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Evidence based informed practice

Jan Steffel, Peter Verhamme, Tatjana S Potpara, Pierre Albaladejo, Matthias Antz, Lien Desteghe, Karl Georg Haeusler, Jonas Oldgren, Holger Reinecke, Vanessa Roldan-Schilling, Nigel Rowell, Peter Sinnaeve, Ronan Collins, A John Camm, Hein Heidbüchel
The current manuscript is the Executive Summary of the second update to the original Practical Guide, published in 2013. Non-vitamin K antagonist oral anticoagulants (NOACs) are an alternative for vitamin K antagonists (VKAs) to prevent stroke in patients with atrial fibrillation (AF), and have emerged as the preferred choice, particularly in patients newly started on anticoagulation. Both physicians and patients are becoming more accustomed to the use of these drugs in clinical practice. However, many unresolved questions on how to optimally use these agents in specific clinical situations remain...
March 19, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Jan Steffel, Peter Verhamme, Tatjana S Potpara, Pierre Albaladejo, Matthias Antz, Lien Desteghe, Karl Georg Haeusler, Jonas Oldgren, Holger Reinecke, Vanessa Roldan-Schilling, Nigel Rowell, Peter Sinnaeve, Ronan Collins, A John Camm, Hein Heidbüchel
The current manuscript is the second update of the original Practical Guide, published in 2013 [Heidbuchel et al. European Heart Rhythm Association Practical Guide on the use of new oral anticoagulants in patients with non-valvular atrial fibrillation. Europace 2013;15:625-651; Heidbuchel et al. Updated European Heart Rhythm Association Practical Guide on the use of non-vitamin K antagonist anticoagulants in patients with non-valvular atrial fibrillation. Europace 2015;17:1467-1507]. Non-vitamin K antagonist oral anticoagulants (NOACs) are an alternative for vitamin K antagonists (VKAs) to prevent stroke in patients with atrial fibrillation (AF) and have emerged as the preferred choice, particularly in patients newly started on anticoagulation...
March 17, 2018: European Heart Journal
Linda Shore-Lesserson, Robert A Baker, Victor Ferraris, Philip E Greilich, David Fitzgerald, Philip Roman, John Hammon
Despite more than a half century of "safe" cardiopulmonary bypass (CPB), the evidence base surrounding the conduct of anticoagulation for CPB has not been organized into a succinct guideline. For this and other reasons, there is enormous practice variability relating to the use and dosing of heparin, monitoring heparin anticoagulation, reversal of anticoagulation, and the use of alternative anticoagulants. To address this and other gaps, the Society of Thoracic Surgeons (STS), the Society of Cardiovascular Anesthesiologists (SCA), and the American Society of Extracorporeal Technology (AmSECT) developed an Evidence Based Workgroup...
March 2018: Journal of Extra-corporeal Technology
Jessica R Dykstra Steinbrenner
Around 30% of elementary school students with autism spectrum disorder (ASD) are considered minimally verbal, yet there is limited research addressing the needs of this group of students. Several recent studies have demonstrated successful improvement of the communication skills of elementary school students with limited verbal skills. Additionally, there are focused intervention practices that are evidence based and may be useful in targeting communication skills for children with ASD who are minimally verbal...
April 2018: Seminars in Speech and Language
Deborah H Charbonneau, LaTeesa N James
DynaMed Plus® from EBSCO Health is an evidence-based tool that health professionals can use to inform clinical care. DynaMed Plus content undergoes a review process, and the evidence is synthesized in detailed topic overviews. A unique three-level rating scale is used to assess the quality of available evidence. Topic overviews summarize current evidence and provide recommendations to support health providers at the point-of-care. Additionally, DynaMed Plus content can be accessed via a desktop computer or mobile platforms...
April 2018: Medical Reference Services Quarterly
Joanne M Muellenbach, Kathryn M Houk, Dana E Thimons, Bredny Rodriguez
This column describes a process for integrating information literacy (IL) and evidence-based medicine (EBM) content within a new school of medicine curriculum. The project was a collaborative effort among health sciences librarians, curriculum deans, directors, and faculty. The health sciences librarians became members of the curriculum committees, developed a successful proposal for IL and EBM content within the curriculum, and were invited to become course instructors for Analytics in Medicine. As course instructors, the librarians worked with the other faculty instructors to design and deliver active learning class sessions based on a flipped classroom approach using a proprietary Information Mastery curriculum...
