International journal for quality in health care : journal of the International Society for Quality in Health Care
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Int J Qual Health Care · Aug 1999
Multicenter Study Comparative StudyOveruse and underuse of diagnostic upper gastrointestinal endoscopy in various clinical settings.
To describe and compare both overuse and underuse of diagnostic upper gastrointestinal endoscopy in different settings. ⋯ Rates of overuse and underuse depend mainly on case presentation and patient characteristics. Both over- and underuse should be addressed to maintain and improve quality of care.
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Int J Qual Health Care · Jun 1999
The quality of abstracting medical information from the medical record: the impact of training programmes.
To evaluate the impact of a programme of training, education and awareness on the quality of the data collected through discharge abstracts. ⋯ Training and continuous monitoring, and feedback of information to departments have proved to be successful in improving the quality of abstracting information at patient level from the medical record. The effort to increase administrative data quality at hospital level will facilitate the use of those data sets for internal quality management activities and for population-based quality of care studies.
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Int J Qual Health Care · Feb 1999
ReviewDevelopment and application of a generic methodology to assess the quality of clinical guidelines.
Despite clinical guidelines penetrating every aspect of clinical practice and health policy, doubts persist over their ability to improve patient care. We have designed and tested a generic critical appraisal instrument, that assesses whether developers have minimized the biases inherent in creating guidelines, and addressed the requirements for effective implementation. ⋯ Use of this instrument should encourage developers to create guidelines that reflect relevant research evidence more accurately. Potential users or groups adapting guidelines for local use could apply the instrument to help decide which one to follow. The National Health Service Executive is using the instrument to assist in deciding which guidelines to recommend to the UK National Health Service. This methodology forms the basis of a common approach to assessing guideline quality in Europe.