International journal of technology assessment in health care
-
Int J Technol Assess Health Care · Jan 2000
ReviewPreoperative evaluation in elective surgery. INAHTA synthesis report.
To collect and summarize information published by INAHTA agencies on the indications, habitual attitudes and practices, and economic and legal implications of preoperative evaluation in elective surgeries. ⋯ The conclusions found in the reports about indications in preoperative evaluation are similar or differ slightly, e.g., as regards age limits in patients for whom the tests are recommended. However, more important differences are shown in other areas, especially in reports where consensus methods were used. In some instances, the opinions, attitudes, and customary practices of professionals during the preoperative stage do not concur with the recommendations extracted from the assessment reports and the customary practice of doctors. In relation to economic considerations, a substantial quantity of resources could be liberated if the recommended general clinical practices were followed. From the point of view of civil law, the evidence-based recommendations could be considered as a kind of coded lex artis.
-
Int J Technol Assess Health Care · Jan 2000
Comparative StudyA comparison of the cost-effectiveness of stroke care provided in London and Copenhagen.
This study compared the relative cost-effectiveness of stroke care provided in London and Copenhagen. ⋯ The ICERs of the Copenhagen compared with the London model of care were within a range generally regarded as cost-effective.
-
Int J Technol Assess Health Care · Jan 2000
The use of technologies to minimize exposure to perioperative allogeneic blood transfusion in elective surgery. A survey of Canadian hospitals.
Despite the growing medical and public interest in reducing exposure to allogeneic blood, little is known about the use of alternatives to allogeneic transfusion. This study was conducted to determine the availability of these technologies in Canadian hospitals and was undertaken under the auspices of the International Study of Peri-Operative Transfusion (ISPOT), a 10-country study of the effectiveness of, attitudes toward, and practices related to the use of alternatives to allogeneic transfusion. ⋯ In general, alternatives to perioperative allogeneic transfusion were rarely used except in cardiac surgery.
-
Int J Technol Assess Health Care · Jan 2000
A cost-benefit analysis of mechanical ventilation. An examination of DRG 475.
An economic evaluation of the resources used for mechanically ventilated patients using various measures for the benefits of extending life. ⋯ Since the benefits of extending life associated with DRG 475 exceed the payments per life saved at most ages, economic evaluations may be best applied with psychosocial evaluations to allocate resources more ethically.
-
Int J Technol Assess Health Care · Jan 2000
The development of evidence-based clinical practice guidelines. Integrating medical science and practice.
Practice guidelines are rapidly becoming preferred decision-making resources in medicine, as advances in technology and pharmaceutics continue to expand. An evidence-based approach to the development of practice guidelines serves to anchor healthcare policy to scientific documentation, and in conjunction with practitioner opinion can provide a powerful and practical clinical tool. ⋯ Evidence-based practice guidelines, in conjunction with practice standards and practice advisories, are invaluable resources for clinical decision making. The judicious use of these documents by practitioners will serve to improve the efficiency and safety of health care well.