The quiet revolution: Reporting of health outcomes in general medical journals

This study reviews the extent of evaluation of health outcomes in three general medicaljournals over the past decade by examining papers published in the original researchsection of the New England Journal of Medicine (NEJM), The Lancet, and theMedical Journal of Australia (MJA) in 1982 and 1992. Evaluations were identifiedand classified according to the type of comparison group and the type of outcomemeasures employed. They were divided into three categories: those employing acomparison group; those employing a before-and-after study design (or owncomparison group); and those with no comparison group. The categories of outcomemeasures were mortality, clinical or intermediate measures of health state, and finaloutcome measures (quality of life). Results show that the proportion of papersevaluating a health services intervention remained stable over the period. However,the MJA published considerably fewer evaluations than the other journals. In theNEJM and The Lancet, 75- per cent of evaluations incorporated comparison groups,in the MJA, less than 40- per cent. Overall, the proportion of papers reporting finaloutcome measures increased significantly between 1982 and 1992 (p = 0.04) butthe change in each journal individually did not reach statistical significance. Thisstudy indicates that the reporting of health outcomes evaluations has remainedconstant but there has been some change in the use of comparison groups and finaloutcome measures over time.

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Impact of Hearing Aids on Poverty, Quality of Life and Mental Health in Guatemala: Results of a before and after Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17103470 ◽

2020 ◽

Vol 17 (10) ◽

pp. 3470 ◽

Cited By ~ 1

Author(s):

Mark Spreckley ◽

David Macleod ◽

Brenda González Trampe ◽

Andrew Smith ◽

Hannah Kuper

Keyword(s):

Quality Of Life ◽

Mental Health ◽

Hearing Loss ◽

Hearing Aids ◽

Household Income ◽

Comparison Group ◽

Before And After ◽

Before And After Study

There are 466 million people globally with disabling hearing loss, many of whom can benefit from hearing aids. The aim of the study was to assess the impact of providing hearing aids on poverty, mental health, quality of life, and activities, among adults in Guatemala. A nonrandomised before and after study was conducted, with a comparison group to assess for secular trends. Adult cases with bilateral hearing impairment were identified within 150 km of Guatemala City, as well as age- and sex-matched comparison subjects without disabling hearing loss. All participants were interviewed with a semistructured questionnaire, and cases were offered hearing aids. Participants were reinterviewed 6–9 months later. We interviewed 135 cases and 89 comparison subjects at baseline and follow-up. At baseline, cases were poorer than comparison subjects with respect to individual income (p = 0.01), household income (p = 0.02), and per capita expenditure (PCE) (p = 0.003). After provision of hearing aids, median household income improved among cases (p = 0.03). In the comparison group, median individual income (p = 0.01) and PCE (p = 0.03) fell between baseline at follow-up. At follow-up, there were also improvements in productive time use, quality of life, and depressive symptoms among cases, but these were less apparent in the comparison group. In conclusion, this study has demonstrated a positive effect of hearing aids in improving quality of life, economic circumstances and mental health among Guatemalan adults.

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Gametocyte carriage after seasonal malaria chemoprevention in Plasmodium falciparum infected asymptomatic children

Malaria Journal ◽

10.1186/s12936-021-03706-1 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Abdullahi Ahmad ◽

Aurelia Prom ◽

John Bradley ◽

Mamadou Ndiath ◽

Blessed Etoketim ◽

...

Keyword(s):

