scholarly journals Preoperative laboratory testing - Comparison of National Institute of Clinical Excellence guidelines with current practice - An observational study

2019 ◽  
Vol 35 (2) ◽  
pp. 227 ◽  
Author(s):  
Anitha Nileshwar ◽  
Neeraj Guttikonda ◽  
Madhu Rao ◽  
TK Sushma
Keyword(s):  
Observational Study ◽  
Laboratory Testing ◽  
Current Practice ◽  
Clinical Excellence

EVIDENCE, VALUES, AND DECISION MAKING

2014 ◽  
Vol 30 (2) ◽  
pp. 233-238 ◽  
Author(s):  
Michael D. Rawlins
Keyword(s):  
Decision Making ◽  
Cost Effectiveness ◽  
Observational Study ◽  
Social Values ◽  
Clinical Excellence ◽  
Health Technology ◽  
Evidence Base ◽  
Social Value ◽  
Value Judgments ◽  
Study Designs

Background: The evidence supporting the use of new, or established, interventions may be derived from either (or both) experimental or observational study designs. Although a rigorous examination of the evidence base for clinical and cost-effectiveness is essential, it is never sufficient, and those undertaking a health technology assessment (HTA) also have to exercise judgments.Methods: The basis for this discussion is largely from the author's experience as chairman of the national Institute for Health and Clinical Excellence (NICE).Results: The judgments necessary for HTA to make are twofold. Scientific judgments relate to the interpretation of the science. Social value judgments are concerned with the ethical principles, preferences, culture, and aspirations of society.Conclusions: How scientific and social value judgments might be most appropriately captured is a challenge for all HTA agencies. Although competent HTA bodies should be able to exercise scientific judgments they have no legitimacy to impose their own social values. These must ultimately be informed by the general public.

scholarly journals Current Practice and Barriers to an Early Antimicrobial Conversion from Intravenous to Oral among Hospitalized Patients at Jimma University Specialized Hospital: Prospective Observational Study

2019 ◽  
Vol 2019 ◽  
pp. 1-8
Author(s):  
Alemseged Beyene Berha ◽  
Gizat Molla Kassie
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Current Practice ◽  
Significant Proportion ◽  
Severe Infection ◽  
Hospitalized Patients ◽  
P Values ◽  
Specialized Hospital ◽  
Jimma University ◽  
Clinical Stability

Objective. The aim of the present study was to explore the current practice and its barriers to an early antimicrobial conversion from intravenous (IV) to oral (PO) therapy among hospitalized patients.Method. Hospital based prospective observational study was conducted to assess the practice of an early antimicrobial IV to PO conversion and its barriers using medical chart and case-specific physicians’ interviews, respectively, from February to September, 2014. Patient charts and medication records were reviewed for appropriateness of IV to PO conversion program every 24hrs using a pretested data collection abstraction format. Independent samplest-test was used to compare the duration of therapy and time to clinical stability between converted and nonconverted patients. Two-tailed P values of < 0.05 were regarded as statistically significant.Results. One hundred forty-two patients were included in the study, of whom two-thirds (67.6%) of the patients were eligible for IV to PO antimicrobial conversion. However, only 20.9% of patients’ timely conversion was made. A shorter duration of IV therapy was recorded for converted (2.80±1.87) versus nonconverted patients (8.50±6.32), (P=0.009). The most important barriers of not converting IV to PO in clinically stable patients were presence of comorbidity; clinicians perceived that the patient should always complete IV course of antimicrobials as a standard practice.Conclusion. Conversion from IV to PO antimicrobials was found to be unnecessarily delayed in a significant proportion of patients hospitalized with moderate to severe infection due to a range of different barriers. Addressing these issues has the potential to reduce inappropriate antimicrobial use and resistance.

Warm-reactive (immunoglobulin G) autoantibodies and laboratory testing best practices: review of the literature and survey of current practice

Transfusion ◽  
2016 ◽  
Vol 57 (2) ◽  
pp. 463-477 ◽  
Author(s):  
Alyssa Ziman ◽  
Claudia Cohn ◽  
Patricia M. Carey ◽  
Nancy M. Dunbar ◽  
Mark K. Fung ◽  
...  
Keyword(s):  
Best Practices ◽  
Immunoglobulin G ◽  
Laboratory Testing ◽  
Current Practice ◽  
Review Of The Literature

Current Practice and Regional Variability in Recommendations for Patient Preparation for Laboratory Testing in Primary Care

2019 ◽  
Vol 51 (3) ◽  
pp. e32-e37
Author(s):  
Maria Salinas ◽  
Maite López-Garrigós ◽  
Emilio Flores ◽  
Carlos Leiva-Salinas
Keyword(s):  
Primary Care ◽  
Laboratory Testing ◽  
Current Practice ◽  
Significant Proportion ◽  
Order Entry ◽  
Regional Variability ◽  
Fasting Period ◽  
Computerized Order Entry ◽  
Patient Preparation ◽  
Doctor's Office

Abstract Background Preparation of the patient for laboratory tests is crucial. Our aim was to investigate the current practice and regional variability of recommendations regarding patient preparation for laboratory testing. Methods A call for data was posted by email. Spanish laboratories were invited to fill out and submit a survey. Results Sixty-eight laboratories participated in the study. In 73% of those laboratories, fasting was always recommended regardless of the requested tests. Only one-third of the laboratories systematically recommended a 12-hour fast before the tests. In 71% of the laboratories, water intake was allowed without restrictions during the fasting period. In 57% of the laboratories, computerized order entry offered the possibility to print customized recommendations automatically in the primary care doctor’s office according to the requested tests. Seventy-two percent of the laboratories agreed with the proposed recommendation. Conclusions There was high variability in patient preparation for laboratory testing. A significant proportion of centers did not follow international guidelines.

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