Diseño y validación de una escala de adherencia a antineoplásicos orales / Design and validation of an adherence scale to oral antineoplastic drugs

Objetivo: diseñar y validar una escala para medir la adherencia a antineoplásicos orales. Disponer de una herramienta sencilla, validada y aplicable a la rutina asistencial que permitirá detectar e identificar la falta de adherencia para establecer estrategias que permitan mejorarla y optimizar la calidad de los servicios sanitarios.Métodoestudio de validación de una escala diseñada para evaluar la adherencia a antineoplásicos orales en una muestra de pacientes ambulatorios que recogen su medicación en 4 hospitales españoles. Se analizará su validez y fiabilidad, elaborada a partir de un estudio previo de metodología cualitativa, mediante la teoría clásica de los test y el análisis Rasch. Se examinará su funcionamiento, el ajuste de los ítems, la estructura de respuesta y de las personas a las predicciones del modelo, así como la dimensionalidad, la fiabilidad ítem-persona, la adecuación del nivel de dificultad de los ítems a la muestra, y el funcionamiento diferencial de los ítems en función del sexo. (AU)

Objective: To design and validate a questionnaire to measure adherence to oral antineoplastic drugs. The availability of a simple, validated tool that can be applied to routine care will make it possible to detect and identify non-adherence in order to establish strategies to improve adherence and optimize the quality of healthcare services.MethodValidation study of the questionnaire designed to assess adherence to antineoplastic drugs in a sample of outpatients who collect their medication in two Spanish hospitals. Its validity and reliability will be analyzed, based on a previous qualitative methodology study, using classical test theory and Rasch analysis. We will examine its performance, item fit, response structure and person fit to the predictions of the model, as well as dimensionality, item-person reliability, the appropriateness of the level of difficulty of the items to the sample, and the differential performance of the items according to gender.

Design and validation of an adherence scale to oral antineoplastic drugs. / Diseño y validación de una escala de adherencia a antineoplásicos orales.

OBJECTIVE: To design and validate a questionnaire to measure adherence to oral antineoplastic drugs. The availability of a simple, validated tool that can be applied to routine care will make it possible to detect and identify non-adherence in order to establish strategies to improve adherence and optimize the quality of healthcare services. METHOD: Validation study of the questionnaire designed to assess adherence to antineoplastic drugs in a sample of outpatients who collect their medication in two Spanish hospitals. Its validity and reliability will be analyzed, based on a previous qualitative methodology study, using classical test theory and Rasch analysis. We will examine its performance, item fit, response structure and person fit to the predictions of the model, as well as dimensionality, item-person reliability, the appropriateness of the level of difficulty of the items to the sample, and the differential performance of the items according to gender.

[Translated article] Design and validation of a scale to measure adherence to oral antineoplastic drugs.

OBJECTIVE: Design and validate a scale to measure adherence to oral antineoplastic drugs. The availability of a simple, validated tool that can be applied to routine care will make it possible to detect and identify non-adherence in order to establish strategies to improve adherence and optimize the quality of healthcare services. METHOD: Validation study of the scale designed to assess adherence to antineoplastic drugs in a sample of outpatients who collect their medication in two Spanish hospitals. Its validity and reliability will be analyzed, based on a previous qualitative methodology study, using classical test theory and Rasch analysis. We will examine its performance, item fit, response structure and person fit to the predictions of the model, as well as dimensionality, item-person reliability, the appropriateness of the level of difficulty of the items to the sample, and the differential performance of the items according to gender.

Prevalence of symptoms, severity and diagnosis of asthma in adolescents in the Province of Salamanca, Spain: Global Asthma Network (GAN) Phase I.

