geoffrey modest medical blogs

a small study was just published as a research letter looking at the impact on  patient   satisfaction  when providers use computers in the exam room (see  computer use and pt  satisfaction  jamainternmed2015  in dropbox, or doi:10.1001/jamainternmed. 2015.6186.). this was an observational study done from Nov 2011 to Nov 2013 in an academic safety-net public hospital in San Francisco. details: --47  patients  (mean age 56.5, 55% women, 57% Hispanic/17% African-American/15% Asian/6% white, 55% primary Spanish speakers, 54% with high school education or less, 30% with inadequate health literacy as determined by their ability to fill out medical forms), and 39 clinicians (mean age 43.7, 64% women, 72% in primary care, 72% MDs, mean 13.9 years since getting professional degree) --provider- patient   relationship was <1 year in 16%, 1-5 years in 54% and >5 years in 30%. --mean visit length was 24.6 minu...

There was a small but I think important study on the perceptions of patients who smoke and had low-dose lung cancer screening --LDCT (see  lung cancer CT and continued smoking jamaintmed 2015  in dropbox, or doi:10.1001/jamainternmed.2015.3558​). This was a VA study of patients who had in-depth semi-structure qualitative interviews about their health beliefs relating to smoking and lung cancer, done in 2014.  details: --37 patients (89% male, mean age 62, 62% white/27% black or pacific islander, mean 49 pack-years smoking, mean Fagerstrom score of 4.75 -- suggesting moderate nicotine dependence) who participated in the VA pilot study on lung cancer screening in one of 151 VA medical centers were interviewed, most after they got their results. There was a detailed pretest description of the risks and benefits of screening. --results:         --18 of the participants had abnormal screen...