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Biomedical subjects

Philip T Hagen

Publications and source records attributed to Philip T Hagen.

4 recordsLinked to original sources

Telemedicine applications in occupational medicine.

Telemedicine combines telecommunication technology and medicine to increase access to health care services for patients living in remote areas and enhance the efficiency of delivering that care. This article describes the results of a Mayo Clinic pilot study on the use of telemedicine in an occupational medicine clinic for Mayo Clinic employees and their dependents. The study involved 21 patients who came for initial evaluations for work-related problems or injuries, follow-up visits, visits for acute problems such as low-back pain, and periodic health evaluations. It found that patients and providers were comfortable with the technology after a short training session and satisfied with the outcomes of the visits. More rigorous research evaluating the applications of telemedicine in occupational health care is needed.

Academic Medical Centers↗

Agreement between patient reports of cardiovascular disease and patient medical records.

OBJECTIVE: To determine how well patient-reported cardiovascular disease (CVD) and CVD risk factor information agrees with medical record information. METHODS: Information from Patient/Family History (PFH) questionnaires completed between 1996 and 1999 by residents of Olmsted County, Minnesota, aged 20 years and older was compared with information available through the Mayo Clinic medical diagnostic index. Positive and negative agreement values were calculated by comparing agreement between the 2 data sources. Also, with the Mayo Medical Index serving as the criterion standard, sensitivity, specificity, and positive and negative predictive values of questionnaire information were calculated overall and by subgroups of sex, age, and years of education. RESULTS: Questionnaire responses were retrieved for 26,162 patients. Positive agreement values ranged from 31% for report of a medical problem or surgery related to arteries to the head, arms, or legs or the aorta to 78% for high blood pressure. Negative agreement values ranged from 90% for high cholesterol to 98% for medical problem or surgery related to arteries to the head, arms, or legs or the aorta. Sensitivity of questionnaire information ranged from 37% to 73%, whereas positive predictive values ranged from 27% to 86%. Positive agreement, sensitivity, and positive predictive values tended to increase with increasing age of the patient. Specificity and negative predictive values were 87% or greater, and negative agreement, specificity, and negative predictive values decreased with increasing age. CONCLUSION: Positive patient reports of CVD conditions and risk factors are relatively inaccurate. However, negative self-reports of these conditions are unlikely to be noted in the medical record. Further development of the PFH questionnaire is necessary to ensure accurate patient reporting of CVD data.

Adult↗

Confronting bioterrorism: physicians on the front line.

The events surrounding September 11, 2001, and its aftermath have compelled the public health and medical community to face the hitherto unfamiliar reality of bioterrorism. Physicians and public health personnel are frontline soldiers in this new form of warfare. This article provides a general overview of the pathophysiology, clinical presentation, diagnosis, and management of patients infected with the 6 highest priority agents that could potentially be used in bioterrorism. The diseases discussed include anthrax, smallpox, tularemia, plague, botulism, and viral hemorrhagic fevers. Despite the unpredictable nature of bioterrorism, disaster preparedness and knowledge of essential diagnostic and epidemiological principles can contribute substantially toward combating this new threat.

Anthrax↗

Validation of a five-point self-rated stress score.

PURPOSE: To validate a five-point self-rated stress score (SRSS) with the Symptom Checklist-90-Revised (SCL-90-R) questionnaire in identifying psychological distress. METHODS: A retrospective cohort study was conducted involving 266 consecutive patients seen in the division of clinical health psychology. Patients were asked to rate their stress level on a numeric score from 1 (low stress) to 5 (high stress). Patients also completed the SCL-90-R questionnaire, from which the Global Severity Index (GSI) was calculated. RESULTS: The SRSS correlated positively with the GSI (r = .40, p < .001). After multivariate adjustment, the odds ratio of psychological distress for patients with an SRSS of 2, 3, 4, and 5 relative to those with low stress were 2.6 (p = .30), 2.4 (p = .30), 6.1 (p < .05), and 24.8 (p < .001). DISCUSSION: Patients with the highest self-rated stress levels have a significantly increased risk of psychological distress. The SRSS is simple to administer in the outpatient setting and may be a useful instrument in screening for psychological distress.

Adolescent↗