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PubMed2005

What features do patients notice that help to distinguish between benign pigmented lesions and melanomas?: the ABCD(E) rule versus the seven-point checklist.

The ABCD(E) rule and the seven-point checklist are diagnostic aids that have proven to be useful in the hands of physicians; however, little is known of their value to patients with respect to aiding self-detection. The objective of this study was to investigate features that patients notice when identifying melanomas and to explore how well these features correspond to the ABCD(E) rule and the seven-point checklist. A retrospective, modified, case-control study involving patient interviews was performed. All interviews were conducted through the private consulting rooms of a Melbourne dermatologist (JWK) and a Newcastle plastic surgeon (CH) prior to the result of pathology being known to the patients and the interviewers. Sixty-seven patients with benign pigmented skin lesions and 46 patients with melanomas were included. Using a logistic regression model, the change in size/new lesion and change in colour (major criteria, seven-point checklist) were most useful in differentiating between melanomas and benign pigmented lesions in the hands of patients [odds ratio (OR), 4.74; 95% confidence interval (CI), 1.85-12.19; P=0.001; OR, 4.27; 95% CI, 1.62-11.26; P=0.003, respectively). The ABCD(E) rule failed to discriminate between melanoma and other benign pigmented skin lesions. It can be concluded that, of the patients' observations, changes in size or colour were most important in distinguishing between benign pigmented lesions and melanomas. Such features therefore deserve emphasis in public education campaigns. Medical professionals should also remember to seek a history of change in assessing pigmented skin lesions.

Case-Control Studies↗

PubMedDate not supplied

Developing clinical competencies/training checklists: when you have to start from scratch!

Where does an educator begin to develop competencies if the organization has not had formal written standards, has few clinical policies and procedures, or has not had consistent training checklists? The educator may have to begin from scratch. During a year-long process, 50+ clinical sites and 500+ clinical staff (nurses and medical assistants) played an active role in improving clinical orientation by assisting with the development of clinical competencies/ training checklists. This article outlines the development of the clinical competencies/ training checklists for the University of Wisconsin Medical Foundation (UWMF), Madison, Wisconsin.

Attitude of Health Personnel↗

PubMedDate not supplied

Development of a military competency checklist for case management.

This presentation will discuss the design, implementation, and evaluation of a competency-based checklist in military nursing network. The checklist was initiated to help assess case manager competency where background and preparation for the case manager role were quite diverse. The checklist assisted initially with the assessment of learning needs; later, it served as a self-assessment for case managers to determine their areas for improvement. Finally, the assessment was used not only to verify competency by the case management supervisor, but also to establish systemwide quality in case management.

Case Management↗

PubMedDate not supplied

Comparing the effect of a skills checklist on teaching time required to achieve independence in administration of infusion medication.

This study evaluated the efficacy of a skills checklist, which included a standardized instruction sheet based in part on Rutledge and Donaldson's recommendations for reducing the amount of time required to make a patient independent in the administration of an antibiotic. The use of a skills checklist was found to reduce the time it takes for a patient to become independent with their therapy by reducing the number of teaching visits, and thereby the total time of instruction. Time-saving and a decrease in the number of individuals providing instruction to a patient offer the prospect of lowering the cost of care. The skills checklist also improves communication between nurses providing instruction.

Drug Administration Schedule↗

PubMed2004

A checklist for assessing the risk of falls among the elderly.

The purpose of this study was to estimate the risk of falls among elderly citizens by using a checklist. This checklist was initially developed using the Delphi technique, then refined on the basis of research findings. Cross-sectional design and a purposive sample were used, with the sample selected from three sheltered housing projects (n = 302) and from Win-san district (n = 103) in Taipei, comprising 405 participants. On the basis of their experiences of falling in the previous year, participants were classified into two groups: fall (n = 202) and non-fall (n = 203). Participants in the fall group had lower scores on an SPMSQ (Short Portable Mental Status Questionnaire), took longer to complete the Get-up and Go test and were more afraid of falling. Participants who took longer than one second to complete the Get-up and Go test or had urinary frequency or incontinence problems were found to be at greater risks for falls. The elderly who lived in homes with dimly lit kitchens and clutters at entryways (or backyards) were found to be at a considerably greater risk, by 22 or 13 times respectively. This checklist can be used by care providers to identify those providing care to the elderly, those at high risk of falls, and to prevent such falls or, at least lessen the risks of falls.

Accidental Falls↗

PubMed1990

From ICU to rehabilitation: a checklist to ease the transition for the spinal cord injured.

