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Chang JW, Kim JS, Jung JG, Kim SS, Yoon SJ, Jang HS. Validity of Alcohol Use Disorder Identification Test-Korean Revised Version for Screening Alcohol Use Disorder according to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Criteria. Korean J Fam Med 2016; 37:323-328. [PMID: 27900069 PMCID: PMC5122663 DOI: 10.4082/kjfm.2016.37.6.323] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 05/25/2016] [Accepted: 05/26/2016] [Indexed: 11/20/2022] Open
Abstract
Background The Alcohol Use Disorder Identification Test (AUDIT) has been widely used to identify alcohol use disorder (AUD). This study evaluated the validity of the AUDIT-Korean revised version (AUDIT-KR) for screening AUD according to Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) criteria. Methods This research was conducted with 443 subjects who visited the Chungnam National University Hospital for a comprehensive medical examination. All subjects completed the demographic questionnaire and AUDIT-KR without assistance. Subjects were divided into two groups according to DSM-5 criteria: an AUD group, which included patients that fit the criteria for AUD (120 males and 21 females), and a non-AUD group, which included 146 males and 156 females that did not meet AUD criteria. The appropriate cut-off values, sensitivity, specificity, and positive and negative predictive values of the AUDIT-KR were evaluated. Results The mean±standard deviation AUDIT-KR scores were 10.32±7.48 points in males and 3.23±4.42 points in females. The area under the receiver operating characteristic curve (95% confidence interval, CI) of the AUDIT-KR for identifying AUD was 0.884 (0.840–0.920) in males and 0.962 (0.923–0.985) in females. The optimal cut-off value of the AUDIT-KR was 10 points for males (sensitivity, 81.90%; specificity, 81.33%; positive predictive value, 77.2%; negative predictive value, 85.3%) and 5 points for females (sensitivity, 100.00%; specificity, 88.54%; positive predictive value, 52.6%; negative predictive value, 100.0%). Conclusion The AUDIT-KR has high reliability and validity for identifying AUD according to DSM-5 criteria.
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Physician Cost Consciousness and Use of Low-Value Clinical Services. J Am Board Fam Med 2016; 29:785-792. [PMID: 28076262 DOI: 10.3122/jabfm.2016.06.160176] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2016] [Revised: 08/25/2016] [Accepted: 08/26/2016] [Indexed: 11/08/2022] Open
Abstract
PURPOSE Choosing WiselyTM engaged medical specialties, creating "top 5 lists" of low-value services. We describe primary care physicians' (PCPs') self-reported use of these services and perceived barriers to guideline adherence. We quantify physician cost consciousness and determine associations with use. METHODS PCP attendees of a continuing medical education conference completed a survey. For each Family Medicine Choosing Wisely behavior, participants reported clinical adherence. Likert scale items assessed perceived barriers. Low-value service frequency was the dependent variable. A validated Cost Consciousness Scale created the predictor variable. We hypothesized that participants with greater cost consciousness would report less frequent use of low-value services. RESULTS Of 199 PCP attendees, 143 (72%) participated. Papanicolaou test after hysterectomy was performed least (0.2 mean services performed/10 patients). Provider knowledge of sinusitis treatment guidelines was greatest but provided most frequently (3.9 mean services performed/10 patients). Practice related barriers were perceived most frequently for adhering to sinusitis treatment guidelines. Attitudinal barriers were greatest for avoiding osteoporosis screening in low risk patients. Greater cost consciousness was associated with less use of low-value services (P = .03), greater knowledge of guidelines (P = .001), and fewer perceived attitudinal and practice behavior-related barriers (P < .001 for each). Greater knowledge of guidelines was not associated with less use of low-value services (P = .58). Familiarity with Choosing Wisely was associated with both greater cost consciousness (P = .004) and less use of low-value services (P = .03). CONCLUSIONS Greater PCP cost consciousness was associated with less use of low-value services. Interventions to decrease perceived barriers and increase cost consciousness, perhaps by increasing awareness of Choosing Wisely, may translate into improved performance.
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Prediabetes Screening and Treatment in Diabetes Prevention: The Impact of Physician Attitudes. J Am Board Fam Med 2016; 29:663-671. [PMID: 28076248 DOI: 10.3122/jabfm.2016.06.160138] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 07/13/2016] [Accepted: 07/18/2016] [Indexed: 11/08/2022] Open
Abstract
PURPOSE Detection and treatment of prediabetes is an effective strategy in diabetes prevention. However, most patients with prediabetes are not identified. Our objective was to evaluate the relationship between attitudes toward prediabetes as a clinical construct and screening/treatment behaviors for diabetes prevention among US family physicians. METHODS An electronic survey of a national sample of academic family physicians (n 1248) was conducted in 2016. Attitude toward prediabetes was calculated using a summated scale assessing agreement with statements regarding prediabetes as a clinical construct. Perceived barriers to diabetes prevention, current strategies for diabetes prevention, and perceptions of peers were also examined. RESULTS Physicians who have a positive attitude toward prediabetes as a clinical construct are more likely to follow national guidelines for screening (58.4% vs 44.4; P < .0001) and recommend metformin to their patients for prediabetes (36.4% vs 20.9%; P < .0001). Physicians perceived a number of barriers to treatment, including a patient's economic resources (71.9%), sustaining patient motivation (83.2%), a patient's ability to modify his or her lifestyle (75.3%), and time to educate patient (75.3%) as barriers to diabetes prevention. CONCLUSIONS How physicians view prediabetes varies significantly, and this variation is related to treatment/screening behaviors for diabetes prevention.
