Information exchange among physicians caring for the same patient in the community

The exchange of information is an integral component of continuity of health care and may limit or prevent costly duplication of tests and treatments. This study determined the probability that patient information from previous visits with other physicians was available for a current physician visit...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Canadian Medical Association journal 2008-11, Vol.179 (10), p.1013-1018
Hauptverfasser: van Walraven, Carl, MD MSc, Taljaard, Monica, PhD, Bell, Chaim M., MD PhD, Etchells, Edward, MD MSc, Zarnke, Kelly B., MD, Stiell, Ian G., MD MSc, Forster, Alan J., MD MSc
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page 1018
container_issue 10
container_start_page 1013
container_title Canadian Medical Association journal
container_volume 179
creator van Walraven, Carl, MD MSc
Taljaard, Monica, PhD
Bell, Chaim M., MD PhD
Etchells, Edward, MD MSc
Zarnke, Kelly B., MD
Stiell, Ian G., MD MSc
Forster, Alan J., MD MSc
description The exchange of information is an integral component of continuity of health care and may limit or prevent costly duplication of tests and treatments. This study determined the probability that patient information from previous visits with other physicians was available for a current physician visit. We conducted a multicentre prospective cohort study including patients discharged from the medical or surgical services of 11 community and academic hospitals in Ontario. Patients included in the study saw at least 2 different physicians during the 6 months after discharge. The primary outcome was whether information from a previous visit with another physician was available at the current visit. We determined the availability of previous information using surveys of or interviews with the physicians seen during current visits. A total of 3250 patients, with a total of 39 469 previous-current visit combinations, met the inclusion criteria. Overall, information about the previous visit was available 22.0% of the time. Information was more likely to be available if the current doctor was a family physician (odds ratio [OR] 1.75, 95% confidence interval [CI] 1.54-1.98) or a physician who had treated the patient before the hospital admission (OR 1.33, 95% CI 1.21-1.46). Conversely, information was less likely to be available if the previous doctor was a family physician (OR 0.38, 95% CI 0.32-0.44) or a physician who had treated the patient before the admission (OR 0.72, 95% CI 0.60-0.86). The strongest predictor of information exchange was the current physician having previously received information about the patient from the previous physician (OR 7.72, 95% CI 6.92-8.63). Health care information is often not shared among multiple physicians treating the same patient. This situation would be improved if information from family physicians and patients' regular physicians was more systematically available to other physicians.
doi_str_mv 10.1503/cmaj.080430
format Article
fullrecord <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_2572647</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A188276402</galeid><sourcerecordid>A188276402</sourcerecordid><originalsourceid>FETCH-LOGICAL-c642t-90c3797bf15d2af2706e70af82109bec507042a692a7aec62b6e8ab120f647093</originalsourceid><addsrcrecordid>eNqV0s9r2zAUB3AzNtas22n3YXYoG8PZkyxb8qVQyn4ESgfddhaK8mwrWFJq2Uvz309pQpeUXoYPhuePvpL1XpK8JTAlBeSftVXLKQhgOTxLJoQJkdGcVs-TCQCIjDGoTpJXISwBYh3Yy-SEiEoQxugkuZm52vdWDca7FO90q1yDqbLeNemq3QSjjXIh1ao3sRJpOrSYBmUxXcVF6IbUuPua9taOzgyb18mLWnUB3-zfp8nvr19-XX7Prn58m11eXGW6ZHTIKtA5r_i8JsWCqppyKJGDqgUlUM1RF8CBUVVWVHGFuqTzEoWaEwp1yThU-WlyvstdjXOLCx3P0qtOrnpjVb-RXhl5_MWZVjb-j6QFpzEiBpztA3p_O2IYpDVBY9cph34Msqw4i4dhEb5_BJd-7F38ORnvUxQUeBFRtkON6lCaeK1xU92gw7i3d1ibWL4gQlBestiJh9Ajr1fmVh6i6RMoPgu0Rj-Z-vFoQTQD3g2NGkOQs583_2Gvj-3ZgW1RdUMbfDdu5yYcw087qHsfQo_1Q0MIyO28yu28yt28Rv3usIf_7H5AI_iwA61p2rXpUQarui5yItfrNeHVfS6QPP8LeSvvzQ</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>204852075</pqid></control><display><type>article</type><title>Information exchange among physicians caring for the same patient in the community</title><source>MEDLINE</source><source>DOAJ Directory of Open Access Journals</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><source>Alma/SFX Local Collection</source><creator>van Walraven, Carl, MD MSc ; Taljaard, Monica, PhD ; Bell, Chaim M., MD PhD ; Etchells, Edward, MD MSc ; Zarnke, Kelly B., MD ; Stiell, Ian G., MD MSc ; Forster, Alan J., MD MSc</creator><creatorcontrib>van Walraven, Carl, MD MSc ; Taljaard, Monica, PhD ; Bell, Chaim M., MD PhD ; Etchells, Edward, MD MSc ; Zarnke, Kelly B., MD ; Stiell, Ian G., MD MSc ; Forster, Alan J., MD MSc</creatorcontrib><description>The exchange of information is an integral component of continuity of health care and may limit or prevent costly duplication of tests and treatments. This study determined the probability that patient information from previous visits with other physicians was available for a