[Bibliometric indicators, subjects analysis and methodology of research published in Spain on epidemiology and public health care (1988-1992)]. / Indicadores bibliométricos, análisis temático y metodológico de la investigación publicada en España sobre epidemiología y salud pública (1988-1992).

BACKGROUND: To describe Spanish scientific output in epidemiology and public health through the bibliometric indexes utilization and with regard to subjects, design and statistical methods employed, as well as its appropriateness, importance and funding. MATERIAL AND METHODS: Descriptive, longitudinal and retrospective study over 594 originals published in Spanish medical journals and listed in the Spanish Medical Index (Indice Médico Español) during the 5 years period 1988-1992. RESULTS: The average autors by article was of 4.9 and the Lotka's index, for the authors that publish articles on the topic, was -2.92; 82% of the authors have a productivity index equal to zero. Almost 70% of the articles are signed by an isolated institution, being a hospital in 51% of the cases. The journal that publishes most articles on the topic is Medicina Clínica. The average references by article is about 24. The Price' index is 36.5% and the isolation' index is 36.2%. "The non AIDS infections", the descriptive designs and the lack of inferential statistics methods, characterize the content of the articles. Regarding to the criteria established by the study, more than half of the analyzed research (56.5%) was appropriate and almost a fourth (22%) could be considered that was about important topics. CONCLUSIONS: Concerning bibliometric indicators, research on epidemiology and public health in Spain does not seem to differ from other medical specialties. The epidemiology as scientific method is widely used over the medical specialties, something which could explain the wide dispersion of scientific literature on this topic. There seems to be a certain lack of agreement between the research topics and the real health problems of Spain.

[The reliability of the ankle/arm index for the study of chronic arteriopathy of the lower limbs in primary care]. / Fiabilidad del índice tobillo/brazo para el estudio de la arteriopatía crónica de los miembros inferiores en atención primaria.

OBJECTIVE: To validate the "ankle/arm" index (AAI) or "Yao index" for the primary care assessment of chronic arteriopathy in the lower limbs (CALL). DESIGN: A descriptive crossover study. SETTING: Primary care. PATIENTS: 21 with suspected or diagnosed CALL. MEASUREMENTS AND MAIN RESULTS: Four primary-care doctors made 164 examinations by means of palpation and determination of blood pressure with Doppler waves. The presence or absence of pulses was recorded and the AAI calculated. The interobserver Kappa ranged from 0.20 to 0.47 and the intraobserver from 0.52 to 0.76, according to the pulse examined. The intraclass interobserver correlation coefficient for the AAI was 0.80 and the intraobserver 0.79. Interobserver SD for the AAI was 0.14, and intraobserver SD 0.15. CONCLUSIONS: The ankle-arm index obtained by primary-care doctors using Doppler is a reliable method of studying CALL. However, due to its wide variability, it is advisable always to evaluate its evolution together with clinical data.

[Thematic and methodological analysis of investigation in primary care (1988-1992)]. / Análisis temático y metodológico de la investigación en atención primaria (1988-1992).

OBJECTIVE: To describe Spanish scientific output in primary care with regard to subjects, design and statistical methods employed and also its appropriateness, importance and funding. DESIGN: Descriptive, longitudinal and retrospective study. SETTING: Spanish scientific output in primary care published in medical journals and listed in the Indice Medico Español during the five year period 1988-1992. MATERIAL: 446 original articles published in thirty-four journals. MEASUREMENTS AND MAIN RESULTS: The greatest percentage of articles came under the heading "policy and health" (23.6%), next was "health services" (14.8%). There was a predominance of observational designs (79.9%) and within this category, descriptive studies (67.1%). The most common statistical methods used were contingency tables (35,9%). The majority of articles (94.8%) do not indicate the source of their funding. The appropriateness was around 50% and the importance around 4%. CONCLUSIONS: According to our study, research into primary care centres on the evaluation and organization of the health services. The majority of the designs have little inferential power and simple statistical methods. There is hardly any funding available, and only a half of the articles comply with appropriateness criteria.

[Bibliometric indicators of research in primary care (1988-1992)]. / Indicadores bibliométricos de la investigación en atención primaria (1988-1992).

AIM: To describe Spanish scientific production in primary care by means of using bibliometric indexes. SETTING: Spanish scientific production which was published in medical periodicals and indexed in the Indice Médico Español during the years 1988-1992. MATERIAL: 446 articles published in thirty-four different medical journals. DESIGN: Descriptive, longitudinal and retrospective study. MEASUREMENTS AND MAIN RESULTS: The number of articles slightly increases over the complete time of the study, principally in 1992. 98.4% were written in Spanish language. The average number of signatures per article is about five. Most of the authors are family doctors or interns of the medical specialty. In 76.46% of the cases, the articles were signed by only one institution. The majority of them (38.56%), were done in teaching units of family medicine. Barcelona is the most important producer of articles (20.2%) and 78% were published in the Atención Primaria periodical. The average number of references slightly increases during the whole period and is about 17 references in the five years studied. CONCLUSIONS: The scientific production on primary care seems to have an exponential increase according to Price's Law and it is concentrated in the Atención Primaria periodical. Most of authors are family doctors or interns of such specialty, who work in units of family medicine. Collaborative studies among institutions are uncommon. The number of signatures and the use of references were found to be similar to other medical specialties.

[Functional capacity of patients over 65 according to the Katz index. Reliability of the method]. / Capacidad funcional de pacientes mayores de 65 años, según el índice de Katz. Fiabilidad del método.

OBJECTIVE: To find functional capacity of elderly patients by using the Katz Index, which measures the "Basic Activities of Daily Life". To examine how reliable the Katz Index is in the Primary Care field. DESIGN: Descriptive crossover study. Assessment of the measuring instrument's internal consistency and reliability, using a test-retest method. SITE. Otero Health Area, in Oviedo. PATIENTS OR OTHERS PARTICIPANTS: This was a random sample, ordered by age and gender, of people over 65 who used the Otero Health centre. MAIN MEASUREMENTS AND RESULTS: The elderly population made up 12.86% of our base Health Area. The Katz Index showed that 81.6% of the elderly in the sample were independent in all their functions. A significant age difference was found. Internal consistency was measured by Cronbach's Alpha and was 0.8612 for nurses and 0.8362 for doctors. The correlation coefficient within Sperman's estimated observer was r = 0.936074. Kappa was 0.8436 (p < 0.0000) for the different observers, i.e. nurses or doctors. CONCLUSIONS: Most of the elderly patients in our base Health area possess full functional capacity, at the level of the routine activities of their daily life. The Katz Index is a reliable method of evaluating elderly peoples' functional capacity, at the Primary Care level. It can be used by any professional in the health team.