scholarly journals Improving Adherence to Guidelines for the Diagnosis and Management of Pelvic Inflammatory Disease: A Systematic Review

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Bette Liu ◽  
Basil Donovan ◽  
Jane S. Hocking ◽  
Janet Knox ◽  
Bronwyn Silver ◽  
...  
Keyword(s):  
Time Series ◽  
Pelvic Inflammatory Disease ◽  
Inflammatory Disease ◽  
Clinical Guidelines ◽  
Patient Adherence ◽  
Medication Compliance ◽  
Treatment Guideline ◽  
Interrupted Time Series ◽  
Control Group ◽  
Diagnosis And Management

Background.Evidence suggests adherence to clinical guidelines for pelvic inflammatory disease (PID) diagnosis and management is suboptimal. We systematically reviewed the literature for studies describing strategies to improve the adherence to PID clinical guidelines.Methods.The databases MEDLINE and EMBASE, and reference lists of review articles were searched from January 2000 to April 2012. Only studies with a control group were included.Results.An interrupted time-series study and two randomised controlled trials (RCTs) were included. The interrupted time-series found that following a multifaceted patient and practitioner intervention (practice protocol, provision of antibiotics on-site, written instructions for patients, and active followup), more patients received the recommended antibiotics and attended for followup. One RCT found a patient video on PID self-care did not improve medication compliance and followup. Another RCT found an abbreviated PID treatment guideline for health-practitioners improved their management of PID in hypothetical case scenarios but not their diagnosis of PID.Conclusion.There is limited research on what strategies can improve practitioner and patient adherence to PID diagnosis and management guidelines. Interventions that make managing PID more convenient, such as summary guidelines and provision of treatment on-site, appear to lead to better adherence but further empirical evidence is necessary.

Peritoneal Fluid and Plasma Fibrinolytic Activity in Women with Pelvic Inflammatory Disease

1992 ◽  
Vol 68 (02) ◽  
pp. 102-105 ◽  
Author(s):  
P J Dörr ◽  
E J P Brommer ◽  
G Dooijewaard ◽  
H M Vemer
Keyword(s):  
Pelvic Inflammatory Disease ◽  
Inflammatory Disease ◽  
Peritoneal Fluid ◽  
Fibrinolytic Activity ◽  
Degradation Products ◽  
Adhesion Formation ◽  
High Rate ◽  
Control Group ◽  
The Difference ◽  
Fibrinolytic Parameters

SummaryPrevious studies have shown that the fibrinolytic activity of peritoneum is depressed in local inflammation. We measured fibrinolytic parameters in peritoneal fluid and in plasma of 10 women with pelvic inflammatory disease (PID). Nine women, in whom laparoscopy for sterilisation was performed, served as a control group.In the peritoneal fluid of women with PID, PAI-Ag, t-PA-Ag and u-PA-Ag were many times higher than in the control group. In contrast to the antigens which may be present in inert complexes, the potentially active compounds, measured as t-PA activity and plasmin-activable scu-PA, were not significantly different in the two groups, and in none of the samples was the active enzyme tcu-PA detectable. Nevertheless, the mean peritoneal fluid TDP and FbDP concentrations were about twenty times higher in the PID group than in the control group. In plasma of PID patients, none of the parameters except u-PA-Ag differed from those in the control group. The difference between control and patient plasma u-PA-Ag was statistically significant, but too small to attach any relevance to the observation.Our data suggest that, in contrast to the classical concept of decreased fibrinolytic activity as a cause of adhesion formation, intraperitoneal fibrinolysis is enhanced in peritoneal inflammation through stimulation of the local production of t-PA and u-PA. Despite concomitant production of PAI, fibrinolysis occurs at a high rate, resulting in high levels of fibrin degradation products. Since this activated fibrinolysis does not meet the demand, therapeutic enhancement should be considered to prevent adhesions.

Pelvic inflammatory disease associated with Chlamydia trachomatis but not Mycoplasma genitalium in New Zealand

Sexual Health ◽  
2016 ◽  
Vol 13 (1) ◽  
pp. 43 ◽  
Author(s):  
Jeannie Oliphant ◽  
Sunita Azariah
Keyword(s):  
New Zealand ◽  
Chlamydia Trachomatis ◽  
Sexual Health ◽  
Pelvic Inflammatory Disease ◽  
Inflammatory Disease ◽  
Trichomonas Vaginalis ◽  
Mycoplasma Genitalium ◽  
Control Group ◽  
Sexual Health Service ◽  
Relevant Variables

