Articles: outcome-assessment-health-care.
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J. Thorac. Cardiovasc. Surg. · Jun 2005
Multicenter StudyDoes reporting of coronary artery bypass grafting from administrative databases accurately reflect actual clinical outcomes?
Quality assessment of coronary artery bypass grafting has traditionally been performed with data from clinical databases. Administrative databases that rely primarily on information collected for billing purposes increasingly have been used as tools for public reporting of outcomes quality. The correlation of administrative data with clinical data for clinical quality assessment has not been confirmed. ⋯ Substantial variability of reported outcomes is seen in administrative data sets compared with an audited clinical database in the end points of the number of procedures performed and mortality. This variability makes it challenging for the nonclinician unfamiliar with outcomes analysis to make an informed decision.
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Multicenter Study
Validity of the Spanish version of the Scoliosis Research Society-22 (SRS-22) Patient Questionnaire.
A cross-sectional multicenter study was performed to validate the Spanish version of the Scoliosis Research Society-22 (SRS-22) Patient Questionnaire. ⋯ The Spanish version of the SRS-22 is valid. It has a factorial structure similar to that of the original questionnaire. Moreover, it relates to known severity characteristics of the disease, distinguishes among scoliosis patient groups, and shows concordant values with another valid instrument for measuring self-perceived health.
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Multicenter Study Comparative Study
A comparison of patient characteristics and rehabilitation treatment content of chronic low back pain (CLBP) and stroke patients across six European countries.
So far no studies have been conducted on the issue of comparability of rehabilitation treatment profiles and patient characteristics across countries. These aspects might have implications for the feasibility of treating patients abroad but also for the comparison of treatment outcome on an international level. ⋯ International treatment and outcome assessment of CLBP patients is not possible unless standardisation is considered of treatment content and patient selection. For stroke treatment international traffic and multi-centre outcome assessment might be more feasible.
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Am. J. Respir. Crit. Care Med. · Feb 2005
Multicenter StudyCumulative influence of organ dysfunctions and septic state on mortality of critically ill children.
The interaction between sepsis and multiple organ dysfunction syndrome is poorly defined in children. We analyzed by Cox regression models the cumulative influence of organ dysfunctions, using the pediatric logistic organ dysfunction (PELOD) score, and septic state (systemic inflammatory response syndrome or sepsis, severe sepsis, and septic shock) on mortality of critically ill children. We included 593 children (mortality rate: 8.6%) from three pediatric intensive care units; 514 patients had at least a systemic inflammatory response syndrome and 269 had two or more organ dysfunctions. ⋯ Each increase of one unit in the PELOD score multiplied the hazard ratio by 1.096 (p < 0.0001); hazard ratio of diagnostic category was 9.039 (p = 0.031) for systemic inflammatory response syndrome or sepsis, 18.797 (p = 0.007) for severe sepsis and 32.572 (p < 0.001) for septic shock. Cumulative hazard ratio of death = (hazard ratio of PELOD score) x (hazard ratio of diagnostic category). We conclude that there is a cumulative accrual of the risk of death both with an increasing severity of organ dysfunction and an increasing severity of the diagnostic category of septic state.
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Multicenter Study Comparative Study
A comparison among the abilities of various injury severity measures to predict mortality with and without accompanying physiologic information.
A few recent studies have compared the abilities of different injury severity measures to predict inpatient mortality. This study extended previous studies in that it used a registry with noncenters as well as centers, and examined the relative marginal abilities of competing severity measures to predict mortality when physiologic data also are available. ⋯ On the average, the ICISS had the best discrimination of all of the measures, as well as a slight edge with respect to calibration in predicting trauma mortality with or without the aid of demographic or physiologic measures.