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Kollath-Cattano C, Thrasher JF, Osman A, Andrews JO, Strayer SM. Physician Advice for e-Cigarette Use. J Am Board Fam Med 2016; 29:741-747. [PMID: 28076257 PMCID: PMC6143900 DOI: 10.3122/jabfm.2016.06.160092] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Revised: 07/14/2016] [Accepted: 07/19/2016] [Indexed: 11/08/2022] Open
Abstract
PURPOSE To determine characteristics of smokers discussing e-cigarette use with their physician and receiving recommendations from their physician to use e-cigarettes for smoking cessation. METHODS US adult smokers who had visited a physician in the previous 12 months (n = 2671) were surveyed. Logistic generalized estimating equation models were used to assess the characteristics of smokers who (1) talked to a physician about e-cigarettes, and (2) received physician advice to use e-cigarettes for smoking cessation. RESULTS 15% (n = 406) of smokers who visited a physician talked with their physician about e-cigarettes. Among those asked whether their physician recommend e-cigarettes for smoking cessation (n = 257), 61% responded affirmatively. Current e-cigarette users were more likely to talk to their physicians about e-cigarettes (nondaily users vs never users: OR, 2.70; 95% CI, 1.79-4.05; daily users vs never users: OR, 4.29; 95% CI, 2.34-7.84) and have their physician recommend e-cigarettes for smoking cessation (daily users vs never users: OR, 9.40; 95% CI, 2.54-34.71). CONCLUSIONS The majority of smokers who talk to their physician about e-cigarettes report that they received advice to use e-cigarettes to quit smoking, despite limited evidence for their efficacy. More studies are needed to better understand e-cigarette recommendations in clinical settings.
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Nash JL, McElfresh KR. A journal cancellation survey and resulting impact on interlibrary loan. J Med Libr Assoc 2016; 104:296-300. [PMID: 27822151 DOI: 10.3163/1536-5050.104.4.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE The research describes an extensible method of evaluating and cancelling electronic journals during a budget shortfall and evaluates implications for interlibrary loan (ILL) and user satisfaction. METHODS We calculated cost per use for cancellable electronic journal subscriptions (n=533) from the 2013 calendar year and the first half of 2014, cancelling titles with cost per use greater than $20 and less than 100 yearly uses. For remaining titles, we issued an online survey asking respondents to rank the importance of journals to their work. Finally, we gathered ILL requests and COUNTER JR2 turnaway reports for calendar year 2015. RESULTS Three hundred fifty-four respondents completed the survey. Because of the level of heterogeneity of titles in the survey as well as respondents' backgrounds, most titles were reported to be never used. We developed criteria based on average response across journals to determine which to cancel. Based on this methodology, we cancelled eight journals. Examination of ILL data revealed that none of the cancelled titles were requested with any frequency. Free-text responses indicated, however, that many value free ILL as a suitable substitute for immediate full-text access to biomedical journal literature. CONCLUSIONS Soliciting user feedback through an electronic survey can assist collections librarians to make electronic journal cancellation decisions during slim budgetary years. This methodology can be adapted and improved upon at other health sciences libraries.
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Tam-Tham H, King-Shier KM, Thomas CM, Quinn RR, Fruetel K, Davison SN, Hemmelgarn BR. Prevalence of Barriers and Facilitators to Enhancing Conservative Kidney Management for Older Adults in the Primary Care Setting. Clin J Am Soc Nephrol 2016; 11:2012-2021. [PMID: 27551007 PMCID: PMC5108196 DOI: 10.2215/cjn.04510416] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Accepted: 07/14/2016] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND OBJECTIVES Conservative management of adults with stage 5 CKD (eGFR<15 ml/min per 1.73 m2) is increasingly being provided in the primary care setting. We aimed to examine perceived barriers and facilitators for conservative management of older adults by primary care physicians. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS In 2015, we conducted a cross-sectional, population-based survey of all primary care physicians in Alberta, Canada. Eligible participants had experience caring for adults ages ≥75 years old with stage 5 CKD not planning on initiating dialysis. Questionnaire items were on the basis of a qualitative descriptive study informed by the Behavior Change Wheel and tested for face and content validity. Physicians were contacted via postal mail and/or fax on the basis of a modified Dillman method. RESULTS Four hundred nine eligible primary care physicians completed the questionnaire (9.6% response rate). The majority of respondents were men (61.6%), were ages 40-60 years old (62.6%), and practiced in a large/medium population center (68.0%). The most common barrier to providing conservative care in the primary care setting was the inability to access support to maintain patients in the home setting (39.1% of respondents; 95% confidence interval, 34.6% to 43.6%). The second most common barrier was working with nonphysician providers with limited kidney-specific clinical expertise (32.3%; 95% confidence interval, 28.0% to 36.7%). Primary care physicians indicated that the two most common strategies that would enhance their ability to provide conservative management would be the ability to use the telephone to contact a nephrologist or clinical staff from the conservative care clinic (86.9%; 95% confidence interval, 83.7% to 90.0% and 85.6%; 95% confidence interval, 82.4% to 88.9%, respectively). CONCLUSIONS We identified important areas to inform clinical programs to reduce barriers and enhance facilitators to improve primary care physicians' provision of conservative kidney care. In particular, primary care physicians require additional resources for maintaining patients in their home and telephone access to nephrologists and conservative care specialists.
