The Methodology of Meta-Analyses and Its Potential Contribution to Patient Care

IntroductionOptimising the safety of obstetric patient care is a primary concern for many hospitals. Performance indicators measuring aspects of patient care processes can lead to improvements in health systems and the prevention of harm to the patient. We present our protocol for a scoping review to identify indicators for obstetric safety in low risk births. We aim to identify indicators addressing preventable hospital harms, to summarise the data and synthesise results.Methods and analysisWe will use methods described by Arksey and O’Malley and further expanded by Levacet al. We will search electronic databases such as Medline, Embase, CINAHL and the Cochrane Library, and websites from professional bodies and other organisations, using an iterative search strategy.Two reviewers will independently screen titles and abstracts of search results to determine eligibility for inclusion. If eligibility is not clear, the reviewers will screen the full text version. If reviewers’ decisions regarding eligibility differ, a third reviewer will review the record. Two reviewers will independently extract data from records that meet our inclusion criteria using a standardised data collection form. We will narratively describe quantitative data, such as the frequency with which indicators are identified, and conduct a thematic analysis of the qualitative data. We will compile a comprehensive list of patient safety indicators and organise them according to concepts that best suit the data such as the Donabedian model or the Hospital Harm Framework. We will discuss the implications for future research, clinical practice and policy-making. We will report the conduct of the review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews checklist.Ethics and disseminationThe sources of information included in this scoping review will be available to the public. Therefore, ethics approval is not warranted. We will disseminate results in a peer-reviewed publication, conference/event presentation(s) and stakeholder communications.

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Board-Certified Oncology Pharmacists: Their Potential Contribution to Reducing a Shortfall in Oncology Patient Visits

Journal of Oncology Practice ◽

10.1200/jop.2015.008490 ◽

2016 ◽

Vol 12 (4) ◽

pp. e359-e368 ◽

Cited By ~ 18

Author(s):

Robert Ignoffo ◽

Katherine Knapp ◽

Mitchell Barnett ◽

Sally Yowell Barbour ◽

Steve D’Amato ◽

...

Keyword(s):

Health Care ◽

Cancer Treatment ◽

Patient Care ◽

Nurse Practitioners ◽

Physician Assistants ◽

Delphi Panel ◽

Potential Contribution ◽

Oncology Patient ◽

Care Services ◽

Number Of Patients

Purpose: With an aging US population, the number of patients who need cancer treatment will increase significantly by 2020. On the basis of a predicted shortage of oncology physicians, nonphysician health care practitioners will need to fill the shortfall in oncology patient visits, and nurse practitioners and physician assistants have already been identified for this purpose. This study proposes that appropriately trained oncology pharmacists can also contribute. The purpose of this study is to estimate the supply of Board of Pharmacy Specialties–certified oncology pharmacists (BCOPs) and their potential contribution to the care of patients with cancer through 2020. Methods: Data regarding accredited oncology pharmacy residencies, new BCOPs, and total BCOPs were used to estimate oncology residencies, new BCOPs, and total BCOPs through 2020. A Delphi panel process was used to estimate patient visits, identify patient care services that BCOPs could provide, and study limitations. Results: By 2020, there will be an estimated 3,639 BCOPs, and approximately 62% of BCOPs will have completed accredited oncology pharmacy residencies. Delphi panelists came to consensus (at least 80% agreement) on eight patient care services that BCOPs could provide. Although the estimates given by our model indicate that BCOPs could provide 5 to 7 million 30-minute patient visits annually, sensitivity analysis, based on factors that could reduce potential visit availability resulted in 2.5 to 3.5 million visits by 2020 with the addition of BCOPs to the health care team. Conclusion: BCOPs can contribute to a projected shortfall in needed patient visits for cancer treatment. BCOPs, along with nurse practitioners and physician assistants could substantially reduce, but likely not eliminate, the shortfall of providers needed for oncology patient visits.

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Addressing barriers to evidence-based medicine in pediatric surgery: an introduction to the Canadian Association of Paediatric Surgeons Evidence-Based Resource

World Journal of Pediatric Surgery ◽

10.1136/wjps-2021-000332 ◽

2022 ◽

Vol 5 (1) ◽

pp. e000332

Author(s):

Viviane Grandpierre ◽

Irina Oltean ◽

Manvinder Kaur ◽

Ahmed Nasr

Keyword(s):

