Screening Tool For Risk Factors Research Articles

The Effectiveness of Workplace Musculoskeletal Injury Risk Factor Screening Tools for Reducing Injury: A Systematic Review.

Musculoskeletal injury (MSI) contributes to global health burdens. Effective MSI prevention is necessary. MSI risk factor screening tools can be used by employers to identify and mitigate occupational hazards. Rigorous synthesis of the effectiveness of these tools has not taken place. We synthesized literature on effectiveness of MSI risk factor screening tools for reducing injury through informing prevention interventions. A literature search of Medline, Embase, Cochrane Library (Trials), CINAHL, Scopus and PsycINFO databases was performed. Included studies required an analytic design, used an MSI risk factor screening tool to inform an intervention in a working-age population and reported an outcome of MSI development, injury or compensation/work absence. Data extraction and study quality rating (Downs and Black criteria) were completed. Studies were sub-categorized as having used a single MSI screening tool (single-tool) to inform an injury prevention intervention or involving multiple simultaneous screening tools (multiple-tool). Study outcomes were synthesized when possible. Eighteen articles representing fourteen studies met our inclusion criteria. No high-quality studies were identified (maximum Downs and Black score of 19). Studies did not employ previously validated tools but instead, typically, those purpose-built for a single use. The results were inconsistent both when using tools alone and in combination with other tools. Outcome measure heterogeneity precluded meaningful meta-analysis. There is limited evidence regarding use of MSI risk factor screening tools for preventing injury. Rigorous studies that utilize previously validated tools are needed.

Incidence and Prevention of Thromboembolic Complications for Sports and Arthroscopic-related Surgery: Evidence-based Recommendations.

The incidence of thromboembolic events following arthroscopic surgery is relatively rare. Despite this, these are important complications to be aware of, as arthroscopic procedures are performed in high frequency each year and can lead to a substantial burden within health care. Over the past several decades, pharmacologic antithrombotic prevention strategies following knee arthroscopy have been extensively studied; however, their efficacy remains controversial, and there is a lack of consensus regarding a standard prevention protocol, with the exception of the established benefits of early mobilization. Several surgical and medical risk factors have been established and are important to consider as they specifically relate to each individual patient's risk of thromboembolic disease. Based on the best available evidence, chemical thromboprophylaxis appears to be unnecessary among healthy patients but may be beneficial for higher risk patients, especially those with a prior history of venous thromboembolism. A standard screening tool for risk factors in arthroscopy patients may be a cost-effective and safe solution for implementing preventative efforts.

Effective use of musculoskeletal injury risk factor screening tools – a systematic review

Effective use of musculoskeletal injury risk factor screening tools – a systematic review

DIABETES RISK FACTOR SCREENING IN ADULTS USING PERKENI QUESTIONNAIRE AND ORAL GLUCOSE TOLERANCE TEST IN SOCAH COUNTY, BANGKALAN

There are 8.4 million diabetes adult patients in Indonesia and most remained undiagnosed. Screening process for diabetes is very important. PERKENI has recommended the use of questionnaire and Oral Glucose Tolerance Test (OGTT) as risk factor screening tools. This study aimed to find out the use of PERKENI questionnaire and OGTT in adults as diabetes risk factor screening tools. This was a descriptive cross sectional study conducted in 2015 in Socah County Bangkalan. Participants (n=91) were interviewed regarding diabetes risk factor using PERKENI questionnaire. Anthropometric (height, weight, and abdominal circumference) measurements were also taken. The results were categorized into: very low risk, increased risk, moderate risk and high risk. Only those categorized as high risk were asked to take OGTT. Exclusion criteria were participants who had been diagnosed with diabetes by a physician and/or routinely taking anti diabetic medication, consumed drugs during the previous two weeks and does not finish the required procedures. From 91 eligible participants, only 9 (9.89%) were categorized as high risk. The result of OGTT were: 4 were within normal limit, 1 had impaired glucose tolerance (IGT) and 4 were newly diagnosed with diabetes. The use of PERKENI questionnaire and OGTT in high risk adult population as a diabetes risk factor screening tool increased new findings of diabetes cases. Our analysis may support the adoption of diabetes risk factor screening methods through questionnaires and OGTT in high risk adult population, especially in low resource setting.

Risk assessment instruments for screening bone mineral density in a Mediterranean population.

AIMTo evaluate the power of six osteoporosis-screening instruments in women in a Mediterranean country.METHODSData concerning several osteoporosis risk factors were prospectively collected from 1000 postmenopausal women aged 42-87 years who underwent dual-energy X-ray absorptiometry (DEXA) screening. Six osteoporosis risk factor screening tools were applied to this sample to evaluate their performance and choose the most appropriate tool for the study population.RESULTSThe most important screening tool for osteoporosis status was the Simple Calculated Osteoporosis Risk Estimation, which had an area under the curve (AUC) of 0.678, a sensitivity of 72%, and a specificity of 72%, with a cut-off point of 20.75. The most important screening tool for osteoporosis risk was the Osteoporosis Self-assessment Tool, which had an AUC of 0.643, a sensitivity of 77%, and a specificity of 46%, with a cut-off point of -2.9.CONCLUSIONSome commonly used clinical risk instruments demonstrate high sensitivity for distinguishing individuals with DEXA-ascertained osteoporosis or reduced bone mineral density.

Risk of Pre-and Post-Operative Delirium and the Delirium Elderly At Risk (DEAR) Tool in Hip Fracture Patients.