Spinal cord injuries are devastating. The injured person faces many unknowns including surgical procedures, hospitalization and rehabilitation. Frequently, the transition from acute care to rehabilitation is frightening. In the intensive care unit (ICU), the patient receives one-to-one nursing care and develops trust, but then may feel abandoned when faced with rehabilitation. In order to facilitate readiness for rehabilitation, coordinators of the Southeastern Michigan Spinal Cord Injury System proposed a checklist of activities designed to meet individual patient and family needs. Coordinators assess the patient within 24 hours of admission to the spinal ICU. The physiatrist is notified of the admission and recommends initial therapies as appropriate. The patient is followed through the acute phase and preparations are made for rehabilitation. A checklist format has been developed to coordinate the transfer. This article describes the checklist and its use at our institution.

Adaptation, Psychological↗

PubMed1984

The effect of a checklist on medical students' exposures to practical skills.

The effect is evaluated of a checklist exploring acquisition of practical skills by medical students during the first clinical course in internal medicine. A group of forty-five students using the checklist was compared with two reference groups doing their clerkship before and after the study group. The amount of exposure to practical procedures increased by about 30%. At the same time exposure to some simpler procedures was reduced, while there was an increase in exposures to more complicated procedures. The conclusion is that a checklist has potential value for increasing exposure to practical procedures, if given with advice about the procedures to be preferred and by demand for mastery of particular skills.

Clinical Clerkship↗

PubMed2005

The validity and reliability of the World Health Organization Mental Disorders Checklist for use in a telehealth clinic in Hong Kong.

This research aimed to test the validity and reliability of the 'World Health Organization Mental Disorders Checklist' for use in a telehealth clinic in Hong Kong. The Checklist adopted four subscales: (i) depression; (ii) anxiety; (iii) alcohol use disorders; and (vi) functioning and disablement, and was translated from English into Chinese. It was validated by a panel of five experts to confirm its content validity (content validity index = 0.98) and cultural appropriateness in Hong Kong. The reliability of the checklist was supported by the findings of a test-retest procedure (Pearson correlation = 0.66-0.88, P < 0.01), internal consistency reliability (Cronbach's alpha = 0.54-0.83), and interrater reliability (Kendall's coefficient of concordance = 0.58-1.00, P < 0.01) involving a sample of 197 subjects from one telehealth clinic in Hong Kong.

Activities of Daily Living↗

PubMed1992

Clinical predictors of malignant pigmented lesions. A comparison of the Glasgow seven-point checklist and the American Cancer Society's ABCDs of pigmented lesions.

Reducing morbidity and mortality from malignant melanoma is the greatest challenge facing dermatology today. We present a comparison of the Glasgow seven-point checklist and the American Cancer Society's ABCDs of pigmented lesions for detecting early melanomas. Logistic regression analysis showed that the Glasgow checklist (N = 205 lesions) contained two significant variables (irregular outline, P = .001, relative odds = 10.9; diameter greater than 1 cm, P = .005, relative odds = 6.7) for differentiating benign from malignant pigmented lesions whereas a three-point version of the ABCDs (N = 192 lesions) had three significant variables (irregular outline, P = .001, relative odds = 9.3; diameter greater than 6 mm, P = .008, relative odds = 5.5; variegation, P = .05, relative odds = 3.7). All six melanomas scored 3 out of 3 on the ABCD scale for a sensitivity of 1.00 and specificity of 0.98 at a threshold of 3 out of 3. Patients rarely sought dermatologic consultation because of these predictors but often sought help for nonsignificant reasons such as inflammation (P = .93), color change (P = .84), itch (P = .72), and increasing size (P = .38). The simpler three-point scale at a threshold of two had equal specificity (0.88 versus 0.94) and better sensitivity (0.73 versus 0.44) than the Glasgow seven-point checklist at the recommended threshold of three out of seven. We therefore recommend that the American public be better educated about the ABCDs to help increase self-referral so that early melanomas can be found and eradicated.

Adolescent↗

PubMed1994

Checklist for the removable prosthesis wax trial insertion appointment.

A checklist is described that is designed to permit a systematic evaluation of the factors involved in the trial insertion appointment. The checklist aids both the student and the instructor in assuring that items are not overlooked during this important appointment. More equitable grading of the student's preparation and knowledge is facilitated. The checklist also serves as an excellent patient approval form.

Denture, Complete↗

PubMed1992

Comparison of Composite International Diagnostic Interview and clinical DSM-III-R criteria checklist diagnoses.

This article describes a comparison of Composite International Diagnostic Interview (CIDI) diagnostic results and results based on clinicians' observation of CIDI assessments. Psychiatrists scored a DSM-III-R criteria checklist either while observing or after administering 20 CIDI interviews. Overall diagnostic concordance between the checklist and CIDI diagnoses was found to be good (kappa = 0.78). Good diagnostic agreement was also found for 3 groups of DSM-III-R disorders: depressive disorders (kappa = 0.84), psychoactive substance use disorders (kappa = 0.83) and anxiety phobic disorders (kappa = 0.76). These results are consistent with the results from a similar comparison between the CIDI and checklist results for ICD-10 diagnoses.

