Quality Assessment of HTA reports: a Critical Appraisal Toolkit within an institutional HTA program

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
E Bossi ◽  
M Tringali ◽  
P Colombo ◽  
C Mazzali ◽  
G Puleo ◽  
...  
Keyword(s):  
Health Care Professionals ◽  
Critical Appraisal ◽  
Population Aging ◽  
Clinical Effectiveness ◽  
Evidence Based ◽  
Lombardy Region ◽  
Double Blinded ◽  
Sustainable Health ◽  
Local Healthcare

Abstract Issue With population aging, increased demand for healthcare and limited availability of economic and human resources, well-functioning and sustainable health systems have to rely on rigorous and evidence-based assessments of complex technologies' clinical effectiveness and safety. The Lombardy Region in Northern Italy has a well-established HTA program that offers technical support to its hospitals' network to produce and to review Health Technology Assessment (HTA) reports. Description of the Problem To better coordinate the HTA network and to reduce self-referencing of University and Community hospitals, Lombardy Region carried out an intense field training and distance learning from year 2017, with a project aimed at involving health care professionals in an accurate evaluation of technologies in 18 HTA reports. The regional HTA Supporting Centre developed a Toolkit for the critical appraisal of reports and supporting literature to improve the quality of hospital-based reports. Results In compliance with the regional Law DGR XI/1046 17.12.2018 and the framework proposed, during year 2019 hospitals used the Toolkit to help writing complete and good quality HTA reports on 37 different technologies. With a Public Health resident internship, the Toolkit was revised, extended and then used in 2020 by the hospital's HTA network during the double blinded peer review, mandated by the regional Law DGR XI/2672 16.12.2019, of the year 2019 HTA reports. Detailed results will be presented at the conference. Lessons We observed an increase in number of HTA reports from 2018 to 2019, a greater language's and format's homogeneity and an improvement in the quality of some reports, which will be submitted to the Regional HTA Committee for appraisal and reimbursement. Key messages The development and use of a Critical Appraisal Toolkit in an Regional HTA program can help hospitals write complete and good quality HTA reports. A centrally supported quality improvement of distributed assessment activities in a network of hospitals can enhance the production of HTA reports, relevant to the needs of a local healthcare system.

scholarly journals Critical appraisal and meta-analysis of biological variation studies on glycosylated albumin, glucose and HbA1c

2020 ◽  
Vol 1 (3) ◽  
Author(s):  
Carmen Ricós ◽  
Pilar Fernández-Calle ◽  
Elisabet Gonzalez-Lao ◽  
Margarida Simón ◽  
Jorge Díaz-Garzón ◽  
...  
Keyword(s):  
Healthy Subjects ◽  
Critical Appraisal ◽  
Meta Analysis ◽  
Biological Variation ◽  
Evidence Based ◽  
Literature Searches ◽  
Variation Data ◽  
Global Estimates ◽  
Systematic Literature Searches

AbstractObjectivesNumerous biological variation (BV) studies have been performed over the years, but the quality of these studies vary. The objectives of this study were to perform a systematic review and critical appraisal of BV studies on glycosylated albumin and to deliver updated BV estimates for glucose and HbA1c, including recently published high-quality studies such as the European Biological Variation study (EuBIVAS).MethodsSystematic literature searches were performed to identify BV studies. Nine publications not included in a previous review were identified; four for glycosylated albumin, three for glucose, and three for HbA1c. Relevant studies were appraised by the Biological Variation Data Critical Appraisal Checklist (BIVAC). Global BV estimates were derived by meta-analysis of BIVAC-compliant studies in healthy subjects with similar study design.ResultsOne study received BIVAC grade A, 2B, and 6C. In most cases, the C-grade was associated with deficiencies in statistical analysis. BV estimates for glycosylated albumin were: CVI=1.4% (1.2–2.1) and CVG=5.7% (4.7–10.6), whereas estimates for HbA1c, CVI=1.2% (0.3–2.5), CVG=5.4% (3.3–7.3), and glucose, CVI=5.0% (4.1–12.0), CVG=8.1% (2.7–10.8) did not differ from previously published global estimates.ConclusionsThe critical appraisal and rating of BV studies according to their methodological quality, followed by a meta-analysis, generate robust, and reliable BV estimates. This study delivers updated and evidence-based BV estimates for glycosylated albumin, glucose and HbA1c.

