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Effects of a checklist on self-assessment of blood glucose level by a memory-impaired woman with diabetes mellitus.

This study evaluated effects of a checklist on the accuracy of self-assessment of blood glucose level by a diabetic woman with memory impairments caused by viral encephalitis. The checklist consisted of 54 steps for operating an electronic glucometer, which the subject performed in sequence and checked off when completed. Following introduction of the checklist, the percentage of steps completed correctly increased in simulated and actual blood glucose tests and yielded clinically useful information.

Attitude to Health↗

Improving the quality of Web surveys: the Checklist for Reporting Results of Internet E-Surveys (CHERRIES).

Analogous to checklists of recommendations such as the CONSORT statement (for randomized trials), or the QUORUM statement (for systematic reviews), which are designed to ensure the quality of reports in the medical literature, a checklist of recommendations for authors is being presented by the Journal of Medical Internet Research (JMIR) in an effort to ensure complete descriptions of Web-based surveys. Papers on Web-based surveys reported according to the CHERRIES statement will give readers a better understanding of the sample (self-)selection and its possible differences from a "representative" sample. It is hoped that author adherence to the checklist will increase the usefulness of such reports.

Data Collection↗

SARS preparedness checklist for state and local health officials.

A planning checklist for widespread severe acute respiratory syndrome, modeled on an Association of State and Territorial Health Officials (ASTHO) pandemic influenza planning checklist, was developed jointly by ASTHO, the National Association of County and City Health Officials, and the Centers for Disease Control and Prevention. This checklist, distributed May 2003, has been widely used.

Centers for Disease Control and Prevention, U.S.↗

Checklist for the prescription of slings for the hemiplegic patient.

The wide variety of hemiplegic sling designs, the lack of a uniform approach to sling selection, and the paucity of research data in this area have tended to make prescribing a sling a subjective process. Based on clinical experience and a comprehensive literature review, the authors propose a checklist for examining hemiplegic slings. The Checklist, which includes 19 desirable and 4 undesirable characteristics of slings, provides a more objective basis for comparing sling designs, warns of potential hazards, and facilitates the thorough examination of hemiplegic slings. The uses and limitations of the Checklist are discussed.

Arm↗

Spanish translation of the role checklist.

OBJECTIVE: The purpose of this study was to create a Spanish version of the Role Checklist that is content valid and reliable and to demonstrate usefulness of a translation method. METHOD: A modified version of the translation method of Hachey, Jumoorty, and Mercier was used to translate the English Role Checklist into Spanish. The English and Spanish versions were then evaluated for test-retest reliability at a 2-week interval, using 14 bilingual college students. RESULTS: The intralanguage correlation was .907 for Part I and .798 for Part II. CONCLUSION: A content valid and reliable Spanish version of the Role Checklist was created, using replicable translation methods.

Communication Barriers↗

Using checklists and reminders in clinical pathways to improve hospital inpatient care.

OBJECTIVES: To determine whether the quality of hospital inpatient care can be improved by using checklists and reminders in clinical pathways. DESIGN: Comparison of key indicators before and after the introduction of clinical pathways incorporating daily checklists and reminders of best practice integrated into patient medical records. SETTING AND PARTICIPANTS: The study, at Wimmera Base Hospital in Horsham, Victoria, included patients admitted between 1 January 1999 and 31 December 2002 with ST-elevation acute myocardial infarction (AMI) and patients admitted between 31 July 1999 and 31 December 2002 with stroke. MAIN OUTCOME MEASURES: Compliance with key process measures determined as best practice for each clinical pathway. RESULTS: 116 patients with AMI and 123 patients with stroke were included in the study. ST-elevation AMI. After introducing the clinical pathway program, percentage-point increases for treatment compliance were 21.4% (95% CI, 7.3%-32.7%) for patients receiving aspirin in the emergency department; 42.7% (95% CI, 26.3%-59.0%) for eligible patients receiving beta-blockers within 24 h of admission; 48.1% (95% CI, 31.4%-64.8%) for eligible patients being prescribed beta-blockers on discharge; 43.7% (95% CI, 28.4%-59.1%) for patients having fasting lipid levels measured; and 41.2% (95% CI, 19.0%-63.5%) for eligible patients having lipid therapy. Stroke. After introducing the clinical pathway program, percentage-point increases for treatment compliance were 40.7% (95% CI, 21.0%-60.2%) for dysphagia screening within 24 h of admission; 55.4% (95% CI, 32.9%-77.9%) for patients with ischaemic stroke receiving aspirin or clopidogrel within 24 h of admission; and 52.4% (95% CI, 33.8%-70.9%) for patients having regular neurological observations during the first 48 h after a stroke. There was a fall of 1.0 percentage point (ie, a difference of -1% [95% CI, -4.7% to 10.0%]) in the proportion of patients having a computed tomography brain scan within 24 h of admission. CONCLUSION: Significant improvements in the quality of patient care can be achieved by incorporating checklists and reminders into clinical pathways.