Plasmodium Falciparum ◽

Comparison Group ◽

Conditional Logistic Regression ◽

Gametocyte Carriage ◽

Asymptomatic Children ◽

Seasonal Malaria Chemoprevention ◽

Before And After ◽

Chi Squared ◽

Comparison Groups ◽

To Receive

Abstract Background Treatment of clinical Plasmodium falciparum malaria with sulfadoxine-pyrimethamine (SP) and amodiaquine (AQ) is associated with increased post-treatment gametocyte carriage. The effect of seasonal malaria chemoprevention (SMC) with SP and AQ on gametocyte carriage was assessed in asymptomatic P. falciparum infected children. Methods The study was carried out in eastern Gambia. Asymptomatic P. falciparum malaria infected children aged 24–59 months old who were eligible to receive SMC (SMC group) and children 5–8 years that were not eligible to receive SMC (comparison group) were recruited. Gametocytaemia was determined by molecular methods before and after SMC administration. Gametocyte carriage between the groups was compared using the chi-squared test and within-person using conditional logistic regression. Results During the 2017 and 2018 malaria transmission seasons, 65 and 75 children were recruited in the SMC and comparison groups, respectively. Before SMC administration, gametocyte prevalence was 10.7% (7/65) in the SMC group and 13.3% (10/75) in the comparison group (p = 0.64). At day 13 (IQR 12, 13) after SMC administration, this was 9.4% (5/53) in children who received at least the first dose of SMC treatment and 12.7% (9/71) for those in the comparison group (p = 0.57). Similarly, there was no difference in prevalence of gametocytes between children that adhered to all 3-day doses of SMC treatment 15.6% (5/32) and those in the comparison group (p = 0.68). In the SMC group, within-group gametocyte carriage was similar before and after SMC administration in children that received at least the first dose of SMC treatment (OR 0.6, 95% CI 0.14–2.51; p = 0.48) and in those that adhered to all 3-day doses of SMC treatment (OR 1.0, 95% CI 0.20–4.95; p = 1.0). Conclusion In this study with relative low gametocyte prevalence prior to SMC treatment, no evidence was observed that SMC treatment increased gametocyte carriage in asymptomatic P. falciparum malaria infected children.

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The Effects of Patients' and Care-Givers' Knowledge, Attitude, & Practice (KAP) on Quality of Life Among Thalassemia Major Patients' in Damascus-Syrian Arab Republic

European Scientific Journal ESJ ◽

10.19044/esj.2018.v14n12p308 ◽

2018 ◽

Vol 14 (12) ◽

pp. 308

Author(s):

Yaser Adnan Abo Jeesh ◽

Magda El-hadi Ahmad Yousif ◽

Moauya Al-Balal Al-Haboub

Keyword(s):

Quality Of Life ◽

Statistical Significance ◽

Thalassemia Major ◽

Cross Sectional ◽

Attitudes And Practices ◽

Teaching Guide ◽

Care Givers ◽

Significant Difference ◽

Before And After

Background: Thalassemia is the most common autosomal abnormality in Syria. Its complications have an important effect on education; time off school; sport; difference from friends/ siblings; social interactions; and stigmatization. Knowledge of factors associated with quality of life in thalassemia patients is necessary for forming appropriate clinical programs, social support, and improving treatment outcomes. Purpose: The study was to assess the effects of Patients' and Care-givers' Knowledge, Attitude, & Practice (KAP) with Quality of Life among Thalassemia Major Patients' in Syria. Methods: Cross-sectional descriptive analytical design was conducted at the national thalassemia center in Damascus. WHOQOL-BREF and a questionnaire developed by the researcher were used to measure the participants’ knowledge, attitudes and practices of thalassemia. Results: Total of 238 thalassemia patients participated in the study. A statistical significance was found regarding improvement of skill and knowledge scores among caregivers and thalassemia patients before and after receiving the teaching guide from 12.52±1.77 to 14.07±1.01, t=11.447, p=0.000 and from 34.12±4.50 to 37.43±4.61, t=-8.58, p= .000 respectively. Stigmatization was significantly noticed among families caring for thalassemic patients. There were a significant differences in the mean score regarding nutritional status before and after teaching guide paired t test= 12.11, p= 0.000. A statistical significance was found in females regarding social domain p=0.04. However, mean scores for overall quality of life were better in females rather than males, but these mean scores were statistically insignificant p>0.05. A statistical significant difference in ferritin levels and patient’s age was found. Results also revealed that no statistical significant differences was observed between overall quality of life of the four domains in relation to the two treatment groups (subcutaneous vs oral) and age groups. Conclusion: Thalassemia is a socio-economic problem. The most efficient way to reduce risks of having affected patients is by increasing the knowledge through training of parents regarding the disease. Our findings highlighted that there was lack in patients’ knowledge and skills regarding the disease, but a remarkable improvement in both knowledge and performance was found after patients received the teaching guide, which lead to an increase in overall patient's quality of life.

