Journal of general internal medicine
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Comparative Study Clinical Trial
Case-finding instruments for depression. Two questions are as good as many.
To determine the validity of a two-question case-finding instrument for depression as compared with six previously validated instruments. ⋯ The two-question case-finding instrument is a useful measure for detecting depression in primary care. It has similar test characteristics to other case-finding instruments and is less time-consuming.
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Comparative Study Clinical Trial
Identification of patient attitudes and preferences regarding treatment of depression.
To identify attitudes that influence patient help-seeking behavior and aspects of treatment that influence patient preferences for management of depression. ⋯ In-depth focus group discussions with depressed patients can provide valuable and unique information about patient experiences and concerns regarding treatment for depression. Clinicians, researchers, and policymakers need to incorporate the range of factors identified by patients into their decision making for individuals with depression.
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Clinical Trial
Development and validation of a geriatrics knowledge test for primary care residents.
This study reports the development and preliminary validation of an instrument to measure geriatrics knowledge of primary care residents. A 23-item test was developed using questions selected from the American Geriatrics Society's Geriatrics Review Syllabus. ⋯ Findings support the reliability (Cronbach's alpha = 0.66) and validity (content and "known groups") of this short test. Predictive validity and sensitivity of the test to changes in knowledge will have to be further explored as residents progress through their training.
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Multicenter Study
A regional evaluation of variation in low-severity hospital admissions.
Determine patient and hospital-level variation in proportions of low-severity admissions. ⋯ Rates of low-severity admissions for congestive heart failure and pneumonia varied across hospitals and were higher among nonwhite and poorly insured patients. Although the current study does not identify causes of this variability, possible explanations include differences in access to ambulatory services, decisions to admit patients for clinical indications unrelated to the risk of hospital mortality, and variability in admission practices of individual physicians and hospitals. The development of protocols for ambulatory management of low-severity patients and improvement of access to outpatient care would most likely decrease the utilization of more costly hospital services.