Implementing Scientific Evidence-Based Guidelines: Case Study of Severe Traumatic Brain Injuries

2003 ◽  
Vol 20 (1) ◽  
pp. 81-87 ◽  
Author(s):  
W. Mauritz ◽  
M. Rusnak ◽  
I. Janciak ◽  
Keyword(s):  
Brain Injuries ◽  
Scientific Evidence ◽  
Traumatic Brain Injuries ◽  
Evidence Based ◽  
Evidence Based Guidelines

Suboptimal compliance with evidence-based guidelines in patients with traumatic brain injuries

2014 ◽  
Vol 120 (3) ◽  
pp. 773-777 ◽  
Author(s):  
Shahid Shafi ◽  
Sunni A. Barnes ◽  
D Millar ◽  
Justin Sobrino ◽  
Rustam Kudyakov ◽  
...  
Keyword(s):  
Scale Score ◽  
Brain Injuries ◽  
Injury Severity ◽  
Compliance Rate ◽  
Traumatic Brain Injuries ◽  
Evidence Based ◽  
Clinical Practices ◽  
Severe Tbi ◽  
Level I ◽  
Evidence Based Guidelines

Object Evidence-based management (EBM) guidelines for severe traumatic brain injuries (TBIs) were promulgated decades ago. However, the extent of their adoption into bedside clinical practices is not known. The purpose of this study was to measure compliance with EBM guidelines for management of severe TBI and its impact on patient outcome. Methods This was a retrospective study of blunt TBI (11 Level I trauma centers, study period 2008–2009, n = 2056 patients). Inclusion criteria were an admission Glasgow Coma Scale score ≤ 8 and a CT scan showing TBI, excluding patients with nonsurvivable injuries—that is, head Abbreviated Injury Scale score of 6. The authors measured compliance with 6 nonoperative EBM processes (endotracheal intubation, resuscitation, correction of coagulopathy, intracranial pressure monitoring, maintaining cerebral perfusion pressure ≥ 50 cm H2O, and discharge to rehabilitation). Compliance rates were calculated for each center using multivariate regression to adjust for patient demographics, physiology, injury severity, and TBI severity. Results The overall compliance rate was 73%, and there was wide variation among centers. Only 3 centers achieved a compliance rate exceeding 80%. Risk-adjusted compliance was worse than average at 2 centers, better than average at 1, and the remainder were average. Multivariate analysis showed that increased adoption of EBM was associated with a reduced mortality rate (OR 0.88; 95% CI 0.81–0.96, p < 0.005). Conclusions Despite widespread dissemination of EBM guidelines, patients with severe TBI continue to receive inconsistent care. Barriers to adoption of EBM need to be identified and mitigated to improve patient outcomes.

scholarly journals Health professionals’ adherence to evidence-based obesity guidelines: a cohort study.

2019 ◽  
Author(s):  
Nuria Trujillo Garrido ◽  
Mariangeles Bernal ◽  
Maria José Santi Cano
Keyword(s):  
Physical Activity ◽  
Primary Care ◽  
Health Professionals ◽  
Medical Records ◽  
Scientific Evidence ◽  
Behavioural Change ◽  
Overweight And Obesity ◽  
Evidence Based ◽  
Practice Methods ◽  
Evidence Based Guidelines

Abstract BACKGROUND The prevalence of obesity is on the increase worldwide and yet scientific evidence shows that primary care professionals are not adequately addressing overweight and obesity. In this study, we evaluate how obesity guidelines are being implemented in routine clinical practice. METHODS The study obtained the following data on a cohort of 209 obese patients attending primary care consultations: electronic medical records, body mass index (BMI), waist circumference (WC), cardiovascular risk factors, comorbidities and whether or not their health professional adhered to obesity evidence-based guidelines. RESULTS 57.9% of the participants were women and their average age was 65.8 ± 12.7 years. Only 25.4% of the medical records met all the criteria established in the therapeutic guidelines regarding diet prescription. This percentage was significantly higher in males than females (36.4% vs 17.4, p = 0.002). 1.4% met the criteria for physical activity and 1.5% for behavioural change activities. In the multivariate analysis, the variable associated with the most favourable BMI and WC figures, after adjusting for age, was a follow up by health professionals on physical activity (β=0.347, p=0.027, CI=0.429-6.868; β=0.367, p=0.024, CI=1.256-17.556) during routine check-ups with women. CONCLUSIONS We detected low adherence to the evidence-based guidelines among professionals. Recording dietetic prescription and physical exercise in the patient's medical record is associated with a better control of obesity. This data suggest that primary health care should be improved for obese patient.

