Articles: outcome-assessment-health-care.
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Cochrane Db Syst Rev · Jan 2006
Review Meta AnalysisAudit and feedback: effects on professional practice and health care outcomes.
Audit and feedback continues to be widely used as a strategy to improve professional practice. It appears logical that healthcare professionals would be prompted to modify their practice if given feedback that their clinical practice was inconsistent with that of their peers or accepted guidelines. Yet, audit and feedback has not consistently been found to be effective. ⋯ Audit and feedback can be effective in improving professional practice. When it is effective, the effects are generally small to moderate. The relative effectiveness of audit and feedback is likely to be greater when baseline adherence to recommended practice is low and when feedback is delivered more intensively.
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J Int Neuropsychol Soc · Jul 2005
Meta Analysis Comparative StudyThe neuropsychological impact of sports-related concussion: a meta-analysis.
There is increasing interest in the potential neuropsychological impact of sports-related concussion. A meta-analysis of the relevant literature was conducted to determine the impact of sports-related concussion across six cognitive domains. The analysis was based on 21 studies involving 790 cases of concussion and 2014 control cases. ⋯ These findings were moderated by cognitive domain and comparison group (control group versus preconcussion self-control). Specifically, delayed memory in studies utilizing a control group remained problematic at 7 days. The implications and limitations of these findings are discussed.
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Improving quality and effectiveness of health care is one of the priorities of health policies. Hospital or physician volume of activity may be a measurable variable with a relevant impact on effectiveness of health care. There are several studies and systematic reviews evaluating the association between volume and outcome of health care. The aim of this review is to identify: areas, clinical conditions or interventions (prevention, diagnostic, therapeutic, surgical or clinical) for which an association between volume and outcome has been investigated; those for which an association between volume and outcome has been proved ⋯ In some areas the evidence seems strong enough to guide health care organizational choices, although it is not possible to identify well defined volume thresholds. In other areas, particularly for non surgical conditions, where there is not enough evidence, it seems necessary to conduct proper epidemiological studies. Also the evaluation of effectiveness of using volume as an instrument of health policy requires further research. Taking into account the rapid and continuing process of technology development, the definition of standard and prerequisite volumes of care should be specific of each temporal period and health care system. It is therefore a dynamic process requiring a continuous review of the available evidence. In the area of evidence based public health, the limited available evidence should not impair the choice of actions based on limited evidence, but rather it should lead to the application of thefew available evidence on one side and to the planning of proper research in the areas of lack of evidence.
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Review Meta Analysis
Measuring quality of life in patients with melanoma: development of the FACT-melanoma subscale.
A systematic review of the literature on quality of life (QOL) in melanoma patients suggested an overwhelming need for a disease-specific subscale. A melanoma subscale for the Functional Assessment of Cancer Therapy (FACT-Melanoma) was developed to meet this need. This instrument was developed in three stages. ⋯ After final revisions were made, the FACT-Melanoma tool included 24 items encompassing three QOL domains: 20 items relate to physical well-being, 3 to emotional well-being,and 1 to social well-being. The face and content validity of the FACT-Melanoma assessment tool has been confirmed in melanoma patients and by professionals. Formal validation and reliability testing of the questionnaire is being determined in a prospective cohort of melanoma patients.
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Meta Analysis
Evaluation of new treatments in radiation oncology: are they better than standard treatments?
The superiority of innovative over standard treatments is not known. To describe accurately the outcomes of innovations that are tested in randomized controlled trials (RCTs) 3 factors have to be considered: publication rate, quality of trials, and the choice of the adequate comparator intervention. ⋯ The finding that the results in individual trials cannot be predicted in advance indicates that the system and rationale for RCTs is well preserved and that successful interventions can only be identified after an RCT is completed.