Articles: outcome-assessment-health-care.
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The American surgeon · Sep 2002
Multicenter Study Comparative StudyIs bariatric surgery safe in academic centers?
Contemporary outcomes of bariatric surgery are not well defined. Our aim was to document the outcomes of bariatric surgery on the basis of surgeon caseload and affiliation. We analyzed prospectively collected Florida-wide hospital discharge data. ⋯ We conclude that outcomes of bariatric surgery in high-risk patients are similar among academic and community-based surgeons. Academic surgeons undertake bariatric surgery in high-risk patients more frequently than community-based surgeons, which underlies their increased complication rate. These prospectively collected data reflect surgical outcomes more accurately than clinical series and will impact our practice of bariatric surgery.
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An essential principle of competency-based education (CBE) is use of observable outcomes with assessments as judgments of competence based on defined criteria. Faculty are accustomed to using learning objectives as the defining criteria for knowledge, assessing students using written exams. Faculty are less familiar with how the principles of CBE are applied to other competencies. We recently adopted school-wide goals and objectives, modeled after the ACGME Outcomes Project. The present objective was to give faculty first-hand experience in CBE within a basic science course, including both cognitive and non-cognitive outcomes. ⋯ Faculty achieved enhanced understanding of students, assisted by descriptive criteria, while suggesting improvements in forms. Better agreement on criteria definitions and consistency in form use is needed. Students developed understanding and improved communication/professionalism skills, based on repeated exposures to criteria and feedback. It remains to be seen whether the skills are used/developed in other courses. A majority of students did not use the learning portfolio as envisioned. Better design and implementation of school-wide rather than course-specific reflective portfolios may increase use and integrate learning in all courses with all six competencies.
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Journal of critical care · Sep 2002
Comparative StudyDo isolation rooms reduce the rate of nosocomial infections in the pediatric intensive care unit?
To determine the effect of isolation rooms on the direct spread of nosocomial infections (NIs) owing to cross-colonization in a pediatric intensive care unit (PICU). ⋯ Our preliminary analysis suggests a possible beneficial effect of single isolation rooms in reducing NI rate in the PICU. Hence, the influence of room isolation on NIs in pediatric intensive care warrants further investigation.
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Multicenter Study
Trauma in the elderly: intensive care unit resource use and outcome.
As the population ages, the elderly will constitute a prominent proportion of trauma patients. The elderly suffer more severe consequences from traumatic injuries compared with the young, presumably resulting in increased resource use. In this study, we sought to examine ICU resource use in trauma on the basis of age and injury severity. ⋯ Age is confirmed as an independent predictor of outcome (mortality) in trauma after stratification for injury severity in this largest study of elderly trauma patients to date. Elderly patients with severe injury (ISS > 30) have decreased ICU resource use secondary to associated increased mortality rates.
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Journal of neurosurgery · Sep 2002
Validity and reliability of the Short Form-36 in cervical spondylotic myelopathy.
Validity (the extent to which a test measures what it is intended to measure) and reliability (the stability and reproducibility of measures of the same concept over time or across methods of gathering data) are important characteristics of any outcomes instrument. Generic outcomes instruments are designed for use in any population; however, their validity and reliability in particular diseases should be verified to ensure their appropriateness for use in that disease. In this study the authors assessed the validity and reliability of the Medical Outcomes Study Short Form-36 (SF-36), a generic outcomes instrument, in a population of patients with cervical spondylotic myelopathy (CSM). ⋯ The SF-36 provides valid and reliable data on patients with CSM.