Articles: outcome-assessment-health-care.
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Clin Neurol Neurosurg · Jun 2015
Multicenter StudyPrimary decompressive craniectomy for poor-grade middle cerebral artery aneurysms with associated intracerebral hemorrhage.
Aggressive surgery seems mandatory for poor-grade middle cerebral artery (MCA) aneurysm with associated intracerebral hemorrhage (ICH). However, primary decompressive craniectomy (DC) is controversial. We performed a case control study to define the role of primary DC. ⋯ Although primary DC does not increase postoperative complication and mortality risk, current results showed primary DC does not seem to be significantly associated with improved outcomes. However, more than one half of patients most benefit from primary DC. Further prospective controlled studies are warranted to clarify the issue.
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Multicenter Study
Impact of Just-in-Time and Just-in-Place Simulation on Intern Success With Infant Lumbar Puncture.
Simulation-based skill trainings are common; however, optimal instructional designs that improve outcomes are not well specified. We explored the impact of just-in-time and just-in-place training (JIPT) on interns' infant lumbar puncture (LP) success. ⋯ Across multiple institutions, intern success rates with infant LP are poor. Despite improving process measures, adding JIPT to training bundles did not improve success rate. More research is needed on optimal instructional design strategies for infant LP.
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Current outcome predictors for illness and injury are measured at a single time point-admission. However, patient prognosis often changes during hospitalization, limiting the usefulness of those predictions. Accurate depiction of the dynamic interaction between competing events during hospitalization may enable real-time outcome assessment. ⋯ Real-time measurement of dynamic interrelationships among burn outcome predictors using competing risk analysis demonstrated that the key factors influencing outcomes differed throughout hospitalization. Further application of this analytic technique to other injury or illness types may improve assessment of outcomes.
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Individualized risk prediction tools have an important role as decision aids for use by patients and surgeons before surgery. Patient-centered outcomes should be incorporated into such tools to widen their appeal and improve their usability. ⋯ Individualized risk of discharge to postacute care can be predicted with excellent accuracy. This outcome will be incorporated into the ACS NSQIP Surgical Risk Calculator.
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Multicenter Study
SRS-7: A Valid, Responsive, Linear, and Unidimensional Functional Outcome Measure for Operatively Treated Patients With AIS.
Comparison of the Scoliosis Research Society-22 (SRS-22) questionnaire with a 7-item Rasch-derived questionnaire (SRS-7). ⋯ 4.