1.Views of faculty members in a medical school with regards to error disclosure and reporting to parents and/or higher authorities
Chin Hoong Wong ; Amanda Cheng Li Phuah ; Nathaniel Shiang Yann Naik ; Weng Shen Choo ; Helen Siew Yean Ting ; Shaun Mun Leong Kuan ; Cheong Lieng Teng ; Nalliah Sivalingam
The Medical Journal of Malaysia 2016;71(5):244-249
Background: Little is known about the views of faculty
members who train medical students concerning open
disclosure.
Objectives: The objectives of this study were to determine
the views of faculty in a medical school on: 1 what
constitutes a medical error and the severity of such an error
in relation to medication use or diagnosis; 2 information
giving following such an adverse event, based on severity;
and 3 acknowledgement of responsibility, remedial action,
compensation, disciplinary action, legal action, and
reporting to a higher body in relation to such adverse event.
Methods: We adapted and contextualized a questionnaire
developed from a previous study. The questionnaire had 4
case vignettes that described 1 clear medication error with
lifelong disability; 2 possible diagnostic error with lifelong
disability; 3 possible diagnostic error without harm; and 4
clear medication error without harm. We invited all faculty
members attached to the medical school at the International
Medical University to participate in the study.
Results: Seventy faculty members took part. Faculty
members viewed a medical error as having taken place
depending on how clearly an error had occurred (94% and
73% versus 53% and 27%). They viewed cases as more
severe based on the severity of complications (85% and 46%
versus 5% and 10%). With increasing severity, they tended to
attribute responsibility for the event and the duty to disclose
towards more senior clinicians. They were also more
agreeable with remedial action, compensation, disciplinary
action, and reporting to a higher agency. There was no
strong evidence of association between these areas and the
demographics of faculty members.
Conclusions: Faculty members are more likely to perceive
an error had occurred depending on the clarity of the
circumstances. They viewed severity based on the presence
of complications. Severity determined how they attributed
responsibility, duty to disclose, and other areas related to
open disclosure.
2.Factors influencing protective behaviours during haze episodes in Singapore: A population-based study.
Kennedy Y Y NG ; Wesley YEUNG ; Ka Lon SOU ; Jie Xin LIM ; Sai LIANG ; Ryan K J LEE ; Nigel J M FONG ; Alex LUA ; Xinqi LOOK ; Julia ANN-LEE ; Yun Hao LEONG ; Claudia CHONG ; Kai Yun ANG ; Cheryl LIE ; Amanda CHIN ; Judy Gek Khim SNG ; Bee Choo TAI
Annals of the Academy of Medicine, Singapore 2021;50(7):514-526
INTRODUCTION:
Haze is a recurrent problem in Southeast Asia. Exposure to haze is linked to ophthalmic, respiratory and cardiovascular diseases, and mortality. In this study, we investigated the role of demographic factors, knowledge and perceived risk in influencing protective behaviours during the 2013 haze in Singapore.
METHODS:
We evaluated 696 adults in a cross-sectional study. Participants were sampled via a 2-stage simple random sampling without replacement from a large residential district in Singapore in 2015. The questionnaire measured the participant's knowledge, perceived risk and behaviours during the Southeast Asian haze crisis in 2013. Reliability and validity of the questionnaire were assessed using comparative fit index (≥0.96) and root mean square error of approximation (≤0.05). We performed structural equation modelling to examine the relationship between the hypothesised factors and protective behaviours.
RESULTS:
More than 95% of the individuals engaged in at least 1 form of protective behaviour. Knowledge was strongly associated with protective behaviours via direct effect (β=0.45, 95% CI 0.19-0.69,
CONCLUSION
Knowledge was associated with protective behaviours, suggesting the importance of public education. Efforts should target those of lower education level and smokers. The wearing of N95 masks correlates with uptake of other protective behaviours.
Adult
;
Asia, Southeastern
;
Cross-Sectional Studies
;
Ethnic Groups
;
Humans
;
Minority Groups
;
Reproducibility of Results
;
Singapore/epidemiology*
3.Validating lactate dehydrogenase (LDH) as a component of the PLASMIC predictive tool (PLASMIC-LDH)
Christopher Chin KEONG LIAM ; Jim Yu-Hsiang TIAO ; Yee Yee YAP ; Yi Lin LEE ; Jameela SATHAR ; Simon MCRAE ; Amanda DAVIS ; Jennifer CURNOW ; Robert BIRD ; Philip CHOI ; Pantep ANGCHAISUKSIRI ; Sim Leng TIEN ; Joyce Ching MEI LAM ; Doyeun OH ; Jin Seok KIM ; Sung-Soo YOON ; Raymond Siu-Ming WONG ; Carolyn LAUREN ; Eileen Grace MERRIMAN ; Anoop ENJETI ; Mark SMITH ; Ross Ian BAKER
Blood Research 2023;58(1):36-41
Background:
The PLASMIC score is a convenient tool for predicting ADAMTS13 activity of <10%.Lactate dehydrogenase (LDH) is widely used as a marker of haemolysis in thrombotic thrombocytopenic purpura (TTP) monitoring, and could be used as a replacement marker for lysis. We aimed to validate the PLASMIC score in a multi-centre Asia Pacific region, and to explore whether LDH could be used as a replacement marker for lysis.
Methods:
Records of patients with thrombotic microangiopathy (TMA) were reviewed. Patients’ ADAMTS13 activity levels were obtained, along with clinical/laboratory findings relevant to the PLASMIC score. Both PLASMIC scores and PLASMIC-LDH scores, in which LDH replaced traditional lysis markers, were calculated. We generated a receiver operator characteristics (ROC) curve and compared the area under the curve values (AUC) to determine the predictive ability of each score.
Results:
46 patients fulfilled the inclusion criteria, of which 34 had ADAMTS13 activity levels of <10%. When the patients were divided into intermediate-to-high risk (scores 5‒7) and low risk (scores 0‒4), the PLASMIC score showed a sensitivity of 97.1% and specificity of 58.3%, with a positive predictive value (PPV) of 86.8% and negative predictive value (NPV) of 87.5%. The PLASMIC-LDH score had a sensitivity of 97.1% and specificity of 33.3%, with a PPV of 80.5% and NPV of 80.0%.
Conclusion
Our study validated the utility of the PLASMIC score, and demonstrated PLASMIC-LDH as a reasonable alternative in the absence of traditional lysis markers, to help identify high-risk patients for treatment via plasma exchange.