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Journal of Evaluation in Clinical Practice

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https://www.readbyqxmd.com/read/28730671/many-faces-of-rationality-implications-of-the-great-rationality-debate-for-clinical-decision-making
#1
Benjamin Djulbegovic, Shira Elqayam
Given that more than 30% of healthcare costs are wasted on inappropriate care, suboptimal care is increasingly connected to the quality of medical decisions. It has been argued that personal decisions are the leading cause of death, and 80% of healthcare expenditures result from physicians' decisions. Therefore, improving healthcare necessitates improving medical decisions, ie, making decisions (more) rational. Drawing on writings from The Great Rationality Debate from the fields of philosophy, economics, and psychology, we identify core ingredients of rationality commonly encountered across various theoretical models...
July 20, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28726254/the-bobath-concept-a-guru-led-set-of-teachings-unsupported-by-emerging-evidence-a-response-to-vaughan-graham-and-cott-j-eval-clin-pract-2016-doi-10-1111-jep-12751
#2
LETTER
Roger Mepsted, Sarah Tyson
No abstract text is available yet for this article.
July 20, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28719134/development-and-implementation-of-a-clinical-pathway-for-cardiac-surgery-in-the-intensive-care-unit-effects-on-protocol-adherence
#3
Marion van der Kolk, Mark van den Boogaard, Corine Ter Brugge-Speelman, Jeroen Hol, Luc Noyez, Kees van Laarhoven, Hans van der Hoeven, Peter Pickkers
RATIONALE, AIMS AND OBJECTIVES: Cardiac surgery (CS) is facilitated by multiple perioperative guidelines and protocols. Use of a clinical pathway (CP) may facilitate the care of these patients. METHODS: This is a pre-post design study in the ICU of a tertiary referral centre. A CP for CS patients in the ICU was developed by ICU-nurses and enabled them to execute proactively predefined actions in accordance with and within the preset boundaries which were part of a variance report...
July 18, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28714561/service-quality-and-maturity-of-health-care-organizations-through-the-lens-of-complexity-leadership-theory
#4
Ana Horvat, Jovan Filipovic
RATIONALE, AIMS AND OBJECTIVES: This research focuses on Complexity Leadership Theory and the relationship between leadership-examined through the lens of Complexity Leadership Theory-and organizational maturity as an indicator of the performance of health organizations. METHODS: The research adopts a perspective that conceptualizes organizations as complex adaptive systems and draws upon a survey of opinion of 189 managers working in Serbian health organizations...
July 17, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28714551/influence-of-the-mode-of-administration-on-the-results-of-medication-adherence-questionnaires
#5
Ana C Cabral, Mariana Moura-Ramos, Margarida Castel-Branco, Margarida Caramona, Fernando Fernandez-Llimos, Isabel V Figueiredo
INTRODUCTION AND OBJECTIVES: Adherence to medication regimen is commonly assessed through questionnaires, some of which are validated via self-administration. The inadequate health literacy of elderly people pushes researchers to the use of interviews as a method of administration. The aims of this study were to compare the results obtained with an interviewer-administered and a self-administered medication adherence questionnaire and to evaluate the consequences of the adherence status classification of individuals...
July 17, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28707421/safer-and-more-appropriate-opioid-prescribing-a-large-healthcare-system-s-comprehensive-approach
#6
Jan L Losby, Joel D Hyatt, Michael H Kanter, Grant Baldwin, Denis Matsuoka
RATIONALE, AIMS, AND OBJECTIVES: The United States is in the midst of a public health epidemic with more than 40 people dying each day from prescription opioid overdoses. Health care systems are taking steps to address the opioid overdose epidemic by implementing policy and practice interventions to mitigate the risks of long-term opioid therapy. Kaiser Permanente Southern California launched a comprehensive initiative to transform the way that chronic pain is viewed and treated. Kaiser Permanente Southern California created prescribing and dispensing policies, monitoring and follow-up processes, and clinical coordination through electronic health record integration...
July 14, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28695684/the-pitfalls-of-qualified-moral-veganism-a-critique-of-jan-deckers-holistic-health-approach-to-animal-ethics
#7
Eze Paez
I critically examine Jan Deckers' position in Animal (De)liberation, where he defends two main views. The first is "qualified moral veganism": Most humans have a duty to abstain from consuming animal products, even if there are circumstances in which doing so is justified. The author argues, on the one hand, from a pan-sentientist view that attributes sentience to all elementary entities and their compounds. Thus, all living things (such as animals and plants) have a capacity for positive and negative experiences...
