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PubMed2004

The interview mode effect on the Center for Epidemiological Studies Depression (CES-D) scale: an item response theory analysis.

BACKGROUND: Evidence of a mode effect has raised concerns about the comparability and validity of self- versus interviewer-administered versions of the Center for Epidemiological Studies Depression (CES-D) scale. Response anonymity has been proposed to explain this effect. However, the factors that contribute to this mode effect are not well understood. We used item response theory (IRT) to examine the nature of the CES-D mode effect. METHODS: A sample of depressed primary care patients from the Partners-in-Care Study were randomized to receive either a phone interview (N=139) or a mail survey (N=139) of the CES-D. We used likelihood ratio tests to identify differentially functioning items in the 2 groups. Category response curves are used to describe these effects. RESULTS: Twelve items manifested differential functioning. Category response curves consistently indicate that phone respondents had a lower probability of endorsing the third of 4 response categories than mail respondents, suggesting a possible cognitive effect. CONCLUSION: Although response anonymity could be important in mode effects observed in surveys of sensitive topics, cognitive factors appear more important to the mode effect in the CES-D.

Adult↗

PubMed1999

Quantitative trait loci associated with short-term intake of sucrose, saccharin and quinine solutions in laboratory mice.

The goal of this study was simultaneously to map two genetic loci which, collectively, have a large effect on intake of sucrose, saccharin and quinine solutions in mice. These loci had been previously identified using long-term measurements with the traditional two-bottle test, but the present study used a short-term, one-bottle test. Intake of distilled water, 100 mM sucrose, 10 mM sodium saccharin and 1.1 mM quinine HCl over 6 h was measured on two occasions from a non-deprived group of 61 male and 72 female F2 mice derived from a cross of the C57BL/6J and DBA/2J mouse strains and used to detect quantitative trait loci (QTL). DNA from each animal was typed for polymorphisms in anonymous microsatellite markers on mouse chromosomes 4 and 6. Saccharin and sucrose relevant QTL were detected on distal chromosome 4 and a quinine relevant QTL was detected on medial/distal chromosome 6 in the region of Prp. The location of these QTL and the proportion of phenotypic variance they accounted for were similar to those arrived at following previous determinations using the two-bottle test. Measurement stability for the three gustatory phenotypes was high, product-moment correlation coefficients between first and second determinations varying between approximately 0.80 for sucrose and saccharin and 0.73 for quinine. QTL parameters assessed independently for first and second presentations of sucrose and saccharin were stable, but the location of the quinine QTL differed between presentations. The present experiment illustrates the utility of a 6 h fluid intake test in the mapping of Sac and Qui loci. The short duration of the test provides a simple means of measuring variation in gustatory processes and the discovery that these loci influence short-term as well as long-term fluid intake extends understanding of the mechanism of gene action.

Analysis of Variance↗

PubMed2001

Factors affecting fellowship satisfaction among gynecologic oncology fellows.