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607
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Kim SI, Kim N, Lee S, Lee S, Joo J, Seo SS, Chung SH, Park SY, Lim MC. Development of the short version of the Gynecologic Cancer Lymphedema Questionnaire: GCLQ-7. J Gynecol Oncol 2016; 28:e9. [PMID: 27819411 PMCID: PMC5323290 DOI: 10.3802/jgo.2017.28.e9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2016] [Revised: 09/19/2016] [Accepted: 09/28/2016] [Indexed: 11/30/2022] Open
Abstract
Objective The Gynecologic Cancer Lymphedema Questionnaire (GCLQ) was designed to identify gynecologic cancer patients with lower limb lymphedema (LLL). The questionnaire consists of 20 items distributed over 7 symptom clusters. The present study aimed to develop an abridged form of the GCLQ for simpler screening and more effective follow-up of LLL. Methods Data that had been collected for the development and validation of the Korean version of the GCLQ (GCLQ-K) were used in this study. Receiver-operating characteristic (ROC) curves were drawn according to the individual items of the GCLQ-K. Based on discrimination ability, the candidate items were selected in each symptom cluster. After combining the items, the best model was identified and named GCLQ-7. The area under the ROC curve (AUC) was compared between the GCLQ-7 and the original GCLQ-K. Results In total, 11 candidate items were selected from the original GCLQ-K. Among the models made with the candidate items, GCLQ-7, the best model, was constructed with 7 items as follows: 1) limited knee movement, 2) general swelling, 3) redness, 4) firmness/tightness, 5) groin swelling, 6) heaviness, and 7) aching. This model exhibited an AUC of 0.945 (95% confidence interval [CI], 0.900–0.991), which is comparable with that of the original GCLQ-K (AUC, 0.867; 95% CI, 0.779–0.956). The best cutoff value was 2 points, at which the sensitivity and specificity were 97.0% and 76.5%, respectively. Conclusion The newly developed short version model, GCLQ-7, showed acceptable discrimination ability as compared with the original GCLQ-K.
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608
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Diagnostic Tool for Assessing Overactive Bladder Symptoms: Could the International Prostate Symptom Storage Subscore Replace the Overactive Bladder Symptom Score? Int Neurourol J 2016; 20:209-213. [PMID: 27706011 PMCID: PMC5083829 DOI: 10.5213/inj.1632534.267] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 04/04/2016] [Indexed: 11/08/2022] Open
Abstract
PURPOSE The goal of this study was to compare the International Prostate Symptom Storage Subscore (IPSS-s) and the overactive bladder symptom score (OABSS) as tools for assessing the symptoms of overactive bladder (OAB). METHODS A cross-sectional study was conducted of a sample of 1,341 patients aged 50 years and older with lower urinary tract complaints who had undergone a medical examination at one of several centers. For each patient, we reviewed the International Prostate Symptom Score and the OABSS. The patients were divided into 2 groups according to their IPSS-s result (group 1, score ≥6; group 2, score<6) and into another 2 groups according to their OABSS diagnosis (group 3, OAB patients; group 4, non-OAB patients). We determined whether the OABSS varied to a statistically significant extent between groups 1 and 2. Furthermore, we evaluated the correlation of IPSS-s severity with the OABSS results in group 3, and the OAB diagnosis rate was compared between groups 1 and 2. RESULTS In groups 1 and 2, the OABSS results were not found to vary to a statistically significant extent (P=0.326). In group 3, no significant correlation was found between IPSS-s severity and the OABSS results (P=0.385). In the prevalence analysis, no statistically significant difference was found among the groups, and the receiver operating characteristic curve showed an area under the curve of 0.474. CONCLUSIONS The results of this cross-sectional analysis suggest that the IPSS-s and the OABSS are not significantly correlated. Although both scores are used to measure OAB symptoms, the simultaneous use of IPSS-s and OABSS is not warranted.
