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1.
PLoS Med ; 18(10): e1003793, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34665805

RESUMO

BACKGROUND: The importance of infectious disease epidemic forecasting and prediction research is underscored by decades of communicable disease outbreaks, including COVID-19. Unlike other fields of medical research, such as clinical trials and systematic reviews, no reporting guidelines exist for reporting epidemic forecasting and prediction research despite their utility. We therefore developed the EPIFORGE checklist, a guideline for standardized reporting of epidemic forecasting research. METHODS AND FINDINGS: We developed this checklist using a best-practice process for development of reporting guidelines, involving a Delphi process and broad consultation with an international panel of infectious disease modelers and model end users. The objectives of these guidelines are to improve the consistency, reproducibility, comparability, and quality of epidemic forecasting reporting. The guidelines are not designed to advise scientists on how to perform epidemic forecasting and prediction research, but rather to serve as a standard for reporting critical methodological details of such studies. CONCLUSIONS: These guidelines have been submitted to the EQUATOR network, in addition to hosting by other dedicated webpages to facilitate feedback and journal endorsement.


Assuntos
Pesquisa Biomédica/normas , COVID-19/epidemiologia , Lista de Checagem/normas , Epidemias , Guias como Assunto/normas , Projetos de Pesquisa , Pesquisa Biomédica/métodos , Lista de Checagem/métodos , Doenças Transmissíveis/epidemiologia , Epidemias/estatística & dados numéricos , Previsões/métodos , Humanos , Reprodutibilidade dos Testes
3.
BJOG ; 128(12): 2013-2021, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34363293

RESUMO

OBJECTIVE: To understand the prevalence of intrapartum oxytocin use, assess associated perinatal and maternal outcomes, and evaluate the impact of a WHO Safe Childbirth Checklist intervention on oxytocin use at primary-level facilities in Uttar Pradesh, India. DESIGN: Secondary analysis of a cluster-randomised controlled trial. SETTING: Thirty Primary and Community public health facilities in Uttar Pradesh, India from 2014 to 2017. POPULATION: Women admitted to a study facility for childbirth at baseline, 2, 6 or 12 months after intervention initiation. METHODS: The BetterBirth intervention aimed to increase adherence to the WHO Safe Childbirth Checklist. We used Rao-Scott Chi-square tests to compare (1) timing of oxytocin use between study arms and (2) perinatal mortality and resuscitation of infants whose mothers received intrapartum oxytocin versus who did not. MAIN OUTCOME MEASURES: Intrapartum and postpartum oxytocin administration, perinatal mortality, use of neonatal bag and mask. RESULTS: We observed 5484 deliveries. At baseline, intrapartum oxytocin was administered to 78.2% of women. Two months after intervention initiation, intrapartum oxytocin (I) was administered to 32.1% of women compared with 70.6% in the control (C) (P < 0.01); this difference diminished after the end of the intervention (I = 48.2%, C = 74.7%, P = 0.03). Partograph use remained at <1% at all facilities. Resuscitation was performed on 7.5% of infants whose mother received intrapartum oxytocin versus 2.0% who did not (P < 0.0001). CONCLUSIONS: In this setting, intrapartum oxytocin use was high despite limited maternal/fetal monitoring or caesarean capability, and was associated with increased neonatal resuscitation. The BetterBirth intervention was successful at decreasing intrapartum oxytocin use. Ongoing support is needed to sustain these practices. TWEETABLE ABSTRACT: Coaching + WHO Safe Childbirth Checklist reduces intrapartum oxytocin use and need for newborn resuscitation.