April 2018: Medical Reference Services Quarterly
Lance B Irons, Heidi Flatin, Maya T Harrington, Turaj Vazifedan, John W Harrington
This article assesses parental confidence and current behavioral techniques used by mostly African American caregivers of young children in an urban Southeastern setting, including their use and attitudes toward corporal punishment (CP). Two hundred and fifty parental participants of children aged 18 months to 5 years completed a survey on factors affecting their behavioral management and views on CP. Statistical analysis included χ2 test and logistic regression with confidence interval significance determined at P <...
March 1, 2018: Clinical Pediatrics
Shanta R Dube
Currently, in the U.S. and worldwide, childhood trauma is a public health crisis. Childhood adversities, such as abuse, neglect, and related household stressors, are common, interrelated and contribute to multiple adverse social, behavioral and health outcomes throughout the lifespan. The present article provides further discussion regarding adverse childhood experiences (ACEs) screening in healthcare utilizing the etic and emic perspectives. Screening in the healthcare system leans toward the etic view: objective observations of symptoms, which may then lead to intervention delivery...
March 16, 2018: Child Abuse & Neglect
Meghan L Wilson, Thomas E Strayer, Rebecca Davis, Samantha M Harden
Efficacy and effectiveness data for strength-training programs targeting older adults have been well established, but it is evident that they are not translated within practice-based settings to have a public health impact, as most (~90%) older adults are not meeting strength-training recommendations. Strength-training interventions developed, delivered, and evaluated in highly controlled settings (e.g., eligibility requirements, certified instructor, etc.) may not reflect real-world needs. One strategy to improve these outcomes is to work through an integrated research-practice partnership (IRPP) to plan and evaluate an intervention to better fit within the intended delivery system...
2018: Frontiers in Public Health
Rupert Page, Rohit Shankar, Brendan N McLean, Jane Hanna, Craig Newman
Epilepsy is associated with a significant increase in morbidity and mortality. The likelihood is significantly greater for those patients with specific risk factors. Identifying those at greatest risk of injury and providing expert management from the earliest opportunity is made more challenging by the circumstances in which many such patients present. Despite increasing recognition of the importance of earlier identification of those at risk, there is little or no improvement in outcomes over more than 30 years...
2018: Frontiers in Neurology
Sarang Kim, Mitchell McMaster, Susan Torres, Kay L Cox, Nicola Lautenschlager, George W Rebok, Dimity Pond, Catherine D'Este, Ian McRae, Nicolas Cherbuin, Kaarin J Anstey
INTRODUCTION: It has been estimated that a 10%-25% reduction in seven key risk factors could potentially prevent 1.1-3.0 million Alzheimer's disease cases globally. In addition, as dementia is preceded by more subtle cognitive deficits which have substantial social and economic impact, effective preventative interventions would likely have more extensive benefits. The current study evaluates in primary care a multidomain risk-reduction intervention targeting adults with high risk of developing dementia...
March 17, 2018: BMJ Open
L Power, W Shute, B McOwan, K Murray, D Szmulewicz
This retrospective review aims to survey the clinical characteristics and management of vestibular migraine (VM) patients seen in a tertiary hospital multi-disciplinary balance disorders clinic, and how this aligns with the evidence base in the literature. A single investigator reviewed the medical records of the patients who presented to a tertiary hospital balance disorders clinic over a four month period and identified 90 cases of VM. The mean age of patients with a diagnosis of VM was 50 years (range of 17-84) and 72 (80%) were female...
March 14, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Giuseppe Brescia, Claudia Zanotti, Daniela Parrino, Umberto Barion, Gino Marioni
PURPOSE: Endotyping chronic rhinosinusitis with nasal polyps (CRSwNP) poses a challenge for rhinologists nowadays. Phenotyping CRSwNP proved inappropriate as an approach to their classification because of their common clinical features. Endotyping, being based on the pathogenic mechanism, provides a precise picture more appropriate for use in clinical practice. Patients' treatment and follow-up can thus be tailored to cope with the degree of aggressiveness of a specific CRSwNP endotype...
