The continuity of care is the relationship between a physician and a patient that extends through... more The continuity of care is the relationship between a physician and a patient that extends throughout different episodes of illness. This care includes that in some opportunities the patient must consult a medical specialist. In this qualitative study, we set out to explore and describe the different requests for referral authorization to a specialist by patients affiliated with private health insurance, in order to understand the different patterns of interaction between general practitioners (GP) and their patients. The conversation analysis let us identify categories (structural and functional) after a critical reading of messages between GPs and their patients through an Electronic Health Records (EHR) messaging system. This work allowed us to know more in depth the process of continuity of care. In most cases, the doctor answered affirmatively to the request for a new referral to a specialist.
Background: documentation of aspirin consumption is usually not complete and clear, probably beca... more Background: documentation of aspirin consumption is usually not complete and clear, probably because it's a cheap drug that can be easily acquired. Objective: To evaluate the quality of the record of aspirin consumption documented in the electronic medical records (EMRs) of a Private University Hospital of Argentina. Design: Qualitative and quantitative descriptive exploratory study. Results: principal findings were that 86 % of the notes mentioned aspirin as a chronic prescription. 12% mentioned its temporary suspension. Numerous EMRs mentioned the use of an "antiplatelet" drug without specifying which, and didn't specify abbreviations, consumed dose or when to start or stop aspirin. Conclusions: overall quality of aspirin related information registration in EMRs was poor. This is concerning since it's a frequently prescribed drug, not exempt from adverse events.
Telemedicine is the provision of services by health professionals through the use of information ... more Telemedicine is the provision of services by health professionals through the use of information and communication technologies. Its implementation is usually carried out through systems of va riable usability. In 2016, Parmanto et al, developed and validated a questionnaire in English that measures its usability and allows to evaluate all factors that influence it. In 2019, we translated, adapted cross-culturally, and published this questionnaire in Spanish. With the aim of transforming it into a reliable and accessible tool, the utility of which is indisputable in the current context, we carried out a research work that allowed its validation and simplification.
Study aimsWe sought to evaluate the diagnostic performance of quantitative elastography (shear wa... more Study aimsWe sought to evaluate the diagnostic performance of quantitative elastography (shear wave elastography) and to establish the optimal cutoff value to differentiate malignant and benign breast lesions using QelaXtoTM software.MethodsWe conducted a retrospective observational study of adult women with suspicious breast lesions (BIRADS 3, 4 or 5) who underwent programmed ultrasound-guided core biopsies. Breast lesions were assessed using quantitative elastography combined with B-mode ultrasound. Histopathology was used as reference standard. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were estimated, and a ROC curve analysis was conducted. Three elastography cutoff values were considered: 36, 50 and 80 kPa.ResultsWe included 143 women (mean age of 56 years) with a total of 145 breast lesions: 68 benign tumors (47.26%) and 77 malignancies (52.74%). Mean elasticity measurements of benign and malignant lesions were significantly different (24.6 kPa, SD 28.47, vs. 101.49 kPa, SD 47.38, p<0.0001). Using the 50 kPa cutoff, elastography showed a global sensitivity of 87% to discriminate malignant lesions (AUC = 0.897). Moreover, sensitivity was 90.7% when lesions were located 5–40 mm below the skin surface (optimal elastographic field of view). Our false positive rate was 17.65%, comprised mainly of fibroepithelial neoplasms, fibroadenomas and fibrosis.ConclusionsQuantitative elastography can differentiate malignant and benign breast lesions with acceptable to excellent performance. In our sample, the QelaXtoTM software showed a lower optimal cutoff than other ultrasound systems.
The continuity of care is the relationship between a physician and a patient that extends through... more The continuity of care is the relationship between a physician and a patient that extends throughout different episodes of illness. This care includes that in some opportunities the patient must consult a medical specialist. In this qualitative study, we set out to explore and describe the different requests for referral authorization to a specialist by patients affiliated with private health insurance, in order to understand the different patterns of interaction between general practitioners (GP) and their patients. The conversation analysis let us identify categories (structural and functional) after a critical reading of messages between GPs and their patients through an Electronic Health Records (EHR) messaging system. This work allowed us to know more in depth the process of continuity of care. In most cases, the doctor answered affirmatively to the request for a new referral to a specialist.
Background: documentation of aspirin consumption is usually not complete and clear, probably beca... more Background: documentation of aspirin consumption is usually not complete and clear, probably because it's a cheap drug that can be easily acquired. Objective: To evaluate the quality of the record of aspirin consumption documented in the electronic medical records (EMRs) of a Private University Hospital of Argentina. Design: Qualitative and quantitative descriptive exploratory study. Results: principal findings were that 86 % of the notes mentioned aspirin as a chronic prescription. 12% mentioned its temporary suspension. Numerous EMRs mentioned the use of an "antiplatelet" drug without specifying which, and didn't specify abbreviations, consumed dose or when to start or stop aspirin. Conclusions: overall quality of aspirin related information registration in EMRs was poor. This is concerning since it's a frequently prescribed drug, not exempt from adverse events.
Telemedicine is the provision of services by health professionals through the use of information ... more Telemedicine is the provision of services by health professionals through the use of information and communication technologies. Its implementation is usually carried out through systems of va riable usability. In 2016, Parmanto et al, developed and validated a questionnaire in English that measures its usability and allows to evaluate all factors that influence it. In 2019, we translated, adapted cross-culturally, and published this questionnaire in Spanish. With the aim of transforming it into a reliable and accessible tool, the utility of which is indisputable in the current context, we carried out a research work that allowed its validation and simplification.
Study aimsWe sought to evaluate the diagnostic performance of quantitative elastography (shear wa... more Study aimsWe sought to evaluate the diagnostic performance of quantitative elastography (shear wave elastography) and to establish the optimal cutoff value to differentiate malignant and benign breast lesions using QelaXtoTM software.MethodsWe conducted a retrospective observational study of adult women with suspicious breast lesions (BIRADS 3, 4 or 5) who underwent programmed ultrasound-guided core biopsies. Breast lesions were assessed using quantitative elastography combined with B-mode ultrasound. Histopathology was used as reference standard. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were estimated, and a ROC curve analysis was conducted. Three elastography cutoff values were considered: 36, 50 and 80 kPa.ResultsWe included 143 women (mean age of 56 years) with a total of 145 breast lesions: 68 benign tumors (47.26%) and 77 malignancies (52.74%). Mean elasticity measurements of benign and malignant lesions were significantly different (24.6 kPa, SD 28.47, vs. 101.49 kPa, SD 47.38, p<0.0001). Using the 50 kPa cutoff, elastography showed a global sensitivity of 87% to discriminate malignant lesions (AUC = 0.897). Moreover, sensitivity was 90.7% when lesions were located 5–40 mm below the skin surface (optimal elastographic field of view). Our false positive rate was 17.65%, comprised mainly of fibroepithelial neoplasms, fibroadenomas and fibrosis.ConclusionsQuantitative elastography can differentiate malignant and benign breast lesions with acceptable to excellent performance. In our sample, the QelaXtoTM software showed a lower optimal cutoff than other ultrasound systems.
Uploads