scholarly journals Are monitoring instructions provided in direct healthcare professional communications (DHPCs) of sufficient quality? A retrospective analysis of DHPCs sent out between 2007 and 2018

BMJ Open ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. e036498 ◽  
Author(s):  
Maja-Marie Grønfeldt Højer ◽  
Marie Louise De Bruin ◽  
Arnela Boskovic ◽  
Christine Erikstrup Hallgreen
Keyword(s):  
Clinical Practice ◽  
Healthcare Professional ◽  
Retrospective Cohort ◽  
European Medicines Agency ◽  
Quality Of Information ◽  
Honestly Significant Difference ◽  
Significant Difference ◽  
Post Hoc ◽  
Different Characteristics

ObjectiveTo assess whether direct to healthcare professional communications (DHPCs) are of sufficient quality to be applicable in clinical practice and study how the quality differs according to safety concerns and type of monitoring.DesignRetrospective cohort study.SettingDHPCs containing monitoring instructions were identified among all DHPC issued in Denmark between 2007 and 2018.InterventionQuality of information of monitoring instructions was assessed according to the Systematic Information for Monitoring (SIM) score. Associations between different characteristics of instructions and the SIM score were compared with analysis of variance and the post hoc test Tukey’s honestly significant difference if significant.ResultsIn total, 297 DHPCs were issued, of which 97 contained 134 monitoring instructions. For 95% of these DHPCs the European Medicines Agency was involved. The average SIM score was 2.6±1.6 (ranging 0–6) and only 47% were considered of sufficient quality (SIM score ≥3). In addition, even fewer (11%) instructions were considered a ‘adequate instruction’ which also reported about facts and risks. Differences between quality of information according to type of monitoring were observed, specifically between clinical monitoring (average SIM score 1.9) and biomarker monitoring (physical average SIM score 2.9, p=0.029 and laboratory average SIM score 3.4, p<0.0001).ConclusionsMonitoring instructions were found not to be of sufficient quality to be applicable in clinical practice according to the SIM score. Our study concludes the need for further research and regulatory steps to ensure improve quality of information in safety communications.

scholarly journals Quality of life assessments in clinical practice using either the EORTC-QLQ-C30 or the SEIOQL-DW: a randomized study

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Åsa Kettis ◽  
Hanna Fagerlind ◽  
Jan-Erik Frödin ◽  
Bengt Glimelius ◽  
Lena Ring
Keyword(s):  
Quality Of Life ◽  
Clinical Practice ◽  
Significant Difference ◽  
Patient Reported ◽  
Health Related Qol ◽  
Health Related ◽  
Secondary Outcomes ◽  
The Impact ◽  
Over Time

Abstract Background Effective patient-physician communication can improve patient understanding, agreement on treatment and adherence. This may, in turn, impact on clinical outcomes and patient quality of life (QoL). One way to improve communication is by using patient-reported outcome measures (PROMs). Heretofore, studies of the impact of using PROMs in clinical practice have mostly evaluated the use of standardized PROMs. However, there is reason to believe that individualized instruments may be more appropriate for this purpose. The aim of this study is to compare the effectiveness of the standardized QoL-instrument, the European Organization for Research and Treatment of Cancer Quality of Life C-30 (EORTC-QOL-C30) and the individualized QoL instrument, the Schedule for the Evaluation of Individual Quality of Life-Direct Weighting (SEIQoL-DW), in clinical practice. Methods In a prospective, open-label, controlled intervention study at two hospital out-patient clinics, 390 patients with gastrointestinal cancer were randomly assigned either to complete the EORTC-QOL-C30 or the SEIQoL-DW immediately before the consultation, with their responses being shared with their physician. This was repeated in 3–5 consultations over a period of 4–6 months. The primary outcome measure was patients’ health-related QoL, as measured by FACIT-G. Patients’ satisfaction with the consultation and survival were secondary outcomes. Results There was no significant difference between the groups with regard to study outcomes. Neither intervention instrument resulted in any significant changes in health-related QoL, or in any of the secondary outcomes, over time. This may reflect either a genuine lack of effect or sub-optimization of the intervention. Since there was no comparison to standard care an effect in terms of lack of deterioration over time cannot be excluded. Conclusions Future studies should focus on the implementation process, including the training of physicians to use the instruments and their motivation for doing so. The effects of situational use of standardized or individualized instruments should also be explored. The effectiveness of the different approaches may depend on contextual factors including physician and patient preferences.

