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Introduction: Education on lymphoedema and lymphoedema risk is an essential part of the cancer care package. This study evaluated recall and retention of lymphoedema-linked education knowledge in patients following breast cancer surgery. Method: Seventy participants at risk of developing lymphoedema were assigned to a 1:1 or group education programme. Surveys captured self-reported recall of their lymphoedema education and demonstration of upper-limb exercises over 12 months. Results: Participant's ability to recall lymphoedema education and associated exercises decreased over time. Recall increased by 12 months but remained suboptimal. Delivery method and lymphoedema risk category were not significant factors affecting participants recall. Conclusion: Recall and retention of lymphoedema education was sub-optimal, however, participants with clinical symptoms demonstrated greater knowledge and performance. [ABSTRACT FROM AUTHOR]

In health economics, the use of patient recall of health care utilisation information is common, including in national health surveys. However, the types and magnitude of measurement error that relate to different recall periods are not well understood. This study assessed the accuracy of recalled doctor visits over 2-week, 3-month, and 12-month periods by comparing self-report with routine administrative Australian Medicare data. Approximately 5,000 patients enrolled in an Australian study were pseudo-randomised using birth dates to report visits to a doctor over three separate recall periods. When comparing patient recall with visits recorded in administrative information from Medicare Australia, both bias and variance were minimised for the 12-month recall period. This may reflect telescoping that occurs with shorter recall periods (participants pulling in important events that fall outside the period). Using shorter recall periods scaled to represent longer periods is likely to bias results. There were associations between recall error and patient characteristics. The impact of recall error is demonstrated with a cost-effectiveness analysis using costs of doctor visits and a regression example predicting number of doctor visits. The findings have important implications for surveying health service utilisation for use in economic evaluation, econometric analyses, and routine national health surveys. [ABSTRACT FROM AUTHOR]

Background Late diagnosis is a considered to be a major factor contributing to poorer cancer survival rates in the UK. Interventions have focussed on the promotion of earlier diagnosis in patients with potential cancer symptoms. However, to assess the effectiveness of these interventions, the time from symptom onset to presentation needs to be reliably and accurately measured. This qualitative study explored the use of calendar landmarking instruments in cancer symptom research. Methods We performed a secondary analysis of transcripts of interviews using the calendar landmarking instrument, undertaken with patients who had either been diagnosed with cancer (n = 40, IRCO study, Western Australia), or who had symptoms suggestive of cancer (n = 38, SYMPTOM study, North East and Eastern England). We used constant comparison methods to identify use of the calendar landmarking instruments and the impact of their application. Results The calendar landmarking instrument appeared to help many patients, either by acting as a prompt or helping to refine recall of events. A combination of personal (e.g. birthday) and national (e.g. Christmas) landmarks seemed to be the most effective. Calendar landmarking instruments appeared more useful where the time period between onset of symptoms and date of first consultation was less than three months. The interviewee's age, gender and cancer type did not appear to influence whether or not the instrument facilitated recall, and there were no instances where the use of the instrument resulted in the disclosure of a new first symptom. Symptoms of similar chronic conditions could create difficulties when applying the instrument; it was difficult for these participants to characterise and disentangle their symptoms which prompted their decisions to seek help. Some participants tended to prefer to use their own, already personalised, diaries to assist in their recall of events. Conclusions This study is the first to describe the potential role of calendar landmarking instruments to support research interviews which explore symptoms and events along the cancer diagnostic pathway. The major challenge remains as to whether they actually improve accuracy of recall. [ABSTRACT FROM AUTHOR]

We examined whether the cognitive interview (CI) procedure increased event recall in children with severe intellectual disabilities (ID) compared with children with no ID. Forty-six children with and without ID watched a videotaped event; they were aged between eight and 11 years. The next day they were individually interviewed using the CI or a structured interview (SI). Interviews consisted of free recall and specific questions, some of which contained leading or misleading information. The leading and misleading questions determined children’s susceptibility to information presented after the event. Overall, children without ID reported more correct information than children with ID. For all children, the CI led to more correct recall than the SI without increases in incorrect details or confabulations. Although the CI did not decrease children’s susceptibility to the misleading questions compared with the SI, children without ID disagreed with more of the misleading suggestions than children with ID. These results suggest that the CI may indeed be a valuable tool to elicit information from very vulnerable witnesses. [ABSTRACT FROM PUBLISHER]