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Lee TH, Jung JH, Hong YK. Diagnosis and Management of Pediatric and Adolescent Varicocele: A Survey of Pediatric Urologists in Korea. Chonnam Med J 2016; 52:207-11. [PMID: 27689031 PMCID: PMC5040770 DOI: 10.4068/cmj.2016.52.3.207] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Revised: 06/02/2016] [Accepted: 06/14/2016] [Indexed: 11/25/2022] Open
Abstract
The aim of this study was to evaluate current practice patterns on diagnosis and management of pediatric varicoceles. Questionnaires of approaches to diagnosis and management of pediatric varicoceles were sent electronically to pediatric urologists. Of the 70 questionnaires e-mailed, 37 (53%) responded to the survey. 10 respondents (27%) chose to operate on varicoceles, whereas 9 (24%) chose to observe, and 18 (49%) chose to decide upon treatment depending on the clinical situation. The most important indication for varicocelectomy was a decrease in ipsilateral testicular size (n=29, 78%) followed by testicular or scrotal pain (n=4, 11%) and varicocele grade (n=4, 11%). The optimal age for varicocelectomy was answered as 13.8±2.3 years mean. 32 respondents (86%) have used ultrasonography to aid in the diagnosis of varicoceles, and 26 respondents (70%) have considered repairing varicocele incidentally detected on ultrasonography. In an otherwise asymptomatic patient with varicocele, 17 respondents (46%) considered surgery for grade 3, but 15 respondents (41%) would not repair the varicocele. The most commonly used surgical approach was subinguinal microsurgical (n=19, 51%), followed by inguinal (n=9, 24%) and laparascopic (n=5, 14%) procedures. The most commonly experienced post-operative complication was recurrence (n=22, 59%) followed by persistence (n=13, 35%) and hydrocele (n=10, 27%). 28 respondents (76%) did not have long-term follow-up data including regarding fertility on their varicocele patients. Our survey demonstrates that there is lack of consensus on diagnosis and management of pediatric and adolescent varicoceles among pediatric urologists. A prospective randomized study of pediatric and adolescent varicoceles is needed to assess the outcomes and develop universal management guidelines.
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Sainz García P, Ferrer Svoboda MC, Sánchez Ruiz E. [Cooking Skills and Consumption of Ready Meal in University Students of Barcelona, Spain]. Rev Esp Salud Publica 2016; 90:e1-e13. [PMID: 27650661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 09/12/2016] [Indexed: 06/06/2023] Open
Abstract
OBJECTIVE Confidence in cooking skills is relevant in health. The objective was to study the status of cooking skills and consumption of ready meal among university students in the city of Barcelona, assessing their association with sociodemographic variables and confidence in some culinary skills and knowing how to cook. METHODS Cross-sectional study, carried out during the 2014-2015 academic year, 525 students (81.3% women, median age 21 years) using an on-line questionnaire. Bivariate and multivariate analyses were performed; odds ratios and 95% confidence intervals were estimated. RESULTS Between 53% and 89% of the students reported feeling very confident in 10 of the 18 cooking skills. No statistically significant differences were observed by sex, and between 62% and 86% of those over 21 years expressed great confidence in 9 competitions. The consumption of ready meal was prevalent (49.4%) and associated with age (OR=0.95 95% CI: 0.91-0.99), gender (male, OR=1.98 95% CI: 1.23-3.18) and not knowing how to cook (OR=2.25 95% CI: 1.10-4.60). In students who knew how to cook, eating ready meal was associated with gender (male, OR =1.67 95% CI: 1.00 to 2.77) and no longer feel confident in preparing more than one food at one time (OR = 1.73 95% CI: 1.58 to 2.60). CONCLUSIONS Students at a university in Barcelona have a level in cooking skills which could be improved, and consume ready meals usually.
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Merks P, ŚWieczkowski D, Jaguszewski MJ. Patients' perception of pharmaceutical services available in a community pharmacy among patients living in a rural area of the United Kingdom. Pharm Pract (Granada) 2016; 14:774. [PMID: 27785163 PMCID: PMC5061519 DOI: 10.18549/pharmpract.2016.03.774] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Accepted: 08/31/2016] [Indexed: 11/17/2022] Open
Abstract
Objective: Patients’ opinion about prevalence of pharmaceutical services available in a community pharmacy among patients living in a rural area of the United Kingdom. The secondary objective was to identify appropriate action(s) to enhance patients’ awareness of pharmaceutical services in rural areas. Methods: A self-administered, anonymous questionnaire was distributed to patients visiting a community pharmacy in Eye, Suffolk, United Kingdom between July and August, 2015. The main inclusion criterion was living in a rural area. Comparisons were performed using chi-square tests and logistic regression. Results: The study included 103 respondents: 70 women (69.0%) and 33 men (32.0%), aged 16–85 years. Most respondents declared the primary tasks of a community pharmacy were dispensing medicines (86.4% of respondents) and repeat dispensing (72.8% of respondents). Additionally, 23.3% of respondents treated minor ailments at the pharmacy, including bacterial/viral infections, minor injuries, stomach problems, and allergies. The Medicines Use Review service was the only advanced service used in this pharmacy (12.6% of respondents), primarily by men. Younger patients were more familiar with the term of pharmaceutical care (p<0.05; OR=0.33). Conclusions: Only a few pharmaceutical services are utilized by people living in rural areas in the UK, namely prescription dispensing, repeat dispensing, and sale of medications that support self-care for minor ailments. We found an overall poor awareness of the expanded variety of pharmaceutical services encouraged by the community pharmacy contract introduced in the UK in 2005. Therefore, politicians, pharmacists, and pharmacy experts should actively promote these advanced pharmaceutical services in rural areas.
