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Doctors' Knowledge (doctor + knowledge)
Selected AbstractsWhy do primary care doctors diagnose depression when diagnostic criteria are not met?INTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue 3 2000Michael Höfler Abstract This study examines predictors of false positive depression diagnoses by primary care doctors in a sample of primary care attendees, taking the patients' diagnostic status from a self-report measure (Depression Screening Questionnaire, DSQ) as a yardstick against which to measure doctors' correct and false positive recognition rates. In a nationwide study, primary care patients aged 15,99 in 633 doctors' offices completed a self-report packet that included the DSQ, a questionnaire that assesses depression symptoms on a three-point scale to provide diagnoses of depression according to the criteria of DSM-IV and ICD-10. Doctors completed an evaluation form for each patient seen, reporting the patient's depression status, clinical severity, and treatment choices. Predictor analyses are based on 16,909 patient-doctor records. Covariates examined included depression symptoms, the total DSQ score, number and persistence of depression items endorsed, patient's prior treatment, history of depression, age and gender. According to the DSQ, 11.3% of patients received a diagnosis of ICD-10 depression, 58.9% of which were correctly identified by the doctor as definite threshold, and 26.2% as definite subthreshold cases. However, an additional 11.7% of patients not meeting the minimum DSQ threshold were rated by their doctors as definitely having depression (the false positive rate). Specific DSQ depression items endorsed, a higher DSQ total score, more two-week depression symptoms endorsed, female gender, higher age, and patient's prior treatment were all associated with an elevated rate of false positive diagnoses. The probability of false positive diagnoses was shown to be affected more by doctors ignoring the ,duration of symptoms' criterion than by doctors not following the ,number of symptoms' criterion for an ICD or DSM diagnosis of depression. A model selection procedure revealed that it is sufficient to regress the ,false positive diagnoses' on the DSQ-total score, symptoms of depressed mood, loss of interest, and suicidal ideation; higher age; and patient's prior treatment. Further, the total DSQ score was less important in prediction if there was a prior treatment. The predictive value of this model was quite good, with area under the ROC-curve = 0.86. When primary care doctors use depression screening instruments they are oversensitive to the diagnosis of depression. This is due to not strictly obeying the two weeks duration required by the diagnostic criteria of ICD-10 and DSM-IV. False positive rates are further increased in particular by the doctor's knowledge of a patient's prior treatment history as well as the presence of a few specific depression symptoms. Copyright © 2000 Whurr Publishers Ltd. [source] Doctors' attitudes towards invasive prenatal diagnosisJOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 1 2009Somsri Pitukkijronnakorn Abstract Aim:, To assess the influence of a doctor's gender, age group, religion and invasive prenatal diagnosis (PND) knowledge on their attitude towards invasive PND. Methods:, All non,obstetric and gynecologic doctors were surveyed using a structured questionnaire. The questionnaire enquired about demographic information, and doctors' knowledge, attitude and experience regarding invasive PND for themselves, and their spouses, relatives, friends, colleagues and patients. Results:, Responses from the 289 respondents revealed that two-thirds of respondents knew only a little about invasive PND. Most males and females were in the 31,39 and ,30-year-old groups, respectively. There were no statistically significant differences in gender, age group, religion and invasive PND knowledge when recommending of invasive PND. If fetal anomalies were detected, most of the females in the Buddhist group (P < 0.05), males with quite a lot of PND knowledge group (p < 0.05) and younger doctors group (P < 0.05) would their own terminate pregnancies, or those of wives and relatives. Conclusion:, Attitudes towards invasive PND and pregnancy termination was influenced by gender, age group, religion and PND knowledge. Females and younger doctors from both gender groups tended to recommend the termination of pregnancy if they found fetal anomalies. [source] Testing an empirically derived mental health training model featuring small groups, distributed practice and patient discussionMEDICAL EDUCATION, Issue 2 2009Rachael C Murrihy Objectives, Internationally, family doctors seeking to enhance their skills in evidence-based mental health treatment are attending brief training workshops, despite clear evidence in the literature that short-term, massed formats are not likely to improve skills in this complex area. Reviews of the educational literature suggest that an optimal model of training would incorporate distributed practice techniques; repeated practice over a lengthy time period, small-group interactive learning, mentoring relationships, skills-based training and an ongoing discussion of actual patients. This study investigates the potential role of group-based training incorporating multiple aspects of good pedagogy for training doctors in basic competencies in brief cognitive behaviour therapy (BCBT). Methods, Six groups of family doctors (n = 32) completed eight 2-hour sessions of BCBT group training over a 6-month period. A baseline control design was utilised with pre- and post-training measures of doctors' BCBT skills, knowledge and engagement in BCBT treatment. Results, Family doctors' knowledge, skills in and actual use of BCBT with patients improved significantly over the course of training compared with the control period. Conclusions, This research demonstrates preliminary support for the efficacy of an empirically derived group training model for family doctors. Brief CBT group-based training could prove to be an effective and viable model for future doctor training. [source] A controlled study of the short- and long-term effects of a Train the Trainers courseMEDICAL EDUCATION, Issue 7 2008Sune Rubak Objectives, This study aimed to establish the longterm effects of a 3-day ,Training for Trainers' course (TTC) on doctors' knowledge, teaching behaviour and clinical learning climate. Methods, The study was designed as an intervention study with pre-, post- and long-term measurements. The intervention group (I-group) included 118 doctors from the departments of internal medicine and orthopaedic surgery at one university hospital. The control group (C-group) consisted of 125 doctors from the corresponding departments at another university hospital. Gains in knowledge about teaching skills were assessed by a written test. Teaching behaviour and learning climate were evaluated by questionnaires. Results, In the I-group, 98.4% of doctors, both specialists and trainees, participated in a TTC. Response rates on the written test varied from 90% at baseline to 70% at 6 months after the intervention. Knowledge about teaching skills increased in the I-group by 25% after the TTC and was sustained at 6 months. Questionnaire response rates varied from 98.4% at baseline to 84.8% at 6 months. Post-course, the teaching behaviour of the I-group significantly changed and its learning climate improved compared with the C-group. Scores for use of feedback and supervision in the I-group increased from 4,5 to 6,7 (maximum score = 9). This was significantly higher than in the C-group. Conclusions, A 3-day residential TTC has a significant impact in terms of gains of knowledge concerning teaching skills, teaching behaviour and learning climate after 6 months. The positive effects demonstrated in this study were rooted in both the specialists and trainees who attended the course. [source] | ||||||||||