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1.
J Dermatolog Treat ; 35(1): 2343072, 2024 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38626923

RESUMO

BACKGROUND: Systematic reviews (SRs) could offer the best evidence supporting interventions, but methodological flaws limit their trustworthiness in decision-making. This cross-sectional study appraised the methodological quality of SRs on atopic dermatitis (AD) treatments. METHODS: We searched MEDLINE, EMBASE, PsycINFO, and Cochrane Database for SRs on AD treatments published in 2019-2022. We extracted SRs' bibliographical data and appraised SRs' methodological quality with AMSTAR (A MeaSurement Tool to Assess systematic Reviews) 2. We explored associations between methodological quality and bibliographical characteristics. RESULTS: Among the 52 appraised SRs, only one (1.9%) had high methodological quality, while 45 (86.5%) critically low. For critical domains, only five (9.6%) employed comprehensive search strategy, seven (13.5%) provided list of excluded studies, 17 (32.7%) considered risk of bias in primary studies, 21 (40.4%) contained registered protocol, and 24 (46.2%) investigated publication bias. Cochrane reviews, SR updates, SRs with European corresponding authors, and SRs funded by European institutions had better overall quality. Impact factor and author number positively associated with overall quality. CONCLUSIONS: Methodological quality of SRs on AD treatments is unsatisfactory. Future reviewers should improve the above critical methodological aspects. Resources should be devolved into upscaling evidence synthesis infrastructure and improving critical appraisal skills of evidence users.


Assuntos
Dermatite Atópica , Humanos , Estudos Transversais , Dermatite Atópica/tratamento farmacológico , Revisões Sistemáticas como Assunto , Projetos de Pesquisa
2.
Zhongguo Zhong Yao Za Zhi ; 49(3): 842-848, 2024 Feb.
Artigo em Chinês | MEDLINE | ID: mdl-38621888

RESUMO

Due to the lack of specialized guidance, the post-marketing research on clinical effectiveness of Chinese patent medicines demonstrates varied quality and lacks high-quality evidence, failing to meet the demands of policy-making, clinical decision-making, and industrial decision-making. To address this issue, this project gathered experts in clinical medicine, clinical pharmacy, evidence-based medicine, drug epidemiology, medical ethics, and policy and regulation in China. They referred to the model of international post-marketing research on medicines and developed Guidelines for post-marketing research on clinical effectiveness of Chinese patent medicines under the framework of relevant laws and regulations and technical guidance documents in China. The guidelines were developed with consideration to the characteristics of Chinese patent medicines, China's national conditions, and all the stakeholders including marketing authorization holders, clinical researchers, drug administration, and users. The development of the guidelines followed the requirements for developing group standards set by the China Association of Chinese Medicine. The guidelines fully implement the concept of full life-cycle research, emphasizing the combination of traditional Chinese medicine(TCM) theory, human use experience, and clinical trials and pay attention to the compliance, scientificity, and ethics of research. The guidelines clarify the topic selection and decision-making path of the post-marketing research on effectiveness of Chinese patent medicines through six steps: determining research purpose, analyzing drug characteristics, evaluating research basis, proposing clinical orientation, clarifying research purpose, and implementing classified research. The general principles of research design and implementation were clarified from eight aspects: research type, research objects, sample size, efficacy indicators, bias, missing data, evidence level, and practicality. It focuses on the research on the TCM syndrome-based efficacy evaluation, clinical value-oriented mechanism of action, and the effectiveness of Chinese patent medicines with different routes of administration. The guidelines provide a universal methodological basis for the post-marketing research on clinical effectiveness of Chinese patent medicines.


