Journal of evaluation in clinical practice
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Review Meta Analysis
Interventions to increase appointment attendance in safety net health centers: A systematic review and meta-analysis.
Missed appointments are a persistent problem across healthcare settings, and result in negative outcomes for providers and patients. We aimed to review and evaluate the effectiveness of interventions designed to reduce missed appointments in safety net settings. ⋯ Strategies to improve appointment adherence in safety net hospitals varied widely and were only modestly effective. Further research harmonizing intervention delivery within each strategy and comparing strategies with the most potential for success is needed.
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Despite the available evidence to support optimal practices in rehabilitation, significant knowledge practice gaps persist. Opinion leaders (OLs) and knowledge brokers (KBs) can enhance the success of knowledge translation (KT) interventions and improve uptake of best practices among clinicians. However, the literature on the mechanisms underpinning OLs'/KBs' activities, and guidance on the type of support needed for successful implementation of these roles in rehabilitation contexts is scarce. This research aimed to highlight the differences and similarities between OLs and KBs with respect to context, mechanism, and outcomes as well as describe the common patterns of OLs and KBs by creating a context-mechanism-outcomes configuration. ⋯ Findings of this realist review converge to create a context-mechanism-outcomes configuration with suggestions to optimally utilize OLs/KBs in rehabilitation. The configurations suggest desirable features that can lead to a greater potential to achieve targeted goals. It is preferable that OLs/KBs be embedded in the organization and that they are adequately skilful and well-trained. Also, OLs/KBs should perform the required roles using KT interventions adapted to the local context.
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Cell-based therapeutics are among the latest advances in health care technologies. The rapid evolution of stem cell science in Iran has necessitated the application of scientific achievements in clinical settings. However, various issues hindered their translation, in particular, impediments in the interactions of basic stem cell scientists and clinicians. We highlighted the impediments in the interactions of stem cell scientists and physicians involved in the opinion of professionals from both groups. ⋯ Most of the impediments were seemingly global, for example, the incoherent medical and basic science educational systems, the vulnerable career path of physician-scientists, and an increasing tendency towards overspecialization. However, some local specific issues were also described, for example, limited funding opportunities and the negative impacts of the division of medical education from the ministry of science, research, and technology in Iran. Proposed interventions include the reinforcement of physician-scientist programs, designing a distributed leadership model, and bringing back the scientific integrity to higher education in Iran.
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Our aim was to investigate verbal representations of intervention effect-size, uncertainty of evidence, and possible intervention comparators in statements concerning effects of interventions in Finnish clinical practice guidelines. ⋯ Communicating beneficial intervention effects, effect-sizes, possible comparators, and uncertainty of evidence require much broader attention in the clinical practice guideline context.
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To estimate in-hospital and 30-day outcomes after transcatheter aortic valve replacement (TAVR) in South America through a systematic review and meta-analysis of observational data. ⋯ As compared with published international registries, the overall results of TAVR in South America seemed underrated. Significant heterogeneity was observed in procedural success, pacemaker requirement, and post-procedure moderate or severe aortic regurgitation. This study provides a real-life framework for the analysis of the performance of this technology in the region, intended to be a starting point for quality improvement.