Anxiety Disorders↗

PubMed1994

Emotional reactions to psychiatric patients. Analysis of a feeling checklist.

In psychodynamic milieu treatment, the relations between patients and nurses are the main tools for understanding and helping the patients. For this reason, it is important to construct methods to follow the development of relations and to study characteristics of helpful and nonhelpful relations. In this article, a checklist with feeling words given to nurses and aides in psychiatric treatment facilities is presented and its measurement properties are described. The analysis showed that the checklist as a whole measures the amount of emotional arousal in a reliable way. The individual feeling words have acceptable variance. A factor analysis gave a limited number of factors that are clinically understandable. The checklist seems to be well worth further study.

Countertransference↗

PubMed2001

Clinical studies on submicroscopic subtelomeric rearrangements: a checklist.

BACKGROUND: Submicroscopic subtelomeric chromosome defects have been found in 7.4% of children with moderate to severe mental retardation and in 0.5% of children with mild retardation. Effective clinical preselection is essential because of the technical complexities and cost of screening for subtelomere deletions. METHODS: We studied 29 patients with a known subtelomeric defect and assessed clinical variables concerning birth history, facial dysmorphism, congenital malformations, and family history. Controls were 110 children with mental retardation of unknown aetiology with normal G banded karyotype and no detectable submicroscopic subtelomeric abnormalities. RESULTS: Prenatal onset of growth retardation was found in 37% compared to 9% of the controls (p<0.0005). A higher percentage of positive family history for mental retardation was reported in the study group than the controls (50% v 21%, p=0.002). Miscarriage(s) were observed in only 8% of the mothers of subtelomeric cases compared to 30% of controls (p=0.028) which was, however, not significant after a Bonferroni correction. Common features (>30%) among subtelomeric deletion cases were microcephaly, short stature, hypertelorism, nasal and ear anomalies, hand anomalies, and cryptorchidism. Two or more facial dysmorphic features were observed in 83% of the subtelomere patients. None of these features was significantly different from the controls. Using the results, a five item checklist was developed which allowed exclusion from further testing in 20% of the mentally retarded children (95% CI 13-28%) in our study without missing any subtelomere cases. As our control group was selected for the "chromosomal phenotype", the specificity of the checklist is likely to be higher in an unselected group of mentally retarded subjects. CONCLUSIONS: Our results suggest that good indicators for subtelomeric defects are prenatal onset of growth retardation and a positive family history for mental retardation. These clinical criteria, in addition to features suggestive of a chromosomal phenotype, resulted in the development of a five item checklist which will improve the diagnostic pick up rate of subtelomeric defects among mentally retarded subjects.

Abnormalities, Multiple↗

PubMed2003

The relationship between serotonergic function and the Psychopathy Checklist: Screening Version.

Reduced serotonergic (5-HT) neurotransmission has been reported in impulsive and aggressive personality disordered and offender samples. What is not clear is the relationship between 5-HT function and the North American construct of psychopathy assessed using the Psychopathy Checklist and its derivatives, which emphasizes the core interpersonal/affective as well as behavioural components of this syndrome. Fifty-one DSM-III-R personality disordered offenders who had a dynamic assessment of 5-HT function (prolactin response to 30 mg d-fenfluramine challenge) were rated on the Psychopathy Checklist: Screening Version based on interview and file data. The Psychopathy Checklist: Screening Version (PCL: SV) mean score in the sample was similar to other reports in European forensic samples. A three-factor structure best explained the PCL: SV data: arrogant/deceitful, callous-unemotional and impulsive-antisocial behaviour factors. 5-HT function did not correlate with psychopathy as a unidimensional phenomenon. The impulsive-antisocial component correlates negatively with 5-HT function while the arrogant/deceitful component correlates positively with 5-HT. In line with previous research findings, impulsive-antisocial conduct shows an inverse relationship with 5-HT function. Arrogant/deceitful traits correlate positively with 5-HT function and may be an adaptive component of psychopathy.

Adult↗

PubMedDate not supplied

The early detection of postpartum depression: midwives and nurses trial a checklist.

