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Jeffrey C Kwong

Publications and source records attributed to Jeffrey C Kwong.

3 recordsLinked to original sources

Using OHIP physician billing claims to ascertain individual influenza vaccination status.

The objective of this study was to validate physician billing claims against self-reported influenza vaccination to assess individual-level vaccination status. We compared responses to the Canadian Community Health Survey 1.1 (CCHS) and Ontario Health Insurance Plan (OHIP) physician billing claims and found moderate agreement. Using self-report as the gold standard, OHIP claims based on using both influenza-specific and general vaccination codes have high specificity and positive predictive value (PPV), reasonable negative predictive value (NPV), but only fair sensitivity. OHIP physician billing claims are suboptimal for ascertaining the vaccination status of individuals because many individuals receive their vaccinations outside doctor's offices, but may be used as the backbone for the creation of an immunization registry.

Adolescent↗

Appropriate measures of influenza immunization program effectiveness.

Groll and Thomson's evaluation of the effectiveness of Ontario's Universal Influenza Immunization Campaign used per capita cases of laboratory-confirmed influenza. We argue that these data are susceptible to various biases and should not be used as an outcome measure. Laboratory data are traditionally used to identify the presence of influenza activity rather than to identify levels of influenza activity. A better measure of viral activity is the proportion of influenza tests positive; whereas the weekly proportion of tests positive was relatively consistent, a marked increase over time in the numbers of laboratory-confirmed cases paralleled an increase in the number of tests performed. Regardless, for evaluating universal influenza immunization program effectiveness, other established and available measures employed in previous studies describing the epidemiology of influenza should be used instead of laboratory data.

Humans↗

Death rates of medical school class presidents.

Medical professionals often face many competing demands to contribute both to the clinical care of patients and to the public health of society. We studied the long-term survival of doctors graduating from one medical school over one century (n = 1521), comparing those who were presidents of their class to those who appeared alphabetically before or alphabetically after the president in the graduating class photograph. Statistics on long-term mortality were obtained from licensing authorities, medical obituaries, professional associations, alumni records, and national physician directories (follow-up 94% complete, median follow-up duration = 38 years, total deaths = 220). We found that most graduates were male (88%), white (93%), and younger than 30 years at time of graduation (93%). Presidents more frequently made contributions to society than their classmates, as recognized by professional alumni notices (21.9% vs. 13.3%, P < 0.001) and Who's Who directory listings (7% vs. 0.5%, P < 0.001). Nonetheless, survival after medical school was 2.4 years shorter for presidents than their classmates (49.0 vs. 51.4, P = 0.036). The decrease in life-expectancy was unrelated to medical school marks or early career mortality and was accentuated after adjustments for birth year, gender, race, and specialization (P = 0.001 ). We suggest that the type of medical professional who sacrifices themselves for this type of professional prestige may also be the type who fails to look after their health or is otherwise prone to early mortality.

Age Factors↗