MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'Journal of Evaluation in Clinical Practice' source. Wed, 08 Feb 2012 18:50:25 +0100 http://www.medworm.com/index.php?rid=5668397&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01768.x AbstractThe regression discontinuity (RD) design is considered to be the closest to a randomized trial that can be applied in non‐experimental settings. The design relies on a cut‐off point on a continuous baseline variable to assign individuals to treatment. The individuals just to the right and left of the cut‐off are assumed to be exchangeable – as in a randomized trial. Any observed discontinuity in the relationship between the assignment variable and outcome is therefore considered evidence of a treatment effect. In this paper, we describe key advances in the RD design over the past decade and illustrate their implementation using data from a health management intervention. We then introduce the propensity score‐based weighting technique as a complement to the RD design to c... Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5668397 Sun, 05 Feb 2012 05:00:00 +0100 5668397 http://www.medworm.com/index.php?rid=5668396&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01803.x Conclusion  Over all three of the data collection periods adherence to effectively applied management of asthma guidelines proved to be below the minimum recommended clinical evaluation work‐up as set out by the Expert Panel Report 3 (EPR3) of the National Asthma Education and Prevention Program (NAEPP). Applying a greater focus on essential outcomes through different disease management documents resulted in an improved quality of managed care, but still requires dedicated and continuous education and motivation. (NWU‐0052‐08‐A5) (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5668396 Sun, 05 Feb 2012 05:00:00 +0100 5668396 http://www.medworm.com/index.php?rid=5668395&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01806.x Conclusion  Although most out‐of‐hours care patients present non‐urgent health problems, at the ED they are more likely to receive diagnostic tests and follow‐up contacts. This may reflect differences in patient populations between the ED and GPC or suggest opportunities for improving efficiency of planning follow‐up contacts. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5668395 Sun, 05 Feb 2012 05:00:00 +0100 5668395 http://www.medworm.com/index.php?rid=5668394&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01814.x Conclusion  Herpes zoster vaccination rate significantly improved with implementation of a web‐based clinical decision support system. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5668394 Sun, 05 Feb 2012 05:00:00 +0100 5668394 http://www.medworm.com/index.php?rid=5668393&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01816.x Conclusions  The VA National Quality Scholars program continues to nurture and develop leaders for the new millennium focusing on interprofessional education. The nations' health care systems need strong interdisciplinary leaders in advanced quality improvement science who are dedicated to improving the overall quality of health and health care. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5668393 Wed, 01 Feb 2012 05:00:00 +0100 5668393 http://www.medworm.com/index.php?rid=5561646&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01792.x AbstractBackground  Everyone wants a sustainable well‐functioning health system. However, this notion has different meaning to policy makers and funders compared to clinicians and patients. The former perceive public policy and economic constraints, the latter clinical or patient‐centred strategies as the means to achieving a desired outcome.Design  Theoretical development and critical analysis of a complex health system model.Results and conclusions  We introduce the concept of the health care vortex as a metaphor by which to understand the complex adaptive nature of health systems, and the degree to which their behaviour is predetermined by their ‘shared values’ or attractors. We contrast the likely functions and outcomes of a health system with a people‐centred attractor... Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5561646 Thu, 05 Jan 2012 23:35:19 +0100 5561646 http://www.medworm.com/index.php?rid=5561645&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01789.x AbstractIt is the ‘moral compass’, however subtle, that underpins leadership. Leadership, meaning showing the way, demands as much conviction as gentile diplomacy in the discourse with supporters and detractors. In particular, leadership defends the goal by safeguarding its principles from its detractors. The authors writing in the Forum on Complexity in Medicine and Healthcare since its inception are leaders in an intellectual transition to complex systems thinking in medicine and health. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5561645 Thu, 05 Jan 2012 23:35:14 +0100 5561645 http://www.medworm.com/index.php?rid=5561644&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01813.x (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5561644 Thu, 05 Jan 2012 23:35:08 +0100 5561644 http://www.medworm.com/index.php?rid=5561643&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01796.x (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5561643 Thu, 05 Jan 2012 23:35:05 +0100 5561643 http://www.medworm.com/index.php?rid=5561642&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01794.x (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5561642 Thu, 05 Jan 2012 23:35:03 +0100 5561642 http://www.medworm.com/index.php?rid=5561641&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01815.x (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5561641 Thu, 05 Jan 2012 23:34:24 +0100 5561641 http://www.medworm.com/index.php?rid=5506505&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01785.x Conclusions  Primary care doctors are aware of the need to estimate a global cardiovascular risk, recognize the usefulness of the tables but find problems in their practical application. In order to make their application feasible, tables should be simplified and unified, and their format should be improved. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5506505 Fri, 16 Dec 2011 05:00:00 +0100 5506505 http://www.medworm.com/index.php?rid=5506506&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01791.x Conclusion  Initial development of research relied heavily upon a centralized network involving external collaboration; a central position of the research director during research development was not important. Changes in collaboration depended upon faculty gender and tenure track as well as transitivity and the ‘popularity of PIs’. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5506506 Wed, 14 Dec 2011 05:00:00 +0100 5506506 http://www.medworm.com/index.php?rid=5506507&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01807.x Conclusion  The evidence‐ and consensus‐based method suggested for the development of nutrition management guidelines for IMDs will result in the production of consistent and accessible guidelines that can be created in a timely and cost‐effective manner and offer a validated methodology to develop management guidelines for this field to optimize outcomes. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5506507 Tue, 13 Dec 2011 05:00:00 +0100 5506507 http://www.medworm.com/index.php?rid=5506509&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01799.x Conclusion  FMECA is a useful approach to improve the medication process. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5506509 Mon, 12 Dec 2011 05:00:00 +0100 5506509 http://www.medworm.com/index.php?rid=5506508&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01812.x (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5506508 Mon, 12 Dec 2011 05:00:00 +0100 5506508 http://www.medworm.com/index.php?rid=5470076&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01779.x Conclusion  Predicted intra‐operative blood loss was within 500 mL of measured blood loss in 89% of operations. In 30% of patients who ultimately receive a blood transfusion, both the surgeon and anaesthetist significantly underestimate the risk of blood loss by greater than 500 mL. Theatre staff must be aware that 1 in 14 patients undergoing intermediate or major surgery will have an unexpected blood loss exceeding 500 mL and so robust policies to identify and manage such circumstances should be in place to improve patient safety. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5470076 Fri, 02 Dec 2011 05:00:00 +0100 5470076 http://www.medworm.com/index.php?rid=5470075&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01805.x Conclusions  This study demonstrated that COPD chronic care management has the potential to improve outcomes of care; heterogeneity in outcomes was explained. Further research is needed to elucidate the diversity between COPD chronic care management studies in terms of the effects measured and strengthen the support for chronic care management. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5470075 Fri, 02 Dec 2011 05:00:00 +0100 5470075 http://www.medworm.com/index.php?rid=5470074&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01809.x Conclusions  Racial disparities in DES use initially disappeared during a period of rapid diffusion and high usage rates; the reappearance of disparities in use by 2007 may reflect DES use tailored to unmeasured aspects of case mix and socio‐economic status. Further work is needed to understand whether underlying differences in race reflect decisions regarding treatment appropriateness. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5470074 Fri, 02 Dec 2011 05:00:00 +0100 5470074 http://www.medworm.com/index.php?rid=5553148&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01798.x Conclusion  The main purpose of the MDD system is to increase patient safety by reducing medication errors. However, this study shows that prescribing and transcribing errors frequently occur when patients are hospitalized. Because the population enrolled in the MDD system is an elderly, physically vulnerable group with a high number of prescribed drugs, preventive measures to ensure safe prescribing of MDD drugs are warranted. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5553148 Thu, 01 Dec 2011 05:00:00 +0100 5553148 http://www.medworm.com/index.php?rid=5516192&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01790.x Conclusion  As the nature of complexity offers no one single ultimate solution, the paper concludes that, for operationalizing the insights received from complexity science into their day‐to‐day work, practitioners in health care and other domains need to address a range of challenges that are outlined in the paper. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5516192 Thu, 01 Dec 2011 05:00:00 +0100 5516192 http://www.medworm.com/index.php?rid=5506504&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01797.x Conclusion and practice implications  A group‐based programme using PBL seems to facilitate adaptive and developmental learning and result in acceptable CPAP adherence levels. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5506504 Thu, 01 Dec 2011 05:00:00 +0100 5506504 http://www.medworm.com/index.php?rid=5470073&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01808.x Conclusions  We developed an Internet‐based blended learning programme providing core competency in clinical research. Most busy health care professionals completed the programme successfully. In addition, the participants could attain the core competency effectively, regardless of their occupation. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5470073 Thu, 01 Dec 2011 05:00:00 +0100 5470073 http://www.medworm.com/index.php?rid=5459223&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01811.x Conclusions  There is a weak positive attitude of physical therapists, teachers, supervisors and students towards participating in research in general practice, but there is a lack of knowledge and active behaviour regarding EBM, especially among physical therapy students. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5459223 Thu, 01 Dec 2011 05:00:00 +0100 5459223 http://www.medworm.com/index.php?rid=5459228&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01800.x Conclusion  The SF‐12v2 was valid, reliable and sensitive for the Chinese. It is an equivalent substitute for the SF‐36v2 for the summary scales. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5459228 Tue, 29 Nov 2011 05:00:00 +0100 5459228 http://www.medworm.com/index.php?rid=5459227&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01801.x Conclusions  Feedback interventions reported to date, even when results are positive, often fail to include concepts of behaviour change. This may partially explain the large variation in approaches and in results of such interventions and presents major challenges for replicating any given intervention. If feedback processes are to be successfully used and disseminated and implemented widely, some standardization and certainly more clarity is needed in the specific action steps taken to apply behavioural theory to practice. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5459227 Tue, 29 Nov 2011 05:00:00 +0100 5459227 http://www.medworm.com/index.php?rid=5459226&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01802.x Conclusion  Efforts should be made to improve causal inference of treatment effects from observational studies found in secondary data sources. Extra care and caution should be exercised in the interpretation and reporting of results from these studies. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5459226 Tue, 29 Nov 2011 05:00:00 +0100 5459226 http://www.medworm.com/index.php?rid=5459225&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01804.x Conclusions  Data from electronic patient entries complemented with data of the operable condition can be used for defining the optimal operation time with regard to the pre‐operative condition of the patients. The implication of prolonged waiting times was not very profound, but elderly patients benefit from a short waiting time. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5459225 Tue, 29 Nov 2011 05:00:00 +0100 5459225 http://www.medworm.com/index.php?rid=5459224&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01810.x Conclusion  Effective interventions to align practice with evidence rely on identifying and addressing barriers to practice change. The barriers identified in this study may be useful for those designing similar clinical practice improvement projects, as well as for continued efforts to improve practice in the SEA‐ORCHID hospitals. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5459224 Tue, 29 Nov 2011 05:00:00 +0100 5459224 http://www.medworm.com/index.php?rid=5442794&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01776.x Conclusion  The results provided stage and site‐specific estimations of the direct medical costs of CRN in a Chinese population that can assist policy decision making and facilitate health care service planning and cost‐effectiveness evaluations. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5442794 Fri, 25 Nov 2011 12:01:12 +0100 5442794 http://www.medworm.com/index.php?rid=5432686&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01795.x ConclusionTherefore, the protocols from various clinicians that serve to sustain the reliability claim of the ‘scientific’ Diagnostic Statistical Manual of Mental Disorders cannot be regarded as independent measurements of the cognitive content and value of the psychological rating scales or vice versa. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5432686 Tue, 22 Nov 2011 11:58:19 +0100 5432686 http://www.medworm.com/index.php?rid=5432687&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01777.x Conclusions  Several themes were identified that shaped clinicians' views. Results were sufficiently clear to permit recommendations for the form and content of standard reports for the National Health Service. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5432687 Sun, 20 Nov 2011 05:00:00 +0100 5432687 http://www.medworm.com/index.php?rid=5389342&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01793.x (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5389342 Thu, 10 Nov 2011 13:08:48 +0100 5389342 http://www.medworm.com/index.php?rid=5389338&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01773.x Conclusions  Less than one in four readmissions were deemed avoidable. Health system planners need to use caution in interpreting all cause readmission statistics as they are only partially influenced by quality of care. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5389338 Thu, 10 Nov 2011 13:04:36 +0100 5389338 http://www.medworm.com/index.php?rid=5389339&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01763.x Conclusions  While it is necessary to review reported incident data and disseminate the educational messages for the improvement of quality, this traditional risk management process is inadequate on its own. Reporting systems can be enhanced by collective examination of reported information about medicines by local clinical teams. We identified a strong message from the focus groups for learning about each other and from each other, and that the method piloted may be an important inter‐professional mechanism for improvement. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5389339 Wed, 09 Nov 2011 05:00:00 +0100 5389339 http://www.medworm.com/index.php?rid=5389341&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01769.x Conclusions  This study points up the lack of organizational structure fostering uniform knowledge translation across all clinicians, although the managers expect it to happen in the near future or would like to see it in an ideal world. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5389341 Tue, 01 Nov 2011 04:00:00 +0100 5389341 http://www.medworm.com/index.php?rid=5389340&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01788.x Conclusion  The community health facilities are not able to fulfil their designated mission because of the limited diagnostic capacity and poor competency of the primary care practitioners. Priorities should be given to capacity building for the development of community health services in the future. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5389340 Tue, 01 Nov 2011 04:00:00 +0100 5389340 http://www.medworm.com/index.php?rid=5363216&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01775.x Conclusions  Doctor attitudes and hospital organization are still among the most common reasons for inappropriate in‐hospital days of care. Monitoring whether the length of stay is appropriate combined with protocol interventions for scheduling of diagnosis, treatment and discharge are likely to improve efficiency in this area of medical care. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5363216 Wed, 26 Oct 2011 04:00:00 +0100 5363216 http://www.medworm.com/index.php?rid=5363215&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01778.x Conclusions  The CPPQ‐Mohedo questionnaire presented discriminating power in men and women with symptoms of CPP. This questionnaire may be used as a screening tool to identify patients and include them in treatment programmes, as an outcome assessment tool for treatment and clinical trials, or as a tool to assess the prevalence of CPP in epidemiologic studies. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5363215 Wed, 26 Oct 2011 04:00:00 +0100 5363215 http://www.medworm.com/index.php?rid=5363214&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01780.x Conclusion  Clinical practice was improved by a tailored multi‐modal approach. Educating staff, improving communication and documentation, and re‐audit has shown significant improvement. However, further improvements are required to reach best practice. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5363214 Wed, 26 Oct 2011 04:00:00 +0100 5363214 http://www.medworm.com/index.php?rid=5363213&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01781.x Conclusion  These findings suggest that experienced clinical psychologists and students are likely to use newly learned causal knowledge in a normative, rational way in diagnostic reasoning. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5363213 Wed, 26 Oct 2011 04:00:00 +0100 5363213 http://www.medworm.com/index.php?rid=5363212&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01782.x Conclusion  The results of the three trials underscore the need to reinvest in nurse‐led HPDP interventions in home care to optimize HRQOL and promote ageing in place in the target population of frail older adults. More studies are needed to evaluate the effectiveness of additional nurse‐led HPDP interventions in other contexts and settings. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5363212 Wed, 26 Oct 2011 04:00:00 +0100 5363212 http://www.medworm.com/index.php?rid=5363211&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01783.x Conclusion  These findings suggest that there are several measures that could be taken to improve the patient's surgical experience. In particular, providing appropriate information to patients in a timely manner and ensuring that support and advice is easily accessible for those patients that need it are key areas for improvement. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5363211 Wed, 26 Oct 2011 04:00:00 +0100 5363211 http://www.medworm.com/index.php?rid=5363210&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01786.x Conclusions  This cost per fall estimate was substantially lower than three previous internationally derived estimates possibly as a consequence of how fall data were collected and modelled in these studies. Cost of falls per person may be a preferable statistic for future use. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5363210 Wed, 26 Oct 2011 04:00:00 +0100 5363210 http://www.medworm.com/index.php?rid=5363209&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01787.x Conclusions  Strategies aimed at addressing operating theatre delays are unlikely to achieve their desired aims without a more detailed understanding of medical decision making and work practices, and the intra‐ as well as inter‐professional hierarchies underpinning them. While the nature of surgical work poses some challenges for measures designed to address delays, it is also necessary to focus on surgical practice in devising workable solutions. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5363209 Wed, 26 Oct 2011 04:00:00 +0100 5363209 http://www.medworm.com/index.php?rid=5324849&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01770.x Conclusion  This study reflected substantial flaws in CINV prophylaxis practice in Lebanon which should alert health care professionals of the adverse consequences resulting from non‐adherence to guidelines. Our study also highlighted areas for improvement and suggested recommendations in order to minimize patient risk and optimize safe and effective CINV management. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5324849 Mon, 17 Oct 2011 04:00:00 +0100 5324849 http://www.medworm.com/index.php?rid=5324848&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01771.x Conclusions  Using a cognitive approach, we describe the basis of medical error, with particular emphasis on diagnostic error. We then propose a conceptual scheme of the diagnostic process by the use of fuzzy cognitive maps. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5324848 Mon, 17 Oct 2011 04:00:00 +0100 5324848 http://www.medworm.com/index.php?rid=5363208&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01784.x Conclusions  Cost‐effective treatment modalities such as SCS and EECP are valuable additions to medical and revascularization therapy in patients with refractory angina pectoris. Pre‐existing conditions and the patient's preferences should be taken in consideration when clinicians choose between treatments for this group of patients. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5363208 Sat, 01 Oct 2011 04:00:00 +0100 5363208 http://www.medworm.com/index.php?rid=5324847&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01772.x Conclusions  Delayed transmission or absence of a discharge summary is associated with readmission of the patient; more so in patients less than 80 years old. If no summary is generated by 7 days after discharge, the rate of readmission within 7 or 28 days after discharge is indistinguishable from no summary being written at all. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5324847 Sat, 01 Oct 2011 04:00:00 +0100 5324847 http://www.medworm.com/index.php?rid=5262332&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01767.x Conclusion  Our study provides an updated epidemiological indication of possible errors in the CVD risk algorithms of many clinical guidelines. If our findings are generalizable, clinical and public health recommendations regarding the ‘dangers’ of cholesterol should be revised. This is especially true for women, for whom moderately elevated cholesterol (by current standards) may prove to be not only harmless but even beneficial. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5262332 Thu, 29 Sep 2011 12:31:43 +0100 5262332 http://www.medworm.com/index.php?rid=5251802&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01745.x (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5251802 Sun, 25 Sep 2011 23:58:43 +0100 5251802 http://www.medworm.com/index.php?rid=5251801&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01741.x (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5251801 Sun, 25 Sep 2011 23:58:41 +0100 5251801 http://www.medworm.com/index.php?rid=5251800&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01740.x (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5251800 Sun, 25 Sep 2011 23:58:40 +0100 5251800 http://www.medworm.com/index.php?rid=5251799&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01739.x (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5251799 Sun, 25 Sep 2011 23:58:38 +0100 5251799 http://www.medworm.com/index.php?rid=5251798&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01738.x (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5251798 Sun, 25 Sep 2011 23:58:36 +0100 5251798 http://www.medworm.com/index.php?rid=5251797&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01737.x (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5251797 Sun, 25 Sep 2011 23:58:35 +0100 5251797 http://www.medworm.com/index.php?rid=5251796&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01736.x (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5251796 Sun, 25 Sep 2011 23:58:33 +0100 5251796 http://www.medworm.com/index.php?rid=5251795&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01744.x (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5251795 Sun, 25 Sep 2011 23:58:31 +0100 5251795 http://www.medworm.com/index.php?rid=5251794&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01735.x (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5251794 Sun, 25 Sep 2011 23:58:30 +0100 5251794 http://www.medworm.com/index.php?rid=5251793&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01734.x (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5251793 Sun, 25 Sep 2011 23:58:28 +0100 5251793 http://www.medworm.com/index.php?rid=5251792&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01733.x (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5251792 Sun, 25 Sep 2011 23:58:26 +0100 5251792 http://www.medworm.com/index.php?rid=5251791&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01732.x (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5251791 Sun, 25 Sep 2011 23:58:25 +0100 5251791 http://www.medworm.com/index.php?rid=5251790&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01750.x AbstractThere are strong arguments in favour of the need for more ‘empirically informed philosophy’. Using papers in the current issue of JECP as case studies, I raise fundamental and unresolved methodological questions about the proper relationship between philosophy and empirical research, in particular concerning the relationship between ‘data’ in empirical research and the ‘responses’ people give in to questions in the process of philosophical dialogue. There are tensions between the role of data in empirical research and the critical stance required for philosophy that need to be addressed, if empirically informed philosophy is to make a serious and substantial contribution to our thinking about the matters of great import it addresses. (Source: Journal of Evaluation in Cl... Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5251790 Sun, 25 Sep 2011 23:58:23 +0100 5251790 http://www.medworm.com/index.php?rid=5251789&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01742.x (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5251789 Sun, 25 Sep 2011 23:58:18 +0100 5251789 http://www.medworm.com/index.php?rid=5251788&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01746.x (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5251788 Sun, 25 Sep 2011 23:58:15 +0100 5251788 http://www.medworm.com/index.php?rid=5251787&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01729.x (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5251787 Sun, 25 Sep 2011 23:58:13 +0100 5251787 http://www.medworm.com/index.php?rid=5251786&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01749.x (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5251786 Sun, 25 Sep 2011 23:58:03 +0100 5251786 http://www.medworm.com/index.php?rid=5251785&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01748.x (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5251785 Sun, 25 Sep 2011 23:57:44 +0100 5251785 http://www.medworm.com/index.php?rid=5251784&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01774.x (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5251784 Sun, 25 Sep 2011 23:57:42 +0100 5251784 http://www.medworm.com/index.php?rid=5227722&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01755.x Discussion  EHR adoption rates and participation in HIE are higher among New York hospitals than hospitals nationwide, suggesting that state initiatives funding community EHR implementation may influence these efforts by hospitals. However, overall rates of adoption and preparedness to meet meaningful use remain low. Direct support for hospitals, such as that provided through the national EHR Incentive Program, will likely be critical for rates of EHR adoption and HIE to significantly rise, even in advanced states. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5227722 Tue, 13 Sep 2011 04:00:00 +0100 5227722 http://www.medworm.com/index.php?rid=5227721&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01759.x Conclusions  We believe that patient safety and welfare can benefit from the adoption of a more flexible and person‐centred approach to how risk assessments are carried out. Enriching formal guidelines such as the ‘Risk Assessment made easy’ document with successful techniques and strategies which healthcare staff have informally developed has the potential to not only improve patient safety (since it will be based on the accumulated experience and knowledge of such staff) but also foster higher levels of self esteem amongst healthcare professionals. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5227721 Tue, 13 Sep 2011 04:00:00 +0100 5227721 http://www.medworm.com/index.php?rid=5185338&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01752.x Conclusions  In community‐treated patients with PNP, total costs were considerably less for those patients initiated with pregabalin therapy than for those patients starting gabapentin add‐on therapy. The relatively higher treatment acquisition cost of pregabalin was largely compensated by the overall lower costs for the other components of health care resources and sick leave, thus reducing the economic impact on the health care provider's budget and society. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5185338 Mon, 29 Aug 2011 23:00:00 +0100 5185338 http://www.medworm.com/index.php?rid=5164044&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01758.x Conclusions  The MAI is the most convincing tool in evaluating medication appropriateness, but is very time consuming to apply. Beers' criteria 2003 and the IPET perform to an acceptable standard within the clinical setting and are more practical in their application. The HEDIS, although simplest to apply, does not have the sensitivity to measure change in appropriateness over time. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5164044 Tue, 23 Aug 2011 23:00:00 +0100 5164044 http://www.medworm.com/index.php?rid=5164051&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01751.x Conclusions  At present, the most appropriate data collection method for conducting post‐introduction observation of new technologies is the use of prospective clinical registries. Electronic clinical records may replace clinical registries in the near future, but currently there are still many doubts as to the quality of the information retrieved. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5164051 Mon, 22 Aug 2011 23:00:00 +0100 5164051 http://www.medworm.com/index.php?rid=5164050&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01754.x Conclusion  The waiting time of VTI for children with otitis media with effusion (OME) has not been shortened after the increase in VTI payment. Waiting time in private hospitals is shorter than that in public hospitals. Increased payment for VTI has no effect on the physicians' decision making regarding to waiting time for children with OME in Taiwan. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5164050 Mon, 22 Aug 2011 23:00:00 +0100 5164050 http://www.medworm.com/index.php?rid=5164049&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01756.x Conclusion  This study provides groundwork for understanding the facilitators and barriers to provider satisfaction after the transition between EHRs and provides insight into areas requiring attention by entities undergoing similar transitions. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5164049 Mon, 22 Aug 2011 23:00:00 +0100 5164049 http://www.medworm.com/index.php?rid=5164048&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01757.x We present a set of causal axioms, according to which the problem of time‐dependent confounding does not exist, and ‘treatment regime’ affects nothing. Per our axiomatization, marginal structural models do not introduce a new idea of deconfounding, but simply estimate a weighted average of effects. Whenever a weighted average and the weighting scheme can both be rationalized, the models are acceptable. Whenever a weighted average does not estimate an effect (e.g. important effect modification is ignored), or the weights are senseless – the models should not be fit. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5164048 Mon, 22 Aug 2011 23:00:00 +0100 5164048 http://www.medworm.com/index.php?rid=5164047&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01760.x Conclusion  We conclude that important variation exists in the included interventions and in their timing. The results of this study suggest that, before use in daily patient care, CPDs should be reviewed by peers and checked to ensure that all evidence‐based key interventions are included and properly planned. Only in this way can pathways documents be used interprofessionally during the entire perioperative period in the search for optimal quality and patient safety. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5164047 Mon, 22 Aug 2011 23:00:00 +0100 5164047 http://www.medworm.com/index.php?rid=5164046&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01762.x Conclusions  Although the classifier is customized to a particular setting and cannot be generalized to other scenarios, the simplicity of its development and the results obtained make it a promising approach for designing a simple model for different heart surgery centres needing a customized decision‐support system for planning transfusion requirements in intensive care unit. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5164046 Mon, 22 Aug 2011 23:00:00 +0100 5164046 http://www.medworm.com/index.php?rid=5164045&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01764.x Conclusions  The SES6G is a reliable and valid instrument to assess patients' self‐efficacy for managing chronic diseases. It may enhance further research in German‐speaking countries and appears to be a valuable measure for clinical practice. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5164045 Mon, 22 Aug 2011 23:00:00 +0100 5164045 http://www.medworm.com/index.php?rid=5145430&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01728.x This article problematizes medicine's narrow viewpoint, grounding its critique in philosophical ideas from phenomenology and pragmatism. I will reflect upon the historical context within which medical humanities has emerged and briefly examine specific examples of how its interdisciplinary approach, involving humanities scholars with clinicians and medical scientists, may develop new research directions in medicine. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5145430 Wed, 17 Aug 2011 23:00:00 +0100 5145430 http://www.medworm.com/index.php?rid=5145429&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01743.x AbstractEvidence‐based medicine (EBM) is frequently portrayed as a value‐free approach to knowing what kinds of treatment ‘really work.’ Since practitioners should help patients to improve their health, and EBM tells us which interventions will work, then it follows that we must practice EBM, offering only those interventions supported by evidence. The primary goal of EBM, then, is an ethical one – to improve health. More recently, EBM's authors have also committed themselves to ‘shared decision making’ in which evidence plays a role in the clinical encounter, but where patients, motivated by their own values, should have final decision‐making authority. Envisioned this way, strengthening the informed consent process, rather than improved health per se, is viewed as the goa... Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5145429 Wed, 17 Aug 2011 23:00:00 +0100 5145429 http://www.medworm.com/index.php?rid=5133265&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01701.x Conclusions  To develop effective telemonitoring for patients with chronic disease, more attention needs to be given to agreeing the central aim of early detection and, to ensure potential implementation, engaging a wide range of stakeholders in the design process, especially patients and clinicians. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5133265 Mon, 15 Aug 2011 23:00:00 +0100 5133265 http://www.medworm.com/index.php?rid=5133264&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01715.x AbstractThe question what scientific progress means for a particular domain such as medicine seems importantly different from the question what scientific progress is in general. While the latter question received ample treatment in the philosophical literature, the former question is hardly discussed. I argue that it is nonetheless important to think about this question in view of the methodological choices we make. I raise specific questions that should be tackled regarding scientific progress in the medical sciences and demonstrate their importance by means of an analysis of what evidence‐based medicine (EBM) has, and has not, to offer in terms of progress. I show how critically thinking about EBM from the point of view of progress can help us in putting EBM and its favoured methodolo... Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5133264 Mon, 15 Aug 2011 23:00:00 +0100 5133264 http://www.medworm.com/index.php?rid=5133263&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01725.x AbstractIn this paper we reflect upon and problematize the ways in which ‘patient involvement’ is interpreted in a substantial proportion of the research literature on involvement and shared decision making. Drawing upon an analysis of this literature we raise concerns about the ‘medicalization of involvement’ embedded in, and reproduced by, some dominant research lenses, suggesting that this medicalization has powerful discursive and material effects. For example, we suggest that it tends to normalize and arguably trivialize intrinsically problematic and contentious concepts such as ‘patient preferences’ and, at the same time, to obscure the full range of possibilities for reciprocity in the exchanges between the medical world of the professional and the experiential and narra... Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5133263 Mon, 15 Aug 2011 23:00:00 +0100 5133263 http://www.medworm.com/index.php?rid=5120913&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01714.x Conclusions  This new account, Constructive Realism, may provide a better account of medicine than either realism or constructivism. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5120913 Wed, 10 Aug 2011 23:00:00 +0100 5120913 http://www.medworm.com/index.php?rid=5120912&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01717.x AbstractMuch of medical research involves large‐scale randomized controlled trials designed to detect small differences in outcome between the study groups. This approach is believed to produce reliable evidence on which the management of patients is based. But can we be sure that the demonstration of a small, albeit statistically significant, difference is sufficient to infer the presence of a causal relationship between the drug and the outcome?A study is claimed to have internal validity when other explanations for the observed difference – namely, inequalities between the groups, bias in the assessment of the outcome and chance – have been excluded. Despite the various processes that are put into place – including, for example, randomization, allocation concealment, double‐bl... Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5120912 Wed, 10 Aug 2011 23:00:00 +0100 5120912 http://www.medworm.com/index.php?rid=5120911&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01719.x Conclusions  The compound virtue of prudent love provides a comprehensive approach to practising medicine that meets not only the needs of patients but also fulfils the physician's sense as healer. Although challenges face teaching virtues in the medical curriculum, strategies are available for incorporating training in virtues into the curriculum. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5120911 Wed, 10 Aug 2011 23:00:00 +0100 5120911 http://www.medworm.com/index.php?rid=5120910&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01720.x Conclusion  Although an infallibly rule‐oriented robot seems more reliable at first view, in situations that require complex decisions like clinical practice the agency of a moral human person is more trustworthy. Furthermore, the understanding of the patient's emotions must remain insufficient for a non‐emotional, non‐human being. Because these are crucial preconditions for good clinical practice, enough attention should be given to develop these virtues and emotional skills, in addition to the usual attention on knowledge, technical skills and the obedience to moral rules and principles. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5120910 Wed, 10 Aug 2011 23:00:00 +0100 5120910 http://www.medworm.com/index.php?rid=5120909&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01721.x AbstractAs bioethicists increasingly turn their attention to the profession of public health, many candidate frameworks have been proposed, often with an eye toward articulating the values and foundational concepts that distinguish this practice from curative clinical medicine. First, I will argue that while these suggestions for a distinct ethics of public health are promising, they arise from problems within contemporary bioethics that must be taken into account. Without such cognizance of the impetus for public health ethics, we risk developing a set of ethical resources meant exclusively for public health professionals, thereby neglecting implications for curative medical ethics and the practice of bioethics more broadly. Second, I will present reasons for thinking some of the critique... Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5120909 Wed, 10 Aug 2011 23:00:00 +0100 5120909 http://www.medworm.com/index.php?rid=5120908&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01731.x AbstractThe increasing complexity of contemporary health care policy and practice leads us to ask questions about what might constitute ‘the good health care practitioner’. Yet, attempts through empirical work to address such questions are sparse. This paper reports on a small‐scale qualitative study, which sought to explore questions with a number of health care professionals and academics about the nature of ‘the good practitioner’. Four themes emerged from our exploration and analysis: the difficulty in trying to talk about ‘the good practitioner’, the importance of systems and contexts in understanding this area, the place of consultation and diagnosis in conceptions of ‘good practice’ and ‘the good practitioner’, and the dissembling of the elusive idea of the ‘... Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5120908 Wed, 10 Aug 2011 23:00:00 +0100 5120908 http://www.medworm.com/index.php?rid=5098922&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01723.x AbstractEvidence‐based medicine (EBM) has been rapidly and widely adopted because it claims to provide a method for determining the safety and efficacy of medical therapies and public health interventions more generally. However, as others have noted, EBM may be riven through with cultural bias, both in the generation of evidence and in its translation. We suggest that technological and scientific advances in medicine accentuate and entrench these cultural biases, to the extent that they may invalidate the evidence we have about disease and its treatment. This creates a significant ethical, epistemological and ontological challenge for medicine. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5098922 Wed, 03 Aug 2011 23:00:00 +0100 5098922 http://www.medworm.com/index.php?rid=5098921&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01724.x AbstractFollowing my own involvement in the rise of evidence‐based medicine in General Practice in the UK, and having seen how this tide has led to a relative devaluation of other kinds of knowing this paper sets out four alternative approaches to the problem of knowledge in a way which both undermines the predominance of a strictly evidence‐based approach and re‐emphasizes these other means through which we come to know the world. Philosophically, this brings together the works of Heidegger, Sebald, Bachelard and Gadamer and shows how these apparently disparate authors suggest that there is, underlying our empirical understanding of the world, a more primordial relationship between consciousness and world which supports empirical or evidence‐based knowledge and without which evide... Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5098921 Wed, 03 Aug 2011 23:00:00 +0100 5098921 http://www.medworm.com/index.php?rid=5098920&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01727.x AbstractIn evidence‐based medicine, randomized controlled trials are said to be the highest evidence of what works, while anecdotes have low value or are not even considered to be medical evidence. Similar hierarchical views of evidence have infected other disciplines, including evidence‐based education and evidence‐based government. Here, I explore the artificial divisions of acceptable from unacceptable evidence, numbers from narrative and sciences from humanities. I challenge the deprecation of stories in medicine. Some stories are based on experiments while others are based on more or less plausible theories. Some stories offer vast and impressive statistics gathered from many observations while others present one noteworthy event. Published reports are themselves stories of what... Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5098920 Wed, 03 Aug 2011 23:00:00 +0100 5098920 http://www.medworm.com/index.php?rid=5227720&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01766.x Conclusions  Osteoporosis treatment change occurred in approximately 12% of members, while a greater proportion of members discontinued treatment completely within 12 months. Member characteristics may be used to predict therapy change for evaluation and quality initiatives within a health plan. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5227720 Mon, 01 Aug 2011 04:00:00 +0100 5227720 http://www.medworm.com/index.php?rid=5185337&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01761.x Conclusions  Activating learning methods, tailored according to the participants' readiness to change, improved clinical performance of GPs in continuing medical education and can be recommended for continuing professional development. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5185337 Sun, 31 Jul 2011 23:00:00 +0100 5185337 http://www.medworm.com/index.php?rid=5164043&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01765.x Conclusions  Our study suggested that EBM was still not well practised, using rosiglitazone prescription as a study case. Further education and encouragement to strengthen physicians' EBM practice remain urgently needed within the medical community. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5164043 Sun, 31 Jul 2011 23:00:00 +0100 5164043 http://www.medworm.com/index.php?rid=5145427&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01753.x Conclusion  Traditional Chinese version of the FACT‐C was demonstrated to have satisfactory psychometric properties in terms of applicability, reliability, validity and sensitivity in Chinese patients with colorectal neoplasm. The FACT‐C was valid colorectal‐specific health‐related quality of life tool for the Chinese population. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5145427 Sun, 31 Jul 2011 23:00:00 +0100 5145427 http://www.medworm.com/index.php?rid=5133262&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01718.x AbstractUncertainty is unavoidable in health care, yet frequently tacit. When uncertainty is acknowledged, it tends to be defined in terms of the unpredictable nature of the care, and limits to human knowledge. It is cast as a problem that evidence‐based health care can minimize. Challenging that simplistic perspective, this paper reconstructs uncertainty as a property whose meaning derives from how people are relationally disposed to perceive it in the social context in which they are embedded. Five conditions are suggested to define a need to protect and cultivate uncertainty as a virtue or positive disposition. These conditions are that uncertainty is natural, promotes creativity and a critical attitude, can signify wisdom, nurtures safety, sustains hope and protects against excess. I... Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5133262 Sun, 31 Jul 2011 23:00:00 +0100 5133262 http://www.medworm.com/index.php?rid=5120907&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01726.x Conclusions  We suggest that clinical ethics can help to provide a theoretical justification for patient‐centred care, and that clinical ethical practices can further patient‐centred initiatives through ethics consultation, education and policy development and review. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5120907 Sun, 31 Jul 2011 23:00:00 +0100 5120907 http://www.medworm.com/index.php?rid=5098919&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01730.x Conclusion  Virtue ethics, construed as the appraisal of acts in contexts of risk, danger or threat to foundational values, emerged as the ‘natural’ ethical approach for medical practitioners in this case study. Teaching medical ethics to students and graduates alike needs to accommodate the priority attached to virtuous acts. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5098919 Sun, 31 Jul 2011 23:00:00 +0100 5098919 http://www.medworm.com/index.php?rid=5081184&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01722.x AbstractPay‐for‐performance schemes reward standardized professional behaviours associated with effective care. However, they neglect the significance of virtue and devalue and erode professional motivation based on virtue. Pay for training to cultivate virtue, and/or pay‐for‐virtue, may mitigate these dangers. Although virtue is typically considered its own reward, and the assessment of virtue is problematic, pay‐for‐virtue could involve (1) stringent checks on the appropriateness of the standardized care currently rewarded by pay‐for‐performance for individual patients or (2) pay for indicators of virtue. These indicators could be based on virtues identified from a framework of universal virtues and through logical inferences from features of practice. It is possible that... Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5081184 Sun, 31 Jul 2011 23:00:00 +0100 5081184 http://www.medworm.com/index.php?rid=5070944&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01713.x (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5070944 Thu, 28 Jul 2011 15:05:00 +0100 5070944 http://www.medworm.com/index.php?rid=5070943&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01747.x (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5070943 Thu, 28 Jul 2011 15:04:59 +0100 5070943 http://www.medworm.com/index.php?rid=5081185&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01716.x AbstractRationale  In this article, I argue that we need a new perspective in the debate on autonomy in medicine, to understand many of the problems we face today – dilemmas that are situated at the intersection of autonomy and heteronomy, such as why well informed and autonomous people make unhealthy lifestyle choices. If people do not choose what they want, this is not simply caused by their lack of character or capability, but also by the fact that absolute autonomy is impossible; autonomous individuals are ‘contaminated’ by heteronymous aspects, by influences from ‘outside’. Consequently, there are many good reasons to question the widely accepted hierarchical opposition of autonomy (progress) versus heteronomy (paternalism) in medicine. In an earlier article an analysis is... Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5081185 Wed, 27 Jul 2011 23:00:00 +0100 5081185 http://www.medworm.com/index.php?rid=4978498&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01697.x Conclusion  Morbidity records and prescribing records should be used both in order to identify all patients with ACD in primary care. Patients who use antiplatelet prescriptions but do not have a recorded ACD deserve extra attention, because they are either treated without a good indication for antiplatelet therapy (overtreatment) or need a correction of their morbidity records. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=4978498 Mon, 27 Jun 2011 23:00:00 +0100 4978498 http://www.medworm.com/index.php?rid=4971449&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01712.x Conclusion  The automated engine accurately classified the evidence level. Misclassification might have resulted from incomplete information retrieval and inaccurate data extraction. Further efforts will focus on assessing relevance and using additional study design features to refine evidence level classification. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=4971449 Sat, 25 Jun 2011 23:00:00 +0100 4971449 http://www.medworm.com/index.php?rid=4962353&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01702.x Conclusions  The findings suggest a link between processes of care and outcomes that is exciting to observe internationally and suggest the opportunity to expedite performance improvement through global benchmarking. Using HAPU as a complement to point prevalence of PU in Sweden has revealed this indicator as a more valid measure for patient care quality. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=4962353 Tue, 21 Jun 2011 23:00:00 +0100 4962353 http://www.medworm.com/index.php?rid=4962360&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01699.x Conclusions  Following the introduction of DES, there was a rapid adoption of DES by interventional cardiologists, followed by a rapid abandonment of DES when significant safety issues were raised. After the safety of DES was called into question, there was a reduction in the use of DES and in the use of stents in general. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=4962360 Sun, 19 Jun 2011 23:00:00 +0100 4962360 http://www.medworm.com/index.php?rid=4962359&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01700.x Conclusions  Many cluster trials published in leading medical journals are not clear in their justification for the design. We also found significant proportions of cluster trials used suboptimal designs that increase their risk of introducing selection bias. Better design of cluster trials is possible and should be adopted. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=4962359 Sun, 19 Jun 2011 23:00:00 +0100 4962359 http://www.medworm.com/index.php?rid=4962358&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01703.x Conclusions  EHR query using glucose measurements can identify prediabetic patients and those requiring further glucose metabolism evaluation, including those with undiagnosed diabetes. Future research should investigate EHR‐based, population‐level interventions to facilitate prediabetes recognition and counselling. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=4962358 Sun, 19 Jun 2011 23:00:00 +0100 4962358 http://www.medworm.com/index.php?rid=4962357&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01704.x Conclusions  When a clinical pharmacist is present on a ward in which a CPOE is in use, the pharmacists' interventions are well accepted by physicians. Specific predictors of the acceptance by physicians emerge, but further research as to the impact of CPOE on pharmacist–physician communication is needed. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=4962357 Sun, 19 Jun 2011 23:00:00 +0100 4962357 http://www.medworm.com/index.php?rid=4962356&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01711.x Conclusion  We suggest the regular and routine use of vote cards in EBM journal clubs. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=4962356 Sun, 19 Jun 2011 23:00:00 +0100 4962356 http://www.medworm.com/index.php?rid=4962355&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01707.x Conclusion  This critical appraisal tool will aid both the health care practitioner to critically appraise the relevant literature and researchers to improve the quality of reporting of the validity and reliability of objective clinical tools. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=4962355 Sun, 19 Jun 2011 23:00:00 +0100 4962355 http://www.medworm.com/index.php?rid=4962354&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01708.x Conclusion  The presence of specialists in facilities and the age of patients were strong factors affecting ICS prescription. Increases in ICS therapy for the elderly and ICS prescription by non‐specialists would lead to an overall increase in patients receiving ICS and consequently achieving the goal of asthma control. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=4962354 Sun, 19 Jun 2011 23:00:00 +0100 4962354 http://www.medworm.com/index.php?rid=4939299&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2010.01453.x Conclusions  Among various preventive strategies annual Pap smear screening programme is still the most cost‐effective and additional HPV DNA testing is a cost‐effective choice under a reasonable threshold of willingness to pay. Vaccination programme in combination with triennial screening would be cost‐effective if vaccine cost can be greatly reduced in a large economic scale. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=4939299 Wed, 15 Jun 2011 23:00:00 +0100 4939299 http://www.medworm.com/index.php?rid=4939298&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01709.x AbstractA system approach termed P4 medicine has recently been proposed in the field of oncology. This approach has been advanced as an extension of what is usually called ‘personalized’ or ‘genomic medicine’. P4 medicine creates effective predictive, personalized, preventive and participatory models to treat patients. In order to give more relevance to the behavioural component that impinges on the way individuals act to prevent, cope and react to illnesses, how they decide between different therapeutic options and interact with physicians and adhere to treatment, we propose that P4 medicine should be transformed into P5 medicine. The fifth P represents the psycho‐cognitive aspects to be considered in order to empower the patient, increase his/her quality of life and transform h... Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=4939298 Wed, 15 Jun 2011 23:00:00 +0100 4939298 http://www.medworm.com/index.php?rid=4939300&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01688.x Conclusion  Video may be effective at changing patients' and health care professionals' attitudes towards patient involvement in some, but not all safety‐related behaviours. Our findings suggest video may be most effective at encouraging involvement in behaviours patients are less inclined to participate in and health care professionals are less willing to support. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=4939300 Tue, 14 Jun 2011 23:00:00 +0100 4939300 http://www.medworm.com/index.php?rid=4915085&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01691.x Conclusions  The AFSS has high diagnostic accuracy and reliability for the early identification of patients with severe acute fever. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=4915085 Tue, 07 Jun 2011 23:00:00 +0100 4915085 http://www.medworm.com/index.php?rid=5000313&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01705.x Conclusion  On average, although all types of interventions are effective, improving the diagnostic instrument seems to be the most effective. Especially when highly technical instruments were concerned, improvement proved to be very effective (β = 0.52). Because instrumental variables constitute a major source of error, improving the instrument is an important approach. However, this review offers solid arguments that can complement the literature and practice, with a focus on training the user of the instrument. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=5000313 Tue, 31 May 2011 23:00:00 +0100 5000313 http://www.medworm.com/index.php?rid=4987274&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01675.x Conclusion  In conclusion, the three methods are not showing the same estimations and thus may not be exchangeable. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=4987274 Tue, 31 May 2011 23:00:00 +0100 4987274 http://www.medworm.com/index.php?rid=4978497&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01698.x Conclusion  Specialty databases such as TIRCEL could not be used for epidemiological research or for the extraction of indicators for professional practice evaluation without strict quality control or the set‐up of data‐entering limits and alarms. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=4978497 Tue, 31 May 2011 23:00:00 +0100 4978497 http://www.medworm.com/index.php?rid=4971448&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01696.x Conclusions  GP assessment and management of tinnitus represents potential inequity of service for tinnitus patients. While the GPG aims to promote equity of care, it is only referred to by a minority of clinicians and so its utility for guiding service delivery is questionable. Although some GPs highlighted little demand for tinnitus management within their practice, many others expressed an unmet need for specific and concise GP training on tinnitus management. Further work should therefore evaluate current informational resources and propose effective modes of delivering educational updates. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=4971448 Tue, 31 May 2011 23:00:00 +0100 4971448 http://www.medworm.com/index.php?rid=4962352&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01706.x Conclusions  The practice of physicians on the diagnosis and management of ATH varied. The practices of physicians on the diagnosis and rechallenged method were in high compliance with the ATS guidelines. For the initial management and selection of alternative regimens, the physicians' compliance was not good. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=4962352 Tue, 31 May 2011 23:00:00 +0100 4962352 http://www.medworm.com/index.php?rid=4939297&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01710.x Conclusions  The majority of physicians considered CPG to be useful tools. It was evident that few knew where to acquire CPG, and this would lead to their limited use. Findings from this study enabled procuring a broader idea of the level of knowledge and attitudes of Mexican Institute of Social Security physicians towards CPG. This information is relevant when planning strategies for the purpose of sharing and implementing CPG. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=4939297 Tue, 31 May 2011 23:00:00 +0100 4939297 http://www.medworm.com/index.php?rid=4915084&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01695.x Discussion  Professional isolation and context specificity are important to consider when extending the EBM paradigm to rural surgical practice and understanding the EBM uptake in the rural surgery context. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=4915084 Tue, 31 May 2011 23:00:00 +0100 4915084 http://www.medworm.com/index.php?rid=4886656&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2010.01425.x Conclusion  We developed a 13‐item OESS with high reliability and validity which may be used to assess outcome expectancy for self‐care. A patient's psychological condition with regard to behaviour and affective status can be accurately evaluated using the OESS with SESS. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=4886656 Tue, 31 May 2011 23:00:00 +0100 4886656 http://www.medworm.com/index.php?rid=4886657&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01694.x Conclusion  The health care providers at KKUH have positive practice and attitude towards CPGs in general, which could positively influence the future introduction and implementation of evidence‐based CPGs. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=4886657 Mon, 30 May 2011 23:00:00 +0100 4886657 http://www.medworm.com/index.php?rid=4865493&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01693.x This study focused on factors that most concern specialist societies when choosing an evidence grading system, such as methodological strengths and weaknesses, applicability and ease of use. The grading systems chosen were the Scottish Intercollegiate Guidelines Network (SIGN), the Grading of Recommendations Assessment, Development and Evaluation (GRADE) and the National Service Framework for long‐term neurological conditions critical appraisal tool (NSF‐LTC).Methodology  Twelve assessors, representing typical members of society‐based guideline development groups, graded papers and a recommendation using a key question as a guide. Key questions and recommendations were extracted from existing clinical guidelines representing a variety of research fields. Assessors were given 3 mont... Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=4865493 Thu, 26 May 2011 18:33:27 +0100 4865493 http://www.medworm.com/index.php?rid=4865494&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01684.x Conclusions  Peer review groups can be an important method of quality improvement in GPs' prescribing behaviour in favour of generics. QCPs also facilitate the exchange between GPs on problems encountered and provide feedback to policy makers. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=4865494 Tue, 24 May 2011 23:00:00 +0100 4865494 http://www.medworm.com/index.php?rid=4823047&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01669.x Conclusion  Chronic or refractory diseases, especially when regarded as ‘functional’ may be approached by a systems medicine methodology, which allows physicians to fine‐tune the vast amount of specific pieces of knowledge to achieve an integrated approach to managing the whole person. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=4823047 Sat, 14 May 2011 22:31:01 +0100 4823047 http://www.medworm.com/index.php?rid=4823046&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01692.x (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=4823046 Sat, 14 May 2011 22:30:47 +0100 4823046 http://www.medworm.com/index.php?rid=4783723&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01678.x Conclusions  Research suggests that efficient FM care delivery during diagnosis and treatment can be associated with improved practice economics. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=4783723 Mon, 02 May 2011 23:00:00 +0100 4783723 http://www.medworm.com/index.php?rid=4749498&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01679.x Conclusion  Cost‐sharing models reduce HSU. The challenge is to create cost‐sharing models which do not preclude vulnerable populations from seeking essential health care. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=4749498 Mon, 25 Apr 2011 23:00:00 +0100 4749498 http://www.medworm.com/index.php?rid=4749497&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01685.x The objective was to present an overview of methods to examine the reliability of the interRAI Acute Care. For each line of evidence, examples of hypotheses and research questions are listed. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=4749497 Mon, 25 Apr 2011 23:00:00 +0100 4749497 http://www.medworm.com/index.php?rid=4749501&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01672.x Conclusion  The study demonstrates a significant increase in knowledge and interest among primary care staff as a result of a strategic communication process.Practice implications  Strategic communication should lead to a more evenly distributed research commitment among all health care professionals, thus facilitating communication between them and patients in order to clarify, for example, the causes of disease. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=4749501 Sat, 23 Apr 2011 23:00:00 +0100 4749501 http://www.medworm.com/index.php?rid=4749500&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01683.x Conclusion  A five‐item instrument was developed to detect preclinical glaucoma. Anyone with a score of 2 or more may need further ophthalmic examination and treatment. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=4749500 Sat, 23 Apr 2011 23:00:00 +0100 4749500 http://www.medworm.com/index.php?rid=4749499&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01686.x Conclusion  LHT provision was estimated to be cost‐effective for people at risk of CVD. However, a large level of uncertainty was associated with that decision. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=4749499 Sat, 23 Apr 2011 23:00:00 +0100 4749499 http://www.medworm.com/index.php?rid=4727159&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01676.x Conclusions  The Dutch translation of the MRSS identified four factors and revealed acceptable validity and reliability. The adapted version of the translated scale as a component of the psychological assessment procedure in a smoking cessation treatment in Dutch‐speaking areas should be implemented. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=4727159 Mon, 18 Apr 2011 23:00:00 +0100 4727159 http://www.medworm.com/index.php?rid=4727158&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01681.x Conclusion  These findings show some common ground to literature pointing the importance of adequate infrastructure. Managers showed a low valuation of both the level of knowledge and the professionals' adhesion to the guidelines. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=4727158 Mon, 18 Apr 2011 23:00:00 +0100 4727158 http://www.medworm.com/index.php?rid=4727157&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01689.x AbstractThis paper examines the sources of practice variations and definitions of unwarranted variation, as derived from the literature. The literature suggests variables/factors related to patient health needs, doctor ‘practice style’ and environmental constraints/opportunities as sources of practice variations. However, this list is likely to be incomplete because of significant unexplained variation in each study. Furthermore, it is unclear which factors are sources of unwarranted variation because the reviewed studies do not clearly discriminate between those variations that are unwarranted and those that are not. It is also unclear if context plays a role in determining if and when a factor is unwarranted. The literature contains few frameworks of what constitutes unwarranted vari... Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=4727157 Mon, 18 Apr 2011 23:00:00 +0100 4727157 http://www.medworm.com/index.php?rid=4727156&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01673.x Conclusion  Taken together, all these organizational changes have allowed to reduce the total ischemic time from 465 minutes in year 2005 to 232 minutes in year 2009, thereby demonstrating the effectiveness of our intervention. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=4727156 Mon, 18 Apr 2011 23:00:00 +0100 4727156 http://www.medworm.com/index.php?rid=4727155&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01674.x Conclusions  In the end, the outcomes of a critical appraisal affect the weight that is placed on particular studies. The use of a checklist is recommended because of its more distinguishing ability. The method that was developed for assigning weights to the evidence is discussed in light of both the quality appraisal in qualitative research and the objectives of qualitative synthesis. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=4727155 Mon, 18 Apr 2011 23:00:00 +0100 4727155 http://www.medworm.com/index.php?rid=4727154&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01677.x Conclusions  The EBNAQ is brief, making it a user‐friendly tool. It is the first Spanish‐language questionnaire that exclusively measures attitude towards EBN in nurses who work in the community. The EBNAQ can be used efficiently in research and practice settings to better understand nurses' attitudes towards evidence‐based practice. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=4727154 Mon, 18 Apr 2011 23:00:00 +0100 4727154 http://www.medworm.com/index.php?rid=4727160&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01667.x Discussion and conclusions  The four papers of this edition attempt to expand the boundaries of ‘common certainty’ in terms of statistical interpretation, management of individual patients, disease management and health policy. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=4727160 Sun, 17 Apr 2011 23:00:00 +0100 4727160 http://www.medworm.com/index.php?rid=4727163&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01670.x Conclusion  Longitudinal patient journeys encompass different phases with characteristic dynamics and are likely to require different interventions and strategies – thus being ‘adaptive’ to the changing complex dynamics of the patient's illness and care needs. CACC journey types provide a clinical tool for health professionals to focus time and care interventions in response to patterns of instability in multiple domains in chronic illness care. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=4727163 Sat, 16 Apr 2011 23:00:00 +0100 4727163 http://www.medworm.com/index.php?rid=4727161&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01671.x AbstractBackground  Governments around the world are looking at means to improve health care services and health outcomes for their communities within a sustainable expenditure framework. There is a general agreement that strengthening primary health care is the way for the future. Primary health care organizations (PHCOs) are seen as a means to achieving more effective and efficient health care.Results and conclusions  This paper proposes a complex adaptive framework for PHCOs, taking account of health and illness being subjective experiences, health care being ‘whole person’‐focused, and PHCOs focusing on all of a community's health determinants and community‐based health care needs. Such approach would foster building healthy local communities as much as seamless integration... Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=4727161 Sat, 16 Apr 2011 23:00:00 +0100 4727161 http://www.medworm.com/index.php?rid=4783722&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01690.x Conclusions  TPB helped understanding of GPs prescribing behaviour and their intentions to implement a clinical guideline. Beliefs (e.g. normative beliefs) were better predictors of behaviour than the composite scores for their corresponding higher‐level construct (e.g. indirect subjective norm). TPB models should be tested alongside randomized trials to test the assumption of causality that change in beliefs ultimately results in change in behaviour. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=4783722 Thu, 31 Mar 2011 23:00:00 +0100 4783722 http://www.medworm.com/index.php?rid=4749496&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01687.x Conclusions  A multifaceted implementation strategy is not sufficient to maintain long‐term adherence. To ensure long‐term adherence, especially of controversial guidelines, adherence should be monitored and reported regularly over time. Strong staff support and leadership on all wards is crucial to maintain awareness. Medical and nursing curricula should include the pros and cons of taking BTM, combined with enhancing self‐efficacy. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=4749496 Thu, 31 Mar 2011 23:00:00 +0100 4749496 http://www.medworm.com/index.php?rid=4727153&cid=s_30441_22_f&fid=30441&url=http%3A%2F%2Fdx.doi.org%2F10.1111%252Fj.1365-2753.2011.01682.x Conclusions  The IMM programme of care has proven to be transferable to routine hospital care within two hospitals in Northern Ireland. It is anticipated that this current research will further inform the development of IMM as routine clinical practice across Northern Ireland and beyond. (Source: Journal of Evaluation in Clinical Practice) Journal of Evaluation in Clinical Practice journals http://www.medworm.com/rss/comments.php?id=4727153 Thu, 31 Mar 2011 23:00:00 +0100 4727153