scholarly journals A validation study of data in the National Tonsil Surgery Register in Sweden: high agreement with medical records ensures that data can be used to monitor clinical practices and outcomes

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Filip Lundström ◽  
Erik Odhagen ◽  
Fredrik Alm ◽  
Claes Hemlin ◽  
Pia Nerfeldt ◽  
...  

Abstract Background The ambition of the National Tonsil Surgery Register in Sweden (NTSRS) is to improve otorhinolaryngological care by monitoring trends in the clinical practices, complications, and outcomes of tonsil surgery. The NTSRS collects data from both surgeons and patients and provides the participating clinics with daily updated data on a publicly available website. On the website, national and local results can be compared and monitored. The use of NTSRS data necessitates that the data is valid, but the NTSRS has not yet been validated. With approximately half of the registered patients responding to the postoperative questionnaires, an analysis of responders and non-responders is also necessary. The aim of this study was to assess the criterion validity of NTSRS data. Another aim was to compare the characteristics and rates of complications between postoperative questionnaire responders and non-responders. Methods Data in the NTSRS were compared with data in electronic medical records. The 200 most recent surgeries, up to 31 Dec 2019, in each of 11 surgical units were included. Criterion validity was analysed in terms of observed agreement, Cohens kappa, Gwet’s AC1, and positive and negative agreement. The sign test was used to analyse systematic differences between the NTSRS and the medical records. Comparisons of rates between groups were made with Fisher’s exact test, the chi-square test, and Fisher’s non-parametric permutation test. Results A total of 1991 registrations were included in the study. All variables showed very high observed agreement ranging from 0.91 to 1.00, and all variables had AC1 values corresponding to almost perfect agreement. The analysis of questionnaire responders and non-responders showed no statistically significant differences regarding age, indication, or type of surgery. The proportion of women was higher in the responder group. The rate of reoperation due to bleeding was higher in the responder group, but there were no differences regarding other complications. Conclusions The results of this study show that data in the NTSRS have criterion validity. The NTSRS is thus well suited for monitoring the clinical practices and outcomes of tonsil surgery. The quality of the data also implies that the registry can be used in both clinical improvement projects and research.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 20-20
Author(s):  
Masataka Yagisawa ◽  
Michio Nakamura ◽  
Chika Matsuda ◽  
Taichi Murai ◽  
Kazufumi Itaya ◽  
...  

20 Background: Eye disorders (EDs) are common adverse events in patients received S-1 chemotherapy. Although there are some retrospective reports about EDs induced by S-1 mono therapy (mono) as adjuvant chemotherapy (Adj) in gastric cancer (GC), there are few reports about S-1 induced EDs in other gastrointestinal cancer (GIC). So we conducted this retrospective cohort study to investigate the incidence of S-1 induced EDs in GIC and the association with several clinicopathological factors, such as primary site, treatment setting, regimen, and duration. Methods: All the patients received S-1 chemotherapy for GIC in our institution from January 2008 to May 2016 were identified through medical records review extracted by our hospital data warehouse. We analyzed the incidence of S-1 induced EDs by reviewing all the medical records and the association between ED incidence and several clinicopathological factors using a chi-square test or a Fisher's exact test and logistic regression. Results: Two hundred eighty three GIC patients were analyzed on this study. Patients characteristics were as follows; male/female 170/113, GC/colorectal cancer (CRC)/pancreatic cancer (PC)/biliary cancer (BC) 119/67/57/32, non-Adj/Adj 263/20, S-1 mono/S-1 combination therapy (combo) 130/153. The overall incidence rate with EDs such as epiphora, gum, photophobia, nephelopsia was 15.2% (n = 43). The median time to onset of EDs was 109 days (range 5-1100). The each of ED incidence was 16.5% (n = 28) and 13.3% (n = 15) in male and female (p = 0.503), 14.8% (n = 39) and 20.0% (n = 4) in non-Adj and Adj setting (p = 0.520), 13.8% (n = 18) and 16.3% (n = 25) in S-1 mono and combo (p = 0.619), respectively. The incidence of EDs in GC, CRC, PC, and BC were 15.1% (n = 18), 17.9% (n = 12), 17.5% (n = 10), and 9.4% (n = 3) (p = 0.635), respectively. Conclusions: We found that the incidence of EDs induced by S-1 chemotherapy for GIC was relatively high regardless of cancer site, treatment regimen, setting and duration. Further accumulation of data as prospective cohort study is necessary to confirm the incidence of S-1 induced EDs. Clinical trial information: UMIN000024160.


