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Clinical Quality

Amy Y Tsou, Jonathan R Treadwell
BACKGROUND: Systematic review (SR) abstracts are important for disseminating evidence syntheses to inform medical decision making. We assess reporting quality in SR abstracts using PRISMA for Abstracts (PRISMA-A), Cochrane Handbook, and Agency for Healthcare Research & Quality guidance. METHODS: We evaluated a random sample of 200 SR abstracts (from 2014) comparing interventions in the general medical literature. We assessed adherence to PRISMA-A criteria, problematic wording in conclusions, and whether "positive" studies described clinical significance...
October 20, 2016: Research Synthesis Methods
Hu Luo, Liang Gong, Bingjing Zhu, Ying Huang, Chunlan Tang, Shicang Yu, Zhi Yang, Xiangdong Zhou
OBJECTIVE: Few clinical studies have confirmed the role of cytokine-induced killer cells (CIKs) in the maintenance therapy of advanced lung cancer patients. We investigate effectiveness and tolerability of CIKs as a maintenance therapy in the treatment of advanced lung cancer patients. METHODS: 70 patients with advanced lung cancer (stage IIIB to IV) admitted to the First Affiliated Hospital of Third Military Medical University in Chongqing from Nov. 2011 to Jan...
October 17, 2016: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
Amara Krag, Gregory L Holmes
Infantile spasms, one of the catastrophic epilepsies, can be a diagnostic challenge since the clinical manifestations may be subtle and may mimic benign conditions. Because of the rarity of the condition, primary care physicians and pediatricians may never see a case of infantile spasms during their career and may be unfamiliar with the seizure semiology. This is a serious issue since there is evidence that early diagnosis and treatment may improve outcome. Patients and families are increasingly using the internet more than their physician as a source of medical information about epilepsy...
October 17, 2016: Epilepsy & Behavior: E&B
Xin Tong, Jiani Chen, Sung-Pa Park, Xi Wang, Chiyi Wang, Minglian Su, Dong Zhou
The aim of this study was to better understand social support in adult people with epilepsy (PWE) in China and to explore the factors related to weaker or stronger social support in PWE when compared with a group of matching healthy controls. Consecutively, we recruited PWE from the epilepsy outpatient clinic of the West China Hospital and healthy controls from nearby urban and rural areas. People with epilepsy and healthy controls were gender- and age-matched. Each participant was interviewed and completed the following instruments: the Social Support Rating Scale (SSRS) and the Hospital Anxiety and Depression Scale (HADS)...
October 17, 2016: Epilepsy & Behavior: E&B
Glória Maria Almeida Souza Tedrus, Lineu Corrêa Fonseca, Marina Nobrega Augusto, Fernanda Savoia Trindade
PURPOSE: In patients with epilepsy (PWE), relationships between depression, epilepsy characteristics, and cognitive aspects are complex. This study aimed to assess the occurrence of possible major depressive episode in PWE and to verify whether it is associated with the clinical aspects of the disease and cognition. METHODS: Two hundred consecutive PWE with a mean age and standard deviation of 47.6 (±15.1) years were included in the study. We determined whether their Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) scores were associated with their clinical, cognitive, and QOLIE-31 aspects using a significance level of 5% (p<0...
October 17, 2016: Epilepsy & Behavior: E&B
Linda Garton, Amalie Dyda, Rebecca Guy, Bronwyn Silver, Skye McGregor, Belinda Hengel, Alice Rumbold, Debbie Taylor-Thomson, Janet Knox, Lisa Maher, John Kaldor, James Ward
Background: Extremely high rates of diagnosis of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) have been recorded in remote communities across northern and central Australia. Re-testing at 3 months, after treatment administered, of CT or NG is recommended to detect repeat infections and prevent morbidity and ongoing transmission. Methods: Baseline CT and NG laboratory data (2009-2010) from 65 remote health services participating in a cluster randomised trial was used to calculate the proportion of individuals re-tested after an initial CT or NG diagnosis at <2 months (not recommended), 2-4 months (recommended) and 5-12 months and the proportion with repeat positivity on re-test...
October 21, 2016: Sexual Health
Steffen T Simon, Irene J Higginson, Sara Booth, Richard Harding, Vera Weingärtner, Claudia Bausewein
BACKGROUND: This is an updated version of the original Cochrane review published in Issue 1, 2010, on 'Benzodiazepines for the relief of breathlessness in advanced malignant and non-malignant diseases in adults'. Breathlessness is one of the most common symptoms experienced in the advanced stages of malignant and non-malignant disease. Benzodiazepines are widely used for the relief of breathlessness in advanced diseases and are regularly recommended in the literature. At the time of the previously published Cochrane review, there was no evidence for a beneficial effect of benzodiazepines for the relief of breathlessness in people with advanced cancer and chronic obstructive pulmonary disease (COPD)...
