al-gassimi ◽

Hassan Bin Usman Shah ◽

Rawan Sendi ◽

Heba A Ezmeirlly ◽

Lauren Ball ◽

...

Keyword(s):

Primary Care ◽

Chronic Disease ◽

Primary Care Physicians ◽

Cross Sectional Study ◽

Nutrition Knowledge ◽

Sectional Study ◽

Cross Sectional ◽

Knowledge And Skills ◽

Nutrition Care ◽

Dietary Behaviours

ObjectivesPrimary care physicians have an opportunity to support healthy dietary behaviours of patients by providing nutrition care. However, it is unclear whether primary care physicians in the Kingdom of Saudi Arabia (KSA) are sufficiently competent in nutrition. This study aimed to assess the nutrition competence of primary care physicians in KSA and identify whether nutrition competence is associated with the provision of nutrition care to patients living with diet-related chronic disease.DesignA cross-sectional study.SettingChronic disease clinics across 48 primary care centres under the Ministry of Health in the city of Jeddah, KSA.Participants90 primary care physicians completed the survey (response rate: 98%). General practitioners and family medicine residents, specialists, and consultants actively working in chronic disease clinics between February and May 2019 were included.Primary and secondary outcome measuresPrimary outcome measure was nutrition competence of primary care physicians measured via the validated nutrition competence (NUTCOMP) questionnaire.ResultsPrimary care physicians perceived themselves as competent in nutrition care but their reported provision of nutrition care was limited. Confidence in their nutrition knowledge and skills elicited the lowest mean scores of 25.8 (±5.4) out of 35 and 29 (±5.2) out of 40, respectively. The reported provision of nutrition care was closely correlated with physicians’ confidence in their nutrition knowledge (r=0.57) and communication (r=0.52). Three factors were identified as predicting whether physicians provide nutrition care to patients: confidence in counselling about nutrition (p<0.001), having previous nutrition education (p=0.005) and a higher professional qualification (p=0.008).ConclusionsPrimary care physicians felt confident in providing nutrition care to patients living with diet-related chronic disease. Primary care physicians would benefit from higher levels of nutrition knowledge and skills to effectively support patients to improve their dietary behaviours and health conditions, leading to a positive impact on public health.

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