Biomedical subjects

Thomas V Perneger

Publications and source records attributed to Thomas V Perneger.

60 records · Page 4Linked to original sources

PubMed2002

Nicotine replacement to reduce cigarette consumption in smokers who are unwilling to quit: a randomized trial.

The objective of this study was to assess whether nicotine replacement therapy, administered in a real-life situation, could reduce cigarette consumption in smokers who were not prepared to quit smoking. Daily smokers of more than 20 cigarettes per day who had no intention to quit smoking in the next 6 months were recruited from the general population and randomly assigned to either a 6-month treatment of nicotine (choice among a 15-mg nicotine patch, a 4-mg nicotine gum, a 10-mg nicotine inhaler, or a combination of these, N = 265), matching placebo products (N = 269), or no intervention (N = 389). Products were sent to participants by mail. Education was limited to a booklet. Of 923 participants, 879 (95%) were followed up after 6 months. Mean baseline consumption was 30 cigarettes per day in all groups. At 6 months, cigarette consumption decreased by a median of 10 cigarettes per day in the nicotine group, 7.5 in the placebo group, and 2.5 among controls ( < 0.04 for all pair-wise comparisons). Smoking cessation rates were low (2%-4%) and did not differ significantly between groups. Quit attempts were less frequent among controls (21%) than among the nicotine (28%, = 0.04) and placebo (27%, = 0.08) subjects. In conclusion, nicotine replacement therapy helped smokers reduce their cigarette consumption and maintain this reduction over 6 months, but a large part of this reduction was attributable to a placebo effect. Nicotine treatment for smoking reduction had no detectable impact on smoking cessation.

Administration, Cutaneous↗

PubMed2002

Questionnaire color and response rates to mailed surveys. A randomized trial and a meta-analysis.

The authors conducted a randomized trial in Geneva, Switzerland, to assess whether response rates to a mailed survey could be increased by printing the questionnaire on green paper. The authors also conducted a meta-analysis of 10 experimental studies that tested the effect of colored questionnaires on response rates. The randomized trial showed no effect (relative risk of responding [RR] = 1.00). The meta-analysis showed that mailing questionnaires on pink paper increased response rates by 12% (RR = 1.12, 95% confidence interval = 1.01 to 1.25, p = 0.04). Other colors had no statistically significant effect (blue: RR = 1.03, p = 0.49; green: RR = 1.02, p = 0.23; yellow: RR = 0.96, p = 0.30). Overall, using colored instead of white paper had no effect (RR = 1.02, p = 0.17). Thus, printing questionnaires on colored paper does not substantially increase response rates in surveys, except for pink paper.

Adult↗

PubMed2002

Scale to measure patient satisfaction with physical therapy.

BACKGROUND AND PURPOSE: Patient satisfaction can be one indicator of quality of care. In this study, a patient satisfaction questionnaire for physical therapy was developed. SUBJECTS: The subjects were a consecutive sample of 1,024 patients who received physical therapy between January and March 1999 at a teaching hospital in Geneva, Switzerland. METHODS: A cross-sectional mail survey was conducted in which a structured questionnaire measuring patient satisfaction with various aspects of physical therapy followed by open-ended questions was sent to the subjects. RESULTS: Overall, 528 of 1,024 patients (52%) responded (patient demographics for 501 respondents who provided demographic data: mean years of age=58.6, SD=18.9, range=15-95; 258 men, 243 women). Factor analysis was used to identify main domains of satisfaction, and a scale was constructed to measure satisfaction with each dimension: treatment subscale (5 items), admission subscale (3 items), logistics subscale (4 items), and a global assessment subscale (2 items). All subscales had good acceptability and small floor and ceiling effects. Internal consistency coefficients varied between.77 and.90, indicating good reliability for all subscales. Scale validity was supported by a logical grouping of items into subscales, according to their content, and by correlations of satisfaction scores with the patient's intention to recommend the facility and with the number of positive and negative comments to open-ended questions. Younger patients were less satisfied than older patients for 2 of the subscales (admission and logistics). DISCUSSION AND CONCLUSION: The 14-item instrument is a promising tool for the evaluation of patient satisfaction with physical therapy in both inpatients and outpatients.