The frequency effect in short-term serial recall is influenced by the composition of lists. In pure lists, a robust advantage in the recall of high-frequency (HF) words is observed, yet in alternating mixed lists, HF and low-frequency (LF) words are recalled equally well. It has been argued that the preexisting associations between all list items determine a single, global level of supportive activation that assists item recall. Preexisting associations between items are assumed to be a function of language co-occurrence; HF-HF associations are high, LF-LF associations are low, and mixed associations are intermediate in activation strength. This account, however, is based on results when alternating lists with equal numbers of HF and LF words were used. It is possible that directional association between adjacent list items is responsible for the recall patterns reported. In the present experiment, the recall of three forms of mixed lists-those with equal numbers of HF and LF items and pure lists-was examined to test the extent to which item-to-item associations are present in serial recall. Furthermore, conditional probabilities were used to examine more closely the evidence for a contribution, since correct-in-position scoring may mask recall that is dependent on the recall of prior items. The results suggest that an item-to-item effect is clearly present for early but not late list items, and they implicate an additional factor, perhaps the availability of resources at output, in the recall of late list items. [ABSTRACT FROM AUTHOR]

Background: Informed consent is a basic standard of care for all patients undergoing medical procedures, but recall of information has been shown to be poor. We sought to compare verbal, written and animated audiovisual information delivery, during consent for coronary angiography, by measuring improvement in recall. Method: A sample population of 99 cardiac patients at Flinders Medical Centre was randomised (1:1:1) to receive one of three information delivery methods. The information content was standardised by a risk proforma, which explained the procedure and defined 12 specific risks. Recall, satisfaction and anxiety were assessed by a questionnaire administered at three different time points: post-consent, post-procedure and at 30 days. Effect of delivery method on satisfaction and anxiety was rated on a self-reported scale from 1-5, with 5 representing very satisfied or very anxious. Groups were compared by non-parametric testing and a p-value of <0.05 was considered statistically significant. Results: Patients were a median age of 64 (i.q.r. 56, 72) years. Information delivery method had no effect on recall of risks at any time-point (p=0.2, 0.7, 0.5, respectively) and the average recall score across the population was 3-4 out of 12. There was no significant effect on median satisfaction scores: verbal; 5 (i.q.r.4, 5) versus written/audiovisual; 4 (i.q.r.4, 5) (p=ns), or on median anxiety scores: verbal; 3 (i.q.r.2, 4) versus written/audiovisual; 3 (i.q.r.2, 4) (p=ns). Conclusion: Despite careful design of an innovative audiovisual delivery technique aimed at optimising comprehension and aiding memory, recall of information was poor and informational aids showed no improvement. Modes of information delivery are not the key to patient assimilation of complex medical information. [ABSTRACT FROM AUTHOR]

Over the past 15 years, research in health sciences has consistently shown that differences in the performance of novice and expert clinicians are predominantly due to their clinical reasoning abilities. Furthering our knowledge of the ways expert and novice occupational therapists reason can help us to explicate the complexities of practice and ultimately assist novices to think like experts. This paper presents the findings of a study which investigated qualitatively and quantitatively the clinical reasoning of novice and expert occupational therapists. Three expert and two novice occupational therapists working in rehabilitation settings wore head-mounted video cameras while completing three therapy sessions (assessment, treatment, discharge planning). Therapists then viewed the videos and reported back on their reasoning. These verbal reports were transcribed and analysed. While the quantitative results indicated several differences in both the amounts and types of clinical reasoning used by novices and experts, the qualitative analyses were more useful in revealing differences in the ways these two groups presented their clinical reasoning. The findings suggest that novice therapists could benefit from spending more time reflecting on the therapy process, and discussing their therapy with expert colleagues. [ABSTRACT FROM AUTHOR]

Clinical decision support systems (CDSSs) provide a valuable tool for clinicians to aid in the care of patients with chronic disease. Various questions have emerged about their implications for the doctor's legal duty of care to their patients, in terms of recognition of risk, recall, testing and treatment. In this article, through an analysis of Australian legislation and international case law, we address these questions, considering the potential impact of CDSSs on doctors' liability in negligence. We conclude that the appropriate use of a well-designed CDSS should minimise, rather than heighten, doctor's potential liability. It should support optimal patient care without diminishing the capacity of the doctor to make individualised decisions about recall, testing and treatment for each patient. We foreshadow that in the future doctors in Australia may have a duty to use available well-established software systems in patient care., Competing Interests: The authors are investigators on the Future Health Today project, which has a clinical decision support component.