Critical Pathways↗

[Symptomatological patterns of infancy diseases. Presentation of a new Symptom Checklist].

BACKGROUND: Recently it is often very frequent a request of specialist consultation for children with psychic discomfort expressed through somatic complaints and/or behavior disorders. The real meaning of these symptoms in terms of prognosis, is not clear; indeed they can be the first signs of a poor prognosis of developmental disorders or a transient developmental crisis. The objective of this study is the evaluation of a Symptom Checklist as an instrument which allows to point out the somatic complaints and the behavior disorders of Italian children aged less than 48 months and to identify symptoms patterns which label the main neurological and psychiatric diseases in that age. METHODS: The Symptom Checklist has been used transversely in a clinical sample of 30 subjects (24 males and 6 females) aged less than 48 months with developmental linguistic disorder, born prematurely or with a developmental pervasive disorder and in a control sample of 37 children (21 males and 16 females). RESULTS AND CONCLUSIONS: The results obtained, matching every single group to each other and every single group to the control group, identify symptoms pattern (somatic or behavioral) specific for each clinical condition examined; therefore, the clinical utility of Symptom Checklist in pointing out in infancy psychiatric risk cases for a poor prognosis is confirmed.

Age Factors↗

The environmental checklist--a quality assurance tool.

Most people agree that staff productivity and quality of work are influenced by physical surroundings. This awareness usually kindles a desire to implement a plan of action. The environmental checklist can serve as a quality assurance tool to monitor comprehensively the work environment. In our Central Service department, we have seen a number of positive changes as a result of implementing environmental checklists. The efficiency of work performed has increased through appropriately organized and labeled supplies. Positive images of the department have been emphasized and communicated to others. Awareness of and appreciation for the physical surroundings in which we work each day are integral parts of our management routine. Regardless of how large or small your healthcare facility may be, we believe the efficiency and safety of any Central Service operation will be significantly improved through the consistent use of a well-designed environmental checklist. And yes, you will be better prepared for those unexpected visitors and surprise inspections.

Central Supply, Hospital↗

Toward a checklist for reporting of studies of diagnostic accuracy of medical tests.

BACKGROUND: : "Diagnostic accuracy" refers to the ability of medical tests to provide accurate information about diagnosis, prognosis, risk of disease, and other clinical issues. Published reports on diagnostic accuracy of medical tests frequently fail to adhere to minimal clinical epidemiological standards, and such failures lead to overly optimistic assessments of evaluated tests. Our aim was to enumerate key items for inclusion in published reports on diagnostic accuracy, with a related aim of making the reports more useful for systematic reviews. METHODS: : We examined published reports on shortcomings of studies of diagnostic accuracy. We prepared an initial draft of a checklist to address common errors and presented it at a meeting of editors. After incorporation of comments from editors, we published a revised version in Clinical Chemistry in 1997 for comment from readers. One of us (E.M.) additionally circulated copies of the draft to methodologists and others interested in Evidence-Based Medicine. We updated the checklist with input from these sources. RESULTS: : The updated document lists items for inclusion in the title, abstract, methods, results, and discussion sections of published papers. Depending on the nature of the study, the total number of items for a single paper is approximately 40. We invite comments on this document, which is freely available at Clinical Chemistry Online, where it can accessed readily from the Table of Contents for the July 2000 issue at www. clinchem.org/content/vol46/issue7/. Comments (eLetters) can be posted there for general reading. CONCLUSIONS: : The suggested revisions incorporated in this report appear useful to ensure inclusion of additional information that can allow assessment of the validity of the conclusions and the applicability of the study in other settings. The list can be useful in formulating guidelines and a checklist, which will require testing by authors and study of their effect on published studies of diagnostic accuracy.