A COMPARISON OF PATIENT AND HEALTHCARE PROFESSIONAL VIEWS WHEN ASSESSING QUALITY OF INFORMATION ON PITUITARY ADENOMA AVAILABLE ON THE INTERNET

2017 ◽  
Vol 23 (10) ◽  
pp. 1217-1222 ◽  
Author(s):  
Irena Druce ◽  
Chantal Williams ◽  
Carolyn Baggoo ◽  
Erin Keely ◽  
Janine Malcolm
Keyword(s):  
Pituitary Adenoma ◽  
Healthcare Professional ◽  
The Internet ◽  
Quality Of Information

scholarly journals Development of Airtightness of Estonian Wooden Buildings

2019 ◽  
Vol 24 (1) ◽  
pp. 36-43 ◽  
Author(s):  
Jaanus Hallik ◽  
Targo Kalamees
Keyword(s):  
Field Measurements ◽  
Building Structure ◽  
Air Leakage ◽  
Large Dataset ◽  
Apartment Buildings ◽  
Timber Construction ◽  
Significant Difference ◽  
Minimum Requirements ◽  
Post Hoc

The field measurements of airtightness in Estonian detached and apartment buildings conducted between2003 – 2017 were combined into a large dataset for further analysis. The buildings were classified basedon building structure, number of storeys, year of construction, energy classification and compactnessfactors. A subset with all wooden buildings (313 in total) was statistically analysed to determine theaverage (median) air leakage rates at 50 Pa and tested (Kruskal-Wallis test with post-hoc Conovertest) for significant differences within the grouping factors. As expected, the median air leakage (q50)of older buildings between 10.7 and 13.9 m3/(hm2) has decreased to 1.1 m3/(hm2) after the minimumrequirements for energy efficiency have taken effect. A more detailed analysis on newer buildings showedthat quality of the workmanship combining systematic measurement routines as well as prefabrication,yields significantly lower median air leakages compared to on-site construction. The buildings with betterenergy classification targets also achieved lower median air leakages compared to buildings designedto meet minimum requirements. Further analysis showed significant differences between buildingswith lightweight timber construction and those with log construction. This can be due to fact that theairtightness has been predominantly measured in prefabricated buildings compared to on-site buildingtechnology. Surprisingly, the analysis showed no significant difference between buildings with a differentcompactness factor or a different number of storeys. For use in energy calculations, the base values ofair leakage rates for each group are calculated and presented accounting for variation of measurements.

scholarly journals PENGARUH DOSIS RAGI DAN PENAMBAHAN GULA TERHADAP KUALITAS GIZI DAN ORGANOLEPTIK TAPE BIJI GANDUM

Agric ◽  
2016 ◽  
Vol 26 (1) ◽  
pp. 75
Author(s):  
Jalalina Abdillah ◽  
Nugraheni Widyawati ◽  
Suprihati
Keyword(s):  
Analysis Of Variance ◽  
Block Design ◽  
Wheat Grain ◽  
Christian University ◽  
Randomized Block Design ◽  
Honestly Significant Difference ◽  
Sugar Addition ◽  
Significant Difference ◽  
And Mathematics

<p>Tape yeast in certain dose is required in making tape. Addition of 5% sugar could increase the sweetness as well as energy for the microorganissm. The experiment about the effect of yeast dosage and sugar addition on the quality of wheat grain tape in the Laboratory of Faculty of Science and Mathematics Satya Wacana Christian University started from 29th February until 23rd April 2012. This research used Randomized Block Design (RBD) with six treatments as follows: 1% yeast; 2% yeast; 3% yeast; 1% yeast with sugar; 2% yeast with sugar; 3% yeast with sugar. Finally, data of the result were analyzed using analysis of variance (ANOVA) and honestly significant difference (HSD) at 5% level. The research showed that: 1) 1% yeast dose had the highest quality of wheat tape compared to 2% and 3% yeast dose, 2) 1% yeast dose with sugar gave the best taste from organoleptic test.</p>

scholarly journals Examination of the Concept of School Climate from the Perspective of Physical Education and Sports Teacher Candidates

2021 ◽  
Vol 11 (1) ◽  
pp. 11
Author(s):  
Cüneyt Taşkın ◽  
Umut Canlı
Keyword(s):  
School Climate ◽  
Physical Education ◽  
Student Success ◽  
Teacher Candidates ◽  
Point Of View ◽  
Quality Of Education ◽  
Significant Difference ◽  
Climate Scale ◽  
Post Hoc

School climate, which is the sum of behaviors in a school, is also defined as the character of the school. A school’s climate has a significant impact on the quality of education, and on student success or failure. From this point of view, this study aims to examine the school climate from the perspectives of physical education and sports teacher candidates. To this end, the "School Climate Scale for University Students", developed by Ali R. Terzi, was applied to 303 physical education and sports teaching department students with three sub-factors. The data obtained were first subjected to a structure analysis and then to the reliability validity test, and the validity of the scale was determined. According to the type of variables, independent groups t-tests, one-way analysis of variance tests, post hoc tests, or effect size (Eta-square) tests were applied. While the answers given by the teacher candidates did not differ according to gender, a significant difference was found according to the grade they were studying in (in favor of first and fourth year students).

