Paper Files Research Articles

The Roles of English Language and Imagined Communities of a Facebook Group

Social network sites are the networked public places for university students. The most famous social network site in Malaysia for university students is Facebook. University students spend a lot of their time navigating collapsed contexts with global and local audience. Thus, Facebook is the most appropriate site to investigate ESL learning acquisition through L2 learners’ interactions and digital footprints. The study investigates the roles of English language and the types of imagined communities of ten L2 learners at a public university. Transcripts of a Facebook group’s online discussion and semi-structured interviews were analysed using qualitative data software Atlas.ti 7. The findings reveal that the key informants are invested to learn English due to its roles in Malaysia. English language has four dominant roles such as the language for their future employment, the language of instruction, the lingua franca and a tool of empowerment. The research also indicates the imagined communities of the key participants are fluent local speakers, fluent non-native speakers and native speakers. The results of the study provide present needs of ESL learners that will enable insights to language instructors, course designers and curriculum designers in facilitating effective language acquisition. instructions give you basic guidelines for preparing camera-ready papers for conference proceedings. Use this document as a template if you are using Microsoft Word 6.0 or later. Otherwise, use this document as an instruction set. The electronic file of your paper will be formatted further. Define all symbols used in the abstract. Do not cite references in the abstract.

Admissibility of the Document File: Focusing on the Judgement of Supreme Court in Won Se-Hun case

Admissibility of the Document File: Focusing on the Judgement of Supreme Court in Won Se-Hun case

How good are routinely collected primary healthcare data for evaluating the effectiveness of health service provision in a remote Aboriginal community?

Evaluation and monitoring of primary health care requires the establishment and maintenance of an appropriate data system. This study reviews the application and effectiveness of the Communicare data management system in the delivery of health services to the Fitzroy Valley in the Kimberley region of Western Australia. Key demographic fields (sex, date of birth and Aboriginal status) were examined for completeness (whether the date fields were all completed and correct when compared with the paper file) while the 'conditions' field was examined for accuracy. Three chronic diseases (diabetes, hypertension and chronic kidney disease) in adults and age-specific incidence for four acute diseases (otitis media, gastroenteritis, lower respiratory tract infection and skin infection) in children were included. Completeness of chosen demographic fields was 100% for date of birth and sex and 98% for Aboriginal status. Chronic conditions matched the paper files 100%, while the recording of acute conditions was incomplete. Among older adults (≥55 years) the prevalences of diabetes, chronic kidney disease and hypertension were 43%, 42% and 39% respectively. Age-specific incidence of acute conditions was highest in the 0-4 years age group where 25% had had at least one episode of otitis media and 20% at least one episode of skin infection. The recording of demographic and chronic disease data was complete, but lower for acute conditions. Routinely collected data have a number of limitations, but nonetheless are a feasible way to establish population health indices, particularly for chronic diseases for this remote health service with minimal expenditure and effort. These rates provide useful baselines for monitoring and evaluating the impact of service delivery on health outcomes. This audit provides an indication of the accuracy of routinely collected data in the electronic system compared to the paper medical records, which have traditionally been considered the gold standard. Data collected on chronic disease information were accurate and clinically useful for health service planning, monitoring and evaluation. Acute disease data were not accurate enough to be clinically useful.

Patient information: confidentiality and the electronic record

The rise of the electronic record now allows nurses to access a large archive of patient information that was more difficult to obtain when records consisted of manually held paper files. There have been several instances where curiosity and, occasionally, more malicious motivations have led nurses to access these records and read the notes of a celebrity or a person they know. In this article, Richard Griffith considers whether nurses' accessing and reading of the record of someone who is not in their care is in breach of their duty of confidentiality.

Assessing Complex Emergency Management with Clinical Case-Vignettes: A Validation Study.