OBJECTIVE: The objective of this study was to determine fellowship satisfaction through a survey of gynecologic oncology fellows. METHODS: A survey was sent to all gynecologic oncology fellows in May 1998. Surveys were returned anonymously and confidentially. The questions focused on demographics, research and clinical experience, education, faculty involvement, future plans, and fellowship satisfaction. Association between variables were studied using chi(2) and two-tailed t tests. RESULTS: Of the surveys 53.8% were returned. Reputation, faculty, and clinical diversity were ranked the top three reasons for choosing a fellowship program. Eighty-seven and three-tenths percent were satisfied and 89.1% would recommend their fellowship. Fellows listed the two areas they were most satisfied with as surgical training and research support. Seventy-nine and four-tenths percent agreed they spent adequate time in the operating room and 94.1% had enough variety. Sixty percent or more of the clinical fellows felt they would be uncomfortable performing vaginal radical hysterectomies, splenectomies, radical vaginectomies, laparoscopic lymph node dissection (LND), scalene LND, skin grafts, creation of neovagina, tram flaps, and ureterovaginal fistula repairs by the end of their fellowship. Of the fellows surveyed, 94.7% were currently performing research. All believed they would finish their thesis by the end of their training. Thirty percent of fellows from Gynecologic Oncology Group institutions were not required to participate in their research trials. Among the clinical fellows 62.2% thought time for self-education was lacking compared with 35.3% of the research fellows, P = 0.07. The two areas fellows were least satisfied with were didactics and lack of time for other pursuits. Performance evaluations were received by 72.2%; however, evaluations of the program and of the attending staff occurred in only 51.3 and 34.0%, respectively. Sixty-seven and three-tenths percent stated they had a mentor and 34.0% an advisor. Fellows that did not have mentors or advisors thought they spent less time with faculty in educational pursuits (P = 0.03, 0.06). CONCLUSION: Areas that could improve fellowship satisfaction include formal didactics and time for self-education. Evaluations of the fellowship and faculty could provide a forum to continue to assess their needs. Requiring a more active role of fellows in research trials may prove to increase research productivity in the future.

Adult↗

PubMed1995

Relationships between motivation and depression in chronic marijuana users.

The "amotivational syndrome" which has been associated with marijuana use has not been examined systematically in relation to marijuana use and mental health. Light and heavy users were solicited by personal contact. They were asked to complete anonymous questionnaires which measured marijuana, alcohol and cocaine use, perceived states during marijuana intoxication, depressive symptoms in the last year, the Orientation to Life Scale and a modified form of the Thematic Apperception Test, from which Need for Achievement, Affiliation and Power were assessed. Several group comparisons were made: Chronic heavy-users (medians: daily use for 6 years) with and without significant symptoms of depression within the last year were compared with Light users (medians: several times per month for 4.5 years) with and without significant symptoms of depression within the last year. Subjects in all groups reported similar ratings of intoxication (being stoned) during marijuana use. No differences were found in alcohol or cocaine use among the comparison groups. Scores on Need for Achievement were significantly lower in heavy users with depressive symptoms when compared with all other groups. No effects were found among groups in measures of the Need for Affiliation and the Need for Power. Both light and heavy users with symptoms of depression had significantly lower scores than those without depressive symptoms, on the overall Orientation to Life questionnaire and on each subscale measuring Meaningfulness, Manageability and Comprehensibility. These data suggest that amotivational symptoms observed in heavy marijuana users in treatment are due to depression.

Adult↗

PubMed1990

A genetic map of mouse chromosome 1 near the Lsh-Ity-Bcg disease resistance locus.

Isozyme and restriction fragment length polymorphism (RFLP) analyses of backcross progeny, recombinant inbred strains, and congenic strains of mice positioned eight genetic markers with respect to the Lsh-Ity-Bcg disease resistance locus. Allelic isoforms of Idh-1 and Pep-3 and RFLPs detected by Southern hybridization for Myl-1, Cryg, Vil, Achrg, bcl-2, and Ren-1,2, between BALB/cAnPt and DBA/2NPt mice, were utilized to examine the cosegregation of these markers with the Lsh-Ity-Bcg resistance phenotype in 103 backcross progeny. An additional 47 backcross progeny from a cross between C57BL/10ScSn and B10.L-Lshr/s mice were examined for the cosegregation of Myl-1 and Vil RFLPs with Lsh phenotypic differences. Similarly, BXD recombinant inbred strains were typed for RFLPs upon hybridization with Vil and Achrg. Recombination frequencies generated in the different test systems were statistically similar, and villin (Vil) was identified as the molecular marker closest (1.7 +/- 0.8 cM) to the Lsh-Ity-Bcg locus. Two other DNA sequences, nebulin (Neb) and an anonymous DNA fragment (D2S3), which map to a region of human chromosome 2q that is homologous to proximal mouse chromosome 1, were not closely linked to the Lsh-Ity-Bcg locus. This multipoint linkage analysis of chromosome 1 surrounding the Lsh-Ity-Bcg locus provides a basis for the eventual isolation of the disease gene.

