Adherence measurement and patient recruitment methods are poor in intervention trials to improve patient adherence.

OBJECTIVES: To develop a scale and survey the measurement of patient adherence and patient recruitment, and to explore how these methods impact the results in randomized controlled trials of interventions to improve patient adherence to medications. STUDY DESIGN: Analytic survey of a purposively selected sample of patient adherence intervention trials from a systematic review, assessing the quality of adherence measurement and patient recruitment methods. RESULTS: We identified 44 different measures of adherence, with qualities ranging from valid and objective to unreliable and subjective. The median overall quality of measures of adherence was 5 (interquartile range [IQR], 3; range, 0-9, 9 is high quality). The quality of the measures was associated with variation in the estimate of adherence (Spearman r = 0.66; 95% confidence interval: 0.39, 0.83). The median overall quality of patient recruitment methods was 2 (IQR, 1; maximum score 6, higher is better). There was no significant correlation between the power of the trial to detect an effect and the quality of the patient recruitment methods. CONCLUSION: Measurement and recruitment methods in adherence trials varied considerably, and most methods were of low quality. Adherence research could be advanced by using higher quality measures of adherence and better selection and baseline assessment of study participants.

The quality, breadth, and timeliness of content updating vary substantially for 10 online medical texts: an analytic survey.

OBJECTIVE: To evaluate the quality of evidence reporting, breadth of coverage, and timeliness of content updating of 10 selected online medical texts. STUDY DESIGN AND SETTING: Each text was assessed for quality based on an 11-item scale, which included items related to editorial policy and updating, appraisal, and transparent incorporation of newly published clinical research and evidence-based guidelines. Breadth of coverage was determined by the percentage of 60 randomly selected International Classification of Diseases 10 (ICD-10) codes covered by each of the texts. The same 60 ICD-10 codes were used to obtain a sample of topic chapters for the assessment of timeliness of updates. RESULTS: Quality scores ranged from a high of 9 of 11 points (Clinical Evidence) to a low of 0 of 11 points (PEPID), with a mean score of 6.7. Breadth of coverage ranged from 83% of randomly selected topics covered (UpToDate) to 25% (Clinical Evidence), with 6 of 10 texts covering 60% or more; average coverage across all texts was 57%. Variability was also observed with regard to average time since last content update, ranging from 3.5 (DynaMed) to 29 months (First Consult), with an average time since update of 12.4 months. CONCLUSION: No single resource was ideal and those seeking answers to clinical questions are well-advised not to rely solely on a single point-of-care product.

Interacting with sexist men triggers social identity threat among female engineers.

Social identity threat is the notion that one of a person's many social identities may be at risk of being devalued in a particular context (C. M. Steele, S. J. Spencer, & J. Aronson, 2002). The authors suggest that in domains in which women are already negatively stereotyped, interacting with a sexist man can trigger social identity threat, undermining women's performance. In Study 1, male engineering students who scored highly on a subtle measure of sexism behaved in a dominant and sexually interested way toward an ostensible female classmate. In Studies 2 and 3, female engineering students who interacted with such sexist men, or with confederates trained to behave in the same way, performed worse on an engineering test than did women who interacted with nonsexist men. Study 4 replicated this finding and showed that women's underperformance did not extend to an English test, an area in which women are not negatively stereotyped. Study 5 showed that interacting with sexist men leads women to suppress concerns about gender stereotypes, an established mechanism of stereotype threat. Discussion addresses implications for social identity threat and for women's performance in school and at work.