Abstract:
RATIONALE, AIMS AND OBJECTIVES:Appropriate indications for colonoscopy (C) are essential for a rational use of resources. The aim of this study is to evaluate the appropriateness of indication for C according to the American Society for Gastrointestinal Endoscopy (ASGE) guidelines and to evaluate whether appropriate use was correlated with the diagnostic yield of C. METHODS:We analysed 677 consecutive C performed over an 11-month period in a digestive endoscopy unit with an open access system. RESULTS:The rate of 'generally indicated' C was 77% and 'generally not indicated' C was 18%. The rate of indication not listed in the ASGE guidelines was 5%. The percentage of generally not indicated C requested by gastroenterologists for outpatients was lower than that requested by primary care surgeons or doctors (9.5%, 29%, 25.3%, respectively). In 38 (7.3%) and in 111 (21.3%) of 520 patients with appropriate C, cancer and polyps larger than 5 mm were found, respectively. Twenty polyps greater than 5 mm were detected in 15 cases (12%) of 122 inappropriate C, with only one case of intramucosal carcinoma; four (12%) polyps measuring over 5 mm were found in C not listed in ASGE guidelines. No advanced stage cancer was detected in the inappropriate group and in C not listed in ASGE guidelines. CONCLUSIONS:Our results showed the high rate of inappropriate procedures, according to ASGE guidelines, requested by surgeons, internists and primary care doctors for both outpatients and inpatients. The proportion of not indicated endoscopic procedures requested by gastroenterologists must be reduced through more carefully application of ASGE guidelines. Endoscopic findings were more stringent in appropriate C.
journal_name
J Eval Clin Practjournal_title
Journal of evaluation in clinical practiceauthors
Suriani R,Rizzetto M,Mazzucco D,Grosso S,Gastaldi P,Marino M,Sanseverinati S,Venturini I,Borghi A,Zeneroli MLdoi
10.1111/j.1365-2753.2008.00950.xsubject
Has Abstractpub_date
2009-02-01 00:00:00pages
41-5issue
1eissn
1356-1294issn
1365-2753pii
JEP950journal_volume
15pub_type
杂志文章abstract:RATIONALE AND OBJECTIVES:Quality of life has emerged as a crucial concept for the assessment of health and the planning of health care. Desirable features for the evaluation of quality of life include comprehensiveness, self-ratedness, cultural sensitivity, practicality and psychometric soundness. An attempt to meet th...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2010.01609.x
更新日期:2011-04-01 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:BACKGROUND:Shared decision making (SDM) is very important from patients' perspective. This process has not yet been evaluated in Romania. The study aims to evaluate SDM from the patients' perspective and to evaluate patients' characteristics that associate with SDM. MATERIAL AND METHODS:A cross-sectional multicentric ...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章,多中心研究
doi:10.1111/jep.13257
更新日期:2019-12-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:Complex problems require strategies to engage diverse perspectives in a focused, flexible manner, yet few options exist that fit with the current health care and public health system constraints. The Complex Network Electronic Knowledge Translation Research model (CoNEKTR) brings together...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2010.01534.x
更新日期:2010-10-01 00:00:00
abstract::Recent surveys have uncovered major variations in key aspects of intercostal drain management, suggesting that decisions are being made on individual preferences without resorting to sound evidence. We provide an up-to-date review of the best practice with evidence-based recommendations and expert consensus views. The...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章,评审
doi:10.1046/j.1365-2753.2002.00339.x
更新日期:2002-08-01 00:00:00
abstract::Evidence-based health care (EBHC), previously evidence-based medicine (EBM), is considered by many to have modernized health care and brought it from an authority-based past to a more rationalist, scientific grounding. But recent concerns and criticisms pose serious challenges and urge us to look at the fundamentals o...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12752
更新日期:2017-10-01 00:00:00
abstract:OBJECTIVE:The study aims to identify key enablers fostering clinical risk management (CRM) in hospitals to guide health care in this vital area of patient safety. METHOD:A cross-sectional survey was conducted at the national level in 324 Swiss hospitals in 2007-2008 to assess the relationship between key elements and ...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2012.01836.x
更新日期:2013-04-01 00:00:00
abstract::Medical malpractice claims can be analysed to gain insights aimed at improving quality of care. However, using medical malpractice claims in medical research raises epistemological and methodological concerns related to certain features of the litigation process. Medical research should therefore approach medical malp...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.13178
更新日期:2019-10-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:The London Health Sciences Centre found that its emergency room (ER) mental health services were affected by people presenting with problems that did not require psychiatric intervention. Consequently, a second triage using a crisis worker (CW) was introduced in the ER to identify those p...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2006.00759.x
更新日期:2007-04-01 00:00:00
abstract:RATIONALE:Nurses' work is inextricably linked to the evaluation of the quality of care provision in health care. Within this evaluation, individualized care is a topical theme in western countries. Currently, there is no suitable instrument to measure the level of individualized care from the nurses' point of view. AI...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1365-2753.2009.01168.x
更新日期:2010-02-01 00:00:00
abstract:AIMS AND OBJECTIVES:We report findings from a qualitative study to identify patient views of community hospital care. We consider how far these were in accord with the hospital staffs' views. This constituted part of a wider randomized controlled trial (RCT). The methodological challenges in seeking to identify patient...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1365-2753.2006.00653.x
更新日期:2007-02-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:The incidence of falls and fall-related injuries in older age is predicted to increase concomitantly with global population ageing, representing a serious challenge to health care systems. In spite of the availability of policy and practice guidelines for the prevention of falls and fall-...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2009.01307.x
更新日期:2010-12-01 00:00:00
abstract::The use of process measures in the assessment of the quality of care has been neglected of late. The outcomes movement has gathered momentum and process measurement appears to have been left trailing in the wake. Yet process measures can be sensitive indicators of the quality of care and have many advantages over outc...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章,评审
doi:10.1046/j.1365-2753.1998.t01-1-00003.x
