Articles: outcome-assessment-health-care.
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Psychother Psychosom · Jan 2012
Randomized Controlled TrialA blind randomized controlled trial of cognitive versus behavioral versus cognitive-behavioral therapy for patients with rheumatoid arthritis.
Despite evidence that cognitive-behavioral therapy (CBT) is effective for rheumatoid arthritis (RA), little is known about which components of therapy are most efficacious. The present study compared the efficacy of CBT with cognitive therapy (CT) and behavioral therapy (BT) for patients with RA. We hypothesized that CBT would be more efficacious on a broader range of outcomes. ⋯ CBT did not demonstrate the broader benefits to patients that we expected, nor was there evidence that BT produced effects that were superior to CT alone. CT was superior to at least one of the other two active treatment components on 3 of the 7 outcome measures at post-treatment. Effect sizes for the interventions that included cognitive components were similar to those reported in the literature. These results suggest that CT is an effective treatment for RA and need not necessarily include behavioral strategies.
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Randomized Controlled Trial Multicenter Study
Lumbar disc herniation in the Spine Patient Outcomes Research Trial: does educational attainment impact outcome?
Randomized trial with concurrent observational cohort. A total of 1171 patients were divided into subgroups by educational attainment: high school or less, some college, and college degree or above. ⋯ Patients with higher educational attainment demonstrated significantly greater improvement with nonoperative treatment while educational attainment was not associated with surgical outcomes.
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American heart journal · Sep 2011
Randomized Controlled Trial Multicenter Study Comparative StudyMode of hospital presentation in patients with non-ST-elevation myocardial infarction: implications for strategic management.
Contemporary non-ST-elevation myocardial infarction-acute coronary syndrome guidelines emphasize early-risk stratification and optimizing therapy including an invasive strategy in high-risk patients. To assess the feasibility of initiating this strategy in the prehospital environment, we examined how such patients are transported to hospital, their risk profile, and the proportion potentially eligible for such a strategy. ⋯ Regional strategies using risk-based triage, early medical therapy, and timely triage to percutaneous coronary intervention centers represents an unrealized opportunity to enhance ST-segment elevation myocardial infarction care.
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Randomized Controlled Trial
Effect of early intensive multifactorial therapy on 5-year cardiovascular outcomes in individuals with type 2 diabetes detected by screening (ADDITION-Europe): a cluster-randomised trial.
Intensive treatment of multiple cardiovascular risk factors can halve mortality among people with established type 2 diabetes. We investigated the effect of early multifactorial treatment after diagnosis by screening. ⋯ National Health Service Denmark, Danish Council for Strategic Research, Danish Research Foundation for General Practice, Danish Centre for Evaluation and Health Technology Assessment, Danish National Board of Health, Danish Medical Research Council, Aarhus University Research Foundation, Wellcome Trust, UK Medical Research Council, UK NIHR Health Technology Assessment Programme, UK National Health Service R&D, UK National Institute for Health Research, Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, Novo Nordisk, Astra, Pfizer, GlaxoSmithKline, Servier, HemoCue, Merck.
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Pediatric emergency care · Jul 2011
Review Randomized Controlled TrialUniversally poor outcomes of pediatric traumatic arrest: a prospective case series and review of the literature.
Few data are available on traumatic cardiopulmonary arrest in children. Efforts at resuscitation typically result in heavy utilization of finite resources with little understanding of which characteristics, if any, may be associated with success. The objectives of this study were to describe the outcome of children in traumatic cardiac arrest and to identify patients for whom aggressive resuscitation may or may not be warranted. ⋯ Children who had trauma resulting in cardiac arrest have universally poor outcomes, and survivors have severe neurological compromise. We are unable to identify a subset of patients for whom aggressive resuscitation is indicated. This is the largest prospective study of pediatric traumatic arrest to date.