Assuntos
Medicamentos de Ervas Chinesas , Medicamentos sem Prescrição , Humanos , Medicamentos sem Prescrição/uso terapêutico , Medicina Tradicional Chinesa , Medicina Baseada em Evidências , Resultado do Tratamento , China , Medicamentos de Ervas Chinesas/uso terapêutico
3.
BMC Oral Health ; 24(1): 474, 2024 Apr 19.
Artigo em Inglês | MEDLINE | ID: mdl-38641652

RESUMO

BACKGROUND: Important evidence has been constantly produced and needs to be converted into practice. Professional consumption of such evidence may be a barrier to its implementation. Then, effective implementation of evidence-based interventions in clinical practice leans on the understanding of how professionals value attributes when choosing between options for dental care, permitting to guide this implementation process by maximizing strengthens and minimizing barriers related to that. METHODS: This is part of a broader project investigating the potential of incorporating scientific evidence into clinical practice and public policy recommendations and guidelines, identifying strengths and barriers in such an implementation process. The present research protocol comprises a Discrete Choice Experiment (DCE) from the Brazilian oral health professionals' perspective, aiming to assess how different factors are associated with professional decision-making in dental care, including the role of scientific evidence. Different choice sets will be developed, either focusing on understanding the role of scientific evidence in the professional decision-making process or on understanding specific attributes associated with different interventions recently tested in randomized clinical trials and available as newly produced scientific evidence to be used in clinical practice. DISCUSSION: Translating research into practice usually requires time and effort. Shortening this process may be useful for faster incorporation into clinical practice and beneficial to the population. Understanding the context and professionals' decision-making preferences is crucial to designing more effective implementation and/or educational initiatives. Ultimately, we expect to design an efficient implementation strategy that overcomes threats and potential opportunities identified during the DCEs, creating a customized structure for dental professionals. TRIAL REGISTRATION: https://osf.io/bhncv .


Assuntos
Prática Clínica Baseada em Evidências , Odontopediatria , Criança , Humanos , Projetos de Pesquisa , Assistência Odontológica , Brasil
4.
Respirology ; 29(5): 369-371, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38499335
6.
J Nurs Care Qual ; 2024 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-38489766

RESUMO

BACKGROUND: With an increasing number of doctor of nursing practice (DNP) graduates, the volume of peer-reviewed journal publications among DNP-prepared nurses is rising. PURPOSE: The primary aim of this study was to quantify, analyze, and categorize DNP-authored peer-reviewed journal publications. METHODS: A descriptive research design was used to analyze DNP-authored peer-reviewed journal publications in the WorldCat, EBSCO Discovery Service, and PubMed databases from 2011 through 2021. RESULTS: The 3839 journal publications included at least one DNP-prepared nurse author. There were 2495 (65%) publications with a DNP first author, 921 (24%) with a DNP solo author, and 2918 (76%) included publication collaboration. The majority of publications were practice- (40%), nursing- (17%), and education-focused (15%). Science translation in evidence-based practice and quality improvement publications accounted for 24%. CONCLUSIONS: This study demonstrates the proliferation of DNP-authored peer-reviewed journal publications, which may indicate an increase in the number of nursing care quality initiatives occurring in the clinical setting.

7.
BMJ Open ; 14(3): e084164, 2024 Mar 11.
Artigo em Inglês | MEDLINE | ID: mdl-38471680

RESUMO

INTRODUCTION: Randomised controlled trials (RCTs) inform healthcare decisions. It is now apparent that some published RCTs contain false data and some appear to have been entirely fabricated. Systematic reviews are performed to identify and synthesise all RCTs that have been conducted on a given topic. While it is usual to assess methodological features of the RCTs in the process of undertaking a systematic review, it is not usual to consider whether the RCTs contain false data. Studies containing false data therefore go unnoticed and contribute to systematic review conclusions. The INveStigating ProblEmatic Clinical Trials in Systematic Reviews (INSPECT-SR) project will develop a tool to assess the trustworthiness of RCTs in systematic reviews of healthcare-related interventions. METHODS AND ANALYSIS: The INSPECT-SR tool will be developed using expert consensus in combination with empirical evidence, over five stages: (1) a survey of experts to assemble a comprehensive list of checks for detecting problematic RCTs, (2) an evaluation of the feasibility and impact of applying the checks to systematic reviews, (3) a Delphi survey to determine which of the checks are supported by expert consensus, culminating in, (4) a consensus meeting to select checks to be included in a draft tool and to determine its format and (5) prospective testing of the draft tool in the production of new health systematic reviews, to allow refinement based on user feedback. We anticipate that the INSPECT-SR tool will help researchers to identify problematic studies and will help patients by protecting them from the influence of false data on their healthcare. ETHICS AND DISSEMINATION: The University of Manchester ethics decision tool was used, and this returned the result that ethical approval was not required for this project (30 September 2022), which incorporates secondary research and surveys of professionals about subjects relating to their expertise. Informed consent will be obtained from all survey participants. All results will be published as open-access articles. The final tool will be made freely available.