March 7, 2018: American Journal of Otolaryngology
Omar B Da'ar, Abdulaziz Alshaya
This study estimated whether continued programming of a highly specialized four-year dentistry residency training in Saudi Arabia was cost-beneficial. We utilized a purposive sampling to administer a survey to trainees in major cities. Additionally, we used publically available market information about general practitioners. We employed Benefit-Cost Analysis accounting approach as a conceptual framework. Using general practitioners as the base category, we grouped overall social analytical perspectives into resident trainees and rest of society...
February 19, 2018: Evaluation and Program Planning
A Fauconnier, B Borghese, C Huchon, I Thomassin-Naggara, C-A Philip, T Gauthier, N Bourdel, A Denouel, A Torre, P Collinet, M Canis, X Fritel
Based on the best evidence available, we have provided guidelines for clinical practice to target the nature of endometriosis as a disease, the consequences of its natural history on management, and the clinical and imaging evaluation of the disease according to the level of care (primary care, specialized or referral). The frequency of endometriosis is unknown in the general population; endometriosis requires management when it causes symptoms (pain, infertility) or when it affect the function of an organ...
March 13, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
Nicholas Golda, Stephen Beeson, Nita Kohli, Brandon Merrill
The relationship between patient experience and health care quality has generated significant interest in the patient experience measure. However, it is challenging to find information on how to improve one's patient experience score because scientific data on this topic are weak or lacking, and suggestions provided by scoring vendors are often overgeneralized and not specialty-specific. This review will focus on the current state of evidence supporting factors influencing patient experience (both positive and negative) in outpatient specialist encounters that are applicable to general and surgical dermatology...
April 2018: Journal of the American Academy of Dermatology
Christine A DeForest, Virginia Blackman, John E Alex, Lauren Reeves, Alejandra Mora, Crystal Perez, Joseph Maddry, Domenique Selby, Benjamin Walrath
Introduction: Military prehospital and en route care (ERC) directly impacts patient morbidity and mortality. Provider knowledge and skills are critical variables in the effectiveness of ERC. No Navy doctrine defines provider choice for patient transport or requires standardized provider training. Frequently, Search and Rescue Medical Technicians (SMTs) and Navy Nurses (ERC RNs) are tasked with this mission though physicians have also been used. Navy ERC provider training varies greatly by professional role...
March 14, 2018: Military Medicine
Aida Kamišalić, David Riaño, Tatjana Welzer
BACKGROUND: In medical practice, long term interventions are common and they require timely planning of the involved processes. Unfortunately, evidence-based statements about time are hard to find in Clinical Practice Guidelines (CPGs) and in other sources of medical knowledge. At the same time, health care centers use medical records and information systems to register data about clinical processes and patients, including time information about the encounters, prescriptions, and other clinical actions...
May 2018: Computer Methods and Programs in Biomedicine
Thomas Stephan Hiller, Antje Freytag, Jörg Breitbart, Tobias Teismann, Elisabeth Schöne, Wolfgang Blank, Mercedes Schelle, Horst Christian Vollmar, Jürgen Margraf, Jochen Gensichen
BACKGROUND: Behavior therapy-oriented methods are recommended for treating anxiety disorders in primary care. The treatment of patients with long-term conditions can be improved by case management and structured clinical monitoring. The present paper describes the rationale, design and application of the 'Jena Anxiety Monitoring List' (JAMoL), a monitoring tool for the treatment of patients with panic disorder, with or without agoraphobia, in primary care. METHODS: JAMoL's design was based on established clinical measures, the rationale of exposure-based anxiety treatment, and research on family practice-based case management...
March 12, 2018: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
Ketan Shankardass, Carles Muntaner, Lauri Kokkinen, Faraz Vahid Shahidi, Alix Freiler, Goldameir Oneka, Ahmed M Bayoumi, Patricia O'Campo
BACKGROUND: There has been a renewed interest in broadening the research agenda in health promotion to include action on the structural determinants of health, including a focus on the implementation of Health in All Policies (HiAP). Governments that use HiAP face the challenge of instituting governance structures and processes to facilitate policy coordination in an evidence-informed manner. Due to the complexity of government institutions and the policy process, systems theory has been proposed as a tool for evaluating the implementation of HiAP...
March 15, 2018: Health Research Policy and Systems
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