Patient Care ◽

Evidence Based Medicine ◽

Pediatric Surgery ◽

Improve Patient Care ◽

Evidence Based ◽

Training Methods ◽

Research Gaps ◽

Canadian Association ◽

Meta Analyses ◽

Based Medicine

BackgroundPediatric surgical practice lags behind medicine in presence and use of evidence, primarily due to time constraints of using existing tools that are not specific to pediatric surgery, lack of sufficient patient data and unstructured pediatric surgery training methods.MethodWe developed, disseminated and tested the effectiveness of an evidence-based resource for pediatric surgeons and researchers that provides brief, informative summaries of quality-assessed systematic reviews and meta-analyses on conflicting pediatric surgery topics.ResultsResponses of 91 actively practicing surgeons who used the resource were analysed. The majority of participants found the resource useful (75%), improved their patient care (66.6%), and more than half (54.2%) found it useful in identifying research gaps. Almost all participants reported that the resource could be used as a teaching tool (93%).ConclusionLack of awareness of the resource is the primary barrier to its routine use, leading to potential calls for more active dissemination worldwide. Users of the Canadian Association of Paediatric Surgeons Evidence-Based Resource find that the summaries are useful, identify research gaps, help mitigate multiple barriers to evidence-based medicine, and may improve patient care.

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Predicting mortality with cardiac troponins: recent insights from meta-analyses

Diagnosis ◽

10.1515/dx-2019-0061 ◽

2019 ◽

Vol 0 (0) ◽

Cited By ~ 3

Author(s):

Giuseppe Lippi ◽

Gianfranco Cervellin ◽

Fabian Sanchis-Gomar

Keyword(s):

Cardiac Troponin ◽

Troponin I ◽

Stable Coronary Artery Disease ◽

High Sensitivity ◽

Healthy Population ◽

Potential Contribution ◽

Prognostic Information ◽

Risk Of Death ◽

Coronary Syndrome ◽

Meta Analyses

AbstractThe introduction of cardiac troponin (cTn) testing in clinical practice has been one of the most important breakthroughs that have occurred in the recent history of laboratory medicine. Although it is now uncontestable that cTn values are essential for diagnosing acute coronary syndrome (ACS), solid evidence is also emerging that assessment of either cardiac troponin I (cTnI) or T (cTnT) may provide valuable prognostic information in the general healthy population, as well as in patients with a vast array of cardiac and extra-cardiac diseases. We have hence performed a critical review of the scientific literature for identifying meta-analyses which have investigated the potential contribution of cTns in predicting the risk of death in health and disease. According to the articles identified with our research, we can conclude that increased cTn values may be considered independent risk factors for all-cause mortality in the general population, as well as in patients with ACS, in those undergoing revascularization procedures, or with stable coronary artery disease (CAD), heart failure (HF) and atrial fibrillation (AF). Measurement of cTn may then be helpful for stratifying the mortality risk in non-cardiac hospitalized patients, in those with critical illness or sepsis, syncope, stroke, acute aortic dissection, pulmonary diseases, brain injury, renal failure, vascular and non-cardiac surgery. Although this evidence has notable clinical implications, the cost-effectiveness of population screening with high-sensitivity (hs) cTn immunoassays has not been proven so far.

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Geriatric Patient Care by U.S. Pharmacists in Healthcare Teams: Systematic Review and Meta‐Analyses

Journal of the American Geriatrics Society ◽

10.1111/jgs.12323 ◽

2013 ◽

Vol 61 (7) ◽

pp. 1119-1127 ◽

Cited By ~ 46

Author(s):

Jeannie K. Lee ◽

Marion K. Slack ◽

Jennifer Martin ◽

Clara Ehrman ◽

Marie Chisholm‐Burns

Keyword(s):

Systematic Review ◽

Patient Care ◽

Geriatric Patient ◽

Healthcare Teams ◽

Meta Analyses

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Saúde e espiritualidade. Contribuição dos presbíteros nos hospitais

Revista Eclesiástica Brasileira ◽

10.29386/reb.v75i300.265 ◽

2018 ◽

Vol 75 (300) ◽

pp. 827

Author(s):

Paulo Franco Taitson ◽

Ricardo Barbosa Correa

Keyword(s):

