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Journal of Evaluation in Clinical Practice

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https://www.readbyqxmd.com/read/27917564/mind-the-gap-in-clinical-trials-a-participatory-action-analysis-with-citizen-collaborators
#1
Amy Price, Su May Liew, Jo Kirkpatrick, Jazmin Price, Taylor Lopreto, Yasmin Nelken
What are the strengths, gaps, expectations, and barriers to research engagement in clinical trials as communicated through social media? Clinical trials test treatments to provide reliable information for safety and effectiveness. Trials are building blocks in which what is learned in earlier research can be used to improve treatments, compare alternatives, and improve quality of life. For 20 years, the percentages of clinical trials volunteers have decreased whereas the costs of running clinical trials have multiplied...
December 4, 2016: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/27896902/substantial-reduction-in-hospital-stay-of-children-and-adolescents-with-diabetic-ketoacidosis-after-implementation-of-clinical-practice-guidelines-in-a-university-hospital-in-saudi-arabia
#2
Abdulrahman Al Nemri, Yasser Sami Amer, Hala Gasim, Mohamed Elfaki Osman, Ayman Aleyadhy, Hessah Al Otaibi, Shaikh Mohammed Iqbal, Nasir Abdullah Aljurayyan, Asaad M Assiri, Amir Babiker, Sarar Mohamed
RATIONALE, AIMS AND OBJECTIVES: We aimed to determine the effect of Clinical Practice Guideline (CPG) implementation on length of hospital stay of children and adolescents with diabetic ketoacidosis (DKA). METHODS: This was a 6-year (2008-2014) case-control retrospective study conducted at King Khalid University Hospital, Riyadh, that compared patients with DKA managed using CPG with those treated before CPG implementation. RESULTS: There were 63 episodes of DKA in 41 patients managed using CPG compared with 40 episodes in 33 patients treated before implementation of CPG...
November 29, 2016: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/27882650/a-qualitative-assessment-of-west-virginia-pharmacist-activities-and-attitude-in-diabetes-management
#3
Aymen Shatnawi, David A Latif
AIMS AND OBJECTIVES: The role of pharmacists in chronic disease state management has been shown to significantly improve patient health outcomes and reduce overall health care costs. The current study is designed to assess the roles and attitudes of West Virginia (WV) pharmacists toward diabetes, evaluate services provided, address pharmacist clinical understanding and training, and demonstrate the challenges that limit pharmacists ability to deliver an efficient disease state management...
November 24, 2016: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/27882636/fear-of-knowledge-clinical-hypotheses-in-diagnostic-and-prognostic-reasoning
#4
Daniele Chiffi, Renzo Zanotti
Patients are interested in receiving accurate diagnostic and prognostic information. Models and reasoning about diagnoses have been extensively investigated from a foundational perspective; however, for all its importance, prognosis has yet to receive a comparable degree of philosophical and methodological attention, and this may be due to the difficulties inherent in accurate prognostics. In the light of these considerations, we discuss a considerable body of critical thinking on the topic of prognostication and its strict relations with diagnostic reasoning, pointing out the distinction between nosographic and pathophysiological types of diagnosis and prognosis, underlying the importance of the explication and explanation processes...
November 24, 2016: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/27860065/the-application-of-lean-six-sigma-methodology-to-reduce-the-risk-of-healthcare-associated-infections-in-surgery-departments
#5
Emma Montella, Maria Vincenza Di Cicco, Anna Ferraro, Piera Centobelli, Eliana Raiola, Maria Triassi, Giovanni Improta
RATIONALE: Nowadays, the monitoring and prevention of healthcare-associated infections (HAIs) is a priority for the healthcare sector. AIMS AND OBJECTIVES: In this article, we report on the application of the Lean Six Sigma (LSS) methodology to reduce the number of patients affected by sentinel bacterial infections who are at risk of HAI. METHODS: The LSS methodology was applied in the general surgery department by using a multidisciplinary team of both physicians and academics...
November 18, 2016: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/27860101/on-a-learning-curve-for-shared-decision-making-interviews-with-clinicians-using-the-knee-osteoarthritis-option-grid
#6
Glyn Elwyn, Julie Rasmussen, Katharine Kinsey, Jill Firth, Katy Marrin, Adrian Edwards, Fiona Wood
RATIONAL: Tools used in clinical encounters to illustrate to patients the risks and benefits of treatment options have been shown to increase shared decision making. However, we do not have good information about how these tools are viewed by clinicians and how clinicians think patients would react to their use. OBJECTIVE: Our aim was to examine clinicians' views about the possible and actual use of tools designed to support patients and clinicians to collaborate and deliberate about treatment options, namely, Option Grid decision aids...
November 16, 2016: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/27862689/applying-lean-six-sigma-methodology-to-reduce-cesarean-section-rate
#7
Ze-Ying Chai, Hua-Min Hu, Xiu-Ling Ren, Bao-Jin Zeng, Ling-Zhi Zheng, Feng Qi
OBJECTIVES: This study aims to reduce cesarean section rate and increase rate of vaginal delivery. METHODS: By using Lean Six Sigma (LSS) methodology, the cesarean section rate was investigated and analyzed through a 5-phase roadmap consisting of Define, Measure, Analyze, Improve, and Control. The principal causes of cesarean section were identified, improvement measures were implemented, and the rate of cesarean section before and after intervention was compared...