Background and PurposeDelirium is common after hip fracture. Previous work has shown that a simple delirium risk factor tool, the Delirium Elderly At Risk instrument (DEAR), has a high inter-rater reliability in this population. Little research has looked at the ability of risk factor screening tools to identify patients at high risk of pre-operative delirium. This study investigates the ability of the DEAR to identify patients at high risk of pre-operative delirium, as well as reporting its performance in a post-operative validation sample. Associations between delirium risk factors and pre-operative delirium are explored.MethodsThis prospective cohort study took place on an orthopedic in-patient service at a University-affiliated tertiary care hospital. Patients aged 65 and older who were admitted for surgical repair of hip fracture (N = 283) were assessed pre-operatively for 5 delirium risk factors (cognitive impairment, sensory impairment, functional dependence, substance use, age) using the DEAR. Patients were assessed for delirium using the Mini-Mental State Examination and the Confusion Assessment Method pre-operatively and on post-operative days 1, 3 and 5. Characteristics of patients who developed delirium were compared with the characteristics of those who did not.ResultsDelirium was present in 58% (95% CI = 52–63%) of patients pre-operatively and 42% (95% CI = 36–48%) post-operatively. Individually, sensory impairment (χ2 = 21.7, p = .0001), functional dependence (χ2 = 24.1, p = .0001), cognitive impairment (χ2 = 55.5, p = .0001) and substance use (χ2 = 7.5, p = .007) were significantly associated with pre-operative delirium, as was wait-time for surgery (t = 3.1, p = .003) and length of stay (t = 2.8, p =.03). In multivariate modeling, the strongest association with pre-operative delirium was cognitive impairment.ConclusionsThe DEAR, a simple, delirium risk factor screening tool, can be used to identify hip fracture patients at risk of both pre-operative and post-operative delirium, which may allow targeted implementation of delirium prevention strategies.

Student-Led Rural Health Fairs

Residents of rural communities, especially in the Southeast, have decreased access to health care. Ensuring medical students receive adequate exposure to their issues is complicated by the urban location of most schools. We describe health fairs conducted in rural communities to suggest how having medical students use screening tools can identify patients with risk factors for disease which can offer students the opportunity to learn about rural health issues through patient counseling. The Mitchell Wolfson Sr. Department of Community Service, a University of Miami Miller School of Medicine student-led organization, conducts fairs at four sites throughout the rural Florida Keys. Medical students, under the supervision of attending physicians, offer screening and preventive health services including risk factor screening for cardiovascular disease, ophthalmological exams, dermatologic exams, osteoporosis screening, and female exams with pap smears. These fairs were reviewed. In the past three years, 1694 unique patients were seen. Many lacked a primary care provider (46%) or health insurance (43%) and were provided screening for several disorders including cardiovascular disease risk factors (hypertension, diabetes, dyslipidemia, and obesity). Screening revealed that many patients (41%) had multiple markers of elevated cardiovascular disease risk. This provided experiences to more than 200 students each year. Fairs provide medical students exposure to rural health issues through the valuable opportunity of using risk factor screening tools and counseling. This provides valuable information to patients of rural communities. Future research should examine how fairs influence student knowledge and attitudes toward rural health and affect health outcomes.

Identifying Women with Low Bone Mass: A Systematic Review of Screening Tools

Several osteoporosis risk-factor screening tools have been developed to identify women at increased risk of low bone mineral density, who would most benefit from dual x-ray absorptiometry (DXA) screening. The purpose of this systematic review was to assess the effectiveness of these screening tools in determining postmenopausal Caucasian women at risk of developing osteoporosis. Appropriate databases and sources of primary studies were identified. A systematic review of the literature using a comprehensive search strategy was employed, and all citations were stored. Exclusion criteria were established, and critical quality was assessed. Study characteristics were tabulated and comparisons made. Upon reviewing the evidence, 6 screening tools (Simple Calculated Osteoporosis Risk Estimation, the Osteoporosis Risk Assessment Instrument, the Osteoporosis Self-Assessment Tool [OST], the body weight criterion, the Osteoporosis Index of Risk, and Age, Body Size, No Estrogen) were identified. Studies show that these screening tools are useful in identifying postmenopausal Caucasian women in need of DXA screening and possible intervention for osteoporosis. For clinical and community practice, the OST is the simplest approach to determine individuals at risk of osteoporosis and in need of DXA screening. There is still a need for further development and validation of screening tools in both men and ethnicities other than Caucasian.

Physician screening for multiple behavioral health risk factors

Background Screening rates in primary care for single behavioral health risk factors are widely documented. However, such risk factors cluster in individuals and populations. This article examines the number and types of behavioral risk factors that U.S. adults reported, and reported having been screened for in their last routine medical checkup. Methods The sample consisted of 16,818 adults from the 1998 National Health Interview Survey who reported having a routine checkup in the past year. Respondents completed questions regarding four behavioral risk factors (physical inactivity, overweight, cigarette smoking, risky drinking), and provider screening for behaviors related to these risk factors. Results Half of the sample (52.0%) reported having two or more of the four risk factors, and more than half (59.4%) were screened for two or more risk behaviors during their last routine checkup, although 28.6% reported being screened for none of them. Respondents reporting at least one risk factor were screened for an average of 57.7% of their own risk factors. Women, adults with lower levels of income and education, and those aged 65 and older, reported being screened for fewer of their risk factors. Conclusions While guidelines for risk factor screening and intervention typically focus on single behavioral risk factors, most primary care patients present with, and are screened for, more than one. Behavioral risk factor screening tools and interventions must be expanded to cover multiple risks. Additionally, efforts are needed to reduce the substantial missed opportunities for screening, and to eliminate demographic disparities in screening practices and accuracy.