Measuring the Improving Quality of Outpatient Care in Medical Oncology Practices in the United States

2013 ◽  
Vol 31 (11) ◽  
pp. 1471-1477 ◽  
Author(s):  
Michael N. Neuss ◽  
Jennifer L. Malin ◽  
Stephanie Chan ◽  
Pamela J. Kadlubek ◽  
John L. Adams ◽  
...  
Keyword(s):  
Clinical Information ◽  
The United States ◽  
Measuring Process ◽  
The Past ◽  
The Mean ◽  
Highly Correlated ◽  
American Society ◽  
Oncology Practice ◽  
Over Time

Purpose The American Society of Clinical Oncology Quality Oncology Practice Initiative (QOPI) has provided a method for measuring process-based practice quality since 2006. We sought to determine whether QOPI scores showed improvement in measured quality over time and, if change was demonstrated, which factors in either the measures or participants were associated with improvement. Methods The analysis included 156 practice groups from a larger group of 308 that submitted data from 2006 to 2010. One hundred fifty-two otherwise eligible practices were excluded, most commonly for insufficient data submission. A linear regression model that controlled for varied initial performance was used to estimate the effect of participation over time and evaluate participant and measure characteristics of improvement. Results Participants completed a mean of 5.06 (standard deviation, 1.94) rounds of data collection. Adjusted mean quality scores improved from 0.71 (95% CI, 0.42 to 0.91) to 0.85 (95% CI, 0.60 to 0.95). Overall odds ratio of improvement over time was 1.09 (P < .001). The greatest improvement was seen in measures that assessed newly introduced clinical information, in which the mean scores improved from 0.05 (95% CI, 0.01 to 0.17) to 0.69 (95% CI, 0.33 to 0.91; P < .001). Many measures showed no change over time. Conclusion Many US oncologists have participated in QOPI over the past 6 years. Participation over time was highly correlated with improvement in measured performance. Greater and faster improvement was seen in measures concerning newly introduced clinical information. Some measures showed no change despite opportunity for improvement.

Measuring the improving quality of outpatient care in medical oncology practices in the United States.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 66-66
Author(s):  
Michael N. Neuss ◽  
Jennifer Malin ◽  
Stephanie Chan ◽  
Pamela Kadlubek ◽  
John L. Adams ◽  
...  
Keyword(s):  
Clinical Information ◽  
The United States ◽  
Time Period ◽  
Medical Oncologists ◽  
The Mean ◽  
Highly Correlated ◽  
American Society ◽  
Oncology Practice ◽  
Over Time

66 Background: The American Society of Clinical Oncology (ASCO) Quality Oncology Practice Initiative (QOPI) has provided a method for measurement of process based practice quality since 2006. We sought to determine whether QOPI participants show improvement in measured quality over time, and if change is demonstrated, those factors in either the measures or participants which are associated with change. Methods: 156 participant medical practice groups, which did not submit trainee data, participated in at least two collection rounds from 2006 through 2010, and reported on ≥30 patients per round from were included in analysis from a larger group of 306 participants from this time period. A database of these reports was used to evaluate trends in scoring among participants. A linear regression model, which controlled for varied initial performance, was used to estimate the effect of participation over time and evaluate participant and measure characteristics. Measures were aggregated into categories to evaluate which factors correlated with change. Results: Participants completed a mean of 5.71 (S.D. 1.84) rounds of data collection. Adjusted mean quality scores improved from 0.71 (95% C.I. 0.42 – 0.91) to 0.85 (95% C.I. 0.60 – 0.95). Overall odds ratio of improvement over time was 1.09 (p < 0.0001). The greatest improvement was seen in measures assessing newly introduced clinical information, where the mean scores improved from 0.05 (95% C.I. 0.01 – 0.17) to 0.69 (95% C.I. 0.33 – 0.91), (p ≤ 0.0001). Many measures showed no change over time. Conclusions: QOPI has gained widespread adoption and approximately 15% of U.S. medical oncologists participate. Participation over time is highly correlated with improvement in measured performance. Much of this improvement is the result of the adoption of newly introduced clinical information. Some measures show no change despite significant opportunity for improvement.