November 14, 2016: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/27859988/challenges-to-the-validity-of-using-medicine-labels-to-categorize-clinical-behavior-an-empirical-and-normative-critique-of-off-label-prescribing
#8
Narcyz Ghinea, Ian Kerridge, Miles Little, Wendy Lipworth
This study aimed to determine whether the label status of a medicine penetrates into the clinical reasoning of Australian medical practitioners and to explore the possible reasons for our findings using semistructured interviews with 14 Australian physicians. The interviews revealed 3 broad catalysts for off-label prescribing. The first of these was lack of awareness or understanding of the regulatory process in general and labels more specifically. The second was the perception that labels are not meaningful guides for clinical practice...
November 14, 2016: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/27859970/barriers-for-guideline-adherence-in-knee-osteoarthritis-care-a-qualitative-study-from-the-patients-perspective
#9
David Spitaels, Patrik Vankrunkelsven, Jurgen Desfosses, Frank Luyten, Sabine Verschueren, Dieter Van Assche, Bert Aertgeerts, Rosella Hermens
RATIONALE, AIMS AND OBJECTIVES: Guidelines for patients with knee osteoarthritis (OA) are suboptimally implemented in clinical care. To improve guideline adherence, patients' perceived barriers and facilitators in current care were investigated. METHODS: Eleven patients with knee OA were extensively interviewed using a semistructured script based on quality indicators. Directed content analysis, within the framework of Grol and Wensing, was performed to describe barriers and facilitators in 6 domains: guideline, health care professional, patient, social environment, organization, and financial context...
November 14, 2016: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/27862710/frequent-emergency-department-visitors-are-frequent-primary-care-visitors-and-report-unmet-primary-care-needs
#10
Amy Cunningham, Dawn Mautner, Bon Ku, Kevin Scott, Marianna LaNoue
A small percentage of emergency department (ED) visitors account for a disproportionate portion of ED visits. Little is known about their relationships with their primary care providers (PCPs). This study compares frequent and infrequent ED visitors' primary care utilization and perceptions of primary care access, continuity, and connectedness and examines primary care utilization and perceptions as predictors of ED use. Data were obtained from 2 cross-sectional studies of psychosocial predictors of high levels of utilization at 2 urban hospitals...
November 8, 2016: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/27807921/antihypertensive-adherence-and-outcomes-among-community-dwelling-medicare-beneficiaries-the-atherosclerosis-risk-in-communities-study
#11
Jerome J Federspiel, Carla A Sueta, Anna M Kucharska-Newton, Hadi Beyhaghi, Lei Zhou, Salim S Virani, Jo E Rodgers, Patricia P Chang, Sally C Stearns
RATIONALE, AIMS, AND OBJECTIVES: Despite proven benefits for reducing incidence of major cardiac events, antihypertensive drug therapy remains underutilized in the United States. This analysis assesses antihypertensive drug adherence, utilization predictors, and associations between adherence and outcomes (a composite of cardiovascular events, Medicare inpatient payments, and inpatient days). METHODS: The sample consisted of Atherosclerosis Risk in Communities Study cohort participants reporting hypertension without prevalent cardiovascular disease during 2006 to 2007 annual follow-up calls...
November 3, 2016: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/27807920/assessment-of-implementability-of-an-adapted-clinical-practice-guideline-for-surgical-antimicrobial-prophylaxis-at-a-tertiary-care-university-hospital
#12
Tariq I Altokhais, Omar A Al-Obaid, Abdullah E Kattan, Yasser S Amer
RATIONALE, AIMS AND OBJECTIVES: Surgical site infections are the most common healthcare-associated infections. Appropriate surgical antimicrobial prophylaxis (SAP), which is an integral part of surgical site infection SSI prevention, is one of the major preventable risks to surgical patient safety. Several clinical practice guidelines (CPGs) for SAP have been published. The aim of this study was to adapt a CPG for SAP and to assess its implementability. METHODS: The methodology was based on two validated tools for CPGs, namely, the ADAPTE and the Guideline Implementability Appraisal (GLIA)...
November 3, 2016: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/27804216/challenges-to-validity-in-single-group-interrupted-time-series-analysis-even-with-a-crossover-design
#13
Ariel Linden
RATIONALE, AIMS AND OBJECTIVES: The basic single-group interrupted time series analysis (ITSA) design has been shown to be susceptible to the most common threat to validity-history-the possibility that some other event caused the observed effect in the time series. A single-group ITSA with a crossover design (in which the intervention is introduced and withdrawn 1 or more times) should be more robust. In this paper, we describe and empirically assess the susceptibility of this design to bias from history...
