scholarly journals LINKING THE EVIDENCE: INTERMEDIATE OUTCOMES IN MEDICAL TEST ASSESSMENTS

2012 ◽  
Vol 28 (1) ◽  
pp. 52-58 ◽  
Author(s):  
Lukas P. Staub ◽  
Suzanne Dyer ◽  
Sarah J. Lord ◽  
R. John Simes
Keyword(s):  
Health Outcomes ◽  
Web Sites ◽  
English Language ◽  
Health Technology ◽  
Disease Classification ◽  
Test Results ◽  
Medical Test ◽  
Intermediate Outcomes ◽  
The Impact

Objectives: The aim of this study is to review how health technology assessments (HTA) of medical tests incorporate intermediate outcomes in conclusions about the effectiveness of tests on improving health outcomes.Methods: Systematic review of English-language test assessments in the HTA database from January 2005 to February 2010, supplemented by a search of the Web sites of International Network of Agencies for Health Technology Assessment (INAHTA) members.Results: A total of 149 HTAs from eight countries were assessed. Half evaluated tests for screening or diagnosis, a third for disease classification (including staging, prognosis, monitoring), and a fifth for multiple purposes. In seventy-one HTAs (48 percent) only diagnostic accuracy was reported, while in seventeen (11 percent) evidence of health outcomes was reported in addition to accuracy. Intermediate outcomes, mainly the impact of test results on patient management, were considered in sixty-one HTAs (41 percent). Of these, forty-seven identified randomized trials or observational studies reporting intermediate outcomes. The validity of these intermediate outcomes as a surrogate for health outcomes was not consistently discussed; nor was the quality appraisal of this evidence. Clear conclusions about whether the test was effective were included in approximately 60 percent of HTAs.Conclusions: Intermediate outcomes are frequently assessed in medical test HTAs, but interpretation of this evidence is inconsistently reported. We recommend that reviewers explain the rationale for using intermediate outcomes, identify the assumptions required to link intermediate outcomes and patient benefits and harms, and assess the quality of included studies.

Impact of community participation in primary health care: what is the evidence?

2015 ◽  
Vol 21 (1) ◽  
pp. 2 ◽  
Author(s):  
Jessamy Bath ◽  
John Wakerman
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Outcomes ◽  
Community Participation ◽  
Service Providers ◽  
Developmental Process ◽  
Service Access ◽  
Primary Health ◽  
Intermediate Outcomes ◽  
The Impact

Community participation is a foundational principle of primary health care, with widely reputed benefits including improved health outcomes, equity, service access, relevance, acceptability, quality and responsiveness. Despite considerable rhetoric surrounding community participation, evidence of the tangible impact of community participation is unclear. A comprehensive literature review was conducted to locate and evaluate evidence of the impact of community participation in primary health care on health outcomes. The findings reveal a small but substantial body of evidence that community participation is associated with improved health outcomes. There is a limited body of evidence that community participation is associated with intermediate outcomes such as service access, utilisation, quality and responsiveness that ultimately contribute to health outcomes. Policy makers should strengthen policy and funding support for participatory mechanisms in primary health care, an important component of which is ongoing support for Aboriginal Community Controlled Health Services as exemplars of community participation in Australia. Primary health-care organisations and service providers are encouraged to consider participatory mechanisms where participation is an engaged and developmental process and people are actively involved in determining priorities and implementing solutions.

scholarly journals Pengaruh Kedalaman Keprasan Tebu dengan Menggunakan Mesin Kepras Traktor Roda Dua Terhadap Kualitas Keprasan dan Pertumbuhan Tunas

2016 ◽  
Vol 1 (1) ◽  
pp. 995-1001
Author(s):  
Arzal Bili ◽  
Syafriandi Syafriandi ◽  
Mustaqimah Mustaqimah
Keyword(s):  
Sugar Cane ◽  
Test Results ◽  
Noticeable Effect ◽  
The Impact ◽  
Tractor Engine

Tebu kepras adalah menumbuhkan kembali bekas tebu yang telah ditebang. Keprasan tebu bertujuan untuk memperbaiki pertumbuhan tebu supaya tunas yang keluar tidak mengambang diatas permukaan tanah. Tujuan dari penelitian ini untuk mengetahui pengaruh kedalaman keprasan tebu dengan menggunakan mesin kepras traktor roda dua terhadap kualitas keprasan dan pertumbuhan tunas. Hasil uji F analisis sidik ragam menyatakan kedalaman keprasan tebu tidak memiliki pengaruh nyata terhadap kualitas keprasan, namun berpengaruh terhadap pertumbuhan yaitu berpengaruh terhadap diameter batang umur 21 HSK dan umur 28 HSK. Potongan utuh yang paling banyak dijumpai pada kedalaman keprasan 6-9 cm, dan potongan pecah banyak dijumpai pada kedalaman 0-3 cm, sedangkan tunggul yang terbongkar banyak dijumpai pada kedalaman 3-6 cm.The cutting of sugarcane is regrow trace sugar cane that has been cut down. The cutting of sugarcane aim to process  growth of sugarcane  which shoots out of floating off the ground. The purpose of this study to determine the influence of the depth cutting of  sugar cane using a tractor engine two wheels on the quality of cutting and growth buds. The test results were famous analysis of fingerprint range of express the depth of cuts in sugar cane has no noticeable effect on the quality of cutting, but the effect on the growth of the impact on the diameter of the age of 21 HSK and the age of 28 HSK. The cutting intact the most prevalent at a depth of cutting 6-9 cm, and broke out lots of found at a depth of 0- 3 cm, while the uncovered a lot of found at a depth of 3-6 cm.