2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Tifanny Tantoso ◽  
Mega Sari Sitorus ◽  
Lita Feriyawati ◽  
Dian Dwi Wahyuni

Obesity is a worldwide problem that has been steadily increasing even in developing countries. Obesity has been linked to various types of cancer, one of which is breast cancer. Breast cancer has been classified into various types based on gene and hormone receptor expressions, which offered new insights to therapies and prognoses. We conducted a case-control study using 42 breast cancer patients and 43 healthy women, all of which are older than 55 years of age and have experienced menopause, and for case subjects, additional immunohistochemistry profiles have been provided. Data were collected by interviews and medical records. For data analysis, we used Pearson’s Chi-Square test and Fisher’s Exact test. Results showed that high BMI is significantly associated with breast cancer, and risk is elevated (p < 0.05, OR = 1.263, 95% CI = 1.007-1.583). No significant association with molecular subtypes was observed.


2013 ◽  
Vol 31 (4) ◽  
pp. 459-465
Author(s):  
Rafael Fabiano M. Rosa ◽  
Melina Vaz Sarmento ◽  
Janaina Borges Polli ◽  
Daniela de Paoli Groff ◽  
Patrícia Petry ◽  
...  

OBJECTIVE: To describe gestational, perinatal and family findings of patients with Patau syndrome (PS). METHODS: The study enrolled patients with PS consecutively evaluated during 38 years in a Clinical Genetics Service of a pediatric referral hospital in Southern Brazil. The clinical data and the results of cytogenetic analysis were collected from the medical records. For statistical analysis, the two-tailed Fisher's exact test and the chi-square test with Yates' correction were used, being significant p<0.05. RESULTS: The sample was composed of 27 patients, 63% were male, with a median age of nine days at the first evaluation. Full trisomy of chromosome 13 was the main cytogenetic finding (74%). Only six patients were submitted to obstetric ultrasound and none had prenatal diagnosis of PS. The patients' demographic characteristics, compared to born alive infants in the same Brazilian state showed a higher frequency of: mothers with 35 years old or more (37.5%); multiparous mothers (92.6%); vaginal delivery (77%); preterm birth (34.6%); birth weight <2500g (33.3%), and Apgar scores <7 in the 1st (75%) and in the 5th minute (42.9%). About half of them (53%) died during the first month of life. CONCLUSIONS: The understanding of the PS patients' gestational, perinatal and family findings has important implications, especially on the decision about the actions to be taken in relation to the management of these patients.