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Chan V, Tran H. Purchasing Over-the-counter medicines from Australian pharmacy: What do the pharmacy customers value and expect? Pharm Pract (Granada) 2016; 14:782. [PMID: 27785164 PMCID: PMC5061520 DOI: 10.18549/pharmpract.2016.03.782] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Accepted: 07/09/2016] [Indexed: 11/26/2022] Open
Abstract
Background: Over-the-counter medicines (OTC) are widely available and can be purchased without a prescription. Their availability means that a customer may choose to purchase them without the involvement of a pharmacy/pharmacist. It is important to understand customer OTC purchasing perceptions and behaviour from a pharmacy to better understand the needs and opportunities in this space. Objective: This study aimed to examine customers’ key expectations and what they value when purchasing OTC and how the effect of health status/stress and perceived risks/benefits of purchasing OTCs from a pharmacy may influence their OTC shopping behaviour. Methods: Customers from two metropolitan pharmacies across two different suburbs in Brisbane, Queensland, Australia completed a self-administered questionnaire. Data collection was conducted over a six-week period. The questionnaire examined demographics, current level of health and stress, as well as a range of questions (seven-point Likert-scale) examining perceived benefits and risks, what they value, trust and expect when purchasing OTC. Results: A total of 86 customers from a broad range of demographics were captured in this study. When asked about their current health state, 41% and 23% respectively indicated that they were stressed and tense when they arrived at the pharmacy but many were feeling well (38%). Most customers strongly agreed/agreed that trust in the advice from a pharmacy (96%), trust in the products (73%), and the altruistic approach of a pharmacy (95%) were critical to them. Further, 82% and 78% respectively disagreed that time pressures or costs were concerns, despite many feeling tense and stressed when they came in. When asked where they intend to buy their future OTC, 89% indicated pharmacy instead of a supermarket. Conclusions: High levels of trust, confidence and sense of altruism and care were key factors for customers buying OTC from a pharmacy, regardless of time pressures, costs or existing levels of stress and health.
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Aggarwal VP, Garg R, Goyal N, Kaur P, Singhal S, Singla N, Gijwani D, Sharma A. Exploring the missing link - Empathy among dental students: An institutional cross-sectional survey. Dent Res J (Isfahan) 2016; 13:419-423. [PMID: 27857767 PMCID: PMC5091000 DOI: 10.4103/1735-3327.192279] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Empathy plays an important role in healthy dentist and patient relationship. Hence, the aim of the study is to (a) to measure the self-reported empathy levels among dental undergraduate and postgraduate students. (b) To review the trend of changes in empathy level with experience, age, and gender among dental undergraduate and postgraduate students. MATERIALS AND METHODS This cross-sectional, questionnaire-based study was carried out in two private dental institutions situated in Sri Ganganagar, India, with a sample size of 978. Data were obtained from the 1st to final year (BDS), interns, and postgraduate students from January to March 2015. An empathy level of students was assessed by the Jefferson Scale of Physician Empathy - Health Profession Students Version Questionnaire. An exploratory factor analysis using Kaiser's criteria was undertaken to appraise the construct validity and dimensionality. Based on the results of the factor analysis, three factors were selected; labeled as perspective taking, compassionate care, and standing in patient's shoes. RESULTS The majority of the students was female in a equivalent ratio of 1338:618. There were significant differences in empathy scores by gender and age (P < 0.01). The lowest and highest mean empathy scores were found in postgraduate (mean = 108.77, standard deviation [SD] =9.12) and 1st year (mean = 117.23, SD = 14.19) dental students, respectively. CONCLUSION Dental educators should consider the likely decline in empathy among students as early as possible and adopt communication teaching strategies to promote the development of empathy and reduce the risk of further decline.
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Cross-cultural Adaptation of the Pelvic Girdle Questionnaire for the French-Canadian Population. J Manipulative Physiol Ther 2016; 39:494-499. [PMID: 27535785 DOI: 10.1016/j.jmpt.2016.06.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 06/08/2016] [Accepted: 06/17/2016] [Indexed: 11/20/2022]
Abstract
OBJECTIVE The Pelvic Girdle Questionnaire (PGQ) is the only condition-specific tool assessing activity limitations and symptoms for those with pelvic girdle pain (PGP). It is simple to administer and can be used in research and clinical settings during pregnancy and postpartum periods; however, there currently is no version for the French-Canadian population. The aim of this study was to translate and culturally adapt the PGQ for the French-Canadian population. METHODS The French-Canadian translation and adaptation of the PGQ was completed following a 4-stage approach: (1) forward translation, (2) synthesis, (3) expert committee review, and (4) testing of the prefinal version of the questionnaire. The testing stage was conducted with a cohort of 34 women, aged 18 to 45 years, who experienced PGP over the span of pregnancy or during the first year postpartum. RESULTS The global understanding of the PGP concept was rated as either "Fair" (41.2%) or "Good" (32.4%) by the majority of participants, which led to the consensual decision to add an illustration of the pelvic girdle region to the final version of the French-Canadian PGQ. Only 1 item ("Has your leg/have your legs given way?") was reported as unclear by 12 participants (35.3%). The expert committee unanimously agreed to add a brief explanation of the term "given way" to the final version to ensure proper understanding of the question. CONCLUSIONS The current study yielded a satisfactory French-Canadian translation of the PGQ.
