Journal of evaluation in clinical practice
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Despite research being done on spinal tuberculosis, diagnosing this condition at an early stage remains problematic due to its insidious onset and the varying symptoms being associated. Most individuals present to the health care facility with either simple back pain at an early stage or neurological complications at a later stage, when spinal compression and vertebral collapse have occurred as a result of delayed diagnosis. The prevention of secondary complications is therefore dependent on early recognition and diagnosis. The objective of this review was to identify common clinical patterns in case presentations and develop an evidence-based clinical guidance tool to assist clinicians in the early identification of spinal tuberculosis. ⋯ Through the use of an evidence-based clinical guidance tool, the clinician could be guided in the early suspicion and management of individuals with spinal tuberculosis and prevention of secondary complications.
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Postoperative respiratory failure after cardiac surgery (CS-PRF) is a devastating complication and its incidence and predictors vary depending on how it is defined and the patient population. ⋯ Knowledge of predictors for CS-PRF may help identify patients who are at risk for this complication and who may benefit from preventive measures to promote early extubation and to avert reintubation.
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Data on abortion services are critical for monitoring trends in access and utilization, evaluating policies, and examining a wide range of research questions. Accurate and timely data, however, can be difficult to obtain for abortion services. Oregon is one of several states that use state funds to finance abortion services in their Medicaid programmes. Oregon's Medicaid programme contracts with managed care plans that receive global budgets to provide care. Abortion services, however, must be billed directly to the state through fee-for-service (FFS) billing to ensure that federal funds are not used. In this study, we identify possible abortions using Medicaid insurance claims data from Oregon and categorize identified abortions as high, medium, or low confidence according to convergent validity analysis of FFS billing. ⋯ Research on abortion services using insurance claims has important implications for women's health care and public health policy. A high-quality claims-based measure can facilitate monitoring the provision of abortion services within health systems and evaluation of initiatives to increase equitable abortion access.
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While different imaging and treatment options are available in acute coronary syndrome (ACS) care, there is a lack of data regarding their use across Europe. We examined the diagnostic and treatment strategies in patients with known or suspected ACS as reported by physicians and identified variations in responses across European countries and geographical areas. ⋯ In this survey, respondents reported different diagnostic and treatment strategies in ACS care. These variations seem to have geographic components. Larger studies or real world data are needed to verify these observations and investigate their causes. More research is needed to compare the quality and efficiency of ACS care across countries and explore pathways for improvement.
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Inappropriate prescribing is associated with preventable morbidity and mortality in the elderly. The American Geriatrics-Beers (AGS-Beers) Criteria was developed to guide healthcare professionals (HCPs) to prescribe medications appropriately in the elderly. However, there is a dearth of information about the knowledge and awareness of HCPs of these criteria, and their perceptions of appropriate prescribing in the elderly. This study aimed to evaluate the knowledge and perceptions of Nigerian and South African HCPs about appropriate prescribing in the elderly. ⋯ Many HCPs in Nigeria and South Africa had a fair knowledge of appropriate prescribing to the elderly and considered basic professional training as adequate for appropriate prescribing to the elderly.