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1.
Clin Transplant ; 36(9): e14774, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-35829691

RESUMO

INTRODUCTION AND OBJECTIVES: The Index for Mortality Prediction After Cardiac Transplantation (IMPACT) score was derived and validated as a predictor of mortality after heart transplantation (HT). The primary objective of this work is to externally validate the IMPACT score in a contemporary Spanish cohort. METHODS: Spanish Heart Transplant Registry data were used to identify adult (>16 years) HT patients between January 2000 and December 2015. Retransplantation, multiorgan transplantation and patients in whom at least one of the variables required to calculate the IMPACT score was missing were excluded from the analysis (N = 2810). RESULTS: Median value of the IMPACT score was five points (IQR: 3, 8). Overall, 1-year survival rate was 79.1%. Kaplan-Meier 1-year survival rates by IMPACT score categories (0-2, 3-5, 6-9, 10-14, ≥15) were 84.4%, 81.5%, 79.3%, 77.3%, and 58.5%, respectively (Log-Rank test: p < .001). Performance analysis showed a good calibration (Hosmer-Lemeshow chi-square for 1 year was 7.56; p = .47) and poor discrimination ability (AUC-ROC .59) of the IMPACT score as a predictive model. CONCLUSIONS: In a contemporary Spanish cohort, the IMPACT score failed to accurately predict the risk of death after HT.


Assuntos
Transplante de Coração , Adulto , Estudos de Coortes , Humanos , Sistema de Registros , Medição de Risco , Taxa de Sobrevida
2.
Colorectal Dis ; 24(6): 773-781, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35090085

RESUMO

OBJECTIVE: To test the reliability and validity of the Chinese version of the colostomy impact score (CIS) among patients with a permanent colostomy in China. METHODS: A total of 218 patients completed the survey either in the clinic or remotely and mailed their responses. Reliability was estimated based on test-retest reliability. Validity was evaluated based on content validity, construct validity, and discriminative validity. The sensitivity and specificity of the score were analysed. The area under the curve was analysed by drawing the receiver-operating characteristic (ROC) curve; the optimal cutoff point was calculated to assess the impact of a stoma on domestic patients. RESULTS: The test-retest reliability of the CIS was 0.967. The content validity was 0.98, and the construct and discriminative validities were good; sensitivity, specificity, and area under the ROC curve were 100, 48.53, and 0.806%, respectively. The optimal cutoff point for the Chinese version of the Colostomy Impact Score was 11.5. CONCLUSIONS: The Chinese version of the CIS indicated good reliability and validity, making it suitable for the evaluation of the impact of a permanent colostomy.


Assuntos
Colostomia , Neoplasias Retais , China , Humanos , Psicometria , Neoplasias Retais/cirurgia , Reprodutibilidade dos Testes , Inquéritos e Questionários
3.
Telemed J E Health ; 27(9): 1029-1038, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-33170109

RESUMO

Background: Clinical studies of telemedicine (TM) programs for chronic illness have demonstrated mixed results across settings and populations. With recent uptake in use of digital health modalities, more precise patient classification may improve outcomes, efficiency, and effectiveness. Objective: The purpose of the research was to develop a predictive score that measures the influence of patient characteristics on TM interventions. The central hypothesis is that disease type, illness severity, and the social determinants of health influence outcomes, including resource utilization, and can be precisely characterized. Methods: The retrospective study evaluated the feasibility of creating a patient "Telemedicine ImPact" (TIP) score derived from a Virginia Medicare and Medicaid claims data set. Claims were randomly selected, stratified by disease type, and matched by illness severity into a TM intervention group (N = 7,782) and a nontelemedicine "usual care" control cohort (N = 7,981). The individual records were then summarized into 15,762 cases with 80% of the cases used to develop, train, and test four predictive models (hospital utilization, readmissions, total utilization, and mortality) using 10-fold cross-validation. Results: Bayesian supervised machine learning achieved reference model performance index area under the curve for receiver operating characteristic (AUC/ROC) ≥0.85. Posterior probabilities for each outcome model were generated on a "hold-back" set of 3,082 cases. Robust parametric statistical methods enabled dimension reduction, model validation, and derivation of a reliable composite scaled score that quantified the overall health risk for each case. The TM intervention cohort demonstrated higher total utilization (representing the sum of inpatient, outpatient, and prescription use) and lower mean inpatient utilization than the usual standard of care. This finding suggests TM-based care may shift the composition of health resource utilization, reducing hospitalizations while increasing outpatient services, adjusted for patient differences. Conclusions: The creation of a patient score using machine learning to predict the effect of TM on outcomes is feasible. Adoption of the TIP score may reduce variability in results by more precisely accounting for the effects of patient characteristics on health outcomes and utilization. More consistent outcome prediction may lead to greater support for digital health.