scholarly journals Incentives and Support Programs to Improve Adherence to Tuberculosis Treatment

2021 ◽  
Vol 1 (2) ◽  
Author(s):  
Charlotte Wells ◽  
Melissa Severn
Keyword(s):  
High Risk ◽  
Methodological Quality ◽  
Clinical Effectiveness ◽  
Conclusive Evidence ◽  
Active Tuberculosis ◽  
Tuberculosis Treatment ◽  
Support Programs ◽  
Evidence Based ◽  
Evidence Based Guidelines

Three overviews of reviews and 11 systematic reviews were identified regarding the clinical effectiveness of adherence incentives in those who require assistance to complete their tuberculosis treatment. Four evidence-based guidelines were identified that provided recommendations regarding the use of adherence incentives in those who require assistance completing their tuberculosis treatment. The reported clinical effectiveness of adherence incentives for patients with tuberculosis was mixed. There were no detrimental effects of providing incentives, but there was also no conclusive evidence pointing to a clinical benefit. The overall quality of the included reviews was moderate to high. The included guidelines recommended that incentives and enablers be included as a part of a patient-centred strategy for treatment and for patients with active tuberculosis or patients at high risk; however, the evidence formulating these recommendations was of low certainty or quality. Two of the included guidelines were of high methodological quality, and 2 were of lower methodological quality.

scholarly journals A Tool to Assess the Trustworthiness of Evidence-Based Point-of-Care Information for Health Care Professionals (CAPOCI): Design and Validation Study (Preprint)

2021 ◽  
Author(s):  
Gerlinde Lenaerts ◽  
Geertruida E Bekkering ◽  
Martine Goossens ◽  
Leen De Coninck ◽  
Nicolas Delvaux ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Delphi Study ◽  
Critical Appraisal ◽  
Point Of Care ◽  
Scoring Systems ◽  
Likert Scale ◽  
Ordinal Scale ◽  
Evidence Based ◽  
Care Information

BACKGROUND User-friendly information at the point of care for health care professionals should be well structured, rapidly accessible, comprehensive, and trustworthy. The reliability of information and the associated methodological process must be clear. There is no standard tool to evaluate the trustworthiness of such point-of-care (POC) information. OBJECTIVE We aim to develop and validate a new tool for assessment of trustworthiness of evidence-based POC resources to enhance the quality of POC resources and facilitate evidence-based practice. METHODS We designed the Critical Appraisal of Point-of-Care Information (CAPOCI) tool based on the criteria important for assessment of trustworthiness of POC information, reported in a previously published review. A group of health care professionals and methodologists (the authors of this paper) defined criteria for the CAPOCI tool in an iterative process of discussion and pilot testing until consensus was reached. In the next step, all criteria were subject to content validation with a Delphi study. We invited an international panel of 10 experts to rate their agreement with the relevance and wording of the criteria and to give feedback. Consensus was reached when 70% of the experts agreed. When no consensus was reached, we reformulated the criteria based on the experts’ comments for a next round of the Delphi study. This process was repeated until consensus was reached for each criterion. In a last step, the interrater reliability of the CAPOCI tool was calculated with a 2-tailed Kendall tau correlation coefficient to quantify the agreement between 2 users who piloted the CAPOCI tool on 5 POC resources. Two scoring systems were tested: a 3-point ordinal scale and a 7-point Likert scale. RESULTS After validation, the CAPOCI tool was designed with 11 criteria that focused on methodological quality and author-related information. The criteria assess authorship, literature search, use of preappraised evidence, critical appraisal of evidence, expert opinions, peer review, timeliness and updating, conflict of interest, and commercial support. Interrater agreement showed substantial agreement between 2 users for scoring with the 3-point ordinal scale (τ=.621, <i>P</i>&lt;.01) and scoring with the 7-point Likert scale (τ=.677, <i>P</i>&lt;.01). CONCLUSIONS The CAPOCI tool may support validation teams in the assessment of trustworthiness of POC resources. It may also provide guidance for producers of POC resources.