ObjectiveTo evaluate whether responses to dynamic case-vignettes accurately reflect actual practices in complex emergency situations. We hypothesized that when obstetricians were faced with vignette of emergency situation identical to one they previously managed, they would report the management strategy they actually used. On the other hand, there is no reason to suppose that their response to a vignette based on a source case managed by another obstetrician would be the same as the actual management.MethodsA multicenter vignette-based study was used in 7 French maternity units. We chose the example of severe postpartum hemorrhage (PPH) to study the use of case-vignettes for assessing the management of complex situations. We developed dynamic case-vignettes describing incidents of PPH in several steps, using documentation in patient files. Vignettes described the postpartum course and included multiple-choice questions detailing proposed clinical care. Each participating obstetrician was asked to evaluate 4 case-vignettes: 2 directly derived from cases they previously managed and 2 derived from other obstetricians’ cases. We compared the final treatment decision in vignette responses to those documented in the source-case by the overall agreement and the Kappa coefficient, both for the cases the obstetricians previously managed and the cases of others.ResultsThirty obstetricians participated. Overall agreement between final treatment decisions in case-vignettes and documented care for cases obstetricians previously managed was 82% (Kappa coefficient: 0.75, 95% CI [0.62–0.88]). Overall agreement between final treatment decisions in case-vignettes and documented care in vignettes derived from other obstetricians’ cases was only 48% (Kappa coefficient: 0.30, 95% CI [0.12–0.48]). Final agreement with documented care was significantly better for cases based on their own previous cases than for others (p<0.001).ConclusionsDynamic case-vignettes accurately reflect actual practices in complex emergency situations. Therefore, they can be used to assess the quality of management in these situations.

Medical Device Integration Model Based on the Internet of Things

At present, hospitals in our country have basically established the HIS system, which manages registration, treatment, and charge, among many others, of patients. During treatment, patients need to use medical devices repeatedly to acquire all sorts of inspection data. Currently, the output data of the medical devices are often manually input into information system, which is easy to get wrong or easy to cause mismatches between inspection reports and patients. For some small hospitals of which information construction is still relatively weak, the information generated by the devices is still presented in the form of paper reports. When doctors or patients want to have access to the data at a given time again, they can only look at the paper files. Data integration between medical devices has long been a difficult problem for the medical information system, because the data from medical devices are lack of mandatory unified global standards and have outstanding heterogeneity of devices. In order to protect their own interests, manufacturers use special protocols, etc., thus causing medical decices to still be the "lonely island" of hospital information system. Besides, unfocused application of the data will lead to failure to achieve a reasonable distribution of medical resources. With the deepening of IT construction in hospitals, medical information systems will be bound to develop towards mobile applications, intelligent analysis, and interconnection and interworking, on the premise that there is an effective medical device integration (MDI) technology. To this end, this paper presents a MDI model based on the Internet of Things (IoT). Through abstract classification, this model is able to extract the common characteristics of the devices, resolve the heterogeneous differences between them, and employ a unified protocol to integrate data between devices. And by the IoT technology, it realizes interconnection network of devices and conducts associate matching between the data and the inspected at the device terminal in a timely manner.

Lab-inventory management: Time to take stock.

Inventory-tracking systems range from paper filing to custom-made databases. Using the right system can save researchers time, money and frustration.

Questioning security devices: Performativity, resistance, politics

Algorithms, biometrics and body scanners, computers and databases, infrastructures of various kinds, ranging from what is commonly referred to as ‘hi-tech’ to ‘low-tech’ items such as walls or paper files, have garnered increased attention in critical approaches to (in)security. This article introduces a special issue whose contributions aim to further these approaches by questioning the role and political effects of security devices. It proposes an analytics of devices to examine the configuration and reconfiguration of security practices by attending to the equipment or instrumentation that make these practices possible and temporally stabilize them. The aim here is not to advance devices as a new unit of analysis, but to open new forays in ongoing debates about security politics and practices, by asking different research questions and developing new research angles. We start by outlining what is at stake when thinking of and analysing security practices through devices, or shifting from the language of technology and ‘technologies of security’ to security devices. The remainder of the article then specifies how an analytics of devices involves a more varied vocabulary of performativity, on the one hand, and agency, on the other.