INTRODUCTION AND OBJECTIVES: Asthma is the most prevalent chronic disease in childhood. However, the latest data on its prevalence in Spain are from Phase III of the International Study of Asthma and Allergies in Childhood (ISAAC), 2004. The objective of our study was to assess the prevalence of asthma symptoms, severity and diagnosis in the paediatric population aged between 13 and 14 years in the province of Salamanca. MATERIAL AND METHODS: Cross-sectional multicentre study carried out in 2017-2018 in 13-and 14-year-old school children in the province of Salamanca as a centre participating in of the Global Asthma Network (GAN) Phase I. The standardised validated written questionnaire and that directed by a video was administered; it was self-completed by the pupils. RESULTS: A total of 3485 questionnaires were completed, and the pupils' participation rate was 95.01%. Among the total, 25.7% indicated having had wheeze ever (20.7% in the video questionnaire); 14.7% indicated having had wheeze in the past 12 months (11.3% in the video questionnaire). The prevalence of current wheeze that limited speech was 3.9% (7.5% in the video questionnaire) and the current prevalence of severe wheeze was 6.5%. Regarding asthma diagnosis, 19.7% of the sample answered that they had had asthma ever, whilst 14.0% referred to having physician-diagnosed asthma. The agreement between the written questionnaire and that directed by video was acceptable for the questions of wheeze ever (Cohen Kappa index [k] = 0.53) and current wheeze (k = 0.42). CONCLUSIONS: The prevalence of current asthma (wheeze in the past 12 months) in the population aged 13 and 14 years in the province of Salamanca is higher compared with that presented in 2004 in Spain, but similar to that described at the world level (low-moderate level), according to the ISAAC Phase III studies.

Prevalence of symptoms, severity and diagnosis of asthma in adolescents in the Province of Salamanca, Spain: Global Asthma Network (GAN) Phase I

Introduction and objectives: Asthma is the most prevalent chronic disease in childhood. However, the latest data on its prevalence in Spain are from Phase III of the International Study of Asthma and Allergies in Childhood (ISAAC), 2004. The objective of our study was to assess the prevalence of asthma symptoms, severity and diagnosis in the paediatric population aged between 13 and 14 years in the province of Salamanca. Material and methods: Cross-sectional multicentre study carried out in 2017–2018 in 13-and 14-year-old school children in the province of Salamanca as a centre participating in of the Global Asthma Network (GAN) Phase I. The standardised validated written questionnaire and that directed by a video was administered; it was self-completed by the pupils. Results: A total of 3485 questionnaires were completed, and the pupils’ participation rate was 95.01%. Among the total, 25.7% indicated having had wheeze ever (20.7% in the video questionnaire); 14.7% indicated having had wheeze in the past 12 months (11.3% in the video questionnaire). The prevalence of current wheeze that limited speech was 3.9% (7.5% in the video questionnaire) and the current prevalence of severe wheeze was 6.5%. Regarding asthma diagnosis, 19.7% of the sample answered that they had had asthma ever, whilst 14.0% referred to having physician-diagnosed asthma. The agreement between the written questionnaire and that directed by video was acceptable for the questions of wheeze ever (Cohen Kappa index [k] = 0.53) and current wheeze (k = 0.42). Conclusions: The prevalence of current asthma (wheeze in the past 12 months) in the population aged 13 and 14 years in the province of Salamanca is higher compared with that presented in 2004 in Spain, but similar to that described at the world level (low-moderate level), according to the ISAAC Phase III studies (AU)

Creación del Colegio Doctoral Tordesillas de Salud Pública e Historia de la Ciencia: un modelo de internacionalización académica / Tordesillas Doctoral School of Public Health and History of Science: A model of academic internationalization

