Who are the patients who use non-pharmacological home remedies? Cross-sectional study in Switzerland and France.

BACKGROUND: Many patients may be tempted to use non-pharmacological home remedies (NPHRs) to relieve various complaints. To the best of our knowledge, there is little data on the characteristics of patients using NPHRs. In this cross-sectional study carried out between March 2020 and July 2021, we examined the socio-demographic factors underlying their use in patient populations in Switzerland and France. METHODS: Using official registries, we randomly selected 50 primary care physicians (PCPs) in Geneva (Switzerland) and Lyon/Grenoble (France). Seven research assistants consecutively recruited patients from PCP waiting rooms (20-25 patients per practice). Patients completed a paper-based questionnaire assessing the use [yes/no] of 304 NPHRs for 79 medical conditions. The NPHR list was developed by our team with input from 97 patients. We used univariable and multivariable logistic regressions, adjusting for intra-cluster correlations, to examine associations between NPHR use and patient characteristics (gender, age, practice location, nationality, education level, and self-rated health). RESULTS: Of the 1198 eligible patients, 1012 agreed to participate (85%). Overall, 635 patients (63%) reported using at least one of the remedies tested in the study. In multivariable analysis, women (OR = 1.7 [95%CI = 1.3-2.3], P-value < 0.001), younger patients (< 40 years: OR = 2.1 [95%CI = 1.6-2.9], P-value < 0.001), and French patients (OR = 1.6 [95%CI = 1.1-2.3], P-value < 0.001) tended to use NPHRs more often than other patients. CONCLUSIONS: Many patients, particularly women, young people, and French patients, reported using NPHRs. This survey's findings hold the potential to inform healthcare providers, policymakers, and researchers about the diverse preferences that shape patients' healthcare choices.

Gender Inequalities in Citations of Articles Published in High-Impact General Medical Journals: a Cross-Sectional Study.

BACKGROUND: Besides the number of publications, the number of citations is another key metric often used to compare researchers with each other. While women researchers tend to have fewer publications than their men colleagues, the data is scarce for the number of citations. We aimed to determine whether there is a gender gap in citations. METHODS: We used Web of Science to retrieve the number of citations per year for all research articles and reviews published between January 2015 and December 2019 in fourteen high-impact general medical journals (impact factor > 5). We used Gender API to identify the gender of the first/last authors. We compared the results by gender using multivariable negative binomial regressions (adjusting for intra-cluster correlations within journals). RESULTS: The gender of the first/last author was determined for 13,218/13,350 (99%) and 11,894/12,026 (99%) articles, respectively. The proportion of women among first/last authors was 40% and 29%, respectively. The median number of citations per year was 5 (IQR = 11.3) for women and 6.8 (IQR = 17.8) for men for first authors (IRR = 1.5 [95% CI = 1.3-1.8], p value < 0.001), and 6 (IQR = 12.4) and 7.5 (IQR = 17.4) for last authors (IRR = 1.3 [95% CI = 1.2-1.5], p value < 0.001). Articles whose first and last authors were women were the least cited and those whose first and last authors were men were the most cited. CONCLUSION: In this cross-sectional study, we found that articles authored by women were cited less often than those authored by men. Further studies are needed to explore the reasons for these gender differences in article citations.

Nonpharmacological home remedies for upper respiratory tract infections: a cross-sectional study of primary care patients in Switzerland and France.

BACKGROUND: Many patients might be tempted to use nonpharmacological home remedies (NPHRs) to relieve upper respiratory tract infection (URTI) symptoms. However, primary care physicians (PCPs) rarely recommend NPHRs due to a lack of knowledge in this field. We conducted a questionnaire-based survey among primary care patients in Switzerland and France to explore which NPHRs they use and consider effective for 3 common URTI symptoms: sore throat/cough/common cold. METHODS: Using official physician registries, we randomly selected 50 PCPs in Geneva (Switzerland) and Lyon/Grenoble (France). Seven research assistants were involved in the recruitment of consecutive patients from the waiting rooms of these PCPs (20-25 patients per practice). Patients were asked to complete a paper-based questionnaire to assess the use and perceived effectiveness of 72 NPHRs for URTI symptoms. The list of NPHRs was developed by our research team with the help of 97 patients. Remedies were considered effective if patients reported that they were effective/very effective. Data were analysed descriptively. RESULTS: Of the 1,198 eligible patients, 1,012 agreed to participate (84.5%). The 4 most frequently used NPHRs were honey/lemon/thyme/herbal teas. Most patients using these NPHRs considered them as effective (between 77% of patients for onion syrup for cough and 94% of patients for thyme inhalations for common colds). CONCLUSIONS: Many patients reported using honey/lemon/thyme/herbal teas for URTI symptoms, and generally considered these treatments to be effective. Future research should explore the extent to which these remedies can be safely proposed as alternatives for the symptomatic treatment of ear/nose/throat complaints in primary care.

