Clinical outcomes research: contributions to the evidence base for homeopathy

Homeopathy ◽  
2003 ◽  
Vol 92 (1) ◽  
pp. 56-57 ◽  
Author(s):  
Robert T Mathie
Keyword(s):  
Clinical Outcomes ◽  
Outcomes Research ◽  
Evidence Base

A Systematized Review of Professional Employment Following Thoracic Transplantation

2022 ◽  
pp. 152692482110648
Author(s):  
Stefan Jobst ◽  
Jonas Schaefer ◽  
Christina Kleiser ◽  
Christiane Kugler
Keyword(s):  
Clinical Outcomes ◽  
Associated Factors ◽  
Evidence Base ◽  
Transplant Recipients ◽  
Modifiable Factors ◽  
Systematized Review ◽  
Health Related ◽  
Employment Rates ◽  
Lung Transplant Recipients ◽  
Thoracic Transplantation

Introduction Acknowledging the evolved landscape in thoracic transplantation, professional employment becomes an important outcome measure to quantify the success of this costly procedure. Objective We aimed to assess rates of and characterize factors associated with professional employment in patients following thoracic transplantation, and create an evidence-base on the relationship between professional employment and relevant outcome parameters. Methods We systematically searched Medline, Cinahl, and GoogleScholar to identify studies published between 1998 and 2021 reporting on professional employment following heart and lung transplantation. Results Twenty-two studies from 11 countries with varying sample sizes (N = 27; 10 066) were included. Employment rates ranged from 19.7% to 69.4% for heart, and from 7.4% to 50.8% for lung transplant recipients. Most frequently reported positively associated factors with employment after transplant were younger age, higher education, and history of pretransplant employment. Longer duration of unemployment prior to transplantation and Medicaid coverage were the most frequently reported negatively associated factors. Relationships between professional employment and clinical outcomes included lower rates of acute and chronic rejection, less infection episodes, and better quality of life among working patients; one study reported a lower 5-year-mortality rate. Reasons not to work were “physical or mental health-related,” “employment-related,” “financial reasons,” and “lifestyle choices.” Discussion Substantial proportions of patients following thoracic transplantation are not professionally employed, potentially diminishing the success of transplantation on individual and societal levels. Considering adverse clinical outcomes in employed transplant recipients were low, more efforts are needed to identify modifiable factors for employment in these populations.

Practice-based Outcomes Research: Crucial, Feasible, and Neglected

PEDIATRICS ◽  
1996 ◽  
Vol 97 (1) ◽  
pp. 113-114
Author(s):  
Jerry Avorn
Keyword(s):  
Health Care ◽  
Clinical Outcomes ◽  
Outcomes Research ◽  
Cost Containment ◽  
American Health Care System ◽  
American Health Care ◽  
Experimental Subjects ◽  
Contemporary Medicine ◽  
Pharmacologic Therapies

The article from the Vermont-Oxford Neonatal Network1 in this issue of Pediatrics comparing two surfactant preparations represents an important case study of a central issue in contemporary medicine: the need for rigorous, even-handed evaluation of competing therapies. Even at a time in which patients and payers are expecting ever-higher standards for clinical outcomes, and policymakers and insurers are demanding more and more stringent cost containment, the American health care system lacks a coherent mechanism for assembling and analyzing the data needed to meet these goals. For pharmacologic therapies, the Food and Drug Administration (FDA) prefers that mew agents be tested against placebos whenever possible, unless this would result in harm to experimental subjects.

The role of single pill combination therapy in the prevention of ischaemic stroke

2019 ◽  
Vol 64 (4) ◽  
pp. 126-132
Author(s):  
Wan Y Ho ◽  
Azmil H Abdul-Rahim ◽  
Jesse Dawson ◽  
Alan C Cameron
Keyword(s):  
Combination Therapy ◽  
Clinical Outcomes ◽  
Stroke Prevention ◽  
Healthcare Professionals ◽  
Evidence Base ◽  
Stroke Survivors ◽  
Perceived Benefit ◽  
Single Pill ◽  
Individualised Care

Background and aims The role of single pill combination therapy for stroke prevention remains to be established. We explored the perspectives of stroke survivors and healthcare professionals on single pill combination therapy for stroke prevention. Methods We conducted focus groups involving stroke survivors and healthcare professionals. Results We recruited six stroke survivors: four (67%) were female and mean age was 70 ± 12 years; and eight healthcare professionals (three Stroke Consultants, two Nurse Specialists, three General Practitioners). Improved adherence is the main perceived benefit of single pill combination therapy, although concerns exist surrounding less individualised care, unsuitability for use in the acute setting, reduced ability to titrate doses and difficulty identifying the cause of side effects. The clinical stability of patients, alongside single pill combination therapy efficacy, cost, side effect profile and evidence base for impact on risk factors and clinical outcomes are key factors influencing acceptability. Stroke survivors and healthcare professionals feel single pill combination therapy is most suitable for stable patients, although there is no evidence base for its use in this context. Conclusion Stroke healthcare professionals and stroke survivors are most amenable to using single pill combination therapy for stable patients, although its role in this context should be evaluated in studies with risk factor targets and clinical outcomes as endpoints.