Author(s):  
Y. Widyastuti Y. Widyastuti

  ABSTRACT [In advanced countries the number of permanent contraception option ( kontap ) approximately 10 % of all national family planning methods , while in Indonesia reached approximately 5.7 % . Based on data obtained from medical records Bhayangkara Hospital Palembang in 2010 the number of achievement when seen from the percentage of contraceptive use is only 9.10 % The purpose of this study is known age and parity relationship with the selection of contraceptive methods Surgery Women ( MOW ) in Palembang RS.Bhayangkara obstetrics clinic in 2012 . This study uses the analytic survey with cross sectional approach . The population in this study were women who become new acceptors were recorded in medical records at the hospital . Palembang Bhayangkara Hospitals January 1, 2012 to December 31 in 2012 . The sample in this study is part of a whole number of new acceptors ( either using contraception methods MOW and other family planning methods ) were registered in the hospital . Palembang Police Hospitals of January 1, 2012 to December 31 years of data 2012.Analisa univariate and bivariate statistical Chi - Square test with significance level α = 0.05 . The results showed there were 80 respondents ( 46.3 % ) who became MOW contraceptive acceptors , acceptors who have old age by 45 respondents ( 56.3 % ) and who has a young age by 35 respondents ( 43.8 % ) . acceptors which have high parity were 44 respondents ( 55 % ) who had low parity and a total of 36 respondents ( 45 % ) . From the results of Chi-square test value obtained ρ = 0.00 is smaller than α = 0.05 . There is a significant correlation between age and the selection of MOW Chi square test results obtained ρ value = 0.00 and there was a significant association between parity with the election MOW Chi square test results obtained ρ value = 0 , . From these results , it is expected to power health, especially family planning services at the hospital . Palembang Police Hospitals in order to improve the quality of family planning services in an effective, efficient , and safe are considered particularly suitable for users of contraception OperatingMethodWomen(MOW).                                      ABSTRAK Di negara sudah maju jumlah pilihan kontrasepsi mantap (kontap) sekitar 10% dari semua metode KB nasional, sedangkan di Indonesia baru mencapai sekitar 5,7 %. Berdasarkan data yang diperoleh dari Rekam medik  Rumah Sakit Bhayangkara Palembang tahun 2010 Jumlah pencapain tersebut jika dilihat dari persentasi penggunaan kontrasepsi MOW hanya  9,10% Tujuan penelitian ini adalah diketahuinya hubungan umur dan paritas dengan pemilihan alat kontrasepsi Metode Operasi Wanita (MOW) di poliklinik kebidanan RS.Bhayangkara Palembang Tahun 2012. Penelitian ini menggunakan metode survey analitik dengan pendekatan cross sectional. Populasi dalam penelitian ini adalah wanita yang menjadi akseptor KB Baru yang tercatat di rekam medik  di RS. Bhayangkara Palembang tanggal 1 januari 2012 sampai dengan 31 Desember  tahun 2012. Sampel dalam penelitian ini adalah sebagian dari seluruh jumlah akseptor KB Baru (baik yang menggunakan alat kontrasepsi Metode MOW maupun Metode KB lain) yang teregister di RS. Bhayangkara Palembang dari tanggal 1 januari 2012 sampai dengan 31 Desember  tahun 2012.Analisa data dilakukan secara univariat dan bivariat dengan uji statistik Chi-Square dengan tingkat kemaknaan α = 0,05. Hasil penelitian menunjukkan dari 80 responden terdapat (46,3%) yang menjadi akseptor kontrasepsi MOW, akseptor yang memiliki umur tua sebanyak 45 responden (56,3%) dan yang memiliki  umur muda sebanyak 35 responden (43,8%). akseptor yang memiliki paritas tinggi sebanyak 44 responden  (55%) dan yang memiliki  paritas rendah sebanyak 36 responden (45%). Dari hasil uji Chi square didapatkan ρ value = 0,00 lebih kecil dari α = 0,05. Ada hubungan yang bermakna antara umur dengan pemilihan MOW dari hasil uji Chi square didapatkan ρ value = 0,00 dan ada hubungan yang bermakna antara paritas dengan pemilihan MOW hasil uji Chi square didapatkan ρ value = 0,.Dari hasil penelitian ini, diharapkan kepada tenaga kesehatan khususnya pelayanan KB  di RS. Bhayangkara Palembang  agar dapat meningkatkan kualitas pelayanan KB secara efektif, efisien, dan aman yang dianggap cocok bagi penggunanya khususnya mengenai kontrasepsi Metode Operasi Wanita (MOW).    


2020 ◽  
Vol 2 (1) ◽  
pp. 53-59
Author(s):  
Josimara A. de Araújo Varela ◽  
Tatiana F.T. Palitot ◽  
Smyrna L.X. de Souza ◽  
Alidianne F.C. Cavalcanti ◽  
Alessandro L. Cavalcanti

Objective: This study aimed to analyze the presence of lesions in the skull and face and the associated factors in pedestrian victims of traffic accidents. Methods: A cross-sectional, descriptive-analytical study carried out through the analysis of medical records of pedestrian victims of traffic accidents in an emergency service in the city of Campina Grande, Brazil, during the year of 2016. Information was collected regarding gender, age group, day of the week, time of the accident, type of vehicle involved, presence of trauma to the skull and face, and outcomes. The Chi-square and Fisher's Exact tests were used, with a significance level of 5%. Results: A total of 1,884 medical records were evaluated, out of which 7.1% (n = 133) involved pedestrians. Men were the most frequent victims (68.4%), and victims of age 60 years old or over (30.5%) predominated. Almost one-third of the cases were recorded during the weekends (30.5%), and the most prevalent time was at night (52.7%). Regarding the type of vehicle involved, motorcycles predominated (47.4%). Head trauma was present in 37.6% of victims, while facial injuries corresponded to 8.2%. In 12% of cases, the victims died. The variables of gender, age group, occurrence on weekends, and trauma to the face showed a statistically significant association with the occurrence of traffic accidents (Chi-square test; p<0.05). Conclusion: Among pedestrian victims of traffic accidents, there is a predominance of men aged 65 years or over. Accidents are frequent at night, and motorcycles are the main vehicles involved. The presence of trauma to the skull and face regions is high.