Animals↗

PubMed2006

Anabolic steroid abuse among teenage girls: an illusory problem?

BACKGROUND: Recent media reports have portrayed an alarming increase in apparent anabolic-androgenic steroid (AAS) use among American teenage girls; Congress even held hearings on the subject in June 2005. We questioned whether AAS use among teenage girls was as widespread as claimed. METHODS: We reviewed four large national surveys and many smaller surveys examining the prevalence of AAS use among teenage girls. Virtually all of these surveys used anonymous questionnaires. We asked particularly whether the language of survey questions might generate false-positive responses among girls who misinterpreted the term "steroid." We also reviewed data from other countries, together with results from the only recent study (to our knowledge) in which investigators personally interviewed female AAS users. RESULTS: The surveys produced remarkably disparate findings, with the lifetime prevalence of AAS use estimated as high as 7.3% among ninth-grade girls in one study, but only 0.1% among teenage girls in several others. Upon examining the surveys reporting an elevated prevalence, it appeared that most used questions that failed to distinguish between anabolic steroids, corticosteroids, and over-the-counter supplements that respondents might confuse with "steroids." Other features in the phrasing of certain questions also seemed likely to further bias results in favor of false-positive responses. CONCLUSIONS: Many anonymous surveys, using imprecise questions, appear to have greatly overestimated the lifetime prevalence of AAS use among teenage girls; the true lifetime prevalence may well be as low as 0.1%. Future studies can test this impression by using a carefully phrased question regarding AAS use.

Adolescent↗

PubMed2005

The New Zealand national immunisation hotline--what are callers seeking?

This study aimed to conduct quantitative and qualitative analyses of anonymous data from an immunisation hotline call centre over equal periods in 1999 and 2003. Transcripts for all telephone calls in two periods were analysed using thematic and descriptive statistical analyses and significance testing of comparisons made between data from the two periods. Caller numbers increased from 1010 in 1999 to 3413 in 2003. There was a significant increase in service utilisation by both the public (mostly parents) and health professionals, especially by general practice nurses. The nature of the enquiries shifted according to schedule changes and media stories. Findings are discussed in the context of prominent issues at that time, and suggestions are made for improving communication to meet the needs of both the public and health professionals.

Attitude to Health↗

PubMed1997

Plasmodium falciparum malaria transmitted in hospital through heparin locks.

BACKGROUND: After a community investigation had implicated hospital admission as a shared feature of a cluster of acute Plasmodium falciparum malaria (AFM) cases in Riyadh, Saudi Arabia, we began an in-hospital investigation to determine the method of transmission. METHODS: We investigated all AFM patients admitted to one paediatric hospital for any reason from December, 1991, to April, 1992. We classified AFM as locally acquired (LAFM) if during the month before AFM onset the patient had not visited a malarious area, and as hospital acquired (HAFM) if the LAFM patient had been admitted to hospital during that month. We compared exposures of HAFM cases with those of other patients sampled from the same wards. We observed nursing practices and investigated by anonymous questionnaire how nurses administered parenteral drugs. FINDINGS: Of 21 LAFM cases, 20 (95%) had a previous hospital admission (exposure admission) compared with 15 (25%) of 61 other patients (p < 0.001; chi 2 test). During the exposure admission, all HAFM patients had occupied the same room as, or a room adjacent to, an AFM patient; 14 (23%) of 60 other patients occupied the same room or rooms adjacent to an AFM patient (p < 0.001, chi 2). 90% of HAFM patients received infusions through a heparin lock during the exposure admission, compared with 49% of 120 general patients (p < 0.001, chi 2). 10% of nurses admitted to using one syringe for more than one heparin lock and 50% filled syringes with enough heparin for three to ten heparin locks. INTERPRETATION: P falciparum was transmitted between patients when single syringes were used on heparin locks of sequential patients. This practice would easily transmit other blood-borne agents.

