Journal of evaluation in clinical practice
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The evidence to support the effectiveness of home telemonitoring interventions for patients with chronic obstructive pulmonary disease (COPD) is limited, yet there are many efforts made to implement these technologies across health care services. ⋯ Despite these caveats, the study reports are themselves positive about their results. However, given the risk of bias in the design and scale of the evaluations we conclude that the benefit of telemonitoring for COPD is not yet proven and that further work is required before wide-scale implementation be supported.
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American College of Physicians (ACP) published guidelines for the diagnosis and treatment of acute pharyngitis in adults in 2001. The objective of this study is to characterize antibiotic prescribing patterns in the USA for acute pharyngitis and evaluate concordance with the 2001 ACP pharyngitis treatment guidelines. ⋯ Publishing of ACP guidelines for the diagnosis and treatment of pharyngitis was associated with a decrease in the overall prescribing of antibiotics but not the prescribing of ACP-recommended antibiotics.
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As each clinical procedure must be justified by a corresponding diagnosis in Japanese health insurance claim (HIC), unconfirmed diagnoses marked as rule-out diagnoses will be written on an HIC. However, little is known about the statistical profiles of such rule-out diagnoses. ⋯ The existence of rule-out diagnoses affects the results of statistics based on HIC data. Japanese statistics based on HIC data should be improved by utilizing the information on rule-out diagnoses.
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In the UK, cancer care is managed via multidisciplinary teams (MDT). Core members of these teams are typically surgeons, oncologists, radiologists, pathologists and clinical nurse specialists (with other health care professionals potentially present). Good teamwork, including team communication and leadership, has been shown to be a prerequisite for safe care delivery in other health care contexts, but cancer MDT team working processes are yet to be fully explored. This study aimed to assess the self-perceived contribution of oncologists to MDTs, with emphasis on their potential role as team leaders. ⋯ Despite a high level of contribution to MDTs and the respect of their colleagues, oncologists are not taking leadership roles within MDTs at the level that they expect. This study raises the question of whether a re-evaluation the leadership of MDTs is required with clinicians from a variety of specialities being given opportunities to develop skills necessary to lead cancer MDTs and improve team performance and ultimately cancer care.
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To describe the development and use of a quality improvement service self-evaluation tool within Pacific addiction services in New Zealand. ⋯ The study found that there is a need for an evaluation tool for the provision of quality services. For Pacific services it was important that the tool recognize and capture the Pacific approaches utilized in their service delivery. Overall the tool was found to be acceptable and feasible to use, assisted services to identify areas of achievement and to prioritize areas requiring improvement and was adaptable to 'real world' Pacific addiction treatment settings in New Zealand.