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R G McAuley

Publications and source records attributed to R G McAuley.

At least 19 recordsLinked to original sources
PubMed2001

Waiting times from abnormal breast screen to diagnosis in 7 Canadian provinces.

BACKGROUND: Delay to breast cancer diagnosis following an abnormal screening result is associated with anxiety and personal disruption. We assessed the patterns and timeliness of diagnostic follow-up after breast cancer screening for women with abnormal results who attended organized screening programs in 7 provinces. METHODS: Using data from the Canadian Breast Cancer Screening Database, we identified 203,141 women aged 50-69 years who underwent screening in 1996 through provincially organized breast cancer screening programs in British Columbia, Alberta, Saskatchewan, Manitoba, Ontario, Nova Scotia and Newfoundland. We prospectively followed women with an abnormal screening result through to the completion of the assessment process. We evaluated the waiting times from screening examination to first assessment, from screening examination to first imaging, from screening examination to diagnosis and from first assessment to diagnosis for 13,958 women, stratified according to screening program, mode of detection, whether a biopsy was performed and whether cancer was diagnosed. RESULTS: We observed considerable variations between and within programs in the time to diagnosis. The median time from screening examination to first assessment was 2.6 weeks. The median time from screening examination to diagnosis was 3.7 weeks; this time increased to 6.9 weeks for women undergoing biopsy. Even when no biopsy was performed, 10% of the women waited 9.6 weeks or longer for a diagnosis, as compared with 15.0 weeks or longer for 10% of the women undergoing biopsy. Among the women who had a biopsy, the use of core biopsy was associated with a shorter median time to diagnosis than was open biopsy, and those found to have cancer had shorter waiting times than women with benign biopsy findings. INTERPRETATION: Women undergoing assessment of an abnormal breast cancer screening result waited many weeks for a diagnosis, especially when a biopsy was performed. To ensure that targets for timeliness, adopted nationally in 1999, are realized, improved models of care or dissemination of existing efficient techniques to reach a diagnosis will be needed.

Aged↗
PubMed1997

Recruiting women for breast screening. Family Physician Model strategy.

OBJECTIVE: To determine whether family physicians would participate in the Family Physician Model (FPM) recruitment strategy for mammography screening, whether participating physicians differed from non-participating physicians, and whether the strategy would recruit 70% of eligible women in the participating practices. DESIGN: Family physicians were invited to participate in the project. Staff from the Ontario Breast Screening Program-Hamilton Centre (OBSP-H) identified eligible women, prepared personalized letters recommending screening, and monitored compliance. Participating and non-participating physicians were asked to complete a questionnaire. SETTING: Family practices in Dundas, Ancaster, and Hamilton, Ont. PARTICIPANTS: Women aged 50 years and older who met eligibility criteria for screening. Family physicians in Dundas, Ancaster, and Hamilton. INTERVENTION: Family physicians were approached by the Health Promotion Officer at the OBSP-H about participating in the FPM. Eligible women in their practices were sent letters recommending breast screening. MAIN OUTCOME MEASURES: Percentage of family physicians agreeing to participate in the FPM, characteristics of participating and non-participating physicians, and percentage of eligible women who scheduled mammograms. RESULTS: Of the 114 family physicians approached, 76 (67%) agreed to participate. Significantly more participating than non-participating physicians were in group practice and had certification in family medicine. In response to the letters, 54% of eligible women obtained mammograms. Because 12% of women were ineligible since they had been referred for screening within the previous 12 months, 66% of women in the participating practices actually obtained mammograms over the 2-year period-almost the target 70%. CONCLUSION: The FPM is a successful recruitment strategy.

Aged↗
PubMed1996

Health problems in family practice. An Icelandic multicentre study.

OBJECTIVE: To establish epidemiological data on the health problems within family practice in Iceland by multicentre analysis of well-defined geographic areas. DESIGN: Prospective practice audit. SUBJECTS AND SETTINGS: Thirteen Icelandic health centres (HC) with computerized contact data from 1 January - 31 December 1988. MAIN OUTCOME MEASURES: Health problems during one year in a population, as perceived by health care providers. RESULTS: A total of 176 384 health problems during one year in a population of 31 248, as perceived by the health care provider, were analysed. Musculoskeletal disorders accounted for 9.3% of all health problems (prevalence 210.6/1000 inhabitants), respiratory disorders 9.4% (189.9/1000), accidents 7.4% (203.2/1000), cardiovascular disorders 7.4% (112.0/1000) and mental disorders 6.1% (87.6/1000). The commonest single health problems were: hypertension, upper respiratory tract infections and non-articular rheumatism. The health problems accounting for the most frequent contacts were: mental disorders (4.0 contacts per individual per year), cardiovascular (3.7), and endocrine, nutrition and metabolic (3.2). CONCLUSION: Problem-oriented medical records from HCs, computerized in a uniform standardized way, can give extensive information about the content and burden of health problems in family practice and presumably public health. Our results are valuable because the population (the denominator) and the geographic study area are well defined. This information is an important part of clinical epidemiology and can be of great value for educators and health care planners.

Adolescent↗
PubMed1994

Flying solo.

Explore the source record for details and available documents.

Female↗
PubMed1992

On content of practice. An Icelandic multicentre study, population, practices and contacts.

