Ontario health technology assessment series
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Ont Health Technol Assess Ser · Jan 2015
Review Meta AnalysisPatient Perspectives on Quality of Life With Uncontrolled Type 1 Diabetes Mellitus: A Systematic Review and Qualitative Meta-synthesis.
Patients with uncontrolled type 1 diabetes mellitus may be candidates for pancreatic islet cell transplantation. This report synthesizes qualitative research on how patients with uncontrolled type 1 diabetes perceive their quality of life. ⋯ Uncontrolled type 1 diabetes has significant negative impacts on the quality of life of both people with the disease and their families.
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Ont Health Technol Assess Ser · Jan 2015
Review Meta AnalysisPatient Perspectives on Quality of Life With Uncontrolled Type 1 Diabetes Mellitus: A Systematic Review and Qualitative Meta-synthesis.
Patients with uncontrolled type 1 diabetes mellitus may be candidates for pancreatic islet cell transplantation. This report synthesizes qualitative research on how patients with uncontrolled type 1 diabetes perceive their quality of life. ⋯ Uncontrolled type 1 diabetes has significant negative impacts on the quality of life of both people with the disease and their families.
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Ont Health Technol Assess Ser · Jan 2014
Review Meta AnalysisThe Determinants of Place of Death: An Evidence-Based Analysis.
According to a conceptual model described in this analysis, place of death is determined by an interplay of factors associated with the illness, the individual, and the environment. ⋯ The results obtained were consistent with previously published systematic reviews. The analysis identified several factors that are associated with place of death.
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Ont Health Technol Assess Ser · Jan 2014
ReviewThe appropriate use of neuroimaging in the diagnostic work-up of dementia: an evidence-based analysis.
Diagnosis of dementia is challenging and requires both ruling out potentially treatable underlying causes and ruling in a diagnosis of dementia subtype to manage patients and suitably plan for the future. ⋯ A diagnosis of reversible dementia is rare. Imaging has the most clinical utility in cases where there is potentially mixed dementia or ambiguity as to the type of dementia despite prolonged follow-up (e.g., 2 years or more). Both CT and MRI are useful for detecting a vascular component of dementia.
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Ont Health Technol Assess Ser · Jan 2014
ReviewTeam-Based Models for End-of-Life Care: An Evidence-Based Analysis.
End of life refers to the period when people are living with advanced illness that will not stabilize and from which they will not recover and will eventually die. It is not limited to the period immediately before death. Multiple services are required to support people and their families during this time period. The model of care used to deliver these services can affect the quality of the care they receive. ⋯ Moderate-quality evidence shows that a comprehensive, direct-contact, team-based model of care provides the following benefits for end-of-life patients with an estimated survival of up to 9 months: it improves caregiver satisfaction and increases the odds of dying at home while decreasing the odds of dying in a nursing home. Moderate-quality evidence also shows that improvement in patient quality of life, symptom management, and patient satisfaction occur when end-of-life care via this model is provided early (up to 24 months before death). However, using this model to deliver end-of-life care does not impact hospital admissions or hospital length of stay. Team membership includes at minimum a physician and nurse, with at least one having specialist training and/or experience in end-of-life care. Team services include symptom management, psychosocial care, development of patient care plans, end-of-life care planning, and coordination of care.