Abstract:
RATIONALE:Variability in indications for total hip replacement (THR) and unequal waiting times may limit health care access. OBJECTIVE:To analyse the relationship between appropriateness and previously developed surgical priority instruments. METHOD:Multicentre cross-validation study of patients placed on the waiting list for THR. Information on surgical priority, surgeons' evaluation of priority through a visual analogue scale (VAS) and health-related quality of life (HRQOL) (Health Utilities Index mark 3, EQ-5D, Western Ontario McMaster Osteoarthritic Index) was collected. THR indications were considered appropriate, uncertain or inappropriate according to appropriateness criteria. Statistical differences and clinically important differences in surgical priority, VAS and HRQOL between appropriateness categories were analysed with the Mann-Whitney U-test and effect size (ES), respectively. Surgical priority score's ability to discriminate appropriate and inappropriate indications was evaluated through the area under the receiver-operating characteristic curve (AUC) and its 95% confidence interval (95% CI). RESULTS:49.4% (87) of the THR indications were deemed appropriate, 39.8% (70) uncertain and 10.8% (19) inappropriate. Differences in surgical priority score, VAS and HRQOL between appropriateness categories were statistically significant. Clinically important differences were generally small (ES, 0.2-0.5) between inappropriate and uncertain, moderate (ES, 0.5-0.8) between uncertain and appropriate, and large (ES > 0.8) between inappropriate and appropriate categories. The AUC to discriminate appropriate and inappropriate indications was 0.97 (95% CI: 0.96-0.99) and 0.90 (95% CI: 0.83-0.97), respectively. CONCLUSIONS:The relationship between the surgical priority and appropriateness instruments reinforces their validity and could improve waiting list management by establishing maximum waiting periods based on patients' characteristics.
journal_name
J Eval Clin Practjournal_title
Journal of evaluation in clinical practiceauthors
Allepuz A,Quintana JM,Espallargues M,Escobar A,Moharra M,Arostegui Idoi
10.1111/j.1365-2753.2010.01362.xsubject
Has Abstractpub_date
2011-02-01 00:00:00pages
18-25issue
1eissn
1356-1294issn
1365-2753pii
JEP1362journal_volume
17pub_type
杂志文章,多中心研究abstract:RATIONALE, AIMS AND OBJECTIVES:Hospital discharge notes can be used to identify rates of revisions in hip and knee arthroplasty surgeries if such administrative codes are accurate. In order to trust the data taken from the hospital discharge abstracts it is important to assess their reliability. The purpose of this stu...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1365-2753.2010.01622.x
更新日期:2012-06-01 00:00:00
abstract::The goals of medical ethics education comprise several dimensions: legal duties to secure informed consent, tell the truth and protect confidentiality; objective competencies that include an understanding of DNR regulations and surrogate decision-making procedures; discursive moral skills such as moral sensitivity, re...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1046/j.1365-2753.2001.00277.x
更新日期:2001-11-01 00:00:00
abstract:RATIONALE:There is growing interest in validating tools aimed at supporting the clinical decision-making process and research. However, an increased bureaucratization of clinical practice and redundancies in the measures collected have been reported by clinicians. Redundancies in clinical assessments affect negatively ...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章,随机对照试验
doi:10.1111/jep.12539
更新日期:2016-10-01 00:00:00
abstract::Clinical guidelines are essential in promoting the implementation of evidence-based practice within the NHS. But there are two broad schools of thought about their development and implementation: the first argues that guidelines should be entirely evidence-based and tolerates a degree of complexity which may make the ...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.1998.tb00088.x
更新日期:1998-11-01 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:Single-group interrupted time series analysis (ITSA) is a popular evaluation methodology in which a single unit of observation is studied; the outcome variable is serially ordered as a time series, and the intervention is expected to "interrupt" the level and/or trend of the time series, ...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12638
更新日期:2017-04-01 00:00:00
abstract:OBJECTIVE:To identify and review evidence relating to the measurement properties of published multi-item outcome measures for the conservative management of lateral ligament injuries of the ankle. METHODS:Systematic literature searches were used to identify measures, which were then assessed against pre-defined criter...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章,评审
doi:10.1111/j.1365-2753.2003.00435.x
更新日期:2004-05-01 00:00:00
abstract::This article draws attention to an absurd feature of contemporary political life that significantly affects health service policy and calls for an urgent explanation. Policies are formed by a process that privileges rhetoric over reality, producing policies that are conceptualized at a later date. Two influential arti...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1046/j.1365-2753.2002.00361.x
更新日期:2002-05-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:Second-generation antipsychotic agents have varying propensities to cause weight gain, elevated lipid levels and associated long-term complications. This study evaluates the cost-effectiveness of four second-generation antipsychotic agents used in Canada for the treatment of schizophrenia...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2009.01189.x
更新日期:2010-08-01 00:00:00
abstract:RATIONALE, AIMS, AND OBJECTIVES:Clinical studies show equivalent health outcomes from interventional procedures and treatment with medication only for stable angina patients. However, patients may be subject to overuse or access barriers for interventional procedures and may exhibit suboptimal adherence to medications....
