Articles: outcome-assessment-health-care.
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Critical care medicine · Mar 2007
Multicenter StudyAssessing contemporary intensive care unit outcome: an updated Mortality Probability Admission Model (MPM0-III).
To update the Mortality Probability Model at intensive care unit (ICU) admission (MPM0-II) using contemporary data. ⋯ MPM0-II risk factors remain relevant in predicting ICU outcome, but the 1993 model significantly overpredicts mortality in contemporary practice. With the advantage of a much larger sample size and the addition of new variables and interaction effects, MPM0-III provides more accurate comparisons of actual vs. expected ICU outcomes.
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Frequent exacerbations are associated with a faster decline in FEV(1), impaired health status, and worse survival. Their impact and temporal relationship with other outcomes such as functional status, dyspnea, and the multidimensional body mass index, obstruction, dyspnea, exercise capacity (BODE) index remain unknown. ⋯ COPD exacerbations negatively impact on the BODE index and its components. The BODE index is a sensitive tool used to assess the impact of exacerbations and to monitor COPD disease progression.
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Multicenter Study Comparative Study
Responsiveness of pain and disability measures for chronic whiplash.
Cohort study. ⋯ Pain bothersomeness and the Patient Specific Functional Scale provide the most responsive measures of pain and disability, respectively, in patients with chronic whiplash.
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Qual Saf Health Care · Feb 2007
Randomized Controlled Trial Multicenter StudyMultifaceted implementation of stroke prevention guidelines in primary care: cluster-randomised evaluation of clinical and cost effectiveness.
To evaluate clinical and cost effectiveness of implementing evidence-based guidelines for the prevention of stroke. ⋯ Implementation of evidence-based guidelines improved the quality of primary care for atrial fibrillation and TIA. The intervention was feasible and very cost effective. Key components of the model include contextual analysis, strong professional support, clear recommendations based on robust evidence, simplicity of adoption, good communication and use of established networks and opinion leaders.
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Bmc Health Serv Res · Jan 2007
Randomized Controlled Trial Multicenter StudyA pragmatic randomised, controlled trial of intensive care follow up programmes in improving longer-term outcomes from critical illness. The PRACTICAL study.
A number of intensive care (ICU) patients experience significant problems with physical, psychological, and social functioning for some time after discharge from ICU. These problems have implications not just for patients, but impose a continuing financial burden for the National Health Service. To support recovery, a number of hospitals across the UK have developed Intensive Care follow-up clinics. However, there is a lack of evidence base to support these, and this study aims to test the hypothesis that intensive care follow up programmes are effective and cost-effective at improving physical and psychological quality of life in the year after intensive care discharge. ⋯ The provision of intensive care follow-up clinics within the UK has developed in an ad hoc manner, is inconsistent in both the number of hospitals offering such a service or in the type of service offered. This study provides the opportunity to evaluate such services both in terms of patient benefit and cost-effectiveness. The results of this study therefore will inform clinical practice and policy with regard to the appropriate development of such services aimed at improving outcomes after intensive care.