Poster 120 Case Study of Five Patients with Severe Traumatic Brain Injuries that Underwent Hyperbaric Oxygen Treatment

2011 ◽  
Vol 92 (10) ◽  
pp. 1726
Author(s):  
Robert Kent ◽  
Marissa Mccarthy ◽  
Risa Nakase-Richardson ◽  
Jill Massengale ◽  
David Cifu ◽  
...  
Keyword(s):  
Hyperbaric Oxygen ◽  
Brain Injuries ◽  
Traumatic Brain Injuries ◽  
Hyperbaric Oxygen Treatment ◽  
Oxygen Treatment

A new approach for case acquisition in CBR based on multi-label text categorization: a case study in child’s traumatic brain injuries

2021 ◽  
Vol 10 (1) ◽  
pp. 1003-1018
Author(s):  
Hichem Benfriha ◽  
Baghdad Atmani ◽  
Fatiha Barigou ◽  
Belarbi Khemliche ◽  
Ali Douah ◽  
...  
Keyword(s):  
Text Categorization ◽  
Brain Injuries ◽  
Traumatic Brain Injuries ◽  
New Approach

scholarly journals Canadian Asthma Consensus Conference Summary of Recommendations

1996 ◽  
Vol 3 (2) ◽  
pp. 89-101 ◽  
Author(s):  
Pierre Ernst ◽  
J Mark Fitzgerald ◽  
Sheldon Spier
Keyword(s):  
Ambulatory Care ◽  
Consensus Statement ◽  
Scientific Evidence ◽  
Local Level ◽  
Asthma Management ◽  
Consensus Conference ◽  
Evidence Based ◽  
Randomized Controlled ◽  
Optimal Approach ◽  
Evidence Based Guidelines

The Asthma Committee of the Canadian Thoracic Society invited a group of Canadian physicians with a particular interest in asthma to meet in Montebello, Quebec, March 9-12, 1995 to arrive at a consensus statement on the optimal approach to the management of asthma in the pediatric and adult ambulatory care settings. The societies and associations represented are listed in the appendix with the names of the contributors to this document. The objectives of the Montebello conference were: 1. To review the current ambulatory care management of asthma in Canada; 2. To develop guidelines with the participation of family physicians and specialists; 3. To develop guidelines which are evidence-based; 4. In creating evidence-based guidelines to focus attention on aspects of asthma management that are currently not supported by randomized controlled trials; 5. To develop strategies that allow for the implementation of rational guidelines at a local level. Recommendations were based on a critical review of the scientific literature by small groups prior to the meeting and are categorized according to the strength of the scientific evidence supporting each recommendation (Table 1).

scholarly journals Clinicians adopting evidence based guidelines: a case study with thromboprophylaxis

2011 ◽  
Vol 11 (1) ◽  
Author(s):  
Nicola H Chapman ◽  
Steven P Lazar ◽  
Margaret Fry ◽  
Marissa N Lassere ◽  
Beng H Chong
Keyword(s):  
Evidence Based ◽  
Evidence Based Guidelines

Epilogue

2019 ◽  
pp. 210-216
Author(s):  
Kathleen Bachynski
Keyword(s):  
Cultural Values ◽  
Brain Injuries ◽  
Scientific Evidence ◽  
Head Injuries ◽  
Traumatic Brain Injuries ◽  
Alternative Interpretation ◽  
Return To Play ◽  
Sports Organizations ◽  
Youth Football ◽  
Adult Supervision

Contemporary debates over head injuries in youth football are at a crossroads, with competing framings of the risks of traumatic brain injuries resulting in significantly different potential responses to addressing the sport’s risks. The prevailing framework, shaped in many ways by the NFL and other sports organizations, suggests that improved adult supervision, return-to-play guidelines, better helmet design, and other similar strategies can sufficiently address the risks of youth football. An alternative interpretation of the scientific evidence on sub-concussive hits, however, indicates that the full-body collisions associated with tackling carry inherent risks of brain trauma that cannot be substantially reduced. The cultural values and meanings attached to youth football inform these contemporary debates, as well as the possible future of America’s most popular sport.

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