October 20, 2016: Cochrane Database of Systematic Reviews
Matthew Thomas Sims, Zachary Carter Sanchez, James Murphy Herrington, James Barrett Hensel, Nolan Michael Henning, Caleb Josiah Scheckel, Matt Vassar
INTRODUCTION: With the intent of improving transparency in clinical research, the International Committee of Medical Journal Editors (ICMJE) established guidelines in 2005 regarding prospective clinical trial registration. This action worked to address bias related to selective outcome reporting in the medical literature. The objective of this study was to assess and characterize the quality of registration of clinical trials appearing in shoulder arthroplasty-related medical journals...
2016: PloS One
Seema T Meloni, Charlotte A Chang, Geoffrey Eisen, Toyin Jolayemi, Bolanle Banigbe, Prosper I Okonkwo, Phyllis J Kanki
BACKGROUND: While there has been a rapid global scale-up of antiretroviral therapy programs over the past decade, there are limited data on long-term outcomes from large cohorts in resource-constrained settings. Our objective in this evaluation was to measure multiple outcomes during first-line antiretroviral therapy in a large treatment program in Nigeria. METHODS: We conducted a retrospective multi-site program evaluation of adult patients (age ≥15 years) initiating antiretroviral therapy between June 2004 and February 2012 in Nigeria...
2016: PloS One
Dong Kwang Seo, Moon Kyu Kim, Soo Jung Choi, Jun Young Sohn, Young Ki Kim, Eui Kyun Jeong, Jung-Ki Ha, Chung Hwan Kim, Jin Hoon Park
STUDY DESIGN: This is a case series of device failure patients. OBJECTIVE: To identify poor candidates for anterior cervical discectomy and fusion (ACDF) using an anchored cage. SUMMARY OF BACKGROUND DATA: An anchored cage has been used as an alternative implant for ACDF surgery because of ease of use, relatively acceptable fusion rate, and lower risk of plate-related complications, including dysphagia. MATERIALS AND METHODS: We retrospectively reviewed the outcomes of 36 patients who underwent ACDF using an anchored cage between January 2012 and December 2013...
October 19, 2016: Clinical Spine Surgery
Amir M Abtahi, Kade Shumway Lyman, Darrel S Brodke, Brandon D Lawrence, Chong Zhang, William Ryan Spiker
STUDY DESIGN: This is a retrospective review. OBJECTIVE: To evaluate the relationship between patient functional status and self-assessment of disability as measured by 3 commonly used clinical assessment instruments-the Oswestry Disability Index (ODI), the Neck Disability Index (NDI), and the EuroQol (EQ)-5D and patient satisfaction scores in a spine surgery clinic population. SUMMARY OF BACKGROUND DATA: Patient satisfaction surveys, which measure the "patient experience of care" are becoming an increasingly important measure of the quality of medical care...
October 19, 2016: Clinical Spine Surgery
Alexander J Steiner, Nathalie Boulos, James Mirocha, Stephanie M Wright, Katherine L Collison, Waguih W IsHak
OBJECTIVES: Posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) often have high comorbidity, consequently influencing patient-reported outcomes of depressive symptom severity, quality of life (QOL), and functioning. We hypothesized that the combined effects of concurrent PTSD and MDD would result in worse treatment outcomes, whereas individuals who achieved MDD remission would have better treatment outcomes. METHODS: We analyzed 2280 adult participants who received level 1 treatment (citalopram monotherapy) in the Sequenced Treatment Alternatives to Relieve Depression study, including 2158 participants with MDD without comorbid PTSD and 122 participants with MDD with comorbid PTSD (MDD + PTSD)...
October 18, 2016: Clinical Neuropharmacology
Andrea Bowyer, Colin F Royse
PURPOSE OF REVIEW: Recovery after surgery is a complex interplay of the patient, the surgery, and the perioperative anaesthesia management. Assessment of recovery should address the needs of multiple stakeholders, including the institutions and healthcare providers, but primarily should be focused on the patients and their perception of quality of recovery and return to normalcy. This review will summarize the development of assessment of recovery to a multidimensional dichotomous construct that requires a real-time assessment tool validated for repeat measures and containing cognitive assessment...