Assuntos
Medicina Baseada em Evidências , Projetos de Pesquisa , Humanos , Consenso , Medicina Baseada em Evidências/métodos , Consentimento Livre e Esclarecido , Ensaios Clínicos Controlados Aleatórios como Assunto , Revisões Sistemáticas como Assunto
8.
Med Decis Making ; 44(3): 335-345, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38491851

RESUMO

BACKGROUND: Evidence-based medicine recognizes that clinical expertise gained through experience is essential to good medical practice. However, it is not known what beliefs clinicians hold about how personal clinical experience and scientific knowledge contribute to their clinical decision making and how those beliefs vary between professions, which themselves vary along relevant characteristics, such as their evidence base. DESIGN: We investigate how years in the profession influence health care professionals' beliefs about science and their clinical experience through surveys administered to random samples of Swedish physicians, nurses, occupational therapists, dentists, and dental hygienists. The sampling frame was each profession's most recent occupational registry. RESULTS: Participants (N = 1,627, 46% response rate) viewed science as more important for decision making, more certain, and more systematic than experience. Differences among the professions were greatest for systematicity, where physicians saw the largest gap between the 2 types of knowledge across all levels of professional experience. The effect of years in the profession varied; it had little effect on assessments of importance across all professions but otherwise tended to decrease the difference between assessments of science and experience. Physicians placed the greatest emphasis on science over clinical experience among the 5 professions surveyed. CONCLUSIONS: Health care professions appear to share some attitudes toward professional knowledge, despite the variation in the age of the professions and the scientific knowledge base available to practitioners. Training and policy making about clinical decision making might improve by accounting for the ways in which knowledge is understood across the professions. HIGHLIGHTS: Study participants, representing 5 health care professions-medicine, nursing, occupational therapy, dentistry, and dental hygiene-viewed science as more important for decision making, more certain, and more systematic than their personal clinical experience.Of all the professions represented in the study, physicians saw the greatest differences between the 2 types of knowledge.The effect of years of professional experience varied but tended to be small, attenuating the differences seen between science and clinical experience.


Assuntos
Pessoal de Saúde , Médicos , Humanos , Suécia , Projetos de Pesquisa , Tomada de Decisão Clínica
10.
Health Technol Assess ; 28(2): 1-114, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38327177

