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.Clinical features and treatment outcomes of Hodgkin lymphoma: A retrospective review in a Malaysian tertiary hospital
Yang Liang BOO ; Helen Siew Yean TING ; Diana Fui Sing YAP ; See Guan TOH ; Soo Min LIM
Blood Research 2019;54(3):210-217
BACKGROUND: Classical Hodgkin lymphoma (cHL) is a clinicopathologically unique, aggressive lymphoma arising from germinal center B-cells and is one of the most curable hematological malignancies. This study aimed to determine the clinical course, treatment regimens, response rates, and survival data of patients diagnosed with cHL in a tertiary center. METHODS: A retrospective review was conducted to include patients with a diagnosis of cHL from 2013 to 2017. Data of demographic and clinical characteristics, treatment regimens, and outcomes were collected and analyzed. RESULTS: We recruited 94 patients with a median age of 27.0 [interquartile range (IQR), 12] years. Most of the patients were male (61.7%) and 73.4% were ethnic Malay. Nodular sclerosis was the most common histology (77.6%), followed by mixed cellularity (6.4%) and others (16%). The median follow-up time was 28.0 (IQR, 32) months. All patients received chemotherapy but only 13.8% received radiotherapy as consolidation. The doxorubicin-bleomycin-vinblastine-dacarbazine regimen was the most common (85.1%), followed by the escalated bleomycin-etoposide-doxorubicin-cyclophosphamide-vincristineprednisolone-procarbazine regimen (14.9%). Following treatment, 76.1% of patients achieved complete response. The 2-year overall survival (OS) and progression-free survival (PFS) of the entire cohort were 96.5% and 71.1%, respectively. The 2-year OS and PFS for advanced-stage disease were 93.9% and 62.8%, compared to 100% and 82.7% for early-stage disease, respectively (P=0.252 and P=0.052, respectively). CONCLUSION: This study provides insight into the clinical presentation and treatment outcomes among patients with cHL in Malaysia. A longer study duration is required to identify OS and PFS benefits and treatment-related complications for different chemotherapeutic regimens.
B-Lymphocytes
;
Cohort Studies
;
Diagnosis
;
Disease-Free Survival
;
Drug Therapy
;
Follow-Up Studies
;
Germinal Center
;
Hematologic Neoplasms
;
Hodgkin Disease
;
Humans
;
Lymphoma
;
Malaysia
;
Male
;
Radiotherapy
;
Retrospective Studies
;
Sclerosis
;
Tertiary Care Centers