Clinical Oncology Practice 2015: Preparing for the Future

2015 ◽  
pp. e622-e627 ◽  
Author(s):  
Michael P. Kosty ◽  
Anupama Kurup Acheson ◽  
Eric D. Tetzlaff
Keyword(s):  
Clinical Oncology ◽  
Nurse Practitioners ◽  
Cancer Care ◽  
Medical Knowledge ◽  
Physician Assistants ◽  
The United States ◽  
Practice Model ◽  
American Society ◽  
Oncology Practice

The clinical practice of oncology has become increasingly complex. An explosion of medical knowledge, increased demands on provider time, and involved patients have changed the way many oncologists practice. What was an acceptable practice model in the past may now be relatively inefficient. This review covers three areas that address these changes. The American Society of Clinical Oncology (ASCO) National Oncology Census defines who the U.S. oncology community is, and their perceptions of how practice patterns may be changing. The National Cancer Institute (NCI)-ASCO Teams in Cancer Care Project explores how best to employ team science to improve the efficiency and quality of cancer care in the United States. Finally, how physician assistants (PAs) and nurse practitioners (NPs) might be best integrated into team-based care in oncology and the barriers to integration are reviewed.

scholarly journals Clinical Information Systems – From Yesterday to Tomorrow

2016 ◽  
Vol 25 (S 01) ◽  
pp. S62-S75 ◽  
Author(s):  
R. M. Gardner
Keyword(s):  
Patient Safety ◽  
Information Systems ◽  
Patient Care ◽  
Clinical Information ◽  
Clinical Decision ◽  
The United States ◽  
Clinical Information Systems ◽  
The Past ◽  
Clinical Computing

Summary Objectives: To review the history of clinical information systems over the past twenty-five years and project anticipated changes to those systems over the next twenty-five years. Methods: Over 250 Medline references about clinical information systems, quality of patient care, and patient safety were reviewed. Books, Web resources, and the author’s personal experience with developing the HELP system were also used. Results: There have been dramatic improvements in the use and acceptance of clinical computing systems and Electronic Health Records (EHRs), especially in the United States. Although there are still challenges with the implementation of such systems, the rate of progress has been remarkable. Over the next twenty-five years, there will remain many important opportunities and challenges. These opportunities include understanding complex clinical computing issues that must be studied, understood and optimized. Dramatic improvements in quality of care and patient safety must be anticipated as a result of the use of clinical information systems. These improvements will result from a closer involvement of clinical informaticians in the optimization of patient care processes. Conclusions: Clinical information systems and computerized clinical decision support have made contributions to medicine in the past. Therefore, by using better medical knowledge, optimized clinical information systems, and computerized clinical decision, we will enable dramatic improvements in both the quality and safety of patient care in the next twenty-five years.

Biopsychosocial Patterning of Multimorbidity and Its Consequences

2018 ◽  
pp. 220-236
Author(s):  
Elliot Friedman ◽  
Beth LeBreton ◽  
Lindsay Fuzzell ◽  
Elizabeth Wehrpsann
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Functional Outcomes ◽  
The United States ◽  
Chronic Medical Conditions ◽  
Quality Of Life Research ◽  
Increased Risk ◽  
Over Time

By many estimates the majority of adults over age 65 have two or more chronic medical conditions (multimorbidity) and are consequently at increased risk of adverse functional outcomes. Nonetheless, many older adults with multimorbidity are able to maintain high levels of function and retain good quality of life. Research presented here is designed to understand the influences that help ensure better functional outcomes in these older adults. This chapter presents findings that draw on data from the Midlife in the United States study. The independent and interactive contributions of diverse factors to multimorbidity and changes in multimorbidity over time are reviewed. The degree that multimorbidity increases risk of cognitive impairment and disability is examined. The role of inflammation as a mediator is considered. Multimorbidity is increasingly the norm for older adults, so better understanding of factors contributing to variability in multimorbidity-related outcomes can lead to improved quality of life.

scholarly journals Bibliometric Analysis of Microtia-Related Publications From 2006 to 2020