current physician visit. We conducted a multicentre prospective cohort study including patients discharged from the medical or surgical services of 11 community and academic hospitals in Ontario. Patients included in the study saw at least 2 different physicians during the 6 months after discharge. The primary outcome was whether information from a previous visit with another physician was available at the current visit. We determined the availability of previous information using surveys of or interviews with the physicians seen during current visits. A total of 3250 patients, with a total of 39 469 previous-current visit combinations, met the inclusion criteria. Overall, information about the previous visit was available 22.0% of the time. Information was more likely to be available if the current doctor was a family physician (odds ratio [OR] 1.75, 95% confidence interval [CI] 1.54-1.98) or a physician who had treated the patient before the hospital admission (OR 1.33, 95% CI 1.21-1.46). Conversely, information was less likely to be available if the previous doctor was a family physician (OR 0.38, 95% CI 0.32-0.44) or a physician who had treated the patient before the admission (OR 0.72, 95% CI 0.60-0.86). The strongest predictor of information exchange was the current physician having previously received information about the patient from the previous physician (OR 7.72, 95% CI 6.92-8.63). Health care information is often not shared among multiple physicians treating the same patient. This situation would be improved if information from family physicians and patients' regular physicians was more systematically available to other physicians.</description><identifier>ISSN: 0008-4409</identifier><identifier>ISSN: 0820-3946</identifier><identifier>EISSN: 1488-2329</identifier><identifier>DOI: 10.1503/cmaj.080430</identifier><identifier>PMID: 18981442</identifier><identifier>CODEN: CMAJAX</identifier><language>eng</language><publisher>Canada: Can Med Assoc</publisher><subject>Access control ; Access to Information ; Communication ; Confidential communications ; Continuity of Patient Care ; Cooperative Behavior ; Female ; Follow-Up Studies ; Hospitals, Community ; Hospitals, University ; Humans ; Information management ; Information sharing ; Male ; Medical Record Linkage ; Medical records ; Medical research ; Middle Aged ; Office Visits ; Ontario ; Physicians ; Practice ; Prospective Studies</subject><ispartof>Canadian Medical Association journal, 2008-11, Vol.179 (10), p.1013-1018</ispartof><rights>COPYRIGHT 2008 CMA Impact Inc.</rights><rights>Copyright Canadian Medical Association Nov 4, 2008</rights><rights>2008 Canadian Medical Association</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c642t-90c3797bf15d2af2706e70af82109bec507042a692a7aec62b6e8ab120f647093</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2572647/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2572647/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,860,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18981442$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>van Walraven, Carl, MD MSc</creatorcontrib><creatorcontrib>Taljaard, Monica, PhD</creatorcontrib><creatorcontrib>Bell, Chaim M., MD PhD</creatorcontrib><creatorcontrib>Etchells, Edward, MD MSc</creatorcontrib><creatorcontrib>Zarnke, Kelly B., MD</creatorcontrib><creatorcontrib>Stiell, Ian G., MD MSc</creatorcontrib><creatorcontrib>Forster, Alan J., MD MSc</creatorcontrib><title>Information exchange among physicians caring for the same patient in the community</title><title>Canadian Medical Association journal</title><addtitle>CMAJ</addtitle><description>The exchange of information is an integral component of continuity of health care and may limit or prevent costly duplication of tests and treatments. This study determined the probability that patient information from previous visits with other physicians was available for a current physician visit. We conducted a multicentre prospective cohort study including patients discharged from the medical or surgical services of 11 community and academic hospitals in Ontario. Patients included in the study saw at least 2 different physicians during the 6 months after discharge. The primary outcome was whether information from a previous visit with another physician was available at the current visit. We determined the availability of previous information using surveys of or interviews with the physicians seen during current visits. A total of 3250 patients, with a total of 39 469 previous-current visit combinations, met the inclusion criteria. Overall, information about the previous visit was available 22.0% of the time. Information was more likely to be available if the current doctor was a family physician (odds ratio [OR] 1.75, 95% confidence interval [CI] 1.54-1.98) or a physician who had treated the patient before the hospital admission (OR 1.33, 95% CI 1.21-1.46). Conversely, information was less likely to be available if the previous doctor was a family physician (OR 0.38, 95% CI 0.32-0.44) or a physician who had treated the patient before the admission (OR 0.72, 95% CI 0.60-0.86). The strongest predictor of information exchange was the current physician having previously received information about the patient from the previous physician (OR 7.72, 95% CI 6.92-8.63). Health care information is often not shared among multiple physicians treating the same patient. This situation would be improved if information from family physicians and patients' regular physicians was more systematically available to other physicians.