Catheters, Indwelling↗

PubMed2003

Self-help for substance-use disorders: history, effectiveness, knowledge gaps, and research opportunities.

Scientific evidence suggests substance-use disorder (SUD)-focused self-help group involvement is a helpful adjunct to SUD treatment, yet significant knowledge gaps remain. The principal aim of this review is to highlight areas of knowledge deficit and their implications for research and practice. To accomplish this, evidence regarding whether self-help group involvement is effective, for whom, and why, is reviewed. The appropriateness of self-help groups for certain subpopulations is considered with respect to psychiatric comorbidity, religious orientation, gender, and age. An increasingly rigorous body of evidence suggests consistent benefits of self-help group involvement. Regarding subpopulations, current evidence suggests non- or less-religious individuals benefit as much from self-help groups as more religious individuals and women become as involved and benefit as much as men. However, participation in, and effects from, traditional self-help groups for dually diagnosed patients may be moderated by type of psychiatric comorbidity. Some youth appear to benefit, but remain largely unstudied. Dropout and nonattendance rates are high, despite clinical recommendations to attend. Clinicians can significantly influence the effectiveness of self-help, but optimal methods and duration of facilitation efforts need testing. Greater understanding of the reasons why many do not attend or drop out would benefit facilitation efforts.

Alcoholics Anonymous↗

PubMed1993

HIV infection in injecting drug users attending centres in England and Wales, 1990-1991.

OBJECTIVE: To monitor trends in HIV infection and associated risk behaviours in injecting drug users (IDU) in England and Wales. DESIGN: Ongoing voluntary unlinked anonymous cross-sectional survey. METHOD: IDU attending centres in 1990 and 1991 were invited to complete a brief questionnaire requesting demographic and behavioural information, and to provide a saliva sample to be tested for antibodies to HIV and to the core antigen of hepatitis B virus (HBV). RESULTS: In 1990, 1.2% (19 out of 1543) of samples from 33 centres, and in 1991 1.8% (25 out of 1417) of samples from 37 centres contained antibody to HIV. Antibody t9 HBV core-antigen was found in 33 and 31% of IDU in 1990 and 1991, respectively. The prevalence of HIV infection in IDU attending centres in London (4.2%) was higher than in those attending centres elsewhere (0.8%). The prevalence of HIV infection in 1991 varied between individual centres from 0 to 10.6%, and at many centres outside London no IDU were infected with HIV. In the same year the prevalence of past infection with HBV varied from 14 to 54%, and IDU who had evidence of HBV infection were found among attenders in nearly all centres. The prevalences of sharing injecting equipment and risky sexual behaviour were high at many centres. The prevalence of HIV infection was higher in IDU who had started to inject in 1985 or earlier, than in those who started injecting later. In each year, approximately half the IDU surveyed reported having had a voluntary confidential HIV-antibody test, and the prevalence of HIV infection was five times higher in those tested than in those who had not been tested. CONCLUSIONS: HIV prevalence in IDU attending centres in England and Wales was low in 1990-1991. There is some indication that IDU have modified their injecting or sexual behaviour, but even at existing reduced levels of risk behaviour, transmission can occur in HIV is introduced into previously unexposed groups.

Adolescent↗

PubMed2004

Application of Maastricht 2-2000 guidelines for the management of Helicobacter pylori among specialists and primary care physicians in israel: are we missing the malignant potential of Helicobacter pylori?