To establish data on the content of Icelandic family practice, a prospective practice audit was made of all Icelandic health centres with computerized contact data from 1 January to 31 December 1988. The study comprised 17 community health centres in Iceland and their target populations, 13 rural and four urban. The main subjects for study were population characteristics, practice sizes, types of health care providers, and contacts. The study population, 50,865 subjects, comprised 20.2% of the Icelandic population. Rural and urban populations were different and are described separately. The 17 health centres had a mean of 1,152 subjects/doctor. The target population had a total of 257,188 contacts: 155,526 rural contacts, 5.1/subject (3.3 office-, 1.1 phone-, and 0.4 home-contacts); 101662 urban contacts, 5.1/subjects (2.8 office-, 1.6 phone-, and 0.4 home-contacts). During 1988, 88.9% of the rural target population made contact. These data are comparable to data from other countries; the observed office and home contact rates were similar, but phone-calls were more frequent. Computer systems in family practice provide a feasible way to collect data on a regular basis for epidemiological purposes and for performance review.

Community Health Centers↗
PubMed1992

Reasons for contact in family practice. An Icelandic multicentre study on content of practice.

To establish data on the patient's reasons for a contact, as a part of data on content of Icelandic family practice, a prospective practice audit was made of 16 Icelandic health centres with computerized contact data from 1 January to 31 December 1988. The study comprised 16 community health centres in Iceland and their target population, 12 rural and four urban. The reasons for contact in the study group are analysed. A total of 284348 reasons for contact were analysed; 36-39% were for symptoms and 44-50% were initiated by health professionals. The latter included renewal of prescriptions, which comprised 17-18% of all reasons for contact. Musculoskeletal symptoms were the most common symptomatic complaint, 6.6-7.3% of all reasons for contact. The five most often stated symptoms were: rash, cough, cold, lower limb symptoms, and fever. A "reason for contact" record increases the understanding of the patient's presenting complaint, as well as the patient's agenda in each contact. This record gives an opportunity to follow the presenting complaint in the continuous process of care i. e. reason for contact diagnosis, management, and follow-up. We are reminded that common things are common in family practice; nevertheless more research is needed to understand the process of care.

Community Health Centers↗
PubMed1990

Five-year results of the peer assessment program of the College of Physicians and Surgeons of Ontario.

The office practices of 918 physicians selected through stratified random sampling from the College of Physicians and Surgeons of Ontario (CPSO) registry were assessed by peers and the Peer Assessment Committee of the CPSO from 1981 to 1985. The sample comprised 662 general practitioners (GPs) and family physicians (FPs) and 256 specialists in 11 fields. Of the physicians 749 (82%) had neither deficient records nor an unsatisfactory level of patient care. Of the GPs and FPs 97 (15%) had serious deficiencies in one or both areas, as compared with 4 (2%) of the specialists (p2 less than 0.00001). The proportions of certificants of the Royal College of Physicians and Surgeons of Canada and of the College of Family Physicians of Canada (CFPC) with serious deficiencies were low (2% and 3% respectively). Three statistically significant predictors of physician performance were found among the GPs and FPs: age, CFPC membership status and type of practice. Of the 56 physicians who were reassessed 6 to 12 months later 29 (52%) had made the improvements recommended by the committee. Our findings demonstrate the need, feasibility and acceptance of a peer assessment program of office practices in Ontario.

Age Factors↗
PubMed1984

Results of the peer assessment program of the College of Physicians and Surgeons of Ontario.

This paper describes the experience of the College of Physicians and Surgeons of Ontario in developing and conducting a program for the peer assessment of physicians' office practices that would allow the standards of medical practice to be reviewed and assessed. Following two pilot projects in 1978 and 1979 that demonstrated the need, the feasibility and the acceptance of a peer assessment program the office practices of 391 randomly selected physicians were reviewed in 1981 and 1982. Included in the sample were 255 general/family practitioners and 136 specialists in seven fields. Serious deficiencies were found in the medical records of or in the care provided by 30 of the general/family practitioners and 3 of the specialists, accounting for 8% of the practices studied. The difference between the two groups of physicians was statistically significant (p less than 0.01). No predictors of significance were demonstrated in the general/family practitioner group. When follow-up assessments were done most of the physicians were found to have made the improvements that had been recommended.

Ambulatory Care↗
PubMed1984

Characteristics of medical students who choose primary care as a career: the McMaster experience.

We examined the relation between demographic characteristics and the career choices of medical students who entered McMaster University medical school between 1969 and 1975. In contrast to earlier work, this study found no significant differences in sex, age, marital status at the time of entry into medical school, undergraduate major, whether prerequisite premedical courses had been taken, undergraduate grade point average and academic performance between the graduates who chose primary care and those who chose a specialty. This suggests that many medical school graduates in the 1970s entered primary care by choice rather than by default.

Adult↗
PubMed1983

Can the academic background of medical graduates be detected during internship?

Performance ratings were obtained by the clinical supervisors of four graduated classes of McMaster University medical students during internship. The supervisors detected no difference in performance between the graduates who met the "traditional" admissions criteria (both an undergraduate grade point average of 3.1 or greater on a 4-point scale and previous training in biology, general and organic chemistry, and physics) and those who lacked one or both of these prerequisites. These data suggest that medical schools can expand their admissions criteria without fearing that their graduates will perform less well as interns because of a lack of traditional academic preparation for medical school.

Educational Measurement↗