Background There is a paucity of studies looking at associations between Mycoplasma genitalium and pelvic inflammatory disease (PID). The objectives of this study were to estimate the prevalence of M. genitalium in women attending a sexual health service in New Zealand and secondly to examine for an association of M. genitalium with PID. Methods: Women consecutively attending the service for a sexual health screen (Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis) were recruited to establish a baseline prevalence of M. genitalium. An extra cervical swab was taken for the detection of M. genitalium. Recruitment of additional women with a clinical diagnosis of PID continued until a sufficient sample size was obtained to examine the association of PID with M. genitalium. Women in the baseline sample without PID were used as the control group. Results: The control group included 250 women, with M. genitalium diagnosed in 8.7% (95% CI 5.8–12.9%) and C. trachomatis in 9.9% (95% CI 6.8–14.2%). Ninety-one women were recruited with PID; M. genitalium was diagnosed in 9.9% (95% CI 5.3–17.7%) and C. trachomatis in 27.5% (95% CI 19.4–37.4%). Multivariate analysis using clinically relevant variables showed that a diagnosis of C. trachomatis (OR 2.44, 95% CI 1.24–4.81) but not M. genitalium (OR 0.91, 95% CI 0.38–2.20) was significantly associated with a PID diagnosis. Conclusions: M. genitalium was almost as commonly diagnosed as C. trachomatis in this population. C. trachomatis was the only infection that was significantly associated with PID.

Updated French guidelines for diagnosis and management of pelvic inflammatory disease

2016 ◽  
Vol 134 (2) ◽  
pp. 121-125 ◽  
Author(s):  
Jean-Luc Brun ◽  
Olivier Graesslin ◽  
Arnaud Fauconnier ◽  
Renaud Verdon ◽  
Aubert Agostini ◽  
...  
Keyword(s):  
Pelvic Inflammatory Disease ◽  
Inflammatory Disease ◽  
Diagnosis And Management

scholarly journals An Overview on Pelvic Inflammatory Disease Diagnosis and Management Approach

2021 ◽  
Vol 12 (2) ◽  
pp. 103-105
Author(s):  
Shihanah Mansour Alshammari ◽  
Nermeen Nasser Alrajhi ◽  
Shouq Sulaiman Al-Rumayh ◽  
Mohammed Abdullah Alosaimi ◽  
Renad Mohammed Alsharyuf ◽  
...  
Keyword(s):  
Pelvic Inflammatory Disease ◽  
Inflammatory Disease ◽  
Disease Diagnosis ◽  
Management Approach ◽  
Diagnosis And Management

scholarly journals The effect of a specialist paramedic primary care rotation on appropriate non-conveyance decisions: a controlled interrupted time series analysis

2020 ◽  
Author(s):  
Richard Pilbery ◽  
Tracey Young ◽  
Andrew Hodge
Keyword(s):  
Primary Care ◽  
Time Series ◽  
Cost Effectiveness ◽  
Intervention Group ◽  
Interrupted Time Series ◽  
Ambulance Service ◽  
Control Group ◽  
Interrupted Time Series Analysis ◽  
Cost Effectiveness Ratio ◽  
The Cost

AbstractIntroductionNHS ambulance service conveyance rates in the UK are almost 70%, despite an increase in non-emergency cases. This is increasing the demands on crowded emergency departments (ED) and contributes to increased ambulance turnaround times. Yorkshire Ambulance Service introduced a specialist paramedic (SP) role to try and address this, but non-conveyance rates in this group have not been as high as expected.MethodsWe conducted a controlled interrupted time series analysis of appropriate non-conveyance rates in the 12 months before and after an SP primary care placement, using matched groups of patients cared for by SPs and control paramedics. A costing analysis examined the average cost per appropriate non-conveyance and the cost-effectiveness ratio between groups.ResultsBetween June 2017 and December 2019 there were 7349 incidents attended by intervention group SPs and eligible for inclusion. Following removal of cases with missing data, 5537/7349 (75.3%) cases remained. Post-placement, the intervention group demonstrated an increase in appropriate non-conveyance rate by 32.2% (95%CI 20.1–44.3%, p<0.001) and a reduction in the trend of appropriate non-conveyance relative to the control group of −1.8% (95%CI −3.5—0.0%, p=0.045).Post-placement, the cost per appropriate non-conveyance for intervention paramedics was a mean of £501.94 (95% bootstrapped CI £477.99–£526.46) versus £1217.89 (95% bootstrapped CI £1121.49–£1321.85) for the control group. This represents a mean saving of £715.95 per appropriate non-conveyance (95% bootstrapped CI £638.23–£795.69) for SPs compared to the control group, and a cost-effectiveness ratio of £2226.04 per percentage increase in appropriate non-conveyance (95% bootstrapped CI £1854.11–£2748.44).ConclusionIn this single UK NHS ambulance service study, we found a clinically important and statistically significant increase in appropriate non-conveyance rates by specialist paramedics who had completed a 10-week GP placement. This improvement persisted for the 12-month period following the placement and demonstrated cost savings compared to usual care.

scholarly journals Assessing the impact of the Provincial Reimbursement Scheme on the use of Targeted Anticancer Medications in Zhejiang, China: A Controlled Interrupted time-series Analysis

