Journal of evaluation in clinical practice
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Observational Study
Negative effect of fatty liver on visualization of pancreatic cystic lesions at screening transabdominal ultrasonography.
The aim of this observational study is to identify factors by which some pancreatic cystic lesions (PCLs) were undetectable at transabdominal ultrasonography (TAUS), using magnetic resonance imaging (MRI) as reference standard. ⋯ It should be noted that coexisting fatty liver may lower the detection of PCL, and its size may be underestimated by TAUS.
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Observational Study
GheOP3 S tool and START/STOPP criteria version 2 for screening of potentially inappropriate medications and omissions in nursing home residents.
There is limited information about the comparative effectiveness of the START/STOPP (Screening Tool of Older Person's Prescriptions/Screening Tool to Alert doctors to Right Treatment) criteria and the Ghent Older People's Prescriptions community Pharmacy Screening tool (GheOP3 S tool) for the screening of potentially inappropriate prescribing (PIP) in the geriatric population. Considering this, the aim of this study was to compare the ability of the START/STOPP criteria and GheOP3 S tool to identify the PIP and potential prescribing omissions (PPOs) among elderly patients visiting their primary care physician. ⋯ The results of this study indicate that both tested tools demonstrated efficiency to detect PIPs and PPOs. The GheOP3 S tool detected significantly more PIPs than did the STOPP criteria. On the other hand, the START criteria performed much better for the screening of PPOs.
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American Academy of Pediatrics released a clinical practice guideline (CPG) in 2016 recommending the term apparent life-threatening events (ALTE) be replaced by brief resolved unexplained events (BRUE). The CPG provides recommendations for the clinical evaluation and management of infants with this condition based on the risk of a serious underlying disorder or repeat event. The lower-risk CPG was applied to a modelled population, studying predictors of hospital admission, defined as length of stay (LOS) ≥ 24 hours. ⋯ Results suggest that use of the CPG under strict conditions would lead to fewer hospital admissions among infants with a lower-risk BRUE. Implementation of CPGs in modelled populations may help clinicians identify unanticipated factors and address these issues beforehand. We noted differences in care based on race, necessitating further investigation.
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Patient sitters provide one-to-one care for hospital patients at high risk of falls. The study aimed to explore patient sitters' task readiness to assist in fall prevention on hospital wards. ⋯ There is a gap between what patient sitters report as the cause of falls (patient factors) and what was suggested to prevent falls (environment factors). Education and practical training addressing challenging patient behaviours may improve sitters' task readiness to assist in preventing falls on wards. Improving communication and cooperation between patient sitters and nursing staff is also important.
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To evaluate the Patient Participation in Rehabilitation Questionnaire (PPRQ) according to Rasch measurement theory. ⋯ The PPRQ-17 showed that a ruler with a reasonable and clinical hierarchy can be constructed, although the expectations of dimensionality and local dependency need to be evaluated further. Despite room for further development, PPRQ-17 nevertheless shows improved measurement precision in terms of patient leniency compared with previous evaluations with classical test theory. In turn, this can play a crucial role when comparing different rehabilitation programs and planning tailored care development activities.