Assuntos
Lista de Checagem/métodos , Parto Obstétrico/estatística & dados numéricos , Tutoria/métodos , Ocitocina/uso terapêutico , Ressuscitação/estatística & dados numéricos , Adulto , Lista de Checagem/normas , Análise por Conglomerados , Parto Obstétrico/normas , Feminino , Fidelidade a Diretrizes/estatística & dados numéricos , Humanos , Índia , Recém-Nascido , Tutoria/normas , Parto/efeitos dos fármacos , Mortalidade Perinatal , Gravidez , Melhoria de Qualidade , Organização Mundial da Saúde
4.
Res Nurs Health ; 44(5): 854-863, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34196013

RESUMO

Fidelity (consistency of intervention implementation) is essential to rigorous research. Intervention fidelity maintains study internal validity, intervention reproducibility, and transparency in the research conduct. The purpose of this manuscript is to describe intervention fidelity strategies/procedures developed for a pilot study testing a new palliative care nursing intervention (FamPALcare) for families managing advanced lung disease. The procedures described herein are based on the fidelity best practices recommendations from the NIH Consortium. An evidence-based checklist guided observational ratings of the fidelity procedures used and the intervention content implemented in each intervention session. Descriptive data on how participants understood (received), enacted, or used the intervention information were summarized. The fidelity checklist observational scores found ≥93% of the planned intervention content was implemented, and the fidelity strategies were adhered to consistently during each intervention session. The small variation (7%) in implementation was expected and related to participants' varying experiences, input, and/or questions. The helpfulness scale items include participants' ability to use home care resources, to anticipate and manage end-of-life symptoms, and to use Advance Directive forms. The high ratings (M = 4.4) on the 1-5 (very helpful) Likert Helpfulness Scale verified participants utilized the information from the intervention. Furthermore, there was an improvement in patients' breathlessness scores and completion of Advance Directive forms at 3 months after baseline. It is essential to plan intervention fidelity strategies to use throughout a study and to report fidelity results.


Assuntos
Serviços de Assistência Domiciliar/estatística & dados numéricos , Serviços de Assistência Domiciliar/normas , Neoplasias Pulmonares/terapia , Pesquisa em Enfermagem/normas , Cuidados Paliativos/estatística & dados numéricos , Cuidados Paliativos/normas , Qualidade da Assistência à Saúde/normas , Adulto , Idoso , Idoso de 80 Anos ou mais , Lista de Checagem/métodos , Lista de Checagem/normas , Feminino , Guias como Assunto , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Reprodutibilidade dos Testes
5.
J Clin Epidemiol ; 138: 40-48, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34182146

RESUMO

BACKGROUND: Predatory journals (PJs) pose a threat to the quality/integrity of scientific publishing. Checklists have been proposed to identify PJs, but few are "evidence-based". This study's objective was to search for/assess evidence-based checklists (EBCs) for reliability and validity, based on a new consensus definition of PJs. METHODS: A published methods guideline for scale development was used to identify how many steps were completed in the generation of identified EBCs. Items from each EBC were compared against the consensus definition, and a list of items to be considered in the creation of a composite EBC to identify PJs was generated. RESULTS: Four EBCs were identified. None of these had completed the first of the nine steps for scale development and validation. Forty-seven items from the four EBCs were assessed against the consensus definition, of which 28 items fell within the definition. A proposed composite EBC was created from items matching components of the consensus definition. CONCLUSION: EBCs to detect PJs lack assessment of reliability and validity. To a varying degree, the EBCs contain items that match the scope of the new consensus definition of PJs. With the recent consensus definition, EBCs creators now have a clearer target, and can make adjustments.


Assuntos
Lista de Checagem/normas , Guias como Assunto , Publicações Periódicas como Assunto/normas , Relatório de Pesquisa/normas , Lista de Checagem/estatística & dados numéricos , Humanos , Publicações Periódicas como Assunto/estatística & dados numéricos , Reprodutibilidade dos Testes
6.
S Afr Med J ; 111(2): 106-109, 2021 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-33944718