Clinical Chemistry Tests↗

[A simplified six-item checklist for screening of fragile X syndrome].

OBJECTIVE: To investigate whether a simplified six-item checklist could be developed to improve the screening fragile X syndrome test result. METHODS: Nine clinical characteristics were selected from patient records of 190 male and 18 female pediatrics for fragile X screening test were analyzed. The characteristics included mental retardation, family history of mental retardation, elongated face, large or prominent ears, attention deficit hyperactivity disorder, Autistic-like behavior, simian crease, macroorchidism, and hyperextensible joints. RESULTS: Seven cases were diagnosed with fragile X syndrome by Southern analysis on PCR product. Among the nine characteristics, simian crease, macroorchidism, and hyperextensible joints were eliminated, because of low frequency and statistical insignificance. Using remaining six-item clinical checklist, if a score of 6 or more was used as the criteria for screening fragile X test, about 60% of this test in our cases could have been eliminated clinically without missing any positive cases. Thereby the proportion of case with positive results improved 8.8%. CONCLUSIONS: With our simplified six-item clinical checklist, 60% of testing could have been eliminated clinically, thereby improving the effectiveness of fragile X screening test and promoting the proportion of cases with positive results in two groups.

Adolescent↗

Preventive care checklist form. Evidence-based tool to improve preventive health care during complete health assessment of adults.

PROBLEM ADDRESSED: Preventive care is a cornerstone in the practice of family medicine, but is often difficult to provide because of a lack of time and logistic difficulties. OBJECTIVE OF PROGRAM: To develop an evidence-based practice-relevant preventive care checklist form to be used by family physicians during complete health assessment of adults. PROGRAM DESCRIPTION: Guidelines for preventive health care of adults at average risk from the Canadian Task Force on Preventive Health Care and from other Canadian sources where the Task Force guidelines were not up-to-date were reviewed. Checklist forms covering recommended preventive health care maneuvers were created. The forms incorporate evidence-based preventive care guidelines as well as non-evidence-based components that are a part of routine practice. The forms require few resources to implement, are cost-effective, and are easy to use. The forms list items needed to meet provincial billing requirements for complete health assessments and have space for physicians to make notes. The forms can be used electronically or printed off and photocopied for use in paper-based charts. CONCLUSION: The Preventive Care Checklist Form is a low-cost, easy-to-use tool that merges practice maneuvers with evidence-based recommendations. It could help improve preventive care practices in Canada.

Adult↗

Planning new medical library buildings: an annotated checklist with selected references.

Special attention is paid to several planning essentials for new medical library buildings. These should be covered in the program of requirements that appears as item six on the checklist. The checklist assumes that the decision to build a new medical library has been made and that monies have been allocated for that purpose. References pertaining to the checklist items are provided along with a suggested timetable for achieving each, based on the author's own experiences.

Facility Design and Construction↗

[Polydiagnostic approach to schizophrenia. Validation of a computerized checklist (Diagnostic and Prognostic Scales)].

