Blanca Lumbreras

Universidad Miguel Hernández de Elche | UMH · Department of Public Health, History of Science and Gynecology

Introduction Patients’ decisions on prostate cancer (PCa) opportunistic screening may vary. This study aimed to assess how demographic and health-related characteristics may influence knowledge and decisions regarding PCa screening. Methods A cross-sectional survey was conducted among men aged over 40, randomly sampled from the Spanish population,...

Background Recent guidelines on opportunistic prostate cancer screening conclude that the decision to screen with prostate-specific antigen should be made by each patient individually together with the clinician. However, there is evidence of a lack of clinicians’ awareness of prostate cancer screening. This study sought to assess the recent eviden...

Purpose Biomarkers as screening for precision medicine is a fundamental step. The purpose of this article is twofold. First, to highlight the existing barriers in the implementation of Precision Medicine in Spain, with a special emphasis on barriers in access to the determination of biomarkers. Second, to provide a Roadmap that can help implement P...

Objective To identify barriers and facilitators of the implementation of shared decision-making (SDM) on PSA testing in primary care. Design Systematic review of articles. Data sources PubMed, Scopus, Embase and Web of Science. Eligibility criteria Original studies published in English or Spanish that assessed the barriers to and facilitators of...

Background: Frequently, the community pharmacies are the only points of consultation for upper-gastrointestinal symptomology. However, the heterogeneity of symptoms often limits the correct management of the patient. The study aim is to describe the epidemiological and clinical characteristics of patients with upper-gastrointestinal symptoms who as...

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Background: Lack of adherence to Oral antineoplastic agents (OAAs) treatment has important clinical, social and economic consequences. Objective: To develop and validate a novel instrument for assessing adherence to OAAs, based on the reported experiences of people with cancer in relation to their treatment and the opinions of the healthcare profes...

Forde et al proposed an interesting framework to understand marketing response to a tax in sugary drinks based on stakeholder interviews. Sugary drinks regulation can lead to various strategies in the industry’s marketing activity. That is, it can either result in the industry introducing no changes or it can lead to changes, which can conflict or...

Introduction: The Colonoscopy Satisfaction and Safety Questionnaire based on Patient experience (CSSQP) was recently developed and validated within a Bowel Cancer Screening Program. We aimed to identify factor related to patient experience through the CSSQP, including all indications for colonoscopy. Indicators of satisfaction and perceived safety...

(1) Background: The frequency of imaging tests grew exponentially in recent years. This increase may differ according to a patient’s sex, age, or socioeconomic status. We aim to analyze the impact of the Council Directive 2013/59/Euratom to control exposure to radiation for men and women and explore the impact of patients’ age and socioeconomic sta...

Objective: Design and validate a scale to measure adherence to oral antineoplastic drugs. The availability of a simple, validated tool that can be applied to routine care will make it possible to detect and identify non-adherence in order to establish strategies to improve adherence and optimize the quality of healthcare services. Method: Valida...

Background The real impact of the degree of association (DoA) between endpoint components of a composite endpoint (CE) on sample size requirement (SSR) has not been explored. We estimate the impact of the DoA between death and acute myocardial infarction (AMI) on SSR of trials using use the CE of major adverse cardiac events (MACE). Methods A syst...

Objective To evaluate the appropriateness of imaging tests associated with radiation in the field of otolaryngology according to the available recommendations, and to estimate the effective radiation dose associated. Method Cross-sectional epidemiological study of the totality of the imaging test requests carried out by two Spanish hospitals ( n =...

(1) Background: Heartburn and reflux discomfort are frequent reasons for consultation at the community pharmacy. To facilitate the assistance work of the community pharmacist and its coordination between different levels of care, a group of experts in Community Pharmacy, Primary Care, and Gastroenterology have recently worked on an algorithm to man...

Background: Opportunistic prostate-specific antigen (PSA) screening may reduce prostate cancer mortality risk but is associated with false positive results, biopsy complications and overdiagnosis. Although different organisations have emphasised the importance of shared decision making (SDM) to assist men in deciding whether to undergo prostate can...

According to this review, the inclusion of more than one diagnostic test in the diagnostic process for COVID-19 infection shows high diagnostic accuracy values. Imaging characteristics, patients’ symptoms, demographic characteristics, and lymphocyte count were the variables most frequently included in the diagnostic models.