RESUMO

Background: Randomised controlled trials ('trials') are susceptible to poor participant recruitment and retention. Studies Within A Trial are the strongest methods for testing the effectiveness of strategies to improve recruitment and retention. However, relatively few of these have been conducted. Objectives: PROMoting THE Use of Studies Within A Trial aimed to facilitate at least 25 Studies Within A Trial evaluating recruitment or retention strategies. We share our experience of delivering the PROMoting THE Use of Studies Within A Trial programme, and the lessons learnt for undertaking randomised Studies Within A Trial. Design: A network of 10 Clinical Trials Units and 1 primary care research centre committed to conducting randomised controlled Studies Within A Trial of recruitment and/or retention strategies was established. Promising recruitment and retention strategies were identified from various sources including Cochrane systematic reviews, the Study Within A Trial Repository, and existing prioritisation exercises, which were reviewed by patient and public members to create an initial priority list of seven recruitment and eight retention interventions. Host trial teams could apply for funding and receive support from the PROMoting THE Use of Studies Within A Trial team to undertake Studies Within A Trial. We also tested the feasibility of undertaking co-ordinated Studies Within A Trial, across multiple host trials simultaneously. Setting: Clinical trials unit-based trials recruiting or following up participants in any setting in the United Kingdom were eligible. Participants: Clinical trials unit-based teams undertaking trials in any clinical context in the United Kingdom. Interventions: Funding of up to £5000 and support from the PROMoting THE Use of Studies Within A Trial team to design, implement and report Studies Within A Trial. Main outcome measures: Number of host trials funded. Results: Forty-two Studies Within A Trial were funded (31 host trials), across 12 Clinical Trials Units. The mean cost of a Study Within A Trial was £3535. Twelve Studies Within A Trial tested the same strategy across multiple host trials using a co-ordinated Study Within A Trial design, and four used a factorial design. Two recruitment and five retention strategies were evaluated in more than one host trial. PROMoting THE Use of Studies Within A Trial will add 18% more Studies Within A Trial to the Cochrane systematic review of recruitment strategies, and 79% more Studies Within A Trial to the Cochrane review of retention strategies. For retention, we found that pre-notifying participants by card, letter or e-mail before sending questionnaires was effective, as was the use of pens, and sending personalised text messages to improve questionnaire response. We highlight key lessons learnt to guide others planning Studies Within A Trial, including involving patient and public involvement partners; prioritising and selecting strategies to evaluate and elements to consider when designing a Study Within A Trial; obtaining governance approvals; implementing Studies Within A Trial, including individual and co-ordinated Studies Within A Trials; and reporting Study Within A Trials. Limitations: The COVID-19 pandemic negatively impacted five Studies Within A Trial, being either delayed (n = 2) or prematurely terminated (n = 3). Conclusions: PROMoting THE Use of Studies Within A Trial significantly increased the evidence base for recruitment and retention strategies. When provided with both funding and practical support, host trial teams successfully implemented Studies Within A Trial. Future work: Future research should identify and target gaps in the evidence base, including widening Study Within A Trial uptake, undertaking more complex Studies Within A Trial and translating Study Within A Trial evidence into practice. Study registration: All Studies Within A Trial in the PROMoting THE Use of Studies Within A Trial programme had to be registered with the Northern Ireland Network for Trials Methodology Research Study Within A Trial Repository. Funding: This award was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme (NIHR award ref: 13/55/80) and is published in full in Health Technology Assessment; Vol. 28, No. 2. See the NIHR Funding and Awards website for further award information.


A Study Within A Trial is a research study nested inside a larger 'host trial', promoting the use of Studies Within A Trial aimed to do Study Within A Trial routine practice in clinical trial units by funding and supporting at least 25 Studies Within A Trial. The best way to test health and social care treatments is to do a randomised controlled trial ('trial'), where some patients get the treatment being tested and some do not. The results of different groups are compared to see if the treatment improves care. Recruiting patients and keeping them involved in trials is often very difficult. Research teams often do not know how best to recruit and keep patients engaged as the methods have not been tested to see if they work. The best way to test these methods is by doing a Study Within A Trial. We test a programme of Studies Within A Trial for recruiting and keeping patients engaged in trials. Trial teams were able to apply for funding of up to £5000 and receive support from Promoting the use of Study Within A Trial team to do Studies Within A Trial. We used our experience of doing Studies Within A Trial to outline lessons learnt for doing Studies Within A Trial. We funded 42 Studies Within A Trial and gave teams necessary advice to do them. We significantly increased the knowledge for both recruitment and retention strategies, and found 'pre-notifying' before sending questionnaires, sending pens and personalised text messages were all effective for increasing responses by participants. We tested Studies Within A Trial across several different trials at the same time to find out more quickly whether their methods worked. We highlight key lessons learnt to guide others doing Studies Within A Trial, including involving patient partners; picking the right strategy to test; getting ethical approvals; how to do and report Studies Within A Trial. Promoting the use of studies within a trial was successful and supported more Studies Within A Trial than planned. We hope our experience will support those doing Studies Within A Trial in the future.