Assuntos
Aprendizado de Máquina , Medicare , Idoso , Teorema de Bayes , Estudos de Coortes , Humanos , Estudos Retrospectivos , Estados Unidos
4.
Colorectal Dis ; 22(12): 2270-2277, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32741098

RESUMO

AIM: The colostomy impact (CI) score is a patient-reported outcome measure assessing reduction in health-related quality of life (HRQL) due to a stoma. The score was originally developed and validated in a cohort of rectal cancer survivors with a permanent colostomy. For the CI score to be applied to patients with a colostomy after surgery for a benign condition it must be validated in this patient group. The aim of this study was to assess construct validity and known groups validity of the CI score in patients with a colostomy after surgery for a benign condition. METHOD: In a cross-sectional survey among ostomates in the Capital Region of Denmark, patients completed the CI score and the SF-36 v2 questionnaires. Construct validity was assessed by Pearson's correlation coefficients and known groups validity was assessed by t-test when dividing patients into groups of minor or major CI. RESULTS: The CI score showed a moderate negative correlation with the Physical Component Summary (PCS) of -0.41 and a weak negative correlation with the Mental Component Summary (MCS) of -0.39. The strength of the correlation depended on the underlying condition leading to stoma formation. Differences were significant between the minor and major CI groups in mean PSC and MCS with t-values of 5.32 and 3.86, respectively. CONCLUSION: The CI score is a valid instrument for assessing stoma-related impact on HRQL regardless of the underlying condition leading to stoma formation, and the CI score discriminates meaningfully between groups with known differences in stoma-related reduced HRQL.


Assuntos
Colostomia , Estomas Cirúrgicos , Estudos Transversais , Humanos , Qualidade de Vida , Inquéritos e Questionários
5.
J Environ Manage ; 245: 210-215, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31154166

RESUMO

The iron and steel industry discharges large quantities of wastewater. The environmental impact of the wastewater is traditionally assessed from the quantitative aspect. However, the water quality of discharged wastewater plays a more significant role in damaging the natural environment. Moreover, comprehensive assessment of multi-pollutants in wastewater from both quality and quantity is still a gap. In this work, a total environmental impact score (TEIS) is defined to assess the environmental impact of wastewater discharge, by considering the volume of wastewater and the quality of main processes. To implement the comprehensively qualitative and quantitative assessment, a field monitoring and measurement of wastewater discharge volume and the quality is conducted to acquire pH, suspend solids (SS), chemical oxygen demand (COD), total nitrogen (TN), total iron (TFe), and hexavalent chromium (Cr(VI)). The sequence of TEIS values is obtained as steelmaking > ironmaking > sintering > hot rolling > coking > cold rolling and TN > COD > SS > pH > Cr(VI) > TFe. The TEIS of the investigated steel plant is 26.27. The leading process lies in steelmaking with a TEIS of 19.98. The dominant pollutant is TN with a TEIS of 15.00. Finally, a sensitivity analysis is performed to validate the feasibility and generalisability of the TEIS.