With a polydiagnostic approach of schizophrenia in mind, the authors present, in french language, a computer-diagnostic instrument, essential for any research at the present time. This includes a 183-item checklist constructed from 14 diagnostic systems for schizophrenia and from Chronic Hallucinatory Psychosis (CHP), a typically french diagnostic entity, not recognized by English-speaking countries which do not individualize it from schizophrenia. This study tested the reliability in interviewing the patients simultaneously by 2 examiners with the checklist. The interrater agreement was excellent (Kappa from 0.75 to 1) for schizophrenic diagnoses under the systems CATEGO, DSM III-R, Feighner, ICD9, Langfeldt, Pull, Schneider and Taylor-Abrams. It was good (Kappa from 0.40 to 0.75) for the 6 other schizophrenic systems, Bleuler (k = 0.52; p > 0.01), Carpenter with a cut-off at 6 (k = 0.52; p < 0.05), ICD10 (k = 0.70; p < 0.01), New-Haven (k = 0.58), RDC (k = 0.59; p < 0.01), Vienne (k = 0.68; p < 0.01), and the Chronic Hallucinatory Psychosis (Pull) (k = 0.71; p < 0.01). The validity of the computer program was tested by the concordance (Cohen's Kappa) between the diagnoses established by a medical examiner and by computer, both obtained from the same collected data (the checklist). The tests show that the concordances were excellent for the 15 diagnoses for schizophrenia and CHP (Kappa form 0.75 to 1) and always above those obtained by the tests of interreliability.

Adult↗

Development of the Children's Communication Checklist (CCC): a method for assessing qualitative aspects of communicative impairment in children.

The Children's Communication Checklist (CCC) was developed to assess aspects of communicative impairment that are not adequately evaluated by contemporary standardised language tests. These are predominantly pragmatic abnormalities seen in social communication, although other qualitative aspects of speech and language were also included. Some items covering social relationships and restricted interests were incorporated, so that the relationship between pragmatic difficulties and other characteristics of pervasive developmental disorders could be explored. Checklist ratings were obtained for 76 children aged 7 to 9 years, all of whom had received special education for language impairment. In 71 cases, 2 raters (usually a teacher and speech-language therapist) independently completed the checklist, making it possible to establish inter-rater reliability. From an initial pool of 93 items, 70 items, grouped into 9 scales, were retained. Five of the subscales were concerned with pragmatic aspects of communication. A composite pragmatic impairment scale formed from these subscales had inter-rater reliability and internal consistency of around .80. This composite discriminated between children with a school diagnosis of semantic-pragmatic disorder and those with other types of specific language impairment (SLI). The majority of children with pragmatic language impairments did not have any evidence of restricted interests or significant difficulties in the domains of social relationships.

Adolescent↗

[Common and specific methodological features of checklists].

As medical aims, diagnosis, prognosis, intervention and prevention benefit from scientific method, although they have specific characteristics requiring distinct types of design and statistical analysis. The present article aims to provide definitions of the common and differential features of checklists for the main study designs. Distinctions are made between statistical inference and decision, systematic and random error, confirmation and exploration, prediction and intervention, observation and experimentation, and random allocation and random selection. In addition, the main tools available to researchers to control random and systematic errors are described. How all of these elements are contained in the main types of design is discussed. Importantly, checklists are not a measure of the quality of a study but rather represent minimum requirements that aim to improve the quality of scientific reports.

Authorship↗

Use of the Pediatric Symptom Checklist to screen for psychosocial problems in pediatric primary care: a national feasibility study.