Assuntos
Terapia por Exercício , Pandemias , Humanos , Análise Custo-Benefício , Estudos de Viabilidade , Ensaios Clínicos Controlados Aleatórios como Assunto , Projetos de Pesquisa , Inquéritos e Questionários , Reino Unido
11.
Soc Work Public Health ; 39(2): 184-198, 2024 Feb 17.
Artigo em Inglês | MEDLINE | ID: mdl-38390708

RESUMO

This study aimed to assess the effectiveness of achronic kidney disease (CKD) peer coach's educational intervention on the quality of life of African-American individuals with CKD. This study employed an experimental research design to assess a peer coaching educational intervention for African-American individuals with CKD. The theoretical underpinning was grounded in social learning theory, emphasizing observational learning, imitation, and modeling. 165 patients were randomly assigned to either the intervention group (n = 81) or the control group (n = 84). Pre- and post-intervention analyses showed no significant differences in most health measures between the two groups. However, the intervention group demonstrated significant improvement in the energy/fatigue subscale, witha16-point difference supporting the intervention group (p = .003). Additionally, the intervention group showed increased scores in the pain subscale (p = .015), while the control group did not. The CKD educational intervention highlighted cultural considerations and provided cost-effective strategies for social workers. It emphasizes the importance of targeted educational interventions and calls for further research and interventions to address the comprehensive needs of CKD patients and improve their quality of life.


Assuntos
Negro ou Afro-Americano , Insuficiência Renal Crônica , Humanos , Qualidade de Vida , Medicina Baseada em Evidências , Insuficiência Renal Crônica/terapia
12.
Am J Nurs ; 124(3): 50-54, 2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38386835

RESUMO

Editor's note: This is the 20th article in a series on clinical research by nurses. The series is designed to be used as a resource for nurses to understand the concepts and principles essential to research. Each column will present the concepts that underpin evidence-based practice-from research design to data interpretation. To see all the articles in the series, go to https://links.lww.com/AJN/A204.


Assuntos
Comitês de Ética em Pesquisa , Ética em Pesquisa , Humanos
13.
PLoS One ; 19(2): e0297071, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38330025

RESUMO

Evidence-based practice (EBP) has gained significant importance in clinical practice worldwide, including in nursing. This study aimed to explore the potential impact of applying a web-based training program on nurses' knowledge, skills, and attitudes regarding EBP. A quasi-experimental pretest-posttest research design was utilized with a purposive sample of 64 professional nurses who agreed to participate. The study took place in different hospitals and primary healthcare centers in the Bisha Governorate, Aseer region, Saudi Arabia. A four-week standardized web-based training program was implemented using an online learning approach. Nurses were provided with an online self-rated data collection tool through the Google Forms platform. The findings indicated a highly significant difference in the total knowledge and EBP skills mean scores of the post-intervention (53.08±15.9) and (66.03±8.95), respectively compared to pre-intervention (P<0.05). Additionally, there was marked improvement in the mean scores of the positive attitude of the training sessions post-intervention compared to pre-intervention. The program was also well-received by the nurses in terms of quality and usability. The program has the potential to enhance nurses' knowledge, skills, and attitudes toward EBP. Therefore, healthcare organizations may consider adopting web-based training as a means of continuing professional education to promote EBP competencies among nurses.


Assuntos
Competência Clínica , Enfermeiras e Enfermeiros , Humanos , Atitude do Pessoal de Saúde , Inquéritos e Questionários , Prática Clínica Baseada em Evidências , Educação Continuada em Enfermagem , Internet , Conhecimentos, Atitudes e Prática em Saúde
14.
Syst Rev ; 13(1): 28, 2024 01 13.
Artigo em Inglês | MEDLINE | ID: mdl-38216987