scholarly journals Capturing the value of peer support: measuring recovery-oriented services

2019 ◽  
Vol 18 (3) ◽  
pp. 180-187
Author(s):  
Stacey L. Barrenger ◽  
Victoria Stanhope ◽  
Emma Miller
Keyword(s):  
Clinical Outcomes ◽  
Peer Support ◽  
Support Services ◽  
Outcome Measurement ◽  
Evidence Base ◽  
Content Type ◽  
Evaluation Approach ◽  
The People ◽  
Starting Point ◽  
Peer Support Services

Purpose The purpose of this paper is to examine the gap between recovery-oriented processes and clinical outcomes in peer support, an exemplar of recovery-oriented services, and offer suggestions for bridging this gap. Design/methodology/approach This viewpoint is a brief review of literature on peer support services and gaps in outcome measurement towards building an evidence base for recovery-oriented services. Findings Clinical outcomes like hospitalizations or symptoms remain a focus of research, practice and policy in recovery-oriented services and contribute to a mixed evidence base for peer support services, in which recovery-oriented outcomes like empowerment, self-efficacy and hopefulness have more evidentiary support. One approach is to identify the theoretical underpinnings of peer support services and the corresponding change mechanisms in models that would make these recovery-oriented outcomes mediators or process outcomes. A better starting point is to consider which outcomes are valued by the people who use services and develop an evaluation approach according to those stated goals. User driven measurement approaches and more participatory types of research can improve both the quality and impact of health and mental health services. Originality/value This viewpoint provides a brief review of peer support services and the challenges of outcome measurement in establishing an evidence base and recommends user driven measurement as a starting point in evaluation of recovery-oriented services.

scholarly journals Quality of Colonoscopy Performed in Rural Practice: Experience From the Clinical Outcomes Research Initiative and the Oregon Rural Practice-Based Research Network

2017 ◽  
Vol 34 ◽  
pp. s75-s83 ◽  
Author(s):  
Jennifer L. Holub ◽  
Cynthia Morris ◽  
Lyle J. Fagnan ◽  
Judith R. Logan ◽  
LeAnn C. Michaels ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Outcomes Research ◽  
Rural Practice ◽  
Research Network ◽  
Practice Experience ◽  
Research Initiative ◽  
Practice Based Research

Developing a Dermatology Clinical Trials Network for Improved Therapeutics and Clinical Outcomes Research

2015 ◽  
Vol 4 (2) ◽  
pp. 90-95
Author(s):  
Joanne R. Chalmers ◽  
Carron Layfield ◽  
Hywel C. Williams
Keyword(s):  
Clinical Trials ◽  
Clinical Outcomes ◽  
Outcomes Research

An update on the growing evidence base for peer support

2017 ◽  
Vol 21 (3) ◽  
pp. 161-167 ◽  
Author(s):  
Chyrell Bellamy ◽  
Timothy Schmutte ◽  
Larry Davidson
Keyword(s):  
Mental Health ◽  
Physical Health ◽  
Clinical Outcomes ◽  
Peer Support ◽  
Support Services ◽  
Evidence Base ◽  
Current Evidence ◽  
Content Type ◽  
Current Evidence Base ◽  
Peer Support Services

Purpose As peer support services have become increasingly used in mental health settings as a recovery-oriented practice, so has the body of published research on this approach to care. The purpose of this paper is to provide an update on the current evidence base for peer support for adults with mental illness in two domains: mental health and recovery, and physical health and wellness. Design/methodology/approach To provide a robust, non-redundant, and up-to-date review, first the authors searched for meta-analyses and systematic reviews. Second, the authors found individual studies not included in any of the reviews. Findings Peer services are generally equally effective to services provided by non-peer paraprofessionals on traditional clinical outcomes. Although some studies found peer services to be effective at reducing hospitalization rates and symptom severity, as a whole, the current evidence base is confounded by heterogeneity in programmatic characteristics and methodological shortcomings. On the other hand, the evidence is stronger for peer support services having more of a positive impact on levels of hope, empowerment, and quality of life. Research limitations/implications In addition to the need for further high-quality research on peer support in mental and physical health domains, the authors also question whether measures of hope, empowerment, and integration into the community are more relevant to recovery than traditional clinical outcomes. Originality/value This paper provides an original, robust, and up-to-date review of the evidence for peer services.

Sign in / Sign up

Export Citation Format

Share Document