Annals of family medicine
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Annals of family medicine · Apr 2022
Assessment and management of allergy history with a novel mRNA vaccine.
Tertiary care hospital provided onsite COVID-19 vaccine roll out as a work benefit for all care team members with medically supervised waiting period at the time of the distribution of the first round of the novel mRNA COVID-19 vaccines. Little was known about the immediate hypersensivity reactions or what might predispose to cross reactivity. ⋯ We used this data to inform our employee health vaccination campaign and to inform the health system as strategies and safety protocols for vaccination of the population were developed.
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Annals of family medicine · Apr 2022
Assessing the impact of Geo-demographic factors on antibiotic prescribing for adults with acute, uncomplicated bronchitis.
Acute bronchitis is a common reason patients seek primary care and has predominately viral causes. Yet, antibiotics are often prescribed despite limited evidence of clinical benefit. Interventions targeting antibiotic prescribing for acute bronchitis have reduced prescribing, but rates continued to remain higher than expected. There is also a paucity of data describing variability in antibiotic prescribing and its determinants; specifically, non-clinical, patient-level factors. Identifying non-clinical determinants of antibiotic prescribing for bronchitis could inform better care for these patients in primary care. ⋯ This study identified antibiotic prescribing disparities for adults with acute bronchitis at the level of the patient, prescriber and the patient residential area. Interventions targeting antibiotic prescribing in this population should consider the role these factors have in prescribing decisions.
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Annals of family medicine · Apr 2022
Diagnostic accuracy of a new COVID-19 antigen test obtained by mid-turbinate swab.
Context: At the mid-point of the COVID-19 pandemic, polymerase chain reaction (PCR) testing for SARS-CoV-2 was difficult to obtain and took several days to return a result. Our health system wished to explore the use of the Quidel Sofia™ antigen test to diagnose COVID-19 in our primary care clinics, but the test was approved for emergency use authorization by the US Food and Drug Administration with only 250 test subjects. In addition, because it was important to avoid aerosol generating procedures in primary care clinics, it was necessary to test the diagnostic performance of the antigen test using mid-turbinate (MT) swabs rather than the approved nasopharyngeal (NP) swab technique. ⋯ The likelihood ratio for a positive test was 63.75 (95% CI 8.99, 451.97) and the likelihood ratio for a negative test was 0.25 (95% CI 0.14, 0.46). Conclusions: This antigen test for SARS-CoV-2 was of reasonable clinical utility in a low prevalence environment but concerns about the actual prevalence of COVID-19 and the ramifications of false negatives limited its use. Difficulty recruiting subjects and the resultant delay in the results made it impossible to implement this antigen testing in primary care practices, but it is hoped that these data will contribute to the accumulation of evidence about diagnostic testing for COVID-19.
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Annals of family medicine · Apr 2022
Using artificial intelligence to support rapid, mixed-methods analysis: Developing an automated qualitative assistant (AQUA).
Context: Qualitative research - crucial for understanding human behavior - remains underutilized, in part due to the time and cost of annotating qualitative data (coding). Artificial intelligence (AI) has been suggested as a means to reduce those burdens. Older AI techniques (Latent Semantic Indexing / Latent Dirichlet Allocation (LSI/LDA)) have fallen short, in part because qualitative data is rife with idiom, non-standard expressions, and jargon. ⋯ AQUA's analysis (including human interpretation) took approximately 5 hours, compared to approximately 30 person hours for traditional coding. Conclusions: AQUA enables qualitative researchers to identify categories amenable to automated coding, and to rapidly conduct that coding on the entirety of very large datasets. This saves time and money, and avoids limitations inherent in limiting qualitative analysis to limited samples of a given dataset.
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Annals of family medicine · Apr 2022
Impacts of the COVID-19 pandemic on gamblers in Canada: qualitative analysis of responses to an open-ended question.
draw up a portrait of the experience of gamblers regarding the impacts of the COVID-19 pandemic on their gambling practices. STUDY DESIGN: Qualitative analysis. SETTING: Content analysis of responses to a single open-ended question placed at the end of a cross-sectional survey which was online from February 16 to March 15 2021 in Quebec (Canada). Participants were recruited by a non-randomised online sampling. POPULATION STUDIED: 1529 individuals participated in the study, of whom 724 answered the open-ended question. Inclusion criteria were: (1) 18 years and older (2) living in the province of Quebec, Canada (3) has gambled at least once in the past year. ⋯ The pandemic has created space to fill into many individuals' lives as usual leisure activities, hobbies and spending habits became out of reach. It led to increased gambling for many participants. While many did not report deleterious effects of this increase, others expressed being at great risk and therefore need primary care professionals to be equipped to support them.