Ontology for Data Quality and Chronic Disease Management

2015 ◽  
pp. 303-331
Author(s):  
Alireza Rahimi ◽  
Siaw-Teng Liaw ◽  
Pradeep Kumar Ray ◽  
Jane Taggart ◽  
Hairong Yu
Keyword(s):  
Chronic Disease ◽  
Data Quality ◽  
English Language ◽  
Assessment Tools ◽  
Fitness For Purpose ◽  
Language Studies ◽  
Full Text Review ◽  
Automated Tools ◽  
The Impact

Improved Data Quality (DQ) can improve the quality of decisions and lead to better policy in health organizations. Ontologies can support automated tools to assess DQ. This chapter examines ontology-based approaches to conceptualization and specification of DQ based on “fitness for purpose” within the health context. English language studies that addressed DQ, fitness for purpose, ontology-based approaches, and implementations were included. The authors screened 315 papers; excluded 36 duplicates, 182 on abstract review, and 46 on full-text review; leaving 52 papers. These were appraised with a realist “context-mechanism-impacts/outcomes” template. The authors found a lack of consensus frameworks or definitions for DQ and comprehensive ontological approaches to DQ or fitness for purpose. The majority of papers described the processes of the development of DQ tools. Some assessed the impact of implementing ontology-based specifications for DQ. There were few evaluative studies of the performance of DQ assessment tools developed; none compared ontological with non-ontological approaches.

Impact of Career Experiences on Health Outcomes Among Immigrants in the Midwest

2021 ◽  
pp. 101-123
Author(s):  
Caroline Kingori ◽  
Mohammad Rifat Haider ◽  
Seleshi Ayalew Asfaw ◽  
Senya Afi Ghamli
Keyword(s):  
Health Outcomes ◽  
High Growth ◽  
Immigrant Workers ◽  
Career Experiences ◽  
Skilled Immigrants ◽  
Playing Field ◽  
The Us ◽  
The Impact ◽  
The U.S

Immigrants in the US work in diverse professions and contribute to the economy. They play an important role in the economies in which they settle by complementing the skills lacking and create a level playing field for wages in the labor market. The U.S. Midwest has seen exceptionally high growth in immigrant populations in recent decades. While employment leads to a better quality of life when workers can afford basic necessities, immigrants encounter dire health challenges due to unemployment, underemployment, extreme working conditions, long work hours, and no paid leave. There is limited research examining the connection between career development experiences with the health of immigrant workers. This chapter examines the impact that employment circumstances have on skilled immigrants' health outcomes in the Midwest.

Early palliative care in haematological patients: a systematic literature review

2020 ◽  
Vol 10 (4) ◽  
pp. 395-403
Author(s):  
Silvia Tanzi ◽  
Francesco Venturelli ◽  
Stefano Luminari ◽  
Franco Domenico Merlo ◽  
Luca Braglia ◽  
...  
Keyword(s):  
Palliative Care ◽  
Comparative Studies ◽  
English Language ◽  
Meta Analysis ◽  
Early Palliative Care ◽  
Study Results ◽  
Registration Number ◽  
Integrated Or ◽  
The Impact

BackgroundEarly palliative care together with standard haematological care for advanced patients is needed worldwide. Little is known about its effect. The aim of the review is to synthesise the evidence on the impact of early palliative care on haematologic cancer patients’ quality of life and resource use.Patients and methodsA systematic review was conducted. The search terms were early palliative care or simultaneous or integrated or concurrent care and haematological or oncohaematological patients. The following databases were searched: PubMed, Embase, Cochrane, CINHAL and Scopus. Additional studies were identified through cross-checking the reference articles. Studies were in the English language, with no restriction for years. Two researchers independently reviewed the titles and abstracts, and one author assessed full articles for eligibility.ResultsA total of 296 studies titles were reviewed. Eight articles were included in the synthesis of the results, two controlled studies provided data on the comparative efficacy of PC interventions, and six one-arm studies were included. Since data pooling and meta-analysis were not possible, only a narrative synthesis of the study results was performed. The quality of the two included comparative studies was low overall. The quality of the six non-comparative studies was high overall, without the possibility of linking the observed results to the implemented interventions.ConclusionsStudies on early palliative care and patients with haematological cancer are scarce and have not been prospectively designed. More research on the specific population target, type and timing of palliative care intervention and standardisation of collected outcomes is required.PROSPERO registration numberCRD42020141322.