Research Data Services at the University of Colorado Boulder

EDITOR'S SUMMARYThe University of Colorado Boulder's Research Data Services (RDS) is a joint activity of the University Libraries and the Office of Information Technology. Started in 2011 to meet the National Science Foundation's mandate for data management plans with all grant submissions, RDS grew from helping to write the plans to indicating resources to educating researchers on their use and providing individual consultations and reviews. RDS staff also aid researchers with metadata documentation, helping to develop file documentation and later migrating to final formats. Researchers often contact RDS about long‐term data storage or for assistance with data dissemination and complying with the requirements of data repositories, funding agencies or scholarly journals. Urging researchers to learn about data management, using a variety of communication channels and venues, is key. Incorporating a data management plan requirement to in‐house grants and creating a data management plan competition with financial award have been most successful at promoting the RDS.

Rescue of long-tail data from the ocean bottom to the Moon: IEDA Data Rescue Mini-Awards

Over the course of a scientific career, a large fraction of the data collected by scientific investigators turns into data at risk of becoming inaccessible to future science. Although a part of the investigators’ data is made available in manuscripts and databases, other data may remain unpublished, non-digital, on degrading or near obsolete digital media, or inadequately documented for reuse. In 2013, Integrated Earth Data Applications (IEDA) provided data rescue mini-awards to three Earth science investigators. IEDA’s user communities in geochemistry, petrology, geochronology, and marine geophysics collect long-tail data, defined as data produced by individuals and small teams for specific projects, tending to be of small volume and initially for use only by these teams, thus being less likely to be easily transferred or reused. Long-tail data are at greater risk of omission from the scientific record. The awarded projects topics were (1) Geochemical and Geochronological data on volcanic rocks from the Fiji, Izu-Bonin-Mariana arc, and Endeavor segments of the global mid-ocean ridge, (2) High-Resolution, Near-bottom Magnetic Field Data, and (3) Geochemistry of Lunar Glasses. IEDA worked closely with the awardees to create a plan for the data rescue, resulting in the registration of hundreds of samples and the entry of dozens of data and documentation files into IEDA data systems. The data were made openly accessible and citable by assigning persistent identifiers for samples and files. The mini-award program proved that a relatively small incentive combined with data facility guidance can motivate investigators to accomplish significant data rescue.

A retrospective review of diagnosis and treatment modalities of neuroendocrine tumors (excluding primary lung cancer) in 10 oncological institutions of the East German Study Group of Hematology and Oncology (OSHO), 2010-2012.

There is a paucity of data on the incidence of neuroendocrine tumors (NET) outside pulmonary primaries and on treatment modalities applied to patients with NET in clinical practice. Only very little therapeutic progress has been made with respect to response and overall survival, particularly among patients with poorly differentiated, WHO grade 3 neuroendocrine carcinomas (G3-NEC). We sought to document the incidence and treatment modalities in patients with NET/NEC within a period of 2 years. We conducted a retrospective data analysis using a simple documentation file to be completed in written form or electronically, including localization, WHO grading, treatment modalities, and specific therapeutic regimens applied. Primary lung cancer was excluded. The time period to be covered was 2010 through 2012. Individual patient data such as names or age were not documented, so that no ethics committee approval was required. Ten different hospital- or practice-based institutions contributed their data. One to 35 patients were documented per institution, summing up to 149 patients with 154 tumor localizations. Midgut (n = 46), foregut (n = 42), hindgut (n = 17), lung (n = 9), bladder (n = 8), unknown primary (n = 11), and other including prostate and liver (n = 21) were documented as tumor sites. Histological gradings were G1 (n = 71), G2 (n = 27), G3 (n = 34), undifferentiated "G4" (n = 4), and not specified (n = 13). Treatment modalities were surgical resection (n = 102), chemotherapy (n = 49), somatostatin analogs (n = 39), radiotherapy (n = 22), receptor-directed radionuclide therapy (n = 12), and systemic tyrosine kinase inhibition (n = 5). Chemotherapy was given to patients not only with G3-NEC (n = 31), but also with G2 (n = 12) and G1 NET (n = 7). Somatostatin analogs as well as receptor-directed radionuclides were applied to patients throughout all gradings. NET and NEC are not very rare tumor entities, but are diagnosed with very different frequencies, possibly depending upon the alertness of pathologists and clinicians. Chemotherapy, receptor-directed radionuclide application, and somatostatin analog therapy are applied without a clear correlation to different histologic gradings. Diagnostic and therapeutic progress in the field of NETs/carcinomas is urgently needed.

