Double-blind control of the data manager doesn't have any impact on data entry reliability and should be considered as an avoidable cost.

BACKGROUND: Database systems have been developed to store data from large medical trials and survey studies. However, a reliable data storage system does not guarantee data entering reliability.We aimed to evaluate if double-blind control of the data manager might have any effect on data-reliability. Our secondary aim was to assess the influence of the inserting position in the insertion-sheet on data-entry accuracy and the effectiveness of electronic controls in identifying data-entering mistakes. METHODS: A cross-sectional survey and single data-manager data entry.Data from PACMeR_02 survey, which had been conducted within a framework of the SESy-Europe project (PACMeR_01.4), were used as substrate for this study. We analyzed the electronic storage of 6,446 medical charts. We structured data insertion in four sequential phases. After each phase, the data stored in the database were tested in order to detect unreliable entries through both computerized and manual random control. Control was provided in a double blind fashion. RESULTS: Double-blind control of the data manager didn't improve data entry reliability. Entries near the end of the insertion sheet were correlated with a larger number of mistakes. Data entry monitoring by electronic-control was statistically more effective than hand-searching of randomly selected medical records. CONCLUSION: Double-blind control of the data manager should be considered an avoidable cost. Electronic-control for monitoring of data-entry reliability is suggested.

Screening Evaluation System--Europe (SESy_Europe) met skin cancer screening.

Skin tumors are the most frequent malignancies in the white population worldwide and have reached the proportion of an epidemic disease. Since non-melanocytic skin cancers can be cured when timely detected, given that still malignant melanoma may have good prognosis if early diagnosed, and considering the key role of primary care in cancer screening advising and implementation, the international PACMeR study group (trial_01.3) adjourned SESy_Europe database in a version comprehensive of skin-malignancies screening indexing. The novel database provides standardized pre-codified translations of 2,331 parameters in eight languages (English, French, German, Greek, Italian, Romanian, Spanish and Turkish) and records the time elapsed from last skin examination, cause and frequency of skins examinations and stratifies skin cancer risk patterns by a systematic registering of risk factors. A comprehensive indexing of skin cancer screening practices among European countries may in fact turn helpful in programming future health policy and tailoring interventions.

Colorectal cancer screening awareness among physicians in Greece.

BACKGROUND: Data comparison between SEER and EUROCARE database provided evidence that colorectal cancer survival in USA is higher than in European countries. Since adjustment for stage at diagnosis markedly reduces the survival differences, a screening bias was hypothesized. Considering the important role of primary care in screening activities, the purpose of the study was to investigate the colorectal cancer screening awareness among Hellenic physicians. METHODS: 211 primary care physicians were surveyed by mean of a self-reported prescription-habits questionnaire. Both physicians' colorectal cancer screening behaviors and colorectal cancer screening recommendations during usual check-up visits were analyzed. RESULTS: Only 50% of physicians were found to recommend screening for colorectal cancer during usual check-up visits, and only 25% prescribed cost-effective procedures. The percentage of physicians recommending stool occult blood test and sigmoidoscopy was 24% and 4% respectively. Only 48% and 23% of physicians recognized a cancer screening value for stool occult blood test and sigmoidoscopy. Colorectal screening recommendations were statistically lower among physicians aged 30 or less (p = 0.012). No differences were found when gender, level and type of specialization were analyzed, even though specialists in general practice showed a trend for better prescription (p = 0.054). CONCLUSION: Contemporary recommendations for colorectal cancer screening are not followed by implementation in primary care setting. Education on presymptomatic control and screening practice monitoring are required if primary care is to make a major impact on colorectal cancer mortality.

Old habits die hard: chest radiography for screening purposes in primary care.

