Establishing the validity of English GP Patient Survey items evaluating out-of-hours care

Author's manuscript. The final published version is available as an open access article from the publisher via: doi:10.1136/bmjqs-2015-004215Copyright: Article author (or their employer) 2015. Produced by BMJ Publishing Group Ltd under licence.BACKGROUND: A 2014 national audit used the English General Practice Patient Survey (GPPS) to compare service users' experience of out-of-hours general practitioner (GP) services, yet there is no published evidence on the validity of these GPPS items. OBJECTIVES: Establish the construct and concurrent validity of GPPS items evaluating service users' experience of GP out-of-hours care. METHODS: Cross-sectional postal survey of service users (n=1396) of six English out-of-hours providers. Participants reported on four GPPS items evaluating out-of-hours care (three items modified following cognitive interviews with service users), and 14 evaluative items from the Out-of-hours Patient Questionnaire (OPQ). Construct validity was assessed through correlations between any reliable (Cochran's α>0.7) scales, as suggested by a principal component analysis of the modified GPPS items, with the 'entry access' (four items) and 'consultation satisfaction' (10 items) OPQ subscales. Concurrent validity was determined by investigating whether each modified GPPS item was associated with thematically related items from the OPQ using linear regressions. RESULTS: The modified GPPS item-set formed a single scale (α=0.77), which summarised the two-component structure of the OPQ moderately well; explaining 39.7% of variation in the 'entry access' scores (r=0.63) and 44.0% of variation in the 'consultation satisfaction' scores (r=0.66), demonstrating acceptable construct validity. Concurrent validity was verified as each modified GPPS item was highly associated with a distinct set of related items from the OPQ. CONCLUSIONS: Minor modifications are required for the English GPPS items evaluating out-of-hours care to improve comprehension by service users. A modified question set was demonstrated to comprise a valid measure of service users' overall satisfaction with out-of-hours care received. This demonstrates the potential for the use of as few as four items in benchmarking providers and assisting services in identifying, implementing and assessing quality improvement initiatives.National Institute for Health Research (NIHR

Vaatetussuunnittelijan, yrityksen ja kuluttajan kolmiyhteys

Vaatetussuunnittelijoiden, yritysten ja kuluttajien kolmiyhteydestä tehty tutkimus toimii pohjana Andiatan kevät/kesä 2014 -ideamallistolle, jonka kohderyhmä ovat uranaiset. Tutkimuksen tuloksissa ilmenee keitä vaatetussuunnittelijat ovat, mitä he tekevät ja miten, kuinka he kommunikoivat yritysten ja kuluttajien kanssa, ja kuinka vaatetussuunnittelijan suunnittelumetodit ja tyyli, esitystekniikka sekä työnkuva vaihtelevat eri työnantajien mukaan. Tutkimus koostuu kulttuurisista ja yrityspohjaisista tietolähteistä, alan ammattitaitoisten henkilöiden sähköpostihaastatteluista ja Iiris-lehden verkkosivuilla julkaistun E-lomakkeen avulla kerätyistä tiedoista, joista selviää Andiatan kohderyhmän profiili ja heidän toiveensa ja tarpeensa vaatteiden suhteen. E-lomakkeesta on apua suunnitteluprojektissa ja se on osa tutkimustyötä, jossa huomioidaan, kuinka paljon kuluttajien tarpeisiin ja toiveisiin voidaan vastata yritykselle työskennellessä. Tutkimus osoittaa, kuinka tärkeää kommunikointi vaatetussuunnittelijan, yrityksen ja kuluttajan muodostaman kolminaisuuden keskuudessa on, ja kuinka tärkeitä ominaisuuksia vaatetussuunnittelijan persoonallisuus, luovuus, itseensä uskominen ja ahkeruus ovat vaatetusalalla. Tutkimuksen tärkeys ilmenee vaatetussuunnittelijan työnkuvan ymmärtämisellä ja tutkimus on suositeltavissa kaikille vaatetusalan parissa opiskeleville ja työskenteleville, sekä vaatetusalasta kiinnostuneille.Andiata’s Spring/Summer 2014 -idea collection for businesswoman is based on the research that was made on the trinity of fashion designers, companies and consumers. Research results showed who designers are, what they are doing and how, how they communicate with companies and consumers, and how design methods and style change in fashion designers’ work and design presentations when working with different clients. The research is a collection of cultural and enterprise-based sources, information about professional by interviewing them by e-mail, and information about consumers by E-form, where a businesswoman’s profile is expressed and their needs and wishes for clothing. The E-form is published by a magazine called Iiris-lehti and is helpful for Andiata’s Spring/Summer 2014 -collections design project and at the same time is shown how much a fashion designer can fulfill consumers’ wishes when working for a company. The research tells how important communication is in fashion designers, companies and consumers trinity, how much fashion designers personality, creativeness, believing in themselves and hard working is important in the Fashion Industry. The research is an important part of understanding fashion designers’ working area and can be recommendable for all who are part of the fashion world or interested in it

Evaluation of prognostic risk models for postoperative pulmonary complications in adult patients undergoing major abdominal surgery: a systematic review and international external validation cohort study

Background Stratifying risk of postoperative pulmonary complications after major abdominal surgery allows clinicians to modify risk through targeted interventions and enhanced monitoring. In this study, we aimed to identify and validate prognostic models against a new consensus definition of postoperative pulmonary complications. Methods We did a systematic review and international external validation cohort study. The systematic review was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched MEDLINE and Embase on March 1, 2020, for articles published in English that reported on risk prediction models for postoperative pulmonary complications following abdominal surgery. External validation of existing models was done within a prospective international cohort study of adult patients (≥18 years) undergoing major abdominal surgery. Data were collected between Jan 1, 2019, and April 30, 2019, in the UK, Ireland, and Australia. Discriminative ability and prognostic accuracy summary statistics were compared between models for the 30-day postoperative pulmonary complication rate as defined by the Standardised Endpoints in Perioperative Medicine Core Outcome Measures in Perioperative and Anaesthetic Care (StEP-COMPAC). Model performance was compared using the area under the receiver operating characteristic curve (AUROCC). Findings In total, we identified 2903 records from our literature search; of which, 2514 (86·6%) unique records were screened, 121 (4·8%) of 2514 full texts were assessed for eligibility, and 29 unique prognostic models were identified. Nine (31·0%) of 29 models had score development reported only, 19 (65·5%) had undergone internal validation, and only four (13·8%) had been externally validated. Data to validate six eligible models were collected in the international external validation cohort study. Data from 11 591 patients were available, with an overall postoperative pulmonary complication rate of 7·8% (n=903). None of the six models showed good discrimination (defined as AUROCC ≥0·70) for identifying postoperative pulmonary complications, with the Assess Respiratory Risk in Surgical Patients in Catalonia score showing the best discrimination (AUROCC 0·700 [95% CI 0·683–0·717]). Interpretation In the pre-COVID-19 pandemic data, variability in the risk of pulmonary complications (StEP-COMPAC definition) following major abdominal surgery was poorly described by existing prognostication tools. To improve surgical safety during the COVID-19 pandemic recovery and beyond, novel risk stratification tools are required. Funding British Journal of Surgery Society