Looking for patients in guidelines
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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

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


  • Introduction

  • Methods

  • Results

  • Conclusion


NHG –

Dutch College of

General Practitioners

Orde –

Dutch Association of

Medical Specialists


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


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


Methods

  • Definition and scope

  • Construction of concept-filters

  • Validation database

  • Adaptation of concept-filters


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


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


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


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)


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] ……..


Results

  • Validation of concept-filters

  • Tables

  • Comparison


Validation of concept-filters

  • testing in practice

  • 3 subjects primary care (PubMed-filter)

  • 3 subjects secondary care (OVID-filter)

  • sensitivity, specificity, precision, accuracy


General crosstable

precision a/(a+b)

sensitivity a/(a+c)

specificity d/(b+d)

accuracy (a+d)/(a+b+c+d)


Pubmed-new:dyspepsia

precision 74.0% (53-88)

sensitivity 83.3% (62-95)

specificity 98.0% (96-99)

accuracy 92.0%


PubMed-new:BPH, chlamydia, dyspepsia

precision 79.3% (69-87)

sensitivity 90.1% (81-95)

specificity 98.8% (98-99)

accuracy 98.3%


OVID-SIGN:ICD, cataract, spina bifida

precision 21.2% (16-26)

sensitivity 98.4% (91-99)

specificity 69.1% (65-72)

accuracy 71.4%


OVID-new:ICD, cataract, spina bifida

precision 77.0% (65-86)

sensitivity 90.5% (80-96)

specificity 98.0% (96-98)

accuracy 97.0%


Comparison


Conclusions

  • a never-ending story?

  • you can’t have it all

  • work in progress


Contact information

  • m.wessels@orde.nl

  • l.hielkema@nhg.org


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