Continuing education for systematic reviews: a prospective longitudinal assessment of a workshop for librarians.

OBJECTIVE: This prospective, longitudinal study explored the impact of a continuing education class on librarians' knowledge levels about and professional involvement with systematic reviews. Barriers to systematic review participation and the presence of formal systematic review services in libraries were also measured. METHODS: Participants completed web-based surveys at three points in time: pre-class, post-class, and six-months' follow-up. Descriptive statistics were calculated for demographics and survey questions. Linear mixed effects models assessed knowledge score changes over time. RESULTS: Of 160 class attendees, 140 (88%) completed the pre-class survey. Of those 140, 123 (88%) completed the post-class survey, and 103 (74%) completed the follow-up survey. There was a significant increase (p<0.00001) from pre-class to post-class in knowledge test scores, and this increase was maintained at follow-up. At post-class, 69% or more of participants intended to promote peer review of searches, seek peer review of their searches, search for grey literature, read or follow published guidelines on conduct and documentation of systematic reviews, and ask for authorship on a systematic review. Among librarians who completed a systematic review between post-class and follow-up, 73% consulted published guidelines, 52% searched grey literature, 48% sought peer review, 57% asked for authorship, and 70% received authorship. CONCLUSIONS: Attendance at this continuing education class was associated with positive changes in knowledge about systematic reviews and in librarians' systematic review-related professional practices. This suggests that in-depth professional development classes can help librarians develop skills that are needed to meet library patrons' changing service needs.

Review for librarians of evidence-based practice in nursing and the allied health professions in the United States.

OBJECTIVE: This paper provides an overview of the state of evidence-based practice (EBP) in nursing and selected allied health professions and a synopsis of current trends in incorporating EBP into clinical education and practice in these fields. This overview is intended to better equip librarians with a general understanding of the fields and relevant information resources. INCLUDED PROFESSIONS: Professions are athletic training, audiology, health education and promotion, nursing, occupational therapy, physical therapy, physician assisting, respiratory care, and speech-language pathology. APPROACH: Each section provides a description of a profession, highlighting changes that increase the importance of clinicians' access to and use of the profession's knowledgebase, and a review of each profession's efforts to support EBP. The paper concludes with a discussion of the librarian's role in providing EBP support to the profession. CONCLUSIONS: EBP is in varying stages of growth among these fields. The evolution of EBP is evidenced by developments in preservice training, growth of the literature and resources, and increased research funding. Obstacles to EBP include competing job tasks, the need for additional training, and prevalent attitudes and behaviors toward research among practitioners. Librarians' skills in searching, organizing, and evaluating information can contribute to furthering the development of EBP in a given profession.

A Systematic Review of Research Studies Examining Telehealth Privacy and Security Practices used by Healthcare Providers.

The objective of this systematic review was to systematically review papers in the United States that examine current practices in privacy and security when telehealth technologies are used by healthcare providers. A literature search was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P). PubMed, CINAHL and INSPEC from 2003 - 2016 were searched and returned 25,404 papers (after duplications were removed). Inclusion and exclusion criteria were strictly followed to examine title, abstract, and full text for 21 published papers which reported on privacy and security practices used by healthcare providers using telehealth. Data on confidentiality, integrity, privacy, informed consent, access control, availability, retention, encryption, and authentication were all searched and retrieved from the papers examined. Papers were selected by two independent reviewers, first per inclusion/exclusion criteria and, where there was disagreement, a third reviewer was consulted. The percentage of agreement and Cohen's kappa was 99.04% and 0.7331 respectively. The papers reviewed ranged from 2004 to 2016 and included several types of telehealth specialties. Sixty-seven percent were policy type studies, and 14 percent were survey/interview studies. There were no randomized controlled trials. Based upon the results, we conclude that it is necessary to have more studies with specific information about the use of privacy and security practices when using telehealth technologies as well as studies that examine patient and provider preferences on how data is kept private and secure during and after telehealth sessions.

Early decompressive craniectomy for malignant cerebral infarction: Meta-analysis and clinical decision algorithm.