Use and perceived effectiveness of non-pharmacological home remedies for digestive symptoms: a questionnaire-based survey among primary care patients.

BACKGROUND: Patients frequently visit their primary care physician (PCP) for digestive symptoms. We aimed to compile a list of non-pharmacological home remedies (NPHRs) that patients frequently use and find effective so that PCPs can then propose them to their patients with various digestive symptoms. METHODS: In this questionnaire-based survey on the use and perceived effectiveness of NPHRs for digestive symptoms, 50 randomly selected Swiss or French PCPs consecutively recruited 20-25 patients between March 2020 and July 2021. These patients were given a list of 53 NPHRs previously developed by our research team. They were asked whether they used them (Y/N) and whether they considered them to be ineffective, not very effective, moderately effective, or very effective in treating abdominal pain (14 NPHRs), bloating (2), constipation (5), diarrhoea (10), digestion trouble (12), nausea/vomiting (2) and stomach pain (8). We considered NPHRs to be perceived as effective if patients reported that they were moderately or very effective. RESULTS: A total of 1,012 patients agreed to participate in the study (participation rate = 84.5%, median age = 52 years, women = 61%). The two most frequently used NPHRs were rice cooking water for diarrhoea (29% of patients) and prunes for constipation (22%). The perceived effectiveness of the NPHRs ranged from 82% (fennel infusions for abdominal pain) to 95% (bicarbonate for stomach pain). CONCLUSION: Our data could be useful to PCPs interested in proposing NPHRs to their patients suffering from digestive disorders, and more generally to all PCPs interested in learning more about patients' use of NPHRs in primary care.

Women Are Underrepresented Among Authors of Retracted Publications: Retrospective Study of 134 Medical Journals.

We examined the gender distribution of authors of retracted articles in 134 medical journals across 10 disciplines, compared it with the gender distribution of authors of all published articles, and found that women were underrepresented among authors of retracted articles, and, in particular, of articles retracted for misconduct.

Health-related quality of life associated with nocturnal leg cramps in primary care: a mixed methods study.

BACKGROUND: Although nocturnal leg cramps are common, little research is available about their impact on quality of life. This mixed-methods study explored the impact of nocturnal leg cramps on health-related quality of life (HRQoL). METHODS: The study included primary care patients (>50 years) who reported suffering from nocturnal leg cramps (2016-2017). In the quantitative phase, patients completed a questionnaire about their HRQoL (SF-36) and the frequency of their cramps, and we computed the SF-36 scores. Then, we conducted a qualitative study using semi-structured interviews with patients with various levels of HRQol to explore their perception of the impact of cramps on their lives. RESULTS: A total of 114 patients (49%) agreed to participate in the quantitative study (mean age: 71, women: 62%) and 15 patients were included in the qualitative study (mean age: 69, women: 67%). The number of cramps in the previous week was low (mean: 1.6 (SD 1.5)). The SF-36 mean physical and mental summary scores were 43 and 50, respectively, and the domain scores were similar to a comparative general population. Whilst some patients reported little interference with their daily lives, others reported a major decrease in their HRQoL. SF-36 scores were not sufficient to describe the cramp-related impairment, as patients from all levels of SF-36 scores reported major impacts of NLC in the interviews. CONCLUSIONS: Some patients describe a specific impact of cramps on their lives, regardless of their HRQoL. These patients should be the target of future intervention trials.

How accurate are gender detection tools in predicting the gender for Chinese names? A study with 20,000 given names in Pinyin format.

Objective: We recently showed that the gender detection tools NamSor, Gender API, and Wiki-Gendersort accurately predicted the gender of individuals with Western given names. Here, we aimed to evaluate the performance of these tools with Chinese given names in Pinyin format. Methods: We constructed two datasets for the purpose of the study. File #1 was created by randomly drawing 20,000 names from a gender-labeled database of 52,414 Chinese given names in Pinyin format. File #2, which contained 9,077 names, was created by removing from File #1 all unisex names that we were able to identify (i.e., those that were listed in the database as both male and female names). We recorded for both files the number of correct classifications (correct gender assigned to a name), misclassifications (wrong gender assigned to a name), and nonclassifications (no gender assigned). We then calculated the proportion of misclassifications and nonclassifications (errorCoded). Results: For File #1, errorCoded was 53% for NamSor, 65% for Gender API, and 90% for Wiki-Gendersort. For File #2, errorCoded was 43% for NamSor, 66% for Gender API, and 94% for Wiki-Gendersort. Conclusion: We found that all three gender detection tools inaccurately predicted the gender of individuals with Chinese given names in Pinyin format and therefore should not be used in this population.

