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Interrupted Time Series

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https://www.readbyqxmd.com/read/28439716/antipsychotic-prescribing-to-patients-diagnosed-with-dementia-without-a-diagnosis-of-psychosis-in-the-context-of-national-guidance-and-drug-safety-warnings-longitudinal-study-in-uk-general-practice
#1
S Jill Stocks, Evangelos Kontopantelis, Roger T Webb, Anthony J Avery, Alistair Burns, Darren M Ashcroft
INTRODUCTION: Policy interventions to address inappropriate prescribing of antipsychotic drugs to older people diagnosed with dementia are commonplace. In the UK, warnings were issued by the Medicines Healthcare products Regulatory Agency in 2004, 2009 and 2012 and the National Institute for Health and Care Excellence guidance was published in 2006. It is important to evaluate the impact of such interventions. METHODS: We analysed routinely collected primary-care data from 111,346 patients attending one of 689 general practices contributing to the Clinical Practice Research Datalink to describe the temporal changes in the prescribing of antipsychotic drugs to patients aged 65 years or over diagnosed with dementia without a concomitant psychosis diagnosis from 2001 to 2014 using an interrupted time series and a before-and-after design...
April 24, 2017: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/28439002/reading-a-400-000-year-record-of-earthquake-frequency-for-an-intraplate-fault
#2
Randolph T Williams, Laurel B Goodwin, Warren D Sharp, Peter S Mozley
Our understanding of the frequency of large earthquakes at timescales longer than instrumental and historical records is based mostly on paleoseismic studies of fast-moving plate-boundary faults. Similar study of intraplate faults has been limited until now, because intraplate earthquake recurrence intervals are generally long (10s to 100s of thousands of years) relative to conventional paleoseismic records determined by trenching. Long-term variations in the earthquake recurrence intervals of intraplate faults therefore are poorly understood...
April 24, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28437352/effect-and-strategy-of-1-stage-interrupted-2-level-transpedicular-wedge-osteotomy-for-correcting-severe-kyphotic-deformities-in-ankylosing-spondylitis
#3
Yongfei Zhao, Yan Wang, Zheng Wang, Xuesong Zhang, Keya Mao, Yonggang Zhang
STUDY DESIGN: Prospective study. OBJECTIVE: To investigate the safety, outcome, and strategy of the 1-stage interrupted 2-level transpedicular wedge osteotomy for correcting the severe kyphotic deformity in ankylosing spondylitis (AS). SUMMARY OF BACKGROUND DATA: There has been a large series in the literature reporting on results of osteotomy for the correction of kyphotic deformity secondary to AS. However, few articles have reported, in detail, the plan, design, strategy, and effect of 1-stage interrupted 2-level transpedicular wedge osteotomy for the correction of severe kyphotic deformity in AS...
May 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28427353/assessing-the-impact-of-natural-policy-experiments-on-socioeconomic-inequalities-in-health-how-to-apply-commonly-used-quantitative-analytical-methods
#4
Yannan Hu, Frank J van Lenthe, Rasmus Hoffmann, Karen van Hedel, Johan P Mackenbach
BACKGROUND: The scientific evidence-base for policies to tackle health inequalities is limited. Natural policy experiments (NPE) have drawn increasing attention as a means to evaluating the effects of policies on health. Several analytical methods can be used to evaluate the outcomes of NPEs in terms of average population health, but it is unclear whether they can also be used to assess the outcomes of NPEs in terms of health inequalities. The aim of this study therefore was to assess whether, and to demonstrate how, a number of commonly used analytical methods for the evaluation of NPEs can be applied to quantify the effect of policies on health inequalities...
April 20, 2017: BMC Medical Research Methodology
https://www.readbyqxmd.com/read/28421848/an-evaluation-of-a-community-oriented-policing-program-in-taiwan
#5
Shih-Ya Kuo, Yuan-Chin Shih
This study was conducted to evaluate the effect of a community-oriented policing (COP) by documenting results for 16 quantitative outcome variables, including crime incidents, crime clearance, residents' subjective feelings regarding police performance and community safety, and job satisfaction among police officers. The statistical techniques used to analyze the data involved ARIMA interrupted time series, t tests, the Wilcoxon paired signed-rank test, and Pearson's correlation. The quantitative results observed indicated that the program had a positive effect on resident's perceptions for some police performance outcomes and for job satisfaction among police officers...
