PubMed · 12489387
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2002. Clinical pathways program presents challenges.. https://pubmed.ncbi.nlm.nih.gov/12489387/
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STUDY DESIGN: Secondary analysis of data collected from spine patients' normal clinic visits from 1998 to 2001. OBJECTIVE: To evaluate the reliability, validity, and responsiveness of the short form 12-item survey in patients with back pain. SUMMARY OF BACKGROUND DATA: The reliability, validity, and responsiveness of the short form 12-item survey in patients with back pain has not been previously evaluated. METHODS: Patients were asked to complete a comprehensive computerized survey questionnaire during their regular clinic visits. A total of 2520 patients who indicated in their first surveys that they had back pain were included in the study of the reliability and validity of the short form 12-item survey. Of these, 506 patients completed another survey within 3-6 months of follow-up and were included in the responsiveness evaluation. RESULTS: The two summary scales of the short form 12-item survey, physical component summary and mental component summary, demonstrated internal consistency reliability, with Cronbach alpha for both scales exceeding the recommended level of 0.70. Correlation of physical component summary and mental component summary with six other measures theoretically related or unrelated to these scales performed as expected without exception, demonstrating the construct validity of the short form 12-item survey. The responsiveness of the short form 12-item survey was supported by several pieces of evidence. First, the changes in physical component summary and mental component summary scores were correlated with the changes in back pain intensity. Second, for patients whose back pain improved, there was a significant increase in the follow-up physical component summary and mental component summary scores as compared to the baseline. Third, small to moderate effect size was observed for patients whose back pain became improved or became worse. CONCLUSIONS: The short form 12-item survey demonstrated good internal consistency reliability, construct validity, and responsiveness in patients with back pain.
It has been proposed that "near misses" or "close calls" could serve as a focus for corrective action. Voluntary, anonymous error data were collected for 4 weeks and 235 events were reported: 168 were near misses and 67 resulted in adverse patient consequences. Of the 35 errors relating to diet, 17 (49%) resulted in adverse patient consequences, compared with only 5 of 43 (12%) of the errors related to medication.
PURPOSE: Studies describing the use of the Internet by radiation oncology patients are lacking. This multi-institutional study of cancer patients presenting to academic (AC), community (CO), and veterans (VA) radiation oncology centers was designed to analyze the use of the Internet, demographic factors related to utilization, and barriers to access to the Internet. METHODS AND MATERIALS: A questionnaire evaluating the use of the Internet was administered to 921 consecutive patients presenting to radiation oncology centers at AC, CO, and VA medical centers. The study included 436 AC patients (47%), 284 CO patients (31%), and 201 VA patients (22%). A computer was available at home to 427 patients (46%), and 337 patients (37%) had E-mail access. The mean age of the patient population was 64 (range = 14-93). Males represented 70% of the patient population. The most common diagnoses included prostate cancer (33%), breast cancer (13%), and lung cancer (11%). RESULTS: Overall, 265/921 patients (29%) were using the Internet to find cancer-related information. The Internet was used by 42% of AC patients, 25% of CO patients, and only 5% of VA patients (p < 0.0001). A computer was available at home in 62% AC vs. 45% CO vs. 12% VA patients (p < 0.0001). Patients < 60 years were much more likely to use the Internet than older patients (p < 0.0001). Most of the Internet users considered the information either very reliable (22%) or somewhat reliable (70%). Unconventional medical therapies were purchased over the Internet by 12% of computer users. CONCLUSIONS: A significant number of cancer patients seen in radiation oncology departments at academic and community medical centers utilize the Internet to obtain information about cancer. Radiation oncologists must familiarize themselves with this resource because of the large number of patients using the Internet. Veterans lack the computerized access to this information and are thus underserved by this important resource.