Classical and disease-specific quality indicators in glioma surgery – Development of a quality checklist to improve treatment quality in glioma patients

2021 ◽  
Author(s):  
Christiane Menke ◽  
Sebastian Lohmann ◽  
Andrea Baehr ◽  
Oliver Grauer ◽  
Markus Holling ◽  
...  
Keyword(s):  
Quality Indicators ◽  
Outcome Measures ◽  
Best Practice ◽  
Quality Measures ◽  
Treatment Quality ◽  
Control Group ◽  
Inpatient Stay ◽  
Glioma Surgery ◽  
Quality Guidelines ◽  
Disease Specific

Abstract Background There is a pressing demand for more accurate, disease-specific quality measures in the field of neurosurgery. Aiming at most adequately measuring and reflecting the quality of glioma therapy, we developed a novel quality indicator bundle in form of a checklist for all patients that are treated operatively for glioma. Methods On the basis of possible glioma-specific quality indicators retrieved from the literature and quality guidelines, a multidisciplinary team developed a checklist containing 13 patient-need-specific outcome measures. Subsequently, the checklist was prospectively applied to a total of 78 patients compared with a control group consisting of 322 patients. A score was generated based on the maximum of quality measures achieved. Results Significant improvements in quality after prospectively introducing the checklist were achieved for supplemental physical and occupational therapy during inpatient stay (89.4% vs. 100%, p= 0.002), consultation of a social worker during inpatient stay (64% vs. 92.3%, p< 0.001), psycho-oncological screening (14.3% vs. 70.5%, p< 0.001), psycho-oncological consultation (31.1% vs. 82.1%, p< 0.001), and consultation of the palliative care team (20% vs. 40%, p= 0.031). Overall, after introduction of the checklist one third (n= 23) of patients reached best-practice measures in all categories, and over half of the patients (n= 44) achieved above 90% with respect to the outcome measures. Conclusions Aiming at ensuring comprehensive, consistent and timely care of glioma patients the implementation of the checklist for routine use in glioma surgery represents an efficient, easily reproducible and powerful tool for significant improvements.

scholarly journals Measuring Quality in Thyroid Cancer Surgery

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
David F. Schneider ◽  
Rebecca S. Sippel
Keyword(s):  
Thyroid Cancer ◽  
Lymph Node ◽  
Quality Indicators ◽  
Lymph Node Ratio ◽  
Quality Measures ◽  
Cancer Surgery ◽  
Surgical Quality ◽  
Node Ratio ◽  
Lymph Node Evaluation ◽  
Disease Specific

Many of the surgical quality measures currently in use are not disease specific. For thyroid cancer, mortality and even recurrence are difficult to measure since mortality is rare and recurrence can take decades to occur. Therefore, there is a critical need for quality indicators in thyroid cancer surgery that are easily measured and disease specific. Here we will review recent research on two potential quality indicators in thyroid cancer surgery. The uptake percentage on postoperative radioactive iodine scans indicates the completeness of resection. Another measure, the lymph node ratio, is the proportion of metastatic nodes to the total number of nodes dissected. This serves as a more global measure of quality since it indicates not only the completeness of lymph node dissection but also the preoperative lymph node evaluation and decision-making. Together, these two quality measures offer a more accurate, disease-specific oncologic indicator of quality that can help guide quality assurance and improvement.

scholarly journals Donepezil for mild cognitive impairment in Parkinson’s disease

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kyoungwon Baik ◽  
Seon Myeong Kim ◽  
Jin Ho Jung ◽  
Yang Hyun Lee ◽  
Seok Jong Chung ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Treatment Group ◽  
Outcome Measures ◽  
Rating Scale ◽  
Secondary Outcome ◽  
Control Group ◽  
Significant Difference