Assuntos
Poluentes Ambientais , Poluentes Químicos da Água , Análise da Demanda Biológica de Oxigênio , Ferro , Aço , Águas Residuárias
6.
Br J Nutr ; 115(10): 1860-74, 2016 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-26987378

RESUMO

The objective of this study was to develop a novel methodology that enables pig diets to be formulated explicitly for environmental impact objectives using a Life Cycle Assessment (LCA) approach. To achieve this, the following methodological issues had to be addressed: (1) account for environmental impacts caused by both ingredient choice and nutrient excretion, (2) formulate diets for multiple environmental impact objectives and (3) allow flexibility to identify the optimal nutritional composition for each environmental impact objective. An LCA model based on Canadian pig farms was integrated into a diet formulation tool to compare the use of different ingredients in Eastern and Western Canada. By allowing the feed energy content to vary, it was possible to identify the optimum energy density for different environmental impact objectives, while accounting for the expected effect of energy density on feed intake. A least-cost diet was compared with diets formulated to minimise the following objectives: non-renewable resource use, acidification potential, eutrophication potential, global warming potential and a combined environmental impact score (using these four categories). The resulting environmental impacts were compared using parallel Monte Carlo simulations to account for shared uncertainty. When optimising diets to minimise a single environmental impact category, reductions in the said category were observed in all cases. However, this was at the expense of increasing the impact in other categories and higher dietary costs. The methodology can identify nutritional strategies to minimise environmental impacts, such as increasing the nutritional density of the diets, compared with the least-cost formulation.


Assuntos
Ração Animal/análise , Fenômenos Fisiológicos da Nutrição Animal , Dieta/veterinária , Meio Ambiente , Animais , Canadá , Alimentos Formulados , Gado , Suínos
7.
Brain Inj ; 30(7): 899-907, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27058813

RESUMO

OBJECTIVE: To examine the performance of the International Mission for Prognosis and Clinical Trial Design in Traumatic Brain Injury (IMPACT) prognostic models in older patients. METHODS: Using data from the National Study on Costs and Outcomes of Trauma (NSCOT), this study identified adult patients presenting to US hospitals in 2001 and 2002 with non-penetrating moderate or severe traumatic brain injury (GCS ≤ 12). IMPACT model calibration and discrimination in the older stratum (65-84 years) was compared to that in the younger stratum (18-64 years). RESULTS: IMPACT model discrimination did not differ significantly between the older (n = 202; weighted n = 268) and younger strata (n = 613; weighted n = 1632) and was generally adequate (c-statistic for the core-death model = 0.81 [0.77-0.84] vs 0.75 [0.66-0.84], respectively; p = 0.26). IMPACT model calibration was poor for both older and younger strata (Hosmer-Lemeshow p-value for the core-death model = 0.01 vs < 0.0001, respectively). Pre-specified qualitative graphical evaluation suggested substantial under-prediction of mortality in the oldest decades of life, but not among younger patients. CONCLUSIONS: The examined IMPACT prognostic models demonstrated adequate discrimination and poor calibration in both older and younger patients, yet particular caution may be required when applying these models to the elderly.


Assuntos
Lesões Encefálicas Traumáticas/diagnóstico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Teóricos , Prognóstico , Adulto Jovem
8.
Eur J Med Res ; 28(1): 16, 2023 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-36624515

