Abstract:
OBJECTIVE:We aimed to validate the Oudega diagnostic decision rule-which was developed and validated among younger aged primary care patients-to rule-out deep vein thrombosis (DVT) in frail older outpatients. METHODS:In older patients (>60 years, either community dwelling or residing in nursing homes) with clinically suspected DVT, physicians recorded the score on the Oudega rule and d-dimer test. DVT was confirmed with a composite reference standard including ultrasonography examination and 3-month follow-up. The proportion of patients with a very low probability of DVT according to the Oudega rule (efficiency), and the proportion of patients with symptomatic venous thromboembolism during 3 months follow-up within this 'very low risk' group (failure rate) was calculated. RESULTS:DVT occurred in 164 (47%) of the 348 study participants (mean age 81 years, 85% residing in nursing homes). The probability of DVT was very low in 69 patients (Oudega score ≤3 points plus a normal d-dimer test; efficiency 20%) of whom four had non-fatal DVT (failure rate 5.8%; 2.3-14%). With a simple revised version of the Oudega rule for older suspected patients, 43 patients had a low risk of DVT (12% of the total population) of whom only one had DVT (failure rate 2.3%; 0.4-12%). CONCLUSIONS:In older suspected patients, application of the original Oudega rule to exclude DVT resulted in a higher failure rate as compared to previous studies. A revised and simplified Oudega strategy specifically developed for elderly suspected patients resulted in a lower failure rate though at the expense of a lower efficiency.
journal_name
Fam Practjournal_title
Family practiceauthors
Schouten HJ,Koek HL,Oudega R,van Delden JJ,Moons KG,Geersing GJdoi
10.1093/fampra/cmu068subject
Has Abstractpub_date
2015-02-01 00:00:00pages
120-5issue
1eissn
0263-2136issn
1460-2229pii
cmu068journal_volume
32pub_type
杂志文章相关文献
FAMILY PRACTICE文献大全abstract:BACKGROUND:recruitment targets to randomized controlled trials (RCTs) are often not met. Many interventions are used to improve recruitment but there is little empirical evidence on whether these approaches work. OBJECTIVE:to examine whether changes to the design and conduct of a primary care-based RCT were associated...
journal_title:Family practice
pub_type: 杂志文章
doi:10.1093/fampra/cmq050
更新日期:2010-12-01 00:00:00
abstract:Introduction:We must study alternatives to structure an effective diabetic retinopathy screening program for Brazilian public health system. Objectives:Evaluate the diagnostic performance of retinal digital photography for diabetic retinopathy screening in primary care, accuracy of the family physician in diabetic ret...
journal_title:Family practice
pub_type: 杂志文章
doi:10.1093/fampra/cmx020
更新日期:2017-09-01 00:00:00
abstract::A survey was undertaken to evaluate an undergraduate general practice preceptorship by means of an open-ended six-item questionnaire given to students at the end of their general practice attachment. The aim of the survey was to evaluate the preceptorship as a learning experience and to examine ways in which the prece...
journal_title:Family practice
pub_type: 杂志文章
doi:10.1093/fampra/9.3.323
更新日期:1992-09-01 00:00:00
abstract:BACKGROUND:The use of mHealth technology is an innovative approach for screening low-income mothers for depression. Past studies show that the use of technology removes barriers such as literacy issues, language challenges, concerns about privacy and lack of transportation and can also increase reliability. However, li...
journal_title:Family practice
pub_type: 杂志文章
doi:10.1093/fampra/cmu083
更新日期:2015-04-01 00:00:00
abstract:Background:Most well-developed healthcare systems are facing the challenge of managing the increasing prevalence of patients with chronic diseases. Comprehensive frameworks, such as the chronic care model (CCM), receive widespread acceptance for improving care processes, clinical outcomes and costs. Objective:The purp...
journal_title:Family practice
pub_type: 杂志文章
doi:10.1093/fampra/cmx123
更新日期:2018-07-23 00:00:00
abstract::This paper presents a method for assessing the doctor-patient interaction in terms of its patient-centredness. Patient-centredness was defined in terms of doctor responses which enabled patients to express all of their reasons for coming, including symptoms, thoughts, feelings and expectations. The method was tested a...
journal_title:Family practice
pub_type: 杂志文章
doi:10.1093/fampra/6.4.249
更新日期:1989-12-01 00:00:00
abstract:BACKGROUND:Acute otitis media is a common disease, particularly among children. The importance of a correct diagnosis is crucial, especially as unjustified prescription of antibiotics has become a major problem in clinical praxis. OBJECTIVES:Our aim was to evaluate the predictive value of different otological findings...
