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3.
J Manag Care Spec Pharm ; 26(10): 1297-1300, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32996390

RESUMO

BACKGROUND: Three pharmacist-specific Current Procedural Terminology (CPT) codes exist to facilitate medication therapy management (MTM) reimbursement (codes 99605, 99606, and 99607). However, no studies have used CPT codes in administrative claims databases to identify subjects who have received MTM services. OBJECTIVE: To assess the prevalence of MTM services provided, using CPT codes identified in an administrative dataset. METHODS: A retrospective cohort study was conducted using a subset of Medicare Part D individuals from the IBM MarketScan Medicare Supplemental Research Databases (2009-2015). Researchers identified beneficiaries who received MTM services using CPT codes 99605, 99606, and 99607. RESULTS: Of the 16,483,709 individuals in the dataset, only 3,291 had CPT codes indicating that they received MTM services, representing an overall prevalence of 0.020%. CONCLUSIONS: The use of CPT codes as an indicator of MTM service provision resulted in far lower MTM utilization rates than in published literature. Reliance on CPT codes to identify MTM services in administrative claims is not recommended, given that it limited the researchers' ability to properly identify patient receipt of such services. More accurate methodologies are warranted for identifying MTM use and its effects on patient outcomes. DISCLOSURES: This work was supported by Pharmacy Quality Alliance; Merck Sharp & Dohme, a subsidiary of Merck & Co. (Kenilworth, NJ); and SinfoniaRx. The funding sources had no role in study design, collection, analysis, and interpretation of data, writing the report, or decision to submit the article for publication. Tate, Chinthammit, and Campbell completed this work during their employment at the University of Arizona. Pickering was an employee of Pharmacy Quality Alliance at the time of this study. Black is employed by Merck. Axon reports grants from the Arizona Department of Health Services and the American Association of Colleges of Pharmacy; Campbell reports a grant from the Community Pharmacy Foundation; Chinthammit reports fees from Eli Lilly; Black has received a grant from Merck; Warholak reports grants from the Arizona Department of Health Services and Novartis, all unrelated to this study. Taylor reports grants from Tabula Rasa Op-Co, during the conduct of the study, and from the Arizona Department of Health Services, outside the conduct of this study. This research was accepted as a poster presentation at the International Society for Pharmacoeconomics and Outcomes Research Annual Meeting, May 16-20, 2020, in Orlando, FL, but was not presented due to the COVID-19 pandemic. An abstract was published in Value in Health, 2020;23(Suppl 1):S305.


Assuntos
Current Procedural Terminology , Coleta de Dados/métodos , Conduta do Tratamento Medicamentoso/estatística & dados numéricos , Humanos , Reembolso de Seguro de Saúde , Medicare Part D/estatística & dados numéricos , Estudos Retrospectivos , Estados Unidos
4.
Indian J Public Health ; 64(3): 277-284, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32985430

RESUMO

Background: Improving quality of health services and providing safe care require well-trained and skilled workforce. The inclusion of components of patient safety in graduate training curricula, followed by adherence to curricula in teaching programs, can improve the quality of health-care services. Objectives: To review the existing training curricula for five subgroups of health workforce (Allopathic doctors, nurses, laboratory technicians, pharmacists, and nurse midwives) and to document the components and identified variables of patient safety covered. Methods: A mixed-methods study was conducted during July 2017-March 2018. Data were collected through desk review, field visits, in-depth interviews, self-administered questionnaires, and focused group discussions (FGDs). A total of 24 variables were identified by the experts to review the training curricula. Results: Seven states, 28 institutes, and 42 health-care facilities were visited. A total of 516 staff from different health cadres participated in the study through 54 interviews, 156 self-administered questionnaires, and 24 FGDs. Of 24 patient safety variables considered, 16 were covered in the medical and nursing, 9 in laboratory technician and pharmacist, and 5 in midwives' curricula. The teaching material on the patient safety, for most categories of staff, was not available in consolidated form, and there was no standardization. Conclusion: There is a need for the development of comprehensive training material cum operational modules on patient safety, suitably adopted as per the learning needs of different subgroups of health staff. The need for strengthening patient safety has been further underscored as the health workforce is fighting the coronavirus disease 19 (COVID-19) pandemic. The initiatives on patient safety will contribute to improved overall quality of health services, which in turn would advance universal health coverage.