November 1, 2016: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/27804187/partners-in-research-building-academic-practice-partnerships-to-educate-and-mentor-advanced-practice-nurses
#14
Patricia Harbman, Denise Bryant-Lukosius, Ruth Martin-Misener, Nancy Carter, Christine L Covell, Faith Donald, Sharyn Gibbins, Kelley Kilpatrick, James McKinlay, Krista Rawson, Diana Sherifali, Joan Tranmer, Ruta Valaitis
RATIONALE: Clinical practice is the primary focus of advanced practice nursing (APN) roles. However, with unprecedented needs for health care reform and quality improvement (QI), health care administrators are seeking new ways to utilize all dimensions of APN expertise, especially related to research and evidence-based practice. International studies reveal research as the most underdeveloped and underutilized aspect of these roles. AIMS: To improve patient care by strengthening the capacity of advanced practice nurses to integrate research and evidence-based practice activities into their day-to-day practice...
November 1, 2016: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/27766734/program-evaluation-of-neuroscience-competency-programs-to-implement-evidence-based-practices
#15
Staci Sue Reynolds, Susan M McLennon, Patricia R Ebright, Laura L Murray, Tamilyn Bakas
RATIONALE: Program evaluation is essential to help determine the success of an evidence-based practice program and assist with translating these processes across settings. AIMS: The purpose of this study was to evaluate the usefulness of 2 competency programs that sought to improve neurocritical care nurses' knowledge of and adherence to evidence-based stroke and spinal cord injury guidelines. These programs consisted of 3 specific implementation strategies, including local opinion leaders, printed educational materials, and educational outreach...
October 20, 2016: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/27762080/a-proposed-approach-for-quantitative-benefit-risk-assessment-in-diagnostic-radiology-guideline-development-the-american-college-of-radiology-appropriateness-criteria-example
#16
Maria Agapova, Brian B Bresnahan, Mitchell Higashi, Larry Kessler, Louis P Garrison, Beth Devine
The American College of Radiology develops evidence-based practice guidelines to aid appropriate utilization of radiological procedures. Panel members use expert opinion to weight trade-offs and consensus methods to rate appropriateness of imaging tests. These ratings include an equivocal range, assigned when there is disagreement about a technology's appropriateness and the evidence base is weak or for special circumstances. It is not clear how expert consensus merges with the evidence base to arrive at an equivocal rating...
October 19, 2016: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/27761961/using-expert-elicitation-to-estimate-the-potential-impact-of-improved-diagnostic-performance-of-laboratory-tests-a-case-study-on-rapid-discharge-of-suspected-non-st-elevation-myocardial-infarction-patients
#17
Michelle Ma Kip, Lotte Mg Steuten, Hendrik Koffijberg, Maarten J IJzerman, Ron Kusters
Early health technology assessment can provide insight in the potential cost-effectiveness of new tests to guide further development decisions. This can increase their potential benefit but often requires evidence which is lacking in early test development stages. Then, expert elicitation may be used to generate evidence on the impact of tests on patient management. This is illustrated in a case study on a new triple biomarker test (copeptin, heart-type fatty acid binding protein, and high-sensitivity troponin [HsTn]) at hospital admission...
October 19, 2016: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/27747965/translating-biobehavioral-research-advances-into-improvements-in-health-care-a-network-of-networks-approach-to-multimorbidity
#18
Nicolas Rohleder
Biobehavioral research has made great advances in past decades, allowing researchers to paint an ever-improving picture of interactions between the central nervous system and the systems in the periphery of the body. This knowledge allows us, from a researcher's perspective, to better understand diseases and disease symptoms that are not explainable with a narrow view on organ-specific biomedical processes. However, what is lacking is the translation of this knowledge into clinical practice. In their commentary, Sturmberg et al pointed out these shortcomings and proposed a model connecting the different networks in the human body, and the importance of their connectedness, and drew conclusions for necessary changes in patient care...
October 16, 2016: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/27723179/self-and-identity-over-time-dementia
#19
Juliette Brown
Here, the author revisits the discussion on the impact of dementia on experiences of self and identity over time that formed part of the workshop session on Mental Disorder and Selfhood at Kings College London, September 1, 2015. Dementia is described as being synonymous with loss, but this, in the author's view, is due to conscious and unconscious focus on the later stages of the illness that undermine all our abilities to think about and use the intervening years. Those years can deliver remarkable insights into the capacity to navigate fragmented identities...
October 10, 2016: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/27723216/phronesis-practical-wisdom-the-role-of-professional-practice-knowledge-in-the-clinical-reasoning-of-bobath-instructors
#20
Julie Vaughan-Graham, Cheryl Cott
RATIONALE, AIMS, AND OBJECTIVES: Clinical reasoning is an essential aspect of clinical practice, however is largely ignored in the current rehabilitation sciences evidence base. Literature related to clinical reasoning and clinical expertise has evolved concurrently although rehabilitation reasoning frameworks remain relatively generic. The purpose of this study was to explicate the clinical reasoning process of Bobath instructors of a widely used neuro-rehabilitation approach, the Bobath concept...
October 9, 2016: Journal of Evaluation in Clinical Practice
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