Caring for Older Adults During and After Critical Illness

2021 ◽  
pp. 216-234
Author(s):  
Maria C. Duggan ◽  
Julie Van ◽  
E. Wesley Ely
Keyword(s):  
Older Adults ◽  
Critical Illness ◽  
Health Care Professionals ◽  
Interdisciplinary Approach ◽  
Adverse Outcomes ◽  
Evidence Based ◽  
Complex Population ◽  
Multiple Domains ◽  
Over Time

Over half of people with critical illness are older adults, and the number of older adults admitted to intensive care units has been increasing over time. Older adults have increased vulnerability to disease, disability, and adverse outcomes across many domains. To address this most effectively, a unique, interdisciplinary approach is necessary to optimize not only survival but also functional status and quality of life. A shortage of health care professionals equipped to care for the aging population makes it imperative that all professionals become aware of basic principles of caring for older adults. To equip them to care for this complex population, this chapter provides an overview of how aging impacts multiple domains of an older person with critical illness and describes evidence-based approaches to caring for older adults with critical illness.

Evidence-based medicine

2012 ◽  
Author(s):  
Philip Wiffen ◽  
Marc Mitchell ◽  
Melanie Snelling ◽  
Nicola Stoner
Keyword(s):  
Relative Risk ◽  
Clinical Pharmacy ◽  
Evidence Based Medicine ◽  
Critical Appraisal ◽  
Mean Difference ◽  
Continuous Data ◽  
Evidence Based ◽  
Standardized Mean Difference ◽  
Based Medicine

Evidence-based medicine (EBM) and clinical pharmacy 126Statistical versus clinical significance 128Odds ratios and relative risk 130Binary and continuous data 132L’Abbé plots 133Mean difference and standardized mean difference 134Assessing the quality of randomized studies 136Critical appraisal of systematic reviews ...

Mobile-Health (mHealth) Intervention on Chronic Kidney Diseases: A Critical Review and Its Implications (Preprint)

2020 ◽  
Author(s):  
Ira Suarilah ◽  
Chiu-Chu Lin ◽  
Chich-Hsiu Hung
Keyword(s):  
Mobile Health ◽  
Health Care Professionals ◽  
Kidney Diseases ◽  
Health Interventions ◽  
Evidence Based ◽  
Chronic Kidney Diseases ◽  
Mhealth Intervention ◽  
Center Care

BACKGROUND eElectronic health (eHealth) chronic kidney disease (CKD) information is readily available over the mobile devices and placed as mobile-health (mHealth) information resources. The field of mHealth on CKD is promising in that it can empower individuals and delay the progress of the disease. OBJECTIVE This study aims to critically review published papers on the eHealth and its implication on mHealth of CKD. METHODS The academic databases EBSCO (CINAHL and PROQUEST), MEDLINE, PubMed, and Cochrane were systematically searched. Eight studies investigated the specific role of mHealth on CKD, including the detailed contents related to the conceptual acceptance and usage of technology in daily life, user, health care professionals, and the system’s bonding, mobile eHealth, content and evaluation of mHealth on CKD. RESULTS The available evidence on mHealth of CKD is limited and the findings indicate a discrepancy of the wording concept of mHealth. Those evidences might be caused by the scarce evidence on the effectiveness of using mHealth on CKD. CONCLUSIONS The limitation on the availability of CKD’s mobile health interventions that focus on patient education, behavior change and prevention contributes to inconsistent usage. Inadequate evidence might interrupt the development of mHealth intervention for individuals with CKD. Our findings illustrate the need on the conceptualizing of mHealth on CKD, acceptance and accessed, content, and evaluation focused on evidence-based will advance the quality of mHealth services, facilitate the continuity of mHealth application, and proposed patient-center-care.