OBJECTIVE: To evaluate the use of a standard pen-and-paper test versus the use of a checklist for the early identification of women at risk of postpartum depression and to investigate the experiences of nurses in using the checklist. DESIGN: A prospective cohort design using repeated measures. SETTING: The booking-in prenatal clinic at a regional hospital in Victoria, Australia, and the community-based postpartum maternal and child health service. PARTICIPANTS: 107 pregnant women over 20 years of age. MAIN MEASURES: Postpartum Depression Prediction Inventory (PDPI), Postpartum Depression Screening Scale (PDSS), Edinburgh Postnatal Depression Scale (EPDS), demographic questionnaire, and data on the outcome from the midwives and nurses. RESULTS: The PDPI identified 45% of the women at risk of depression during pregnancy and 30% postpartum. The PDSS and EPDS both identified the same 8 women (10%), who scored highly for depression at the 8-week postpartum health visit. Nurses provided 80% of the women with anticipatory guidance on postpartum depression in the prenatal period and 46% of women at the 8-week postpartum health visit. Nurse counseling or anticipatory guidance was provided for 60% of the women in the prenatal period. CONCLUSION: The PDPI was found to be a valuable checklist by many nurses involved in this research, particularly as a way of initiating open discussion with women about postpartum depression. It correlated strongly with both the PDSS and the EPDS, suggesting that it is useful as an inventory to identify women at risk of postpartum depression.

Adult↗

PubMed1993

Evaluation of pharmacoeconomic studies: utilization of a checklist.

OBJECTIVE: To review the fundamental concepts used in clinical economic analysis and establish a simple model to systematically evaluate the quality of pharmacoeconomic studies. DATA SOURCES: A MEDLINE search was used to identify pertinent pharmacoeconomic literature, including reviews. STUDY SELECTION: Selected literature evaluating the methodology of health economics studies was used. CONCLUSIONS: The number of studies presenting a pharmacoeconomic evaluation has increased progressively; however, the quality of the studies has not improved in parallel. The existence of different types of pharmacoeconomic studies does not justify their arbitrary use and the achievement of valid conclusions must be based on sound knowledge of the concepts employed, as well as on use of the most adequate tool in each instance. By evaluating pharmacoeconomic studies systematically, the more common errors (i.e., in planning the study or interpreting the results) can be detected and thus prevented. The checklist we present has 12 sections, each of which includes several subsections. After evaluating the corresponding subsections, each section is labeled as "correct," "acceptable," "doubtful," "incorrect," or "not applicable." From this qualitative evaluation, aspects that have been dealt with correctly and those needing improvement will become apparent. Also, the checklist permits the user to verify whether the results have been correctly obtained and, therefore, whether the conclusions are valid. The use of a checklist for evaluating pharmacoeconomic studies may be useful for researchers, journal editors, and the audience when performing, receiving, reading, or accepting a clinical economic study.

Clinical Trials as Topic↗

PubMed2006

Reliability of a core competency checklist assessment in the emergency department: the Standardized Direct Observation Assessment Tool.

OBJECTIVES: A Council of Emergency Medicine Residency Directors task force developed the Standardized Direct Observation Assessment Tool (SDOT), a 26-item checklist assessment tool to evaluate Accreditation Council for Graduate Medical Education resident core competencies by direct observation. Each of the checklist items is assigned to one or more of five core competencies. The objective of this study was to test the interrater measurement properties of the SDOT instrument. METHODS: Two videos of simulated patient-resident-attending physician encounters were produced. Academic emergency medicine faculty members not involved in the development of the form viewed the two encounters and completed the SDOT for each. Faculty demographic data were collected. Data were collected from 82 faculty members at 16 emergency medicine residency programs. The checklist items were used to generate a composite score for each core competency of patient care, medical knowledge, interpersonal and communication skills, professionalism, and systems-based practice. RESULTS: Univariate analysis demonstrated a high degree of agreement between evaluators in evaluating residents for both videos. Multivariate analysis found no differences in rating by faculty when examined by experience, academic title, site, or previous use of the SDOT. CONCLUSIONS: Faculty from 16 emergency medicine residency programs had a high interrater agreement when using the SDOT to evaluate resident core competency performance. This study did not test the validity of the tool. This data analysis is mainly descriptive, and scripted video scenarios may not approximate direct observation in the emergency department.

Clinical Competence↗

PubMed2000

Phenotypic checklist to screen for fragile X syndrome in people with mental retardation.

The development of a phenotypic checklist for identifying people with fragile X syndrome is described. The checklist was designed to identify people with developmental disabilities of unknown causes for molecular genetic testing for fragile X syndrome. The list consists of 28 items (7 on physical characteristics and 21 on behavioral features). Validation data were collected for 110 boys and men with fragile X syndrome and for 79 members of a control group, matched for CA, level of cognitive development, and social (mal)adaptation. On the basis of checklist results, those boys who are likely to be diagnosed as having fragile X syndrome can be identified. The screening list can be considered to be a consistent, reliable, and valid instrument.

Adolescent↗