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Outcome based care

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https://www.readbyqxmd.com/read/29342435/the-2016-american-academy-of-ophthalmology-iris%C3%A2-registry-intelligent-research-in-sight-database-characteristics-and-methods
#1
Michael F Chiang, Alfred Sommer, William L Rich, Flora Lum, David W Parke
PURPOSE: To describe the characteristics of the patient population included in the 2016 IRIS® Registry (Intelligent Research in Sight) database for analytic aims. DESIGN: Description of a clinical data registry. PARTICIPANTS: The 2016 IRIS Registry database consists of 17 363 018 unique patients from 7200 United States-based ophthalmologists in the United States. METHODS: Electronic health record (EHR) data were extracted from the participating practices and placed into a clinical database...
January 13, 2018: Ophthalmology
https://www.readbyqxmd.com/read/29342009/how-academic-health-systems-can-achieve-population-health-in-vulnerable-populations-through-value-based-care-the-critical-importance-of-establishing-trusted-agency
#2
Donald E Wesson, Heather E Kitzman
Improving population health may require health systems to proactively engage patient populations as partners in the implementation of healthy behaviors as a shared value using strategies that incentivize healthy outcomes for the population as a whole. The current reactive health care model, which focuses on restoring the health of individuals after it has been lost, will not achieve the goal of improved population health. To achieve this goal, health systems must proactively engage in partnerships with the populations they serve...
January 16, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29341970/does-the-use-of-indirect-calorimetry-change-outcome-in-the-icu-yes-it-does
#3
Elisabeth De Waele, Patrick M Honoré, Manu L N G Malbrain
PURPOSE OF REVIEW: To review the recent findings on metabolic monitoring and possible beneficial effects of an adequate nutrition therapy, based on indirect calorimetry as the golden standard to predict energy expenditure. RECENT FINDINGS: in the last decades, major steps are taken in the field of metabolism and nutrition, evolving from nutrition as a baseline support to a therapeutic intervention. The aspect of energy expenditure is of cardinal importance, and technical possibilities have impressively improved: from the first 'calorimetre' in 1789 to the new generation, clinical applicable indirect calorimeters and the high accuracy and easy use model reaching high technology readiness level [Oshima et al...
January 15, 2018: Current Opinion in Clinical Nutrition and Metabolic Care
https://www.readbyqxmd.com/read/29341513/investment-in-epilepsy-monitoring-units-improves-epilepsy-care-experience-in-a-regional-neuroscience-centre
#4
R N McGinty, D J Costello, B McNamara, P Kinirons, B J Sweeney
An evaluation of the clinical yield of inpatient long-term video-EEG (vEEG) in a new epilepsy monitoring unit (EMU) was undertaken, with findings compared to the centre's prior method of bedside vEEG recording in a standard neurology ward, as reported in 2004. A retrospective analysis of neurophysiology reports for all adults who underwent elective vEEG monitoring in the EMU at Cork University Hospital between January 2015 and July 2016 was conducted. Of 115 vEEG studies in the EMU, 100 (87.0%) were deemed diagnostically conclusive, 14 (12...
August 8, 2017: Irish Medical Journal
https://www.readbyqxmd.com/read/29341442/motivating-influences-and-ability-based-outcomes-of-dental-hygiene-baccalaureate-education-in-canada
#5
Z Kanji, D M Laronde
BACKGROUND: There is a scarcity of studies on Canadian baccalaureate dental hygienists. As discussions about baccalaureate education for dental hygiene continue on a national level, examining outcomes of earning a dental hygiene degree is paramount. OBJECTIVE: To investigate the motivating reasons and ability-based outcomes of earning a Bachelor of Dental Science in Dental Hygiene (BDSc) degree from the University of British Columbia (UBC), Canada. METHODS: UBC dental hygiene entry-to-practice (ETP) and degree-completion (DC) graduates (n = 116; 32%) from 1994 to 2016 participated in an online mixed-methods survey...