April 1, 2017: International Journal of Offender Therapy and Comparative Criminology
https://www.readbyqxmd.com/read/28420542/improving-prehospital-trauma-care-in-rwanda-through-continuous-quality-improvement-an-interrupted-time-series-analysis
#6
John W Scott, Jeanne D'Arc Nyinawankusi, Samuel Enumah, Rebecca Maine, Eric Uwitonze, Yihan Hu, Ignace Kabagema, Jean Claude Byiringiro, Robert Riviello, Sudha Jayaraman
INTRODUCTION: Injury is a major cause of premature death and disability in East Africa, and high-quality pre-hospital care is essential for optimal trauma outcomes. The Rwandan pre-hospital emergency care service (SAMU) uses an electronic database to evaluate and optimize pre-hospital care through a continuous quality improvement programme (CQIP), beginning March 2014. MATERIALS AND METHODS: The SAMU database was used to assess pre-hospital quality metrics including supplementary oxygen for hypoxia (O2), intravenous fluids for hypotension (IVF), cervical collar placement for head injuries (c-collar), and either splinting (splint) or administration of pain medications (pain) for long bone fractures...
April 5, 2017: Injury
https://www.readbyqxmd.com/read/28418449/association-of-a-communication-training-program-with-use-of-antipsychotics-in-nursing-homes
#7
Jennifer Tjia, Jacob N Hunnicutt, Laurie Herndon, Carolyn R Blanks, Kate L Lapane, Susan Wehry
Importance: Off-label antipsychotic prescribing in nursing homes (NHs) is common and is associated with increased risk of mortality in older adults. Prior large-scale, controlled trials in the NH setting failed to show meaningful reductions in antipsychotic use. Objective: To quantify the influence of a large-scale communication training program on NH antipsychotic use called OASIS. Design, Setting, and Participants: This investigation was a quasi-experimental longitudinal study of NHs in Massachusetts enrolled in the OASIS intervention...
April 17, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28404485/state-level-gonorrhea-rates-and-expedited-partner-therapy-laws-insights-from-time-series-analyses
#8
K Owusu-Edusei, R Cramer, H W Chesson, T L Gift, J S Leichliter
OBJECTIVE: In this study, we examined state-level monthly gonorrhea morbidity and assessed the potential impact of existing expedited partner therapy (EPT) laws in relation to the time that the laws were enacted. STUDY DESIGN: Longitudinal study. METHODS: We obtained state-level monthly gonorrhea morbidity (number of cases/100,000 for males, females and total) from the national surveillance data. We used visual examination (of morbidity trends) and an autoregressive time series model in a panel format with intervention (interrupted time series) analysis to assess the impact of state EPT laws based on the months in which the laws were enacted...
March 24, 2017: Public Health
https://www.readbyqxmd.com/read/28402420/the-effect-of-health-insurance-and-health-facility-upgrades-on-hospital-deliveries-in-rural-nigeria-a-controlled-interrupted-time-series-study
#9
Daniëlla Brals, Sunday A Aderibigbe, Ferdinand W Wit, Johannes C M van Ophem, Marijn van der List, Gordon K Osagbemi, Marleen E Hendriks, Tanimola M Akande, Michael Boele van Hensbroek, Constance Schultsz
Background : Access to quality obstetric care is considered essential to reducing maternal and new-born mortality. We evaluated the effect of the introduction of a multifaceted voluntary health insurance programme on hospital deliveries in rural Nigeria. Methods : We used an interrupted time-series design, including a control group. The intervention consisted of providing voluntary health insurance covering primary and secondary healthcare, including antenatal and obstetric care, combined with improving the quality of healthcare facilities...
April 11, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/28401116/implementation-of-an-intervention-to-reduce-population-based-screening-for-vitamin-d-deficiency-a-cross-sectional-study
#10
Christopher Naugler, Brenda Hemmelgarn, Hude Quan, Fiona Clement, Tolulope Sajobi, Roger Thomas, Tanvir C Turin, William Hnydyk, Alex Chin, James Wesenberg
BACKGROUND: We describe the implementation of an intervention in Alberta in support of the Choosing Wisely Canada recommendation against population screening for vitamin D deficiency (as determined by serum total 25-hydroxyvitamin D testing). We hypothesized that the introduction of a specialized requisition for vitamin D testing would reduce the annual number of vitamin D tests performed. METHODS: We performed a cross-sectional observational study that included all vitamin D tests ordered in Alberta between Apr...