RESUMO

BACKGROUND: Requiring authors to base their research on a systematic review of the existing literature prevents the generation of redundant scientific studies, thereby avoiding the deprivation of effective therapies for trial participants and the waste of research funds. Scientific medical journals could require this in their author guidelines. While this applies to all areas of research, it is also relevant to physiotherapy and rehabilitation research, which predominantly involve interventional trials in patients. OBJECTIVE: The aim of this study was to determine the extent to which the use of systematic reviews to justify a new trial is already being requested by physiotherapy-related scientific medical journals (PTJs). In addition, a comparison was made between PTJs and scientific medical journals with the highest impact factor in the Science Citation Index Extended (SCIE). METHODS: This meta-research study is based on a systematic examination of the author guidelines of 149 PTJs. The journals were identified and included based on the number of publications with physiotherapy as a keyword in the databases PEDro, and Medline (Pubmed). The included author guidelines were analysed for the extent to which they specified that a new trial should be justified by a systematic review of the literature. Additionally, they were compared with 14 scientific medical journals with the highest impact factor in the SCIE (LJs). RESULTS: In their author guidelines, none of the included PTJs required or recommended the use of a systematic review to justify a new trial. Among LJs, four journals (28.57%), all associated with the Lancet group, required the study justification through a systematic review of the literature. CONCLUSION: Neither PTJs nor LJs require or recommend the use of a systematic review to justify a new trial in their author guidelines. This potentially leaves room for unethical scientific practices and should be critically considered in future research.


Assuntos
Guias como Assunto , Publicações Periódicas como Assunto , Projetos de Pesquisa , Revisões Sistemáticas como Assunto , Humanos , Medicina , Modalidades de Fisioterapia
15.
Dimens Crit Care Nurs ; 43(2): 96-101, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38271315

RESUMO

INTRODUCTION: Quantitative research and quality improvement (QI) both seek to improve care provided to patients. However, clinicians often blur the lines between how to appropriately analyze data from these methodologies. Clinicians may inappropriately use statistical analyses for QI initiatives, rather than using run and statistical process control (SPC) charts to analyze improvements in outcomes. OBJECTIVE: The purpose of this article was to address the analytic methods used for QI initiatives in the clinical setting in an effort to show clinicians how to identify meaningful improvements in clinical practice. METHODS: In this article, we provide an example comparing the same evidence-based practice/QI initiative (chlorhexidine gluconate bathing in a medical intensive care unit) using a quasi-experimental pretest/posttest research design with statistical analyses completed with t tests with analyses using run and SPC charts to show the data trended over time. Using a pretest/posttest design, chlorhexidine gluconate bathing compliance improved from 63% to 65%, a nonsignificant change, P = .075. These same data plotted on run and SPC charts, however, show a shift and a trend, indicating clinically significant improvements per QI methodologies. CONCLUSION: The example in this article highlights the pitfall of relying only on statistical analyses and P values to determine the importance of a clinical project, and provides a practical example for how run or SPC charts can be used to identify improvements over time.


Assuntos
Clorexidina , Melhoria de Qualidade , Humanos
16.
Trials ; 25(1): 80, 2024 Jan 23.
Artigo em Inglês | MEDLINE | ID: mdl-38263138

RESUMO

In an era focused on value-based healthcare, the quality of healthcare and resource allocation should be underpinned by empirical evidence. Pragmatic clinical trials (pRCTs) are essential in this endeavor, providing randomized controlled trial (RCT) insights that encapsulate real-world effects of interventions. The rising popularity of pRCTs can be attributed to their ability to mirror real-world practices, accommodate larger sample sizes, and provide cost advantages over traditional RCTs. By harmonizing efficacy with effectiveness, pRCTs assist decision-makers in prioritizing interventions that have a substantial public health impact and align with the tenets of value-based health care. An international network for pRCT provides several advantages, including larger and diverse patient populations, access to a broader range of healthcare settings, sharing knowledge and expertise, and overcoming ethical and regulatory barriers. The hypothesis and study design of pRCT answers the decision-maker's questions. pRCT compares clinically relevant alternative interventions, recruits participants from diverse practice settings, and collects data on various health outcomes. They are scarce because the medical products industry typically does not fund pRCT. Prioritizing these studies by expanding the infrastructure to conduct clinical research within the healthcare delivery system and increasing public and private funding for these studies will be necessary to facilitate pRCTs. These changes require more clinical and health policy decision-makers in clinical research priority setting, infrastructure development, and funding. This paper presents a comprehensive overview of pRCTs, emphasizing their importance in evidence-based medicine and the advantages of an international collaborative network for their execution. It details the development of PRIME-9, an international initiative across nine countries to advance pRCTs, and explores various statistical approaches for these trials. The paper underscores the need to overcome current challenges, such as funding limitations and infrastructural constraints, to leverage the full potential of pRCTs in optimizing healthcare quality and resource utilization.


