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Journal of Evaluation in Clinical Practice

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
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
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
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
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
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
Leslie Carlin, Kathryn Sibley, Richard Jenkinson, Pia Kontos, Rhona McGlasson, Hans J Kreder, Susan Jaglal
For older adults with osteoporosis, a fall resulting in hip fracture is a life-changing event from which only one-third fully recover. Current best evidence argues strongly for elderly patients to bear weight on their repaired hip fracture immediately after their surgery to maximize their chances of full or nearly full recovery. Patient stakeholders in Canada have argued that some surgeons fail to issue "weight-bearing-as-tolerated" (WBAT) orders in all eligible cases, protecting their bony repair but contributing to increased mortality and long-term disability rates...
October 6, 2016: Journal of Evaluation in Clinical Practice
Amaël Arguel, Oscar Perez-Concha, Simon Y W Li, Annie Y S Lau
RATIONAL, AIMS AND OBJECTIVES: The aim of this review was to identify general theoretical frameworks used in online social network interventions for behavioral change. To address this research question, a PRISMA-compliant systematic review was conducted. METHODS: A systematic review (PROSPERO registration number CRD42014007555) was conducted using 3 electronic databases (PsycINFO, Pubmed, and Embase). Four reviewers screened 1788 abstracts. RESULTS: 15 studies were selected according to the eligibility criteria...
October 6, 2016: Journal of Evaluation in Clinical Practice
Sophie van Baalen, Annamaria Carusi, Ian Sabroe, David G Kiely
In recent years there has been growing attention to the epistemology of clinical decision-making, but most studies have taken the individual physicians as the central object of analysis. In this paper we argue that knowing in current medical practice has an inherently social character and that imaging plays a mediating role in these practices. We have analyzed clinical decision-making within a medical expert team involved in diagnosis and treatment of patients with pulmonary hypertension (PH), a rare disease requiring multidisciplinary team involvement in diagnosis and management...
October 3, 2016: Journal of Evaluation in Clinical Practice
Gregory M Garrison, Paul M Robelia, Jennifer L Pecina, Nancy L Dawson
RATIONALE, AIMS AND OBJECTIVES: Hospital readmission within 30 days of discharge occurs in almost 20% of US Medicare patients and may be a marker of poor quality inpatient care, ineffective hospital to home transitions, or disease severity. Within a patient centered medical home, care transition interventions may only be practical from cost and staffing perspectives if targeted at patients with the greatest risk of readmission. Various scoring algorithms attempt to predict patients at risk for 30-day readmission, but head-to-head comparison of performance is lacking...
October 3, 2016: Journal of Evaluation in Clinical Practice
Henk Verloo, Mario Desmedt, Diane Morin
RATIONALE: Evidence-based practice (EBP) is upheld as a means for patients to receive the most efficient care in a given context. Despite the available evidence and positive beliefs about it, implementing EBP as standard daily practice still faces many obstacles. AIMS AND OBJECTIVES: This study investigated the beliefs about and implementation of EBP among nurses and allied healthcare providers (AHP) in 9 acute care hospitals in the canton of Valais, Switzerland...
September 30, 2016: Journal of Evaluation in Clinical Practice
Antoni Sicras-Mainar, Javier Rejas-Gutiérrez, María Pérez-Páramo, Ruth Navarro-Artieda
To analyze the effect of loss of exclusivity of data on the cost of treatment of peripheral neuropathic pain (PNP) with pregabalin or gabapentin in routine clinical practice. A retrospective observational study, with electronic medical records for patients enrolled at primary care centers managed by the health care provider Badalona Serveis Assistencials, who initiated treatment of PNP with pregabalin or gabapentin. The analysis used drugs and resources prices for year 2015. The 1163 electronic medical records (pregabalin; N = 764, gabapentin; N = 399) for patients (62...