BACKGROUND: The Maastricht 2-2000 guidelines on the current management of Helicobacter pylori infection were recently adopted by the Israeli Gastroenterological Association. GOAL: To determine the impact of these clinical guidelines on the current knowledge, attitudes, and management of H. pylori among primary care physicians, hospital internists, and gastroenterologists in Israel. STUDY: Self-administered, voluntary, anonymous questionnaires were given personally to 229 physicians, 73 primary care physicians, 71 internists, and 85 gastroenterologists. The questions evaluated 4 main issues in the management of H. pylori: (1). the optimal diagnostic test, (2). indications for eradication, (3). combination and duration of triple therapy, and (4). the need for confirmation following eradication. RESULTS: There were significant variations in the adherence of those recommendations among gastroenterologists, internists, and primary care physicians. Specifically, 94.1% of gastroenterologists and 88.9% of internists consider the urea breath test the test of choice for H. pylori diagnosis compared with 60.0% of the primary care physicians. Significant differences in the eradication indications for mucosa-associated lymphoid tissue (MALT) lymphoma, first-degree relatives of gastric cancer patients, atrophic gastritis, functional dyspepsia, and concomitant use of nonsteroidal antiinflammatory drugs were demonstrated among gastroenterologists and the other groups. CONCLUSIONS: Primary care physicians may not be aware of important indications for diagnosis and eradication of H. pylori related to the risk of gastric malignancy or concomitant use of nonsteroidal antiinflammatory drugs. Public health agencies may need to increase penetration of the Maastricht 2000 recommendations to primary care physicians.

Amoxicillin↗

PubMed2001

Antenatal seroprevalence of herpes simplex virus type 2 (HSV-2) in Canadian women: HSV-2 prevalence increases throughout the reproductive years.

BACKGROUND: This study sought to provide the first population estimates of herpes simplex type 2 (HSV-2) seroprevalence in Canada. GOAL: To measure the antenatal seroprevalence of HSV-2 antibodies in reproductive age women. STUDY DESIGN: An anonymous unlinked seroprevalence study used stored sera collected from pregnant women in British Columbia during 1999. Randomized sampling within age strata selected a total of 1215 subjects, ages 15 to 44 years. Serologic testing used the Gull Meridian Test. Overall prevalence was directly standardized to the 1999 Canadian female population. RESULTS: The age-adjusted prevalence for HSV-2 was 17.3% (95% CI, 15.2-19.4). Prevalence ranged from 7.1% (ages, 15-19 years) to 28.1% (ages, 40-44 years), with the largest increases after the age of 24 years. CONCLUSIONS: The HSV-2 seroprevalence among pregnant women in British Columbia is similar to that in the United States and other countries. Seroprevalence continues to rise through the later reproductive years. This observation may relate to continued transmission, an age cohort effect, or both.

Adolescent↗

PubMed1997

Automaticity of cognitive biases in addictive behaviours: further evidence with gamblers.

OBJECTIVES: The hypotheses that automatic, non-volitional, attentional and memory biases for addiction-related constructs exist is tested with compulsive gamblers. DESIGN: An independent groups design was employed. Processing of gambling, compared to neutral and drug-related information was examined in 15 gamblers recruited from new members of Gamblers Anonymous. Comparisons were made with the performance of their spouses (N = 15) to help distinguish addiction mechanisms from more non-specific emotional experiences with gambling, and an independent control group (N = 15), recruited from the staff and students of a university department. METHODS: A modified Stroop procedure was first employed. Automative cognitive interference was assessed relatively, by comparing colour-naming times on the gambling, drug and neutral Stroops. A subsequent word-stem completion task of implicit memory was then used to assess selective and automatic priming of the gambling constructs in memory. RESULTS: Only the gamblers showed selective and automatic interference for gambling-related constructs on the Stroop task. Spouses behaved like the control group on this task. An implicit memory bias for gambling-related words was statistically detected only in the gamblers compared to the control group, although the trend was similar in the comparison with spouses. Further evidence for the specificity of these effects was obtained in subgroup comparisons involving fruit-machine with racing gamblers. CONCLUSIONS: Results are generally consistent with an automaticity in the cognitive biases gamblers show for gambling-related information. Implications for cognitive understanding and treatments are highlighted.

Adult↗

PubMed1992

Attitudes towards prenatal diagnosis and carrier screening for cystic fibrosis among the parents of patients in a paediatric cystic fibrosis clinic.