RESUMO

BACKGROUND: Evaluation of the quality of healthcare depends on measures of structures, processes and outcomes. Progress in recording data allows for better measures of processes, such as the completeness of clinical data, the performance of professional tasks and the use of checklists. OBJECTIVES: To report the results of a radiotherapy (RT) workflow audit and a subsequent online survey of user experience. METHODS: The RT workflow audit was developed in 2016 and has been undertaken twice a year at 28 facilities or units, with a total of 32 linear accelerators. Electronic patient folders were reviewed to assess the documentation of 90 task items, of which 64 were scored. The auditor came from another facility. The online survey took place in July 2020. It contained questions on the audit's process, professional value and future use. Invitations were sent by email to the 151 radiotherapist staff at the 28 units where the audit had been implemented. Responses were anonymous. RESULTS: For the RT workflow audit, scores improved from 60% in some units in 2016 to >90% in all units for at least 2 years since 2018. The number of responders to the online survey was 58, giving a responder rate of 38%. The margin of error of the results was 10%. The audit's task items were considered appropriate by 77% of responders, and feedback was reported by 78% of them. The audit was considered very or extremely valuable to their unit's service delivery by 58% of responders. Changes in the unit as a result of the audit were reported by 77% of responders. The audit was very useful or extremely useful to 75% of responders in maintaining personal professional standards. The proportion of responders who were very or extremely supportive of continuing with the audit was 77%. The comments in the online survey will be helpful for ongoing review of the RT workflow audit. CONCLUSIONS: The RT workflow audit extends the scope of accreditation audits by including measures of processes. Users of the audit evaluate its processes favourably and report that it has value both in their unit's clinical service and for their personal professional standards. The audit is effective in developing quality improvement programmes.


Assuntos
Auditoria Médica/normas , Melhoria de Qualidade/normas , Radioterapia (Especialidade)/normas , Fluxo de Trabalho , Lista de Checagem/normas , Registros Eletrônicos de Saúde , Humanos , Radioterapia/normas , África do Sul
7.
PLoS Biol ; 19(5): e3001177, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33951050

RESUMO

In an effort to better utilize published evidence obtained from animal experiments, systematic reviews of preclinical studies are increasingly more common-along with the methods and tools to appraise them (e.g., SYstematic Review Center for Laboratory animal Experimentation [SYRCLE's] risk of bias tool). We performed a cross-sectional study of a sample of recent preclinical systematic reviews (2015-2018) and examined a range of epidemiological characteristics and used a 46-item checklist to assess reporting details. We identified 442 reviews published across 43 countries in 23 different disease domains that used 26 animal species. Reporting of key details to ensure transparency and reproducibility was inconsistent across reviews and within article sections. Items were most completely reported in the title, introduction, and results sections of the reviews, while least reported in the methods and discussion sections. Less than half of reviews reported that a risk of bias assessment for internal and external validity was undertaken, and none reported methods for evaluating construct validity. Our results demonstrate that a considerable number of preclinical systematic reviews investigating diverse topics have been conducted; however, their quality of reporting is inconsistent. Our study provides the justification and evidence to inform the development of guidelines for conducting and reporting preclinical systematic reviews.


Assuntos
Revisão da Pesquisa por Pares/métodos , Revisão da Pesquisa por Pares/normas , Projetos de Pesquisa/normas , Experimentação Animal/normas , Animais , Viés , Lista de Checagem/normas , Avaliação Pré-Clínica de Medicamentos/métodos , Avaliação Pré-Clínica de Medicamentos/normas , Pesquisa Empírica , Métodos Epidemiológicos , Epidemiologia/tendências , Humanos , Revisão da Pesquisa por Pares/tendências , Publicações , Reprodutibilidade dos Testes , Projetos de Pesquisa/tendências
10.
Ann Ist Super Sanita ; 57(1): 74-79, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33797409

RESUMO

INTRODUCTION: Standardized diabetes monitoring checklists is an efficient registry collection tool and diabetes care improvement aid. Aim of this study was to improve the management of diabetes according to international standards and based on Joint Action CHRODIS Recommendations and Criteria, and to improve general practitioners (GPs) awareness of importance of monitoring via diabetes checklists. POPULATION AND METHODS: Twenty-eight GPs and 1242 diabetic patients were included. GPs were divided in groups regarding the intensity of education and information provided. Quantitative analyses of diabetes quality indicators and their availability as well as qualitative study in intensive group were performed. RESULTS: Average number of patients with fulfilled checklists per GP increased from 20.2 to 30.8 (52.30%). Most GPs had positive attitude towards checklists but there is still a room for further improvement. DISCUSSION AND CONCLUSIONS: Checklists are perceived as positive initiatives by GPs; however, there are areas for further improvements. General practitioners education and feedback regarding the checklists may contribute to better monitoring of patients with diabetes.