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Intra Articular Ozone Reduces Serum Uric Acid and Improves Pain, Function and Quality of Life in Knee Osteoarthritis Patients: A Before-and-After Study

Middle East Journal of Rehabilitation and Health ◽

10.5812/mejrh.68599 ◽

2018 ◽

Vol 5 (3) ◽

Cited By ~ 1

Author(s):

Marcos Edgar Fernandez-Cuadros ◽

Olga Susana Perez-Moro ◽

Maria Jesus Albaladejo-Florin ◽

Ruben Algarra-Lopez

Keyword(s):

Quality Of Life ◽

Uric Acid ◽

Knee Osteoarthritis ◽

Serum Uric Acid ◽

Before And After ◽

Before And After Study

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Evaluation of two strategies to implement physical cancer rehabilitation guidelines for survivors of abdominopelvic cavity tumors: a controlled before-and-after study

Journal of Cancer Survivorship ◽

10.1007/s11764-021-01045-3 ◽

2021 ◽

Author(s):

Charlotte IJsbrandy ◽

Petronella B. Ottevanger ◽

Winald R. Gerritsen ◽

Wim H. van Harten ◽

Rosella P. M. G. Hermens

Keyword(s):

Primary Outcome ◽

Healthcare Professionals ◽

Patient Empowerment ◽

Implementation Strategies ◽

Primary Outcome Measure ◽

Cancer Rehabilitation ◽

Systematic Screening ◽

Before And After ◽

Before And After Study

Abstract Purpose This study evaluates the effectiveness and feasibility of two strategies to implement physical cancer rehabilitation (PCR) guidelines for patients who have survived abdominopelvic cavity malignancies. Methods We tested and compared two tailored strategies to implement PCR guidelines for survivors of gastrointestinal, female organ and urogenital organ malignancies, in a clustered controlled before-and-after study. A patient-directed (PD) strategy was tested in five cancer centers, aiming to empower survivors. A multifaceted (MF) strategy was tested in four cancer centers, aiming additionally to influence healthcare professionals and the healthcare organization. Data were collected from existing registration systems, patient questionnaires and professional questionnaires. We measured both implementation- and client outcomes. For insight into the effectiveness we measured indicators related to PCR guidelines: (1) screening with the Distress Thermometer (DT) (=primary outcome measure), (2) information provision concerning physical activity (PA) and physical cancer rehabilitation programs (PCRPs), (3) advice to take part in PA and PCRPs, (4) referral to PCRPs, (5) participation in PCRPs, (6) PA uptake (PAU); and patient reported outcomes (PROs) such as (7) quality of life, (8) fatigue, and (9) empowerment. Furthermore, survivor and center determinants were assessed as possible confounders. Multilevel analyses were performed to compare the scores of the indicators of the PD and MF strategies, as well as the differences between the characteristics of these groups. The use of and experiences with both strategies were measured using questionnaires and Google Analytics to assess feasibility. Results In total, 1326 survivors participated in the study, 673 in the before- and 653 in the after-measurement. Regarding our primary outcome measure, we found a significant improvement of screening with the DT between the before- and after-measurement for both strategies, respectively from 34.2 to 43.1% (delta=8.9%; odds ratio (OR)=1.6706; p=0.0072) for the PD strategy and from 41.5 to 56.1% (delta=14.6%; OR=1.7098; p=0.0028) for the MF strategy. For both the primary and secondary outcomes, no statistically significant effect of the MF strategy compared to the PD strategy was observed. We found good use of and positive experiences with both strategies. Conclusion Implementation strategies containing tools enhancing patient empowerment seem to be effective in increasing the systematic screening with the DT for survivors of abdominopelvic cavity malignancies. Further research is needed to assess the additional effectiveness of strategies that stimulate compliance among healthcare professionals and healthcare organizations. Implications for Cancer Survivors Using implementation strategies containing tools enhancing patient empowerment seem to be effective in increasing the systematic screening with the DT and might improve the quality of care of patients who have survived abdominopelvic cavity malignancies.