September 27, 2016: Journal of Evaluation in Clinical Practice
David Roder, Gelareh Farshid, Grantley Gill, Jim Kollias, Bogda Koczwara, Chris Karapetis, Jacqui Adams, Rohit Joshi, Dorothy Keefe, Kate Powell, Kellie Fusco, Marion Eckert, Elizabeth Buckley, Kerri Beckmann
RATIONALE: Screening has been found to reduce breast cancer mortality at a population level in Australia, but these studies did not address local settings where numbers of deaths would generally have been too low for evaluation. Clinicians, administrators, and consumer groups are also interested in local service outcomes. We therefore use more common prognostic and treatment measures and survivals to gain evidence of screening effects among patients attending 4 local hospitals for treatment...
September 22, 2016: Journal of Evaluation in Clinical Practice
Carmel Mary Martin
RATIONALE: Much is written about "multimorbidity" as it is a difficult problem for health systems, as it reflects a complex phenomenon unique to each individual health journey and health service context. This paper proposes the adoption of 2 constructs or knowledge streams into mainstream "multimorbidity" care which are arguably most important to person-centered care-personal health perceptions and resilience. ANALYSIS: "Multimorbidity" is the manifestation of multiple nonlinear physical, psychosocial, and environmental phenomena in an individual health journey...
September 21, 2016: Journal of Evaluation in Clinical Practice
Jasperine Ka Yee Ho, Quinnie Lee, Jaden Chun Ho Lam, Kam Shing Tang
RATIONALE, AIMS AND OBJECTIVES: Timely detection and management of acutely deteriorating patients can save lives. Tuen Mun Hospital (TMH), a 1800-bed acute tertiary hospital serving more than 1.06 million populations in Hong Kong, is exploring to quantitatively monitor serious clinical deterioration (SCD) and uses it to guide patient care improvement initiatives. METHODS: Literature review on definition and measurement of SCD was conducted. Monthly SCD rates of TMH were first calculated according to the published methodology and benchmarked against those of international centres...
September 21, 2016: Journal of Evaluation in Clinical Practice
Maria Jaensson, Ulrica Nilsson
RATIONALE, AIMS, AND OBJECTIVES: The Swedish web-version of the Quality of Recovery questionnaire is used to evaluate a person's postoperative recovery after anesthesia and surgery. An earlier study found an increased risk of answering incorrectly when the questionnaire included both positive and negative items. Therefore, this study investigated the effect of changing positively worded items to negatively worded items. METHODS: This was a cross-sectional study including 90 second-year nursing students...
September 21, 2016: Journal of Evaluation in Clinical Practice
Nasir Wabe, Michael D Wiese
Development of the treat-to-target (T2T) strategy, the process whereby drug therapy is adjusted until the therapeutic goal is achieved, has revolutionized how rheumatoid arthritis (RA) patients are treated. With the advent of T2T, the management of RA is more effective than ever, with the possibility of remission and other favorable clinical and patient-reported outcomes. Effective implementation of a T2T strategy in routine clinical practice mainly depends on the long-term commitment of physician and patient to T2T treatment recommendations...
September 21, 2016: Journal of Evaluation in Clinical Practice
Bjørn M Hofmann
No abstract text is available yet for this article.
September 20, 2016: Journal of Evaluation in Clinical Practice
Ariel Linden
RATIONALE, AIMS AND OBJECTIVES: Single-group interrupted time series analysis (ITSA) is a popular evaluation methodology in which a single unit of observation is studied; the outcome variable is serially ordered as a time series, and the intervention is expected to "interrupt" the level and/or trend of the time series, subsequent to its introduction. The most common threat to validity is history-the possibility that some other event caused the observed effect in the time series. Although history limits the ability to draw causal inferences from single ITSA models, it can be controlled for by using a comparable control group to serve as the counterfactual...
September 14, 2016: Journal of Evaluation in Clinical Practice
Johannes Bircher, Eckhart G Hahn
No abstract text is available yet for this article.
September 13, 2016: Journal of Evaluation in Clinical Practice
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