Assuntos
Educação de Pós-Graduação/métodos , Pessoal de Saúde/educação , Segurança do Paciente , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Currículo , Coleta de Dados/métodos , Feminino , Humanos , Índia , Masculino , Pandemias , Pneumonia Viral/epidemiologia , Melhoria de Qualidade
5.
Aust Health Rev ; 44(5): 723-727, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32962798

RESUMO

Objective This study analysed screening for COVID-19 before surgery and outcomes of any perioperative testing for SARS-CoV-2 infection during pandemic-restricted surgery. Methods An audit was conducted with routinely collected health data before both elective and non-elective surgery at two large Melbourne hospitals during April and early May 2020. We looked for documented systematic screening for COVID-19 disease and fever (>38°C) and results of SARS-COV-2 testing, and proposed a minimum acceptable documenting rate of 85%. Results The study included 2197 consecutive patients (1279 (58%) undergoing elective surgery, 917 (42%) undergoing non-elective surgery) across most specialities. Although 926 (72%) patients undergoing elective surgery had both systematic screening and temperature documented, approximately half that percentage undergoing non-elective surgery (n=347; 38%) had both documented. However, 871 (95%) of non-elective surgery patients had temperature documented. Acknowledging limited screening, 85 (9.3%) non-elective surgery patients had positive screening, compared with 39 (3.0%) elective surgery patients. All 152 (7%) patients who were tested for SARS-CoV-2 were negative, and no cases were reported from external contact tracing. Conclusions Although 'not documented' does not necessarily equal 'not done', we found that documenting of COVID-19 screening could be improved. Better understanding of implementing screening practices in pandemics and other crises, particularly for non-elective surgery patients, is warranted. What is known about the topic? Little is known about routine screening for SARS-CoV-2 infection among surgical patients. However, it is well established that implementing effective uptake of safety and quality initiatives can be difficult. What does this paper add? We found that although most patients had documented temperature, fewer than 75% had a documented systematic questionnaire screen for COVID, particularly patients undergoing non-elective surgery. What are the implications for practitioners? Clear documenting is important in managing patients. Pandemics and other crises can require rapid changes in practice. Implementing such measures may be less complete than anticipated and may require greater use of evidence-based implementation strategies, particularly in the less predictable care of non-elective surgery patients.


Assuntos
Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/diagnóstico , Coleta de Dados/métodos , Procedimentos Cirúrgicos Eletivos/métodos , Programas de Rastreamento/métodos , Pandemias/prevenção & controle , Pneumonia Viral/diagnóstico , Cuidados Pré-Operatórios/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Austrália , Betacoronavirus/patogenicidade , Humanos , Masculino , Pessoa de Meia-Idade
6.
PLoS One ; 15(9): e0239441, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32976519

RESUMO

The study aims to understand Twitter users' discourse and psychological reactions to COVID-19. We use machine learning techniques to analyze about 1.9 million Tweets (written in English) related to coronavirus collected from January 23 to March 7, 2020. A total of salient 11 topics are identified and then categorized into ten themes, including "updates about confirmed cases," "COVID-19 related death," "cases outside China (worldwide)," "COVID-19 outbreak in South Korea," "early signs of the outbreak in New York," "Diamond Princess cruise," "economic impact," "Preventive measures," "authorities," and "supply chain." Results do not reveal treatments and symptoms related messages as prevalent topics on Twitter. Sentiment analysis shows that fear for the unknown nature of the coronavirus is dominant in all topics. Implications and limitations of the study are also discussed.