Optimizing Data Collection

Accurate data collection is essential for the validity in use of scientific data entered in databases (DB). From an earlier study we identified the difficult task in entering accurate data to local and international databases. We therefore decided to examine which tools we have available to collect the data. We frequently participate in requests from CIBMTR, EBMT, local DB and we enter patients into clinical research protocols, all tasks where data collection is necessary. The patient file is in a paper and an electronic version. The paper version is documents which either have not been converted nor been able to convert into an electronic version. Within the patient paper file there is already a document to list essential data for data registering, and since the electronic patient file has been implemented, the awareness of paper documents has declined. Currently some data are collected solely by the data managers (DM) and extracted from patient files at the hospital and from national patient registries. Some data, however, must be reviewed and interpreted by a physician in order to extract valid data. Therefore, it is necessary for the treating physician to have an overview of which data is essential to list in the patient file. The BMT unit is preparing for JACIE accreditation and according to standard B9.1: “The Clinical Program must furnish evidence of its own periodic data audits to determine if data are accurate for evaluation of patient outcomes” e.g. outcome analysis on day +100, +180 and annually. To optimize data collection to increase validity of data entered to CIBMTR, EBMT, DB and CRF's. To identify which data are to be collected and entered in CIBMTR, EBMT, DB and Clinical Research Files (CRF). To create an overview of which data are to be collected to DB and CRF's to ease the data collection at patient visits. We reviewed forms from the CIBMTR, EBMT and CRF's from the clinical research team and listed which essential data are needed on day +100, +180 and annually. We identified and reviewed existing paper documents in the patient paper file, which previously has been created to give an overview of which data to be collected and also to enter data on by the treating physician. By looking into our electronic patient file system, we discovered the possibility to create standard notes. The existing paper document is now changed to a schedule to give an overview of which data to be collected on day +100, +180 and annually. The schedule is put in the patient paper file and data collection is divided into: Data collected by treating physician and data collected by data manager. Within the electronic patient file we created standard notes. The physician can click on the relevant day of visit and view which data to be entered on the specific dates of patient visits. From here the DM can extract the data. To implement the new schedules and notes in the patient file, we had a meeting with the BMT-physicians.

Synthetic cannabinoid withdrawal: a new demand on detoxification services.

Synthetic cannabinoid dependence and withdrawal are not well described in the literature. We aimed to report on the characteristics and treatment course of clients attending a detoxification service for support with synthetic cannabinoid withdrawal in Auckland, New Zealand. A retrospective audit of electronic and paper files for clients presenting for treatment in association with problematic synthetic cannabinoid use between May 2013 and May 2014 was conducted. Demographic information, reported synthetic cannabinoid use, other substance use, reported adverse effects, withdrawal symptoms and treatment information were recorded using a piloted template. Descriptive statistics were used to summarise the characteristics of the audit sample. In the 12 month period, 47 people presented to detoxification services reporting problems withdrawing from synthetic cannabinoids. Twenty clients were admitted for medical management within an inpatient setting. Coexisting substance dependence apart from nicotine dependence was low. The most common withdrawal symptoms were agitation, irritability, anxiety and mood swings. Withdrawal symptoms were managed with diazepam and quetiapine. The harm associated with use of synthetic cannabinoids has had a direct impact on the utilisation of specialist alcohol and drug services in Auckland, New Zealand. Many clients with synthetic cannabinoid withdrawal symptoms required intensive support including medication and admission to an inpatient detoxification unit. Clients withdrawing from synthetic cannabinoids were the third largest group of clients admitted to inpatient detoxification services in Auckland, New Zealand, between May 2013 and May 2014.