RESUMO

BACKGROUND: Orthotopic heart transplantation (HTX) is the gold standard to treat end-stage heart failure. Numerous risk stratification tools have been developed in the past years. However, their clinical utility is limited by their poor discriminative ability. High sensitivity troponin T (hsTnT) is the most specific biomarker to detect myocardial cell injury. However, its prognostic relevance after HTX is not fully elucidated. Thus, this study evaluated the predictive value of postoperative hsTnT for 1-year survival and days alive and out of hospital (DAOH) after HTX. METHODS: This retrospective cohort study included patients who underwent HTX at the University Hospital Duesseldorf, Germany between 2011 and 2021. The main exposure was hsTnT concentration at 48 h after HTX. The primary endpoints were mortality and DAOH within 1 year after surgery. Receiver operating characteristic (ROC) curve analysis, logistic regression model and linear regression with adjustment for risk index for mortality prediction after cardiac transplantation (IMPACT) were performed. RESULTS: Out of 231 patients screened, 212 were included into analysis (mean age 55 ± 11 years, 73% male). One-year mortality was 19.7% (40 patients) and median DAOH was 298 days (229-322). ROC analysis revealed strongest discrimination for mortality by hsTnT at 48 h after HTX [AUC = 0.79 95% CI 0.71-0.87]. According to Youden Index, the cutoff for hsTnT at 48 h and mortality was 1640 ng/l. After adjustment for IMPACT score multivariate logistic and linear regression showed independent associations between hsTnT and mortality/DAOH with odds ratio of 8.10 [95%CI 2.99-21.89] and unstandardized regression coefficient of -1.54 [95%CI -2.02 to -1.06], respectively. CONCLUSION: Postoperative hsTnT might be suitable as an early prognostic marker after HTX and is independently associated with 1-year mortality and poor DAOH.


Assuntos
Insuficiência Cardíaca , Transplante de Coração , Troponina T , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Hospitais , Miocárdio/patologia , Estudos Retrospectivos , Troponina T/sangue , Insuficiência Cardíaca/mortalidade , Insuficiência Cardíaca/cirurgia
9.
Asia Pac J Oncol Nurs ; 10(4): 100209, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-37159609

RESUMO

Objective: We aimed to establish and validate the Chinese version of the Pancreatic Cancer Disease Impact (C-PACADI) score for Chinese patients with pancreatic cancer (PC). Methods: This was a methodological and cross-sectional study. We established the C-PACADI score following Beaton's translation guidelines and then included 209 patients with PC to evaluate C-PACADI's reliability and validity. Results: The Cronbach's alpha coefficient of the C-PACADI score was 0.822. The correlation coefficient between "skin itchiness" score and the total score was 0.224, while the correlation coefficients ranged from 0.515 to 0.688 (P â€‹< â€‹0.001) for all the other items. The item content validity index and the scale content validity index, evaluated by eight experts were 0.875 and 0.98, respectively. Regarding concurrent validity, the total score of the C-PACADI score was moderately correlated with the EuroQol-5D (EQ-5D) index and the EQ-5D VAS score (r â€‹= â€‹-0.738, P â€‹< â€‹0.01; r â€‹= â€‹-0.667, P â€‹< â€‹0.01, respectively); the individual-item scores of C-PACADI on pain/discomfort, anxiety, loss of appetite, fatigue, and nausea were strongly associated with the corresponding symptoms of the Edmonton Symptom Assessment System scale (r ranged from 0.879 to 0.916, P â€‹< â€‹0.01). The known-group validity was demonstrated by C-PACADI's ability to detect significant symptom differences between groups stratified by treatment modalities (P â€‹< â€‹0.05) and health status (P â€‹< â€‹0.001). Conclusions: The C-PACADI score is a suitable disease-specific tool for measuring the prevalence and severity of multiple symptoms in the Chinese population with PC.

