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International Journal of Surgery... Mar 2021Success in global surgery interventions cannot be claimed until consistent long-term follow up is achieved and corresponding outcomes are studied. However,...
Success in global surgery interventions cannot be claimed until consistent long-term follow up is achieved and corresponding outcomes are studied. However, post-operative outcomes remain inconsistently collected and analyzed in the setting of global surgery, with current efforts largely focused on the delivery of surgical care. Barriers in low- and middle-income countries include patient cost and distance, low surgical workforce capacity, poor patient health literacy, lack of affordable technology availability, inconsistent documentation, and structural deficiencies. Here, we suggest that future work can be focused on (1) enhancing systems to facilitate long-term follow up and care, (2) expanding availability and adoption of electronic medical record systems, and (3) collaboration with local surgeons in the development of international cross-organizational registries and standardized quality measures. Long-term collaborations between local healthcare administrators and providers, policymakers, international bodies, nonprofit organizations, patients, and the private sector are necessary to build and sustain processes to achieve reliable long-term follow up and rigorous data collection, with the goal of ultimately ensuring better patient outcomes.
Topics: Data Collection; Follow-Up Studies; Humans; Intersectoral Collaboration; Outcome Assessment, Health Care; Surgical Procedures, Operative
PubMed: 33513453
DOI: 10.1016/j.ijsu.2021.01.011 -
Best Practice & Research. Clinical... Feb 2024
Topics: Humans; Reproductive Medicine; Outcome Assessment, Health Care; Clinical Protocols
PubMed: 37952324
DOI: 10.1016/j.bpobgyn.2023.102424 -
British Journal of Anaesthesia Oct 2022Thirty-day mortality is widely used in medical and surgical outcomes research as a quality indicator, and as an endpoint in perioperative clinical trials. However, the...
Thirty-day mortality is widely used in medical and surgical outcomes research as a quality indicator, and as an endpoint in perioperative clinical trials. However, the validity of this metric has recently been questioned. In this issue of the British Journal of Anaesthesia, Fowler and colleagues quantify, update, and put into perspective the looming suspicion that perioperative adverse events cast a 'long shadow' of increased mortality, far beyond the 30-day time frame. Their work not only raises important questions on how we should think about, analyse, and report 'perioperative' complications and mortality, but also stresses anaesthesiologist and surgeon roles as key stakeholders in patient long-term survival.
Topics: Anesthesia; Anesthesiologists; Anesthesiology; Humans; Outcome Assessment, Health Care; Postoperative Complications
PubMed: 35410788
DOI: 10.1016/j.bja.2022.03.014 -
Journal of Alzheimer's Disease : JAD 2020Dementia has been described as the greatest global health challenge in the 21st Century on account of longevity gains increasing its incidence, escalating health and... (Review)
Review
BACKGROUND
Dementia has been described as the greatest global health challenge in the 21st Century on account of longevity gains increasing its incidence, escalating health and social care pressures. These pressures highlight ethical, social, and political challenges about healthcare resource allocation, what health improvements matter to patients, and how they are measured. This study highlights the complexity of the ethical landscape, relating particularly to the balances that need to be struck when allocating resources; when measuring and prioritizing outcomes; and when individual preferences are sought.
OBJECTIVE
Health outcome prioritization is the ranking in order of desirability or importance of a set of disease-related objectives and their associated cost or risk. We analyze the complex ethical landscape in which this takes place in the most common dementia, Alzheimer's disease.
METHODS
Narrative review of literature published since 2007, incorporating snowball sampling where necessary. We identified, thematized, and discussed key issues of ethical salience.
RESULTS
Eight areas of ethical salience for outcome prioritization emerged: 1) Public health and distributive justice, 2) Scarcity of resources, 3) Heterogeneity and changing circumstances, 4) Knowledge of treatment, 5) Values and circumstances, 6) Conflicting priorities, 7) Communication, autonomy and caregiver issues, and 8) Disclosure of risk.
CONCLUSION
These areas highlight the difficult balance to be struck when allocating resources, when measuring and prioritizing outcomes, and when individual preferences are sought. We conclude by reflecting on how tools in social sciences and ethics can help address challenges posed by resource allocation, measuring and prioritizing outcomes, and eliciting stakeholder preferences.
Topics: Alzheimer Disease; Delivery of Health Care; Humans; Outcome Assessment, Health Care
PubMed: 32716354
DOI: 10.3233/JAD-191300 -
The Journal of Allergy and Clinical... Sep 2023
Topics: Humans; Outcome Assessment, Health Care
PubMed: 37684077
DOI: 10.1016/j.jaip.2023.05.018 -
Journal of Neurosurgical Anesthesiology Jan 2023Neurodevelopmental outcomes research in children following extracorporeal membrane oxygenationis a complex and evolving field. From systematic reviews to multi-center... (Review)
Review
Neurodevelopmental outcomes research in children following extracorporeal membrane oxygenationis a complex and evolving field. From systematic reviews to multi-center prospective cohort studies, a variety of research endeavors in this domain have already been conducted. Recent attention has redirected the focus on biomarkers and imaging studies to help better understand the neurological, developmental, and behavioral effects of extracorporeal membrane oxygenation on surviving children. This review provides an overview of major research in the field, ongoing and future studies, and a summary of lessons learned from these efforts.