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Is this an epic innovation? Electronic health record implementation and healthcare workers’ work characteristics and autonomous motivation – a before-and-after study

10.21203/rs.3.rs-563136/v1 ◽

2021 ◽

Author(s):

Gepke L Veenstra ◽

Eric F. Rietzschel ◽

Eric Molleman ◽

Erik Heineman ◽

Jan Pols ◽

...

Keyword(s):

Healthcare Workers ◽

Healthcare Professionals ◽

Work Motivation ◽

Autonomous Motivation ◽

Health Record ◽

Work Characteristics ◽

Job Autonomy ◽

Before And After ◽

Before And After Study

Abstract Background Technological innovation in healthcare is often assumed to contribute to the quality of care. However, the question how technology implementation impacts healthcare workers has received little empirical attention. This study investigates the consequences of Electronic Health Record (EHR) implementation for healthcare workers’ work motivation. The consequences of EHR implementation for healthcare workers’ autonomous work motivation are hypothesized to be mediated by changes in perceived work characteristics (job autonomy and interdependence). Additionally, a moderating effect of profession on the relationship between EHR implementation and work characteristics is explored.Methods A quantitative uncontrolled before-and-after study was performed among employees from a large university medical centre in the Netherlands. Data were analysed following the component approach for testing a first stage moderated mediation model, using Generalized Estimating Equations (GEE). Results A total of 456 healthcare workers (75 physicians, 154 nurses, 145 allied healthcare professionals, and 82 administrative workers) finished both the baseline and the follow-up survey. After EHR implementation, job autonomy decreased, whereas interdependence increased. In line with our hypothesis, job autonomy was positively associated with autonomous motivation. Interdependence showed the same association, which we did not anticipate. Autonomous motivation was stable over the course of EHR implementation. This study did not provide support for a moderating effect of profession, meaning that no differences were observed between the various professions regarding the changes in their experienced job autonomy and interdependence after EHR implementation. Conclusions Our study showed that healthcare professionals’ work characteristics, but not their autonomous motivation, are affected by EHR implementation, and that these experiences were relatively similar for physicians, nurses, allied healthcare professionals. The stability of healthcare workers’ autonomous motivation may be explained by the opposite effects of decreased job autonomy and increased interdependence, and the EHR being in line with healthcare workers’ values. The changes in job autonomy and interdependence may have consequences beyond motivation, for example by affecting clinical decision making, proactive behaviour, and the quality of teamwork. These potential consequences of EHR implementation warrant further research.

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Quality of Life Comparison in Common Rhinologic Surgeries

Allergy & Rhinology ◽

10.2500/ar.2012.3.0020 ◽

2012 ◽

Vol 3 (1) ◽

pp. ar.2012.3.0020 ◽

Cited By ~ 8

Author(s):

Mohsen Naraghi ◽

Behrooz Amirzargar ◽

Alipasha Meysamie

Keyword(s):

Quality Of Life ◽

Statistical Difference ◽

Sleep Problems ◽

Sinus Surgery ◽

Before And After ◽

General Feeling ◽

Related Quality ◽

Health Related ◽

Before And After Study

Various questionnaires are used in patients who undergo rhinologic surgeries but a unique comprehensive questionnaire is needed to evaluate quality of life (QOL) in rhinologic surgeries. The purpose of this study was to prepare a comprehensive questionnaire and compare QOL among four common rhinologic surgeries including functional endoscopic sinus surgery, septoplasty, septorhinoplasty, and septoplasty with turbinoplasty preoperatively and 6 months postoperatively. This was a prospective interventional before-and-after study. Preoperative and 6 months postoperative evaluations were performed with a Modified Health-Related Quality of Life (HRQL) questionnaire designed to cover all needed QOL aspects and the 22-item Sino-nasal Outcome Test questionnaire to cover all needed QOL aspects. The Modified HRQL included 33 items in six subgroups (nasal symptoms, sleep problems, headache, nonnasal symptoms, and practical and emotional problems) and general feeling. From 202 patients who completed the questionnaire before the procedures, 146 (72% of all patients) who were interviewed 6 months postoperatively were included in this study. Comparing preoperative data between followed up patients and missed patients showed no statistical difference among surgeries (p = 0.90). Comparison of patient's pre- and postoperative QOL showed a significant improvement in global QOL and in all questionnaire items (p < 0.0001 in all comparisons). Comparison of QOL changes before and after surgery among different surgeries revealed no statistical difference (p = 0.282). Our data showed a significant improvement in each surgery but the amount of improvement in different surgeries was almost constant.