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Al-Riyami AZ, Al-Marshoodi I, Zia F, Al-Huneini M, Al-Rawas AH, Jose S, Daar S, Al-Khabori M, Al-Sabti H. Transfusion Consent in Oman: Physicians' Perception at a Tertiary Care University Hospital. Oman Med J 2016; 31:253-7. [PMID: 27403236 DOI: 10.5001/omj.2016.50] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Transfusion is a common intervention that mandates the discussion of benefits, risks, and alternatives to planned transfusions. In Oman, transfusion consent was first introduced at the Sultan Qaboos University Hospital in March 2014. We sought to evaluate our physicians' opinions, attitudes, and perception of the transfusion consent process. METHODS Attending physicians of different specialties were invited to complete an anonymous survey on transfusion consent. RESULTS A total of 114 physicians responded to the survey. Transfusion benefits and risks were explained regularly by 91% and 87% of the surveyed physicians, respectively. On the other hand, alternatives were declared by only 38%. Discomfort with the consent process was admitted by 10% of the physicians. There was no statistically significant association between discomfort in obtaining the consent and the physician seniority (p = 0.801), nor their specialties (p = 0.623). The importance of the consent process was acknowledged by 80% of surveyed physicians, who supported its implementation in other hospitals. CONCLUSION This survey reflects positive attitudes of the surveyed physicians on the importance of transfusion consent. However, actions are required to achieve physicians' full ease with the process and to ensure that transfusion alternatives are discussed. We advocate implementation of transfusion consent in other hospitals in Oman.
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Maafi AA, Ghavidel-Parsa B, Haghdoost A, Aarabi Y, Hajiabbasi A, Shenavar Masooleh I, Zayeni H, Ghalebaghi B, Hassankhani A, Bidari A. Serum Vitamin D Status in Iranian Fibromyalgia Patients: according to the Symptom Severity and Illness Invalidation. Korean J Pain 2016; 29:172-8. [PMID: 27413482 PMCID: PMC4942645 DOI: 10.3344/kjp.2016.29.3.172] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 05/08/2016] [Accepted: 05/16/2016] [Indexed: 01/25/2023] Open
Abstract
Background This study was designed to assess serum vitamin D status (25-OHD) in the fibromyalgia (FM) patients and to compare it with a healthy control group. It also aimed to investigate the correlation of serum vitamin D level with FM symptom severity and invalidation experiences. Methods A total of 74 consecutive patients with FM and 68 healthy control participants were enrolled. The eligible FM patients completed the Illness Invalidation Inventory (3*I), the Revised Fibromyalgia Impact Questionnaire (FIQR) and a short-form health survey (SF-12). Venous blood samples were drawn from all participants to evaluate serum 25-OHD levels. Mann-Whitney tests and multiple logistic regression analyses were performed and Spearman's correlations were calculated. Results 88.4% of FM patients had low levels of serum 25-OHD. FM patients had significantly higher level of serum 25-OHD than the control group (17.24 ± 13.50 and 9.91 ± 6.47 respectively, P = 0.0001). There were no significant correlations between serum 25-OHD levels and the clinical measures of disease impact, invalidation dimensions, and health status. Multiple logistic regression analyses revealed that an increased discounting of the disease by the patient's spouse was associated with a 4-fold increased risk for vitamin D deficiency (OR = 4.36; 95% CI, 0.95–19.87, P = 0.05). Conclusions This study showed that although high rates of vitamin D insufficiency or deficiency were seen among FM patients and healthy non-FM participants, but it seems there was no intrinsic association between FM and vitamin D deficiency. Addressing of invalidation experience especially by the patient's spouse is important in management of FM.
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617
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Who is Using Telehealth in Primary Care? Safety Net Clinics and Health Maintenance Organizations (HMOs). J Am Board Fam Med 2016; 29:432-3. [PMID: 27390373 DOI: 10.3122/jabfm.2016.04.150375] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Accepted: 04/18/2016] [Indexed: 11/08/2022] Open
Abstract
Despite rapid advancements in telehealth services, only 15% of family physicians in a 2014 survey reported using telehealth; use varied widely according to the physician's practice setting or designation. Users were significantly more likely than nonusers to work in federally designated "safety net" clinics and health maintenance organizations (HMOs) but not more likely than nonusers to report working in a patient-centered medical home (PCMH) or accountable care organization.
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618
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Alkhateeb FM, Attarabeen OF, Alameddine S. Assessment of Texan pharmacists' attitudes, behaviors, and preferences related to continuing pharmacy education. Pharm Pract (Granada) 2016; 14:769. [PMID: 27785162 PMCID: PMC5061518 DOI: 10.18549/pharmpract.2016.03.769] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2016] [Accepted: 08/01/2016] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Whether the available Continuing Education (CE) programs meet pharmacists' continuously increasing needs and preferences is open to question. OBJECTIVES to investigate pharmacists' perceptions and attitudes concerning available CE programs, evaluate the pharmacists' choices with regard to selecting among different CE programs, and investigate the factors that are associated with preference to utilize online CE programs. METHOD A 17-question survey was developed and mailed to a random sample of 600 Texan pharmacists. In addition to collecting basic demographic information, the survey investigated pharmacists' choices with regard to delivery and content of CE programs, motivations to participation in CE programs, and pharmacists' preferences for future CE programs. RESULTS A total of 161 pharmacists completed the survey and mailed back their responses. Excluding the 75 undeliverable surveys, the response rate was 31%. Approximately 83% of respondents found that currently available CE programs met their educational needs. The most important factors influencing pharmacists' choices with regard to CE programs were the scope programs, the location where programs are held, and the cost associated with enrolling in such programs. Online CE was the most preferred mode of CE among participants. The factors that were associated with pharmacists' preferences to complete 50% or more of required CE through online programs were previous use of online CE programs, preference to limit the duration of CE programs to 1 or 2 hour-long, and perceived ability to find adequate CE programs among currently available CE programs. CONCLUSION The findings suggest modalities for CE programs providers on how to improve CE programs in the future in order to meet the preferences of local pharmacists.