journal_title:Family practice
pub_type: 杂志文章
doi:10.1093/fampra/15.2.133
更新日期:1998-04-01 00:00:00
abstract::Pregnant women's ailments may cause anxiety and reduce the quality of life. Sixty-five pregnant women were followed prospectively in antenatal care in general practice, and spontaneously reported ailments not associated with serious pregnancy complications were registered prospectively. The vast majority of pregnant w...
journal_title:Family practice
pub_type: 杂志文章
doi:10.1093/fampra/9.3.270
更新日期:1992-09-01 00:00:00
abstract::Our objective was to determine what family physicians need in their doctor's bag for urgent and non-urgent house calls. In a prospective survey, family physicians completed a structured report form after consecutive house calls, recording what equipment they needed for each. Thirteen doctors from two urban practices, ...
journal_title:Family practice
pub_type: 杂志文章
doi:10.1093/fampra/12.4.430
更新日期:1995-12-01 00:00:00
abstract:BACKGROUND:Over-the-counter (OTC) medicines are increasingly used for self-medication, but such products can be misused/abused. OBJECTIVES:The aim of this study was to investigate the general public's opinion and perceptions of OTC medicines, including the misuse/abuse of such preparations. METHODS:Data were collecte...
journal_title:Family practice
pub_type: 杂志文章
doi:10.1093/fampra/cmh723
更新日期:2005-04-01 00:00:00
abstract::In response to the UK Government's proposal to increase the proportion of general practitioner income accruing from capitation payments the General Medical Services Committee of the British Medical Association has called for an extension of fee for item of service provision in general practice. In this paper the alloc...
journal_title:Family practice
pub_type: 杂志文章
doi:10.1093/fampra/5.4.265
更新日期:1988-12-01 00:00:00
abstract::This paper describes the perception of general practitioners of violence to which they are subject, and also their fears of violence. It is based on interviews, and a written questionnaire. The outcome suggests that violence is a formidable problem. Some coping strategies are described. On the whole the subject has be...
journal_title:Family practice
pub_type: 杂志文章
doi:10.1093/fampra/8.2.145
更新日期:1991-06-01 00:00:00
abstract:BACKGROUND AND AIMS:Palpitations are a common presentation in primary care. Guidelines have been developed to identify patients with palpitations who require further assessment by a cardiologist in secondary care. However, patients that do not meet guideline thresholds for referrals are still referred to secondary care...
journal_title:Family practice
pub_type: 杂志文章
doi:10.1093/fampra/cmaa094
更新日期:2020-09-12 00:00:00
abstract:BACKGROUND:Increasing medical possibilities, ageing of the population and the growing number of people with chronic illness appears to make advance care planning (ACP) inevitable. However, to what extent and how primary care providers (PCPs) provide ACP in daily practice is largely unknown. OBJECTIVE:To provide an ove...
journal_title:Family practice
pub_type: 杂志文章,评审
doi:10.1093/fampra/cmu074
更新日期:2015-02-01 00:00:00
abstract:BACKGROUND:Smokers vary in their readiness to try stopping smoking, but there currently are no objective tools for identifying smokers' consulting behaviours which indicate their level of motivation to try stopping smoking. OBJECTIVE:The aim of this study was to investigate the construct validity and inter-observer re...
journal_title:Family practice
pub_type: 杂志文章
doi:10.1093/fampra/19.2.154
更新日期:2002-04-01 00:00:00
abstract:BACKGROUND:Inter-clinician electronic consultation (eConsult) programmes are becoming more widespread in the USA as health care systems seek innovative ways of improving specialty access. Existing studies examine models with programmatic incentives or requirements for primary care providers (PCPs) to participate. OBJE...
journal_title:Family practice
pub_type: 杂志文章
doi:10.1093/fampra/cmaa016
更新日期:2020-09-05 00:00:00
abstract:BACKGROUND:In Brazil, there continues to be an excessive use of emergency services by patients with elective medical problems. Those patients who report having a primary care physician are less likely to utilize the emergency department for non-urgent consultations. OBJECTIVE:The objective of this study was to compare...
journal_title:Family practice
pub_type: 杂志文章
doi:10.1093/fampra/19.2.207
更新日期:2002-04-01 00:00:00
abstract:BACKGROUND:Patients sometimes have differences of > or =20/10 mmHg in their blood pressure depending on which arm is measured. The prevalence and prognostic value of this finding in general practice are unknown. If these differences are due to peripheral vascular disease, these patients may be at increased risk of card...
journal_title:Family practice
pub_type: 杂志文章
doi:10.1093/fampra/19.5.439
更新日期:2002-10-01 00:00:00
abstract::Emotional problems are an important component of general morbidity in primary care settings. Research on the sensitivity of primary care physicians to such problems is, however, scanty. This study examines the prevalence of emotional problems among 776 patients in primary care clinics in Israel using the GHQ-28 and as...
