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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 - PowerPoint PPT Presentation
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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