INTRODUCCIÓN: Los futuros profesionales de Medicina y Salud Pública se enfrentarán a rápidos cambios en el conocimiento científico y tecnológico derivados del proceso de la globalización. La formación universitaria debe reconocer que la internacionalización de sus actividades es imprescindible para la trasferencia de conocimiento. Los Colegios Tordesillas de Doctorado nacieron con el propósito de crear una red sólida de cooperación académico-científica entre universidades brasileñas, portuguesas y españolas. MÉTODOS: La Universidad Miguel Hernández coordina el Colegio Doctoral Tordesillas de Salud Pública e Historia de la Ciencia compuesto por las Facultades de Medicina de las Universidades de Porto y Miguel Hernández, y de Medicina y Salud Pública de São Paulo desde julio de 2017. Su objetivo principal es dotar a los programas de posgrado de nuevos contenidos docentes y potenciar la innovación en la investigación a través de la cooperación internacional. En febrero de 2018 se celebró el primer seminario internacional para establecer alianzas en investigación y docencia. RESULTADOS: Se encontraron intereses comunes importantes de colaboración en investigación y docencia de posgrado en las siguientes áreas: en Salud Pública en estudios sobre políticas públicas, evaluación de la innovación en pruebas diagnósticas, relaciones entre los ámbitos político y científico y conflictos de intereses; en derechos de reproducción y en la creciente medicalización de la sociedad; en Historia de la Ciencia, en estudios sobre el análisis de las reformas sanitarias en países europeos y latinoamericanos en el siglo XX. DISCUSIÓN: La internacionalización universitaria es una pieza clave en la transferencia de conocimiento científico. Los Colegios Tordesillas de Doctorado ofrecen un contexto más flexible para superar obstáculos legales y administrativos para esta internacionalización

INTRODUCTION: Future public health and medical professionals will face new scientific and technological requirements resulting from the globalization process. University education must recognize that the internationalization of its activities is essential for the transfer of knowledge. The Tordesillas Doctoral Schools were born with the purpose of creating a solid network of scientific academic cooperation between Brazilian, Portuguese and Spanish universities. METHODS: The University Miguel Hernández has coordinated The Tordesillas Doctorate School of Public health and History of Science (July 2017) composed by the Faculty of Medicine, from Porto University, Miguel Hernández, and the Faculties of Medicine and Public Health of the University of São Paulo, whose aim is to provide postgraduate programs with new teaching content and enhance innovation in research trough international cooperation. In February 2018, the first International seminar of this The Tordesillas Doctorate School was held to establish partnerships in research and postdoctoral teaching. RESULTS: Important common interest for research and teaching collaboration was found: for Public Health in public policies evaluation studies, assessment of innovation in diagnostic tests, relations between the political and scientific agenda and conflict of interests, studies on health reproduction rights, and the increasing medicalization of society in all contexts. For History of Science interest was shown in analysis of sanitary reforms carried out in European and Latin American countries in the 2nd half of the 20th century. DISCUSSION: The university internationalization is as a key piece in the transfer of scientific knowledge. The Tordesillas Doctoral Schools offer a more flexible context to overcome legal and/or administrative obstacles for internationalization of university activities which might be found in each Institution

Crisis e independencia de las políticas de salud pública. Informe SESPAS 2014 / Crisis and the independence of public health policies. SESPAS report 2014

La independencia de la formulación de políticas de salud pública puede verse afectada por distintos agentes con objetivos contrarios a la salud de la población, como son las grandes corporaciones. La crisis económica puede agravar la falta de independencia por la menor financiación de los órganos reguladores relacionados con la salud, o de otras actuaciones de protección de la salud. Las grandes corporaciones han influido en la formulación de determinadas políticas con incidencia en la salud, como son las relacionadas con el tabaco, la industria química, la nutrición, las bebidas alcohólicas, la industria farmacéutica y la de tecnologías sanitarias. Los principales ámbitos en que se ejerce influencia son la ciencia, la formación, la política y la sociedad en general. Ante esta situación, las sociedades científicas de salud pública deben tomar un papel activo que vele por la imparcialidad de las decisiones políticas, con acciones como: proponer actuaciones que garanticen la independencia e imparcialidad de las políticas de salud pública y aplicarse a sí mismas criterios de imparcialidad y transparencia; oponerse a que las administraciones públicas colaboren con corporaciones que son parte del problema de salud que se desea prevenir; contribuir a una comunicación fiable y eficaz en salud pública creando un organismo legitimado para ello que permita contrarrestar la carencia de fuente autorizada de información en salud pública; promover el análisis crítico de la definición de los problemas de salud, de sus soluciones y del establecimiento de las agendas relacionadas (científica, política y mediática); y, establecer alianzas para que la formación continua de los profesionales de salud sea independiente (AU)