scholarly journals Cukorbeteg gyermekek együttműködésének vizsgálata a Diabetes Adherencia Kérdőív gyermekváltozatának validálása során

2019 ◽  
Vol 160 (29) ◽  
pp. 1136-1142
Author(s):  
Brigitta Munkácsi ◽  
Beáta Erika Nagy ◽  
Karolina Eszter Kovács
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Reliability Analysis ◽  
English Language ◽  
Target Level ◽  
Adolescent Population ◽  
The Impact

Abstract: Introduction: Most of the adolescents suffering from type 1 diabetes mellitus (T1DM) can be described with HbA1c values below the target level. Several research investigated the impact of diabetes on the quality of life, however, no complex questionnaire has been developed to examine each area of the disease. Aim: The aim of the present study is to create a Hungarian, reliable and valid questionnaire which can cover each aspect of the adherence related to type 1 diabetes mellitus. Method: In the present study, the attention was drawn to the introduction of a new questionnaire related to diabetes adherence which can be applied among children and adolescents as well. To test the questionnaire and to reduce the number of the items and to determine the scales, reliability analysis (Cronbach’s α) and factor analysis was applied. Results: The new measurement, which was created through the translation of English language international questionnaires, their pre-test, and its reduction by factor and reliability analysis, containing 9 subscales with 58 items, is stated as reliable regarding the results of the Cronbach’s α index. Conclusion: It can be stated that the created Diabetes Adherence Questionnaire can be reliably applied on child and adolescent population and it can be adapted for people suffering from other types of chronic diseases. Orv Hetil. 2019; 160(29): 1136–1142.

Web-Based Information for Patients and Providers

2020 ◽  
pp. 19-33
Author(s):  
Izabella Lejbkowicz
Keyword(s):  
Health Information ◽  
Web Sites ◽  
Information Technologies ◽  
The Internet ◽  
Online Health Information ◽  
World Population ◽  
Web Based ◽  
Access To Health ◽  
The Impact

The exponential development of Information Technologies revolutionized healthcare. A significant aspect of this revolution is the access to health information in the Internet. The Internet World Stats estimates that 56.8% of the world population used the Internet in March 2019, an increase of 1,066% from 2000. According to The Pew Research Center survey of 2012 81% of Americans used the internet and 72% of them searched for health information. Even though there is a lack in more recent data on the percentage of online health information seekers, it is clear that this trend is on the rise. This chapter focuses on the characteristics of the search for online health information by patients and providers, investigates features related to the quality of health web sites, and discusses the impact of these searches on healthcare.

OP135 Confirmatory Versus Explorative Endpoints In Drug Approval Versus Health Technology Assessment

2017 ◽  
Vol 33 (S1) ◽  
pp. 63-64
Author(s):  
Ines Niehaus ◽  
Charalabos-Markos Dintsios
Keyword(s):  
Health Technology Assessment ◽  
Technology Assessment ◽  
Drug Approval ◽  
Health Technology ◽  
Benefit Assessment ◽  
Benefit Ratio ◽  
Early Benefit Assessment ◽  
The Impact ◽  
Early Benefit

INTRODUCTION:The early benefit assessment of drugs in Germany and their preceded market authorization pursue different objectives, resulting in divergent decision-making strategies. This is reflected inter alia by the diverse inclusion of confirmatory endpoints within the assessments of oncological drugs. The pharmaceutical manufacturers are facing the challenge of meeting the requirements for both evaluation processes by the available evidence and avoiding hereby negative early benefit assessments. This is mainly due to the concept of mutually relevant clinical trials.METHODS:Identification and gathering of the endpoints is based on a specifically developed guide. The extracted data from the documents of completed assessments up to July 2015 are used to estimate both separately and together the impact of explorative in relation to confirmatory endpoints on the drug approval and early benefit assessment, by contrasting the European Medicines Agency's risk-benefit-ratio and the benefit-harm-balancing of the national Health Technology Assessment (HTA) jurisdiction.RESULTS:Twenty-one of fourty-one studies’ oncological assessments could be included in the endpoint analysis. From a procedural point of view both the drug approval and the early benefit assessment seem to be not confirmatory since they include explorative endpoints as well. Yet, drug approval is in terms of quality of endpoints more confirmatory than early benefit assessment since it contains a higher proportion of primary endpoints. The latter implies only in 67 percent of the assessments a primary endpoint to be relevant for the benefit-harm-balancing. Moreover, explorative mortality endpoints reached the highest agreement and explorative endpoints capturing health-related quality of life no agreement, referring to the mutual relevance of endpoints for the risk-benefit-ratio and the benefit-harm-balancing.CONCLUSIONS:The missing information transparency of the assessment reports compared to the information offered within the early benefit assessment makes an assignment of endpoints with respect to the mutually relevant clinical trial sometimes troublesome. To warrant, in the long run, a broader confirmatory basis for decisions in health care supported by HTA, a closer inter-institutional cooperation of approval authorities and German HTA jurisdictions seems favorable.

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