January 17, 2018: International Journal of Dental Hygiene
https://www.readbyqxmd.com/read/29341373/antibiotic-allergy-labels-the-impact-of-taking-a-clinical-history
#6
Adrienne Torda, Victor Chan
BACKGROUND: Many patients admitted to hospital have an antibiotic allergy (AAL) documented in their medical record. In many of these, the reaction is not a hypersensitivity reaction or may no longer be relevant. Despite this, the label adversely affects patient care directly in terms of antibiotic selection, and indirectly in terms of patient costs and the development of antimicrobial resistance. AIMS: To estimate the prevalence of AALs in a cohort of hospitalised patients, to investigate the feasibility of de-labelling through re-challenge based solely upon clinical grounds...
January 17, 2018: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/29341336/identification-of-perioperative-pulmonary-aspiration-in-children-using-quality-assurance-and-hospital-administrative-billing-data
#7
Lisa Eisler, Grace Huang, Ka-Eun M Lee, Jennifer A Busse, Ming Sun, Albert Y Lin, Lena S Sun, Caleb Ing
BACKGROUND: Perioperative aspiration is a rare but potentially devastating complication, occurring in 1-10 per 10 000 anesthetics based on studies of quality assurance databases. Quality assurance reporting is known to underestimate the incidence of adverse outcomes, but few large studies use supplementary data sources. This study aims to identify the incidence of and risk factors for perioperative aspiration in children using quality assurance data supplemented by administrative billing records, and to examine the utility of billing data as a supplementary data source...
January 17, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29341162/impact-of-genomics-on-the-surgical-management-of-melanoma
#8
REVIEW
P M Ferguson, G V Long, R A Scolyer, J F Thompson
BACKGROUND: Although surgery for early-stage melanoma offers the best chance of cure, recent advances in molecular medicine have revolutionized the management of late-stage melanoma, leading to significant improvements in clinical outcomes. Research into the genomic drivers of disease and cancer immunology has not only ushered in a new era of targeted and immune-based therapies for patients with metastatic melanoma, but has also provided new tools for monitoring disease recurrence and selecting therapeutic strategies...
January 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/29341066/cerebral-near-infrared-spectroscopy-nirs-for-perioperative-monitoring-of-brain-oxygenation-in-children-and-adults
#9
REVIEW
Yun Yu, Kaiying Zhang, Ling Zhang, Huantao Zong, Lingzhong Meng, Ruquan Han
BACKGROUND: Various techniques have been employed for the early detection of perioperative cerebral ischaemia and hypoxia. Cerebral near-infrared spectroscopy (NIRS) is increasingly used in this clinical scenario to monitor brain oxygenation. However, it is unknown whether perioperative cerebral NIRS monitoring and the subsequent treatment strategies are of benefit to patients. OBJECTIVES: To assess the effects of perioperative cerebral NIRS monitoring and corresponding treatment strategies in adults and children, compared with blinded or no cerebral oxygenation monitoring, or cerebral oxygenation monitoring based on non-NIRS technologies, on the detection of cerebral oxygen desaturation events (CDEs), neurological outcomes, non-neurological outcomes and socioeconomic impact (including cost of hospitalization and length of hospital stay)...
January 17, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29340875/thromboelastography-based-anticoagulation-management-during-extracorporeal-membrane-oxygenation-a-safety-and-feasibility-pilot-study
#10
Mauro Panigada, Giacomo E Iapichino, Matteo Brioni, Giovanna Panarello, Alessandro Protti, Giacomo Grasselli, Giovanna Occhipinti, Cristina Novembrino, Dario Consonni, Antonio Arcadipane, Luciano Gattinoni, Antonio Pesenti
BACKGROUND: There is no consensus on the management of anticoagulation during extracorporeal membrane oxygenation (ECMO). ECMO is currently burdened by a high rate of hemostatic complications, possibly associated with inadequate monitoring of heparin anticoagulation. This study aims to assess the safety and feasibility of an anticoagulation protocol for patients undergoing ECMO based on thromboelastography (TEG) as opposed to an activated partial thromboplastin time (aPTT)-based protocol...
