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  • 1
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    German Medical Science GMS Publishing House; Düsseldorf
    In:  GMS German Medical Science; VOL: 6; DOC03 /20080602/
    Publication Date: 2008-06-03
    Description: Background: With regard to patients' self-reported somatic diseases some researchers transformed "don't know (DK)" responses into "no" responses. The present study examines the appropriateness of this procedure. Methods: Analyses were based on the nationally representative German National Health Interview and Examination Survey (GHS), which assessed both self-reported diseases and physician-diagnosed diseases (N = 7124). Prevalence rates of persons' DK responses and the corresponding prevalences of physicians' diagnoses were calculated for persons with hypertension, coronary heart disease (CHD), heart failure, asthma, chronic bronchitis, thyroid disease, diabetes, cancer, gout, arthrosis, arthritis and osteoporosis. Correlates of physicians' diagnosed diseases of DK cases are reported. Results: Between 1.6% and 9.8% of the participants responded with DK to the question of whether they have the disease. In 3.7% to 29.5% of DK cases, the physicians did regard the respective disease as being present. With regard to persons who responded with DK, the probability of a physicians' diagnosis was increased in the case of increased age and a higher number of somatic comorbidities. Conclusion: The procedure of transforming DK responses into "no" answers does not appear to be recommendable.
    Description: Hintergrund: "Weiß nicht"-Antworten von Patienten auf die Frage nach dem Vorliegen einer körperlichen Erkrankung werden in verschiedenen Studien zu "Nein"-Antworten umkodiert. Die vorliegende Studie untersucht die Validität dieses Vorgehens. Methodik: Die Studie basiert auf Daten des Bundesgesundheitssurveys 1998 (BGS98), in dessen Rahmen sowohl seitens der Probanden berichtete als auch ärztlich diagnostizierte Erkrankungsangaben vorliegen (N=7124). Untersucht wurden probandenseitig berichtete "weiß nicht"-Antworten im Vergleich zu den Arztdiagnosen (liegt vor: ja/nein) in Bezug auf Hypertension, koronare Herzkrankheit (KHK), Herzinsuffizienz, Asthma, chronisch Bronchitis, Schilddrüsenerkrankung, Diabetes, Tumor, Gicht, Arthrose, Arthritis und Osteoporose. Ergebnisse: Zwischen 1,6% und 9,8% der Probanden antworteten mit "weiß nicht" auf die Frage, ob die entsprechende Erkrankung jemals vorlag. In 3,7% bis 29,5% dieser Fälle diagnostizierte der Arzt die Erkrankung als gegeben. Bei Personen mit DK-Antworten, war die Wahrscheinlichkeit, dass ärztlicherseits eine Erkrankung diagnostiziert wurde, bei älteren Patienten und Patienten mit einer höheren Anzahl somatischer Erkrankungen erhöht. Schlussfolgerung: Die Umkodierung von "weiß nicht"-Antworten zu "nein"-Antworten erscheint nicht empfehlenswert.
    Keywords: SELF CONCEPT ; HEALTH STATUS ; DIAGNOSIS ; HEALTH SURVEYS/* ; GERMANY ; DATA INTERPRETATION, STATISTICAL/* ; REPRODUCIBILITY OF RESULTS ; NEOPLASMS/epidemiology ; HEART FAILURE/epidemiology ; CARDIOVASCULAR DISEASES/epidemiology ; HYPERTENSION/epidemiology ; ASTHMA/epidemiology ; BRONCHITIS, CHRONIC/epidemiology ; DIABETES MELLITUS/epidemiology ; THYROID DISEASES/epidemiology ; OSTEOPOROSIS/epidemiology ; GOUT/epidemiology ; RESPIRATORY TRACT DISEASES/epidemiology ; OSTEOARTHRITIS/epidemiology ; ARTHRITIS/epidemiology ; SELBSTKONZEPT ; GESUNDHEITSZUSTAND ; DIAGNOSTIK ; GESUNDHEITSERHEBUNGEN/* ; DEUTSCHLAND ; DATENINTERPRETATION, STATISTISCHE/* ; REPRODUZIERBARKEIT, ERGEBNIS- ; TUMOREN/Epidemiologie ; /Epidemiologie ; HERZ-KREISLAUF-KRANKHEITEN/Epidemiologie ; HYPERTONIE/Epidemiologie ; ASTHMA/Epidemiologie ; BRONCHITIS, CHRONISCHE/Epidemiologie ; DIABETES MELLITUS/Epidemiologie ; SCHILDDRÜSENKRANKHEITEN/Epidemiologie ; OSTEOPOROSE/Epidemiologie ; GICHT/Epidemiologie ; ATEMWEGSKRANKHEITEN/Epidemiologie ; OSTEOARTHROSE/Epidemiologie ; ARTHRITIS/Epidemiologie ; somatic diseases ; validity ; self-report ; somatische Erkrankungen ; Validität ; Selbstbericht ; ddc: 610
    Language: English
    Type: article
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  • 2
    ISSN: 1432-1440
    Keywords: Bronchoscopy ; Bronchoalveolar lavage ; Opportunistic infections ; Diagnosis ; Complications
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Bronchoscopy was performed on 101 immunocompromised patients with fever and pulmonary infiltrates. Underlying diseases were mainly hematological malignancies. In 71% of cases, etiology of pneumonia was clarified by nonbioptic bronchoscopic methods (bronchoalveolar lavage, bronchial secretions, protected specimen brush). In 51% of cases, empirical antibiotic treatment was modified following bronchoscopy. In patients with early bronchoscopy a better prognosis regarding healing and survival was observed than in those cases, where bronchoscopy was performed later during pneumonia. Bronchoalveolar lavage was particularly suited for diagnosis of Pneumocystis carinii and pneumonia due to viruses or Legionella. Sensitivity and specificity of bronchoscopy were lower for diagnosis of mycotic pneumonia and of Gram-negative or Gram-positive bacteria.
    Type of Medium: Electronic Resource
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