journal_title:Family practice
pub_type: 杂志文章
doi:10.1093/fampra/7.3.195
更新日期:1990-09-01 00:00:00
abstract:BACKGROUND:Heart failure due to left ventricular systolic dysfunction (LVSD) has a high prevalence in the adult population but is difficult to diagnose accurately on clinical grounds in the community. Early diagnosis is important as effective treatments are available to reduce morbidity and mortality. Echocardiography ...
journal_title:Family practice
pub_type: 杂志文章
doi:10.1093/fampra/cmg513
更新日期:2003-10-01 00:00:00
abstract::This paper describes the results of a study of the handling of confidentiality by general practitioners. A sample of 272 general practitioners in the eastern part of the Netherlands was interviewed. The general practitioners were presented with 10 cases involving confidentiality and were asked what course of action th...
journal_title:Family practice
pub_type: 杂志文章
doi:10.1093/fampra/7.1.34
更新日期:1990-03-01 00:00:00
abstract:BACKGROUND:Most individuals with current epilepsy are solely under the care of the primary care team for follow-up care. Government working party recommendations, expert epilepsy panels and patients have also stressed the central role of the GP in follow-up care. Problems in the provision of care in the community have,...
journal_title:Family practice
pub_type: 杂志文章
doi:10.1093/fampra/15.5.437
更新日期:1998-10-01 00:00:00
abstract:Background:Family doctors' (FD) attitudes likely play an important role in the recognition and management of depression. Objective:The purpose of the study was to prospectively analyse the short-term and long-term impact of a specifically designed training program on attitudes towards depression among FDs. Methods:A ...
journal_title:Family practice
pub_type: 杂志文章
doi:10.1093/fampra/cmx071
更新日期:2018-01-16 00:00:00
abstract::In November 1991 69% of a random sample of 998 Danish general practitioners (GPs) participated in a survey by anonymously filling in a mailed questionnaire concerning the way in which they use health education in their practices. Among the participating GPs, 97% used health education material. The study showed differe...
journal_title:Family practice
pub_type: 杂志文章
doi:10.1093/fampra/11.1.35
更新日期:1994-03-01 00:00:00
abstract:BACKGROUND:A consulting method known as 'shared decision making' (SDM) has been described and operationalized in terms of several 'competences'. One of these competences concerns the discussion of the risks and benefits of treatment or care options-'risk communication'. Few data exist on clinicians' ability to acquire ...
journal_title:Family practice
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/fampra/cmh401
更新日期:2004-08-01 00:00:00
abstract:BACKGROUND:Overweight and obesity have negative health effects. Primary care clinicians are best placed to intervene in weight management. Previous reviews of weight loss interventions have included studies from specialist settings. The aim of this review was to estimate the effect of behavioural interventions delivere...
journal_title:Family practice
pub_type: 杂志文章,meta分析,评审
doi:10.1093/fampra/cmu064
更新日期:2014-12-01 00:00:00
abstract:BACKGROUND:Medical engagement is a mutual concept of the active and positive contribution of doctors to maintaining and enhancing the performance of their health care organization, which itself recognizes this commitment in supporting and encouraging high quality care. A Medical Engagement Scale (MES) was developed by ...
journal_title:Family practice
pub_type: 杂志文章
doi:10.1093/fampra/cmv085
更新日期:2016-02-01 00:00:00
abstract:BACKGROUND:Rules of thumb used by GPs could be considered as empirical evidence of intuition and a link between science and practice in general practice. OBJECTIVE:The purpose of the present study was to analyse the description of the application of rules of thumb with regard to different situations in general practic...
journal_title:Family practice
pub_type: 杂志文章
doi:10.1093/fampra/cmg503
更新日期:2003-10-01 00:00:00
abstract:BACKGROUND:The World Health Organization and the World Organization of Family Doctors have called for 'doable' and 'limited' tasks to integrate mental health into primary care. Little information is provided about tasks GPs can undertake outside of guidelines that suggest to prescribe medication and refer to specialist...
journal_title:Family practice
pub_type: 杂志文章
doi:10.1093/fampra/cmq016
更新日期:2010-08-01 00:00:00
abstract:BACKGROUND:It is important to understand the experiences surrounding smoking cessation among patients with chronic obstructive pulmonary disease (COPD) to improve the likely success of future smoking cessation programs. OBJECTIVE:To explore the personal experiences surrounding smoking cessation among general practice ...
journal_title:Family practice
pub_type: 杂志文章
doi:10.1093/fampra/cmw083
更新日期:2016-12-01 00:00:00