BACKGROUND: Decompressive craniectomy (DC) is an aggressive life-saving surgical intervention for patients with malignant cerebral infarction (MCI). However, DC remains inconsistently and infrequently utilized, primarily due to enduring concern that increased survival occurs only at the cost of poor functional outcome. Our aim was to clarify the role of DC performed within 48 hours (early DC) for patients with MCI, including patients aged >60 years. METHODS: We performed a meta-analysis of all available randomized controlled trials comparing early DC to best medical care for MCI. Studies were identified through literature searches of electronic databases including PubMed, EMBASE, and Scopus. We employed a Mantel-Haenszel fixed effects model to assess treatment effect on dichotomized modified Rankin Scale (mRS) outcomes at 12 months. RESULTS: A total of 289 patients from 6 randomized controlled trials comparing early DC to best medical care were included. Early DC resulted in an increased rate of excellent outcomes, defined as mRS ≤2 (relative risk [RR] 2.81, 95% confidence interval [CI] 1.01-7.82, p = 0.047), and favorable outcomes, defined as mRS ≤3 (RR 2.06, 95% CI 1.25-3.40, p = 0.005). Early DC also increased the rate of survival with unfavorable outcomes, defined as mRS 4-5 (RR 3.03, 95% CI 1.98-4.65, p < 0.001). CONCLUSIONS: Early DC increases the rate of excellent outcomes, i.e., functional independence, in addition to favorable and unfavorable outcomes; however, these findings must be interpreted within the context of patients' goals of care. We have developed a clinical decision algorithm that incorporates goals of care, which may guide consideration of early DC for MCI in clinical practice.

Protocol for a Systematic Review of Telehealth Privacy and Security Research to Identify Best Practices.

Healthcare professionals engaged in telehealth are faced with complex US federal regulations (e.g., HIPAA/HITECH) and could benefit from the guidance provided by best practices in Privacy and Security (P&S). This article describes a systematic review protocol to address this need. The protocol described herein uses the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). The PRISMA-P contains 17 items that are considered essential, as well as minimum components to include in systematic reviews. PICOS (participants, interventions, comparisons, outcome(s) and study design of the systematic review) are also relevant to the development of best practices in P&S in telehealth systems. A systematic process can best determine what information should be included and how this information should be retrieved, condensed, analyzed, organized, and disseminated.

Telerehabilitation: policy issues and research tools.

The importance of public policy as a complementary framework for telehealth, telemedicine, and by association telerehabilitation, has been recognized by a number of experts. The purpose of this paper is to review literature on telerehabilitation (TR) policy and research methodology issues in order to report on the current state of the science and make recommendations about future research needs. An extensive literature search was implemented using search terms grouped into main topics of telerehabilitation, policy, population of users, and policy specific issues such as cost and reimbursement. The availability of rigorous and valid evidence-based cost studies emerged as a major challenge to the field. Existing cost studies provided evidence that telehomecare may be a promising application area for TR. Cost studies also indicated that telepsychiatry is a promising telepractice area. The literature did not reference the International Classification on Functioning, Disability and Health (ICF). Rigorous and comprehensive TR assessment and evaluation tools for outcome studies are tantamount to generating confidence among providers, payers, clinicians and end users. In order to evaluate consumer satisfaction and participation, assessment criteria must include medical, functional and quality of life items such as assistive technology and environmental factors.

Staff development planning in an academic health sciences library.

OBJECTIVE: A staff development committee (SDC) was convened to implement staff development opportunities for an academic health sciences library system comprised of three separate facilities. The charge for the SDC was to: (1) develop programs to enhance workplace skills and personal growth, (2) communicate the availability of existing programs at the university and medical center, and (3) encourage the staff to participate in these opportunities. PROGRAM: The committee created goals and objectives and developed a survey designed to give staff the opportunity to provide input for this initiative. With an 80% response rate, the survey results were used to plan 15 events based on staff needs and preferences. First-year attendance for SDC-sponsored events was 459. Committee members served as liaisons for each event. Two forms were developed to facilitate event planning. A monthly announcement sheet, email reminders, and the library's local area network are used to communicate upcoming SDC events and encourage attendance. CONCLUSION: This approach can serve as a useful model for similar program planning in any organization.

Use of Web-based library resources by medical students in community and ambulatory settings.

PURPOSE: The purpose was to evaluate the use of Web-based library resources by third-year medical students. SETTING/PARTICIPANTS/RESOURCES: Third-year medical students (147) in a twelve-week multidisciplinary primary care rotation in community and ambulatory settings. METHODOLOGY: Individual user surveys and log file analysis of Website were used. RESULTS/OUTCOMES: Twenty resource topics were compiled into a Website to provide students with access to electronic library resources from any community-based clerkship location. These resource topics, covering subjects such as hypertension and back pain, linked to curriculum training problems, full-text journal articles, MEDLINE searches, electronic book chapters, and relevant Websites. More than half of the students (69%) accessed the Website on a daily or weekly basis. Over 80% thought the Website was a valuable addition to their clerkship. DISCUSSION/CONCLUSION: Web-based information resources can provide curriculum support to students for whom access to the library is difficult and time consuming.