10.
Front Med (Lausanne) ; 10: 1275267, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38239619

RESUMO

Introduction: Cardiometabolic diseases (CMD) are the leading cause of death in high-income countries and are largely attributable to modifiable risk factors. Population health management (PHM) can effectively identify patient subgroups at high risk of CMD and address missed opportunities for preventive disease management. Guided by the Reach, Efficacy, Adoption, Implementation and Maintenance (RE-AIM) framework, this scoping review of PHM interventions targeting patients in primary care at increased risk of CMD aims to describe the reported aspects for successful implementation. Methods: A comprehensive search was conducted across 14 databases to identify papers published between 2000 and 2023, using Arksey and O'Malley's framework for conducting scoping reviews. The RE-AIM framework was used to assess the implementation, documentation, and the population health impact score of the PHM interventions. Results: A total of 26 out of 1,100 studies were included, representing 21 unique PHM interventions. This review found insufficient reporting of most RE-AIM components. The RE-AIM evaluation showed that the included interventions could potentially reach a large audience and achieve their intended goals, but information on adoption and maintenance was often lacking. A population health impact score was calculated for six interventions ranging from 28 to 62%. Discussion: This review showed the promise of PHM interventions that could reaching a substantial number of participants and reducing CMD risk factors. However, to better assess the generalizability and scalability of these interventions there is a need for an improved assessment of adoption, implementation processes, and sustainability.

11.
Pain Ther ; 10(1): 539-550, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33624253

RESUMO

INTRODUCTION: Multidisciplinary patient-reported outcomes are a critical part of assessing patients to better understand their well-being during treatment. The use of multidisciplinary patient-reported outcomes is recommended in many areas of medicine. The Patient-Reported Outcomes Measurement Information System-29 (PROMIS-29) has been utilized as a common measurement language across universally relevant domains, including pain, mood, sleep, social participation, and function. METHODS: Retrospective analysis of prospectively collected data was performed. Subjects were identified and consecutively enrolled upon entry into chronic pain centers across 24 sites in the United States. The PROMIS-29 v2.1 and the numerical rating scale (NRS) were recorded. The pain impact score and the Health Utilities Index Mark 3 (HUI-3) were calculated. Statistical differences were assessed between genders and among age groups comprising subjects less than 40, 41-60, 61-80, and over 80 years of age. RESULTS: A total of 19,546 patients were assessed over the enrollment period from 2018 to 2020. The PROMIS-29 v2.1 was evaluated across the seven domains, along with the numerical rating sale (NRS). The mean scores of the population for PROMIS SF v1.0 Pain Interference 4a, PROMIS SF v1.0 Sleep Disturbance 4a, PROMIS SF v1.0 Fatigue 4a, PROMIS SF v1.0 Anxiety 4a, PROMIS SF V1.0 Depression 4a, PROMIS SF v2.0 Ability to Participate in Social Roles and Activities 4a, and PROMIS SF v1.0 Physical Function 4a, measuring pain interference, sleep disturbance, fatigue, anxiety, depression, social participation, and physical function, were 64.61, 57.19, 58.50, 53.94, 54.45, 40.06, and 36.23, respectively. Pain intensity was 6.38 on an 11-point NRS scale. The pain impact score (PIS) and health utilities index mark 3 (HUI-3) scores, calculated across the designated age groups, were 33.19 and 0.67, respectively. Statistical differences were observed for the domains of sleep disturbance and physical function for age groups less than 40 and greater than 80 years of age. CONCLUSION: This data set is the first published normative data set describing the PROMIS-29 assessment in the chronic pain population. The patient population is more homogeneous than expected, and females were found to have higher levels of dysfunction.

