Baharak Najafi, Fariborz Bakhtiyari, Azar Manavi, Mohammad Reza Soufinejad, Hossein Fakhrzadeh, Seyed Masoud Arzaghi, Mahtab Alizadeh, Neda Nazari, Shervan Shoaee, Farshad Sharifi,
Volume 13, Issue 6 (9-2014)
Abstract
Background: Because of various health problems, the risk of the death in the elderly is higher than adults. The purpose of this study was to investigate the causes of the death, and comparing the cause of death that recorded on the death certificates and those were extracted from the medical records review.
Methods: Variables included the demographic characteristics (age and sex), time of death and the cause of death were recorded in the death certifies and those were extracted from the medical records.
Results: The mean of death age was 83.8 (8.50) years and in women and men were 84.2 and 81.5 years, respectively, (P < 0.01).The most prevalent cause of death was sudden cardiac death based on both death certificates recorded and review of medical records were 42.5% and 25.9% respectively. Sudden cardiac death in both methods was higher in women than men. Using the kappa, the highest degree of correspondence about the cause of death between two method was about gastrointestinal bleeding (K = 0.76) and then the cancers (K = 0.71) and respiratory infections (K =0.67). Total Kappa of two methods for causes of mortality was 0.50. The most cases of death were reported during 12:00 – 13:59 and 8:00 – 9:59am, time period (16.2 % and 14.1% respectively).
Conclusion: the causes of deaths, which are recorded in the elderly nursing homes, do not have enough accuracy. Due to the high incidence of sudden cardiac death in elderly in nursing homes, resuscitation facilities and teams may be helping to reduce these types of death.
Farzane Saeidifard, Akbar Soltani, Fereshteh Ghadiri, Sahar Manavi, Motahareh Taleba, Moein Foroughi, Parvaneh Ansari, Mostafa Qorbani, Hamideh Moosapour,
Volume 17, Issue 4 (5-2018)
Abstract
Background: It is critical to understand how accurately physicians can estimate the importance of each clinical finding in estimating the probability of a specific diagnosis in the process of clinical decision making. This study aimed to investigate whether physicians’ estimates of the importance of various clinical findings of ascites correlated with the positive likelihood ratios of these findings in diagnosis of ascites.
Methods: One hundred and ten physicians were asked to respond to a questionnaire. In this questionnaire they were presented with a clinical scenario about a patient suspected of having ascites followed by a list of clinical findings. Participants were asked to assign a weight (between 0 and 100%) to each clinical finding based on their perception of how much the presence of that finding changed the probability of ascites for the patient. Positive likelihood ratios of those findings were extracted from current best evidence. We investigated if the weights assigned by physicians were associated with the positive likelihood ratios of those findings.
Results: Significant differences were discovered between the weights assigned by the physicians and the positive likelihood ratios for each clinical finding. Significant positive correlation was observed between the weights assigned by different groups of physicians.
Conclusion: Physicians inaccurately estimated the importance of various clinical findings in the diagnosis of ascites. Further research is needed to determine if such inaccurate estimations would lead to any adverse clinical outcomes.