2021 ◽  
pp. 014556132110376
Author(s):  
Wei Wang ◽  
Xinxin Dong ◽  
Jianwen Qu ◽  
Yangyang Lin ◽  
Lei Liu
Keyword(s):  
Core Collection ◽  
Web Of Science ◽  
The United States ◽  
Research Trends ◽  
External Ear ◽  
Future Directions ◽  
Occurrence Matrix ◽  
Author Citations ◽  
Over Time

Objective: Microtia is a congenital auricular malformation with a hypoplastic external ear that ranges in severity from a slightly smaller auricle to complete the absence of the auricle. The present study was conducted to identify and analyze the characteristics of microtia-related articles published from 2006 to 2020 by using bibliometric analyses. Method: Microtia-related studies published from 2006 to 2020 were retrieved from the Web of Science Core Collection database. Keywords, first author, citations, date of publication, and publication journal were extracted and quantitatively analyzed using Bibliographic Item Co-Occurrence Matrix Builder software and the Bibliometric ( https://bibliometric.com/app ). VOSviewer was used to visualize research and form a network map on keywords and citations. Results: A total of 1031 articles from 2006 to 2020 were included. The number of articles showed an overall trend of growth over time. The United States and China are the top 2 countries in terms of the number of microtia-related articles. From the analysis of keyword clustering, keywords could be mainly divided into 4 clusters in the field of microtia research: surgery, tissue engineering, epidemiology, and rehabilitation including hearing-related treatments, evaluation of effects, and quality of life after surgery. The top 10 most frequently cited papers from 2006 to 2020 were also extracted and analyzed. Conclusion: A bibliometric research of microtia-related articles from 2006 to 2020 was conducted. This study may be helpful to understand the current research status of microtia and find the research trends in this field, thus proposing future directions for microtia research.

Longing, Nostalgia, and Golden Age Politics: The American Jeremiad and the Power of the Past

2009 ◽  
Vol 7 (1) ◽  
pp. 125-141 ◽  
Author(s):  
Andrew R. Murphy
Keyword(s):  
Golden Age ◽  
Political Rhetoric ◽  
The United States ◽  
Abraham Lincoln ◽  
Frederick Douglass ◽  
Political Life ◽  
The Past ◽  
American Tradition ◽  
Political Ideal ◽  
American Society

I assess several politically powerful ways of drawing on the past in the search for solutions to problems in the present. To probe these dynamics, I turn to the American jeremiad, a longstanding form of political rhetoric that explicitly invokes the past and laments the nation's falling-away from its virtuous foundations. I begin by focusing on the Christian Right's traditionalist jeremiad, which offers both nostalgic and Golden Age rhetoric in its assessment of the United States' imperiled national promise. I argue that, despite differences in the historical location of their ideals and the significant rhetorical power that they bring to political life, such nostalgic and Golden Age narratives represent a constraining political ideal, one ultimately incapable of doing justice to an increasingly diverse American society. I argue furthermore that there is another strand of the American jeremiad and conclude by sketching a different way of drawing on the past, a progressive jeremiad epitomized by the thought of Abraham Lincoln and Frederick Douglass. Such a jeremiad is also deeply rooted in the American tradition and offers a far more promising contribution to a diverse and pluralistic American future.

Increasing author counts in neurosurgical journals from 1980 to 2020

2021 ◽  
pp. 1-5
Author(s):  
Tyler S. Cole ◽  
Mark A. Pacult ◽  
Michael T. Lawton
Keyword(s):  
Scientific Productivity ◽  
Academic Journals ◽  
Publication Type ◽  
Medical Specialties ◽  
The Past ◽  
The Mean ◽  
Scopus Database ◽  
Publication Volume ◽  
Over Time ◽  
Number Of Authors