Assuntos
Infecções por Coronavirus/psicologia , Pneumonia Viral/psicologia , Mídias Sociais/classificação , Betacoronavirus , Coleta de Dados/métodos , Medo/psicologia , Humanos , Disseminação de Informação , Aprendizado de Máquina , Pandemias
8.
Plast Reconstr Surg ; 146(2): 343-354, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32740587

RESUMO

Routine measurement of outcome of clinical care is increasingly considered important, but implementation in practice is challenging. This article describes (1) how the authors created and implemented a routine outcome measurement cohort of patients with hand and wrist conditions and (2) how these data are used to improve the quality of care and facilitate scientific research. Starting in 2011, routine outcome measurement was implemented at all practice sites (currently 22) of a specialized treatment center for hand and wrist conditions across The Netherlands. The authors developed five "measurement tracks," including measurements administered at predetermined time points covering all hand and wrist disorders and treatments. An online system automatically distributes measurements among patients, which can be accessed by health care professionals. Using this system, the total number of yearly assigned tracks increased up to over 16,500 in 2018, adding up to 85,000 tracks in 52,000 patients in total. All surgeons, therapists, and other staff have direct access to individual patient data and patients have access to their treatment information using a secure patient portal. The data serve as a basis for studies on, among others, comparative effectiveness, prediction modeling, and clinimetric analyses. In conclusion, the authors present the design and successful implementation of a routine outcome measurement system that was made feasible using a highly automated data collection infrastructure, tightly linked to the patient journey and the workflow of health care professionals. The system serves not only as a tool to improve care but also as a basis for scientific research studies.


Assuntos
Implementação de Plano de Saúde , Doenças Musculoesqueléticas/terapia , Sistemas On-Line , Ortopedia/organização & administração , Avaliação de Resultados em Cuidados de Saúde/organização & administração , Estudos de Coortes , Coleta de Dados/métodos , Mãos/fisiopatologia , Humanos , Doenças Musculoesqueléticas/fisiopatologia , Países Baixos , Ortopedia/métodos , Avaliação de Resultados em Cuidados de Saúde/métodos , Medição da Dor , Melhoria de Qualidade , Punho/fisiopatologia
9.
PLoS Comput Biol ; 16(8): e1008117, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32804932

RESUMO

Understanding the behavior of emerging disease outbreaks in, or ahead of, real-time could help healthcare officials better design interventions to mitigate impacts on affected populations. Most healthcare-based disease surveillance systems, however, have significant inherent reporting delays due to data collection, aggregation, and distribution processes. Recent work has shown that machine learning methods leveraging a combination of traditionally collected epidemiological information and novel Internet-based data sources, such as disease-related Internet search activity, can produce meaningful "nowcasts" of disease incidence ahead of healthcare-based estimates, with most successful case studies focusing on endemic and seasonal diseases such as influenza and dengue. Here, we apply similar computational methods to emerging outbreaks in geographic regions where no historical presence of the disease of interest has been observed. By combining limited available historical epidemiological data available with disease-related Internet search activity, we retrospectively estimate disease activity in five recent outbreaks weeks ahead of traditional surveillance methods. We find that the proposed computational methods frequently provide useful real-time incidence estimates that can help fill temporal data gaps resulting from surveillance reporting delays. However, the proposed methods are limited by issues of sample bias and skew in search query volumes, perhaps as a result of media coverage.


Assuntos
Surtos de Doenças/estatística & dados numéricos , Internet , Vigilância em Saúde Pública/métodos , Ferramenta de Busca/estatística & dados numéricos , Biologia Computacional , Coleta de Dados/métodos , Métodos Epidemiológicos , Humanos , Aprendizado de Máquina
11.
Womens Health (Lond) ; 16: 1745506520953353, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32853055

RESUMO

OBJECTIVES: Abortions are difficult to measure; yet, accurate estimates are critical in developing health programs. We implemented and tested the validity of a list experiment of lifetime abortion prevalence in Istanbul, Turkey. We complemented our findings by understanding community perspectives using in-depth interviews with key informants. METHODS: We conducted a household survey between March and June 2018. In a random sample of 4040 married women aged 16-44 years, we implemented a double list experiment. We averaged difference in mean values calculations between the average counts for each list to provide an estimated lifetime abortion prevalence. We conducted in-depth interviews with 16 key informants to provide insights into possible explanations for the quantitative results. RESULTS: The abortion prevalence estimate from the list experiment was close to that of the direct question (3.25% vs 2.97%). Key informant narratives suggest that differing definitions of abortion, inaccessibility, provider bias, lack of knowledge of abortion laws and safety, and religious norms could contribute to under-reporting. Results from the qualitative study suggest that abortion is largely inaccessible and highly stigmatized. CONCLUSION: Measuring experiences of abortion is critical to understanding women's needs and informing harm-reduction strategies; however, in highly stigmatized settings, researchers may face unique challenges in obtaining accurate reports.


