Breaking a Vital Trust: Posting Photos of Patients on Facebook Among a Sample of Peruvian Medical Students.

Background: The doctor-patient relationship may be affected by the indiscriminate use of social media platforms. The aim of this study was to evaluate the content of the photos posted on medical students' Facebook accounts to determine whether they have posted private patient information and compare this to their self-reported behavior of posting such photos. Methods: We performed a cross-sectional study of medical students from a Peruvian private university. With their permission, we reviewed their Facebook accounts for the publication of photos or documents that included private patient information (face, name, diagnosis, medical exams). Those who allowed access to their Facebook accounts were also asked to complete an online survey. We assessed variables related to sociodemographic aspects, self reported Facebook use, and what type of private patient information they posted. Results: A total of 160/220 students joined the study, 59% were women, mean age: 20 years. 25.7% self-reported having posted private patient information in their Facebook profiles but we found such information on 33.1% of the students' pages. Of the pages where private patient information was found, in 94% of cases, the patients' faces were identifiable, and in 7.6%, the patients' real names appeared. However, only half of the students believed that the information in their Facebook post might affect or influence the doctor-patient relationship. Association with narcissism, gender, and account privacy was not found. Having uploaded more than 250 photos (OR:2.90; CI95%:1.14-7.39) and posting photos tagged with the location of a hospital (OR:4.02; CI95%:1.36-11.9) were associated with having posted photos containing private patient information. Conclusion: One out of three of medical students posted patients' private information on their personal Facebook profiles. Development, dissemination, and implementation of guidelines related to ethics in social media platforms are needed.

[Global and disease-free survival in a peruvian cohort of patients with acute lymphoblastic leukemia]. / Sobrevida global y libre de enfermedad en una cohorte peruana de pacientes con leucemia linfoblástica aguda.

OBJECTIVE: To know the five-year survival and its associated factors in patients with Acute Lymphoblastic Leukemia (ALL) in Peru. MATERIALS AND METHODS: A retrospective cohort of patients with ALL treated with chemotherapy in a Peruvian hospital for 13 years was studied. The dependent variables were overall survival (OS) and disease-free survival (DFS). Possible factors that might be associated with diagnosis and response to treatment were evaluated using the Cox proportional risk method. RESULTS: The mortality rate was 32.5% and the relapse rate was 66.1%. The factors associated with lower overall survival were leukocyte count at diagnosis (HR: 1.01; 95% CI: 1.01-1.03), lineage other than B (HR: 2.15; 95% CI: 1,06-4,41), age at diagnosis (HR: 1,09; 95% CI: 1,03-1,16), bone marrow relapse (HR: 6,81; 95% CI: 4,14- 11,21) and induction failure (HR: 3,04; 95% CI: 1,47-6,32). Factors associated with lower disease-free survival: male gender (HR: 1.43; 95% CI: 1.10-1.86), age at diagnosis (HR: 1.06; 95% CI: 1.02-1.10) and leukocytes at diagnosis (HR: 1.01; 95% CI: 1.002-1.011). CONCLUSIONS: The five-year OS and DFS figures for our population are lower than those for the world. More studies are needed to know the factors involved in this reality and thus generate interventions aimed at improving the survival and quality of life of our patients. The variables associated with the decrease in both survival indicators were age and leukocyte count at the time of diagnosis, so the process of disease diagnosis must be improved.

Objetivos. Conocer la supervivencia a los cinco años y sus factores asociados, en pacientes con Leucemia Linfoblástica Aguda (LLA) en Perú. Materiales y Métodos. Se estudió una cohorte retrospectiva sobre pacientes con LLA tratados con quimioterapia en un hospital peruano por 13 años. Las variables dependientes fueron sobrevida global (SG) y sobrevida libre de enfermedad (SLE). Los posibles factores que pudieran estar asociados con el diagnóstico y la respuesta al tratamiento se evaluaron a través del método de riesgos proporcionales de Cox. Resultados. La tasa de mortalidad fue 32,5 % y de recaídas fue 66,1 %. Los factores asociados a menor sobrevida global fueron recuento leucocitario al diagnóstico (HR: 1,01; IC95 %: 1,01-1,03), estirpe distinta a B (HR: 2,15; IC95 %: 1,06-4,41), edad al diagnóstico (HR: 1,09; IC95 %: 1,03-1,16), recaída en médula ósea (HR: 6,81; IC95 %: 4,14-11,21) y falla a la inducción (HR: 3,04; IC95 %: 1,47-6,32). Los factores asociados a menor sobrevida libre de enfermedad: género masculino (HR: 1,43; IC95 %: 1,10-1,86), edad al diagnóstico (HR: 1,06; IC95 %: 1,02-1,10) y leucocitos al diagnóstico (HR: 1,01; IC95 %: 1,002-1,011). Conclusiones. Las cifras de SG y SLE a cinco años de nuestra población son inferiores a las mundiales. Se requieren más estudios para conocer los factores involucrados a esta realidad y así, generar intervenciones destinadas a mejorar la sobrevida y calidad de vida de nuestros pacientes. Las variables asociadas a la disminución de ambas sobrevidas fueron la edad y el recuento de leucocitos al momento del diagnóstico, por lo que se deben mejorar el proceso de diagnóstico de esta enfermedad.