Assuntos
Lista de Checagem/normas , Diabetes Mellitus , Sistema de Registros , Croácia , Humanos , Guias de Prática Clínica como Assunto
11.
Medicine (Baltimore) ; 100(11): e24841, 2021 Mar 19.
Artigo em Inglês | MEDLINE | ID: mdl-33725955

RESUMO

ABSTRACT: Symptom Checklist-90 (SCL-90) is the popular and widely used instrument, whether in mental health screening, psychological consultation, or the diagnosis and estimate of mental illness. In 1984, it was translated from theEnglish version into Chinese and then SCL-90 has been widely used in China. It is a pity that the item text of Chinese version has not been revised since the birth of it until today. We analyzed the Chinese version of the 90-item text from 3 new perspectives: translation, semantic, and cross-cultural, and thought that 18 items should be revised. This study' results have taken one step forward on the basis of previous studies, which will play an important role in improving the quality of Chinese version SCL-90 and improving the mental health level of Chinese people.


Assuntos
Lista de Checagem/normas , Transtornos Mentais/diagnóstico , Testes Psicológicos/normas , Semântica , Avaliação de Sintomas/normas , /psicologia , China , Comparação Transcultural , Humanos , Psicometria , Reprodutibilidade dos Testes , Traduções
12.
Am J Physiol Cell Physiol ; 320(5): C742-C749, 2021 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-33656929

RESUMO

Integrating sex as an important biological variable is imperative to enhance the accuracy and reproducibility of cell-based studies, which provide basic information for subsequent preclinical and clinical study designs. Recently, international funding agencies and renowned journals have been attempting to integrate sex as a variable in every research step. To understand what progress has been made in reporting of cell sex in the articles published in AJP-Cell Physiology since the analysis in 2013, we examined the sex notation of the cells in relevant articles published in the same journal in 2018. Of the 107 articles reporting cell experiments, 53 reported the sex of the cells, 18 used both male and female cells, 23 used male cells only, and 12 used female cells only. Sex omission was more frequent when cell lines were used than when primary cells were used. In the articles describing experiments performed using rodent primary cells, more than half of the studies used only male cells. Our results showed an overall improvement in sex reporting for cells in AJP-Cell Physiology articles from 2013 (25%) to 2018 (50%). However, sex omission and male bias were often found still. Furthermore, the obtained results were rarely analyzed by sex even when both male and female cells were used in the experiments. To boost sex-considerate research implementation in basic biomedical studies, cooperative efforts of the research community, funders, and publishers are urged.


Assuntos
Viés , Publicações Periódicas como Assunto/normas , Projetos de Pesquisa/normas , Caracteres Sexuais , Animais , Linhagem Celular , Lista de Checagem/normas , Políticas Editoriais , Feminino , Guias como Assunto/normas , Humanos , Masculino , Cultura Primária de Células , Fatores Sexuais
13.
CMAJ Open ; 9(1): E295-E301, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33785477

RESUMO

BACKGROUND: The quality of case reports, which are often the first reported evidence for a disease, may be negatively affected by a rush to publication early in a pandemic. We aimed to determine the completeness of reporting (COR) for case reports published on coronavirus disease 2019 (COVID-19). METHODS: We conducted a systematic search of the PubMed database for all single-patient case reports of confirmed COVID-19 published from Jan. 1 to Apr. 24, 2020. All included case reports were assessed for adherence to the CARE (Case Report) 31-item checklist, which was used to create a composite COR score. The primary outcome was the mean COR score assessed by 2 independent raters. Secondary outcomes included whether there was a change in overall COR score with certain publication factors (e.g., publication date) and whether there was a linear relation between COR and citation count and between COR scores and social media attention. RESULTS: Our search identified 196 studies that were published in 114 unique journals. We found that the overall mean COR score was 54.4%. No one case report included all of the 31 CARE checklist items. There was no significant correlation between COR with either citation count or social media attention. INTERPRETATION: We found that the overall COR for case reports on COVID-19 was poor. We suggest that journals adopt common case-reporting standards to improve reporting quality.