更新日期:1998-02-01 00:00:00
abstract:RATIONALE, AIMS, AND OBJECTIVES:The Australian National Heart Foundation Guidelines have been developed to guide clinicians on how to best manage chronic heart failure (CHF) patients according to the current best available evidence. The primary aim of this study is to evaluate the proportion of patients prescribed evid...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12760
更新日期:2017-12-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:Clinical guidelines are tools that systematize scientific evidence and help to achieve proper care. Several difficulties are reported regarding the effective use, such as the shortcomings in the level of knowledge and attitudes by the professionals, the service structure and the preferenc...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2011.01681.x
更新日期:2011-08-01 00:00:00
abstract:BACKGROUND:Child psychoanalytic psychotherapy has been criticized for its reluctance to embrace evidence-based practice. This study aims to explore the historical narrative of a sample of child psychoanalytic psychotherapists about progress in developing the evidence base. METHODS:Fourteen psychotherapists were interv...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2011.01638.x
更新日期:2013-08-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:Patients can play an important role in reducing health care harm. Finding strategies to encourage patients to take on an active role in issues related to the quality and safety of their care is therefore essential. The aim of this study was to examine patients' and health care professiona...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2011.01688.x
更新日期:2012-08-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:Guidelines for stroke management should improve quality of care. Dissemination of guidelines, however, does not guarantee guideline adherence. The aim of this paper is to investigate barriers for guideline adherence to bring about suggestions for possible implementation strategies. METHO...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2003.00460.x
更新日期:2004-05-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:The standard of preventive care for poorly controlled seasonal allergic rhinitis (AR) is subcutaneous immunotherapy (SCIT) with allergen extracts, administered in a physician's office. As an alternative to SCIT, sublingual immunotherapy (SLIT) is now an option for patients with seasonal A...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章,评审
doi:10.1111/jep.12112
更新日期:2014-06-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:The aim of this study was to examine the validity of the Health of the Nation Outcome Scales (HoNOS) in terms of change in relation to sex, clinical characteristics and level of clinical change as assessed using other measures. METHODS:The sample consisted of N = 690 admissions from one ...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12296
更新日期:2015-04-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:It has been proposed that delivery should be accomplished within 30 minutes after diagnosis of fetal distress. The objective of this study was to determine the decision-to-delivery interval (DDI) in emergency caesarean delivery for non-reassuring fetal heart rate (FHR). METHODS:A total o...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12613
更新日期:2016-12-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:To evaluate adherence to guidelines for prophylactic antibiotic use in total knee replacement (TKR) and total hip replacement (THR) procedures and to examine the associations between guideline adherence and health care outcomes. METHODS:Using nationwide health insurance claims data, all ...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2009.01182.x
更新日期:2009-12-01 00:00:00
abstract::The primary goal of evidence-based medicine (EBM) has been to change the way clinicians make decisions. But EBM has inappropriately privileged the results of clinical research for medical decision making and has undermined the importance of other kinds of medical knowledge, pathophysiologic understanding and clinical ...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2010.01405.x
更新日期:2010-04-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVE:Low back pain (LBP) care can involve many providers. The provider chosen for entry into care may predict future health care utilization and costs. The objective of this study was to explore associations between entry settings and future LBP-related utilization and costs. METHODS:A retrosp...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12464
更新日期:2016-04-01 00:00:00
abstract:RATIONALE, AIMS, AND OBJECTIVES:Heterogeneity is a critical issue in meta-analysis, because it implies the appropriateness of combining the collected studies and impacts the reliability of the synthesized results. The Q test is a traditional method to assess heterogeneity; however, because it does not have an intuitive...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.13159
更新日期:2020-02-01 00:00:00
abstract:AIMS AND OBJECTIVES:The aim of this paper is to determine the influence of do not attempt cardiopulmonary resuscitation (DNACPR) orders and the Universal Form of Treatment Options ('UFTO': an alternative approach that contextualizes the resuscitation decision within an overall treatment plan) on nurses' decision making...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章,随机对照试验
doi:10.1111/jep.12559
更新日期:2016-12-01 00:00:00
abstract::Progressive improvements in antihypertensive drug therapy over the past four decades have provided clear benefits in limiting cardiovascular complications. Unfortunately, and largely inexplicably, the inclusion in meta-analyses of defective trials plus the employment of inappropriate diagnostic criteria for adverse co...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章,评审
doi:10.1046/j.1365-2753.2001.00300.x
更新日期:2001-05-01 00:00:00
abstract:RATIONALE, AIMS, AND OBJECTIVES:Human brain connectome is a new and rapidly developing field in neuroscience. The pattern of structural and functional connectivity in the brain is not fixed but is continuously changing in response to experiences. Exploring these phenomena opens a powerful arsenal of analyses and comput...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12911
更新日期:2018-08-01 00:00:00
abstract:INTRODUCTION:Non-routine events (NREs) are atypical or unusual occurrences in a pre-defined process. Although some NREs in high-risk clinical settings have no adverse effects on patient care, others can potentially cause serious patient harm. A unified strategy for identifying and describing NREs in these domains will ...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.13456
更新日期:2020-08-16 00:00:00
abstract:AIMS AND OBJECTIVE:To identify factors important in determining whether an obese child achieves significant reductions in Body Mass Index Standard Deviation Score (BMI SDS) within a UK, hospital-based paediatric obesity service aimed at lifestyle modification. DESIGN:Observational Study. SUBJECTS:137 obese children (...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2006.00706.x
更新日期:2007-06-01 00:00:00