2020 ◽  
Author(s):  
Cong Huang ◽  
Carolina Oi Lam Ung ◽  
Haishaerjiang Wushouer ◽  
Ziyue Xu ◽  
Yichen Zhang ◽  
...  
Keyword(s):  
Time Series ◽  
Time Series Analysis ◽  
Financial Burden ◽  
Interrupted Time Series ◽  
Control Group ◽  
Study Group ◽  
Interrupted Time Series Analysis ◽  
Series Analysis ◽  
Hospital Purchasing ◽  
The Impact

Abstract Background: High prices of targeted anticancer medications (TAMs) subject patients to extreme financial burden. To alleviate problems with access and affordability, 6 TAMs were newly listed in the Provincial Reimbursement Drug List (PRDL) in Zhejiang, China in February 2015. To evaluate the implementation of the PRDL policy, this study examined differences in the hospital purchasing volume (HPV) and the hospital purchasing spending (HPS) of 6 listed TAMs pre- and post-enlistment and comparing with 4 other unlisted TAMs. Methods: Interrupted time-series analysis was employed using the pharmaceutical procurement data of 6 newly listed TAMs (study group) and 4 unlisted TAMs (control group) from 22 tertiary hospitals in Zhejiang, China dated between January 2014 and March 2017. Results: After February 2015, the average HPV per month increased significantly by 34.6 defined daily doses (DDDs) (p<0.001) and the average HPS per month increased significantly by USD 6614.9 (p<0.001) for the listed TAMs in the study group (n=6); neither the average HPV nor the average HPS changed significantly for the unlisted TAMs in the control group (n=4). Although only 4 of the 6 listed TAMs exhibited significant decrease in the monthly HPV and HPS individually, the daily cost of each TAM decreased after enlistment. Conclusions: The PRDL policy has shown positive effect on promoting the access to and improving patients’ affordability of TAMs in Zhejiang. The government should conduct further price negotiations and include more TAMs with clinical benefits into reimbursement schemes to relief patients’ financial burden and promote access.

scholarly journals Does Monetary Support Increase the Number of Scientific Papers? An Interrupted Time Series Analysis

2018 ◽  
Vol 3 (1) ◽  
pp. 19-39 ◽  
Author(s):  
Yaşar Tonta
Keyword(s):  
Time Series ◽  
Time Series Analysis ◽  
Interrupted Time Series ◽  
Support Program ◽  
Series Data ◽  
Control Group ◽  
Interrupted Time Series Analysis ◽  
Series Analysis ◽  
The Impact

Abstract Purpose One of the main indicators of scientific production is the number of papers published in scholarly journals. Turkey ranks 18th place in the world based on the number of scholarly publications. The objective of this paper is to find out if the monetary support program initiated in 1993 by the Turkish Scientific and Technological Research Council (TÜBİTAK) to incentivize researchers and increase the number, impact, and quality of international publications has been effective in doing so. Design/methodology/approach We analyzed some 390,000 publications with Turkish affiliations listed in the Web of Science (WoS) database between 1976 and 2015 along with about 157,000 supported ones between 1997 and 2015. We used the interrupted time series (ITS) analysis technique (also known as “quasi-experimental time series analysis” or “intervention analysis”) to test if TÜBİTAK’s support program helped increase the number of publications. We defined ARIMA (1,1,0) model for ITS data and observed the impact of TÜBİTAK’s support program in 1994, 1997, and 2003 (after one, four and 10 years of its start, respectively). The majority of publications (93%) were full papers (articles), which were used as the experimental group while other types of contributions functioned as the control group. We also carried out a multiple regression analysis. Findings TÜBİTAK’s support program has had negligible effect on the increase of the number of papers with Turkish affiliations. Yet, the number of other types of contributions continued to increase even though they were not well supported, suggesting that TÜBİTAK’s support program is probably not the main factor causing the increase in the number of papers with Turkish affiliations. Research limitations Interrupted time series analysis shows if the “intervention” has had any significant effect on the dependent variable but it does not explain what caused the increase in the number of papers if it was not the intervention. Moreover, except the “intervention”, other “event(s)” that might affect the time series data (e.g., increase in the number of research personnel over the years) should not occur during the period of analysis, a prerequisite that is beyond the control of the researcher. Practical implications TÜBİTAK’s “cash-for-publication” program did not seem to have direct impact on the increase of the number of papers published by Turkish authors, suggesting that small amounts of payments are not much of an incentive for authors to publish more. It might perhaps be a better strategy to concentrate limited resources on a few high impact projects rather than to disperse them to thousands of authors as “micropayments.” Originality/value Based on 25 years’ worth of payments data, this is perhaps one of the first large-scale studies showing that “cash-for-publication” policies or “piece rates” paid to researchers tend to have little or no effect on the increase of researchers’ productivity. The main finding of this paper has some implications for countries wherein publication subsidies are used as an incentive to increase the number and quality of papers published in international journals. They should be prepared to consider reviewing their existing support programs (based usually on bibliometric measures such as journal impact factors) and revising their reward policies.

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