Strategies for Increasing Knowledge Translation of Evidence-Based Practice in Athletic Training

2021 ◽  
pp. 1831-1840
Author(s):  
Brittany V. Allard ◽  
Michelle Lee D'Abundo
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Athletic Training ◽  
Diffusion Of Innovation ◽  
Health Care Professionals ◽  
Evidence Based Practice ◽  
Evidence Based ◽  
Aging Populations ◽  
Reducing Costs

The field of health care needs to change in order to address challenges such as rising health care costs, aging populations and the need to treat increasing numbers of people with chronic health conditions. All of this must be accomplished while reducing costs and maintaining quality of care. Health care professionals are being tasked with facilitating this change. Like many other health care professions, athletic training has turned to evidence-based practice to assure that athletic trainers are trained to deliver the highest quality of care in the most efficient way to their patients. The transition to integrating evidence-based practice will be challenging and will require a massive diffusion of innovation throughout the field of athletic training.

scholarly journals Introducing evidence based public health practice through a journal club for public health officers in Somaliland

2021 ◽  
Author(s):  
Jibril I. M. Handuleh ◽  
Abdirahman A. Sulleiman ◽  
Yusuf S. Yusuf ◽  
Hayat Mohamed ◽  
Daniel Fekadu Wolde-Giorgis
Keyword(s):  
Public Health ◽  
Health Care ◽  
Study Design ◽  
Health Care Professionals ◽  
Critical Appraisal ◽  
Journal Club ◽  
Early Career ◽  
Health Practitioner ◽  
Evidence Based ◽  
Journal Clubs

Evidence based public health is one of the basic training tools of public health students and young officers in decision making. The training tools for early career specialists and trainees in public health is journal clubs (JC). It keeps the knowledge of professionals up to date and assist them in receiving information to design, plan, implement health care services, policies and strategies. The intention of the JC team was to raise awareness of methods for public health literature search, appraising it and applying this knowledge in their daily practices. A senior public health practitioner in Somaliland (the corresponding author) invited medical students and residents to have JCs as a part of their training. They did not accept the offer so the organizer invited practicing junior public health professionals instead. The JC team members were a general practitioner and 3 public health workers from Ministry of Health, public hospital physician, public health school and field public health officer. A weekly or twice weekly journal club took place to train them in critical appraisal. This continued for 15 months in a hybrid mentorship for the health care professionals. The team mentor selected a paper for discussion. Mentees choose a study design appraisal tool from the Critical Appraisal Skills Program (CASP) that matched the study to present. In the process of appraisal, a team member led the discussion using the checklist. The mentees presented their critical appraisal either orally or via a presentation. The checklist and paper were compared for assessing the study design and structure of the paper of the week. This approach of empowering junior public health officers in Somalia is a way forward for encouraging the professionals to use evidence based practice in their daily practices. This will improve their selection of research tools and translating the scientific work into their practice and services.

scholarly journals UOJM editor training: results from the 2013 editor satisfaction survey and highlights from 2013-2014 training workshops

2014 ◽  
Vol 4 (1) ◽  
Author(s):  
Colin Suen ◽  
Loretta Cheung
Keyword(s):  
Critical Appraisal ◽  
Research Training ◽  
Practical Experience ◽  
Satisfaction Survey ◽  
Formal Training ◽  
Evidence Based ◽  
Based Medicine ◽  
Physician Competency

BACKGROUND UOJM recognizes that editor competency and preparedness directly impacts the quality of peer review, which holds the key to producing a great publication. We believe that success of our journal is based on a central goal of promoting physician competency in medical communication and developing leaders in medicine. In the age of evidence-based medicine, there are surprisingly few, if at all, opportunities for medical trainees to gain formal training in scientific writing and critical appraisal. Over the last two years, the UOJM has aimed to address these gaps and worked on developing a training program to equip participants with these important skills. Indeed, the merits of involvement in a peer reviewed journal at this stage of medical/research training have been recognized by its trainee participants, and have been reviewed extensively by Kevin Lee [1]. Following the success of the 2013 issue, UOJM made considerable strides to further improve the quality of content in the journal. In 2012-2013, 30 students participated as reviewers on the editorial board and received a practical experience in peer reviewed research. We conducted a year-end survey to identify issues and areas for improving the editor experience.

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