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PubMed1997

Improving cardiopulmonary resuscitation skills retention: effect of two checklists designed to prompt correct performance.

Previous research has shown that regardless of an individual's experience, life support skills such as cardiopulmonary resuscitation (CPR) are poorly performed as soon as 1 month following training. The purpose of this study was to compare the effects of two checklists designed to prompt correct CPR performance. We compared the performance of 169 undergraduate students, at the time of course assessment, with retention testing that occurred 2 months following the course assessment. Students were randomly assigned to a control group, a short version of a CPR checklist and a longer more detailed version. Two groups of variables were created: procedural and compression-ventilation variables. In addition, an overall-performance variable was created, summarizing performance on the procedural variables. Binary variables were assessed with chi 2-tests of independence. One-way ANOVAs, using 'group' as the between-subjects factor, were used to assess each continuous variable. Comparisons between groups yielded significant differences of P < 0.05. The long checklist generally led to superior performance on the procedural variables. The results support the hypothesis that remembering the steps of CPR is too complex for some. Though preliminary, the findings of this study indicate that the detailed checklist was an effective strategy to improve the post-course performance of CPR.

Cardiopulmonary Resuscitation↗
PubMed2001

Parent and teacher report of pragmatic aspects of communication: use of the children's communication checklist in a clinical setting.

The Children's Communication Checklist (CCC) was developed to provide an objective assessment of pragmatic aspects of children's communication difficulties. We aimed to (1) see whether the checklist provided valid and reliable information when completed by parents, and (2) consider its usefulness in a clinical context. Checklists were completed by parents and a professional who knew the child well for all 5 to 17-year-old referrals to a tertiary developmental paediatrics centre over a 31-month period. Children who were not yet speaking in sentences were excluded. From a sample of 151 children (81% male; mean age 8.7 years) with pervasive or specific developmental disorders, valid checklists were completed by 119 parents and 93 professionals. Reliability, as measured by internal consistency, was 0.7 or higher for most scales. Correlations between ratings for parents and professionals were in the range of 0.30 to 0.58 for individual pragmatic scales, with a correlation of 0.46 (n=82) for the pragmatic composite. For both parents and professionals, the pragmatic composite was lowest for children with a diagnosis of autism; intermediate for those with a diagnosis of Asperger syndrome, pervasive developmental disorder not otherwise specified or attention-deficit-hyperactivity disorder (ADHD); and highest for those with a diagnosis of specific learning disability. The strongest relation between the pragmatic composite and diagnosis was seen when ratings from parents and professionals were combined. Differences between diagnostic groups were not explicable in terms of age or verbal IQ.

Adolescent↗
PubMed1991

Problems of recall and misclassification with checklist methods of measuring stressful life events.

The prevalent use of life event category checklists to facilitate event recall may be one reason that previous studies find that life events play only a small and ambiguous role in the development of health problems. In this study, 136 persons with temporomandibular pain disorder syndrome (TMPDS) and 131 healthy controls reported the occurrence of life events in 10 monthly interviews, using an event category checklist. At the end of the study, they reported retrospectively and in detail about life events over the previous monthly periods. Only one quarter of the event categories appeared in both the monthly interviews and retrospective report for the same period. Detailed analyses revealed problems of inaccuracy inherent in checklists that exacerbate problems of recall. The findings indicate that checklist category approaches should not be used when the goal is to understand the role of stress in adverse health outcomes. Suggestions are made about more adequate methods.

Facial Pain↗
PubMedDate not supplied

A checklist for retrospective database studies--report of the ISPOR Task Force on Retrospective Databases.

