scholarly journals A importância do treinamento, reprodutibilidade e calibragem para a qualidade dos estudos

2021 ◽  
Vol 41 (1) ◽  
pp. 3-7
Author(s):  
Cristiano Susin ◽  
Cassiano Kuchenbecker Rösing
Keyword(s):  
Decision Making ◽  
Scientific Knowledge ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
International Standards ◽  
Scientific Methodology ◽  
Biological Processes ◽  
The Way

Dentistry is undergoing a deep transformation in its way of producing, using and interpreting the scientific knowledge. The need for utilizing the best possible evidence for the understanding of the physical and biological processes, as well as to clinical decision making, has risen the interest in the study of subjects that were not regarded as important before. In this scene, the capacity of evaluating the quality of different studies and of producing them under international standards has enhanced the seeking for knowledge in scientific methodology. The way by which the data are obtained and the procedures are performed in research might definitively influence its capacity to generate evidence. Thus, training, reproducibility and calibration are principles that have to be part of everything concerning the process of creating and using the knowledge.

scholarly journals Variation in LOD Across SARS-CoV-2 Assay Systems: Need for Standardization

2020 ◽  
Author(s):  
Youvraj Sohni
Keyword(s):  
Decision Making ◽  
Clinical Decision Making ◽  
Limit Of Detection ◽  
Clinical Decision ◽  
International Standards ◽  
Performance Characteristics ◽  
Clinical Testing ◽  
Factors Affecting ◽  
Diagnostic Assays ◽  
Technology Platforms

Abstract Multiple SARS-CoV-2 emergency use authorization (EUA) tests are being used for clinical testing across various clinical testing laboratories for meeting the diagnostic challenges of the ongoing pandemic. However, cross-assay variations in performance characteristics need to be recognized. A better understanding is needed of the clinical implications of cross-assay variation in performance characteristics, particularly in the limit of detection (LOD) of the SARS-CoV-2 assays used for clinical testing. Herein, a snapshot of the diversity of SARS-CoV-2 EUA analytical assay systems including methodologies, assay designs, and technology platforms is presented. Factors affecting the variations in LOD are discussed. Potential measures that may standardize across the various assay systems are suggested. Development of international standards and reference materials for the establishment of performance characteristics may substantially alleviate potential clinical decision-making challenges. Finally, cross-assay variation in LODs among the diverse SARS-CoV-2 diagnostic assays impacts clinical decision-making with multiple assay systems in use and lack of standardization across platforms. International standards in parallel with continued cross-platform studies and collaborative efforts across pertinent healthcare entities will help mitigate some of the clinical decision-making challenges.

Beyond the Development of Health-Related Quality-of-Life (HRQOL) Measures: A Checklist for Evaluating HRQOL Outcomes in Cancer Clinical Trials—Does HRQOL Evaluation in Prostate Cancer Research Inform Clinical Decision Making?

2003 ◽  
Vol 21 (18) ◽  
pp. 3502-3511 ◽  
Author(s):  
Fabio Efficace ◽  
Andrew Bottomley ◽  
David Osoba ◽  
Carolyn Gotay ◽  
Henning Flechtner ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Decision Making ◽  
Clinical Trials ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Cancer Clinical Trials ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

Purpose: The aim of this study was to evaluate whether the inclusion of health-related quality of life (HRQOL), as a part of the trial design in a randomized controlled trial (RCT) setting, has supported clinical decision making for the planning of future medical treatments in prostate cancer. Materials and Methods: A minimum standard checklist for evaluating HRQOL outcomes in cancer clinical trials was devised to assess the quality of the HRQOL reporting and to classify the studies on the grounds of their robustness. It comprises 11 key HRQOL issues grouped into four broader sections: conceptual, measurement, methodology, and interpretation. Relevant studies were identified in a number of databases, including MEDLINE and the Cochrane Controlled Trials Register. Both their HRQOL and traditional clinical reported outcomes were systematically analyzed to evaluate their consistency and their relevance for supporting clinical decision making. Results: Although 54% of the identified studies did not show any differences in traditional clinical end points between treatment arms and 17% showed a difference in overall survival, 74% of the studies showed some difference in terms of HRQOL outcomes. One third of the RCTs provided a comprehensive picture of the whole treatment including HRQOL outcomes to support their conclusions. Conclusion: A minimum set of criteria for assessing the reported outcomes in cancer clinical trials is necessary to make informed decisions in clinical practice. Using a checklist developed for this study, it was found that HRQOL is a valuable source of information in RCTs of treatment in metastatic prostate cancer.

Goals of palliative cancer therapy.

1993 ◽  
Vol 11 (2) ◽  
pp. 378-381 ◽  
Author(s):  
F Porzsolt ◽  
I Tannock
Keyword(s):  
Quality Of Life ◽  
Decision Making ◽  
Cost Effectiveness ◽  
Cancer Therapy ◽  
Health Professionals ◽  
Palliative Treatment ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Oncology Practice

The major conclusions of the Workshop on Goals of Palliative Cancer Therapy are as follows: 1. The goals of any cancer therapy should be stated explicitly. 2. If the goal of treatment is palliation, this should be documented according to one of the established and validated methods for assessment of quality of life. Several validated methods are available, and although imperfect, have been shown to give reliable information. 3. The use of simple measures of quality of life (eg, symptom checklists, pain assessment cards) should become routine in oncology practice. The act of introducing such measures improves palliation. 4. Measures of cost-effectiveness should be used more widely in clinical decision making to ensure the appropriate deployment of resources. 5. There must be improved education of all health professionals with regard to the multiple methods for provision of palliative treatment to cancer patients and the assessment of palliation.