12.
Scand J Trauma Resusc Emerg Med ; 29(1): 94, 2021 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-34274009

RESUMO

BACKGROUND: Traumatic brain injuries (TBI) are associated with high risk of morbidity and mortality. Early outcome prediction in patients with TBI require reliable data input and stable prognostic models. The aim of this investigation was to analyze different CT classification systems and prognostic calculators in a representative population of TBI-patients, with known outcomes, in a neurointensive care unit (NICU), to identify the most suitable CT scoring system for continued research. MATERIALS AND METHODS: We retrospectively included 158 consecutive patients with TBI admitted to the NICU at a level 1 trauma center in Sweden from 2012 to 2016. Baseline data on admission was recorded, CT scans were reviewed, and patient outcome one year after trauma was assessed according to Glasgow Outcome Scale (GOS). The Marshall classification, Rotterdam scoring system, Helsinki CT score and Stockholm CT score were tested, in addition to the IMPACT and CRASH prognostic calculators. The results were then compared with the actual outcomes. RESULTS: Glasgow Coma Scale score on admission was 3-8 in 38%, 9-13 in 27.2%, and 14-15 in 34.8% of the patients. GOS after one year showed good recovery in 15.8%, moderate disability in 27.2%, severe disability in 24.7%, vegetative state in 1.3% and death in 29.7%. When adding the variables from the IMPACT base model to the CT scoring systems, the Stockholm CT score yielded the strongest relationship to actual outcome. The results from the prognostic calculators IMPACT and CRASH were divided into two subgroups of mortality (percentages); ≤50% (favorable outcome) and > 50% (unfavorable outcome). This yielded favorable IMPACT and CRASH scores in 54.4 and 38.0% respectively. CONCLUSION: The Stockholm CT score and the Helsinki score yielded the closest relationship between the models and the actual outcomes in this consecutive patient series, representative of a NICU TBI-population. Furthermore, the Stockholm CT score yielded the strongest overall relationship when adding variables from the IMPACT base model and would be our method of choice for continued research when using any of the current available CT score models.


Assuntos
Lesões Encefálicas Traumáticas/diagnóstico por imagem , Lesões Encefálicas Traumáticas/epidemiologia , Índices de Gravidade do Trauma , Adulto , Idoso , Feminino , Humanos , Unidades de Terapia Intensiva , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Suécia/epidemiologia , Tomografia Computadorizada por Raios X
13.
Child Adolesc Psychiatry Ment Health ; 14(1): 44, 2020 Nov 09.
Artigo em Inglês | MEDLINE | ID: mdl-33292463

RESUMO

BACKGROUND: To measure the effects of using different combinations of multiple informants and the impact score on the estimated prevalence of mental health problems in Chinese schoolchildren. METHODS: Complete information on the Strengths and Difficulties Questionnaire (SDQ) were obtained from students (S), parents (P), and teachers (T) for 4986 schoolchildren (11-17 years-old). We used 3 criteria to determine the prevalence of mental health problems: SDQ cut-off value (previously established in the United Kingdom), SDQ cut-off value plus an impact score of 1 or more, or plus an impact score of 2 or more. A student was defined as having a mental health problem if any informant (S, P, or T) classified the child as 'abnormal'. We compared the prevalence of mental health problems determined from 1 informant, 2 informants, and 3 informants. RESULTS: The prevalence of overall mental health problems increased with rising number of informants, but decreased with increasing impact score. When the impact score was not considered, the prevalence was 8.2% to 14.2% when rated by 1 informant, 18.8% to 24.7% when rated by 2 informants, and 28.3% when rated by all 3 informants. Failure to measure the impact score led to a two to threefold greater estimate of the prevalence of mental health problems. CONCLUSIONS: The types, number, and combinations of multiple informants and use of the impact score must be considered when comparing the results of different studies. It is preferable to use multiple informants and have the impact score taken the impact into account to reflect the real burden of mental health burden in children and adolescent.

14.
World Allergy Organ J ; 10(1): 8, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28261374

RESUMO

BACKGROUND: The impact on health related quality of life (HRQL) has been well studied in children with Immunoglobulin E (IgE)-mediated food allergy. However limited data exists on related quality of life (QOL) of families who have a child suffering from food protein induced non-IgE mediated gastrointestinal allergies. We aimed to establish the QOL of families with children at the beginning of following an elimination diet for non-IgE mediated gastrointestinal food allergies. METHODS: A prospective, observational study was performed. Parents of children aged 4 weeks-16 years who improved after 4-8 weeks of following an elimination diet for suspected non-IgE mediated allergies were included. The Family Impact Module (FIM) of the Pediatric Quality of Life (PedsQL™) was used and we compared our data to two historical cohorts: one with sickle cell disease and another with intestinal failure. RESULTS: One hundred and twenty three children with a median age of 20 months were included (84 boys). The total FIM Score was 57.43 (SD 22.27) and particularly low for daily activities and worry. Factors that impacted significantly included age (p < 0.0001), number of foods excluded (p = 0.008), symptom severity (p = 0.041) and chronic nasal congestion (p = 0.012). Children with non-IgE mediated food allergies had worse scores in all domains (p < 0.0001) compared to sickle cell disease and worse physical (p = 0.04), emotional (p = 0.04) and worry (p = 0.01) domains compared to intestinal failure. CONCLUSIONS: This study found that parent QOL and family functioning was worse in those families who had a child on an elimination diet for non-IgE mediated allergies compared to those with sickle cell disease and intestinal failure, highlighting the impact this disease has on families.

