Journal of evaluation in clinical practice
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Multicenter Study
Modelling survival in acute severe illness: Cox versus accelerated failure time models.
The Cox model has been the mainstay of survival analysis in the critically ill and time-dependent covariates have infrequently been incorporated into survival analysis. ⋯ Time dependence of predictors of survival in ALI/ARDS exists and must be appropriately modelled. The Cox model with time-varying covariates remains a flexible model in survival analysis of patients with acute severe illness.
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Limited data exist to estimate the use of electronic health records (EHRs) in ambulatory care practices in the United States. ⋯ Overall, fewer than 1 in 5 medical practices in Massachusetts have an EHR. Even among adopters, though, doctor usage of EHR functions varied considerably by functionality and across practices. Many clinicians are not actively using functionalities that are necessary to improve health care quality and patient safety. Furthermore, among practices that do not have EHRs, more than half have no plan for adoption. Inadequate funding remains an important barrier to EHR adoption in ambulatory care practices in the United States.
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A valid tool to measure clinical competency early in medical school could identify students who may require special educational attention. The overall aim is to assess the relationship between students' scores on an objective structured clinical examination (OSCE) given in the second year of medical school and their subsequent performance on Step 2 of the United States Medical Licensing Examination (USMLE Step 2). ⋯ OSCEs early in medical school can be useful in the early assessment of clinical competence.
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Randomized Controlled Trial
Examining the hierarchical factor structure of the SF-36 Taiwan version by exploratory and confirmatory factor analysis.
The purpose of this study was to examine the factor structure of the Medical Outcome Study Short Form-36 Taiwan version (SF-36 Taiwan version) using data from the 2001 National Health Interview Survey in Taiwan. ⋯ According to the EFA and CFA, it can be concluded that the original structure is still acceptable for the SF-36 Taiwan version.
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Doctors frequently give non-critically ill patients unjustified stress ulcer prophylaxis (SUP). It is unknown if this practice also occurs during residency training. ⋯ Many non-critically ill patients on the teaching service received unjustified SUP, suggesting the need for institutional protocols and educational interventions to promote evidence-based practice during residency training.