Deceptive measures of progress in the NHS long-term plan for cancer: case-based vs. population-based measures.

The NHS Long Term Plan for cancer aims to increase early-stage diagnoses from 50% to 75% and to have 55,000 more people each year survive their cancer for at least 5 years following diagnosis. The targets measures are flawed and could be met without improving outcomes that really matter to patients. The proportion of early-stage diagnoses could increase, while the number of patients presenting at a late-stage remains the same. More patients could survive their cancer for longer, but lead time and overdiagnosis bias make it impossible to know whether anyone had their life prolonged. The target measures should switch from biased case-based measures to unbiased population-based measures that reflect the key objectives in cancer care: reducing late-stage incidence and mortality.

Skeletal pin site care: National Association of Orthopaedic Nurses guidelines for orthopaedic nursing.

A systematic analysis of the research literature on skeletal pin site care was conducted, and the opinions of an expert panel were obtained. Four specific recommendations for skeletal pin site care are offered, with explicit discussions of the level of research support and/or expert panel support for each. Discussion of other pin site care issues is provided, and characteristics of the research base regarding skeletal pin site care are described.

The Braden Scale. A review of the research evidence.

This review of recent research was undertaken to answer questions about the predictive performance of the Braden Scale for Predicting Pressure Ulcer Risk. The data are varied across settings, conditions, and populations. Although the predictive values of an at-risk classification are consistently modest, they may be understated because of the confounding influence of effective care administered to patients during the studies. In contrast, the predictive values of a not-at-risk classification are consistently quite high. The reviewer concludes that the Braden Scale for Predicting Pressure Ulcer Risk is a useful risk prediction tool that should be used in conjunction with clinical nursing judgment and as part of a comprehensive pressure ulcer prevention program.

Test of an educational intervention for osteoporosis prevention with U.S. adolescents.

PURPOSE: To test the effects of an osteoporosis prevention program given to high school students DESIGN: Randomized, multi-site field study. SAMPLE: The final sample for analysis was composed of 693 teens from 18 schools. FINDINGS: The average knowledge difference score of the OPTIONS group was 8.4 percentage points higher than that of the control group. Some of the analysis suggested that girls gained more from the intervention than did boys. Students from all types of schools, responded equivalently to the intervention. Health beliefs about barriers to preventive action were not influenced by the intervention. DISCUSSION: This intervention increased students' knowledge about how to build healthy bones; however, the real challenge lies in building on that knowledge gain to influence behaviors. The modest gain in knowledge also suggests that educational interventions of this type should be tested with younger children, who might be more receptive.

Nursing intervention studies: a descriptive analysis of issues important to clinicians.

When reading a report of an intervention study, clinicians are interested in knowing: whether the intervention is effective, with whom it is effective, how much benefit it produces, and whether associated, adverse outcomes occur. Recommendations have been made in the research literature regarding how to conduct and report intervention studies so as to produce knowledge regarding these questions. This descriptive study was conducted to estimate the frequency with which these recommendations are being used in nursing intervention studies. Data pertinent to five research questions were extracted from 84 experimental and quasi-experimental study reports published between 1998 and 2000. Seventeen percent of the studies used a design that could statistically test for variation in intervention effect depending on the level of an individual characteristic. However, a test of interaction was actually conducted in only 8% of the studies. The magnitude of the intervention's effect was addressed in 38% of the study reports. Providing the proportion of persons in the intervention group who attained a discrete outcome was the most frequently used way of showing intervention magnitude. Associated, adverse outcomes were examined in 23% of the studies, and were most often measured as continuous variables. The low level of use of recommended methods leads the author to suggest dialogue between clinicians and researchers to determine if intervention studies are being conducted and reported in ways that produce knowledge that is useful to clinicians.