Journal of evaluation in clinical practice
-
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.
-
Consumer-based activity trackers aim at quantifying physical activity in a wide range of contexts. Nevertheless, they need to be validated before they are confidently used. This study assessed the concurrent validity of the Nokia Go against reference devices, according to different sensor locations, in two measurement conditions: during a walking task and during a 24-hour free-living condition. ⋯ There are high discrepancies in step count between devices because of the different types of activities in daily life. The Nokia Go may be confidently used for step counting during pure walking tasks, at different locations. However, the lack of concurrent validity with ActiGraph call for caution regarding their use in daily living conditions.
-
Prevention offers the most cost-effective long-term strategy for cancer control. The objective of this study was to ascertain opinions, attitudes, and professional practices towards cancer prevention among primary care professionals and to assess differences between family physicians (FP) and nursing professionals (NP). ⋯ Group and community interventions are rarely practised, especially among FP. Actions targeting improved ability and knowledge could lead to higher involvement in the promotion of health. It would also be necessary to intervene in the examination of the utility of such interventions.
-
While frailty status is an attractive risk stratification tool, the evaluation of frailty in acute care can be challenging as some inpatients are unable to complete performance-based tests as part of frailty assessment and some tools may lack discriminative ability and categorize majority of cohorts as "frail". In this study, we evaluated the feasibility of frailty screening with the simple clinical frailty scale (CFS) by different clinicians, and its association with mortality and rehospitalization in a geriatric acute care setting. ⋯ Frailty status determined by CFS adds to disease severity and comorbidity in predicting short-term mortality but not rehospitalization in older inpatients who received geriatric acute care in our setting. CFS is reliable and has the potential to be incorporated into routine screening to better identify, communicate, and address frailty in the acute settings.
-
Routinely recorded coding data are increasingly being used for clinical research, but the quality of that data is often variable. The clinical coding of pleural empyema has not been studied. If data are not accurately recorded, linking coding data through, for example, Hospital Episode Statistic data (HES), will lead to inappropriate conclusions. ⋯ In the centres studied, empyema coding was generally good (>85% accuracy), although some cases were miscoded. Using codes for elective admissions helped to differentiate post-operative from community acquired empyema. It is likely empyema is under rather than over-recorded in HES data.