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Looking for patients in guidelines

Looking for patients in guidelines. Development of a search filter for identifying articles addressing patient issues Lian Hielkema (Dutch College of General Practioners), Monique Wessels (Dutch Association of Medical Specialists) International Clinical Librarian Conference 2011

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Looking for patients in guidelines

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  1. Looking for patients in guidelines Development of a search filter for identifying articles addressing patient issues Lian Hielkema (Dutch College of General Practioners), Monique Wessels (Dutch Association of Medical Specialists) International Clinical Librarian Conference 2011 Birmingham, 13-14 June 2011

  2. Introduction • Methods • Results • Conclusion

  3. NHG – Dutch College of General Practitioners Orde – Dutch Association of Medical Specialists

  4. Benefits of public involvement (NHS) • better outcomes of treatment and care • a more satisfying experience for patients of using health services • sharing responsibilities for healthcare with the public • more appropriate use of health services

  5. Viewpoint of our two organisations To give patient participation a regular place in guidelines, in order to achieve a more demand-based care by incorporating aspects of patients' perception and experience and their information needs

  6. Methods • Definition and scope • Construction of concept-filters • Validation database • Adaptation of concept-filters

  7. Definition and scope (SIGN) • experiences (condition, diagnosis, treatments, follow-up care and QoL) • (information) needs and preferences • participation in decision-making • overall satisfaction with care received

  8. Construction of concept-filters (for Medline via OVID and via PubMed) Terms derived from: - filter patient issues SIGN - Greenhalgh, T. User involvement in health care (Wiley, 2010) - analysis of known articles

  9. Validation database • guidelines SIGN • Longtin Y et al. Patient participation: current knowledge and applicability to patient safety. Mayo Clin Proc. 2010 85(1):53-62 • guideline diabetes self-management education Result: 176 references

  10. Adaptation of concept-filters • Computerized analysis of MESH-terms of articles in validation database with open source MESH-analysing apps • Manual analysis of missed articles: • 23 (concept OVID-new filter), • 6 (concept PubMed-new filter), • 1 (OVID-SIGN filter)

  11. Part of one of the filters (PubMed-new) • (Patient Participation[Mesh] OR consumer participation[Mesh] OR Professional-Patient Relations[Mesh] OR Patient-Centered Care[Mesh] OR Patient Preference[Mesh] OR Patient Satisfaction[Majr] OR Patient Education as Topic[Mesh] OR Attitude to Health[Mesh] OR Patient Acceptance of Health Care[Mesh] OR Health Knowledge, Attitudes, Practice[Mesh] OR Focus Groups[Mesh] OR Quality of Life[Majr] OR Self Care[mh:noexp] OR Self Concept[Mesh] OR Self-examination[Mesh] OR Cooperative Behavior[Mesh] OR Adaptation, Psychological[Mesh] OR Decision Support Techniques[Mesh] OR Self-Help Groups[Mesh] OR Community Networks[Mesh] OR Emotions[Mesh] OR Consumer Satisfaction[Mesh] OR Needs Assessment[Mesh] OR Personal Autonomy[Mesh] OR Patient Advocacy[Mesh] OR Life Change Events[Mesh]) OR (patient perspective*[tiab] OR patient's perspective*[tiab] OR patient desire*[tiab] OR patient's desire*[tiab] OR "patient's desires"[tiab] OR patient view*[tiab] OR patient's view*[tiab] OR patient expression*[tiab] OR patient's expression*[tiab] OR patient attitude*[tiab] OR patient's attitude*[tiab] OR patient involvement*[tiab] OR patient's involvement*[tiab] OR patient decision*[tiab] OR patient's decision*[tiab] OR patient activation[tiab] OR patient's activation[tiab] OR patients activation[tiab] OR patient empowerment[tiab] OR patient participation[tiab] OR patient's participation[tiab] OR patients participation[tiab] OR patient collaboration[tiab] OR patient's collaboration[tiab] OR patients collaboration[tiab] OR expert patient*[tiab] OR consumer participation[tiab] OR consumer perspective[tiab] OR consumers perspective[tiab] ……..

  12. Results • Validation of concept-filters • Tables • Comparison

  13. Validation of concept-filters • testing in practice • 3 subjects primary care (PubMed-filter) • 3 subjects secondary care (OVID-filter) • sensitivity, specificity, precision, accuracy

  14. General crosstable precision a/(a+b) sensitivity a/(a+c) specificity d/(b+d) accuracy (a+d)/(a+b+c+d)

  15. Pubmed-new:dyspepsia precision 74.0% (53-88) sensitivity 83.3% (62-95) specificity 98.0% (96-99) accuracy 92.0%

  16. PubMed-new:BPH, chlamydia, dyspepsia precision 79.3% (69-87) sensitivity 90.1% (81-95) specificity 98.8% (98-99) accuracy 98.3%

  17. OVID-SIGN:ICD, cataract, spina bifida precision 21.2% (16-26) sensitivity 98.4% (91-99) specificity 69.1% (65-72) accuracy 71.4%

  18. OVID-new:ICD, cataract, spina bifida precision 77.0% (65-86) sensitivity 90.5% (80-96) specificity 98.0% (96-98) accuracy 97.0%

  19. Comparison

  20. Conclusions • a never-ending story? • you can’t have it all • work in progress

  21. Contact information • m.wessels@orde.nl • l.hielkema@nhg.org

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