Abstract:
RATIONALE:Wide variations in referral practice from primary to secondary care have been observed. Clinical, demographic and referrer characteristics explain little of this variation. Patient psychological characteristics have been suggested as a potential explanation of this, biasing referral. The objective of this study is to investigate, in a relatively homogeneous population, the effects of patient's psychological distress and illness beliefs upon GP's requests for urgent outpatient assessment. METHODS:An inception cohort of 188 primary care referrals to a UK NHS Trust orthopaedic department for potential lower limb arthroplasty was assessed for disease-related pain and impairment, disability, psychological distress and illness beliefs. Associations between these and primary care requests for urgent outpatient appointments were estimated. RESULTS:Twenty-two referrals (12%) requested an urgent outpatient appointment. Illness beliefs of greater personal control (OR 2.18, 95% CI 1.18, 4.05) but not psychological distress (OR 0.39, 95% CI 0.11, 1.36) were independently associated with urgent requests. Greater pain and impairment, co-morbidity and disability were univariately associated with this request. In both fully adjusted and parsimonious models, only patient beliefs of greater control and disability were independent determinants of this request for urgency. CONCLUSIONS:Among patients referred for assessment for lower limb arthroplasty primary care practitioner's requests for urgent assessment are influenced by the patient's belief of how well they can control the symptoms, over and above clinical measures, suggesting patients coping better gain faster access. Global disability appears to be the main clinical determinant, which suggests GPs are making urgent referrals appropriately. There is no evidence of any bias on age, gender or socioeconomic status. This request for urgency leads to these patients waiting 2 months less for an outpatient appointment.
journal_name
J Eval Clin Practjournal_title
Journal of evaluation in clinical practiceauthors
Glozier N,Prince Mdoi
10.1111/j.1365-2753.2006.00685.xsubject
Has Abstractpub_date
2007-04-01 00:00:00pages
236-41issue
2eissn
1356-1294issn
1365-2753pii
JEP685journal_volume
13pub_type
杂志文章abstract:RATIONALE, AIMS AND OBJECTIVES:The goal is to fully automate the calculation of a breast ptosis measure from clinical photographs through automatic localization of fiducial points relevant to the measure. METHODS:Sixty-eight women (97 clinical photographs) who underwent or were scheduled for breast reconstruction were...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12397
更新日期:2015-10-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:Artificial intelligence and big data are more and more used in medicine, either in prevention, diagnosis or treatment, and are clearly modifying the way medicine is thought and practiced. Some authors argue that the use of artificial intelligence techniques to analyze big data would even ...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.13528
更新日期:2020-12-23 00:00:00
abstract:RATIONALE:Virtues are an important component in the practice of clinical medicine. Prudence or wisdom and charity or love are often viewed as crucial for virtuous practice. Generally, the two virtues are discussed separately, with no connection between them; however, a synergy exists between the two virtues as a compou...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2011.01719.x
更新日期:2011-10-01 00:00:00
abstract:OBJECTIVES:The efficiency of a hospital's operating room (OR) management can affect its overall profitability. However, existing indicators that assess OR management efficiency do not take into account differences in hospital size, manpower and functional characteristics, thereby rendering them unsuitable for multi-ins...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2012.01829.x
更新日期:2013-04-01 00:00:00
abstract:OBJECTIVE:The purpose of the current study was to assess, in patients scheduled for primary total knee replacement (TKR), the effects of pre-surgery waiting time on pain and functional limitations related to the knee joint undergoing surgery, on health-related quality of life (HRQoL) and on contralateral knee pain 6 mo...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2010.01541.x
更新日期:2012-02-01 00:00:00
abstract:OBJECTIVES:To assess the evidence for tai chi in reducing resting blood pressure (BP) in the elderly. METHODS:Databases were searched up to February 2009. All randomized clinical trials (RCTs) testing the effects of tai chi on resting BP in the elderly were considered. The selection of studies, data extraction and val...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章,评审
doi:10.1111/j.1365-2753.2009.01210.x
更新日期:2010-08-01 00:00:00
abstract::Hepatocellular carcinoma (HCC) is the commonest primary hepatic malignancy and the third most common cause of cancer-related death worldwide. Incidence remains highest in the developing world and is steadily increasing across the developed world. The majority of HCC occurs on a background of cirrhosis, principally cau...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章,评审