July 11, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28695724/contribution-of-medications-and-risk-factors-to-qtc-interval-lengthening-in-the-atherosclerosis-risk-in-communities-aric-study
#8
Khalid A Alburikan, Ahmed Aldemerdash, Samuel T Savitz, James E Tisdale, Eric A Whitsel, Elsayed Z Soliman, Emily M Thudium, Carla A Sueta, Anna M Kucharska-Newton, Sally C Stearns, Jo E Rodgers
RATIONALE, AIMS, AND OBJECTIVES: Prolongation of the corrected QT (QTc) interval is associated with increased morbidity and mortality. The association between QTc interval-prolonging medications (QTPMs) and risk factors with magnitude of QTc interval lengthening is unknown. We examined the contribution of risk factors alone and in combination with QTPMs to QTc interval lengthening. METHOD: The Atherosclerosis Risk in Communities study assessed 15 792 participants with a resting, standard 12-lead electrocardiogram and ≥1 measure of QTc interval over 4 examinations at 3-year intervals (1987-1998)...
July 10, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28691323/knowledge-translation-interventions-to-sustain-direct-care-provider-behaviour-change-in-long-term-care-a-process-evaluation
#9
Susan E Slaughter, Erin Bampton, Daniel F Erin, Carla Ickert, Adrian S Wagg, C Allyson Jones, Corinne Schalm, Carole A Estabrooks
RATIONALE, AIMS, AND OBJECTIVES: Process evaluation can be used to understand the factors influencing the impact of knowledge translation (KT) interventions. The aim of this mixed methods process evaluation was to evaluate the processes and perceived outcomes of eight KT interventions that were used with healthcare aides (HCAs) to introduce a mobility innovation into their daily care practices. The study examined the perceived effectiveness of various KT interventions in sustaining daily performance of the sit-to-stand mobility innovation by HCAs with residents in long-term care...
July 10, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28685913/could-phase-3-medicine-trials-be-tagged-as-pragmatic-a-case-study-the-salford-copd-trial
#10
Rafael Dal-Ré
Randomized clinical trials (RCTs) can be classified as explanatory or pragmatic. Currently, explanatory and pragmatic are considered to be the extremes of a continuum: Many trials have some features of both explanatory and pragmatic RCTs. The Salford Chronic Obstructive Respiratory Disease (COPD) trial was an open-label phase 3 RCT assessing an experimental product (fluticasone furoate-vilanterol) vs usual care. The Salford investigators labelled it as "the world's first phase 3 pragmatic RCT" in COPD patients...
July 7, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28677233/patient-involvement-in-reducing-errors-during-x-ray-imaging-in-an-orthopedic-outpatient-clinic
#11
Joon Yub Kim, Myung Gon Jung, Myung Hee Kwon, Seo Ol Noh, Hye Jin Kim
RATIONALE, AIMS AND OBJECTIVES: The purpose of this study was to verify the effectiveness of patient involvement in identifying both patients and the location(s) before X-ray examinations at orthopedic clinics. METHODS: We analyzed the errors of the X-ray order in 2014 in our orthopedic outpatient clinic and categorized them into 6 categories. We looked at the errors from April to September 2014 (group I, preintervention), introduced the patient involvement system in March 2015 (intervention), and compared the errors from April to September 2015 (group II, postintervention)...
July 5, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28675602/minimizing-imbalances-on-patient-characteristics-between-treatment-groups-in-randomized-trials-using-classification-tree-analysis
#12
Ariel Linden, Paul R Yarnold
RATIONALE, AIMS, AND OBJECTIVES: Randomization ensures that treatment groups do not differ systematically in their characteristics, thereby reducing threats to validity that may otherwise explain differences in outcomes. Large observed imbalances in patient characteristics may indicate that selection bias is being introduced into the treatment allocation process. We introduce classification tree analysis (CTA) as a novel algorithmic approach for identifying potential imbalances in characteristics and their interactions when provisionally assigning each new participant to one or the other treatment group...
July 4, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28675578/a-time-series-analysis-of-the-effects-of-financial-incentives-and-mandatory-clinical-applications-as-interventions-to-improve-spontaneous-adverse-drug-reaction-reporting-by-hospital-medical-staff-in-china
#13
Feng Chang, Yue Xi, Jie Zhao, Xiaojian Zhang, Yun Lu
RATIONALE, AIMS, AND OBJECTIVES: Spontaneous reporting of adverse drug reactions (ADRs) in hospitals is often under-reported, which may lead to problems in patient management. This study was aimed to assess the effectiveness of a financial intervention based on a fine and a bonus for improving spontaneous reporting of ADRs by physicians in a hospital setting. METHODS: This study was conducted at the First Affiliated Hospital of Zhengzhou University (China). Starting in 2009, a bonus of 20 RMB (Chinese currency) was given for each spontaneous ADR report, and a fine of 50 RMB was given for any withheld ADR report...
