Preventive medicine
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Preventive medicine · Jan 2013
Testing the agreement of medical instruments: overestimation of bias in the Bland-Altman analysis.
The Bland-Altman method is the most popular method used to assess the agreement of medical instruments. The main concern about this method is the presence of proportional bias. The slope of the regression line fitted to the Bland-Altman plot should be tested to exclude proportional bias. The aim of this study was to determine whether the overestimation of bias in the Bland-Altman analysis is still present even when the proportional bias has been excluded. ⋯ Testing the slope of regression line of the Bland-Altman plot does not remove the artifactual bias in the prediction.
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Preventive medicine · Jan 2013
Validation of a measure of knowledge about human papillomavirus (HPV) using item response theory and classical test theory.
Public understanding of HPV is important to ensure informed participation in cervical cancer prevention programmes. While many studies have measured HPV knowledge, none has developed a validated measure for use across countries. We aimed to develop and validate such a measure. ⋯ A structurally coherent set of items covering a range of important HPV knowledge was developed. Responses indicated a reliable questionnaire, which allowed the fitting of an IRT model.
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Preventive medicine · Jan 2013
Changes to cervical cancer prevention guidelines: effects on screening among U.S. women ages 15-29.
A shift toward later initiation of cervical cancer screening for women began in 2002. We generated national estimates of screening prevalence rates and guideline-consistent screening among U.S. women ages 15-29 before and after the first evidence-based recommendations for reduced cervical cancer screening. ⋯ Fewer adolescents were being screened before sexual initiation, representing newer guidelines. However, sexually-active young adult women also should have later screening initiation. Factors related to health care access contribute to receipt of screening. Monitoring and provider education are needed to improve guideline-consistent screening, as newer guidelines call for less screening.
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Preventive medicine · Jan 2013
The projected effect of increasing physical activity on reducing the prevalence of common mental disorders among Canadian men and women: a national population-based community study.
Little quantitative research has been conducted on the effect of physical activity (PA) modification on the prevalence of mental disorders in a nationally representative sample. We aimed to provide quantitative evidence regarding the potential effectiveness of PA in the management of mental disorders. ⋯ Clinicians and public health campaigns targeting individual patients and general populations can improve patients' symptoms and prevent a significant proportion of future mental disorders by increasing the amount of PA.
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Preventive medicine · Jan 2013
Observational StudyRisk factors for infection/colonization caused by resistant Gram negative bacilli in critically ill patients (an observational study of 1633 critically ill patients).
The objective of this study is to identify risk factors associated with multi-resistant Gram negative (RGNB) infection and colonization among critically ill patients. ⋯ The major risk factors identified for RGNB infection and colonization in the ICU were mainly patient dependent. However, broad spectrum initial antibiotic treatment remains an important independent modifiable risk factor. Interventions aimed at reducing initial broad spectrum antibiotics are clearly needed to help control the spread of these difficult to treat infections.