doi:10.1111/j.1365-2753.2010.01599.x
更新日期:2012-04-01 00:00:00
abstract::Performance indicators for healthcare organizations represent a strategy for accountability worldwide. A universal approach to either the design for indicators or their applicability to local needs remains a work in progress. The Maryland Hospital Association's Quality Indicator Project (QIP) is the only indicator-bas...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1046/j.1365-2753.2003.00374.x
更新日期:2003-05-01 00:00:00
abstract::Health care purchasers are facing increasing pressure to make the best use of their limited resources and to purchase only those services known to be clinically effective. This paper describes one health authority's experience of promoting clinical effectiveness through clinical audit and clinical guidelines. It highl...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.1997.tb00070.x
更新日期:1997-02-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:Chronic disorders of consciousness (CDoC) pose significant problems of understanding for both medical professionals and the relatives and friends of the patient. This paper explores the tensions between the different interpretative resources that are drawn upon by lay people and professio...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12220
更新日期:2015-06-01 00:00:00
abstract:INTRODUCTION:The patient-centred medical home (PCMH) is an important part of health care reform. While there is hope, the PCMH model can facilitate the provision of higher quality care, the extent to which organizational climate within the PCMH supports the implementation of evidence-based practices (EBPs) is unknown. ...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.13050
更新日期:2019-08-01 00:00:00
abstract::The objectives of this study were to present a short history of the Critical Care Research Network (CCR-Net), describe its approach to health services research and to summarize completed and current research projects. In doing this, we explored the question is this research network accomplishing its goals? We reviewed...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章,评审
doi:10.1046/j.1365-2753.2000.00214.x
更新日期:2000-02-01 00:00:00
abstract:OBJECTIVE:To discuss the usefulness of health care information technology (HIT) in assisting care providers minimize uncertainty while simultaneously increasing efficiency of the care provided. STUDY DESIGN:An ongoing study of HIT, performance measurement (clinical and production efficiency) and their implications to ...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2010.01483.x
更新日期:2011-12-01 00:00:00
abstract:RATIONALE:Clinical reasoning lies at the heart of medical practice and has a long research tradition. Nevertheless, research is scattered across diverse academic disciplines with different research traditions in a wide range of scientific journals. This polyphony is a source of conceptual confusion. AIMS AND OBJECTIVE...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.13432
更新日期:2020-06-22 00:00:00
abstract::Obese people consume significantly greater amounts of health resources. This study set out to determine if health resource utilization by obese people decreases after losing weight in a comprehensive medically supervised weight management programme. Four hundred and fifty-six patients enrolled in a single-centred, mul...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1046/j.1365-2753.2002.00320.x
更新日期:2002-02-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:Invasive pneumococcal diseases (IPD) are associated with substantial burden in adults (≥50 years). Moreover, adults with vascular, metabolic or respiratory diseases have been shown to have a 3-6 times higher risk of IPD when compared with their healthy controls. These persons at higher ri...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12131
更新日期:2014-08-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:Surgical site infections are the most common healthcare-associated infections. Appropriate surgical antimicrobial prophylaxis (SAP), which is an integral part of surgical site infection SSI prevention, is one of the major preventable risks to surgical patient safety. Several clinical prac...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12658
更新日期:2017-02-01 00:00:00
abstract:OBJECTIVES:To describe the practices of physicians on the diagnosis and treatment of antituberculosis drug-induced hepatotoxicity (ATH), and to evaluate the concordance between these practices and the American Thoracic Society (ATS) 2006 guidelines. METHODS:Information was reviewed on 670 new cases of tuberculosis pat...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2011.01706.x
更新日期:2012-12-01 00:00:00
