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Statistical Methods in the Context of Primary Health Care
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Statistical Methods in the Context of Primary Health Care

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Care Sciences".

Deadline for manuscript submissions: closed (31 December 2024) | Viewed by 10647

Special Issue Editors

Dr. Andreia Teixeira

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Guest Editor
1. Centre for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal
2. Department of Community Medicine, Information and Health Decision Sciences-MEDCIDS, Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal
3. ADiT-LAB, Instituto Politécnico de Viana do Castelo, Rua Escola Industrial e Comercial Nun’Álvares, 4900-347 Viana do Castelo, Portugal
Interests: biostatistics; data analysis; information theory; data mining and Kolmogorov complexity
Special Issues, Collections and Topics in MDPI journals
Dr. Sofia Baptista

E-Mail Website
Guest Editor
1. Department of Community Medicine, Information and Health Decision Sciences-MEDCIDS, Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal
2. Centre for Health Technology and Services Research (CINTESIS), Faculty of Medicine University of Porto, 4200-450 Porto, Portuga
Interests: family medicine; primary healthcare; decision-making; systematic reviews and meta-analysis; medical education; qualitative research
Dr. Carlos Martins

E-Mail Website
Guest Editor
1. Department of Community Medicine, Information and Health Decision Sciences-MEDCIDS, Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal
2.Centre for Health Technology and Services Research (CINTESIS), Faculty of Medicine University of Porto, 4200-450 Porto, Portugal
Interests: quaternary prevention; primary health care; family medicine; overdiagnosis prevention and medical education

Special Issue Information

Dear Colleagues,

How can statistics be used to strengthen investigations in primary health care?

For this Special Issue, we welcome works bridging gaps in the area of statistical methods applied to primary health care.

Primary health care, according to the World Health Organisation´s definition, is oriented around communities, centred in individuals, and provides a holistic approach of facilitating people’s needs and preferences concerning health and wellbeing. Research studies aimed at promoting health, preventing diseases, and enhancing the quality of life of individuals are emerging, and studies based on real data are strongly encouraged.

There is a wide variety of statistical methods for data analysis that can be used for different purposes: description, statistical inference, method comparison, modelling, classification, and forecasting, among others.

Your articles will undoubtedly bring this Special Issue relevant results, conveying through statistics an added value to primary care and community-oriented clinical practice.

In addition to original research papers, this Special Issue also intends to include review papers, meta-analysis studies, protocols or methodological papers.

Dr. Andreia Teixeira
Dr. Sofia Baptista
Dr. Carlos Martins
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • primary health care
  • family medicine
  • biostatistics
  • prevention diseases
  • quality of life
  • promotion health
  • data analysis
  • medical education

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Published Papers (4 papers)