July 4, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28670833/modeling-time-to-event-survival-data-using-classification-tree-analysis
#14
Ariel Linden, Paul R Yarnold
RATIONALE, AIMS, AND OBJECTIVES: Time to the occurrence of an event is often studied in health research. Survival analysis differs from other designs in that follow-up times for individuals who do not experience the event by the end of the study (called censored) are accounted for in the analysis. Cox regression is the standard method for analysing censored data, but the assumptions required of these models are easily violated. In this paper, we introduce classification tree analysis (CTA) as a flexible alternative for modelling censored data...
July 3, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28664553/what-hospitals-need-to-know-about-guidelines-a-mixed-method-analysis-of-guideline-implementation-in-dutch-hospitals
#15
Louise H K Blume, Nico J H W van Weert, Jamiu O Busari, Annemiek M V Stoopendaal, Diana M J Delnoij
RATIONALE, AIMS AND OBJECTIVES: This study provides insight into how Dutch hospitals ensure that guidelines are used in practice and identifies what key messages other hospitals can learn from existing practices. We examine current practices in handling compliance and, therefore, focus on hospitals that reported that they do not experience problems in the implementation of guidelines. METHOD: A survey of Dutch hospital boards and 9 semistructured interviews were conducted with a purposive sample of 3 hospitals...
June 30, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28653800/french-validation-of-the-maslach-burnout-inventory-student-survey-mbi-ss
#16
Christine Faye-Dumanget, Julie Carré, Margaux Le Borgne, Pr Abdel Halim Boudoukha
INTRODUCTION: Several international studies have been conducted on student burnout. To contribute to the clinical examination as well as research on the mental health of students, the MBI-SS (Maslach Burnout Inventory-Student Survey) has been validated and used in different countries but not in French. OBJECTIVE: The aim of this study is to examine the validity of the 3-dimensional model of the French version of the MBI-SS, which is characterized by emotional "Emotional Exhaustion" (EE); "Cynicism" (CY); and low scores in "Academic Efficacy" (AE)...
June 27, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28620976/oral-nutritional-supplement-use-in-relation-to-length-of-stay-in-heart-failure-patients-at-a-regional-medical-center
#17
Ellen B Babb, James Rohrer
RATIONALE, AIMS, AND OBJECTIVES: Improving the nutritional status of hospitalized patients has been shown to reduce length of stay (LOS), hospital costs, readmission rates, complication rates, and mortality. Provision of nutrient-rich, liquid, oral nutrition supplements (ONS) is one approach to improve nutritional status. Little information is available on ONS use and LOS among heart failure patients. METHODS: This study used a retrospective design to examine whether routine ONS use was associated with hospital LOS among 570 heart failure inpatients (89 ONS = yes; 481 ONS = no) at a regional medical center, adjusting for significant personal, locational, and time variables using multiple logistic regression analysis...
June 16, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28608613/remote-control-improves-quality-of-life-in-elderly-pacemaker-patients-versus-standard-ambulatory-based-follow-up
#18
Rosanna Irene Comoretto, Domenico Facchin, Marco Ghidina, Alessandro Proclemer, Dario Gregori
BACKGROUND: Health-related quality of life (HRQoL) improves shortly after pacemaker (PM) implantation. No studies have investigated the HRQoL trend for elderly patients with a remote device monitoring follow-up system. METHODS: Using EuroQol-5D Questionnaire and the PM-specific Assessment of Quality of Life and Related Events Questionnaire, HRQoL was measured at baseline and then repeatedly during the 6 months following PM implantation in a cohort of 42 consecutive patients...
June 13, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28585354/-real-world-pediatric-endocrine-practice-how-much-is-it-influenced-by-physician-s-gender-and-region-of-practice-results-of-an-international-survey
#19
Keren Smuel, Yonatan Yeshayahu
OBJECTIVE: To determine whether hormonal treatments for frequent clinical cases (short stature, delayed and precocious puberty) are prescribed strictly according to clinical guidelines or based on personal tendencies, and whether the decisions correlate with physician's personal demographics (age, sex, and place of practice). METHODS: Cross-sectional survey, with made-up clinical cases, distributed to pediatric endocrinologists using 2 web-based professional forums, Israeli and an international...
June 6, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28585254/use-of-clinical-guidelines-in-cardiology-practice-in-sudan
#20
Hwaida Elsadig, Marjorie Weiss, Jenny Scott, Raisa Laaksonen
RATIONALE, AIMS, AND OBJECTIVE: The aim of this study was to explore the views of prescribers in cardiology in Sudan about the use of guidelines in clinical practice and the extent to which guidelines whether national or international can be adopted in clinical practice in Sudan. METHODS: Interviews were conducted with the consultants in 2 of the main cardiac hospitals in Sudan. This was followed by a survey amongst the doctors in the hospitals to examine the views of a larger population of prescribers about the matter investigated...
June 6, 2017: Journal of Evaluation in Clinical Practice
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