INTRODUCTION: Health-related retrospective databases, in particular claims databases, continue to be an important data source for outcomes research. However, retrospective databases pose a series of methodological challenges, some of which are unique to this data source. METHODS: In an effort to assist decision makers in evaluating the quality of published studies that use health-related retrospective databases, a checklist was developed that focuses on issues that are unique to database studies or are particularly problematic in database research. This checklist was developed primarily for the commonly used medical claims or encounter-based databases but could potentially be used to assess retrospective studies that employ other types of databases, such as disease registries and national survey data. RESULTS: Written in the form of 27 questions, the checklist can be used to guide decision makers as they consider the database, the study methodology, and the study conclusions. Checklist questions cover a wide range of issues, including relevance, reliability and validity, data linkages, eligibility determination, research design, treatment effects, sample selection, censoring, variable definitions, resource valuation, statistical analysis, generalizability, and data interpretation. CONCLUSIONS: For many of the questions, key references are provided as a resource for those who want to further examine a particular issue.

Data Interpretation, Statistical↗
PubMed2002

Relationships between nutrition screening checklists and the health and well-being of older Australian women.

OBJECTIVES: To examine associations between nutrition screening checklists and the health of older women. DESIGN: Cross-sectional postal survey including measures of health and health service utilisation. as well as the Australian Nutrition Screening Initiative (ANSI), adapted from the Nutrition Screening Initiative (NSI). SETTING: Australia, 1996. SUBJECTS: In total, 12,939 women aged 70-75 years randomly selected as part of the Australian Longitudinal Study on Women's Health. RESULTS: Responses to individual items in the ANSI checklist, and ANSI and NSI scores, were associated with measures of health and health service utilisation. Women with high ANSI and NSI scores had poorer physical and mental health, higher health care utilisation and were less likely to be in the acceptable weight range. The performance of an unweighted score (TSI) was also examined and showed similar results. Whereas ANSI classified 30% of the women as 'high-risk', only 13% and 12% were classified as 'high-risk' by the NSI and TSI, respectively. However, for identifying women with body mass index outside the acceptable range, sensitivity, specificity and positive predictive values for all of these checklists were less than 60%. CONCLUSIONS: Higher scores on both the ANSI and NSI are associated with poorer health. The simpler unweighted method of scoring the ANSI (TSI) showed better discrimination for the identification of 'at risk' women than the weighted ANSI method. The predictive value of individual items and the checklist scores need to be examined longitudinally.

Aged↗
PubMed2004

Identification of the most common patient problems in patients with chronic conditions using the ICF checklist.

OBJECTIVE: To identify the most common patient problems in patients with 12 different chronic conditions using the ICF checklist. METHODS: A multi-centre, cross-sectional study with convenient samples of patients who had received a clinical diagnosis of any of 12 different chronic conditions undergoing inpatient or outpatient rehabilitation. To describe the population, age, gender, and the SF-36 were recorded. Data for 917 patients from 33 rehabilitation centres were analysed. RESULTS: Most of the ICF-checklist categories were common to at least 1 condition. Pain was the sole category of 125 ICF-checklist categories that was common to all chronic conditions. Patients with low back pain, rheumatoid arthritis, and diabetes mellitus did not often experience the problems listed in the ICF-checklist. CONCLUSION: The main finding, that in most conditions categories from each component were common, underscores the need to address all components when assessing functioning and health in patients with chronic conditions.

Activities of Daily Living↗
PubMed2003

Employing parent, teacher, and youth self-report checklists in identifying pediatric bipolar spectrum disorders: an examination of diagnostic accuracy and clinical utility.

The diagnosis of bipolar spectrum disorders (BPSD) is difficult to evaluate in child and adolescent populations. The current study examines whether commonly used behavior checklists- the Child Behavior Checklist, Teacher Report Form, and the Youth Self-Report form-are clinically useful in making a differential diagnosis between BPSD and other disorders. This study is the first to investigate the validity of integrating pairs of informants using these instruments to differentiate individuals with BPSD from those with disruptive behavior disorders, major depressive disorder, and any child or adolescent not meeting criteria for BPSD. Parent report best predicted diagnostic status, yet diagnostic efficiency statistics associated with these checklists were relatively poor. Results indicate that the Child Behavior Checklist has limited utility when attempting to derive clinically meaningful information about the presentation of juvenile BPSD.

Adolescent↗
PubMed1999

OSCE checklists do not capture increasing levels of expertise.