January 2017: CMAJ Open
https://www.readbyqxmd.com/read/28397317/evaluating-the-effectiveness-of-risk-minimisation-measures-the-application-of-a-conceptual-framework-to-danish-real-world-dabigatran-data
#11
REVIEW
Martin Erik Nyeland, Mona Vestergaard Laursen, Torbjörn Callréus
PURPOSE: For both marketing authorization holders and regulatory authorities, evaluating the effectiveness of risk minimization measures is now an integral part of pharmacovigilance in the European Union. The overall aim of activities in this area is to assess the performance of risk minimization measures implemented in order to ensure a positive benefit-risk balance in patients treated with a medicinal product. METHODS: Following a review of the relevant literature, we developed a conceptual framework consisting of four domains (data, knowledge, behaviour and outcomes) intended for the evaluation of risk minimization measures put into practice in the Danish health-care system...
April 11, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28395006/association-between-hospitals-engagement-in-value-based-reforms-and-readmission-reduction-in-the-hospital-readmission-reduction-program
#12
Andrew M Ryan, Sam Krinsky, Julia Adler-Milstein, Cheryl L Damberg, Kristin A Maurer, John M Hollingsworth
Importance: Medicare is experimenting with numerous concurrent reforms aimed at improving quality and value for hospitals. It is unclear if these myriad reforms are mutually reinforcing or in conflict with each other. Objective: To evaluate whether hospital participation in voluntary value-based reforms was associated with greater improvement under Medicare's Hospital Readmission Reduction Program (HRRP). Design, Setting, and Participants: Retrospective, longitudinal study using publicly available national data from Hospital Compare on hospital readmissions for 2837 hospitals from 2008 to 2015...
April 10, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28393903/medium-term-impact-of-the-economic-crisis-on-mortality-health-related-behaviours-and-access-to-healthcare-in-greece
#13
Filippos T Filippidis, Vasiliki Gerovasili, Christopher Millett, Yannis Tountas
Previous studies on the health consequences of the crisis in Greece investigated short-term impacts on selected outcomes. This study examined the impact of the crisis on a key set of health indicators with longer follow up than previous studies. We conducted interrupted time series (ITS) analysis to compare trends in standardised mortality by cause before and during the crisis. We examined changes in fruit and vegetable consumption, smoking, physical activity, obesity, out-of-pocket payments and unmet needs for healthcare using national household data from the "Hellas Health" surveys...
April 10, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28385026/scaling-lean-in-primary-care-impacts-on-system-performance
#14
Dorothy Y Hung, Michael I Harrison, Meghan C Martinez, Harold S Luft
OBJECTIVES: We examined a wide range of performance outcomes after Lean methodology-a leading strategy to enhance efficiency and patient value-was implemented and scaled across all primary care clinics in a nonprofit, ambulatory care delivery system. STUDY DESIGN: Using a stepped wedge approach, we assessed changes associated with the phased introduction of Lean-based redesigns across 46 primary care departments in 17 different clinic locations. Longitudinal analysis of operational metrics included: workflow efficiency, physician productivity, operating expenses, clinical quality, and satisfaction among patients, physicians, and staff...
March 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28372641/the-impact-of-safety-regulations-on-the-incidence-of-upper-extremity-power-saw-injuries-in-the-united-states
#15
Michael M Vosbikian, Carl M Harper, Ashlyn Byers, Adva Gutman, Victor Novack, Matthew L Iorio
PURPOSE: Over 50,000 power saw-related injuries occur annually in the United States. Numerous safety measures have been implemented to protect the users of these tools. This study was designed to determine which interventions, if any, have had a positive impact on the safety of the consumer or laborer. METHODS: We queried the National Electronic Injury Surveillance System database for hand and upper-extremity injuries attributed to power saws from 1997 to 2014. Demographic information including age, sex, date of injury, device, location, body part involved, diagnosis, and disposition was recorded...