Hazards of Quality-of-Life Data for Clinical Decision Making

2001 ◽  
Vol 19 (2) ◽  
pp. 594-595 ◽  
Author(s):  
Mark Somerfield ◽  
Aminah Jatoi ◽  
Phuong L. Nguyen ◽  
Shaji Kumar ◽  
Jeff Sloan ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Decision Making ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Life Data

Diagnostic conversations: Clinical Decision Making in surgery – Part 2

Diagnosis ◽  
2014 ◽  
Vol 1 (2) ◽  
pp. 189-193 ◽  
Author(s):  
David Allan Watters ◽  
Spencer Wynyard Beasley ◽  
Wendy Crebbin
Keyword(s):  
Decision Making ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Learning Opportunities ◽  
Clinical Decisions ◽  
Decision Making Processes ◽  
Royal Australasian College ◽  
Insight Into ◽  
Made In

AbstractProceduralists who fail to review their decision making are unlikely to learn from their experiences, irrespective of whether the operative outcome is successful or not. Teaching junior surgeons to develop ‘insight’ into their own decision making has long been a challenge. Surgeons and staff of the Royal Australasian College of Surgeons worked together to develop a model to help explain the processes around clinical decision making and incorporated this model into a Clinical Decision Making (CDM) training course. In this course, faculty apply the model to specific surgical cases, within the model’s framework of how clinical decisions are made; thus providing an opportunity to identify specific decision making processes as they occur and to highlight some of the learning opportunities they provide. The conversation in this paper illustrates the kinds of case-based interactions which typically occur in the development and teaching of the CDM course.The focus in this, the second of two papers, is on reviewing post-operative clinical decisions made in relation to one case, to improve the quality of subsequent decision making.

scholarly journals Cronic Kidney Disease, Life Quality Assessment Of Patients

2016 ◽  
Vol 12 (6) ◽  
pp. 103
Author(s):  
Marsida Duli ◽  
Qamil Dika ◽  
Matilda Bushati
Keyword(s):  
Quality Of Life ◽  
Chronic Kidney Disease ◽  
Decision Making ◽  
Kidney Disease ◽  
Clinical Decision Making ◽  
Well Being ◽  
Clinical Decision ◽  
Healthy Population ◽  
Important Indicator

Assessing quality of life in patients with varying degrees of chronic kidney disease is an important issue because of its impact on clinical decision-making as increasing the efficiency of resources in the health system. Through this survey provided an attempt to assess the quality of life of patients with chronic kidney disease undergoing dialysis. Commitment to maximize their functioning and well-being constitutes the essence of the purpose of health care. In recent decades elaborate SF 36 is cut by a gauge derive so simple and basic that helps to evaluate the function of the target of researchers, a certain age group, a disease or a treatment group. Short questionnaire forms SF36 instrument gauge is used to determine the level of quality of life in patients with chronic renal failure under the different stages of treatment with dialysis. The study involved 206 people, 112 from patients to Tirana and Shkodra and 94 healthy persons, who collaborated consensually for completing the questionnaires. Based on the results, the quality of life of dialysis patients is significantly worse than that of the healthy population and patients with other injuries less severe of renal function. Survey indicates that a more holistic approach to be used in the treatment of patients with chronic kidney disease including clinical decision making and patient perception. Precisely for this it is recommended to enter the practice of clinical interest that a set of questionnaires that provide information on patients' perception of health as an important indicator that facilitates the physician-patient collaboration in order to better treatment of the disease and increase the quality the life of the patient.

Nutrition-Related Clinical Decision Making of Pediatric Oncology Nurses

2019 ◽  
Vol 36 (5) ◽  
pp. 352-360
Author(s):  
Amanda J. Lulloff ◽  
Judith A. Vessey ◽  
Lisa Bashore ◽  
Matt Gregas
Keyword(s):  
Decision Making ◽  
Nutritional Status ◽  
Pediatric Oncology ◽  
Clinical Decision Making ◽  
Nutritional Assessment ◽  
Clinical Decision ◽  
Oncology Nurses ◽  
Children With Cancer ◽  
Pediatric Hematology

Children with a cancer diagnosis have risk factors leading to unique nutritional challenges. Malnutrition in this population is correlated with worse patient outcomes. Nurses are responsible for providing holistic care to their patients; however, the quality of nutritional assessments by pediatric oncology nurses is unknown. The purpose of this study was to investigate staff nurses’ clinical decision making regarding nutritional assessment of children with cancer. A web-based survey composed of a demographic form, vignettes of patients with diverse nutritional status and the New General Self-Efficacy Scale, was distributed to members of the Association of Pediatric Hematology Oncology Nurses. Participants were also asked to rate their confidence in responses as well as select key nutritional cues. Nurses were significantly more likely to under-rate the nutritional status and select far fewer cues than the experts. Further research regarding nutritional assessment is warranted. Evidenced-based guidelines for nutritional assessment of children with cancer should be developed to ensure the highest quality of care is provided to this patient population.

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