Assuntos
Pessoal Administrativo , Projetos de Pesquisa , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Tamanho da Amostra , Medicina Baseada em Evidências
17.
Int J Technol Assess Health Care ; 40(1): e13, 2024 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-38282208

RESUMO

OBJECTIVES: Evidence development for medical devices is often focused on satisfying regulatory requirements with the result that health professional and payer expectations may not be met, despite considerable investment in clinical trials. Early engagement with payers and health professionals could allow companies to understand these expectations and reflect them in clinical study design, increasing chances of positive coverage determination and adoption into clinical practice. METHODS: An example of early engagement through the EXCITE International model using an early technology review (ETR) is described which includes engagement with payers and health professionals to better inform companies to develop data that meet their expectations. ETR is based on an early evidence review, a framework of expectations that guides the process and identified gaps in evidence. The first fourteen ETRs were reviewed for examples of advice to companies that provided additional information from payers and health professionals that was thought likely to impact on downstream outcomes or strategic direction. Given that limitations were imposed by confidentiality, examples were genericized. RESULTS: Advice through early engagement can inform evidence development that coincides with expectations of payers and health professionals through a structured, objective, evidence-based approach. This could reduce the risk of business-related adverse outcomes such as failure to secure a positive coverage determination and/or acceptance by expert health professionals. CONCLUSIONS: Early engagement with key stakeholders exemplified by the ETR approach offers an alternative to the current approach of focusing on regulatory expectations. This could reduce the time to reimbursement and clinical adoption and benefit patient outcomes and/or health system efficiencies.


Assuntos
Projetos de Pesquisa , Tecnologia , Humanos , Avaliação da Tecnologia Biomédica
18.
Respir Care ; 2024 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-38296331

RESUMO

Background: Evidence-based practice (EBP) is at the forefront of providing quality patient care by using the best available evidence, clinical expertise, and considering patient needs and preferences for clinical decisions. However, EBP may not be consistently used even when the evidence supports the therapy. The purpose of this study was to assess the factors associated with the use of EBP among respiratory therapy faculty teaching in a large community college system and post-professional students enrolled in a university-based, respiratory therapy baccalaureate degree advancement program. Methods: A non-probability, descriptive survey research design was used to develop and administer an online questionnaire. Results: All participants demonstrated sufficient knowledge and understanding of introductory concepts of EBP but knowledge of specific components of the EBP process was not as strong. Self-efficacy in knowledge and use of EBP among faculty and degree advancement students varied. Faculty and students rated their self-efficacy high in assessing patients' needs, values and treatment preferences but were lower for using the patient/population/problem, intervention, comparison, outcome (PICO) technique and interpreting common statistical tests. Students viewed their previous EBP learning experiences more favorably compared to faculty (p=.008). Faculty and students searched and read the research literature more often compared to critically appraising and using the research literature. Logistic regression analysis indicated no statistically significant relationship of knowledge, self-efficacy, and learning experiences to the use of EBP among respiratory therapy students, X 2(4, N = 54) = 7.73, p = .10. Conclusion: Results suggested respiratory therapy faculty and students were knowledgeable and confident regarding EBP but their use of EBP in clinical decisions was limited. While the EBP knowledge, self-efficacy, and learning experiences had minimal influence on the use of EBP, the results of the study provide a foundation for future research.