American Heart Association Cardiovascular Genome-Phenome Study: foundational basis and program.

The American Heart Association has established the Cardiovascular Genome-Phenome Study (CV-GPS) as a means by which to achieve the goal of using modern genomics and phenotyping optimally to combat cardiovascular disease (CVD). CVD remains the leading cause of death in the United States and has become a major cause of morbidity and mortality worldwide. The course of CVD begins at an early age and evolves throughout life. Typically, risk factor precursors (eg, prehypertension, borderline abnormal lipids) are first observed in adolescence or young adulthood. By middle age, they develop into full-fledged cardiometabolic risk factors and subclinical disease, which usually become clinically apparent in older age. Importantly, risk factors for CVD reflect the complex interplay between genetic and environmental factors and demonstrate the complexity of the multiple determinants of disease. Editorial see p 17 Many of the genetic and environmental determinants of CVD have been identified over the past 50 years, and successful preventive and therapeutic strategies have been developed as a result. However, many potential genetic or acquired disease drivers remain unaccounted for, as illustrated by the observation that the major CVD risk factors combined account for only a fraction of the population-attributable risk.1 In addition, variations in CVD risk exist among individuals with similar risk profiles. Part of these differences may reflect differences in profiles of known risk factors that have not yet been fully refined but also individual differences in underlying genetic modifiers of such risk factors. Modern genomics, with its ability to provide ideally unbiased analysis of the entire genome, offers an approach to the ascertainment of all genetic determinants of CVD. Furthermore, the increasingly broad range of “omics” methods, including RNA-Seq, modern proteomics, metabolomics, and metabonomics, provide deeper and more refined molecular detail by which to define an individual’s genome and its relationship to (patho)phenotype. …

The research publications of members of European national noncommunicable disease health advisory committees

This paper describes a new indicator of research impact or influence, namely the research experience of health advisory committee members in 21 European countries, and how this relates to the burden of disease in those countries. Attention is confined to five noncommunicable diseases (NCDs): Cancer, cardiovascular diseases, diabetes, mental disorders, and chronic respiratory diseases, and the 5 years 2009–2013. In 2010, these five disease groups accounted for 57% of the disease burden in Europe as measured by Disability-Adjusted Life Years. The file of advisers' research papers contained 12,854 biomedical articles and reviews in the Web of Science, of which 5713 were concerned with one or more of the five NCDs. This output was compared with the relative disease burden in the countries concerned, and with the burden from different manifestations of these diseases such as cancer sites and alcoholism and dementia among mental disorders. such as alcoholism and dementia. The extent of other European countries' contributions to the advisers' research portfolios was also determined; it was higher than expected.