ABSTRACT Imaging tests have a central role in the diagnosis and management of lung cancer. Because of the increasing sensitivity of the current diagnostic imaging tests, and the implementation of screening programs, pulmonary nodules are more frequently detected in clinical practice. In addition, early detection of lung cancer and improvements in t...

Background: Several factors can influence adherence to orally administered antineoplastics, including fear or anxiety resulting from situations such as the COVID-19 pandemic. The aim of this study was to analyse the influence of these patients' experiences on adherence to orally administered antineoplastics. Methods: Cross-sectional study in fou...

Objective: This systematic review aims to identify and critically evaluate the available evidence on the impact of switches in pill appearance/packaging on patient's behavior. Methods: Studies from inception to March 2021 were searched across MEDLINE through PubMed, the Cochrane Library, Embase, and Scopus. Included studies carried out an origin...

Introduction The Diabetes Health Profile (DHP‐18), structured in three dimensions (psychological distress (PD), barriers to activity (BA) and disinhibited eating (DE)), assesses the psychological and behavioural burden of living with type 2 diabetes. The objectives were to adapt the DHP‐18 linguistically and culturally for use with patients with ty...

Background Polipharmacy has been identified as a contributing factor to the high hospital readmission rates of heart failure (HF) patients. Nevertheless, there limited evidence on pharmacist-led intervention on the reduction of inappropriate medication use in patients. Objective To summarize the available evidence resulting from interventions, led...

Scientific societies have provided guidelines to reduce PSA-specific harms. We studied the potential non-compliance of PSA testing with current guidelines in general practice. A cross-sectional study of a random sample of 1291 patients with a PSA test was performed between January and April 2018 in primary health care. Patients with a previous pros...

Lack of adherence constitutes one of the most important challenges in patients undergoing treatment with oral antineoplastic drugs (ANEO). Understanding cancer patients’ experiences with respect to their medication is key for optimizing adherence and therapeutic results. We aimed to assess the medication experience (ME) in patients with cancer in t...

Diabetes is a major public health problem, increasingly affecting low- and middle-income countries. The project CEAD (Contextualizing Evidence for Action in Diabetes in low-resource settings) aims to evaluate the implementation of comprehensive diabetes care in two low-resource settings in Ecuador and to stimulate context-led health systems innovat...

Background Given that most evidence-based recommendations for managing type 2 diabetes mellitus (T2DM) are generated in high-income settings, significant challenges for their implementation exist in Latin America and the Caribbean region (LAC), where the rates of T2DM and related mortality are increasing. The aim of this study is to identify the fa...

Objectives Several studies have shown an inverse association between diabetes mellitus and prostate cancer (PCa). Some researchers suggest that this relationship is due to reduced PCa detection in diabetics due to lower prostate-specific antigen (PSA) levels compared to non-diabetics. Our objective is to analyze the impact of diabetes on PSA in asy...

Objective We aimed to evaluate the impact of the European Medicines Agency (EMA) and Food Drug and Administration (FDA) alerts on the use of effective contraceptive method in women of childbearing age undergoing valproic acid treatment in a long-stay psychiatric center. Material and methods An interrupted time-series analysis of women of childbear...

Objectives To explore differences in the clinical management of men and women in the 5 years after detecting a solitary pulmonary nodule (SPN) by chest radiograph or CT in routine clinical practice.Methods We followed up 545 men and 347 women with an SPN detected by chest radiograph or CT in a retrospective cohort of 25,422 individuals undergoing r...

Challenges remain for policy adoption and implementation to tackle the unprecedented and relentless increase in obesity, diabetes and other non-communicable diseases (NCDs), especially in low- and middle-income countries. The aim of this mixed-methods study is to analyse the contextual relevance and applicability to low-resource settings of a sampl...

Introduction: Prostate-specific antigen (PSA) is the main tool for early detection, risk stratification and monitoring of prostate cancer (PCa). However, there are controversies about the use of PSA as a population screening test because of the high potential for overdiagnosis and overtreatment associated. The net benefit of screening is unclear a...

Objectives: Inappropriate prescription is a problem related to ageing and deprescription could be a possible strategy. The aim of this study was to adapt the available evidence on deprescribing to the medication management of older people living in long-term care facilities. Methods: The authors carried out a bibliographic search based on the most...