Adolescent↗

PubMedDate not supplied

Physicians' attitudes toward health care rationing.

BACKGROUND: Optimal allocation of health care resources under a limited budget is controversial. Particularly important questions are whether rationing decisions should be based on efficiency considerations alone or in combination with equity considerations, and who should be in charge of such decisions. In this study, the authors sought to understand the position of Swiss physicians toward rationing using a previously developed rationing scenario. METHODS: The authors examined the acceptability of various scenarios implementing health care rationing in a mail survey of 1,184 physicians practicing in Geneva, Switzerland. Respondents were asked to choose between providing a suboptimal cancer screening test A to the whole population, which would save 1,000 lives, or selecting half of the population to receive a better but more expensive test B, which would save 1,100 lives. Physicians were randomly assigned to 3 versions of the scenario: Beneficiaries of test B could be chosen by lottery, on a first-come-first-served basis, or by medical associations. RESULTS: Only 26% of physicians chose the more effective selective rationing option; this proportion was lowest when test beneficiaries were selected by lottery (14%), intermediate for the first-come-first-served-scenario (26%), and highest when selection was left to medical associations (39%; P < 0.001). Hospital-based physicians and general practitioners were less likely to endorse selective rationing than community-based physicians and specialists. CONCLUSION: Swiss physicians appear to be more concerned about equal allocation of health services than about maximizing health in society, and they prefer physicians to be in charge of rationing decisions.

Adult↗

PubMedDate not supplied

Women's preferences for doctor's involvement in decisions about mammography screening.

OBJECTIVES: To assess women's preferences for doctor's involvement in mammography screening decisions. METHODS: Mail survey of 50- to 69-year-old women residing in Geneva, Switzerland (N = 2216). RESULTS: Women considered that the decision to undergo mammography screening should be made by the doctor alone (5.6%), doctor primarily (42.6%), shared equally between woman and doctor (45.0%), woman primarily (4.2%), and woman alone (2.4%). These subgroups differed considerably. Compared to women in the shared equally group, doctor alone respondents were more likely to be older, to be born outside Switzerland, and to wish to know as late as possible about having cancer. In contrast, woman alone respondents were more likely to report no previous mammogram, to expect bad news from mammograms, and to feel nervous about screening. CONCLUSIONS: Most women wished to see their doctor involved in the decision to undergo a screening mammogram. Nevertheless, notable minorities held other opinions.

Aged↗

PubMedDate not supplied

Assessment of health status in chronic hemodialysis patients.

BACKGROUND: We compared three ways of assessing health status in chronic hemodialysis patients: generic questionnaire compared with population norms, disease-specific questionnaire, and open questions. METHODS: Hemodialysis patients (n=83) treated in Geneva canton, Switzerland, answered the Kidney Disease Quality of Life (KDQOL-SF) questionnaire, which combines 12 disease-specific scales with the generic Short-Form 36 (SF36) health survey, and open questions about the most disturbing and most positive aspects of having end-stage renal disease. SF36 scores were compared with those of the general population, and generic health scales were correlated with dialysis-specific scales. RESULTS: Hemodialysis patients had significantly lower scores than general population controls on 7 of 8 SF36 scales, especially physical functioning (-1.2 standard deviation (SD) units, p<0.001) and general health (-1.2 SD, p<0.001), but their mental health was similar (-0.2 SD, p=0.13). All 12 KDQOL dialysis-specific scores correlated significantly with the SF36 mental summary score, but only 6 correlated significantly with the SF36 physical summary score. Open comments suggested that dialysis itself is the chief problem confronting dialysis patients, but also that the predicament of end-stage renal disease may have a positive impact on the lives of some patients. CONCLUSIONS: While physical problems are the biggest difference between dialysis patients and controls, disease-specific scales and open comments highlighted the importance of psychosocial and treatment-related problems among hemodialysis patients. Generic and disease-specific questionnaires, and open comments provide different information about the health status of dialysis patients.

Adult↗