Erratum to "Performance of gender detection tools: a comparative study of name-to-gender inference services," 2021;109(3):414-21 and "Using genderize.io to infer the gender of first names: how to improve the accuracy of the inference," 2021;109(4):609-12.

[This corrects the article DOI: 10.5195/jmla.2021.1185.][This corrects the article DOI: 10.5195/jmla.2021.1252.].

[Use of non-pharmacological home remedies in ENT: research informs our practices and those of our patients]. / Emploi des remèdes de grand-mère en ORL : la recherche éclaire nos pratiques et celles de nos patients.

Upper respiratory tract infections (URTIs) are a common presenting condition in family medicine. The vast majority of URTIs are treated symptomatically with pharmacological or non-pharmacological treatments. This article presents some of the results of our research projects to compile a list of non-pharmacological home remedies to relieve symptoms such as sore throat, coughs and colds. Honey, thyme or lemon are often used by patients and considered to be effective. These remedies have few side-effects, and we therefore propose to include them in the range of treatments that can be proposed in family medicine.

Les infections des voies respiratoires supérieures (IVRS) constituent un motif de consultation fréquent en médecine de famille. La grande majorité des IVRS fait l'objet d'un traitement symptomatique pharmacologique ou non pharmacologique. Cet article se base sur une partie des résultats de nos projets de recherche pour constituer une liste de remèdes de grand-mère à proposer aux patients pour soulager des symptômes tels que les maux de gorge, la toux et le rhume. Le miel, le thym ou le citron sont souvent utilisés par les patients et considérés comme étant efficaces. Ces remèdes présentent peu d'effets indésirables et nous proposons donc de les intégrer dans l'arsenal thérapeutique en médecine de famille.

[Physician selfcare or the cobblers of Montaigne]. / Selfcare des médecins ou les cordonniers de Montaigne.

A recent survey conducted in the French-speaking part of Switzerland ("Romandie") showed that only about half of the primary care physicians (PCP) in Romandie had a personal doctor. Moreover, 37 % of the PCP declared they had foregone consulting a doctor for a health problem or a check-up during the past year. Finally, 29 % of them had chosen to continue working despite being ill. The literature describes multiple origins for these behaviors, both systemic (especially workload) and individual (denial, fear of social and peer judgment, culture of invincibility…). There is room for improvement for this still too often overlooked problem, in order to enhance the PCP's health (or well-being), and consequently the quality of care.

Une récente enquête menée en Suisse romande a montré qu'environ la moitié seulement des médecins de premier recours (MPR) romands avaient un médecin traitant. De plus, 37 % des MPR ont déclaré avoir renoncé à consulter un médecin pour un problème de santé durant l'année écoulée. Enfin, ils étaient aussi 29 % à avoir choisi de continuer à travailler tout en étant malades. La littérature évoque divers facteurs pouvant expliquer ou du moins contribuer à ces comportements, qu'il s'agisse de facteurs systémiques (principalement la charge de travail) ou individuels (déni, peur du jugement de la société et des pairs ou culture de la toute-puissance). Des voies d'amélioration, pour traiter cette problématique souvent méconnue, sont non seulement possibles, mais certainement nécessaires pour le bien de nos médecins et la qualité des soins délivrés aux patients.

Scientific publications in internal medicine and family medicine: a comparative cross-sectional study in Swiss university hospitals.

BACKGROUND: Family medicine is a relatively new academic medical discipline. We aimed to compare the main bibliometric indices of hospital-based senior physicians practicing internal medicine versus family medicine in Switzerland. METHODS: We conducted this cross-sectional study in March 2020. We selected all hospital-based senior physicians practicing internal medicine or family medicine in the six Swiss university hospitals. Using Web of Science, after removing from both groups of physicians the 5% with the highest number of publications, we extracted the number of publications, the number of publications per year, the number of citations, the number of citations per year, the number of citations per publication and the h-index. We compared the data between the two groups using negative binomial regressions and the proportion of physicians having at least one publication using chi-square tests. RESULTS: We included 349 physicians in the study (internal medicine: 51%, men: 51%). The median number of publications was three [interquartile range (IQR) = 18], the median number of citations was nine (IQR = 158) and the median h-index was one (IQR = 5). All bibliometric indices were similar in both groups, as was the proportion of physicians having at least one publication (family medicine: 87% versus 82%, P = 0.15). CONCLUSIONS: We found no association between the bibliometric indices and the medical specialty. Further studies are needed to explore other important indicators of academic output, such as those more specifically assessing its quality and scientific importance.