Sobrevida global y libre de enfermedad en una cohorte peruana de pacientes con leucemia linfoblástica aguda / Global and disease-free survival in a peruvian cohort of patients with acute lymphoblastic leukemia

RESUMEN Objetivos. Conocer la supervivencia a los cinco años y sus factores asociados, en pacientes con Leucemia Linfoblástica Aguda (LLA) en Perú. Materiales y Métodos. Se estudió una cohorte retrospectiva sobre pacientes con LLA tratados con quimioterapia en un hospital peruano por 13 años. Las variables dependientes fueron sobrevida global (SG) y sobrevida libre de enfermedad (SLE). Los posibles factores que pudieran estar asociados con el diagnóstico y la respuesta al tratamiento se evaluaron a través del método de riesgos proporcionales de Cox. Resultados. La tasa de mortalidad fue 32,5 % y de recaídas fue 66,1 %. Los factores asociados a menor sobrevida global fueron recuento leucocitario al diagnóstico (HR: 1,01; IC95 %: 1,01-1,03), estirpe distinta a B (HR: 2,15; IC95 %: 1,06-4,41), edad al diagnóstico (HR: 1,09; IC95 %: 1,03-1,16), recaída en médula ósea (HR: 6,81; IC95 %: 4,14-11,21) y falla a la inducción (HR: 3,04; IC95 %: 1,47-6,32). Los factores asociados a menor sobrevida libre de enfermedad: género masculino (HR: 1,43; IC95 %: 1,10-1,86), edad al diagnóstico (HR: 1,06; IC95 %: 1,02-1,10) y leucocitos al diagnóstico (HR: 1,01; IC95 %: 1,002-1,011). Conclusiones. Las cifras de SG y SLE a cinco años de nuestra población son inferiores a las mundiales. Se requieren más estudios para conocer los factores involucrados a esta realidad y así, generar intervenciones destinadas a mejorar la sobrevida y calidad de vida de nuestros pacientes. Las variables asociadas a la disminución de ambas sobrevidas fueron la edad y el recuento de leucocitos al momento del diagnóstico, por lo que se deben mejorar el proceso de diagnóstico de esta enfermedad.

Abstract Objective. To know the five-year survival and its associated factors in patients with Acute Lymphoblastic Leukemia (ALL) in Peru. Materials and Methods. A retrospective cohort of patients with ALL treated with chemotherapy in a Peruvian hospital for 13 years was studied. The dependent variables were overall survival (OS) and disease-free survival (DFS). Possible factors that might be associated with diagnosis and response to treatment were evaluated using the Cox proportional risk method. Results. The mortality rate was 32.5% and the relapse rate was 66.1%. The factors associated with lower overall survival were leukocyte count at diagnosis (HR: 1.01; 95% CI: 1.01-1.03), lineage other than B (HR: 2.15; 95% CI: 1,06-4,41), age at diagnosis (HR: 1,09; 95% CI: 1,03-1,16), bone marrow relapse (HR: 6,81; 95% CI: 4,14- 11,21) and induction failure (HR: 3,04; 95% CI: 1,47-6,32). Factors associated with lower disease-free survival: male gender (HR: 1.43; 95% CI: 1.10-1.86), age at diagnosis (HR: 1.06; 95% CI: 1.02-1.10) and leukocytes at diagnosis (HR: 1.01; 95% CI: 1.002-1.011). Conclusions. The five-year OS and DFS figures for our population are lower than those for the world. More studies are needed to know the factors involved in this reality and thus generate interventions aimed at improving the survival and quality of life of our patients. The variables associated with the decrease in both survival indicators were age and leukocyte count at the time of diagnosis, so the process of disease diagnosis must be improved.