2021 ◽  
pp. 153857442110225
Author(s):  
Joel Mathew John ◽  
Vimalin Samuel ◽  
Dheepak Selvaraj ◽  
Prabhu Premkumar ◽  
Albert A Kota ◽  
...  

Objective: The use of drug coated balloon (DCB) for angioplasty has shown superior efficacy against plain balloons for treating complex infrainguinal arterial disease. We report and compare the clinical outcomes following application of DCB(Paclitaxel) and plain angioplasty (POBA) in our tertiary care centre. Methods: A retrospective, single centre analysis of 301 patients with chronic limb-threatening ischemia involving the infrainguinal segment was conducted between September 2014 and September 2018, after approval from the Institutional review board. We analyzed clinical outcomes by measuring postoperative ABI improvement, restenosis requiring reintervention procedure, minor and major amputations at the end of 18 months. . To find the association between the group variables (POBA and DCB) and other risk variables, Chi-square test/Fisher’s exact test was used. Multivariable logistic regression analysis was used. Results: Patients who underwent treatment with plain balloon (POBA) and DCB(Paclitaxel) angioplasty were 246(81.7%) and 55(18.3%) respectively. Our study group was predominantly male (Male: Female = 6.7:1), most patients were more than 50 years of age (n = 251, 83.4%). Smoking (n = 199, 66.1%) and diabetes (n = 210, 69.8%) were the most common atherosclerotic risk factors. Postoperative Ankle Brachial Pressure Index (ABI) improvement were similar in both groups (POBA = 57.7%; DCB = 69.8%; p = 0.103). Minor and major amputations following POBA were 26% and 22%; and DCB were 12.7% and 16.4% respectively. Re-stenosis requiring a re-interventional procedure within 18 months was 15%, (n = 37) following POBA; and 12.7% (n = 7) following DCB (p = 0.661). Conclusions: This retrospective study shows similar clinical limb related outcomes following POBA and DCB at 18 months. However, our comparative analysis between the POBA and DCB groups was totally unadjusted and not adjusted for common confounders such as age and sex. Hence, for one to draw definitive conclusions leading to changes in clinical practice; a randomized, prospective study with a larger patient cohort is needed.


2021 ◽  
pp. 105477382098668
Author(s):  
Kathleen Schell ◽  
Denise Lyons ◽  
Barry Bodt

The aim of this retrospective study was to determine the prevalence of orthostatic hypotension (OH) among a convenience sample of older adults on two Acute Care of the Elderly (ACE) units of the ChristianaCare™ in Delaware. Another aim was to determine if subjects with documented OH experienced falls. Retrospective de-identified data was obtained from electronic medical records for the years 2015 to 2018. Among all patients who had valid first orthostatic vital sign (OVS) readings ( n = 7,745), 39.2% had orthostatic hypotension on the first reading. Among the patients, 42.8% were found to be hypotensive during OVS. Thirty-one (0.9%) of those with OH fell at some point during their stay. The odds ratio for falls in the presence of OH was 1.34 with a 95% confidence interval (0.82, 2.21), but a chi-square test failed to find significance ( p = .2494). The results could not determine if OVS should be mandatory in fall prevention protocols.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1814.3-1814
Author(s):  
I. Madroñal García ◽  
C. Aguilera Cros ◽  
L. Mendez Diaz

Background:Sarcoidosis (S) is a systemic granulomatous disease of unknown etiology, which most frequently affects the ganglion, lung and skin, although it can affect other organs, including the musculoskeletal system.Objectives:- Describe the clinical, analytical and radiological characteristics of patients diagnosed with S presenting joint manifestations.- To assess the association between patients who have joint manifestations and the use of corticosteroids (C) and immunosuppressants (IS), with respect to those without joint involvement.Methods:Retrospective descriptive study of patients with diagnosis of S with joint manifestations, treated in our Hospital from 2017 to 2019. Data were obtained by reviewing medical records. Chi square tests and Fisher’s exact test have been performed to establish the differences described in the objectives.Results:From a database of 102 patients with S, 18 presented joint manifestations (50% women), with a mean age of 57 ± 6 years. Of these patients, 4 (22.2%) have presented positive ANA. Regarding the clinic, 3 patients presented the association of polyarthritis and bilateral ankle swelling, 8 patients presented with polyarthritis, 3 monoatritis and 4 patients presented bilateral ankle swelling. 61.1% had fever at the onset of the disease.14 patients (77.8%) had high ACE values at the onset of the disease, without presenting significant differences with respect to all patients diagnosed with S who do not have joint involvement.All patients received treatment with C and 10 patients (55.5%) needed an IS treatment, finding no differences with respect to patients who do not have joint involvement (p=0.92).On the course of the disease, the majority of patients with joint involvement have a chronic course (72.2%). Nor were significant differences found when compared with patients who have no joint involvement (p = 0.73).Conclusion:Patients with joint involvement in our study have been 17.6% (18), an approximate result to that described in the literature (over 10%), although our result may be increased by the fact that the patients who are followed in Rheumatology present or have presented joint involvement. No significant differences were found between patients with S who presented joint involvement and those who did not, with respect to the initial ACE values, treatment and disease course. Prospective, multicenter and larger sample studies are necessary to better understand these associations.Disclosure of Interests:None declared