</description><subject>Access control</subject><subject>Access to Information</subject><subject>Communication</subject><subject>Confidential communications</subject><subject>Continuity of Patient Care</subject><subject>Cooperative Behavior</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Hospitals, Community</subject><subject>Hospitals, University</subject><subject>Humans</subject><subject>Information management</subject><subject>Information sharing</subject><subject>Male</subject><subject>Medical Record Linkage</subject><subject>Medical records</subject><subject>Medical research</subject><subject>Middle Aged</subject><subject>Office Visits</subject><subject>Ontario</subject><subject>Physicians</subject><subject>Practice</subject><subject>Prospective Studies</subject><issn>0008-4409</issn><issn>0820-3946</issn><issn>1488-2329</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqV0s9r2zAUB3AzNtas22n3YXYoG8PZkyxb8qVQyn4ESgfddhaK8mwrWFJq2Uvz309pQpeUXoYPhuePvpL1XpK8JTAlBeSftVXLKQhgOTxLJoQJkdGcVs-TCQCIjDGoTpJXISwBYh3Yy-SEiEoQxugkuZm52vdWDca7FO90q1yDqbLeNemq3QSjjXIh1ao3sRJpOrSYBmUxXcVF6IbUuPua9taOzgyb18mLWnUB3-zfp8nvr19-XX7Prn58m11eXGW6ZHTIKtA5r_i8JsWCqppyKJGDqgUlUM1RF8CBUVVWVHGFuqTzEoWaEwp1yThU-WlyvstdjXOLCx3P0qtOrnpjVb-RXhl5_MWZVjb-j6QFpzEiBpztA3p_O2IYpDVBY9cph34Msqw4i4dhEb5_BJd-7F38ORnvUxQUeBFRtkON6lCaeK1xU92gw7i3d1ibWL4gQlBestiJh9Ajr1fmVh6i6RMoPgu0Rj-Z-vFoQTQD3g2NGkOQs583_2Gvj-3ZgW1RdUMbfDdu5yYcw087qHsfQo_1Q0MIyO28yu28yt28Rv3usIf_7H5AI_iwA61p2rXpUQarui5yItfrNeHVfS6QPP8LeSvvzQ</recordid><startdate>20081104</startdate><enddate>20081104</enddate><creator>van Walraven, Carl, MD MSc</creator><creator>Taljaard, Monica, PhD</creator><creator>Bell, Chaim M., MD PhD</creator><creator>Etchells, Edward, MD MSc</creator><creator>Zarnke, Kelly B., MD</creator><creator>Stiell, Ian G., MD MSc</creator><creator>Forster, Alan J., MD MSc</creator><general>Can Med Assoc</general><general>CMA Impact Inc</general><general>CMA Impact, Inc</general><general>Canadian Medical Association</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>ISN</scope><scope>ISR</scope><scope>3V.</scope><scope>4T-</scope><scope>4U-</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>88I</scope><scope>8AF</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8FQ</scope><scope>8FV</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>ASE</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FPQ</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K6X</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2M</scope><scope>M2O</scope><scope>M2P</scope><scope>M3G</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20081104</creationdate><title>Information exchange among physicians caring for the same patient in the community</title><author>van Walraven, Carl, MD MSc ; Taljaard, Monica, PhD ; Bell, Chaim M., MD PhD ; Etchells, Edward, MD MSc ; Zarnke, Kelly B., MD ; Stiell, Ian G., MD MSc ; Forster, Alan J., MD MSc</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c642t-90c3797bf15d2af2706e70af82109bec507042a692a7aec62b6e8ab120f647093</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Access control</topic><topic>Access to Information</topic><topic>Communication</topic><topic>Confidential communications</topic><topic>Continuity of Patient Care</topic><topic>Cooperative Behavior</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Hospitals, Community</topic><topic>Hospitals, University</topic><topic>Humans</topic><topic>Information management</topic><topic>Information sharing</topic><topic>Male</topic><topic>Medical Record Linkage</topic><topic>Medical records</topic><topic>Medical research</topic><topic>Middle Aged</topic><topic>Office Visits</topic><topic>Ontario</topic><topic>Physicians</topic><topic>Practice</topic><topic>Prospective Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>van Walraven, Carl, MD MSc</creatorcontrib><creatorcontrib>Taljaard, Monica, PhD</creatorcontrib><creatorcontrib>Bell, Chaim M., MD PhD</creatorcontrib><creatorcontrib>Etchells, Edward, MD MSc</creatorcontrib><creatorcontrib>Zarnke, Kelly B., MD</creatorcontrib><creatorcontrib>Stiell, Ian G., MD MSc</creatorcontrib><creatorcontrib>Forster, Alan J., MD MSc</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Canada</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Docstoc</collection><collection>University Readers</collection><collection>Nursing &amp; Allied Health Database</collection><collection>Health &amp; Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Canadian Business &amp; Current Affairs Database</collection><collection>Canadian Business &amp; Current Affairs Database (Alumni Edition)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>British Nursing Index</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>British Nursing Index</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Nursing &amp; Allied Health Database (Alumni Edition)</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>ProQuest Psychology</collection><collection>Research Library</collection><collection>Science Database</collection><collection>CBCA Reference &amp; Current Events</collection><collection>Research Library (Corporate)</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Canadian Medical Association journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>van Walraven, Carl, MD MSc</au><au>Taljaard, Monica, PhD</au><au>Bell, Chaim M., MD PhD</au><au>Etchells, Edward, MD MSc</au><au>Zarnke, Kelly B., MD</au><au>Stiell, Ian G., MD MSc</au><au>Forster, Alan J., MD MSc</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Information exchange among physicians caring for the same patient in the community</atitle><jtitle>Canadian Medical Association journal</jtitle><addtitle>CMAJ</addtitle><date>2008-11-04</date><risdate>2008</risdate><volume>179</volume><issue>10</issue><spage>1013</spage><epage>1018</epage><pages>1013-1018</pages><issn>0008-4409</issn><issn>0820-3946</issn><eissn>1488-2329</eissn><coden>CMAJAX</coden><abstract>The exchange of information is an integral component of continuity of health care and may limit or prevent costly duplication of tests and treatments. This study determined the probability that patient information from previous visits with other physicians was available for a current physician visit. We conducted a multicentre prospective cohort study including patients discharged from the medical or surgical services of 11 community and academic hospitals in Ontario. Patients included in the study saw at least 2 different physicians during the 6 months after discharge. The primary outcome was whether information from a previous visit with another physician was available at the current visit. We determined the availability of previous information using surveys of or interviews with the physicians seen during current visits. A total of 3250 patients, with a total of 39 469 previous-current visit combinations, met the inclusion criteria. Overall, information about the previous visit was available 22.0% of the time. Information was more likely to be available if the current doctor was a family physician (odds ratio [OR] 1.75, 95% confidence interval [CI] 1.54-1.98) or a physician who had treated the patient before the hospital admission (OR 1.33, 95% CI 1.21-1.46). Conversely, information was less likely to be available if the previous doctor was a family physician (OR 0.38, 95% CI 0.32-0.44) or a physician who had treated the patient before the admission (OR 0.72, 95% CI 0.60-0.86). The strongest predictor of information exchange was the current physician having previously received information about the patient from the previous physician (OR 7.72, 95% CI 6.92-8.63). Health care information is often not shared among multiple physicians treating the same patient. This situation would be improved if information from family physicians and patients' regular physicians was more systematically available to other physicians.</abstract><cop>Canada</cop><pub>Can Med Assoc</pub><pmid>18981442</pmid><doi>10.1503/cmaj.080430</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 0008-4409
ispartof Canadian Medical Association journal, 2008-11, Vol.179 (10), p.1013-1018
issn 0008-4409
0820-3946
1488-2329
language eng
recordid cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_2572647
source MEDLINE; DOAJ Directory of Open Access Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central; Alma/SFX Local Collection
subjects Access control
Access to Information
Communication
Confidential communications
Continuity of Patient Care
Cooperative Behavior
Female
Follow-Up Studies
Hospitals, Community
Hospitals, University
Humans
Information management
Information sharing
Male
Medical Record Linkage
Medical records
Medical research
Middle Aged
Office Visits
Ontario
Physicians
Practice
Prospective Studies
title Information exchange among physicians caring for the same patient in the community
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-04T22%3A42%3A11IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Information%20exchange%20among%20physicians%20caring%20for%20the%20same%20patient%20in%20the%20community&rft.jtitle=Canadian%20Medical%20Association%20journal&rft.au=van%20Walraven,%20Carl,%20MD%20MSc&rft.date=2008-11-04&rft.volume=179&rft.issue=10&rft.spage=1013&rft.epage=1018&rft.pages=1013-1018&rft.issn=0008-4409&rft.eissn=1488-2329&rft.coden=CMAJAX&rft_id=info:doi/10.1503/cmaj.080430&rft_dat=%3Cgale_pubme%3EA188276402%3C/gale_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=204852075&rft_id=info:pmid/18981442&rft_galeid=A188276402&rfr_iscdi=true