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Effectiveness and safety of pidotimod in recurrent respiratory infections in children: a pilot study

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20193715 ◽

2019 ◽

Vol 6 (5) ◽

pp. 2012 ◽

Cited By ~ 1

Author(s):

T. C. Acharya ◽

Kundan Nivangune ◽

Snehal Muchhala ◽

Rishi Jain

Keyword(s):

Prospective Observational Study ◽

Standard Treatment ◽

Respiratory Infections ◽

Single Centre ◽

The Past ◽

Recurrent Respiratory Infections ◽

Before And After ◽

Antibiotic Courses

Background: Recurrent respiratory infections (RRIs) are common in children especially in age 1 to 6 years. Pidotimod, an immunostimulant has been found to lower the recurrences of RRIs and improve the quality of life. The Objective of this study was to assess the efficacy and safety of pidotimod in children with recurrent respiratory infections (RRIs).Methods: In this single-centre, prospective, observational study, children aged 2 to 15 years diagnosed with RRIs were included. RRIs were defined as occurrence of 3 or more episodes of acute respiratory infections (ARIs) or more than 15 days of respiratory symptoms in the past 3 months. These children were treated with pidotimod in addition to standard care treatment. Treatment duration was two months and the follow-up continued for three months. Number of RRIs and severity of RRIs, antibiotic courses and rate of hospitalization before and after treatment were compared.Results: In total 25 children included in the study, mean age was 7.34±3.63 years. Among them, 68% were males. After treatment with pidotimod, there was significant reduction in mean number of ARI episodes (3.84±0.85 at baseline to 0.48±0.51 at follow-up, p<0.0001). Also, there was significant reduction in the duration of acute infectious episodes (p<0.0001), need of antibiotic courses (p<0.0001) and rates of hospitalization (p<0.0001). No safety concerns were identified and pidotimod was well tolerated.Conclusions: Addition of pidotimod to the standard treatment in children with RRIs significantly reduces the recurrence, duration of repeat infectious episodes, need of antibiotic treatments and future rates of hospitalizations. These findings support previous data.

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From Soundwaves to BrainWaves: The effects of choral singing on recovery from stroke and aphasia

British Journal of General Practice ◽

10.3399/bjgp18x696821 ◽

2018 ◽

Vol 68 (suppl 1) ◽

pp. bjgp18X696821 ◽

Cited By ~ 1

Author(s):

John Marley ◽

Bernadette Matthias ◽

Linda Worrall ◽

Maya Guest ◽

Christopher Allan

Keyword(s):

Quality Of Life ◽

New England ◽

Outcome Measurement ◽

Well Being ◽

Community Dwelling ◽

Stroke Survivors ◽

Choral Singing ◽

Before And After ◽

Qualitative Work

BackgroundStroke is a leading cause of death and disability. Recovery is frequently compromised by reduced well-being, mood, socialisation and quality of life. Music and singing are recognised as enhancing well-being and benefit people with chronic illness. Evidence suggested that choir singing may improve the fluency of people with aphasia. Choirs existed for people with brain impairment; no studies had robust design and outcome measurement.AimTo conduct a pilot study in Newcastle, Australia in a collaboration between Hunter New England Health and the University of Newcastle. To explore the effects of choral singing on quality of life, well-being, mood, social participation and communication skills of community-dwelling stroke survivors including people with aphasia.MethodA mixed methods waitlist control design was used. 39 people at least 6 months post-stroke were assessed before and after a 12-week choir rehearsal period. Carers were invited to participate. Subjects were interviewed at the end of the period.ResultsMeasures of communication improved significantly and a trend to improvement in overall quality of life was seen. Depression and disability were significant in their impact on overall quality of life scores. Qualitative work reported increased quality of life, confidence, independence, mood and socialization and improvements in speech and communication were also reported.ConclusionOur pilot showed that a 12-week choir program for stroke survivors and carers is feasible and benefits quality of life, well-being, mood, community participation and communication in people with aphasia.

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