Objectives: To determine the factors associated with lung cancer diagnosis and mortality after detecting a solitary pulmonary nodule (SPN) in routine clinical practice, in men and in women for both chest radiograph and CT. Materials and methods: A 5-year follow-up of a retrospective cohort of of 25,422 (12,594 men, 12,827 women) patients aged ≥3...

Objectives To calculate each patient’s cumulative radiation exposure and the recurrent tests during a 12-year study period, according to sex and age, in routine practice. Design Retrospective cohort study. Setting A general hospital with a catchment population of 224 751 people, in the Southeast of Spain. Participants Population belonged to the...

Colonoscopy services working in colorectal cancer screening programs must perform periodic controls to improve the quality based on patients’ experiences. However, there are no validated instruments in this setting that include the two core dimensions for optimal care: satisfaction and safety. The aim of this study was to design and validate a spec...

Background: Despite considerable research investment, moving from biomarker discovery to clinical application has presented unique challenges. We aimed to evaluate progress toward clinical application of a sample of molecular- and "omics"-based diagnostic tests over a 10-year period. Methods: We used Scopus to locate studies, published before th...

Background: Obesity has a serious impact on public health. Sugar-sweetened beverages (SSBs) are implicated in the obesity epidemic. Regulation has been suggested as one approach to limit consumption. Objective: The aim of this study was to synthesize existing evidence related to the impact of taxes on the consumption, purchase, or sales of SSBs....

Objectives To determine the appropriateness of medical imaging examinations involving radiation and to estimate the effective radiation dose and costs associated. Design Cross-sectional retrospective study. Setting Two Spanish public tertiary hospitals. Participants 2022 medical imaging tests were extracted from the radiology information system...

Objective We aimed to evaluate the population’s awareness about the radiation exposure associated with five specific imaging tests, and their preference regarding three different formats for receiving the information before undergoing an imaging test. Methods A quantitative and qualitative evaluation through a survey and focal groups including gen...

Objectives: To identify the most common referred pain (ReP) pattern of the infraspinatus myofascial trigger point (MTrP) and compare its coincidence with the original ReP pattern, to verify whether there are any significant differences by sex and types of technique and to determine the observed signs and symptoms evoked by deep dry needling (DDN)...

Objective To assess the level of adherence to angiotensin receptor blockers (ARBs) in patients regularly attending a community pharmacy and the influence of a change in patients' adherence to pharmacological treatment. Design Retrospective cohort study of a random sample of consecutive patients collecting their medication. Setting 40 community ph...

Generic substitution, the term applied to the substitution of the brand-name drug by its generic equivalent, is a common practice in pharmacy settings, and a key factor in patient adherence. Pharmacists can make a substitution between generics, choosing one from those available in the national system of reference prices, unless the doctor and/or th...

The aim of this study was to review recent literature in order to provide updated values of the typical effective doses associated with the top 20 imaging tests for adults and children and for the most widely used set of weights (ICRP60) as well as for the most recent one (ICRP103). We performed a systematic research on radiation dosimetry in radio...

Objectives To assess the impact of initiatives aiming to increase clinician awareness of radiation exposure; to explore the challenges they face when communicating with patients; to study what they think is the most appropriate way of communicating the long-term potential risks of medical radiological exposure to patients. Design A quantitative an...

Objective: To compare the diagnostic accuracy of two vision screeners by a visual examination performed by an optometrist (gold standard) and to evaluate the concordance between both screeners and between each screener and the gold standard. Methods: This was a cross-sectional study that included computer workers who attended a routine yearly he...

Background: The appropriate management of the large number of lung nodules detected during the course of routine medical care presents a challenge. We aimed to evaluate the usual clinical practice in solitary pulmonary nodule (SPN) management and associated radiation exposure. Methods: We examined 893 radiology reports of consecutive patients un...

