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At least 235 records · Page 13Linked to original sources
PubMed1998

Screening questionnaires in the detection of hazardous alcohol consumption in the general hospital: direct or disguised assessment?

OBJECTIVE: The aim of this study was to compare the validity of two direct screening questionnaires, the CAGE and MAST, in the detection of hazardous alcohol consumption with a disguised assessment by using the Trauma Scale in a poststratified general hospital sample. METHOD: Surgical and medical inpatients (N = 1,379) completed the three questionnaires. Hazardous alcohol consumption was defined by criteria derived from a World Health Organization study and assessed using self-reported quantity and frequency. RESULTS: The sensitivity of the Trauma Scale was not significantly different compared to the CAGE and MAST, whereas the direct questionnaires were higher in specificity and overall accuracy (p < .0001). In male surgical patients the detection rate of the Trauma Scale was higher compared to the CAGE (p < .05). Thirteen percent of subjects with hazardous levels of alcohol consumption were detected by the Trauma Scale only. In female surgical patients, the Trauma Scale, when used as an additional tool, does not improve the detection of hazardous drinkers. CONCLUSIONS: Because of the low specificity, indirect assessment using a history of trauma cannot be recommended as a screening instrument in a general hospital setting. Despite a high number of false positives, the Trauma Scale may serve as an additional tool in conjunction with direct questionnaires when high sensitivity is desired.

Alcohol Drinking↗
PubMed1978

Consent forms--how, or whether, they should be used.

If written consent forms are to be used--their use normally is not mandatory--care should be taken that their use is proper and, hence, beneficial. To be of benefit to the physician, the consent forms must help him in meeting his duty to inform the patient or in protecting him from a patient's claim that his was not an informed consent (or both). Consent forms are of no benefit to the physician or the patient if they are worded poorly or put to poor use. Suggestions are provided to help the physician in considering his or her use of written consent forms.

Consent Forms↗
PubMedDate not supplied

How do patients want physicians to handle mistakes? A survey of internal medicine patients in an academic setting.

BACKGROUND: Mistakes are an inevitable part of the practice of medicine. While the frequency and severity of medical errors are documented, little is known about patients' attitudes toward physician mistakes. OBJECTIVE: To examine patient attitudes about physician errors. DESIGN: A survey instrument assessed attitudes to 3 levels of physician mistakes (minor, moderate, and severe) and 2 fundamental physician responses: disclosure or nondisclosure. One hundred forty-nine study subjects were randomly selected from an academic general internal medicine outpatient clinic. RESULTS: Virtually all patients (98%) desired some acknowledgment of even minor errors. Patient's desire for referral to another physician ranged from 14% following a minor mistake to 65% following a severe mistake. For both moderate and severe mistakes, patients were significantly more likely to consider litigation if the physician did not disclose the error. In the moderate mistake scenario, 12% of patients would sue if informed by the physician vs 20% if the physician failed to disclose the error and they discovered it by some other means (P < .001). CONCLUSIONS: Patients desire an acknowledgment from their physicians of even minor errors, and doing so may actually reduce the risk of punitive actions. These findings reinforce the importance of open communication between patients and physicians.

Academic Medical Centers↗