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Hammar T, Nilsson AL, Hovstadius B. Patients' views on electronic patient information leaflets. Pharm Pract (Granada) 2016; 14:702. [PMID: 27382423 PMCID: PMC4930857 DOI: 10.18549/pharmpract.2016.02.702] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Accepted: 04/18/2016] [Indexed: 01/06/2023] Open
Abstract
Background: Information in society and in health care is currently undergoing a transition from paper to digital formats, and the main source of information will probably be electronic in the future. Objective: To explore patients’ use and perceptions of the patient information leaflet included in the medication package, and their attitude towards a transition to an electronic version. Methods: The data was collected during October to November 2014 among individuals in South-Eastern Sweden, using a questionnaire (n=406, response rate 78%) and interviews (n=15). Results: The questionnaire showed that the majority of the respondents (52%) occasionally read the patient information leaflet, 37% always read it, and 11% never read it. Almost half of the patients (41%) were positive towards reading the patient information leaflet electronically while 32% were hesitant and 26% neutral. A majority of the patients would request to get the patient information leaflet printed at the pharmacy if it was not included in the package. There were differences in attitude related to age and gender. The interviews showed that patients had mixed views on a transition to an electronic patient information leaflet. The patients perceived several positive aspects with an electronic patient information leaflet but were concerned about elderly patients. Conclusion: Although many were positive towards reading the patient information leaflet electronically, the majority prefer the patient information leaflet in paper form. Providing appropriate and useful eHealth services for patients to access the patient information leaflet electronically, along with education, could prepare patients for a transition to electronic patient information leaflet.
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Paramio-Pérez G, Almagro BJ, Hernando Á, Aguaded I. [Answer to the letter Correlated errors and estimate of reliability in validation studies: comments to work Validation of the eHealth Literacy Scale (eHEALS) in Spanish University Students]. Rev Esp Salud Publica 2016; 90:e1-e2. [PMID: 27324660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Accepted: 06/03/2016] [Indexed: 06/06/2023] Open
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621
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Dominguez-Lara SA. [Correlated errors and estimate of reliability in validation studies: comments to work Validation of the eHealth Literacy Scale (eHEALS) in Spanish University Students]. Rev Esp Salud Publica 2016; 90:e1-e2. [PMID: 27324834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Accepted: 06/03/2016] [Indexed: 06/06/2023] Open
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622
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Josephson MA, Perazella MA, Choi MJ. American Society of Nephrology Quiz and Questionnaire 2015: Transplantation. Clin J Am Soc Nephrol 2016; 11:1114-1122. [PMID: 26915914 PMCID: PMC4891764 DOI: 10.2215/cjn.13451215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The Nephrology Quiz and Questionnaire remains an extremely popular session for attendees of the Annual Kidney Week Meeting of the American Society of Nephrology. Once again, the conference hall was overflowing with audience members and eager quiz participants. Topics covered by the expert discussants included electrolyte and acid-base disorders, glomerular disease, ESRD/dialysis, and kidney transplantation. Complex cases representing each of these categories along with single best answer questions were prepared and submitted by the panel of experts. Before the meeting, training program directors of US nephrology fellowship programs and nephrology fellows answered the questions through an internet-based questionnaire. During the live session, members of the audience tested their knowledge and judgment on a series of case-oriented questions prepared and discussed by the experts. They compared their answers in real time using their cell phones with a special application with the answers of the nephrology fellows and training program directors. The correct and incorrect answers were then discussed after the results of the questionnaire were displayed. As always, the audience, lecturers, and moderators enjoyed this highly educational session. This article recapitulates the session and reproduces its educational value for the Clinical Journal of the American Society of Nephrology readers. Enjoy the clinical cases and expert discussions.