Complications associated with the occurrence and treatment of impacted maxillary canines

BackgroundThe aim of this study was to evaluate the complications associated with the occurrence and treatment of impacted maxillary canines. MethodsThis retrospective study was conducted on 533 Southern Chinese children and adolescents who attended the Paediatric Dentistry and Orthodontics Clinics and had at least one impacted maxillary canine. The study material included all the documentation files and radiographs of these patients. Complications that had been recorded in the clinical and surgical notes and that could be diagnosed from the available radiographs were noted. The data obtained were descriptively analyzed. ResultsThe most frequently reported phenomenon associated with the occurrence of impacted maxillary canine (prior to surgical treatment) was root resorption of an adjacent permanent tooth in 22 (4.1%) patients. The most frequently reported sequelae observed after any surgical procedure was swelling of the soft tissues around the operation site which often persisted for 48h as seen in 76 (18.8%) patients. Complications reported most commonly after any form of surgery included post-operative bleeding: 7(1.7%), hematoma: 7(1.7%), post-operative pain: 6(1.5%) and purulent discharge: 6(1.5%), post-operative complications in relation to surgical exposure and bonding of an attachment which included breakage of ligature wire: 5.7%; de-bonding of the attachment: 4.3% and inability to bond the attachment during surgery: 1.4% occurred rarely. ConclusionsThe frequency of root resorption of teeth adjacent to an impacted maxillary canine was low. Swelling of the soft tissue 48h post-operatively was the most commonly occurring complication after surgical intervention.

Colonel Silas D. Baldwin: Guilty or not Guilty? A Case of Command Influence?

THE IDEA FOR THIS ARTICLE CAME from a footnote in the late John Y. Simon's The Papers of Ulysses S. Grant.' I knew that Colonel Silas D. Baldwin, the commander of the Fifty-Seventh Illinois, had been court-martialed, but I did not know much of the details of the case. The footnote directed me to a file of papers in the Illinois State Archives. I contacted the archivist and he sent me the packet containing 102 pieces of correspondence. Included in this packet were sixteen letters addressed to President Abraham Lincoln written on behalf of Baldwin. I talked with Dr. Simon about this case in 1985 during his presentation on General Grant at the National Archives in Washington, D.C. He was curious about my work and asked for a version of what I had done. I sent him an early version, and he sent me a reply with a few suggestions. This spurred my interest, and I visited the National Archives and read the transcript of the court-martial. There were more documents in this file that were related to this case. combination of these documents and some additional letters provided by the Abraham Lincoln Presidential Library raised questions in my mind about the nature of the case and the many conflicting views of the participants.In this article I propose to present an objective look at the Baldwin case and present the facts as I have discovered them. However, after researching this subject for over twenty years, it is difficult to hide my bias in favor of Baldwin and his efforts to correct the record. I hope this work will provide a basis for further exploration of this episode in history, and bring to light the true circumstances that prevailed during this time in Corinth in 1863.On the last day of December 1862, Lieutenant George S. Nash, judge advocate, reported to Brig. General Grenville M. Dodge the results of his examination of the two charges against Colonel Silas D. Baldwin, violations of the fifty-second and seventeenth Articles of War. Nash had interviewed all the witnesses listed for each of the specifications related to both charges. Here is what he concluded in his report:I have the honor herewith to return charges and specifications against Col. S. D. Baldwin 57th Regt 111 Infantry. In Compliance with your order I have obtained the statements of various officers whose names are in the list of witnesses for the prosecution and instead of being able to ascertain and facts in proof of the ist charge and specifications, their statements are in direct contradiction thereto, and complimentary to the conduct of Col. Baldwin in the various engagements in which he has participated. The specification of the 2nd charge if proven would not support the charge. I have examined the original muster in rolls of the 57th Regt Ills Infy and find the name of the man referred to in the charge and specifications upon the roll of Co A Capt John Phillips which is signed by J. Christopher ist Lieut 16th U. S. Infantry Mustering Officer U.S.A. Consequently the man was a soldier until properly discharged, and the subsequent mustering of him as such was only the duty of his Commanding officer and could not be considered a violation of the 17th Article of War as is charged.2Colonel Silas D. Baldwin was shocked. His fellow regimental commander, Colonel John W. Sprague, had just finished reading the verdict. Colonel Baldwin had been found guilty of three of the five specifications of the charge of violation of the fifty-second Article of War in his court-martial. Baldwin could not believe what he had just heard. Why hadn't the judge advocate, Lieutenant George S. Nash, two months earlier sent the charges back to Brig. General Grenville M. Dodge with a convincing recommendation that there was no basis for the charges? Furthermore, Nash had stated in his letter that to the contrary, Colonel Baldwin should be commended for his actions on the battlefield. Nash wrote that the witness statements were highly complimentary to the conduct of Col. …

Extended laboratory information system downtime: Implementing a backup laboratory information system in the cytology laboratory.