January 16, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29340870/a-pilot-evaluation-of-the-rapid-response-program-a-home-based-family-therapy
#11
Laurene Clossey, Steve Simms, Chin Hu, Jeff Hartzell, Phillip Duah, Lynn Daniels
A pilot evaluation study of the implementation of the Rapid Response Program, a program utilizing the ecosystemic structural family therapy model, in a rural area of Pennsylvania was conducted. This approach was implemented in children's mental health to supplant a costly model of care that had not proven to break the cycle of dependency for children with severe behavioral problems and their families. Initial results show that the Rapid Response Program appears to improve problematic family patterns and children's behavioral problems...
January 16, 2018: Community Mental Health Journal
https://www.readbyqxmd.com/read/29340851/comparison-of-antibiotic-dosing-recommendations-for-neonatal-sepsis-from-established-reference-sources
#12
T B Y Liem, E M A Slob, J U M Termote, T F W Wolfs, A C G Egberts, C M A Rademaker
Background Incorrect dosing is the most frequent prescribing error in neonatology, with antibiotics being the most frequently prescribed medicines. Computer physician order entry and clinical decision support systems can create consistency contributing to a reduction of medication errors. Although evidence-based dosing recommendations should be included in such systems, the evidence is not always available and subsequently, dosing recommendations mentioned in guidelines and textbooks are often based on expert opinion...
January 16, 2018: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/29340680/association-of-bariatric-surgery-vs-medical-obesity-treatment-with-long-term-medical-complications-and-obesity-related-comorbidities
#13
Gunn Signe Jakobsen, Milada Cvancarova Småstuen, Rune Sandbu, Njord Nordstrand, Dag Hofsø, Morten Lindberg, Jens Kristoffer Hertel, Jøran Hjelmesæth
Importance: The association of bariatric surgery and specialized medical obesity treatment with beneficial and detrimental outcomes remains uncertain. Objective: To compare changes in obesity-related comorbidities in patients with severe obesity (body mass index ≥40 or ≥35 and at least 1 comorbidity) undergoing bariatric surgery or specialized medical treatment. Design, Setting, and Participants: Cohort study with baseline data of exposures from November 2005 through July 2010 and follow-up data from 2006 until death or through December 2015 at a tertiary care outpatient center, Vestfold Hospital Trust, Norway...
January 16, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29340166/withdrawal-of-antihypertensive-therapy-in-people-with-dementia-feasibility-study
#14
Veronika van der Wardt, Jennifer K Burton, Simon Conroy, Tomas Welsh, Pip Logan, Jaspal Taggar, Lukasz Tanajewski, John Gladman
Background: This study explored the feasibility of a randomised controlled withdrawal trial of antihypertensive medication in normotensive people with dementia. Feasibility aspects included response, recruitment, exclusion and drop-out rates, suitability of outcome measures, acceptability of study procedures and an indicative economic evaluation for a randomised controlled trial. Methods: A cohort study attempting the withdrawal of antihypertensive drugs where appropriate and a feasibility study of home-based blood pressure monitoring, in people with dementia treated for hypertension, was undertaken...
2018: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/29339930/research-evaluation-support-services-in-biomedical-libraries
#15
Karen Elizabeth Gutzman, Michael E Bales, Christopher W Belter, Thane Chambers, Liza Chan, Kristi L Holmes, Ya-Ling Lu, Lisa A Palmer, Rebecca C Reznik-Zellen, Cathy C Sarli, Amy M Suiter, Terrie R Wheeler
Objective: The paper provides a review of current practices related to evaluation support services reported by seven biomedical and research libraries. Methods: A group of seven libraries from the United States and Canada described their experiences with establishing evaluation support services at their libraries. A questionnaire was distributed among the libraries to elicit information as to program development, service and staffing models, campus partnerships, training, products such as tools and reports, and resources used for evaluation support services...