Independence in the formulation of public health policies can be affected by various agents with objectives contrary to population health, such as large corporations. This lack of independence may be exacerbated by the economic crisis due to lower funding for health regulatory bodies or other measures designed to protect health. Large corporations have influenced the formulation of certain policies with an impact on health, such as those related to the tobacco industry, the chemical industry, nutrition, alcohol, pharmaceuticals, and health technology. The main areas in which these companies can influence policies are science, education, politics, and society in general. In this scenario, public health associations should take an active role in ensuring the independence of political decisions via actions such as the following: supporting strategies that guarantee the independence of public health policies and apply criteria of impartiality and transparency; rejecting those public-private partnerships launched to prevent health problems partly caused by these corporations; establishing partnerships to achieve independent training of health professionals and an institution with scientific authority in order to improve public health communication and counteract the lack of sound public health information; promoting a critical analysis of the definition of health problems and their solutions, and establishing related agendas (scientific, political and media) and alliances, so that continuing training for health professionals is independent (AU)

[Crisis and the independence of public health policies. SESPAS report 2014]. / Crisis e independencia de las políticas de salud pública. Informe SESPAS 2014.

Independence in the formulation of public health policies can be affected by various agents with objectives contrary to population health, such as large corporations. This lack of independence may be exacerbated by the economic crisis due to lower funding for health regulatory bodies or other measures designed to protect health. Large corporations have influenced the formulation of certain policies with an impact on health, such as those related to the tobacco industry, the chemical industry, nutrition, alcohol, pharmaceuticals, and health technology. The main areas in which these companies can influence policies are science, education, politics, and society in general. In this scenario, public health associations should take an active role in ensuring the independence of political decisions via actions such as the following: supporting strategies that guarantee the independence of public health policies and apply criteria of impartiality and transparency; rejecting those public-private partnerships launched to prevent health problems partly caused by these corporations; establishing partnerships to achieve independent training of health professionals and an institution with scientific authority in order to improve public health communication and counteract the lack of sound public health information; promoting a critical analysis of the definition of health problems and their solutions, and establishing related agendas (scientific, political and media) and alliances, so that continuing training for health professionals is independent.

Methodology in diagnostic laboratory test research in clinical chemistry and clinical chemistry and laboratory medicine.

BACKGROUND: The application of epidemiologic principles to clinical diagnosis has been less developed than in other clinical areas. Knowledge of the main flaws affecting diagnostic laboratory test research is the first step for improving its quality. We assessed the methodologic aspects of articles on laboratory tests. METHODS: We included articles that estimated indexes of diagnostic accuracy (sensitivity and specificity) and were published in Clinical Chemistry or Clinical Chemistry and Laboratory Medicine in 1996, 2001, and 2002. Clinical Chemistry has paid special attention to this field of research since 1996 by publishing recommendations, checklists, and reviews. Articles were identified through electronic searches in Medline. The strategy combined the Mesh term "sensitivity and specificity" (exploded) with the text words "specificity", "false negative", and "accuracy". We examined adherence to seven methodologic criteria used in the study by Reid et al. (JAMA1995;274:645-51) of papers published in general medical journals. Three observers evaluated each article independently. RESULTS: Seventy-nine articles fulfilled the inclusion criteria. The percentage of studies that satisfied each criterion improved from 1996 to 2002. Substantial improvement was observed in reporting of the statistical uncertainty of indices of diagnostic accuracy, in criteria based on clinical information from the study population (spectrum composition), and in avoidance of workup bias. Analytical reproducibility was reported frequently (68%), whereas information about indeterminate results was rarely provided. The mean number of methodologic criteria satisfied showed a statistically significant increase over the 3 years in Clinical Chemistry but not in Clinical Chemistry and Laboratory Medicine. CONCLUSIONS: The methodologic quality of the articles on diagnostic test research published in Clinical Chemistry and Clinical Chemistry and Laboratory Medicine is comparable to the quality observed in the best general medical journals. The methodologic aspects that most need improvement are those linked to the clinical information of the populations studied. Editorial actions aimed to increase the quality of reporting of diagnostic studies could have a relevant positive effect, as shown by the improvement observed in Clinical Chemistry.