PURPOSE: To evaluate the effectiveness of binary content checklists in measuring increasing levels of clinical competence. METHOD: Fourteen clinical clerks, 14 family practice residents, and 14 family physicians participated in two 15-minute standardized patient interviews. An examiner rated each participant's performance using a binary content checklist and a global process rating. The participants provided a diagnosis two minutes into and at the end of the interview. RESULTS: On global scales, the experienced clinicians scored significantly better than did the residents and clerks, but on checklists, the experienced clinicians scored significantly worse than did the residents and clerks. Diagnostic accuracy increased for all groups between the two-minute and 15-minute marks without significant differences between the groups. CONCLUSION: These findings are consistent with the hypothesis that binary checklists may not be valid measures of increasing clinical competence.

Analysis of Variance↗
PubMed2006

Beyond the checklist: assessing understanding for HIV vaccine trial participation in South Africa.

OBJECTIVES: Informed consent and understanding are essential ethical requirements for clinical trial participation. Traditional binary measures of understanding may be limited and not be the best measures of level of understanding. This study designed and compared 4 measures of understanding for potential participants being prepared for enrollment in South African HIV vaccine trials, using detailed operational scoring criteria. METHODS: Assessment of understanding of 7 key trial components was compared via self-report, checklist, vignettes, and narrative measures. Fifty-nine participants, including members of vaccine preparedness groups and 1 HIV vaccine trial, took part. RESULTS: There were significant differences across the measures for understanding of 5 components and for overall understanding. Highest scores were obtained on self-report and checklist measures, and lowest scores were obtained for vignettes and narrative descriptions. CONCLUSIONS: The findings suggest that levels of measured understanding are dependent on the tools used. Forced-choice measures like checklists tend to yield higher scores than open-ended measures like narratives or vignettes. Consideration should be given to complementing checklists and self-reports with open-ended measures, particularly for critical trial concepts, where the consequences of misunderstanding are potentially severe.

AIDS Vaccines↗
PubMed1992

The use of a checklist for anaesthetic machines.

The use of the Association of Anaesthetists of Great Britain and Ireland checklist for anaesthetic machines, based on an oxygen analyser, was surveyed over a 5-week period in a teaching hospital. Fifty-five completed checklists were analysed; no problems developed during anaesthesia which were missed by the checklist. The mean time taken to complete the checklist for one machine was 8.9 min with a range of 5 to 19 min; for two consecutive machines it was 18.25 min with a range of 10 to 30 min. The most frequent faults detected were the poor reliability of some oxygen analysers, absent ventilator disconnection alarms, and absent oxygen supply failure alarms on some older machines. Faults were found in 60% of the machines checked; 18% of these were deemed to be serious.

Anesthesiology↗
PubMed2006

Three-point checklist of dermoscopy: an open internet study.

BACKGROUND: In a pilot study, the three-point checklist of dermoscopy has been shown to represent a valid and reproducible tool with high sensitivity for the diagnosis of skin cancer in the hands of a small group of nonexperts. OBJECTIVES: To re-evaluate these preliminary results in a large number of observers independently from their profession and expertise in dermoscopy. METHODS: The study was conducted via the internet to provide worldwide access for participants. After a short web-based tutorial, the participants evaluated dermoscopic images of 165 (116 benign and 49 malignant) skin lesions (15 training and 150 test lesions). For each lesion participants scored the presence of the three-point checklist criteria (asymmetry, atypical network and blue-white structures). Kappa values, odds ratios, sensitivity, specificity and likelihood ratios were estimated. RESULTS: Overall, 150 participants joined the study. The three-point checklist showed good interobserver reproducibility (kappa value: 0.53). Sensitivity for skin cancer (melanoma and basal cell carcinoma) was 91.0% and this value remained basically uninfluenced by the observers' professional profile. Only 20 participants lacking any experience in dermoscopy performed significantly more poorly, but the sensitivity was still remarkably high (86.7%) when considering that they were untrained novices in dermoscopy. The specificity was 71.9% and was significantly influenced by the profession, with dermatologists performing best. CONCLUSIONS: Our study confirms that the three-point checklist is a feasible, simple, accurate and reproducible skin cancer screening tool.