AbstractWe investigated the efficacy of donepezil for mild cognitive impairment in Parkinson’s disease (PD-MCI). This was a prospective, non-randomized, open-label, two-arm study. Eighty PD-MCI patients were assigned to either a treatment or control group. The treatment group received donepezil for 48 weeks. The primary outcome measures were the Korean version of Mini-Mental State Exam and Montreal Cognitive Assessment scores. Secondary outcome measures were the Clinical Dementia Rating, Unified Parkinson’s Disease Rating Scale part III, Clinical Global Impression scores. Progression of dementia was assessed at 48-week. Comprehensive neuropsychological tests and electroencephalography (EEG) were performed at baseline and after 48 weeks. The spectral power ratio of the theta to beta2 band (TB2R) in the electroencephalogram was analyzed. There was no significant difference in the primary and secondary outcome measures between the two groups. However, the treatment group showed a significant decrease in TB2R at bilateral frontotemporoparietal channels compared to the control group. Although we could not demonstrate improvements in the cognitive functions, donepezil treatment had a modulatory effect on the EEG in PD-MCI patients. EEG might be a sensitive biomarker for detecting changes in PD-MCI after donepezil treatment.

Leadership and school self-evaluation in Irish-medium immersion: A roadmap for success

2021 ◽  
pp. 174114322110152
Author(s):  
TJ Ó Ceallaigh ◽  
Aoife Ní Shéaghdha
Keyword(s):  
Quality Indicators ◽  
Cognitive Skills ◽  
Best Practice ◽  
Research Question ◽  
Evaluation Process ◽  
Successful Implementation ◽  
Language And Literacy ◽  
Evaluation Tool ◽  
Self Evaluation ◽  
Individual Interviews

While research on Irish-medium immersion education (IME) has heralded benefits such as cognitive skills, academic achievement and language and literacy development, many studies have also identified challenges to its successful implementation. Immersion-specific research-validated tools can help school leaders navigate the school self-evaluation journey, critically review and evaluate the quality of aspects of their school’s provision and plan for improvement. This paper reports on one theme, leadership, from a larger study, Quality indicators of best practice in Irish-medium immersion (Ó Ceallaigh and Ní Shéaghdha, 2017). Qualitative in nature, the study was guided by the following research question: What are IME educators’ perceptions of best practices in IME?. The study explored 120 IME educators’ perceptions of best practice in IME to inform the development of IME quality indicators. Individual interviews and focus group interviews were utilised to collect data. Data analysis revealed particular themes related to best IME leadership practices. Findings in turn informed the design of an evidence-informed school self-evaluation tool for IME settings. The various functions of the tool will be explored with a particular emphasis on building teaching and leadership capacity in IME through the school self-evaluation process.

scholarly journals Sleep behavior of infants with infantile hemangioma treated with propranolol—a cohort study

2021 ◽  
Author(s):  
Martin Theiler ◽  
Nicole Knöpfel ◽  
Susanne von der Heydt ◽  
Agnes Schwieger-Briel ◽  
Isabelle Luchsinger ◽  
...  
Keyword(s):  
Cohort Study ◽  
Sleep Quality ◽  
Outcome Measures ◽  
Negative Impact ◽  
Behavioral Development ◽  
Sleep Efficiency ◽  
Sleep Pattern ◽  
Control Group ◽  
Infant Sleep ◽  
Sleep Behavior