OBJECTIVE Scientific productivity, as assessed by publication volume, is a common metric by which the academic neurosurgical field assesses its members. The number of authors per peer-reviewed article has been observed to increase over time across a broad range of medical specialties. This study provides an update to this trend in the neurosurgical literature. METHODS All publications from January 1, 1980, to April 30, 2020, were queried from four neurosurgical journals: Neurosurgery, Journal of Neurosurgery (JNS), JNS: Pediatrics, and JNS: Spine. Publication information was acquired from the National Center for Biotechnology Information Entrez database and reconciled with the Scopus database. Publication type was limited to articles and excluded editorials, letters, and reviews. The number of authors and affiliation counts were determined based on structured abstract fields provided in the two databases. RESULTS Between January 1, 1980, and April 30, 2020, the overall increase in author count for the four neurosurgical journals was 0.12 to 0.18 authors per year (p < 0.001). For Neurosurgery, the mean (SD) author count increased from 2.81 (1.4) in 1980–1985 to 7.97 (4.92) in 2016–2020 (p < 0.001). For the JNS, the mean (SD) author count increased from 2.82 (1.04) in 1980–1985 to 7.6 (3.65) in 2016–2020 (p < 0.001). The percentage of articles with more than 10 authors increased from 0.2% to 22.3% in Neurosurgery and from 1.9% to 17.5% in JNS. Only 28% of the author count variation was explained by an increasing number of institutional or departmental affiliations. CONCLUSIONS Author counts for peer-reviewed articles in neurosurgical academic journals have increased significantly during the past 4 decades, with large increases in the numbers of articles with more than 10 authors in the past 5 years. A total of 28% of the variation in this increase can be explained by an increase in multiinstitutional or multidepartmental studies.

Does Party Trump Ideology? Disentangling Party and Ideology in America

2018 ◽  
Vol 113 (1) ◽  
pp. 38-54 ◽  
Author(s):  
MICHAEL BARBER ◽  
JEREMY C. POPE
Keyword(s):  
United States ◽  
Research Design ◽  
The United States ◽  
Group Loyalty ◽  
Policy Statements ◽  
Party Attachment ◽  
Highly Correlated ◽  
Liberal Policy ◽  
Standing Question ◽  
Over Time

Are people conservative (liberal) because they are Republicans (Democrats)? Or is it the reverse: people are Republicans (Democrats) because they are conservatives (liberals)? Though much has been said about this long-standing question, it is difficult to test because the concepts are nearly impossible to disentangle in modern America. Ideology and partisanship are highly correlated, only growing more so over time. However, the election of President Trump presents a unique opportunity to disentangle party attachment from ideological commitment. Using a research design that employs actual “conservative” and “liberal” policy statements from President Trump, we find that low-knowledge respondents, strong Republicans, Trump-approving respondents, and self-described conservatives are the most likely to behave like party loyalists by accepting the Trump cue—in either a liberal or conservative direction. These results suggest that there are a large number of party loyalists in the United States, that their claims to being a self-defined conservative are suspect, and that group loyalty is the stronger motivator of opinion than are any ideological principles.

scholarly journals The Value of Citizen Science in Increasing Our Knowledge of Under-Sampled Biodiversity: An Overview of Public Documentation of Auchenorrhyncha and the Hoppers of North Carolina

2021 ◽  
Vol 9 ◽  
Author(s):  
Kyle D. Kittelberger ◽  
Solomon V. Hendrix ◽  
Çağan Hakkı Şekercioğlu
Keyword(s):  
North Carolina ◽  
Citizen Science ◽  
Spatial Scales ◽  
The United States ◽  
Undescribed Species ◽  
The Past ◽  
Global Biodiversity ◽  
Temporal And Spatial

Due to the increasing popularity of websites specializing in nature documentation, there has been a surge in the number of people enthusiastic about observing and documenting nature over the past 2 decades. These citizen scientists are recording biodiversity on unprecedented temporal and spatial scales, rendering data of tremendous value to the scientific community. In this study, we investigate the role of citizen science in increasing knowledge of global biodiversity through the examination of notable contributions to the understanding of the insect suborder Auchenorrhyncha, also known as true hoppers, in North America. We have compiled a comprehensive summary of citizen science contributions—published and unpublished—to the understanding of hopper diversity, finding over fifty previously unpublished country and state records as well as dozens of undescribed and potentially undescribed species. We compare citizen science contributions to those published in the literature as well as specimen records in collections in the United States and Canada, illuminating the fact that the copious data afforded by citizen science contributions are underutilized. We also introduce the website Hoppers of North Carolina, a revolutionary new benchmark for tracking hopper diversity, disseminating knowledge from the literature, and incorporating citizen science. Finally, we provide a series of recommendations for both the entomological community and citizen science platforms on how best to approach, utilize, and increase the quality of sightings from the general public.

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