OBJECTIVE: To assess whether the use of chest radiography for screening changes over time. DESIGN: Systematic review. DATA SOURCES: MEDLINE, ISI, Cochrane Central Register of Controlled Trials, and handsearching of selected journals. REVIEW METHODS: We evaluated whether the proportion of primary care physicians using chest radiography to screen for (1) malignancy in the general asymptomatic population, (2) malignancy in a high-risk subgroup, (3) any disease in the general population, and (4) any disease in a high-risk subgroup changed over time, using random-effects meta-regression analysis. Adjustments for the availability of national guidelines were also performed. RESULTS: Overall, 10% to 90% of primary care physicians reported using chest x-ray for screening. In unadjusted analyses, the proportion of physicians using chest radiography for cancer screening in the general population tended to increase by 0.9% per year (8 studies, n = 4313). The corresponding annual changes were -2.9% for cancer screening in high-risk subgroups (8 studies, n = 2784) and -0.4% regarding screening for any disease in the population (7 studies, n = 2627). No meta-regressions were run for outcome (4) (only 1 study). In the adjusted analyses, there was a decreasing nonsignificant trend for all outcomes. CONCLUSIONS: Despite formal recommendations, many physicians still use chest x-ray for screening, with their number decreasing slowly over time. This practice may be harmful because the positive predictive value of chest radiography is low, and further evaluation of false-positive findings might be associated with increased cost and risk from additional diagnostic or therapeutic interventions.

Screening chest radiography: results from a Greek cross-sectional survey.

BACKGROUND: Public health authorities worldwide discourage the use of chest radiography as a screening modality, as the diagnostic performance of chest radiography does not justify its application for screening and may even be harmful, since people with false positive results may experience anxiety and concern. Despite the accumulated evidence, various reports suggest that primary care physicians throughout the world still prescribe chest radiography for screening. We therefore set out to index the use of chest radiography for screening purposes among the healthy adult population and to analyze its relationship with possible trigger factors. METHODS: The study was designed as a cross-sectional survey. Five thousand four hundred and ninety-nine healthy adults, coming from 26 Greek provinces were surveyed for screening practice habits in the nationwide anticancer study. Data were obtained for the use of screening chest radiography. Impact of age, gender, tobacco exposure, family history positive for malignancies and professional-risk for lung diseases was further analyzed. RESULTS: we found that 20% (n = 1099) of the surveyed individuals underwent chest radiography for screening purposes for at least one time during the previous three years. Among those, 24% do so with a frequency equal or higher than once yearly, and 48% with a frequency equal or higher than every three years. Screening for chest radiography was more commonly adopted among males (OR 1.130, 95% CI 0.988-1.292), pensioners (OR 1.319, CI 1.093-1.593) and individuals with a positive family history for lung cancer (OR 1.251, CI 0.988-1.583). Multivariate analysis confirmed these results. CONCLUSION: Despite formal recommendations, chest radiography for screening purposes was a common practice among the analyzed sample of Greek adults. This practice is of questionable value since the positive predictive value of chest radiography is low. The implementation of even a relatively inexpensive imaging study on a national scale would greatly burden health economics and the workload of radiology departments.

Socio-demographic status and alcohol drinking patterns among Greek healthy adults.

AIM: To analyze socio-demographic correlates of alcohol drinking among Greek healthy adults. METHODS: Data related to alcohol consumption patterns of 5500 adult individuals, coming from 26 Hellenic provinces were abstracted from SESy-Europe database within a framework of the nationwide Hellenic anticancer-trial PACMeR 02 study. Statistic: chi2 test and logistic regression analyses were used. RESULTS: 42.5% of males and 82.5% of females did not consume alcoholic drinks. Among users, daily alcohol assumption was 28.50 g/day for men and 9.85 g/day for women. The mainland population presented higher proportions for both abstainers and moderate-heavy drinkers. Consumption rate was higher for sub-populations living in islands, but they were mostly light drinkers rather than heavy consumers. Among males, younger subjects, farmers and craftsmen had a higher tendency for alcohol abuse. Among females, the proportion of consumers and abusers was notably more elevated among younger individuals, especially among those living in urban areas of mainland, with higher educational level, employees and freelance professionals. A particular attention to the newly and rapidly growing patterns of alcoholism among young females should be given and prevention programs should be promptly developed.