Extended laboratory information system downtime: Implementing a backup laboratory information system in the cytology laboratory.

Aintree University Hospital NHS Foundation Trust rolls out new electronic medical records system to improve the quality of patient care

Summary of speech: o In the context of the Government’s QIPP agenda and Jeremy Hunt’s challenge to the NHS to be paperless by 2018, scanning paper medical records has gained in popularity as Trusts seek to solve seemingly mutually exclusive challenges – remove a unsustainable paper process, improve the quality of patient care, enhance operational productivity while reducing cost. o A variety of approaches have been taken to try to achieve this: o Some Trusts have invested heavily creating in-house scanning bureaus; o Others have digitised the whole record but paid little attention to navigation so clinicians are faced with hundreds of pages of notes in an unwieldy PDF. o With 86,000 emergency admissions every year, 330,000 outpatient visits and 77,000 inpatient day cases – some 4,200 paper files moved daily Aintree University Hospital couldn’t 100% guarantee availability with clinicians complaining that finding information took too long. o To address this, the Trust has implemented an electronic medical records system to provide clinicians instant access to patient information, guarantee notes availability, improve efficiency, and reduce the costs, risks and space associated with paper handling and storage. o The EDMS solution cost £1.5 million, with the Trust realising annual savings of £1 million. o Professor Mike Pearson, consultant physician and the clinical lead on the project, will talk about the project – its goals, the solution deployed, what has been achieved, and how the project was successfully managed so that others both clinicians and operational staff can benefit from Aintree’s experience. o Ultimately it is not the actual software or the underlying technologies which have ensured success, but the careful application of them along with an understanding of the accompanying organisational and medical processes. This mandates a partnership between the suppliers and the Trust as all have to deliver which has been the case on this project. o Outlined below is comprehensive detail which it is hoped the King’s Fund will find useful as it selects speakers for the International Digital Health and Care Congress 2014 [Innovations in technology category]. International Digital Health and Care Congress, The King’s Fund, London, September 10-12 2014. International Journal of Integrated Care – Volume 14, 01 November – URN:NBN:NL:UI:10-1-116504– http://www.ijic.org/

Comparison of two methods of collecting healthcare usage data in chiropractic clinics: patient-report versus documentation in patient files.

BackgroundThe use of patient-reported questionnaires to collect information on costs associated with routine healthcare services, such as chiropractic, represents a less labour intensive alternative to retrieving these data from patient files. The aim of this paper was to compare patient-report versus patient files for the collection of data describing healthcare usage in chiropractic clinics.MethodsAs part of a prospective single cohort multi-centre study, data on the number of visits made to chiropractic clinics determined using patient-reported questionnaires or as recorded in patient files were compared three months following the start of treatment. These data were analysed for agreement using the Intraclass Correlation Coefficient (ICC) and the 95% Limits of Agreement.ResultsEighty-nine patients that had undergone chiropractic care were included in the present study. The two methods yielded an ICC of 0.83 (95% CI = 0.75 to 0.88). However, there was a significant difference between the data collection methods, with an average of 0.6 (95% CI = 0.25 to 1.01) additional visits reported in patient files. The 95% Limits of Agreement ranged from 3 fewer visits to 4 additional visits in patient files relative to the number of visits recalled by patients.ConclusionThere was some discrepancy between the number of visits made to the clinic recalled by patients compared to the number recorded in patient files. This should be taken into account in future evaluations of costs of treatments.