Journal of evaluation in clinical practice
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Effective treatment of depression involves collaboration with informed patients and families and appropriate knowledge sharing. We describe here our experience, as a case example, of a collaboration to "translate" a clinical guideline designed for practitioners into an accessible, plainlanguage version that patients and families can use during the care process, both to provide basic educational information and to foster informed discussions with their treatment providers. Content experts in knowledge translation, patient advocacy, patient-oriented research, and psychiatry guided overall project design. ⋯ Both during and at the end of the project, writers provided additional recommendations for improving the process, including more in-person meetings, distribution of step-by-step instructions on the writing task, and a key terms glossary of technical terms to support their role. In conclusion, we describe a process with practical tips and reflective feedback on important considerations for engaging persons with lived experience as leaders in the codesign and writing process of lay treatment guidelines. These methods may serve as a model for similar projects in other areas of healthcare.
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In epidemiological research, it is essential to account for the confounding effects of factors such as age, stage, and comorbidity for accurate prediction of cancer outcomes. There are several internationally developed and commonly used comorbidity indices. However, none are regarded as the gold-standard method. This study will assess and compare the predictive validity of established indices for use in a South Australian (SA) colorectal cancer (CRC) population against a local index. Furthermore, the prognostic influence of comorbidity on survival is investigated. ⋯ The existing indices are still valid for adjusting for comorbidity and accurately predicting mortality in an SA CRC population. Internationally developed indices are preferred when policymakers and researchers wish to compare local study results with those of studies (national and international) that have used these indices. Comorbidity is a predictor of mortality and should be considered when assessing CRC survival.
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This paper explores the economic value of rehabilitation to South Africa, using a costed example of cerebrovascular accident (CVA) (stroke) rehabilitation. ⋯ The value of rehabilitation should not be considered in terms of cost-effectiveness alone, but also as an investment for the country. A staged, prioritized approach should be considered in future South African national health budget.
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In the context of the gradual development of artificial intelligence in health care, the clinical decision support systems (CDSS) play an increasing crucial role in improving the quality of the therapeutic and diagnostic efficiency in health care. The fuzzy logic (FL) provides an effective means for dealing with uncertainties in the health decision-making process; therefore, FL-based CDSS becomes a very powerful tool for data and knowledge management, being able to think like an expert clinician. This work proposes an FL-based CDSS for the evaluation of renal function in posttransplant patients. ⋯ We propose that the CDSSs for the assessment and follow-up of kidney-transplanted patients built in this study are applicable to clinical practice.
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Primary health care often has overall responsibility for elderly patients and their medication treatment. This is a challenging task due to the issue of multiple caregivers, different systems for documentation and multimorbidity among the elderly. The multiprofessional project SÄKLÄK2 was developed to raise drug safety in Swedish primary health care, and this study aimed to assess whether the action agreements that emerged from the model were effective enough to potentially improve drug use in elderly patients. ⋯ The SÄKLÄK2 intervention model is considered effective in setting up a variety of relevant measures to improve drug safety in primary health care, which are possible to implement in the near future. Hence, the model is regarded as effective and should therefore be offered in a wider context.