January 2018: Journal of the Medical Library Association: JMLA
https://www.readbyqxmd.com/read/29339660/laparoscopic-surgery-for-gallbladder-cancer-an-expert-consensus-statement
#16
Ho-Seong Han, Yoo-Seok Yoon, Anil K Agarwal, Giulio Belli, Osamu Itano, Andrew A Gumbs, Dong Sup Yoon, Chang Moo Kang, Seung Eun Lee, Toshifumi Wakai, Roberto I Troisi
BACKGROUND: Despite the increasing number of reports on the favorable outcomes of laparoscopic surgery for gallbladder cancer (GBC), there is no consensus regarding this surgical procedure. OBJECTIVE: The study aimed to develop a consensus statement on the application of laparoscopic surgery for GBC based on expert opinions. METHODS: A consensus meeting among experts was held on September 10, 2016, in Seoul, Korea. RESULTS: Early concerns regarding port site/peritoneal metastasis after laparoscopic surgery have been abated by improved preoperative recognition of GBC and careful manipulation to avoid bile spillage...
January 16, 2018: Digestive Surgery
https://www.readbyqxmd.com/read/29339356/kidney-biomarkers-and-decline-in-egfr-in-patients-with-type-2-diabetes
#17
Katherine G Garlo, William B White, George L Bakris, Faiez Zannad, Craig A Wilson, Stuart Kupfer, Muthiah Vaduganathan, David A Morrow, Christopher P Cannon, David M Charytan
BACKGROUND AND OBJECTIVES: Biomarkers may improve identification of individuals at risk of eGFR decline who may benefit from intervention or dialysis planning. However, available biomarkers remain incompletely validated for risk stratification and prediction modeling. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We examined serum cystatin C, urinary kidney injury molecule-1 (uKIM-1), and urinary neutrophil gelatinase-associated lipocalin (UNGAL) in 5367 individuals with type 2 diabetes mellitus and recent acute coronary syndromes enrolled in the Examination of Cardiovascular Outcomes with Alogliptin versus Standard of Care (EXAMINE) trial...
January 16, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29338994/both-patients-and-maternity-care-providers-can-benefit-from-payment-reform-four-steps-to-prepare
#18
Malini A Nijagal, Neel T Shah, Jeff Levin-Scherz
Many Medicaid programs and private health plans are implementing new models of maternity care reimbursement, and clinicians face mounting pressure to demonstrate high quality care at lower cost. Clinicians will be better prepared to meet these challenges with a fuller understanding of new payment models and the opportunities they present. We describe the structure of maternity care "episode payments" and recommend four ways that clinicians can prepare for success as value-based payment models are implemented: identify opportunities to improve outcomes and experience, measure quality, reduce waste and work in teams across settings...
January 12, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29338867/validation-of-a-definition-of-excessive-postoperative-bleeding-in-infants-undergoing-cardiac-surgery-with-cardiopulmonary-bypass
#19
Rachel S Bercovitz, Allison C Shewmake, Debra K Newman, Robert A Niebler, John P Scott, Eckehard Stuth, Pippa M Simpson, Ke Yan, Ronald K Woods
OBJECTIVE: To derive and validate an objective definition of postoperative bleeding in neonates and infants undergoing cardiac surgery with cardiopulmonary bypass. METHODS: Using a retrospective cohort of 124 infants and neonates, we included published bleeding definitions and cumulative chest tube output over different postoperative periods (eg, 2, 12, or 24 hours after intensive care unit admission) in a classification and regression tree model to determine chest tube output volumes that were associated with red blood cell transfusions and surgical re-exploration for bleeding in the first 24 hours after intensive care unit admission...
December 13, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29338852/simulation-based-multidisciplinary-team-training-decreases-time-to-critical-operations-for-trauma-patients
#20
Margaret Murphy, Kate Curtis, Mary K Lam, Cameron S Palmer, Jeremy Hsu, Andrea McCloughen
BACKGROUND: Simulation has been promoted as a platform for training trauma teams. However, it is not clear if this training has an impact on health service delivery and patient outcomes. This study evaluates the association between implementation of a simulation based multidisciplinary trauma team training program at a metropolitan trauma centre and subsequent patient outcomes. METHOD: This was a retrospective review of trauma registry data collected at an 850-bed Level 1 Adult Trauma Centre in Sydney, Australia...
January 8, 2018: Injury
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