BACKGROUND: Routine use of a brief psychosocial screening instrument has been proposed as a means of improving recognition, management, and referral of children's psychosocial morbidity in primary care. OBJECTIVE: To assess the feasibility of routine psychosocial screening using the Pediatric Symptom Checklist (PSC) in pediatrics by using a brief version of the checklist in a large sample representative of the full range of pediatric practice settings in the United States and Canada. We evaluated large-scale screening and the performance of the PSC in detecting psychosocial problems by (1) determining whether the prevalence of psychosocial dysfunction identified by the PSC was consistent with findings in previous, smaller samples; (2) assessing whether the prevalence of positive PSC screening scores varied by population subgroups; and (3) determining whether the PSC was completed by a significant proportion of parents from all subgroups and settings. PATIENTS AND METHODS: Twenty-one thousand sixty-five children between the ages of 4 and 15 years were seen in 2 large primary care networks: the Ambulatory Sentinel Practice Network and the Pediatric Research in Office Settings network, involving 395 pediatric and family practice clinicians in 44 states, Puerto Rico, and 4 Canadian provinces. Parents were asked to complete a brief questionnaire that included demographic information, history of mental health services, the 35-item PSC, and the number of pediatric visits within the past 6 months. RESULTS: The overall prevalence rates of psychosocial dysfunction as measured by the PSC in school-aged and preschool-aged pediatric outpatients (13% and 10%, respectively) were nearly identical to the rates that had been reported in several smaller samples (12%-14% among school-aged children and 7%-14% among preschoolers). Consistent with previous findings, children from low-income families were twice as likely to be scored as dysfunctional on the PSC than were children from higher-income families. Similarly, children from single-parent as opposed to those from 2-parent families and children with a past history of mental health services showed an elevated risk of psychosocial impairment. The current study was the first to demonstrate a 50% increase in risk of impairment for male children. The overall rate of completed forms was 97%, well within an acceptable range, and at least 94% of the parents in each sociodemographic subgroup completed the PSC form. CONCLUSIONS: Use of the PSC offers an approach to the recognition of psychosocial dysfunction that is sufficiently consistent across groups and locales to become part of comprehensive pediatric care in virtually all outpatient settings. In addition to its clinical utility, the consistency and widespread acceptability of the PSC make it well suited for the next generation of pediatric mental health services research, which can address whether earlier recognition of and intervention for psychosocial problems in pediatrics will lead to cost-effective outcomes.

Adolescent↗

Use of the Pediatric Symptom Checklist in a low-income, Mexican American population.

OBJECTIVE: To evaluate the usefulness of the Pediatric Symptom Checklist (PSC) in identifying behavioral problems in low-income, Mexican American children. DESIGN: A cross-sectional study design was used to examine the PSC as a screening test, with the Child Behavior Checklist (CBCL) as the criterion standard. SETTING: The study was conducted at a health center in a diverse low-income community. Patients Eligible patients were children and adolescents, 4 to 16 years of age, who were seen for nonemergent, well-child care. Of 253 eligible children during a 9-month study period, 210 agreed to participate in the study. There was a 100% completion rate of the questionnaires. The average age of the children was 7.5 years, and 45% were female. Ninety-five percent of patients were of Hispanic descent (Mexican American); 86% of families spoke only Spanish. Socioeconomic status was low (more than three fourths of families earned <$20 000 annually). RESULTS: The CBCL Total scale determined that 27 (13%) of the children had clinical levels of behavioral problems. With a cutoff score of 24, the PSC screened 2 (1%) of the 210 children as positive for behavioral problems. Using the CBCL as the criterion standard, the PSC sensitivity was 7.4%, and the specificity was 100%. Receiver operator characteristic analysis determined that a PSC cutoff score of 12 most correctly classified children with and without behavioral problems (sensitivity, 0.74; specificity, 0.94). CONCLUSIONS: When using the PSC, a new cutoff score of 12 for clinical significance should be considered if screening low-income, Mexican American children for behavioral problems. Additional study is indicated to determine the causes of the PSC's apparently lower sensitivity in Mexican American populations.

Adolescent↗

The measurement of psychological states by use of factors derived from a combination of items from mood and symptom checklists.

The similarities in structure and usage of two widely used adjective checklists, the Profile of Mood States (POMS) and Symptom Checklist (SCL), suggested the feasibility of pooling the items from the two scales into a single factor analysis. This procedure was clinically appealing, statistically sound, and provided an efficient method to reduce and refine assessments of psychopathology. Data from 413 Miami Symptomatic Volunteers were used in this factor analysis. Nine factor dimensions were found to meet the dual criteria of statistical salience and clinical meaningfulness. The results demonstrated the factorial stability of the SCL and the POMS and identified the dimensions of psychopathology in which items from the two scales tended to complement each other in factor structure. Some factors were found to be unique to each scale. In addition, it was found that pooling the items from both scales yielded two new factor dimensions that were not previously available from either of the individual scales.

Adult↗