Ranking Significant Discrepancies in Clinical Reports

Medical errors are a major public health concern and a leading cause of death worldwide. Many healthcare centers and hospitals use reporting systems where medical practitioners write a preliminary medical report and the report is later reviewed, revised, and finalized by a more experienced physician. The revisions range from stylistic to corrections of critical errors or misinterpretations of the case. Due to the large quantity of reports written daily, it is often difficult to manually and thoroughly review all the finalized reports to find such errors and learn from them. To address this challenge, we propose a novel ranking approach, consisting of textual and ontological overlaps between the preliminary and final versions of reports. The approach learns to rank the reports based on the degree of discrepancy between the versions. This allows medical practitioners to easily identify and learn from the reports in which their interpretation most substantially differed from that of the attending physician (who finalized the report). This is a crucial step towards uncovering potential errors and helping medical practitioners to learn from such errors, thus improving patient-care in the long run. We evaluate our model on a dataset of radiology reports and show that our approach outperforms both previously-proposed approaches and more recent language models by 4.5% to 15.4%.Comment: ECIR 2020 (short

Fathers as informants of children's fears and worries

The recognition of excessive fears and worries in children is important for early intervention. Despite current knowledge about the important contribution fathers make to their children’s emotional, social and cognitive development, more emphasis is often given to the views of mothers in both research and practice. This paper reports on a community study of 220 families. Fathers, mothers and children reported on children’s fears and worries using three different methods. While father and mother ratings were moderately correlated on two of the measures, there was relatively poor parent-child agreement. Implications for the role of fathers in the assessment of childhood fears and worries are discussed

Counting What Is Measured or Measuring What Counts? League Tables and Their Impact On Higher Education Institutions in England

This report investigates league tables and their impact on higher education institutions (HEIs) in England. It presents findings from two strands of research: – an analysis of five league tables selected for the study, their methodologies and the underlying data employed, and – an investigation of how higher education institutions respond to league tables generally and the extent to which they influence institutional decision-making and actions. The purpose of the research is to stimulate informed debate about the approaches and limitations of the various league tables, and greater understanding among the users and stakeholders of the implications of making decisions based on these sources of information

Impact of CONSORT extension for cluster randomised trials on quality of reporting and study methodology : review of random sample of 300 trials, 2000-8

Peer reviewedPublisher PD

Healthy shopper? Blood pressure testing in a shopping centre Pop-Up in England

Background: Improving detection of elevated blood pressure (BP) remains a public health need. We present results from a Pop-Up health check stationed in shopping centres in England. We hypothesise the rate of case detection is related to measurable ‘unhealthiness’ of the shopping centres. Methods: A Pop-Up health check was sited in four and three shopping centres sampled from the top ten unhealthiest and top 15 healthiest shopping regions respectively, following a report ranking towns/cities based on their unhealthy and healthy retail outlets. On one day in each shopping centre, people were approached and consented to BP testing. Outcome measure was people flagged with BP ≥ 140/90 mmHg (cases). Results: We detected 45 (22.6%) and 20 (13.1%) cases from testing 199 and 152 adults in the unhealthy and healthy locations respectively (relative risk 1.72; 95% confidence interval: 1.06 to 2.78). A measure of unhealthy retail outlets (e.g. fast-food outlets) within each shopping centre was associated with detection rate (R2 = 0.61; p = 0.04). Conclusion: An association exists between cases of suspect hypertension found in a health check Pop-Up and measured ‘unhealthiness’ of the shopping centre site. Results hint at strategies for public testing of BP, potentially in the context of reducing health inequalities

Threats to safe transitions from hospital to home: a consensus study in North West London primary care.

BACKGROUND: Transitions between healthcare settings are vulnerable points for patients. AIM: To identify key threats to safe patient transitions from hospital to primary care settings. DESIGN AND SETTING: Three-round web-based Delphi consensus process among clinical and non-clinical staff from 39 primary care practices in North West London, England. METHOD: Round 1 was a free-text idea-generating round. Rounds 2 and 3 were consensus-obtaining rating rounds. Practices were encouraged to complete the questionnaires at team meetings. Aggregate ratings of perceived level of importance for each threat were calculated (1-3: 'not important', 4-6: 'somewhat important', 7-9: 'very important'). Percentage of votes cast for each patient or medication group were recorded; consensus was defined as ≥75%. RESULTS: A total of 39 practices completed round 1, 36/39 (92%) completed round 2, and 30/36 (83%) completed round 3. Round 1 identified nine threats encompassing problems involving communication, service organisation, medication provision, and patients who were most at risk. 'Poor quality of handover instructions from secondary to primary care teams' achieved the highest rating (mean rating at round 3 = 8.43) and a 100% consensus that it was a 'very important' threat. Older individuals (97%) and patients with complex medical problems taking >5 medications (80%) were voted the most vulnerable. Anticoagulants (77%) were considered to pose the greatest risk to patients. CONCLUSION: This study identified specific threats to safe patient transitions from hospital to primary care, providing policymakers and healthcare providers with targets for quality improvement strategies. Further work would need to identify factors underpinning these threats so that interventions can be tailored to the relevant behavioural and environmental contexts in which these threats arise

Inadequate reporting of research ethics review and informed consent in cluster randomized trials : review of random sample of published trials

Peer reviewedPublisher PD