AbstractSleep problems are frequently reported in infants treated with propranolol for infantile hemangiomas, possibly serving as a marker for a negative impact on central nervous system function. In this cohort study, we objectively investigate the sleep behavior of infants with infantile hemangiomas on propranolol compared to a healthy, untreated control group. Sleep of propranolol-treated infants and controls was investigated using ankle actigraphy and a 24-h diary for 7–10 days at ages 3 and 6 months. The main outcome measures were the Number of Nighttime Awakenings and Sleep Efficiency. The main secondary outcome measures included 24-hour Total Sleep, daytime sleep behavior, and parent-rated infant sleep quality and behavioral development based on the Brief Infant Sleep Questionnaire (BISQ) and the age-appropriate Ages-and-Stages Questionnaire (ASQ), respectively. Fifty-four term-born infants were included in each cohort. No group difference in any investigated parameter was seen at age 3 months. At age 6 months, the propranolol group exhibited a decrease in Sleep Efficiency and a trend towards an increased Number of Nighttime Awakenings compared to the control group. Treated infants at 6 months also had shorter daytime waking periods. 24-hour Total Sleep was unaffected by propranolol. No negative impact of propranolol on subjective sleep quality and behavioral development was noted.Conclusion: Propranolol exerts a measurable yet mild impact on objectively assessed infants’ sleep measures. Behavioral developmental scores were unaffected. Our results support propranolol as first-line therapy for complicated infantile hemangiomas. What is Known:• Sleep disorders are frequently reported in infants with infantile hemangiomas treated with propranolol and often lead to treatment discontinuation.• Investigations of the sleep pattern in this patient group using objective measures are lacking. What is New:• The sleep pattern of propranolol-treated infants is assessed using actigraphy and a 24-h sleep diary and compared to healthy, untreated controls.• Propranolol leads to a decreased sleep efficiency at night and an increased demand of daytime sleep, yet effects are mild overall.

scholarly journals Randomised controlled feasibility trial of an active communication education programme plus hearing aid provision versus hearing aid provision alone (ACE To HEAR)

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e043364
Author(s):  
Judith Watson ◽  
Elizabeth Coleman ◽  
Cath Jackson ◽  
Kerry Bell ◽  
Christina Maynard ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Intervention Group ◽  
Feasibility Trial ◽  
Control Group ◽  
Communication Education ◽  
Treatment As Usual ◽  
Active Communication ◽  
Randomised Controlled

ObjectiveTo establish the acceptability and feasibility of delivering the Active Communication Education (ACE) programme to increase quality of life through improving communication and hearing aid use in the UK National Health Service.DesignRandomised controlled, open feasibility trial with embedded economic and process evaluations.SettingAudiology departments in two hospitals in two UK cities.ParticipantsTwelve hearing aid users aged 18 years or over who reported moderate or less than moderate benefit from their new hearing aid.InterventionsConsenting participants (along with a significant other) were to be randomised by a remote, centralised randomisation service in groups to ACE plus treatment-as-usual (intervention group) or treatment-as-usual only (control group).Primary outcome measuresThe primary outcomes were related to feasibility: recruitment, retention, treatment adherence and acceptability to participants and fidelity of treatment delivery.Secondary outcome measuresInternational Outcomes Inventory for Hearing Aids, Self-Assessment of Communication, EQ-5D-5L and Short-Form 36. Blinding of the participants and facilitator was not possible.ResultsTwelve hearing aid users and six significant others consented to take part. Eight hearing aid users were randomised: four to the intervention group; and four to treatment-as-usual only. Four significant others participated alongside the randomised participants. Recruitment to the study was very low and centres only screened 466 hearing aid users over the 15-month recruitment period, compared with the approximately 3500 anticipated. Only one ACE group and one control group were formed. ACE could be delivered and appeared acceptable to participants. We were unable to robustly assess attrition and attendance rates due to the low sample size.ConclusionsWhile ACE appeared acceptable to hearing aid users and feasible to deliver, it was not feasible to identify and recruit participants struggling with their hearing aids at the 3-month posthearing aid fitting point.Trial registration numberISRCTN28090877.

scholarly journals Effect of pelvic laparoscopic implantation of neuroprosthesis in spinal cord injured subjects: a 1-year prospective randomized controlled study

Spinal Cord ◽  
2021 ◽  
Author(s):  
Helge Kasch ◽  
Uffe Schou Løve ◽  
Anette Bach Jønsson ◽  
Kaare Eg Severinsen ◽  
Marc Possover ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Outcome Measures ◽  
Outcome Measure ◽  
Secondary Outcome ◽  
Controlled Study ◽  
Control Group ◽  
Walking Ability ◽  
Data Set ◽  
Cord Injury

