A case-control study of seated immobility at work as a risk factor for venous thromboembolism.

OBJECTIVE: To determine the relative risk of prolonged seated immobility at work in patients with a deep vein thrombosis (DVT) or pulmonary embolism (PE). DESIGN: A case-control study: cases and controls completed an interviewer-administered questionnaire to obtain information on risk factors for venous thromboembolism (VTE), including prolonged seated immobility at work. Univariate and multivariate logistic regression was used to determine the association between predicted variables and the probability of being a case or control. PARTICIPANTS: Cases were patients<65 years old attending the Wellington Hospital Outpatient VTE Clinic following hospital discharge for DVT and/or PE. Controls were patients<65 years old admitted to the Coronary Care Unit at Wellington Hospital. SETTING: The Wellington Hospital Outpatient VTE Clinic and Coronary Care Unit. MAIN OUTCOME MEASURES: Odds ratio of VTE for prolonged seated immobility. RESULTS: There were 97 cases (53 DVT, 29 PE, 15 DVT and PE), and 106 controls. In the multivariate analysis the odds ratio of VTE for prolonged seated immobility at work was 1.8 (95% CI 0.71-4.8). The maximum number of hours seated at work was associated with VTE, with the risk increasing by 10% per hour longer seated (odds ratio 1.1, 95% CI 1.0-1.2). The maximum number of hours seated at work without getting up was associated with VTE, with the risk increasing by 20% per hour longer seated (odds ratio 1.2, 95% CI 0.96-1.6). CONCLUSIONS: This study provides preliminary evidence that prolonged seated immobility at work may represent a risk factor for VTE.

An analysis of patient care questions asked by pediatricians at an academic medical center.

BACKGROUND: General pediatricians' information needs are not presently well characterized in the literature. OBJECTIVE: To characterize the patient care information needs of academic medical center pediatricians by collecting and classifying questions generated in clinical settings, allowing pediatric educators and authors to more effectively meet the needs of pediatricians. METHODS: A semistructured telephone survey of pediatric residents and faculty at a midwestern US academic medical center over two 6-month periods. The main outcome measures were number of questions asked, age ranges, pediatric subspecialties, and generic question types. RESULTS: A total of 607 pediatrician questions were collected. The infant age range generated the most questions (34.1%), and other age groups were almost equally distributed. The most common pediatric specialties were pharmacology (34.1%), infectious diseases (9.1%), neurology/neurosurgery (5.1%), allergy/pulmonary (4.6%), and neonatology (4.6%). The most common generic questions asked were "What is the dosage of drug X?" (18.0%), "What is the treatment for condition X?" (15.2%), and "What is condition X?" (13.5%). There were qualitative differences between resident and faculty groups. CONCLUSIONS: The information needs of academic medical center pediatricians can be assessed and potentially serve as a foundation for the development of common and digital educational information resources. Resident and faculty groups showed some qualitative differences. Pediatricians need drug-dosing information; clear condition definitions, including manifestation and clinical course descriptions; and physical finding and laboratory testing information. Educators and authors should highlight information concerning pharmacology and infectious diseases when developing educational and information resources.

Reading level of privacy policies on Internet health Web sites.

OBJECTIVE: Most individuals would like to maintain the privacy of their medical information on the World Wide Web (WWW). In response, commercial interests and other sites post privacy policies that are designed to inform users of how their information will be used. However, it is not known if these statements are comprehensible to most WWW users. The purpose of this study was to determine the reading level of privacy statements on Internet health Web sites and to determine whether these statements can inform users of their rights. STUDY DESIGN: This was a descriptive study. Eighty Internet health sites were examined and the readability of their privacy policies was determined. The selected sample included the top 25 Internet health sites as well as other sites that a user might encounter while researching a common problem such as high blood pressure. Sixty percent of the sites were commercial (.com), 17.5% were organizations (.org), 8.8% were from the United Kingdom (.uk), 3.8% were United States governmental (.gov), and 2.5% were educational (.edu). OUTCOMES MEASURED: The readability level of the privacy policies was calculated using the Flesch, the Fry, and the SMOG readability levels. RESULTS: Of the 80 Internet health Web sites studied, 30% (including 23% of the commercial Web sites) had no privacy policy posted. The average readability level of the remaining sites required 2 years of college level education to comprehend, and no Web site had a privacy policy that was comprehensible by most English-speaking individuals in the United States. CONCLUSIONS: The privacy policies of health Web sites are not easily understood by most individuals in the United States and do not serve to inform users of their rights. Possible remedies include rewriting policies to make them comprehensible and protecting online health information by using legal statutes or standardized insignias indicating compliance with a set of privacy standards (eg, "Health on the Net" [HON] http://www.hon.ch).