The parents of all children attending the Royal Brompton National Heart and Lung Hospital cystic fibrosis paediatric clinic were asked to complete an anonymous postal questionnaire addressing attitudes towards prenatal diagnosis and population carrier screening for cystic fibrosis (CF); 65% (170/261) of parents responded. Of the respondents, 92% would support the introduction of a population screening test to detect carriers of CF and 19% felt such a test should be mandatory. A total of 64% of CF parents felt they would choose not to have any further children in the knowledge that they were both carriers, 74% would choose to have a prenatal test if they became pregnant, 44% would consider terminating an affected pregnancy, 33% would not, and 23% were unsure. Overall, 72% of respondents indicated they would choose to avoid having a further child with CF either by not having further children or by terminating an affected pregnancy.

Attitude to Health↗

PubMed2002

Adverse reactions associated with echinacea: the Australian experience.

BACKGROUND: Fifty percent of Australians use complementary and alternative medicines (other than vitamins) in any 12-month period, of which echinacea-containing products are increasingly popular. Recent reports have highlighted the risk of allergic reactions to complementary medicines in atopic patients. OBJECTIVE: To determine the characteristics of adverse reactions linked to use of the popular herbal remedy echinacea. METHODS: Five privately referred patients were evaluated by the authors in their office practice via skin prick testing (SPT) on the volar aspect of the forearm and radioallergosorbent test after adverse reactions to echinacea. As there was little published information on adverse reactions to echinacea, reports to the Australian Adverse Drug Reactions Advisory Committee were reviewed. Those suggestive of possible allergic reactions were evaluated in greater detail by anonymously surveying the healthcare professionals who had reported the cases and from one unreported case. Serum was collected for further analysis where possible. RESULTS: Five cases of adverse reactions to echinacea were personally evaluated by the authors. Two patients suffered anaphylaxis and a third had an acute asthma attack 10 minutes after their first ever dose of echinacea. The fourth patient suffered recurrent episodes of mild asthma each time echinacea was ingested, and the fifth developed a maculopapular rash within 2 days of ingestion which recurred when rechallenged. Three of the patients had positive SPT results. Three reported repeated spontaneous "challenges" and symptoms after further ingestion of echinacea. Fifty-one Australian adverse drug reports implicating echinacea were also reviewed. There were 26 cases suggestive of possible immunoglobulin E-mediated hypersensitivity (4 anaphylaxis, 12 acute asthma, 10 urticaria/angioedema). Of these 26 patients, age ranged from 2 to 58 years, 78% were female and >50% were known to be atopic. Four were hospitalized, 4 reacted after their first known exposure, and 1 patient suffered multiple progressive systemic reactions. Twenty percent of 100 atopic subjects who had never taken echinacea also had positive SPT results to this substance when tested by one of the authors in his office practice. CONCLUSION: Some atopic subjects have positive SPT results to echinacea in the absence of known exposure. Atopic subjects are also overrepresented in those experiencing reactions to echinacea. The possibility that cross-reactivity between echinacea and other environmental allergens may trigger allergic reactions in "echinacea-naïve" subjects is supported by the Australian data. Given its widespread (and largely unsupervised) community use, even rare adverse events become inevitable. Atopic patients should be cautioned appropriately.

Adult↗

PubMed1997

Estimates of infectious disease risk factors in US blood donors. Retrovirus Epidemiology Donor Study.