Abstract Study design 1-year prospective RCT. Objective Examine the effect of implantable pulse generator and low-frequency stimulation of the pelvic nerves using laparoscopic implantation of neuroprosthesis (LION) compared with neuromuscular electrical stimulation (NMES) in SCI. Methods Inclusion criteria: traumatic spinal cord injury (SCI), age 18–55 years, neurological level-of-injury Th4–L1, time-since-injury >1 year, and AIS-grades A–B. Participants were randomized to (A) LION procedure or (B) control group receiving NMES. Primary outcome measure: Walking Index for Spinal Cord Injury (WISCI-II), which is a SCI specific outcome measure assessing ability to ambulate. Secondary outcome measures: Spinal Cord Independence Measure III (SCIM III), Patient Global Impression of Change (PGIC), Penn Spasm Frequency Scale (PSFS), severity of spasticity measured by Numeric Rating Scale (NRS-11); International Spinal Cord Injury data sets-Quality of Life Basic Data Set (QoLBDS), and Brief Pain Inventory (BPI). Results Seventeen SCI individuals, AIS grade A, neurological level ranging from Th4–L1, were randomized to the study. One individual was excluded prior to intervention. Eight participants (7 males) with a mean age (SD) of 35.5 (12.4) years were allocated to the LION procedure, 8 participants (7 males) with age of 38.8 (15.1) years were allocated to NMES. Significantly, 5 LION group participants gained 1 point on the WISCI II scale, (p < 0.013; Fisher´s exact test). WISCI II scale score did not change in controls. No significant changes were observed in the secondary outcome measures. Conclusion The LION procedure is a promising new treatment for individuals with SCI with significant one-year improvement in walking ability.

Effects of Calisthenics and Pilates Exercises on Coordination and Proprioception in Adult Women: A Randomized Controlled Trial

2012 ◽  
Vol 21 (3) ◽  
pp. 235-243 ◽  
Author(s):  
Derya Ozer Kaya ◽  
Irem Duzgun ◽  
Gul Baltaci ◽  
Selma Karacan ◽  
Filiz Colakoglu
Keyword(s):  
Outcome Measures ◽  
Repeated Measures ◽  
Controlled Trial ◽  
Exercise Group ◽  
Lower Limbs ◽  
Control Group ◽  
Adult Women ◽  
Kinetic Chain ◽  
Randomized Controlled ◽  
Closed Kinetic Chain

Objective:To assess and compare the effects of 6 mo of Pilates and calisthenics on multijoint coordination and proprioception of the lower limbs at the 3rd and 6th mo of training.Design:Randomized, controlled, assessor-blinded, repeated-measures.Setting:University research laboratory.Participants and Intervention:Healthy, sedentary, female participants age 25–50 y were recruited and randomly divided into 3 groups: a calisthenic exercise group (n = 34, mean age ± SD 40 ± 8 y, body-mass index [BMI] 31.04 ± 4.83 kg/m2), a Pilates exercise group (n = 32, mean age ± SD 37 ± 8 y, BMI 31.04 ± 4.83 kg/m2), and a control group (n = 41, mean age ± SD 41 ± 7 y, BMI 27.09 ± 4.77 kg/m2). The calisthenics and Pilates groups underwent related training programs for 6 mo, while the controls had no specific training.Main Outcome Measures:Coordination and proprioception of the lower extremities with concentric and eccentric performances in the closed kinetic chain assessed with the monitored rehab functional squat system at baseline and at the 3rd and 6th mo of training.Results:For the within-group comparison, coordinative concentric and eccentric deviation values were significantly decreased for both dominant and nondominant lower limbs at pretraining and at the 3rd and 6th mo posttraining in the calisthenics group (P < .05). In contrast, there was no improvement in the Pilates group throughout the training. However, for comparisons between groups, the baseline values of coordinative concentric and eccentric deviations were different in the calisthenics group than in Pilates and the controls (P < .05). There were no differences in the proprioception values of either visible or nonvisible movement in any group throughout the training (P > .05).Conclusions:It seems that calisthenic exercises are more likely to improve coordination of the lower extremity after 3 and 6 mo of training than Pilates exercises. Calisthenic exercises may be useful for individuals who require improved coordination.

