Journal of critical care
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Journal of critical care · Mar 2005
ReviewA systematic review of the Charlson comorbidity index using Canadian administrative databases: a perspective on risk adjustment in critical care research.
The Charlson index is commonly used for risk adjustment in critical care health services research. However, the literature supporting this methodology has not been thoroughly explored. We systematically reviewed the literature related to administrative database adaptations of the Charlson index. ⋯ Time and cost barriers prevent widespread use of physiology-based risk adjustment in population-based research. The decreased predictive ability of the Charlson index must be weighed against the advantages of using this instrument for population-based research. Future research should focus on updating the Charlson index for recent changes in the prognosis of comorbid diseases and introduction of International Statistical Classification of Diseases, 10th Revision coding of discharge abstracts.
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Journal of critical care · Mar 2005
ReviewA systematic review of the Charlson comorbidity index using Canadian administrative databases: a perspective on risk adjustment in critical care research.
The Charlson index is commonly used for risk adjustment in critical care health services research. However, the literature supporting this methodology has not been thoroughly explored. We systematically reviewed the literature related to administrative database adaptations of the Charlson index. ⋯ Time and cost barriers prevent widespread use of physiology-based risk adjustment in population-based research. The decreased predictive ability of the Charlson index must be weighed against the advantages of using this instrument for population-based research. Future research should focus on updating the Charlson index for recent changes in the prognosis of comorbid diseases and introduction of International Statistical Classification of Diseases, 10th Revision coding of discharge abstracts.
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Journal of critical care · Sep 2004
ReviewInterventions to reduce mortality among patients treated in intensive care units.
Using sensitivity analysis to estimate the impact, in terms of patient lives, of the failure to use proven therapies known to reduce mortality in critically ill intensive care unit patients. ⋯ Mistakes of omission are common in the critical care setting and lead to significant preventable mortality. There is a significant gap between the discovery of effective interventions and their use in clinical practice. By viewing the delivery of healthcare as a science and increasing funding for health services research, we may be able to increase the use of effective therapies and, as a result, reduce patient mortality.
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Journal of critical care · Mar 2004
ReviewInfluencing advance directive completion rates in non-terminally ill patients: a systematic review.
To conduct a systematic review of educational advance care planning interventions directed at patients without terminal illness to determine their influence on the completion rate of advance directives (AD). ⋯ Advance directive completion rates documenting patient preferences for end-of-life care may be increased by simple patient-directed educational interventions.
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Journal of critical care · Mar 2004
ReviewInfluencing advance directive completion rates in non-terminally ill patients: a systematic review.
To conduct a systematic review of educational advance care planning interventions directed at patients without terminal illness to determine their influence on the completion rate of advance directives (AD). ⋯ Advance directive completion rates documenting patient preferences for end-of-life care may be increased by simple patient-directed educational interventions.