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24 pages, 795 KiB  
Article
Sex-Specific Multimorbidity–Multibehaviour Patterns in Primary Care Populations
by Konstantinos Spyropoulos, Naomi J. Ellis and Christopher J. Gidlow
Int. J. Environ. Res. Public Health 2025, 22(4), 485; https://doi.org/10.3390/ijerph22040485 - 24 Mar 2025
Viewed by 317
Abstract
Background: A conceptual shift in healthcare emphasises multimorbidity and multibehaviours as interconnected phenomena, highlighting dose–response associations and sex-specific differences. Data-driven approaches have been suggested for overcoming methodological challenges, of multimorbidity research. By using exploratory factor analysis, this study aimed to identify sex specific [...] Read more.
Background: A conceptual shift in healthcare emphasises multimorbidity and multibehaviours as interconnected phenomena, highlighting dose–response associations and sex-specific differences. Data-driven approaches have been suggested for overcoming methodological challenges, of multimorbidity research. By using exploratory factor analysis, this study aimed to identify sex specific lifestyle associative multimorbidity patterns, providing valuable evidence to primary care providers and informing future multimorbidity guidelines. Methods: A retrospective observational study examined the electronic health records of three general practices in the UK between 2015 and 2018. The participants were aged 18+ with lifestyle multimorbidity, having engaged with multiple health risk behaviours. Stratified exploratory factor analysis with oblique rotation was used to identify sex specific lifestyle associative multimorbidity patterns. Results: The study included N = 7560 patients, with females comprising 53.9%. Eight independent lifestyle associative multimorbidity patterns were identified and distributed as follows. For females, three patterns emerged: cardiometabolic–neurovascular spectrum disorders (42.97% variance), respiratory conditions (8.08%), and sensory impairment (5.63%), with 25.4% assigned to these patterns. For males, five patterns were revealed: cardiometabolic–vascular spectrum disorders (34.10%), genitourinary (9.19%), respiratory–vision (8.20%), ocular (5.70%), and neurovascular–gastro–renal syndrome (4.54%), with 43%. Conclusions: We revealed eight different sex-specific lifestyle-associated patterns, implying the need for tailored clinical approaches. The application of exploratory factor analysis yielded clinically valuable and scientifically rigorous multimorbidity patterns. Clinically, the findings advocate for a paradigm shift towards person-centred care, integrating multimorbidity and SNAP multibehaviours to enhance the complexity of inquiry and treatment of high-risk populations. Full article
(This article belongs to the Special Issue Statistical Methods in the Context of Primary Health Care)
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23 pages, 2832 KiB  
Article
Determining the Development Strategy and Suited Adoption Paths for the Core Competence of Shared Decision-Making Tasks through the SAA-NRM Approach
by Shan-Fu Yu, Hui-Ting Wang, Meng-Wei Chang, Tien-Tsai Cheng, Jia-Feng Chen, Chia-Li Lin and Hsing-Tse Yu
Int. J. Environ. Res. Public Health 2022, 19(20), 13310; https://doi.org/10.3390/ijerph192013310 - 15 Oct 2022
Cited by 5 | Viewed by 2299
Abstract
Shared decision making (SDM) is an interactive process that involves patients and their healthcare professionals reaching joint decisions about medical care through negotiation. As the initiators of medical decision-making in daily routine, physicians should be aware of and concerned about the SDM process. [...] Read more.
Shared decision making (SDM) is an interactive process that involves patients and their healthcare professionals reaching joint decisions about medical care through negotiation. As the initiators of medical decision-making in daily routine, physicians should be aware of and concerned about the SDM process. Thus, professional competency development for SDM has become increasingly critical for physicians’ training. Therefore, this study investigates the professional competency and the important competency development aspects/criteria of SDM tasks through expert interviews and literature research. The study adopts the SAA (satisfaction-attention analysis) method to assess the status of competency development aspects/criteria and determine the NRM (network relation map) based on the DEMATEL (decision-making trial and evaluation laboratory) technique. The results demonstrate that the CE (concept and evaluation) aspect is the dominant aspect, and the CR (communication and relationship) aspect is the aspect being dominated. The CE aspect influences the aspects of SP (skill and practice), JM (joint information and decision making) and CR, and the SP aspect affects the aspects of JM and CR. Then, the JM aspect affects the CR aspect. The study also suggests suitable adoption paths of competency development for SDM tasks using the NRM approach. It provides recommendations and strategic directions for SDM competency development and sustainable training programs. Full article
(This article belongs to the Special Issue Statistical Methods in the Context of Primary Health Care)
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10 pages, 403 KiB  
Article
Inappropriate Prescriptions in Older People—Translation and Adaptation to Portuguese of the STOPP/START Screening Tool
by Luís Monteiro, Matilde Monteiro-Soares, Cristiano Matos, Inês Ribeiro-Vaz, Andreia Teixeira and Carlos Martins
Int. J. Environ. Res. Public Health 2022, 19(11), 6896; https://doi.org/10.3390/ijerph19116896 - 4 Jun 2022
Cited by 13 | Viewed by 4753
Abstract
Inappropriate prescribing, which encompasses the prescription of potentially inappropriate medications (PIMs) and potential prescribing omissions (PPOs), is a common problem for older people. The STOPP/START tool enables general practitioners, who are the main prescribers, to identify and reduce the incidence of PIMs and [...] Read more.
Inappropriate prescribing, which encompasses the prescription of potentially inappropriate medications (PIMs) and potential prescribing omissions (PPOs), is a common problem for older people. The STOPP/START tool enables general practitioners, who are the main prescribers, to identify and reduce the incidence of PIMs and PPOs and appraise an older patient’s prescribed drugs during the diagnosis process to improve the clinical care quality. This study aimed to translate and validate the STOPP/START screening tool to enable its use by Portuguese physicians. A translation-back translation method including the validation of the obtained Portuguese version was used. Intra- and inter-rater reliability and agreement analyses were used in the validation process. A dataset containing the information of 334 patients was analyzed by one GP twice within a 2-week interval, while a dataset containing the information of 205 patients was independently analyzed by three GPs. Intra-rater reliability assessment led to a Kappa coefficient (κ) of 0.70 (0.65–0.74) for the STOPP criteria and 0.60 (0.52–0.68) for the START criteria, considered to be substantial and moderate values, respectively. The results of the inter-rater reliability rating were almost perfect for all combinations of raters (κ > 0.93). The version of the STOPP/START criteria translated into Portuguese represents an improvement in managing the medications prescribed to the elderly. It provides clinicians with a screening tool for detecting potentially inappropriate prescribing in patients older than 65 years old that is reliable and easy to use. Full article
(This article belongs to the Special Issue Statistical Methods in the Context of Primary Health Care)

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7 pages, 330 KiB  
Protocol
Portuguese Family Physicians’ Perceptions on Pain Management—A Qualitative Study Protocol
by Joana Fernandes Ribeiro, Sofia Baptista, Marta Pinto, Ana Mendes, Hugo Almeida, Andreia Teixeira and Carlos Martins
Int. J. Environ. Res. Public Health 2022, 19(22), 14792; https://doi.org/10.3390/ijerph192214792 - 10 Nov 2022
Cited by 1 | Viewed by 1833
Abstract
Pain is an important cause of disability and constitutes the main reason people seek medical care, especially in general practice. Nevertheless, nearly half of adult Europeans with chronic pain receive inadequate pain treatment. Limited knowledge about pain among physicians is recognized as a [...] Read more.
Pain is an important cause of disability and constitutes the main reason people seek medical care, especially in general practice. Nevertheless, nearly half of adult Europeans with chronic pain receive inadequate pain treatment. Limited knowledge about pain among physicians is recognized as a key barrier to treatment. This is due to the well-known insufficiency in pain education at both undergraduate and postgraduate levels. There is a scarcity of research exploring the perceptions of family medicine physicians on these issues. This study aims to evaluate the perceptions of these professionals concerning medical education, as well as their knowledge, skills, and preparedness to manage chronic pain and collect suggestions for improvement. A qualitative exploratory study will be performed using synchronous virtual focus groups and purposive sampling. Eligible participants will be 3rd- and 4th-year family medicine residents and family medicine specialists with at least five years of practice. Sample size and number of focus groups will depend on data saturation. A semi-structured guide will be used. A thematic categorical analysis will be conducted after verbatim transcription of the audiofiles. This protocol has been approved by the Health Ethics Committee. Full article
(This article belongs to the Special Issue Statistical Methods in the Context of Primary Health Care)
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