Le dépistage de la plainte

We propose to take clinical research as a model of conceptualisation of the complaints screening. The clinician or investigator must be neutral without excessive empathy. The complaint can be spontaneous or be expressed after a more or less structured interview. Several studies showed that the spontaneous complaint had a very different value, “caused or sought” complaint (Bronx Aging Study, and Paquid). It can come from the patient or from her or his entourage, because of an anosognosia, which forms part of many psychogeriatric syndromes. It is known that there is a great variability according to whether the complaint, for the same episode, is expressed by the patient or by its entourage and that it is also different according to whether helping it, which one detects the complaint is family or professional. It is necessary to decipher the complaint to know if it acts of a symptom or an adverse effect. It is very well known that in clinical research, one does not have the same adverse effects according to whether a spontaneous complaint is awaited, that the clinician puts question of a general type or subjects the patient to an exhaustive check list. There also exists a great difference in results, according to whether it acts of a cross-sectional study, of a prospective or retrospective longitudinal study. It compared these various methods of studies for the tracking of adverse effects due to non-suitable care among 1,047 patients; they found an increase in the adverse effect (AE) of 6 % per day and a great difference for the same files according to whether the method is transverse, prospective or retrospective.