Assuntos
Aborto Induzido/estatística & dados numéricos , Coleta de Dados/métodos , Aborto Induzido/psicologia , Adolescente , Adulto , Feminino , Humanos , Gravidez , Prevalência , Pesquisa Qualitativa , Estigma Social , Inquéritos e Questionários , Turquia/epidemiologia , Adulto Jovem
12.
PLoS One ; 15(7): e0235249, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32649696

RESUMO

Online experiments are growing in popularity. This study aimed to determine the timing accuracy of web technologies and investigate whether they can be used to support high temporal precision psychology experiments. A dynamic sinusoidal grating and flashes were produced by setInterval, CSS3, and requestAnimationFrame (hereafter, rAF) technologies. They were run at normal or real-time priority processing in Chrome, Firefox, Edge, and Internet Explorer on Windows, macOS, and Linux. Timing accuracies were compared with that of Psychtoolbox which was chosen as gold standard. It was found that rAF with real-time priority had the best timing accuracy compared to the other web technologies and had a similar timing accuracy as Psychtoolbox in traditional experiments in most cases. However, rAF exhibited poor timing accuracy on Linux. Therefore, rAF can be used as technical basis for accuracy of millisecond timing sequences in online experiments, thereby benefiting the psychology field.


Assuntos
Coleta de Dados/instrumentação , Intervenção Baseada em Internet , Psicologia Experimental/instrumentação , Tempo de Reação/fisiologia , Navegador , Coleta de Dados/métodos , Estudos de Viabilidade , Humanos , Psicologia Experimental/métodos , Fatores de Tempo
13.
PLoS One ; 15(7): e0234349, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32628678

RESUMO

BACKGROUND: The importance of randomization in clinical trials has long been acknowledged for avoiding selection bias. Yet, bias concerns re-emerge with selective attrition. This study takes a causal inference perspective in addressing distinct scenarios of missing outcome data (MCAR, MAR and MNAR). METHODS: This study adopts a causal inference perspective in providing an overview of empirical strategies to estimate the average treatment effect, improve precision of the estimator, and to test whether the underlying identifying assumptions hold. We propose to use Random Forest Lee Bounds (RFLB) to address selective attrition and to obtain more precise average treatment effect intervals. RESULTS: When assuming MCAR or MAR, the often untenable identifying assumptions with respect to causal inference can hardly be verified empirically. Instead, missing outcome data in clinical trials should be considered as potentially non-random unobserved events (i.e. MNAR). Using simulated attrition data, we show how average treatment effect intervals can be tightened considerably using RFLB, by exploiting both continuous and discrete attrition predictor variables. CONCLUSIONS: Bounding approaches should be used to acknowledge selective attrition in randomized clinical trials in acknowledging the resulting uncertainty with respect to causal inference. As such, Random Forest Lee Bounds estimates are more informative than point estimates obtained assuming MCAR or MAR.


Assuntos
Coleta de Dados/métodos , Interpretação Estatística de Dados , Ensaios Clínicos Controlados Aleatórios como Assunto/métodos , Viés , Coleta de Dados/estatística & dados numéricos , Humanos , Estudos Longitudinais
14.
Public Health ; 185: 254-260, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32688101

RESUMO

OBJECTIVE: United Nations Programme on human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome and World Health Organization believe that some of the benchmark numbers collected may be inaccurate when using the multiplier method to estimate the size of populations most at risk of acquiring HIV. Here, study data have been evaluated to characterize the inaccurate benchmark numbers. STUDY DESIGN: The study design used is a systematic review. METHODS: Studies published from 1 January 2004 to 1 December 2019 using the multiplier method to estimate the population proportions of men who have sex with men (MSM) and female sex workers (FSWs) in China were reviewed. Five electronic bibliographic databases were searched: Medline, the China National Knowledge Infrastructure, VIP Database for Chinese Technical Periodicals, Wanfang Data, and the Chinese BioMedical Literature Database. RESULTS: In all eight studies of FSW, six of the estimated population proportions fell within the range of national estimates. However, the estimated MSM population proportions of all 18 studies fell outside the range of national estimates. CONCLUSIONS: When estimating the MSM population, the use of benchmark numbers from homosexual websites or MSM-frequented sites usually led to an inaccurate estimation. Therefore, benchmark numbers from services/programs that meet fundamental needs, such as those dealing with health and wellness, should be used.