scholarly journals Asthma in Adolescents: A Randomized, Controlled Trial of an Asthma Program for Adolescents and Young Adults with Severe Asthma

2002 ◽  
Vol 9 (4) ◽  
pp. 253-259 ◽  
Author(s):  
Robert L Cowie ◽  
Margot F Underwood ◽  
Cinde B Little ◽  
Ian Mitchell ◽  
Sheldon Spier ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Emergency Department ◽  
Randomized Controlled Trial ◽  
Asthma Control ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Randomized Controlled ◽  
Disease Specific

BACKGROUND: Asthma is common and is often poorly controlled in adolescent subjects.OBJECTIVE: To determine the impact of an age-specific asthma program on asthma control, particularly on exacerbations of asthma requiring emergency department treatment, and on the quality of life of adolescents with asthma.METHODS: The present randomized, controlled trial included patients who were 15 to 20 years of age and had visited emergency departments for management of their asthma. The interventional group attended an age-specific asthma program that included assessment, education and management by a team of asthma educators, respiratory therapists and respiratory physicians. In the control group, spirometry was performed, and the patients continued to receive usual care from their regular physicians. The outcomes were assessed by a questionnaire six months after entry into the study.RESULTS: Ninety-three subjects entered the study and were randomly assigned to the intervention or control group. Of these, only 62 patients were available for review after six months. Subjects in both the control and the intervention groups showed a marked improvement in their level of asthma control, reflected primarily by a 73% reduction in the rate of emergency department attendance for asthma. Other indexes of disease control, including disease-specific quality of life, as assessed by questionnaires, were improved. There was, however, no discernible difference between the subjects in the two groups, with the exception of an improvement in favour of the intervention group in the symptom (actual difference 0.7, P=0.048) and emotional (actual difference 0.8, P=0.028) domains of the asthma quality of life questionnaire. The overall quality of life score favoured the intervention group by a clinically relevant difference of 0.6, but this difference did not reach statistical significance (P=0.06).CONCLUSIONS: Although all subjects demonstrated a significant improvement in asthma control and quality of life, the improvement attributable to this intervention was limited to two domains in disease-specific quality of life.

STUDYING SEDATIVE ACTIVITY OF COMBINED TINCTURE OF MOTHERWORT AND ST JOHN'S-WORT

2021 ◽  
Vol 92 (2) ◽  
pp. 59-64
Author(s):  
O. M. Khishova ◽  
◽  
V. D. Avdachenok ◽  
Keyword(s):  
Quality Indicators ◽  
Lateral Position ◽  
Control Group ◽  
Sodium Thiopental ◽  
Hypnotic Effect ◽  
St John’S Wort ◽  
Percolation Method ◽  
St John's Wort ◽  
Falling Asleep ◽  
Sedative Activity

The paper presents studying sedative activity of the combined tincture of motherwort and St. John's wort. The combined tincture of motherwort and St. John's wort was obtained by percolation method in a ratio 1:10. Standardization of the obtained tincture was carried out with quality indicators: description, content of active ingredients and ethanol, relative density, dry residue. According to all quality indicators, the tincture obtained met the requirements of the State Pharmacopoeia of the Republic of Belarus. Specific sedative activity of the combined tincture of motherwort and St. John's wort was assessed by barbiturates hypnotic effect prolongation (sodium thiopental), by the rate of falling asleep in animals and by animals staying in lateral position in relation to the control group to which sodium thiopental was injected. In the studies carried out it was found that injection of the combined tincture of motherwort and St. John's wort at a dose of 0,1 ml / kg increases sleep by 125,63% and also accelerates the process of falling asleep by 327,75% compared with the separate injection of motherwort and St. John's wort tincture at doses of 0,1 ml/kg. It was shown that the injection of the combined tincture of motherwort and St. John's wort at a dose of 0,1 ml/kg exhibits a potentiated effect and enhances the hypnotic effect of sodium thiopental administered at a dose of 10 mg/kg.

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