Topics: Child; Humans; Infant; Prospective Studies; Extracorporeal Membrane Oxygenation; Outcome Assessment, Health Care; Respiratory Insufficiency; Biomarkers
PubMed: 36745174
DOI: 10.1097/ANA.0000000000000878 -
American Journal of Obstetrics and... May 2022
Topics: Delphi Technique; Humans; Outcome Assessment, Health Care
PubMed: 35500999
DOI: 10.1016/j.ajog.2022.03.001 -
The Journal of Evidence-based Dental... Jan 2024Dental patient-centered outcomes can improve the relevance of clinical study results to dental patients and generate evidence to optimize health outcomes for dental...
Dental patient-centered outcomes can improve the relevance of clinical study results to dental patients and generate evidence to optimize health outcomes for dental patients. Dental patient-reported outcomes (dPROs) are of great importance to patient-centered dental care. They can be used to evaluate the health outcomes of an individual patient about the impact of oral diseases and treatment, and to assess the quality of oral health care delivery for a health care entity. dPROs are measured with dental patient-reported outcome measures (dPROMs). dPROMs should be validated and tested before wider dissemination and application to ensure that they can accurately capture the intended dPROs. Evidence suggests inadequate dPRO usage among dental trials, as well as potential flaws in some existing dPROMs. This Glossary presents a collection of main terms in dental patient-centered outcomes to help clinicians and researchers read and understand patient-centered clinical studies in dentistry.
Topics: Humans; Outcome Assessment, Health Care; Patient Reported Outcome Measures; Patient-Centered Care; Health Facilities; Quality of Life
PubMed: 38401954
DOI: 10.1016/j.jebdp.2023.101951 -
Wiener Klinische Wochenschrift Nov 2019The aims of this article are to provide an overview and discuss current concepts and future trends in outcomes research in non-specific low back pain, specifically... (Review)
Review
OBJECTIVE
The aims of this article are to provide an overview and discuss current concepts and future trends in outcomes research in non-specific low back pain, specifically considering the perspective of patients, patient-reported outcomes and outcome measures as well as to facilitate knowledge transfer into clinical practice.
REVIEW STRATEGY
The breadth of this work and the required brevity of this article were not amenable to a formal approach, such as a systematic literature review or a formal scoping review. Literature sources were identified through medical databases but different sources of information and of various methodologies were also included. Furthermore, outcomes meaningful for patients and examples of outcome measures that are applicable in clinical practice were extracted. Areas for future research were identified and discussed.
RESULTS
Patient-reported outcomes and outcome measures are essential in patient-centered care. The assessment of the patients' perspective is important to ensure motivation, active involvement, self-management and adherence, especially in non-pharmacological interventions for low back pain. To facilitate the use of outcome measurements for low back pain in clinical practice, future studies should focus on a clinically feasible index, which includes patient-reported as well as clinician-reported or performance-based variables. Relationships between different types of outcomes and outcome measures as well as resource and outcome-based healthcare constitute important topics for future research. New digital technologies can support continuous outcome measurement and might enable new patient-driven models of care.
CONCLUSION
Active patient involvement is an essential part of non-pharmacological treatment in low back pain and needs to be considered in terms of outcomes and outcome measurement.
Topics: Humans; Low Back Pain; Outcome Assessment, Health Care; Patient Participation; Patient Satisfaction; Patient-Centered Care; Treatment Outcome
PubMed: 31236662
DOI: 10.1007/s00508-019-1523-4 -
Value in Health Regional Issues Dec 2019An increasing awareness of the importance of health economics and outcomes research (HEOR) skills has been reported in Latin America. There is, however, no published...
BACKGROUND
An increasing awareness of the importance of health economics and outcomes research (HEOR) skills has been reported in Latin America. There is, however, no published study directly assessing perceived knowledge levels and knowledge gaps on specific HEOR topics among professionals and students in the region.
OBJECTIVES
To assess perceived HEOR knowledge levels and identify knowledge gaps in Latin America.
METHODS
An online needs assessment survey was developed to quantify perceived HEOR knowledge levels and identify knowledge gaps. Members of the International Society for Pharmacoeconomics and Outcomes Research in the Latin American region, regional chapters, and student chapter presidents were invited to participate in the survey. The survey, developed using the SurveyMonkey tool, was distributed to participants electronically. Data were extracted from the survey and analyzed using Microsoft Excel. Data analysis was conducted using descriptive statistics to summarize the survey respondents' demographic information, current and desired knowledge levels, and preferred method/format for delivery of educational training.
RESULTS
Survey responses were collected from 106 participants. The largest knowledge gap was calculated for methods for integrating medication adherence and persistence in health economic evaluations (mean = 2.30 ± 1.48). The smallest knowledge gap was calculated for types of healthcare costs (mean = 1.01 ± 1.17). Most respondents (74% [n = 66]) preferred to receive educational materials related to HEOR topics through online learning and continuing education programs.
CONCLUSIONS
The knowledge gap assessment provided current knowledge gap perceptions among members of the International Society for Pharmacoeconomics and Outcomes Research in Latin America. The survey data collected support a need for developing educational programs for topics with the highest perceived knowledge gap.
Topics: Adult; Aged; Cross-Sectional Studies; Economics, Medical; Female; Health Knowledge, Attitudes, Practice; Humans; Latin America; Male; Middle Aged; Needs Assessment; Outcome Assessment, Health Care; Surveys and Questionnaires
PubMed: 30634087
DOI: 10.1016/j.vhri.2018.10.006