Diagnostics ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 1424
Author(s):  
Esben Nyborg Poulsen ◽  
Anna Olsson ◽  
Stefan Gustavsen ◽  
Annika Reynberg Langkilde ◽  
Annette Bang Oturai ◽  
...  

Spinal cord lesions are included in the diagnosis of multiple sclerosis (MS), yet spinal cord MRI is not mandatory for diagnosis according to the latest revisions of the McDonald Criteria. We investigated the distribution of spinal cord lesions in MS patients and examined how it influences the fulfillment of the 2017 McDonald Criteria. Seventy-four patients with relapsing-remitting MS were examined with brain and entire spinal cord MRI. Sixty-five patients received contrast. The number and anatomical location of MS lesions were assessed along with the Expanded Disability Status Scale (EDSS). A Chi-square test, Fischer’s exact test, and one-sided McNemar’s test were used to test distributions. MS lesions were distributed throughout the spinal cord. Diagnosis of dissemination in space (DIS) was increased from 58/74 (78.4%) to 67/74 (90.5%) when adding cervical spinal cord MRI to brain MRI alone (p = 0.004). Diagnosis of dissemination in time (DIT) was not significantly increased when adding entire spinal cord MRI to brain MRI alone (p = 0.04). There was no association between the number of spinal cord lesions and the EDSS score (p = 0.71). MS lesions are present throughout the spinal cord, and spinal cord MRI may play an important role in the diagnosis and follow-up of MS patients.


2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S792-S792
Author(s):  
Alfredo Traversa ◽  
Linda Poggensee ◽  
Geneva M Wilson ◽  
Katie J Suda ◽  
Charlesnika T Evans ◽  
...  

Abstract Background Carbapenem-resistant Enterobacteriaceae (CRE) are classified as an “urgent threat” to public health. Historically, colistin and tigecycline had been considered the drugs of choice for CRE infections, while other agents such as aminoglycosides and carbapenems had been used as adjunctive therapy. However, the FDA approval of ceftazidime-avibactam in 2015, meropenem-vaborbactam in 2017, and plazomicin in 2018 has expanded treatment options. Our purpose was to assess trends in CRE treatment for “new” antibiotics (ceftazidime-avibactam, meropenem-vaborbactam, plazomicin) as compared with other antibiotics with CRE activity. Methods This was a retrospective cohort study describing treatment of CRE blood stream infections (BSI) across 134 VA facilities from 2012-2018. Patients were censored at their first positive blood culture with CRE. Categorical data was assessed with a Fisher’s exact test or chi-square test. Trends test and logistic regression were used to describe changes in CRE treatment over time. Results 724 patients with positive blood cultures for CRE were identified during the study period. Most patients were male (94%), white (32%) or Hispanic (38%), and the mean age was 71.5+11.9. Of those patients that received antibiotics (N=697), 53.4% carbapenems, 40.3% received aminoglycosides, 39.3% received polymyxins, 32.9% penicillins, 32.6% extended spectrum cephalosporins, 26.1% fluoroquinolones, 11.6% ceftazidime/avibactam, and 0.4% ceftolazone/tazobactam. Over the study period, there was decreased utilization of aminoglycosides (P &lt; 0.0026) and colistin (P&lt; 0.002) and increases in extended spectrum cephalosporins (P &lt; 0.001) and ceftazidime/avibactam (P &lt; 0.001). Conclusion Utilization of “older” agents such as aminoglycosides and polymyxins for the treatment of CRE blood stream infections is decreasing in the VA. Treating CRE with ceftazidime/avibactam, a newly approved antibiotic, and extended spectrum cephalosporins are increasing. Disclosures All Authors: No reported disclosures


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