Self-reported symptoms in French primary care SARS-CoV-2 patients: association with gender and age group.

INTRODUCTION: The early identification of COVID-19 patients is of outmost importance in the current pandemic. As with other pathogens, presenting symptoms of SARS-CoV-2 may vary, depending on sociodemographic factors. We aimed to describe the clinical characteristics of COVID-19 patients by age/gender and to assess whether the diagnostic performance of these symptoms varied according to these variables. METHODS: We analysed data from a cross-sectional study involving primary care patients undergoing RT-PCR testing in Lyon, France. Among patients who tested positive, we examined whether there was an association between age/gender and various symptoms. In addition, we calculated the diagnostic performance of the most specific symptoms (smell/taste disorder). RESULTS: Among 1543 consecutive patients, 253 tested positive (16%). There were significant age/gender-related differences in symptoms. In middle-aged women, the diagnostic performance of smell/taste disorders were AUC = 0.65 [95%CI 0.59-0.71] and PPV = 72% [95%CI 53-87%], that is higher than in the entire sample (smell/taste disorders: AUC = 0.59 [95%CI 0.57-0.62] and PPV = 57% [95%CI 47-67%]. In contrast, the negative predictive values of smell/taste disorders were similar in both groups (85% [95%CI 81-89%] for middle-age women and 86% [95%CI 85-88%] for the entire sample). CONCLUSION: We found significant age/gender-related differences in the clinical characteristics of COVID-19 patients. Screening strategies based on smell/taste disorders performed better in middle-aged women, but could not ensure a diagnosis of COVID-19 in any subgroup of patients. Future diagnostic strategies should use age/gender differentiated approaches.

Using genderize.io to infer the gender of first names: how to improve the accuracy of the inference.

OBJECTIVE: We recently showed that genderize.io is not a sufficiently powerful gender detection tool due to a large number of nonclassifications. In the present study, we aimed to assess whether the accuracy of inference by genderize.io can be improved by manipulating the first names in the database. METHODS: We used a database containing the first names, surnames, and gender of 6,131 physicians practicing in a multicultural country (Switzerland). We uploaded the original CSV file (file #1), the file obtained after removing all diacritic marks, such as accents and cedilla (file #2), and the file obtained after removing all diacritic marks and retaining only the first term of the compound first names (file #3). For each file, we computed three performance metrics: proportion of misclassifications (errorCodedWithoutNA), proportion of nonclassifications (naCoded), and proportion of misclassifications and nonclassifications (errorCoded). RESULTS: naCoded, which was high for file #1 (16.4%), was reduced after data manipulation (file #2: 11.7%, file #3: 0.4%). As the increase in the number of misclassifications was small, the overall performance of genderize.io (i.e., errorCoded) improved, especially for file #3 (file #1: 17.7%, file #2: 13.0%, and file #3: 2.3%). CONCLUSIONS: A relatively simple manipulation of the data improved the accuracy of gender inference by genderize.io. We recommend using genderize.io only with files that were modified in this way.

Performance of gender detection tools: a comparative study of name-to-gender inference services.

OBJECTIVE: To evaluate the performance of gender detection tools that allow the uploading of files (e.g., Excel or CSV files) containing first names, are usable by researchers without advanced computer skills, and are at least partially free of charge. METHODS: The study was conducted using four physician datasets (total number of physicians: 6,131; 50.3% female) from Switzerland, a multilingual country. Four gender detection tools met the inclusion criteria: three partially free (Gender API, NamSor, and genderize.io) and one completely free (Wiki-Gendersort). For each tool, we recorded the number of correct classifications (i.e., correct gender assigned to a name), misclassifications (i.e., wrong gender assigned to a name), and nonclassifications (i.e., no gender assigned). We computed three metrics: the proportion of misclassifications excluding nonclassifications (errorCodedWithoutNA), the proportion of nonclassifications (naCoded), and the proportion of misclassifications and nonclassifications (errorCoded). RESULTS: The proportion of misclassifications was low for all four gender detection tools (errorCodedWithoutNA between 1.5 and 2.2%). By contrast, the proportion of unrecognized names (naCoded) varied: 0% for NamSor, 0.3% for Gender API, 4.5% for Wiki-Gendersort, and 16.4% for genderize.io. Using errorCoded, which penalizes both types of error equally, we obtained the following results: Gender API 1.8%, NamSor 2.0%, Wiki-Gendersort 6.6%, and genderize.io 17.7%. CONCLUSIONS: Gender API and NamSor were the most accurate tools. Genderize.io led to a high number of nonclassifications. Wiki-Gendersort may be a good compromise for researchers wishing to use a completely free tool. Other studies would be useful to evaluate the performance of these tools in other populations (e.g., Asian).

