eLetters

110 e-Letters

  • Important practical limitations for decision support
    Kaveh G. Shojania

    Dear Editor

    I share much of Dr Morris' enthusiasm for decision support. While involved in an evaluation of a decision support targeting vancomycin ordering practice,[1] I had the opportunity to observe the potential impact of this approach. However, as a clinician using the same computerized order entry system in daily practice, I also recognized the major limitation of this approach: users will not tolerate many...

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  • Quality in nursing and health care: resources available
    Ann C Brokenshire

    Dear Editor

    As a member of the professional organisation for nurses in Ontario, I would like to direct nurses and other interested readers to the web page of the Registered Nurses Association of Ontario, www.rnao.org

    This site has a wealth of position statements, policies, submissions to a variety of health stakeholders and other documents relating to providing...

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  • Missing measure
    Arthur L. Yeager

    Dear Editor

    Adding the element of safety to medical education can not be effected unless the institutions supplement their systems with program of outcomes assesment.

    While all that Dr Stevens describes is of interest, only when it is established that the medical safety material that has been presented is absorbed and put into practice will the validity of the suggestions be established.

    This req...

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  • "That is Medicine"
    Jorge H Jimenez

    Dear Editor

    I will call the work of giving Medicine to poor countries, a Great English men do this beautiful things. From a Professor of internal medicine - Jorge H Jimenez.

    Thanks

  • Elucidation of non-compliance - Role of cultural epidemiology
    Vasudeo P Paralikar

    Dear Editor

    This scholarly article has been a fine example of what a fresh approach and interdisciplinary overview can do.

    We work with illness explanatory models of patients from various outpatient clinics who suffer from biomedically unexplained fatigue and weakness for six months or more. Also, in private practice of clinical psychiatry compliance is the pivotal issue. We find that cultural epide...

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  • Santabhanu Chakrabarti

    Dear Editor

    The provision of free access to the electronic versions of journals to the users in the developing world deserves lots of praise, indeed. Coming from such a background, I cannot over emphasize the long felt need for the same.

    Internet use, especially for medical education and training in India, has increased by leaps and bounds over the last five years. In spite of that, institutional subscr...

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  • Re: Patient satisfaction questionnaire - Authors' response
    Sarah Grogan

    Dear Editor,

    Roberts et al[1] provide a commentary on the Patient Satisfaction Questionnaire (PSQ) that we have developed and validated.[2][3] Whilst they accept that the PSQ is a valid and internally reliable tool for assessing patient satisfaction with primary care services, they suggest that further work is required before the measure is adopted. In particular they point to the need to assess the acceptabi...

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  • Patient Satisfaction Questionnaire - Further validation required
    Lesley Roberts
    Dear Editor:

    Grogan et al[1] report that their Patient Satisfaction Questionnaire (PSQ) is a valid and internally reliable tool for assessing patient satisfaction with primary care services despite the acknowledgement in their discussion that further research is required to confirm other aspects of reliability and validity. We feel that their conclusion is premature.

    Having recently been involved in the valida...

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  • Re: Retinopathy Screening: an opportunity for intervention
    Arabella Melville

    Dear Editor:

    I agree that every opportunity should be taken to discuss with patients with diabetes how they can reduce the risk of complications, and that screening can present one such opportunity. However, because the effectiveness of this approach has not been tested in an RCT, it was not included in the review on which this Effective Health Care Bulletin was based.

  • Retinopathy Screening: an opportunity for intervention
    David Kinshuck
    Dear Editor

    The authors point out the effectiveness and need for retinopathy screening and foot care in diabetes. However, as in much of the "screening" literature, the opportunity for intervention during the screening visit is not ephasised.

    We know that by achieving an HbA1c of 6% and blood pressure of 130/80 or below, not smoking, and having a hyperlipidaemia treated, most retinopathy could be avoided or delayed (U...

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