Basal Cell Carcinoma↗
PubMed2004

Motor performance checklist for 5-year-olds: a tool for identifying children at risk of developmental co-ordination disorder.

OBJECTIVE: The aim of this study was to further evaluate the 'Motor Performance Checklist for 5-year-olds', an instrument which had been piloted with some success and reported via this journal in 1996. METHOD: Both validity and reliability in identifying children in most need of paediatric occupational therapy services was assessed. The Motor Performance Checklist was compared against a chosen 'gold standard' test, The Bruininks-Oseretsky test of Motor Proficiency, in a group of 141 5-year-old children. RESULTS: Correlations of 0.72 and 0.85 were found between the tests. The checklist was found to have a sensitivity of 83% and a specificity of 98%. Positive predictive validity was found to be 72% and negative predictive validity 99%. Interrater reliability ranged between 0.79 and 0.99 and intrarater reliability was 0.77. CONCLUSIONS: These results indicate that the Motor Performance Checklist has the potential to assist in identifying children in most need of referral to community occupational therapy services.

Child, Preschool↗
PubMed2005

Ruling out pregnancy among family planning clients: the impact of a checklist in three countries.

Women in many countries are often denied vital family planning services if they are not menstruating when they present at clinics, for fear that they might be pregnant. A simple checklist based on criteria approved by the World Health Organization has been developed to help providers rule out pregnancy among such clients, but its use is not yet widespread. Researchers in Guatemala, Mali, and Senegal conducted operations research to determine whether a simple, replicable introduction of this checklist improved access to contraceptive services by reducing the proportion of clients denied services. From 2001 to 2003, sociodemographic and service data were collectedfrom 4,823 women from 16 clinics in three countries. In each clinic, data were collected prior to introduction of the checklist and again three to six weeks after the intervention. Among new family planning clients, denial of the desired method due to menstrual status decreased significantly from 16 percent to 2 percent in Guatemala and from 11 percent to 6 percent in Senegal. Multivariate analyses and bivariate analyses of changes within subgroups of nonmenstruating clients confirmed and reinforced these statistically significant findings. In Mali, denial rates were essentially unchanged, but they were low from the start. Where denial of services to nonmenstruating family planning clients was a problem, introduction of the pregnancy checklist significantly reduced denial rates. This simple, inexpensive job aid improves women's access to essential family planning services.

Adult↗
PubMed2004

Three-point checklist of dermoscopy. A new screening method for early detection of melanoma.

BACKGROUND: Dermoscopy used by experts has been demonstrated to improve the diagnostic accuracy for melanoma. However, little is known about the diagnostic validity of dermoscopy when used by nonexperts. OBJECTIVE: To evaluate the diagnostic performance of nonexperts using a new 3-point checklist based on a simplified dermoscopic pattern analysis. METHODS: Clinical and dermoscopic images of 231 clinically equivocal and histopathologically proven pigmented skin lesions were examined by 6 nonexperts and 1 expert in dermoscopy. For each lesion the nonexperts assessed 3 dermoscopic criteria (asymmetry, atypical network and blue-white structures) constituting the 3-point method. In addition, all examiners made an overall diagnosis by using standard pattern analysis of dermoscopy. RESULTS: Asymmetry, atypical network and blue-white structures were shown to be reproducible dermoscopic criteria, with a kappa value ranging from 0.52 to 0.55. When making the overall diagnosis, the expert had 89.6% sensitivity for malignant lesions (tested on 68 melanomas and 9 pigmented basal cell carcinomas), compared to 69.7% sensitivity achieved by the nonexperts. Remarkably, the sensitivity of the nonexperts using the 3-point checklist reached 96.3%. The specificity of the expert using overall diagnosis was 94.2% compared to 82.8 and 32.8% achieved by the nonexperts using overall diagnosis and 3-point checklist, respectively. CONCLUSION: The 3-point checklist is a valid and reproducible dermoscopic algorithm with high sensitivity for the diagnosis of melanoma in the hands of non-experts. Thus it may be applied as a screening procedure for the early detection of melanoma.