The Influence of Alteration of kVp and mAs towards the Image Quality of Acrylic Using CBCT

2019 ◽  
Vol 829 ◽  
pp. 252-257
Author(s):  
Azhari ◽  
Yohanes Hutasoit ◽  
Freddy Haryanto
Keyword(s):  
Image Quality ◽  
Signal To Noise Ratio ◽  
Region Of Interest ◽  
Signal To Noise ◽  
Bite Block ◽  
Significant Difference ◽  
Noise Ratio ◽  
Post Hoc ◽  
Radiograph Image

CBCT is a modernized technology in producing radiograph image on dentistry. The image quality excellence is very important for clinicians to interpret the image, so the result of diagnosis produced becoming more accurate, appropriate, thus minimizing the working time. This research was aimed to assess the image quality using the blank acrylic phantom polymethylmethacrylate (PMMA) (C­5H8O2)n in the density of 1.185 g/cm3 for evaluating the homogeneity and uniformity of the image produced. Acrylic phantom was supported with a tripod and laid down on the chin rest of the CBCT device, then the phantom was fixed, and the edge of the phantom was touched by the bite block. Furthermore, the exposure of the X-ray was executed toward the acrylic phantom with various kVp and mAs, from 80 until 90, with the range of 5 kV and the variation of mA was 3, 5, and 7 mA respectively. The time exposure was kept constant for 25 seconds. The samples were taken from CBCT acrylic images, then as much as 5 ROIs (Region of Interest) was chosen to be analyzed. The ROIs determination was analyzed by using the ImageJ® software for recognizing the influence of kVp and mAs towards the image uniformity, noise and SNR. The lowest kVp and mAs had the result of uniformity value, homogeneity and signal to noise ratio of 11.22; 40.35; and 5.96 respectively. Meanwhile, the highest kVp and mAs had uniformity value, homogeneity and signal to noise ratio of 16.96; 26.20; and 5.95 respectively. There were significant differences between the image uniformity and homogeneity on the lowest kVp and mAs compared to the highest kVp and mAs, as analyzed with the ANOVA statistics analysis continued with the t-student post-hoc test with α = 0.05. However, there was no significant difference in SNR as analyzed with the ANOVA statistic analysis. The usage of the higher kVp and mAs caused the improvement of the image homogeneity and uniformity compared to the lower kVp and mAs.

scholarly journals Technology and Process Design for Phenols Recovery from Industrial Chicory (Chicorium intybus) Leftovers

Molecules ◽  
2019 ◽  
Vol 24 (15) ◽  
pp. 2681 ◽  
Author(s):  
Camilla Maria Cova ◽  
Luisa Boffa ◽  
Marco Pistocchi ◽  
Silver Giorgini ◽  
Rafael Luque ◽  
...  
Keyword(s):  
Extraction Process ◽  
Ethanol Solution ◽  
Ultrasound Assisted Extraction ◽  
Mineral Salts ◽  
Primary And Secondary Metabolites ◽  
Assisted Extraction ◽  
Honestly Significant Difference ◽  
Significant Difference ◽  
Tukey Honestly Significant Difference ◽  
Post Hoc

Vegetal leftovers from the agro–food industry represent a huge source of primary and secondary metabolites, vitamin, mineral salts and soluble as well as insoluble fibers. Economic reports on the growth in the polyphenol market have driven us to focus our investigation on chicory (Chicorium intybus L.), which is one of the most popular horticultural plants in the world and a rich source of phenolic compounds. Ultrasound-assisted extraction (UAE), microwave-assisted extraction (MAE) and their simultaneous combination, using either ethanol/water or water alone (also sub-critical), have been investigated with the aim of designing a green and efficient extraction process. Higher total-polyphenol yields as well as dramatic reductions in extraction times and solvent consumption have been obtained under these conditions. ANOVA test for analyses of variance followed by the Tukey honestly significant difference (HSD) post-hoc test of multiple comparisons was used in the statistical analysis. MAE experiments performed with sub-critical water, and MW/US experiments with an ethanol solution have shown polyphenol recovery values of up to ~3 g of gallic acid equivalents (GAE) per kg of fresh material in only 15 min, while conventional extraction required 240 min to obtain the same result.