Management strategies carried out in patients having SPN for CT and the detailed description of the diagnostic pathway. (TIF)

Management strategies carried out in patients having SPN for chest radiography and the detailed description of the diagnostic pathway. (TIF)

Analysis of the radiation exposure (total) associated with the management of SPN for chest radiograph according to the management strategy and for patients with a final diagnosis of lung cancer and those without it. (DOC)

Management strategies carried out in patients having SPN for CT and the detailed description of the diagnostic pathway. (DOCX)

Analysis of the radiation exposure (total) associated with the management of SPN for CT according to the management strategy and for patients with a final diagnosis of lung cancer and those without it. (DOC)

Management strategies carried out in patients having SPN for chest radiography and the detailed description of the diagnostic pathway. (DOC)

Objetivos Evaluar los conocimientos y actitudes relacionados con la exposición a radiación de médicos clínicos y radiólogos. Material y métodos Encuesta a médicos radiólogos y clínicos de las especialidades más peticionarias de pruebas de imagen,(2014-2015). Se realizó tanto de manera online (a través de sus sociedades científicas: neumología, radi...

Incomplete reporting has been identified as a major source of avoidable waste in biomedical research. Essential information is often not provided in study reports, impeding the identification, critical appraisal, and replication of studies. To improve the quality of reporting of diagnostic accuracy studies, the Standards for Reporting of Diagnostic...

To assess the risk of lung cancer and specific mortality rate in patients with and without solitary pulmonary nodules (SPN) on chest radiograph and CT. This prospective study included 16,078 patients ≥35 years old (893 of them had an SPN detected with either chest radiograph or CT) and 15,185 without SPN. Patients were followed up for 18 months or...

The efficacy of statins to reduce LDL-cholesterol serum levels is high, but effectiveness is limited and costs are elevated.

To identify public health core competencies and contents in pharmacy degrees at a meeting of public health lecturers in pharmacy degrees from various public and private universities.

Antecedentes: La eficacia de las estatinas para reducir los niveles de LDL-colesterol es elevada, aunque sus costes son importantes y su efectividad en ámbitos reales, limitada. Objetivo: Analizar la eficiencia y la efectividad de las prescripciones de estatinas y su relación con características del paciente en un estudio piloto en una farmacia com...

Infection with co-pathogens is one of the postulated factors contributing to persistent inflammation and non-AIDS events in virologically-suppressed HIV-infected patients. We aimed to investigate the relationship of human herpesvirus-8 (HHV-8), a vasculotropic virus implicated in the pathogenesis of Kaposi's sarcoma, with inflammation and subclinic...

Objective To determine the prevalence of solitary pulmonary nodules (SPNs) in chest radiology studies and patient’s features associated with malignancy in a non-high-risk clinical population. Methods Patients ≥35 years were referred for thoracic imaging in two hospitals (2010-2011). Eight radiologists determined the presence and characteristics of...

We prospectively followed patients with an incidental finding detected in an image test to assess the additional interventions carried out and the clinical implications of the incidental findings detected. Out of 474 patients with an incidental finding, 63 (13.3%) were further evaluated and of these patients, 25 (39.7%) had clinical implications. P...

Independence in the formulation of public health policies can be affected by various agents with objectives contrary to population health, such as large corporations. This lack of independence may be exacerbated by the economic crisis due to lower funding for health regulatory bodies or other measures designed to protect health. Large corporations...

Independence in the formulation of public health policies can be affected by various agents with objectives contrary to population health, such as large corporations. This lack of independence may be exacerbated by the economic crisis due to lower funding for health regulatory bodies or other measures designed to protect health. Large corporations...

Objective To identify public health core competencies and contents in pharmacy degrees at a meeting of public health lecturers in pharmacy degrees from various public and private universities. Methods The first Meeting of the Forum of University Teaching Staff in Pharmacy Degrees was held at the Faculty of Medicine in the Complutense University, M...

Diagnostic accuracy may be overestimated when using certain study designs; thus, the inclusion of studies using different designs in meta-analyses may have important effects on their results, and influence clinical decision making. The main aim of this study was to explore the influence of heterogeneity (based on the inclusion of different study de...

We aimed to compare the variation in PSA test ordering behavior between ten different health centers according to patients' age and the tendencies in PSA testing during the period of study (2002 - 2009). The study subjects attended 10 primary care centers in Alicante, Spain (2002 - 2009). Variables included: patient age, primary center, and year. W...

To explore clinical and socioeconomic factors related to congenital syphilis in Posadas, Argentina. Data were collected from 102 mothers who had given birth to an infant with congenital syphilis at Dr. Ramón Madariaga Central Hospital (2005-2007) and 306 control mothers. Clinical and demographic information were collected from clinical records, and...