19.
BMJ Open ; 14(1): e074894, 2024 01 30.
Artigo em Inglês | MEDLINE | ID: mdl-38296280

RESUMO

INTRODUCTION: In recent years, information technology and social media have experienced unprecedented growth, particularly in the Nordic countries. However, there is a noticeable lack of comprehensive understanding regarding the latest research findings on online health information seeking behaviour (OHISB) among young adults (18 to >30). There is a need to conduct an updated review to identify knowledge gaps in where young adults find health information and their user interface preferences and to provide research-based guidance and recommendations to governments, health organisations and social media platforms on how to facilitate this prominent pattern. The scoping review protocol outlines a study that will systematically map the existing literature on young adults' preferences for digital platforms and platform characteristics in relation to OHISB, enabling the identification of promising areas for further research and the development of more effective interventions to promote healthy and informed choices. Conducting a scoping review is imperative to gain a comprehensive understanding of young adults' OHISB and support the next generation of dissemination that promotes accurate and reliable digital health information. METHODS AND ANALYSIS: The scoping review will use Arksey and O'Malley's methodological framework (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR)) and employ the citation pearl method and the Sample, Phenomenon of Interest, Design, Evaluation, Research type model to design the search strategy. To identify relevant literature, three databases will undergo a search: Scopus, Web of Science and EMBASE. Additionally, a subsidiarily grey literature search will be conducted in Google Scholar. The data charting process will conform to the PRISMA-ScR standard and will be further structured with EndNote. Qualitative and quantitative analyses of the extracted data will be developed using EndNote and Excel. ETHICS AND DISSEMINATION: Conducting a scoping review involves secondary data analysis of publicly available sources and does not require an ethical review. The protocol will be published to ensure transparency. The scoping review results will be disseminated through open-access peer-reviewed publications, national and international conferences, social media platforms, newspapers and YouTube to service users and stakeholders.


Assuntos
Comportamentos Relacionados com a Saúde , Comportamento de Busca de Informação , Humanos , Adulto Jovem , Bases de Dados Factuais , 60713 , Revisão Ética , Projetos de Pesquisa , Literatura de Revisão como Assunto
20.
Intensive Crit Care Nurs ; 81: 103610, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38171952

RESUMO

OBJECTIVES: To determine the perceived barriers to the implementation of research findings in clinical practice among critical care nurses and allied health professionals. METHODS: A cross-sectional study was conducted using an online questionnaire sent to critical care nurses and allied health professionals in French-speaking countries. The primary objective was the identification and grading of perceived barriers to implementation of research findings into clinical practice, using a previously validated tool (French version of the BARRIERS scale). The scale is divided into 4 dimensions, each containing 6 to 7 questions to be answered using a 4-point Likert scale (1: no barrier, 4: great barrier). Descriptive statistics were performed and weighted score per dimensions were compared. Univariate and multivariate linear regressions were performed to identify factors associated with the total score by dimension. RESULTS: A total of 994 nurses and allied health professionals (85.1 % of ICU nurses) from 5 countries (71.8 % from France) responded to the survey. Main reported barriers to research findings utilization were "Statistical analyses are not understandable" (54.5 %), "Research articles are not readily available" (54.3 %), and "Implications for practice are not made clear" (54.2 %). Weighted scores differed between dimensions, with the "communication" and "organization" dimensions being the greatest barriers (median [IQR]: 2.3 [1.8-2.7] and 2.0 [1.6-2.4], while the "adopter" and "innovation" dimensions having lower scores (1.5 [1.2-1.8] and 1.5 [1.0-1.8] (all pairwise comparisons p-value < 0.0001, except for the adopter vs. innovation comparison, p > 0.05). CONCLUSIONS: Accessibility and understanding of research results seem to be the main barriers to research utilization in practice by respondents. A large number of the reported barriers could be overcome through education and organizational change. IMPLICATIONS FOR PRACTICE: Promoting a research culture among nurses and allied health professionals is an issue that needs investment. This should include training in critical reading of scientific articles and statistics.


Assuntos
Pesquisa em Enfermagem , Humanos , Estudos Transversais , Inquéritos e Questionários , Projetos de Pesquisa , Pessoal Técnico de Saúde , Atitude do Pessoal de Saúde
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