Assuntos
COVID-19/epidemiologia , Lista de Checagem/normas , Editoração/normas , Relatório de Pesquisa/normas , Bibliografia de Medicina , Bibliometria , COVID-19/diagnóstico , COVID-19/virologia , Gerenciamento de Dados , Estudos Epidemiológicos , Ética , Fidelidade a Diretrizes , Humanos , Avaliação de Resultados em Cuidados de Saúde , Relatório de Pesquisa/tendências , SARS-CoV-2/genética , SARS-CoV-2/isolamento & purificação , Mídias Sociais/estatística & dados numéricos
15.
Intern Emerg Med ; 16(8): 2269-2276, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33687692

RESUMO

Checklists can improve adherence to standardized procedures and minimize human error. We aimed to test if implementation of a checklist was feasible and effective in enhancing patient care in an emergency department handling internal medicine cases. We developed four critical event checklists and confronted volunteer teams with a series of four simulated emergency scenarios. In two scenarios, the teams were provided access to the crisis checklists in a randomized cross-over design. Simulated patient outcome plus statement of the underlying diagnosis defined the primary endpoint and adherence to key processes such as time to commence CPR represented the secondary endpoints. A questionnaire was used to capture participants' perception of clinical relevance and manageability of the checklists. Six teams of four volunteers completed a total of 24 crisis sequences. The primary endpoint was reached in 8 out of 12 sequences with and in 2 out of 12 sequences without a checklist (Odds ratio, 10; CI 1.11, 123.43; p = 0.03607, Fisher's exact test). Adherence to critical steps was significantly higher in all scenarios for which a checklist was available (performance score of 56.3% without checklist, 81.9% with checklist, p = 0.00284, linear regression model). All participants rated the checklist as useful and 22 of 24 participants would use the checklist in real life. Checklist use had no influence on CPR quality. The use of context-specific checklists showed a statistically significant influence on team performance and simulated patient outcome and contributed to adherence to standard clinical practices in emergency situations.


Assuntos
Lista de Checagem/normas , Simulação por Computador/estatística & dados numéricos , Adulto , Lista de Checagem/estatística & dados numéricos , Serviço Hospitalar de Emergência/organização & administração , Serviço Hospitalar de Emergência/estatística & dados numéricos , Feminino , Alemanha , Humanos , Masculino , Projetos Piloto , Inquéritos e Questionários
16.
Occup Ther Int ; 2021: 6658786, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33688309

RESUMO

Background: Sensory processing supports children's development and abilities to participate in activities across contexts. Self-regulation skills may influence how children process various sensory experiences in daily life activities. The Sensory Processing and Self-Regulation Checklist (SPSRC) is a 130-item caregiver-reported checklist, covering children's essential sensory processing and self-regulation performance in daily activities. Objectives: This study examines the psychometric properties of the SPSRC (English version) in measuring the sensory processing and self-regulation abilities of children. Methods: A preliminary field testing of the SPSRC-English was conducted in a sample of n = 194 children (164 without disability and 30 with a disability) to evaluate its reliability and validity properties. Results: The SPSRC-English was shown to have high internal consistency and test-retest reliability; and good discriminant, structural, and criterion validity in the sensory processing and self-regulation abilities of children with and without disability ages 4-12 years. Conclusion: The current study provides initial evidence on the reliability and validity of SPSRC-English in measuring the sensory processing and self-regulation abilities in children with and without a disability. The SPSRC-English may provide salient information supporting the understanding of sensory processing difficulties among children.