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.13341
更新日期:2020-12-01 00:00:00
abstract::The American College of Radiology develops evidence-based practice guidelines to aid appropriate utilization of radiological procedures. Panel members use expert opinion to weight trade-offs and consensus methods to rate appropriateness of imaging tests. These ratings include an equivocal range, assigned when there is...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12635
更新日期:2017-02-01 00:00:00
abstract::The paper evaluates the importance of conceptions underlying practices in medicine and in medical education. It uses a study of anaesthetists' approaches to practice, and of lectures in problem-based learning, to illustrate the influence of a conception of 'applying knowledge in, or to, practice' and of its apparently...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1046/j.1365-2753.2000.00264.x
更新日期:2000-08-01 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:Adverse events (AEs) among hospitalized patients occur frequently and result in significant sequelae. Federal policy is incentivizing health information technology (HIT) use, although research demonstrating safety benefits from HIT is mixed. Our objective was to evaluate the potential eff...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12139
更新日期:2014-08-01 00:00:00
abstract:RATIONALE, AIMS, AND OBJECTIVES:Little attention has been given to perceptions of pharmacist availability and role in the community setting following policy changes. The Pakistani model is particularly interesting as it encompasses three different pharmacy practice licensure types with major differences in credentials,...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.13405
更新日期:2020-04-22 00:00:00
abstract::In modern philosophy, the concept of truth has been problematized from different angles, yet in evidence-based health care (EBHC), it continues to operate hidden and almost undisputed through the linked concept of "bias." To prevent unwarranted relativism and make better inferences in clinical practice, clinicians may...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.13010
更新日期:2018-10-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:Little is known about the quality of occupational health care provided to National Health Service (NHS) staff. We designed the first national clinical audits of occupational health care in England. We chose to audit depression and back pain as health care workers have high levels of both ...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2010.01574.x
更新日期:2012-04-01 00:00:00
abstract:OBJECTIVE:To compare glycaemic control, as reflected in the A1c level, of diabetic patients with primary care vs. with specialist care. METHODS:The study used administrative data from eastern Ontario, Canada, and a database containing the results of all A1c tests from this region between 1 September 1999 and 1 Septemb...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2005.00582.x
更新日期:2005-12-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:The onset of acute illness may be accompanied by a profound sense of disorientation for patients. Addressing this vulnerability is a key part of a physician's purview, yet well-intended efforts to do so may be impeded by myriad competing tasks in clinical practice. Resolving this dilemma ...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.13410
更新日期:2020-05-07 00:00:00
abstract:RATIONALE, AIMS, AND OBJECTIVES:Measures of safety climate are increasingly used to guide safety improvement initiatives. However, cost and respondent burden may limit the use of safety climate surveys. The purpose of this study was to develop a 15- to 20-item safety climate survey based on the Patient Safety Climate i...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12731
更新日期:2017-08-01 00:00:00
abstract::Nosology is the science of defining and classifying diseases. Meta-nosology is the study of how we do this, on what principles nosological practices are based, the quality of the resulting medical taxonomy, and primarily whether/how diseases can be defined better than they are now. In modern Western medicine, there ar...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.13012
更新日期:2018-10-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:In 2011 the module cardiometabolic risk of the Prevention Consultation guideline was introduced in the Netherlands in order to prevent cardiometabolic diseases. We aimed to compare attitudes and working methods of Dutch general practitioners (GPs) towards selective prevention of cardiomet...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12179
更新日期:2014-08-01 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 types of diseases, or categories of suffering, referred to as medically unexplained symptoms or syndromes (MUS) are the focus for the following commentary. Such cases seem to invite reflection. The very nature of such complex patterns of disease and suffering raises a number of fundamental epistemological and onto...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12430
更新日期:2016-08-01 00:00:00
abstract:RATIONALE, AIMS, AND OBJECTIVES:Clinical practice guidelines (CPGs) for knee osteoarthritis (OA) guide the provision of high-quality healthcare for people with knee OA, which may improve outcomes. Our aim was to evaluate the quality of and content within recently published CPGs for people with knee OA. METHODS:CPGs (2...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.13391
更新日期:2020-03-26 00:00:00
abstract::Randomized trials are undoubtedly different from observational studies, but authors sometimes propose differences between these designs that do not exist. In this article we examine two claims about randomized trials: first, a recent claim that the causal structure of exposure measurement (information) bias in a rando...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/j.1365-2753.2009.01347.x
更新日期:2009-12-01 00:00:00
abstract:RATIONALE, AIMS, AND OBJECTIVES:Clinical practice guidelines (CPGs) endeavour to incorporate the best available research evidence together with the clinically informed opinions of leading experts in order to guide clinical practice when dealing with a given condition. There has been increased interest in CPGs that are ...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.13026
更新日期:2019-08-01 00:00:00
abstract:RATIONALE, AIMS AND OBJECTIVES:The American College of Cardiology and American Heart Association (ACC/AHA) statin guidelines recommend that people with risk of cardio-vascular disease (CVD) ≥7.5% over 10 years should be treated with statins. This recommendation ignores individual patient CVD risks and preferences. We c...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12473
更新日期:2017-04-01 00:00:00
abstract:AIMS AND OBJECTIVES:The role of pharmacists in chronic disease state management has been shown to significantly improve patient health outcomes and reduce overall health care costs. The current study is designed to assess the roles and attitudes of West Virginia (WV) pharmacists toward diabetes, evaluate services provi...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.12677
更新日期:2017-06-01 00:00:00
abstract:RATIONALE:This paper aims to show how the focus on eradicating bias from Machine Learning decision-support systems in medical diagnosis diverts attention from the hermeneutic nature of medical decision-making and the productive role of bias. We want to show how an introduction of Machine Learning systems alters the dia...
journal_title:Journal of evaluation in clinical practice
pub_type: 杂志文章
doi:10.1111/jep.13535
更新日期:2021-01-22 00:00:00