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Kim Y, Choi YJ, Oh SW, Joh HK, Kwon H, Um YJ, Ahn SH, Kim HJ, Lee CM. Discrepancy between Self-Reported and Urine-Cotinine Verified Smoking Status among Korean Male Adults: Analysis of Health Check-Up Data from a Single Private Hospital. Korean J Fam Med 2016; 37:171-6. [PMID: 27274388 PMCID: PMC4891319 DOI: 10.4082/kjfm.2016.37.3.171] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2015] [Revised: 08/21/2015] [Accepted: 09/27/2015] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Enquiry into smoking status and recommendations for smoking cessation is an essential preventive service. However, there are few studies comparing self-reported (SR) and cotinine-verified (CV) smoking statuses, using medical check-up data. The rates of discrepancy and under-reporting are unknown. METHODS We performed a cross-sectional study using health examination data from Healthcare System Gangnam Center, Seoul National University Hospital in 2013. We analyzed SR and CV smoking statuses and discrepancies between the two in relation to sociodemographic variables. We also attempted to ascertain the factors associated with a discrepant smoking status among current smokers. RESULTS In the sample of 3,477 men, CV smoking rate was 11.1% higher than the SR rate. About 1 in 3 participants either omitted the smoking questionnaire or gave a false reply. The ratio of CV to SR smoking rates was 1.49 (95% confidence interval [CI], 1.38-1.61). After adjusting for confounding factors, older adults (≥60 years) showed an increased adjusted odds ratio (aOR) for discrepancy between SR and CV when compared to those in their twenties and thirties (aOR, 5.43; 95% CI, 2.69-10.96). Educational levels of high school graduation or lower (aOR, 2.33; 95% CI, 1.36-4.01), repeated health check-ups (aOR, 1.45; 95% CI, 1.03-2.06), and low cotinine levels of <500 ng/mL (aOR, 2.03; 95% CI, 1.33-3.09), were also associated with discordance between SR and CV smoking status. CONCLUSION Omissions and false responses impede the accurate assessment of smoking status in health check-up participants. In order to improve accuracy, it is suggested that researcher pay attention to participants with greater discrepancy between SR and CV smoking status, and formulate interventions to improve response rates.
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Alexander KP, Stadnyuk O, Arnold SV, Mark DB, Ohman EM, Anstrom KJ. Assessing Quality of Life and Medical Care in Chronic Angina: An Internet Survey. Interact J Med Res 2016; 5:e12. [PMID: 27125492 PMCID: PMC4865655 DOI: 10.2196/ijmr.4971] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Revised: 11/23/2015] [Accepted: 01/04/2016] [Indexed: 11/13/2022] Open
Abstract
Background Angina is a clinical syndrome whose recognition relies heavily on self-report, so its identification can be challenging. Most data come from cohorts identified by physicians and nurses at the point of care; however, current widespread access to the Internet makes identification of community cohorts feasible and offers a complementary picture of angina. Objective To describe a population self-identified as experiencing chronic angina by use of an Internet survey. Methods Using email and an Internet portal, we invited individuals with a diagnosis of angina and recent symptoms to complete an Internet survey on treatment and quality of life (QOL). In total, 1147 surveys were received. The main analysis was further limited to those reporting a definite coronary heart disease (CHD) history (N=646, 56% of overall). Results Overall, about 15% reported daily angina and 40% weekly angina. Those with more frequent angina were younger, more often depressed, and reported a shorter time since diagnosis. They also had substantially worse treatment satisfaction, physical function, and overall QOL. Fewer than 40% were on ≥ 2 anti-anginals, even with daily angina. The subjects without a history of definite CHD had unexpectedly low use of antianginal and evidence-based medicines, suggesting either a lack of specificity in the use of self-reported angina to identify patients with CHD or lack of access to care. Conclusions Use of inexpensive electronic tools can identify community-based angina cohorts for clinical research. Limitation to subjects with a definite history of CHD lends diagnostic face validity to the approach; however, other symptomatic individuals are also identified.
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Seo YR, Kim JS, Kim SS, Yoon SJ, Suh WY, Youn K. Development of a Simple Tool for Identifying Alcohol Use Disorder in Female Korean Drinkers from Previous Questionnaires. Korean J Fam Med 2016; 37:18-24. [PMID: 26885318 PMCID: PMC4754281 DOI: 10.4082/kjfm.2016.37.1.18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Accepted: 10/08/2015] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND This study aimed to develop a simple tool for identifying alcohol use disorders in female Korean drinkers from previous questionnaires. METHODS This research was conducted on 400 women who consumed at least one alcoholic drink during the past month and visited the health promotion center at Chungnam National University Hospital between June 2013 to May 2014. Drinking habits and alcohol use disorders were assessed by structured interviews using the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition diagnostic criteria. The subjects were also asked to answer the Alcohol Use Disorders Identification Test (AUDIT), AUDIT-Consumption, CAGE (Cut down, Annoyed, Guilty, Eye-opener), TWEAK (Tolerance, Worried, Eye-opener, Amnesia, Kut down), TACE (Tolerance, Annoyed, Cut down, Eye-opener), and NET (Normal drinker, Eye-opener, Tolerance) questionnaires. The area under receiver operating characteristic (AUROC) of each question of the questionnaires on alcohol use disorders was assessed. After combining two questions with the largest AUROC, it was compared to other previous questionnaires. RESULTS Among the 400 subjects, 58 (14.5%) were identified as having an alcohol use disorder. Two questions with the largest AUROC were question no. 7 in AUDIT, "How often during the last year have you had a feeling of guilt or remorse after drinking?" and question no. 5 in AUDIT, "How often during the past year have you failed to do what was normally expected from you because of drinking?" with an AUROC (95% confidence interval [CI]) of 0.886 (0.850-0.915) and 0.862 (0.824-0.894), respectively. The AUROC (95% CI) of the combination of the two questions was 0.958 (0.934-0.976) with no significant difference as compared to the existing AUDIT with the largest AUROC. CONCLUSION The above results suggest that the simple tool consisting of questions no. 5 and no. 7 in AUDIT is useful in identifying alcohol use disorders in Korean female drinkers.
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