Assuntos
Transtorno do Espectro Autista/diagnóstico , Lista de Checagem/normas , Deficiências do Desenvolvimento/diagnóstico , Psicometria/estatística & dados numéricos , Autocontrole , Inquéritos e Questionários/normas , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Percepção , Reprodutibilidade dos Testes
17.
Best Pract Res Clin Anaesthesiol ; 35(1): 41-51, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33742577

RESUMO

Anaesthetists play a major role in the perioperative treatment of patients, sharing responsibility for quality and safety in anaesthesia, intensive care, emergency and pain medicine. Several aspects lead to the fact that these issues are particularly important in obstetric anaesthesia. As morbidity and mortality are dramatically higher than in a nonpregnant population in this age, there is room for improvement even in regions with a well-developed healthcare system. Adverse events and complications during birth often hit fast, hard and unexpectedly and require immediate patient-centred care. This mostly involves an interdisciplinary and interprofessional approach that includes obstetricians, neonatologists, anaesthetists, intensivists and of course midwives and nurses. In this article, established standards and emerging possibilities to improve patient safety by developing a culture of awareness for safety aspects, education, establishing safety and communication strategies and performing teamwork- and simulation training are discussed. Apart from these issues, self-care of clinicians is vital in the prevention of adverse events, because fatigue and burnout are associated with increased rates of complications.


Assuntos
Anestesia Obstétrica/normas , Anestesiologistas/normas , Cuidado do Lactente/normas , Saúde Materna/normas , Equipe de Assistência ao Paciente/normas , Assistência Centrada no Paciente/normas , Anestesia Obstétrica/métodos , Esgotamento Profissional/prevenção & controle , Esgotamento Profissional/psicologia , Lista de Checagem/métodos , Lista de Checagem/normas , Feminino , Humanos , Cuidado do Lactente/métodos , Recém-Nascido , Assistência Centrada no Paciente/métodos , Gravidez
18.
J Autism Dev Disord ; 51(3): 994-1006, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33591436

RESUMO

Most children with autism spectrum disorder (ASD), in resource-limited settings (RLS), are diagnosed after the age of four. Our work confirmed and extended results of Pierce that eye tracking could discriminate between typically developing (TD) children and those with ASD. We demonstrated the initial 15 s was at least as discriminating as the entire video. We evaluated the GP-MCHAT-R, which combines the first 15 s of manually-coded gaze preference (GP) video with M-CHAT-R results on 73 TD children and 28 children with ASD, 36-99 months of age. The GP-MCHAT-R (AUC = 0.89 (95%CI: 0.82-0.95)), performed significantly better than the MCHAT-R (AUC = 0.78 (95%CI: 0.71-0.85)) and gaze preference (AUC = 0.76 (95%CI: 0.64-0.88)) alone. This tool may enable early screening for ASD in RLS.


Assuntos
Transtorno do Espectro Autista/diagnóstico , Lista de Checagem/métodos , Tecnologia de Rastreamento Ocular , Fixação Ocular/fisiologia , Recursos em Saúde , Programas de Rastreamento/métodos , Transtorno do Espectro Autista/epidemiologia , Transtorno do Espectro Autista/fisiopatologia , Lista de Checagem/normas , Criança , Pré-Escolar , Tecnologia de Rastreamento Ocular/normas , Feminino , Recursos em Saúde/normas , Humanos , Masculino , Programas de Rastreamento/normas , Peru/epidemiologia
19.
Laryngoscope ; 131(7): E2251-E2256, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33434315

