Journal of general internal medicine
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To compare the number of preoperative tests ordered for elective ambulatory surgery patients during the 2 years before and the 2 years after the establishment of new hospital testing guidelines. ⋯ Although there was variable compliance among physicians, new hospital guidelines were effective in reducing preoperative testing and did not result in increases in untoward perioperative events or in test ordering by the medical consultant.
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To evaluate personal and professional factors associated with marital and parental satisfaction of physicians. ⋯ For physicians with children, our study indicates that minimizing the level of role conflict and having a supportive spouse are associated with higher levels of marital and parental satisfaction. Working in salaried positions and marriage to a spouse who is either working in a profession or who is a stay-at-home parent are also related to high parental satisfaction.
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To examine patient satisfaction and willingness to return to an emergency department (ED) among non-English speakers. ⋯ Non-English speakers were less satisfied with their care in the ED, less willing to return to the same ED if they had a problem they felt required emergency care, and reported more problems with emergency care. Strategies to improve satisfaction among this group of patients may include appropriate use of professional interpreters and increasing the language concordance between patients and providers.
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Comparative Study Clinical Trial
Impact of a clinical scenario on accuracy of electrocardiogram interpretation.
To examine the effect of clinical history on the electrocardiogram (ECG) interpretation skills of physicians with different levels of expertise, we randomly allocated to an ECG test package 30 final-year medical students, 15 second-year internal medicine residents, and 15 university cardiologists at university-affiliated teaching hospitals. All participants interpreted the same set of 10 ECGs. Each ECG was accompanied by a brief clinical history suggestive of the correct ECG diagnosis, or the most plausible alternative diagnosis, or no history. ⋯ Conversely, a misleading history compared with no history reduced accuracy by 5% for cardiologists, 25% for residents, and 19% for students. Clinical history also affected the participants' frequencies of listing ECG features consistent with the correct diagnosis and features consistent with the alternative diagnosis (all p values < .05). For physicians at all levels of expertise, clinical history has an influence on ECG diagnostic accuracy, both improving accuracy when the history suggests the correct diagnosis, and reducing accuracy when the history suggests an alternative diagnosis.
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To compare the prevalence of hot flashes and health education regarding menopause in African-American and white American women in the late reproductive years. ⋯ These results indicate that hot flashes occur commonly among women in their thirties and forties who have regular menstrual cycles and that the prevalence of hot flashes appears to differ by race. Studies should be designed to evaluate the hormonal and physiologic implications of these symptoms among women in their late reproductive years. Few of these women had discussed menopause with their physicians. Given the differences in sources of information about menopause, development of culture-specific health education programs should be considered.