Assuntos
Coleta de Dados/métodos , Infecções por HIV/epidemiologia , Síndrome de Imunodeficiência Adquirida/epidemiologia , Adolescente , Adulto , China/epidemiologia , Feminino , Homossexualidade Masculina/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Vigilância da População/métodos , Fatores de Risco , Profissionais do Sexo/estatística & dados numéricos , Minorias Sexuais e de Gênero/estatística & dados numéricos , Adulto Jovem
16.
PLoS One ; 15(6): e0235224, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32603345

RESUMO

High quality census data are not always available in developing countries. Instead, mobile phone data are becoming a popular proxy to evaluate the density, activity and social characteristics of a population. They offer additional advantages: they are updated in real-time, include mobility information and record visitors' activity. However, we show with the example of Senegal that the direct correlation between the average phone activity and both the population density and the nighttime lights intensity may be insufficiently high to provide an accurate representation of the situation. There are reasons to expect this, such as the heterogeneity of the market share or the particular granularity of the distribution of cell towers. In contrast, we present a method based on the daily, weekly and yearly phone activity curves and on the network characteristics of the mobile phone data, that allows to estimate more accurately such information without compromising people's privacy. This information can be vital for development and infrastructure planning. In particular, this method could help to reduce significantly the logistic costs of data collection in the particularly budget-constrained context of developing countries.


Assuntos
Telefone Celular , Censos , Densidade Demográfica , Coleta de Dados/métodos , Países em Desenvolvimento , Eletricidade , Humanos , Senegal
17.
Neurology ; 95(6): e697-e707, 2020 08 11.
Artigo em Inglês | MEDLINE | ID: mdl-32616677

RESUMO

OBJECTIVE: In UK Biobank (UKB), a large population-based prospective study, cases of many diseases are ascertained through linkage to routinely collected, coded national health datasets. We assessed the accuracy of these for identifying incident strokes. METHODS: In a regional UKB subpopulation (n = 17,249), we identified all participants with ≥1 code signifying a first stroke after recruitment (incident stroke-coded cases) in linked hospital admission, primary care, or death record data. Stroke physicians reviewed their full electronic patient records (EPRs) and generated reference standard diagnoses. We evaluated the number and proportion of cases that were true-positives (i.e., positive predictive value [PPV]) for all codes combined and by code source and type. RESULTS: Of 232 incident stroke-coded cases, 97% had EPR information available. Data sources were 30% hospital admission only, 39% primary care only, 28% hospital and primary care, and 3% death records only. While 42% of cases were coded as unspecified stroke type, review of EPRs enabled a pathologic type to be assigned in >99%. PPVs (95% confidence intervals) were 79% (73%-84%) for any stroke (89% for hospital admission codes, 80% for primary care codes) and 83% (74%-90%) for ischemic stroke. PPVs for small numbers of death record and hemorrhagic stroke codes were low but imprecise. CONCLUSIONS: Stroke and ischemic stroke cases in UKB can be ascertained through linked health datasets with sufficient accuracy for many research studies. Further work is needed to understand the accuracy of death record and hemorrhagic stroke codes and to develop scalable approaches for better identifying stroke types.


Assuntos
Acidente Vascular Cerebral/epidemiologia , Adulto , Idoso , Isquemia Encefálica/epidemiologia , Coleta de Dados/métodos , Conjuntos de Dados como Assunto , Atestado de Óbito , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Incidência , Classificação Internacional de Doenças , Masculino , Pessoa de Meia-Idade , Admissão do Paciente/estatística & dados numéricos , Atenção Primária à Saúde/estatística & dados numéricos , Estudos Prospectivos , Reino Unido/epidemiologia
18.
PLoS One ; 15(7): e0236189, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32697795

