Worried well and Covid-19: Re-emergence of an old quandary

Chatterjee, Seshadri Sekhar; Vora, Mansi; Malathesh, Barikar C; Bhattacharyya, Ranjan

doi:10.1016/j.ajp.2020.102247

Cited by 10 publications

(5 citation statements)

References 8 publications

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“…Our findings regarding non-consent can partially be explained by the ‘worried well’ phenomenon: relatively healthy (younger) and educated patients tend to seek more medical advice and are more willing to participate in studies [ 26 , 34 , 35 ]. Participating in the UCC-CVRM LHS may give these patients the sense that their health is more closely monitored.…”

Section: Discussionmentioning

confidence: 99%

Asking informed consent may lead to significant participation bias and suboptimal cardiovascular risk management in learning healthcare systems

Zondag

Groenhof

Graaf

et al. 2023

BMC Med Res Methodol

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Background The Utrecht Cardiovascular Cohort – CardioVascular Risk Management (UCC-CVRM) was set up as a learning healthcare system (LHS), aiming at guideline based cardiovascular risk factor measurement in all patients in routine clinical care. However, not all patients provided informed consent, which may lead to participation bias. We aimed to study participation bias in a LHS by assessing differences in and completeness of cardiovascular risk management (CVRM) indicators in electronic health records (EHRs) of consenting, non-consenting, and non-responding patients, using the UCC-CVRM as an example. Methods All patients visiting the University Medical Center Utrecht for first time evaluation of a(n) (a)symptomatic vascular disease or condition were invited to participate. Routine care data was collected in the EHR and an informed consent was asked. Differences in patient characteristics were compared between consent groups. We performed multivariable logistic regression to identify determinants of non-consent. We used multinomial regression for an exploratory analysis for the determinants of non-response. Presence of CVRM indicators were compared between consent groups. A waiver (19/641) was obtained from our ethics committee. Results Out of 5730 patients invited, 2378 were consenting, 1907 non-consenting, and 1445 non-responding. Non-consent was related to young and old age, lower education level, lower BMI, physical activity and haemoglobin levels, higher heartrate, cardiovascular disease history and absence of proteinuria. Non-response increased with young and old age, higher education level, physical activity, HbA1c and decreased with lower levels of haemoglobin, BMI, and systolic blood pressure. Presence of CVRM indicators was 5–30% lower in non-consenting patients and even lower in non-responding patients, compared to consenting patients. Non-consent and non-response varied across specialisms. Conclusions A traditional informed consent procedure in a LHS may lead to participation bias and potentially to suboptimal CVRM, which is detrimental for feedback on findings in a LHS. This underlines the importance of reassessing the informed consent procedure in a LHS.

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Section: Discussionmentioning

confidence: 99%

Asking informed consent may lead to significant participation bias and suboptimal cardiovascular risk management in learning healthcare systems

Zondag

Groenhof

Graaf

et al. 2023

BMC Med Res Methodol

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“…This category needs a separate mention because of the significant associated psychological distress, as well as the high usage of healthcare services. With or without any diagnosable psychiatric syndromes such as somatoform disorder, hypochondriasis, these patients experience sufficient stress and anxiety, worsening their mental health and general well-being (Chatterjee et al, 2020). This presentation may be relevant to the vaccination also, including worries about vaccine and its side effects, perceived severity and lethality of post-vaccine physical symptoms, fear of vaccine-related complications and refusal of vaccine, thereby increasing the public health risk.…”

Section: Unique Roles and Opportunitiesmentioning

confidence: 99%

COVID-19 Vaccination: crucial roles and opportunities for the mental health professionals

et al. 2021

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Besides addressing the increased prevalence of psychiatric disorders, social challenges, and building community resilience during the crisis, mental health professionals (MHPs) are in a unique position to assist the vaccination drive against coronavirus disease-2019 (COVID-19) in various nations. Vaccination programs are adversely affected by misinformation, fake news and vaccine hesitancy fuelled by social media. MHPs can enable this vital public health strategy by prioritizing vaccination for individuals with severe mental illness (SMI) and substance use disorders, promote awareness and public education, debunk misinformation and integrate psychosocial care into the vaccination drives. In order to target the health inequity and discrimination faced by people with SMI coupled with their additional risks, the authors urge the global mental health fraternity to tailor these crucial roles with respect to COVID-19 vaccination based on the regional needs and contexts.

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“…Some countries are under lockdown again, faced with the threat of a second wave of COVID. 4 , 5 Experts are warning about the possibilities of the second wave attributed mainly to human behavior. People were frustrated after being at home for a long time and now breaking all the social rules.…”

Section: Introductionmentioning

confidence: 99%

Prioritizing Infection Prevention and Control Activities for SARS-CoV-2 (COVID-19): A Multi-Criteria Decision-Analysis Method

Sarwar¹,

Imran²

2021

JHL

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Purpose The outbreak of COVID-19 in China has spread to the whole world within a short period. The spread of COVID-19 has caused innumerable economic and social losses. The coronavirus spread directly from individual to individual. WHO and other governing bodies made guidelines and remedial activities to minimize the spread of COVID-19. This study aims to analyze and prioritize infection prevention and control activities for SARS-CoV-2. Methods An analytical study was conducted between medical representatives and scientists to check the impact of these precautionary measures (social distancing, shaking hands and hugging peoples, unnecessary touching things, hygiene, and sharing personal items) on COVID-19. The Analytical Hierarchical Process (AHP) method has been utilized to evaluate and prioritize the preventive measures of COVID-19. Results The results of this investigation shows, unnecessary travel, 3Cs, and touching own body parts should be avoided. Wearing a mask and proper hand washing are important to reduce the spread of coronavirus. Conclusion The SARS-CoV-2 has affected more than 11 million people around the world. The second spike of COVID-19 is also alarming for people. It is important to follow the instruction provided by the WHO, CDC, and other national and international governing bodies. The AHP method was used to check various measures that are spreading the coronavirus disease. It demonstrated that 3Cs (spaces that are closed, crowded, and involve close contacts) and travel, shaking hand, unnecessary touching own body parts should be avoided.

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Worried well and Covid-19: Re-emergence of an old quandary

Cited by 10 publications

References 8 publications

Asking informed consent may lead to significant participation bias and suboptimal cardiovascular risk management in learning healthcare systems

Asking informed consent may lead to significant participation bias and suboptimal cardiovascular risk management in learning healthcare systems

COVID-19 Vaccination: crucial roles and opportunities for the mental health professionals

Prioritizing Infection Prevention and Control Activities for SARS-CoV-2 (COVID-19): A Multi-Criteria Decision-Analysis Method

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