Adult↗
PubMed1975

Criteria for psychiatric hospitalization: experience with a checklist for chart review.

The authors report their experience with a 12-item checklist used to score need for hospitalization. The checklist was filled in and scored by research assistants who reviewed the charts of 100 hospitalized and 50 nonhospitalized patients. A written opinion of a senior clinical consultant was available for hospitalized patients whose charts were rated low in need for hospitalization and for nonhospitalized patients whose charts were rated high. The checklist scores differentiated the two groups of patients. The authors can conclude that the checklist can be a valuable tool in a review process that culminates in review by an experienced clinician.

Connecticut↗
PubMed1991

A checklist of hospitalization criteria for use with children.

Each year in the U.S. more than 130,000 children are hospitalized for psychiatric reasons. The decision to hospitalize a child is based on a complex set of factors. In this study, a 12-item checklist of criteria for hospitalization adapted by the authors was tested for its ability to predict hospitalization in a cohort of 389 children between the ages of two and 12 who were evaluated for either inpatient or outpatient treatment. Eighty-seven (22 percent) of the children were subsequently hospitalized. In 95 percent of the cases, the checklist was able to correctly predict whether the patient was hospitalized. A shorter checklist of six items was also able to predict the subsequent form of treatment in 95 percent of the cases. Although such checklists cannot take the place of informed clinical decisions, they can serve as a guide to decision making, especially for inexperienced mental health workers, and as a tool for utilization review when treatment decisions are questioned.

Child↗
PubMed2000

Development and validation of the workshop behavior checklist: a scale for assessing work performance of people with severe mental illness.

The Workshop Behavior Checklist is a standardized assessment instrument to assess the work performance of people with severe mental illness using the situational assessment approach. It is modified from the Behavior Identification Form developed by the Material Development Center. The modification process was conducted by enlisting input from mental health professionals (n = 150) and potential employers of discharged patients with mental illness (n = 31) by questionnaires specially designed for this purpose. The results of these questionnaires were then analyzed by an expert panel consisting of 10 therapists and one psychiatrist working in relevant fields. Altogether 14 items in general behaviors, vocational behaviors, and social behaviors were selected. In addition, a new version of the checklist together with its rating guidelines were designed. Exploratory factor analysis (n = 112) shows that all 14 items fit well into a four-factor model explaining 67.2% of total variance, which is in line with the original design of the revised checklist. Cronbach alpha analysis shows that the revised checklist has acceptable to very good internal consistency (.51 to .84) and intraclass correlation coefficients indicate that it has good to excellent inter-rater (.57 to .81) and test-retest (.86 to .94) reliability. Clinical implications and further research are discussed.

Adolescent↗
PubMedDate not supplied

The effect of physician feedback and an action checklist on diabetes care measures.

The objective was to evaluate whether physician feedback accompanied by an action checklist improved diabetes care process measures. Eighty-three physicians in an academic general medicine clinic were provided a single feedback report on the most recent date and result of diabetes care measures (glycosylated hemoglobin [A1c], urine microalbumin, serum creatinine, lipid levels, retinal examination) as well as recent diabetes medication refills with calculated dosing and adherence on 789 patients. An educational session regarding the feedback and adherence information was provided. The physicians were asked to complete a checklist accompanying the feedback on each of their patients, indicating requested actions with respect to follow-up, testing, and counseling. The physicians completed 82% of patient checklists, requesting actions consistent with patient needs on the basis of the feedback. Of the physicians, 93% felt the patient information and intervention format to be useful. The odds of urine microalbumin testing, serum creatinine, lipid profile, A1c, and retinal examination increased in the 6 months after the feedback. The increase was sustained at 1 year only for microalbumin and retinal exams. There was no significant change in refill adherence for the group overall after the feedback, although adherence did improve among patients of physicians attending the educational session. No significant change was noted in lipid or A1c levels during the study period. In conclusion, a simple physician feedback tool with action checklist can be both helpful and popular for improving rates of diabetes care guideline adherence. More complex interventions are likely required to improve diabetes outcomes.

Adult↗