October 18, 2016: Current Opinion in Anaesthesiology
Matteo Bonini
PURPOSE OF REVIEW: Asthma is the most prevalent chronic respiratory disease and represents a relevant socioeconomic burden. e-Health has the potential to improve disease control and adherence to treatment in asthmatic patients. Available data are, however, scarce and inconsistent limiting the use of e-health in clinical practice. This article aims to provide a systematic review of the literature published in the last year regarding the real place and impact of e-health in the management of asthma...
October 18, 2016: Current Opinion in Pulmonary Medicine
Harish Kempegowda, Raveesh Richard, Amrut Borade, Akhil Tawari, Abby M Howenstein, Erik N Kubiak, Michael Suk, Daniel S Horwitz
OBJECTIVES: The purpose of this study was to evaluate the role and the necessity of radiographs and office visits obtained during follow-up of intertrochanteric hip injuries. DESIGN: Retrospective study SETTING:: Two level I trauma centers. PATIENTS: 465 elderly patients who were surgically treated for an intertrochanteric fracture of the femur at two level I trauma centers between January 2009 and August 2014 were retrospectively identified from orthopaedic trauma databases...
August 16, 2016: Journal of Orthopaedic Trauma
Itai Danovitch, Alexander Joseph Steiner, Anna Kazdan, Matthew Goldenberg, Margaret Haglund, James Mirocha, Katherine Collison, Brigitte Vanle, Jonathan Dang, Waguih William IsHak
OBJECTIVE: Alcohol use disorders (AUDs) are common among persons with major depressive disorder (MDD) and have an adverse impact on course of illness and patient outcomes. The aim of this study was to examine whether AUD adversely impacted patient-centered outcomes in a sample of research subjects evaluated as part of a large clinical trial for depression. The outcomes of interest to this post hoc analysis are quality of life (QOL), functioning, and depressive symptom severity. METHODS: We analyzed 2280 adult MDD outpatient research subjects using data from the Sequenced Treatment Alternatives to Relieve Depression trial...
October 18, 2016: Journal of Addiction Medicine
Isabell B Purdy, Mary Alice Melwak, Joan R Smith, Carole Kenner, Rebecca Chuffo-Siewert, Donna J Ryan, Sue Hall
BACKGROUND: The neonatal intensive care unit (NICU) can be a stressful environment for infants, their families, and the healthcare team. There is an immediate need for neonatal nurses to embrace and translate the new National Perinatal Association recommendations for psychosocial support of NICU parents into clinical practice to demonstrate best practices for infants, their families, and the whole team. PURPOSE: To summarize the current evidence-based practice recommendations and to provide suggestions for team members to develop strategies to adopt and implement them through quality improvement (QI) projects...
October 19, 2016: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
Carolin A Boecking, Eleanor A Drey, Jennifer L Kerns, Walter E Finkbeiner
CONTEXT: -Despite increased use of dilation and evacuation in the setting of fetuses with developmental anomalies, the pathology examination of fragmented specimens obtained by this technique has been understudied. OBJECTIVES: -To correlate pathologic findings in second-trimester fetal dilation and evacuation specimens with prenatal diagnoses established through ultrasound and/or chromosome studies to determine the value of pathology examination for supplementing or correcting clinical diagnoses...
October 20, 2016: Archives of Pathology & Laboratory Medicine
Lauren E Arthur, Russell S Kizor, Adrian G Selim, Mieke L van Driel, Leonardo Seoane
BACKGROUND: Ventilator-associated pneumonia (VAP) is a significant cause of morbidity and mortality, complicating the medical course of approximately 10% of mechanically-ventilated patients, with an estimated attributable mortality of 13%. To treat VAP empirically, the American Thoracic Society currently recommends antibiotic therapy based on the patients' risk of colonisation by an organism with multidrug resistance. The selection of initial antibiotic therapy in VAP is important, as inappropriate initial antimicrobial treatment is associated with higher mortality and longer hospital stay in intensive care unit (ICU) patients...
October 20, 2016: Cochrane Database of Systematic Reviews
Daniel Stäb, Steffen Bollmann, Christian Langkammer, Kristian Bredies, Markus Barth
With the advent of ultra-high field MRI scanners in clinical research, susceptibility based MRI has recently gained increasing interest because of its potential to assess subtle tissue changes underlying neurological pathologies/disorders. Conventional, but rather slow, three-dimensional (3D) spoiled gradient-echo (GRE) sequences are typically employed to assess the susceptibility of tissue. 3D echo-planar imaging (EPI) represents a fast alternative but generally comes with echo-time restrictions, geometrical distortions and signal dropouts that can become severe at ultra-high fields...
October 20, 2016: NMR in Biomedicine
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