Identification of factors associated with diagnostic error in primary care

Background Missed, delayed or incorrect diagnoses are considered to be diagnostic errors. The aim of this paper is to describe the methodology of a study to analyse cognitive aspects of the process by which primary care (PC) physicians diagnose dyspnoea. It examines the possible links between the use of heuristics, suboptimal cognitive acts and diagnostic errors, using Reason’s taxonomy of human error (slips, lapses, mistakes and violations). The influence of situational factors (professional experience, perceived overwork and fatigue) is also analysed.Methods Cohort study of new episodes of dyspnoea in patients receiving care from family physicians and residents at PC centres in Granada (Spain). With an initial expected diagnostic error rate of 20%, and a sampling error of 3%, 384 episodes of dyspnoea are calculated to be required. In addition to filling out the electronic medical record of the patients attended, each physician fills out 2 specially designed questionnaires about the diagnostic process performed in each case of dyspnoea. The first questionnaire includes questions on the physician’s initial diagnostic impression, the 3 most likely diagnoses (in order of likelihood), and the diagnosis reached after the initial medical history and physical examination. It also includes items on the physicians’ perceived overwork and fatigue during patient care. The second questionnaire records the confirmed diagnosis once it is reached. The complete diagnostic process is peer-reviewed to identify and classify the diagnostic errors. The possible use of heuristics of representativeness, availability, and anchoring and adjustment in each diagnostic process is also analysed. Each audit is reviewed with the physician responsible for the diagnostic process. Finally, logistic regression models are used to determine if there are differences in the diagnostic error variables based on the heuristics identified.Discussion This work sets out a new approach to studying the diagnostic decision-making process in PC, taking advantage of new technologies which allow immediate recording of the decision-making process.The authors gratefully acknowledge funding of this research from the Spanish Research Agency. Ministry of Health (Fondo de Investigaciones Sanitarias) FIS PI10/01468 and the European Regional Development Fund (ERDF)

International Prevalence of Technology-Facilitated Sexual Violence Against Women: A Systematic Review of Observational Studies

The aim of this systematic review is to examine the frequency of Technology facilitated sexual violence committed against women over 16 years of age (young adults and adults)

Longitudinal Life Conditions Survey 2007-2011. Influence of unemployment length, poverty and social public expenditure on self perceived health in Spain

With the goal of observing the employment history of given individuals, a database was built from the longitudinal data files of the Survey on Living Conditions between 2007-2010 and 2008-2011. Only individuals with continuous presence in the data during the four years were included. Individuals under 16 and over 65 were excluded, as well as the population of the autonomous cities of Ceuta and Melilla. The longitudinal database includes 34,692 observations from 9,003 individuals in 17 regions during the financial crisis of 2007-2011 in Spain.This work was supported by the Health Department. Andalusian Board. 2013-2015 under Grant PI-0682-201

Guía para la elaboración de recomendaciones basadas en análisis de decisión multicriterio

Este documento ha sido realizado por la Agencia de Evaluación de Tecnologías Sanitarias de Andalucía en el marco de la financiación del Ministerio de Sanidad, Servicios Sociales e Igualdad para el desarrollo de las actividades del Plan anual de Trabajo de la Red Española de Agencias de Evaluación de Tecnologías Sanitarias y Prestaciones del SNS, aprobado en el Pleno del Consejo Interterritorial del SNS de 8 de noviembre de 2017 (conforme al Acuerdo del Consejo de Ministros de 1 de diciembre de 2017).YesLa evaluación de tecnologías conlleva un proceso sistemático de investigación mediante el cual se identifica, evalúa, selecciona y sintetiza la información científica disponible sobre la eficacia, seguridad y eficiencia de una tecnología sanitaria en comparación con la intervención de referencia, así como el impacto de uso a nivel económico, organizacional, ético y social. El Análisis de Decisión Multicriterio (en adelante ADMC o MCDA, del inglés: MultiCriteria Decision Analysis) es un conjunto de métodos que, de manera explícita y sistemática, permite tener en cuenta criterios adicionales. Esto permite desarrollar un proceso de toma de decisiones con una perspectiva más holística, haciendo explícitos los valores o dimensiones y su importancia relativa en este proceso

Cyberbullying and Associated Factors in Member Countries of the European Union: A Systematic Review and Meta-Analysis of Studies with Representative Population Samples

The aim of this study is to conduct a systematic review and meta-analysis to summarise the current state of empirical research and establish an up-to-date estimate of the prevalence of cyberbullying through the gathering of self-reported experiences from representative population samples from EU countries. Bibliographic searches were conducted on main electronic databases for studies until November 2021. We considered observational studies that provided data on cyberbullying prevalence and/or associated factors. Seven studies with data from 25 countries were included. Rates ranged between 2.8–31.5% for cybervictimization, between 3.0–30.6% for cyberperpetration, and between 13.0–53.1% for cyberbystanding. The rate of cybervictimization perpetration was 4%. Meta-analysis-pooled prevalence showed rates of 9.62% and 11.91% for cybervictimization and cyberperpetration, respectively. Given the large variation in the rates seen between the different examined studies, in addition to the increase over recent years in the prevalence rates of the different examined dimensions of cyberbullying, it would be useful to deepen research into the causes of these differences and the factors associated with each of the dimensions. This should be performed through populational surveys which enable the collection of a greater quantity of more consistent information with a view to designing prevention and intervention CB programs that are targeted and adapted towards the characteristics of the target population