Introduction The finding of a solitary pulmonary nodule (SPN) (<3?cm) in routine radiological examination may represent an early stage of lung cancer or a benign lesion, where any further diagnostic procedures may pose an unnecessary risk to patient health. Although SPNs have been described in high risk populations, their frequency in routine clini...

More clinically meaningful diagnostic tests are needed in exocrine pancreatic cancer (EPC). K-ras mutations are the most frequently acquired genetic alteration in EPC. We analysed the diagnostic utility of detecting K-ras mutations through a systematic analysis of the literature. We searched PubMed using suitable medical subject headings and text w...

To assess the appropriateness of gastroprotective agents (GPA)\ NSAID use in patients' access medication through community pharmacy and the factors associated with any inappropriateness found. A cross-sectional study in which patients requesting NSAIDs through community pharmacy was undertaken. Information was collected through a structured questio...

The diagnostic utility of detecting K-ras mutations for the diagnosis of exocrine pancreatic cancer (EPC) has not been properly studied, and few reports have analysed a clinically relevant spectrum of patients. The objective was to evaluate the clinical validity of detecting K-ras mutations in the diagnosis of EPC in a large sample of clinically re...

Phenotypic assays are considered the gold standard for HIV-1 tropism assessment. However, they are expensive and not widely available. Genotypic assays may provide an easier alternative, but their sensitivity remains low. We hypothesize that combining clinical data with V3 sequences may improve the diagnostic accuracy of genotypic tools. We analyze...

References of the 45 articles evaluated. (0.04 MB DOC)

Flow diagram of search and selection process. (0.26 MB TIF)

Characteristics of 45 studies evaluating the diagnostic use of an ‘-omics’ based test. (0.10 MB DOC)

QUADOMICS is an adaptation of QUADAS (a quality assessment tool for use in systematic reviews of diagnostic accuracy studies), which takes into account the particular challenges presented by '-omics' based technologies. Our primary objective was to evaluate the applicability and consistency of QUADOMICS. Subsequently we evaluated and describe the m...

The objective of this review is to summarise the available evidence on the frequency and management of incidental findings in imaging diagnostic tests. Original articles were identified by a systematic search of the MEDLINE, EMBASE and Cochrane Library Plus databases using appropriate medical headings. Extracted variables were study design; sample...

Objective: To describe the treatment, and prescription determining factors, for arterial hypertension patients that attended a community pharmacy office. Method: Cross-sectional study of 62 patients attending a community pharmacy office in San Juan de Alicante by means of a personal interview based on an in-house questionnaire. Results: Angiotensin...

Placing health in the agendas of all policy makers remains a challenge. Finding new ways to boost Health in All Policies should be a continuous process. Currently, health information initiatives gather core health statistics, indicators related to healthcare, along with individual level risk factors such as smoking or obesity. However, there is a l...

Context.—The preanalytic phase of 24-hour urine collection, before clinical analysis, requires the active participation of patients and usually takes place outside the laboratory. Objective.—We verify whether distribution of adequate information to health care personnel and patients will result in fewer preanalytic incidents. We also determine the...

-The preanalytic phase of 24-hour urine collection, before clinical analysis, requires the active participation of patients and usually takes place outside the laboratory. -We verify whether distribution of adequate information to health care personnel and patients will result in fewer preanalytic incidents. We also determine the intraindividual bi...

Progression of a chronic disease can lead to the development of secondary illnesses. An example is the development of active tuberculosis (TB) in HIV-infected individuals. HIV disease progression, as indicated by declining CD4 + T-cell count (CD4), increases both the risk of TB and the risk of AIDS-related mortality. This means that CD4 is a time-d...

: The objective was to evaluate the prevalence and associated variables of unsuspected findings from imaging tests in clinical practice. : Cross-sectional study of patients referred for an imaging test in 2006. Two independent radiologists classified the imaging tests according to the presence or absence of an unexpected finding in relation with th...

We evaluated whether articles on molecular diagnostic tests interpret appropriately the clinical applicability of their results. We selected original-research articles published in 2006 that addressed the diagnostic value of a molecular test. We defined overinterpretation of clinical applicability by means of prespecified rules that evaluated study...