Pastoral Care ◽

Patient Care ◽

Pastoral Theology ◽

Severe Disease ◽

Potential Contribution ◽

Hospital Organization ◽

Hospital Chaplains ◽

Scientific World ◽

Scientific Approach ◽

Multidisciplinary Patient Care

Síntese: Este artigo investiga a contribuição potencial do cuidado pastoral prestado nos hospitais por capelães hospitalares, como parte de uma visão integrada de atendimento ao paciente, particularmente em instituições que lidam com doença grave. São necessárias melhorias em várias frentes para profissionalizar a pastoral prestada nos hospitais e modernizar a figura do capelão. Essas melhorias incluem: a melhoria das relações entre os capelães modernos e a organização hospitalar e o mundo científico; mais foco em uma abordagem científica para as suas atividades e sobre a avaliação da eficácia da ação pastoral; maior participação nas equipes multidisciplinares de atendimento ao paciente, das quais os capelães hospitalares são parte integrante.Palavras-chave: Espiritualidade. Hospitais. Promoção da saúde. Pastoral. Teologia.Abstract: This article investigates the potential contribution of the pastoral care provided in hospitals by hospital chaplains, as part of an integrated view of patient care, particularly in institutions dealing with severe disease. Improvements are needed on several fronts to professionalize the pastoral care provided in hospitals and modernize the figure of the chaplain. These improvements include better relations between modern chaplains and the hospital organization and scientific world; more focus on a scientific approach to their activities and on evaluating the efficacy of pastoral care activities; greater involvement in the multidisciplinary patient care teams, of which the hospital chaplains are an integral part.Keywords: Spirituality. Hospitals. Health promotion. Pastoral. Theology.

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Improving patient care in neurosurgery through postoperative telephone calls: a systematic review and lessons from all surgical specialties

Neurosurgical FOCUS ◽

10.3171/2021.8.focus21410 ◽

2021 ◽

Vol 51 (5) ◽

pp. E5

Author(s):

Dylan Goehner ◽

Sandeep Kandregula ◽

Harjus Birk ◽

Christopher P. Carroll ◽

Bharat Guthikonda ◽

...

Keyword(s):

Systematic Review ◽

Patient Safety ◽

Patient Care ◽

English Language ◽

Text Message ◽

Telephone Call ◽

Inclusion Criteria ◽

Telephone Calls ◽

Meta Analyses ◽

Enhance Patient Care

OBJECTIVE Postoperative telephone calls are a simple intervention that can be used to improve communication with patients, potentially affecting patient safety and satisfaction. Few studies in the neurosurgical literature have examined the effect of a postoperative telephone call on patient outcomes, although several exist across all surgical specialties. The authors performed a systematic review and analyzed studies published since 2000 to assess the effect of a postoperative telephone call or text message on patient safety and satisfaction across all surgical specialties. METHODS A search of PubMed-indexed articles was performed on June 12, 2021, and was narrowed by the inclusion criteria of studies from surgical specialties with > 50 adult patients published after 1999, in which a postoperative telephone call was made and its effects on safety and satisfaction were assessed. Exclusion criteria included dental, medical, and pediatric specialties; systematic reviews; meta-analyses; and non–English-language articles. Dual review was utilized. RESULTS Overall, 24 articles met inclusion criteria. The majority reported an increase in patient satisfaction scores after a postoperative telephone call was implemented, and half of the studies demonstrated an improvement in safety or outcomes. CONCLUSIONS Taken together, these studies demonstrate that implementation of a postoperative telephone call in a neurosurgical practice is a feasible way to enhance patient care. The major limitations of this study were the heterogeneous group of studies and the limited neurosurgery-specific studies.

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Effects of continuing medical education on improving physician clinical care and patient health: A review of systematic reviews

International Journal of Technology Assessment in Health Care ◽

10.1017/s026646230505049x ◽

2005 ◽

Vol 21 (3) ◽

pp. 380-385 ◽

Cited By ~ 242

Author(s):

Bernard S. Bloom

Keyword(s):

Medical Education ◽

Patient Care ◽

Patient Outcomes ◽

Systematic Reviews ◽

Continuing Medical Education ◽

Clinical Care ◽

Care Quality ◽

Clinical Practices ◽

Patient Health ◽

Meta Analyses

Objectives:The objective of physician continuing medical education (CME) is to help them keep abreast of advances in patient care, to accept new more-beneficial care, and discontinue use of existing lower-benefit diagnostic and therapeutic interventions. The goal of this review was to examine effectiveness of current CME tools and techniques in changing physician clinical practices and improving patient health outcomes.Methods:Results of published systematic reviews were examined to determine the spectrum from most- to least-effective CME techniques. We searched multiple databases, from 1 January 1984 to 30 October 2004, for English-language, peer-reviewed meta-analyses and other systematic reviews of CME programs that alter physician behavior and/or patient outcomes.Results:Twenty-six reviews met inclusion criteria, that is, were either formal meta-analyses or other systematic reviews. Interactive techniques (audit/feedback, academic detailing/outreach, and reminders) are the most effective at simultaneously changing physician care and patient outcomes. Clinical practice guidelines and opinion leaders are less effective. Didactic presentations and distributing printed information only have little or no beneficial effect in changing physician practice.Conclusions:Even though the most-effective CME techniques have been proven, use of least-effective ones predominates. Such use of ineffective CME likely reduces patient care quality and raises costs for all, the worst of both worlds.

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