357 Comparative Effectiveness between Primary and Revision Foraminotomy for the Treatment of Lumbar Foraminal Stenosis

Neurosurgery ◽  
2017 ◽  
Vol 64 (CN_suppl_1) ◽  
pp. 282-282
Author(s):  
Emily Hu ◽  
Jianning Shao ◽  
Heath P Gould ◽  
Roy Xiao ◽  
Colin Haines ◽  
...  
Keyword(s):  
Comparative Effectiveness ◽  
Retrospective Cohort ◽  
Minimum Clinically Important Difference ◽  
Functional Score ◽  
Foraminal Stenosis ◽  
Lumbar Foraminal Stenosis ◽  
Clinically Important Difference ◽  
Significant Difference ◽  
Functional Scores

Abstract INTRODUCTION Foraminotomy has demonstrated clinical benefit for the management of lumbar foraminal stenosis (LFS). Although many patients undergo multiple foraminotomies, there is little data comparing primary foraminotomy (PF) and revision foraminotomy (RF) in terms of cost and quality of life (QOL) outcomes. METHODS A retrospective cohort study was conducted among patients undergoing foraminotomy for LFS. QOL instruments (EQ-5D, PDQ, and PHQ-9) were prospectively collected between 2008 and 2016. Outcome measures included improvement in postoperative QOL, perioperative cost, and QOL minimum clinically important difference (MCID). RESULTS >579 procedures were eligible 476 (82%) PF and 103 (18%) RF. A significantly higher proportion of males underwent RF than PF (71% vs. 59%, P = 0.03) and PF was done on a significantly higher number of vertebral levels (2.2 vs. 2.0, P = 0.04). There were no other significant differences in demographics. Preoperatively, mean PDQ-Functional scores (50 vs. 54, P = 0.04), demonstrated significantly poorer QOL in the RF cohort. Postoperatively, EQ-5D index showed significant improvement in both the PF (0.547?0.648, P < 0.0001) and the RF (0.507?0.648, P < 0.0001) cohorts. Similarly, total PHQ-9 improved significantly in the PF cohort (7.84?5.91, P < 0.001) and in the RF cohort (8.55?5.53, P = 0.02), as did total PDQ (PF: 77?63, P < 0.0001; RF: 85?70, P = 0.04). QOL scores were also compared between groups preoperatively and postoperatively. The only significant difference between PF and RF was observed in preoperative PDQ-Functional score (50 vs. 54, P = 0.04). The proportion of patients achieving an MCID was not significantly associated with cohort. Finally, perioperative cost did not differ significantly between cohorts (PF: $13,383 vs. RF: $13,595, P = 0.82). CONCLUSION RF patients had poorer preoperative PDQ-Functional scores, but both PF and RF produce significant improvement in all measures. There was no difference in QOL outcomes or cost between PF and RF. Therefore, while one procedure does not clearly have superior cost effectiveness than the other, both achieved significant effectiveness.

Readability Assessment of Patient Education Materials on Major Otolaryngology Association Websites

2012 ◽  
Vol 147 (5) ◽  
pp. 848-854 ◽  
Author(s):  
Jean Anderson Eloy ◽  
Shawn Li ◽  
Khushabu Kasabwala ◽  
Nitin Agarwal ◽  
David R. Hansberry ◽  
...  
Keyword(s):  
Patient Education ◽  
Sixth Grade ◽  
Reading Level ◽  
Flesch Reading Ease ◽  
Education Material ◽  
Individual Assessment ◽  
Honestly Significant Difference ◽  
Significant Difference ◽  
Grade Reading Level ◽  
Post Hoc

Objective Various otolaryngology associations provide Internet-based patient education material (IPEM) to the general public. However, this information may be written above the fourth- to sixth-grade reading level recommended by the American Medical Association (AMA) and National Institutes of Health (NIH). The purpose of this study was to assess the readability of otolaryngology-related IPEMs on various otolaryngology association websites and to determine whether they are above the recommended reading level for patient education materials. Study Design and Setting Analysis of patient education materials from 9 major otolaryngology association websites. Methods The readability of 262 otolaryngology-related IPEMs was assessed with 8 numerical and 2 graphical readability tools. Averages were evaluated against national recommendations and between each source using analysis of variance (ANOVA) with post hoc Tukey’s honestly significant difference (HSD) analysis. Mean readability scores for each otolaryngology association website were compared. Results Mean website readability scores using Flesch Reading Ease test, Flesch-Kincaid Grade Level, Coleman-Liau Index, SMOG grading, Gunning Fog Index, New Dale-Chall Readability Formula, FORCAST Formula, New Fog Count Test, Raygor Readability Estimate, and the Fry Readability Graph ranged from 20.0 to 57.8, 9.7 to 17.1, 10.7 to 15.9, 11.6 to 18.2, 10.9 to 15.0, 8.6 to 16.0, 10.4 to 12.1, 8.5 to 11.8, 10.5 to 17.0, and 10.0 to 17.0, respectively. ANOVA results indicate a significant difference ( P < .05) between the websites for each individual assessment. Conclusion The IPEMs found on all otolaryngology association websites exceed the recommended fourth- to sixth-grade reading level.

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