OBJECTIVE: Individuals who do not respond accurately to questions about infectious disease risk factors at the time of blood donation represent a potential threat to the safety of the blood supply. This study was designed to estimate the prevalence of undetected behavioral and other risks in current blood donors. DESIGN: Anonymous mail surveys to collect demographic, medical, and behavioral information were administered to individuals who had donated blood within the previous 2 months. Sampling weights were used in the analysis to adjust for differential sampling and response rates among demographic groups to provide prevalence estimates for the donor population. SETTING: Five geographically and demographically diverse US blood centers. PARTICIPANTS: A stratified probability sample of 50,162 allogeneic blood donors. MAIN OUTCOME MEASURES: Estimated prevalence rates for risk behaviors that would have been a basis for deferral if reported at the time of the donor screening interview (deferrable risk). RESULTS: Completed questionnaires were received for 34,726 donors (69.2% of the sample). A total of 186 per 10,000 respondents (1.9%) reported a deferrable risk that was present at the time of their past donation, while 39 per 10,000 (0.4%) reported this behavior within the 3 months prior to donation. Rates (with 95% confidence intervals [CIs]) of deferrable risk behaviors were 1.4 (95% CI, 1.2-1.6) times higher for men than women, 1.6 (95% CI, 1.3-2.0) times higher for first-time vs repeat donors, 2.7 (95% CI, 2.0-3.6) times higher for donors with reactive screening tests, and 7.6 (95% CI, 3.6-15.8) times higher for donors who used the confidential unit exclusion option. CONCLUSIONS: Despite the high degree of transfusion safety in the United States today, a measurable percentage of active blood donors when assessed by anonymous survey report risks for human immunodeficiency virus and other infections not reported at the time of screening, suggesting the need for further refinements in the blood donor qualification process.

Blood Banks↗

PubMed1992

The Iowa therapeutic community model of chemical dependency treatment.

A model of inpatient chemical dependency treatment used in several facilities in Iowa is described. Through combining 12 Step, Therapeutic Community and Reality Therapy concepts, the issues of denial, control, and self centeredness are addressed in developmental phases. Individualizing the program through multidisciplinary input is explained in terms of identifying hindrances in perceiving reality and assisting the patients reduce resistance in a downhill process of increasing wholeness and growth.

Adult↗

PubMed2004

Laparoscopic training and practice in gynecologic oncology among Society of Gynecologic Oncologists members and fellows-in-training.

OBJECTIVE: To determine the proportion of Society of Gynecologic Oncologists (SGO) members performing laparoscopic procedures and to determine SGO members' and fellows' opinions regarding indications for and the adequacy of training in laparoscopy. METHODS: Surveys were mailed to SGO members and fellows-in-training in December 2002. Anonymous responses were collected by mail or through a Web site. The survey was mailed twice and was estimated to take 5 min to complete. The data were analyzed using frequency distributions and nonparametric tests. RESULTS: Three hundred thirty-six SGO members (45%) and fifty-seven fellows (49%) responded. Among SGO members, 272 (84%) currently performed laparoscopic surgeries. Reasons cited for performing laparoscopy were decreased length of hospital stay (74%), improved patient quality of life (57%), patient preference (48%), improved cosmesis (46%), and better visualization (18%). Among those who did not perform laparoscopy, 50% cited increased operating time as their main reason. When asked to indicate the laparoscopic procedure most commonly performed in their practice, 69% reported diagnosis of an adnexal mass; 11%, prophylactic bilateral salpingo-oophorectomies; and 10%, laparoscopically assisted vaginal hysterectomy and lymph node staging for uterine cancer. Only 3% of SGO respondents performed more than 50% of their procedures laparoscopically, and all respondents reported converting from laparoscopy to laparotomy less than 25% of the time. Most respondents had limited laparoscopic training during their fellowships: 39% received none, and 46% received limited (less than five procedures per month) training. Nevertheless, 78% of SGO respondents rated their laparoscopic skills as either very good or good. Among fellows, only 25% believed they were receiving very good or good laparoscopic training. Eighty percent of SGO respondents believe that at least six procedures per month were necessary for adequate training, yet only 33% of fellows performed that many procedures. CONCLUSIONS: Most SGO respondents used laparoscopy for selective indications, and most developed their laparoscopic skills after their fellowship training. SGO respondents believed laparoscopic instruction is an important part of training, but most fellows perceived their laparoscopic training as inadequate.

Adult↗