Association between body mass index (BMI) percentile and asthma in children of 5–12 years old: A case–control study using electronic medical records in Primary Health Care Corporation, Qatar 2016–2017

Abstract Background Patient safety issues in primary health care and in emergency departments have not been as thoroughly explored as patient safety issues in the hospital setting. Knowledge is particularly sparse regarding which patients have a higher risk of harm in these settings. The objective was to evaluate which patient-related factors were associated with risk of harm in patients with reports of safety incidents. Methods A case–control study performed in primary health care and emergency departments in Sweden. In total, 4536 patients (cases) and 44,949 controls were included in this study. Cases included patients with reported preventable harm in primary health care and emergency departments from January 1st, 2011 until December 31st, 2016. Results Psychiatric disease, including all psychiatric diagnoses regardless of severity, nearly doubled the risk of being a reported case of preventable harm (odds ratio, 1.96; p < 0.001). Adjusted for income and education there was still an increased risk (odds ratio, 1.69; p < 0.001). The preventable harm in this group was to 46% diagnostic errors of somatic disease. Conclusion Patients with psychiatric illness are at higher risk of preventable harm in primary care and the emergency department. Therefore, this group needs extra attention to prevent harm.

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PO 8594 VALIDATION OF A VERBAL AUTOPSY QUESTIONNAIRE APPLIED TO A CASE-CONTROL STUDY OF CEREBRAL MALARIA IN BANDIAGARA AND BAMAKO, MALI

BMJ Global Health ◽

10.1136/bmjgh-2019-edc.158 ◽

2019 ◽

Vol 4 (Suppl 3) ◽

pp. A60.2-A60

Author(s):

Karim Traore ◽

Drissy Coulibaly ◽

Abdoulaye K Kone ◽

Ali Thera ◽

Boureima Guindo ◽

...

Keyword(s):

Health Care ◽

Cerebral Malaria ◽

Severe Malaria ◽

Verbal Autopsy ◽

Medical Records ◽

Case Control Study ◽

Case Control ◽

History Of ◽

Sensitivity Specificity ◽

Control Study

BackgroundMalaria remains a leading cause of child mortality in sub-Saharan Africa. Severe malaria is the main pathway to death caused by malaria. A study of factors associated with protection against severe malaria is best achieved using a case-control design. However, these studies are affected by the quality and appropriateness of the choice of controls that may introduce important bias in study design and definitively alter the conclusions from the studies. It is of paramount importance that the presence or absence of an episode of severe malaria in the history of the controls is ascertained. In settings with reliable medical data this is easily tracked back from hospital records. In settings like Bandiagara, with weak health care systems, a dedicated approach is needed to track history of severe malaria. We used an adapted verbal autopsy questionnaire to identify presence of cerebral malaria in the history of controls in a case-control study of severe malaria in Bandiagara.We have assessed the sensitivity, specificity and predictive positive and negative values of the questionnaire.MethodsFrom January through August 2018 we enrolled 450 children with or without known confirmed cerebral malaria selected at health care centers in Bandiagara and Bamako, with archived medical records. Parents of enrolled children were identified, located and interviewed using the adapted verbal autopsy questionnaire. Interviewers were not aware of children’s diagnosis. We compared the diagnosis derived from the verbal autopsy questionnaire to the confirmed biological diagnosis from the medical records.ResultsWe will present full results on the sensitivity, specificity, the predictive positive and negative values of the verbal questionnaire, and the Kappa coefficient of agreement.ConclusionA good verbal questionnaire will enhance the quality of the choice of controls in case-control studies of severe malaria and overall will improve the quality and relevance of inferences from such studies.

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