abstract::Evidence-based medicine (EBM) calls for medical practitioners to "integrate" our best available evidence into clinical practice. A significant amount of the literature on EBM takes this integration to be unproblematic, focusing on questions like how to interpret evidence and engage with patient values, rather than cri...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.13109
更新日期:2019-12-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:Individual comparisons of the performance of risk-adjustment indices have been widely conducted. Few reviews have been conducted to summarize the performance of different risk-adjustment indices. A 30-day mortality rate is widely used to evaluate the quality of care in hospitals by federa...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章,meta分析,评审
doi:10.1111/jep.12307
更新日期:2015-04-01 00:00:00
abstract::Recent years have witnessed the rising star of evidence-based medicine (EBM) as an approach towards rationalizing clinical practice in the face of an exponentially growing body of knowledge. Along with it, however, a sense of unease is rising among practising doctors, as they feel that well-intentioned principles may ...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2003.00473.x
更新日期:2004-05-01 00:00:00
abstract::Patient non-adherence is a common and important concern in clinical medicine. Some cases of patient non-adherence are cases in which the patient disagrees with the physician's recommended treatment based on particular reasons. Drawing upon science and technology studies literature, specifically the discussion by Colli...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12561
更新日期:2016-08-01 00:00:00
abstract::Access to appointments in primary care is not routinely measured, and there is no one standardized method for doing so. Any measurement tool has to take account of the dynamic status of appointment availability and the definitional problems of appointment types. The aim of this study was to develop and trial a method ...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1046/j.1365-2753.2003.00386.x
更新日期:2003-02-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:Occupational violence is increasingly recognized as a problem in general practice, and has been suggested as adversely affecting general practitioners' (GPs) provision of services to patients. The aim of this study was to investigate the association of experiences of violence and percepti...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2007.00864.x
更新日期:2008-04-01 00:00:00
abstract:RATIONALE, AIMS, AND OBJECTIVES:Current meta-analysis was conducted aiming to assess the efficacy and safety of recombinant human interleukin-11 (rhIL-11) in the treatment of acute leukaemia (AL) patients with chemotherapy-induced thrombocytopenia (CIT). METHODS:We searched PubMed, Embase, Chinese National Knowledge I...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.13152
更新日期:2020-02-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:A common approach to assessing treatment effects in nonrandomized studies with time-to-event outcomes is to estimate propensity scores and compute weights using logistic regression, test for covariate balance, and then estimate treatment effects using Cox regression. A machine-learning al...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12859
更新日期:2018-04-01 00:00:00
abstract::The aim of this study was to determine whether a brief Internet-based education programme could improve physicians' abilities to manage pigmented skin lesions. A pre-test-post-test assessment was used of subjects' knowledge of skin cancer, confidence in their management abilities and actual ability to recommend approp...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1046/j.1365-2753.1999.00194.x
更新日期:1999-05-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:Little is known about which medical providers, other than neurologists, are involved in the care of neurologic conditions. We aimed to describe the current distribution of outpatient neurologic care by provider type. METHODS:We conducted a restrospective, cross-sectional analysis using a...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.13439
更新日期:2020-08-04 00:00:00
abstract::The final years of life present challenges for care. In middle-/high-income countries, the percentage of people of advanced age in the population is growing, and the dying process continues to become more complex and protracted. We propose that a new understanding of care, 'teleological care', be considered as an impo...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章,评审
doi:10.1111/jep.12211
更新日期:2014-12-01 00:00:00
abstract:INTRODUCTION:Recently, some leaders of the evidence-based medicine (EBM) movement drew attention to the "unintended" negative consequences associated with EBM. The term 'cognitive biases plus' was introduced in part I to encompass cognitive biases, conflicts of interests, fallacies and certain behaviours. HYPOTHESIS:'...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章,评审
doi:10.1111/jep.12291
更新日期:2014-12-01 00:00:00