full free access: Preventable adverse drug events and their causes and contributing factors: the analysis of register data — Int J Qual Health Care (patient safety)

"In recent years, the number of patient complaints has also increased, probably because patients are more aware of their rights and more attention has been paid to patient safety [18]. These complaints contain detailed narratives about the case, and these data can be used to understand which factors contribute to errors in health care [1].

The purpose of this study was to evaluate the nature of preventable ADEs based on data from national supervisory authority. In particular, the study focuses on the potential causes and contributing factors of preventable ADEs from the information management point of view.
The study aims to answer the following questions:
1. What are the causes of ADEs, and in which phase of the medication management process are the causes for ADEs present?
2. How does information management affect the origin of ADEs?
3. What are the contributing factors for ADEs in information management?

Racial differences in stage at diagnosis and survival from epithelial ovarian cancer: A fundamental cause of disease approach

Social Science & Medicine

abstract:

Associations between race, socioeconomic status (SES) and health outcomes have been well established. One of the ways in which race and SES affect health is by influencing one’s access to resources, which confers ability to avoid or mitigate adverse outcomes. The fundamental cause of disease approach argues that when a new screening tool is introduced, individuals with greater resources tend to have better access to the innovation, thus benefiting from early detection and leading to better survival.  

Conversely, when there is no established screening tool, racial and SES differences in early detection may be less pronounced.

Most ovarian cancer is diagnosed at advanced stages, because of the lack of an effective screening tool and few early symptoms. However, once detected, racial differences may still be observed in mortality and survival outcomes. We examined the racial differences in diagnosis and survival among ovarian cancer cases diagnosed during 1994–1998, in Cook County, Illinois (N = 351). There were no racial differences in the stage at diagnosis: 51.7% of white and 52.9% of black women were diagnosed at later stages (III and IV). Only age was associated with the stage at diagnosis. Tumor characteristics also did not differ between white and black women. Compared to white women, black women were less likely to be married, less educated, more frequently used genital powder, had tubal ligation, and resided in higher poverty census tracts. As of December 31, 2005, 44.3% of white and 54.5% of black women had died of ovarian cancer. Controlling for known confounding variables, the hazard ratio for ovarian cancer death between black and white women was 2.2. The findings show that fundamental cause perspective provides a potential framework to explore subtleties in racial disparities, with which broader social causes may be accounted for in explaining post diagnosis racial differences.

Comment regarding Pelvic Exams while under Anesthesia

My comment: While Lynn's abstract is interesting, it is noteworthy again that these are not new issues as per the included references. I would disagree that further research is required. A root cause analysis is not going to add anything further to what has already been demonstrated. It is now a matter of policy.

“Come here. I want you to feel a normal rectum. Do it.”