[Innovating to understand the unknown : COVID-19 pandemic research in family medicine]. / Innover pour comprendre l'inconnu : recherche sur la pandémie de Covid-19 en médecine de famille.

The COVID-19 pandemic has brought challenges that sparked a multitude of research questions at the Institutes of Family Medicine in Geneva and Lausanne. This article presents a synthesis of these questions, and the research projects that have resulted from them.

Les défis posés par la pandémie de Covid-19 ont éveillé une multitude de questions de recherche au sein des instituts de médecine de famille de Genève et Lausanne. Cet article présente une synthèse de ces questions et des projets de recherche qui en découlent.

Gender gap in research: a bibliometric study of published articles in primary health care and general internal medicine.

BACKGROUND: Many studies examined gender inequalities in research, but only a few data are available for general biomedical journals. We assessed the prevalence of female first authorship in general biomedical journals and examined its variations across a number of author, article and journal characteristics. METHODS: This study was nested within a larger project designed to analyze the bibliometric characteristics of scientific articles. We retrieved 767 randomly selected articles published in 2016 in high impact factor journals of primary healthcare (n = 9) and general internal medicine (n = 9). We extracted the following data: author (gender, number of publications and affiliation of the first author), paper (number of authors, number of participants and study design) and journal characteristics (journal discipline and 2015 impact factor). We compared the proportion of articles authored by women and men using univariate and multivariate logistic regressions adjusted for intra-cluster correlations. RESULTS: The female authorship proportion was 48% (63% for primary healthcare and 33% for general internal medicine, P-value < 0.001). In multivariate analysis, women published fewer articles (<5 versus >15 publications: OR 1.6 [95% CI 1.1-2.4]), were more often affiliated with institutions in the Western world (OR 2.2 [95% CI 1.2-3.9]), were more likely to publish qualitative studies (versus systematic reviews or experiments: OR 2.7 [95% CI 1.5-4.8]) and to publish in primary healthcare journals (OR 1.7 [95% CI 1.1-2.7]). CONCLUSIONS: The underrepresentation of women in articles published by general internal medicine journals, in articles from the non-Western world and in systematic reviews and trials should be addressed.

Is statistician involvement as co-author associated with reduced time to publication of quantitative research in general medical journals? A bibliometric study.

OBJECTIVE: We aimed to compare the number of submissions until acceptance and the time to publication between articles co-authored and articles not co-authored by statisticians. METHODS: We randomly selected 781 articles published in 2016 in 18 high impact factor journals of general internal medicine and primary care. For each article, we retrieved its date of submission to the journal and its first publication; we also contacted its corresponding author and asked about the number of submissions necessary from the first submission to a journal until acceptance and whether the article was co-authored by a statistician. After having excluded qualitative studies, we compared the articles co-authored with those not co-authored by statisticians in terms of number of submissions and submission-to-publication time, using negative binomial and Cox regressions, adjusted for intracluster correlations. RESULTS: One hundred fifty-eight authors completed the questionnaire (20%); 136 articles with quantitative design were included in the study. Overall, 63 articles (46%) were co-authored by statisticians. There was no statistically significant difference in the number of submissions (statistician group: mean 2.1 (SD 1.1) versus 2.2 (SD 1.2), P value 0.87). By contrast, we found a statistically significant difference in the submission-to-publication time (statistician group: median 211 days [interquartile range (IQR) 171] versus 260 (IQR 144); hazard ratio 1.44 (95% CI 1.01-2.03), adjusted P value 0.04). CONCLUSIONS: Papers co-authored by statisticians have a shorter time to publication. We encourage researchers to closely involve statisticians in the design, conduct and statistical analysis of research, not only to ensure high standards of quality but also to speed up its publication.