April 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28370541/a-prospective-study-of-elderly-initiating-mirabegron-versus-antimuscarinics-patient-reported-outcomes-from-the-overactive-bladder-satisfaction-scales-and-other-instruments
#16
Suvapun Bunniran, Cralen Davis, Rita Kristy, Daniel Ng, Carol R Schermer, Claudia Uribe, Brandon T Suehs
AIMS: To understand differences in patient reported outcomes (PRO) between patients initiating mirabegron or an antimuscarinic using a validated PRO instrument, OAB-Satisfaction (OAB-S). METHODS: This prospective observational study used real-time prescription claims from Humana to identify Medicare patients initiating mirabegron or an antimuscarinic to participate in a series of three phone surveys over ninety days. RESULTS: A total of 1897 mirabegron and 2444 randomly selected antimuscarinic initiators were identified; 174 mirabegron and 193 antimuscarinic initiators completed all three surveys...
March 31, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28369387/resurgence-of-malaria-following-discontinuation-of-indoor-residual-spraying-of-insecticide-in-a-previously-high-transmission-intensity-area-of-uganda
#17
Saned Raouf, Arthur Mpimbaza, Ruth Kigozi, Asadu Sserwanga, Denis Rubahika, Henry Katamba, Steve W Lindsay, Bryan K Kapella, Kassahun A Belay, Moses R Kamya, Sarah G Staedke, Grant Dorsey
Background: Indoor residual spraying (IRS) and long-lasting insecticidal nets (LLINs) are the primary tools for malaria prevention in Africa. It is not known whether reductions in malaria can be sustained after IRS is discontinued. The aim of this study was to assess changes in malaria morbidity in a historically high transmission area of Uganda where IRS was discontinued after a four-year period of effective control followed by a universal LLIN distribution campaign. Methods: Individual-level malaria surveillance data were collected from one outpatient department and one inpatient setting in Apac District, Uganda from July 2009 through November 2015...
March 24, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28368951/effects-of-a-laboratory-health-information-exchange-intervention-on-antiretroviral-therapy-use-viral-suppression-and-racial-ethnic-disparities
#18
William E Cunningham, Chandra L Ford, Janni J Kinsler, Danielle Seiden, Laral Andrews, Terry Nakazono, Douglas S Bell
BACKGROUND: Although antiretroviral therapy (ART) is available to treat HIV+ persons and prevent transmission, ineffective delivery of care may delay ART use, impede viral suppression (VS) and contribute to racial/ethnic disparities along the continuum of care. This study tested the effects of a bi-directional laboratory health information exchange (LHIE) intervention on each of these outcomes. METHODS: We used a quasi-experimental, interrupted time series design to examine whether the LHIE intervention improved ART use and VS, and reduced racial/ethnic disparities in these outcomes among HIV+ patients (N=1,181) in a comprehensive HIV/AIDS clinic in Southern California...
March 25, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28368550/home-or-foster-home-care-versus-institutional-long-term-care-for-functionally-dependent-older-people
#19
REVIEW
Camilla Young, Amanda M Hall, Daniela C Gonçalves-Bradley, Terry J Quinn, Lotty Hooft, Barbara C van Munster, David J Stott
BACKGROUND: Changing population demographics have led to an increasing number of functionally dependent older people who require care and medical treatment. In many countries, government policy aims to shift resources into the community from institutional care settings with the expectation that this will reduce costs and improve the quality of care compared. OBJECTIVES: To assess the effects of long-term home or foster home care versus institutional care for functionally dependent older people...
April 3, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28365306/quasi-experimental-study-designs-series-paper-7-assessing-the-assumptions
#20
Till Bärnighausen, Catherine Oldenburg, Peter Tugwell, Christian Bommer, Cara Ebert, Mauricio Barreto, Eric Djimeu, Noah Haber, Hugh Waddington, Peter Rockers, Barbara Sianesi, Jacob Bor, Günther Fink, Jeffrey Valentine, Jeffrey Tanner, Tom Stanley, Eduardo Sierra, Eric Tchetgen Tchetgen, Rifat Atun, Sebastian Vollmer
Quasi-experimental designs are gaining popularity in epidemiology and health systems research - in particular for the evaluation of healthcare practice, programs and policy - because they allow strong causal inferences without randomized controlled experiments. We describe the concepts underlying five important quasi-experimental designs: Instrumental Variables, Regression Discontinuity, Interrupted Time Series, Fixed Effects, and Difference-in-Differences designs. We illustrate each of the designs with an example from health research...
March 29, 2017: Journal of Clinical Epidemiology
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