15.
J Eur CME ; 6(1): 1375377, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29644137

RESUMO

Outcome measurements play a key role in professional CME (Continuing Medical Education). While assessment of delegate satisfaction and knowledge transfer is a common standard, it appears desirable to address higher levels of evidence. However, measurement of competence and performance is considered complex, difficult and expensive. The CIS (Change Impact Score) is a novel instrument to predict the relevance of the educational intervention to the professional performance of the physician, based on a standardised on-site self-assessment.

16.
J Crohns Colitis ; 8(12): 1642-52, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25113898

RESUMO

INTRODUCTION: Remarkable differences in quality of care (QoC) might be observed in different countries, affecting quality of life of inflammatory bowel disease (IBD) patients. The aim of this study was to assess patient and physician perceptions of the QoC in Italy. METHODS: A multicentre observational study on the quality of care in IBD (SOLUTION-1) was conducted in 36 IG-IBD (Italian Group for Inflammatory Bowel Disease) centres in Italy. The QUOTE-IBD (Quality of Care Through the Patient's Eyes) questionnaire was administered to IBD patients and to the attending physicians. The Quality Impact (QI) score summarises the QUOTE-IBD questionnaire, and a QI >9 is considered satisfactory. RESULTS: Nine-hundred-ninety-two patients and 75 physicians completed the QUOTE-IBD questionnaire. The patients scored the domains of competence (9.47 vs. 8.55) and costs (9.54 vs. 8.26) higher that the physicians, while information (9.31 vs. 9.43) and continuity of care (8.40 vs. 9.01) were scored lower. The QI score was rated worse by physicians with less experience (<12 years) with regard to competence (8.0 vs. 9.01), courtesy (8.12 vs. 10.0) and autonomy (8.97 vs. 10.0). Physicians considered the cost domain unsatisfactory. CONCLUSIONS: Healthcare was rated as satisfactory overall for Italian patients and physicians. The physicians underestimate their competence and consider the cost of medical management unsatisfactory. The patients are more critical regarding the continuity of care and information. Country-specific data on QoC allow local governments to allocate resources more effectively.


Assuntos
Doenças Inflamatórias Intestinais/terapia , Qualidade da Assistência à Saúde , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Atitude do Pessoal de Saúde , Competência Clínica , Continuidade da Assistência ao Paciente , Feminino , Humanos , Itália , Masculino , Pessoa de Meia-Idade , Educação de Pacientes como Assunto , Satisfação do Paciente , Autonomia Profissional , Estudos Prospectivos , Inquéritos e Questionários , Adulto Jovem
17.
Braz. dent. sci ; 22(4): 450-457, 2019. tab, ilus
Artigo em Inglês | BBO - odontologia (Brasil), LILACS | ID: biblio-1024330