RESUMO

Research based on secondary analysis of data stored in electronic health records (EHR) has gained popularity, but whether the data are consistent with those collected under a study setting is unknown. The objective is to assess the agreement between data obtained in a prospective study and routine-care data extracted retrospectively from the EHR. We compared the data collected in a longitudinal lifestyle intervention study with those recorded in the EHR system over 5 years. A total of 225 working adults were recruited at an academic institution between 2008-2012, whose EHR data were also available during the same time period. After aligning the participants' study visit dates with their hospital encounter dates, data on blood pressure, body mass index (BMI), and laboratory measurements (including high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides, and total cholesterol) were compared via a paired t-test for equivalence with pre-specified margins. Summary statistics were used to compare smoking status and medication prescriptions. Overall, data were consistent between the two sources (i.e., BMI, smoking status, medication prescriptions), whereas some differences were found in cholesterol measurements (i.e., HDL and total cholesterol), possibly due to different lab assays and subject's fasting status. In conclusion, some EHR data are fairly consistent with those collected in a clinical study, whereas others may require further examination. Researchers should evaluate the consistency and quality of EHR data and compare them with other sources of data when possible.


Assuntos
Coleta de Dados/métodos , Registros Eletrônicos de Saúde/estatística & dados numéricos , Comportamento de Redução do Risco , Adulto , Idoso , Determinação da Pressão Arterial/estatística & dados numéricos , Índice de Massa Corporal , Colesterol/sangue , Prescrições de Medicamentos/estatística & dados numéricos , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Estudos Retrospectivos , Fumar/efeitos adversos , Fumar/epidemiologia , Triglicerídeos/sangue , Adulto Jovem
19.
PLoS One ; 15(6): e0233154, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32520948

RESUMO

Proponents of big data claim it will fuel a social research revolution, but skeptics challenge its reliability and decontextualization. The largest subset of big data is not designed for social research. Data augmentation-systematic assessment of measurement against known quantities and expansion of extant data with new information-is an important tool to maximize such data's validity and research value. Using trained research assistants or specialized algorithms are common approaches to augmentation but may not scale to big data or appease skeptics. We consider a third alternative: data augmentation with online crowdsourcing. Three empirical cases illustrate strengths and limitations of crowdsourcing, using Amazon Mechanical Turk to verify automated coding, link online databases, and gather data on online resources. Using these, we develop best practice guidelines and a reporting template to enhance reproducibility. Carefully designed, correctly applied, and rigorously documented crowdsourcing help address concerns about big data's usefulness for social research.


Assuntos
Crowdsourcing/métodos , Coleta de Dados/métodos , Ciências Sociais/métodos , Big Data , Humanos , Reprodutibilidade dos Testes , Ciências Sociais/tendências
20.
Ceska Gynekol ; 85(2): 139-143, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32527109

RESUMO

OBJECTIVE: To informed about international surveillance network severe maternal morbidity and mortality - INOSS. DESIGN: Literature review. SETTINGS: 1st Department of Gynaecology and Obstetrics Faculty of Medicine, Comenius University and University Hospital, Bratislava, Slovak Republic. METHODS: Literate review of articles published till august 2019. RESULTS: The International Network of Obstetric Survey Systems (INOSS) is an international network that connects countries with the same or similar system of surveillance of acute severe maternal morbidity and mortality. The INOSS was established in year 2010 by twelve countries. Nowadays 19 countries are involved in the INOSS. The cooperation between member countries is focused on the acquisition of relevant data about rare severe acute maternal morbidities. INOSS in 2017 year unified definitions of 8 severe acute maternal morbidities according Delphi method: eclampsia, amniotic fluid embolism, peripartum hysterectomy, severe primary postpartum haemorrhage, uterine rupture, abnormally invasive placenta, spontaneous hemoperitoneum in pregnancy, and cardiac arrest in pregnancy. CONCLUSION: The international cooperation allows the acquisition of relevant epidemiologic data and the optimalization of the treatment according the evidence-based medicine.


Assuntos
Coleta de Dados/métodos , Medicina Baseada em Evidências/organização & administração , Mortalidade Materna , Morbidade , Complicações do Trabalho de Parto , Vigilância da População , Complicações na Gravidez , Medicina Baseada em Evidências/métodos , Feminino , Humanos , Cooperação Internacional , Complicações do Trabalho de Parto/epidemiologia , Gravidez , Complicações na Gravidez/epidemiologia , Sistema de Registros , Eslováquia/epidemiologia , Inquéritos e Questionários
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