RESUMO

OBJECTIVE/HYPOTHESIS: To appraise the utility of a novel EMR-based checklist for complex head and neck microvascular free-tissue reconstruction. STUDY DESIGN: A prospectively collected retrospective matched cohort study from a single tertiary care academic institution. METHODS: A retrospective matched cohort study from an academic tertiary care center with 76 total patients analyzed for disease-specific and quality outcomes before and after implementation of an EMR-based checklist tailored to complex head and neck care. The intervention group consisted of 38 consecutive patients undergoing microvascular free tissue reconstruction after implementation of the EMR-based checklist strategy. A historic cohort of 38 patients was derived by matching patients meticulously for disease-specific and surgical characteristics. Primary outcomes included post-operative medical and surgical complications, intensive care requirements, 30-day reoperation rates, hospital length of stay, and completion of preoperative metastatic evaluations. Secondary outcomes included patterns of antibiotic administration, ultimate discharge dispositions, flap survival, and recognition of preoperative hypothyroidism in previously radiated patients. RESULTS: Implementation of the perioperative checklist yielded an overall reduction in major medical complications (10.5% vs. 29.0%, P < .05*), post-operative antibiotic administration (17.4% vs. 44.7%, P < .05*), hospital length of stay (median (IQR) days 6 (1) versus 7 (3.25), P < .05*), and improved metastatic evaluation completion (92.1% vs. 63.2%, P < .05*). There was an improved discharge disposition (92.1% vs. 73.7%, P < .05*). No difference was observed in major wound complications (50.0% vs. 57.9%, P = .49), 30-day re-operation rates (31.5% vs. 34.2%, P = .81), 30-day readmission rates (21.1% vs. 21.1%, P > .99), escalations to intensive-care (13.2% vs. 21.1%, P = .36), or flap survival (97.4% vs. 89.5%, P = .17). CONCLUSIONS: Use of our EMR-based perioperative checklist reduced major medical complications, post-operative antibiotic administration, hospital length of stay, and improved discharge outcomes for patients undergoing microvascular free-tissue reconstruction. LEVEL OF EVIDENCE: 3 Laryngoscope, 131:E2251-E2256, 2021.


Assuntos
Lista de Checagem/normas , Neoplasias de Cabeça e Pescoço/cirurgia , Microvasos/cirurgia , Assistência Perioperatória/normas , Procedimentos Cirúrgicos Reconstrutivos/normas , Adulto , Registros Eletrônicos de Saúde , Feminino , Retalhos de Tecido Biológico , Cabeça/cirurgia , Implementação de Plano de Saúde , Humanos , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Pescoço/cirurgia , Alta do Paciente/estatística & dados numéricos , Readmissão do Paciente/estatística & dados numéricos , Assistência Perioperatória/métodos , Estudos Prospectivos , Melhoria de Qualidade , Procedimentos Cirúrgicos Reconstrutivos/métodos , Reoperação/estatística & dados numéricos , Estudos Retrospectivos , Resultado do Tratamento
20.
J Trauma Stress ; 34(1): 248-256, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33089510

RESUMO

The Life Events Checklist for DSM-5 (LEC-5) is a comprehensive screening instrument used to detect exposure to a range of potentially traumatic events. Despite its widespread use, research assessing the psychometric properties of scores on the LEC-5-and trauma exposure more broadly-is scarce. Using a large sample of undergraduate students (N = 1,013), we sought to evaluate the reliability of trauma exposure reporting on the LEC-5 across 8- (N = 379) and 12-week (N = 343) intervals. Reliability estimates were examined for trauma exposure type (e.g., experiencing, witnessing), traumatic event type (e.g., sexual assault), and index trauma (i.e., "worst event") reporting. Reliability was more stable for events that were directly experienced, intraclass correlation coefficients (ICCs) = .62-64, than events that were witnessed, ICCs = .47-.52, or learned about, ICCs = .48-.53. Test-retest agreement was fair to good for reports of sexual assault, physical assault, transportation accidents, natural disasters, and other sexual experiences, κs = .49-.72, but only when individuals directly experienced these events. By contrast, across both assessment intervals, the agreement was attenuated, all κs < .40, for events that individuals witnessed or learned about regardless of event type. For index events, only sexual assault and sudden accidental or violent deaths were consistently reported with a fair or better agreement, κs = .42-.64. These findings suggest that reliable trauma reporting varies largely based on the nature of the traumatic event, yielding important implications for the assessment of DSM-5 Criterion A and posttraumatic stress disorder.


Assuntos
Lista de Checagem/normas , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Adolescente , Adulto , Exposição à Violência/psicologia , Feminino , Humanos , Acontecimentos que Mudam a Vida , Masculino , Reprodutibilidade dos Testes , Autorrelato , Adulto Jovem
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