RESUMO

Self-perception of dental aesthetics needs to be considered in planning orthodontic treatment because it is known that everyone has a self-perception of different oral esthetic conditions. Objective: To assess the state of malocclusion based on self-perception of dental aesthetics using the Oral Aesthetic Subjective Impact Score (OASIS); to determine the relationship of self-perceptions of oral aesthetics and the state of malocclusion from the results of clinical examinations using the Dental Aesthetic Index (DAI). Material and Methods: Research subjects were middle school students aged between 14-18 years as many as 187 students. For oral aesthetic assessment using the OASIS index questionnaire, and to evaluate the aesthetic and anatomical components of the malocclusion clinic using the Dental Aesthetic Index (DAI). Results: The prevalence of malocclusion according to Dental Aesthetic Index (DAI) showed that mild / normal malocclusion (59.9%), moderate malocclusion (33.4%), severe malocclusion (5.7%), and very severe malocclusion (1%). The prevalence of self-perception of oral aesthetics was 54.6% judging good. The results of the analysis with logistic regression tests showed that there was a significant (p (p<0.001) relationship between self-perception of oral aesthetics using the OASIS index and malocclusion status using the DAI index. Conclusion: Based on the results of this study, there was a significant relationship (p <0.01) between oral aesthetic self perception and malocclusion status of high school students. (AU)


A autopercepção da estética dentária precisa ser considerada no planejamento do tratamento ortodôntico, porque é sabido que existem diferenças nesta autopercepção de condições estéticas orais entre os indivíduos. Objetivo: Avaliar o estado de má oclusão com base na autopercepção da estética dentária utilizando o Oral Aesthetic Subjective Impact Score (OASIS); determinar a relação entre a autopercepção da estética bucal e o estado de má oclusão a partir dos resultados de exames clínicos utilizando o Índice de Dental Aesthetic Index (DAI). Material e Métodos: Os sujeitos da pesquisa foram estudantes do ensino médio, com idades entre 14 e 18 anos, num total de 187 alunos. Para avaliação da estética bucal, foi utilizado o questionário do índice OASIS, e para avaliar os componentes estéticos e anatômicos da clínica de más oclusões, o Índice de DAI. Resultados: A prevalência de má oclusão segundo o DAI, mostrou resultados de percepção de: oclusão leve / normal (59,9%), oclusão moderada (33,4%), oclusão grave (5,7%) e oclusão muito grave (1%). A prevalência de autopercepção da estética oral foi de 54,6%, considerando-se boa. Os resultados da análise com testes de regressão logística mostraram que houve uma relação significativa (p <0,01) entre a autopercepção da estética oral e o estado de má oclusão de estudantes do ensino médio. (AU)


Assuntos
Humanos , Adolescente , Estética Dentária , Índice de Necessidade de Tratamento Ortodôntico , Má Oclusão
18.
Artigo em Coreano | WPRIM | ID: wpr-206312

RESUMO

BACKGROUND: The authors produced a new citation index of the Korean Journal of Blood Transfusion (KJBT). The index, which was developed to determine the internal impact score (IIS), could examine contributions to the KJBT according to the manuscript, author and institute. METHODS: For manuscripts published in the KJBT from Volume 1 No. 1 in 1990 to Volume 17 No. 1 in 2006, a database of the journals and their references was constructed, and an index was created. The citation index was analyzed using three indicators, the internal impact score for the manuscript (IIS-M), internal impact score for the author (IIS-A) and the internal impact score for the institute (IIS-I). RESULTS: The total number of references cited in the manuscripts was 5,392. Of these references, 498 (9.2%) were published in the KJBT. The mean IIS-M of all manuscripts cited was 0.97. The total number of authors who participated in the cited manuscripts was 351. The highest IIS-A score, which was calculated in consideration of each author's participation and the weight of the manuscript, was 203.26. The number of institutes that had produced the cited manuscripts was 35. The highest IIS-I score, which was calculated in consideration of each organization's participation and the weight of manuscripts, was 187.45. CONCLUSION: If the indicators developed by the authors are used as tools to analyze the citation indices of the journals, they can quantify the contribution of the manuscripts, authors and institutes to each journal, and promote the development of academic journals based on the quantified contribution.


Assuntos
Academias e Institutos , Transfusão de Sangue
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