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Gynecologic Oncology Sep 2017Clinical outcomes research seeks to understand the real-world manifestations of clinical care. In particular, outcomes research seeks to reveal the effects of... (Review)
Review
Clinical outcomes research seeks to understand the real-world manifestations of clinical care. In particular, outcomes research seeks to reveal the effects of pharmaceutical, procedural, and structural aspects of healthcare on patient outcomes, including mortality, disease control, toxicity, cost, and quality of life. Although outcomes research can utilize interventional study designs, insightful use of observational data is a defining feature of this field. Many questions in gynecologic oncology are not amenable to investigation in randomized clinical trials due to cost, feasibility, or ethical concerns. When a randomized trial is not practical or has not yet been conducted, well-designed observational studies have the potential to provide the best available evidence about the effects of clinical care. Such studies may use surveys, medical records, disease registries, and a variety of administrative data sources. Even when a randomized trial has been conducted, observational studies can be used to estimate the real-world effect of an intervention, which may differ from the results obtained in the controlled setting of a clinical trial. This article reviews the goals, methodologies, data sources, and limitations of clinical outcomes research, with a focus on gynecologic oncology.
Topics: Bias; Biomedical Research; Confounding Factors, Epidemiologic; Databases, Factual; Drug-Related Side Effects and Adverse Reactions; Female; Genital Neoplasms, Female; Health Care Costs; Humans; Medicare; Observational Studies as Topic; Outcome Assessment, Health Care; Patient Readmission; Patient Reported Outcome Measures; Postoperative Complications; Randomized Controlled Trials as Topic; SEER Program; Survival Rate; United States
PubMed: 28651803
DOI: 10.1016/j.ygyno.2017.06.016 -
Current Opinion in Critical Care Oct 2019This review summarizes the results from long-term intensive care outcome research over the past 50 years. Key findings from early studies are reflected in citations of... (Review)
Review
PURPOSE OF REVIEW
This review summarizes the results from long-term intensive care outcome research over the past 50 years. Key findings from early studies are reflected in citations of contemporary research.
RECENT FINDINGS
The postintensive care syndrome (PICS) is a multifaceted entity of residual disability and complications burdening survivors of critical illness. Some interventions applied early in the history of outcomes research have now been confirmed as effective in counteracting specific PICS components.
SUMMARY
Interest in patient-centred outcomes has been present since the beginning of modern intensive care. Findings from early long-term studies remain valid even in the face of contemporary large registries that facilitate follow-up of larger cohorts. A further understanding of the mechanisms leading to experienced physical and psychological impairment of PICS will be essential to the design of future intervention trials.
Topics: Critical Care; Critical Illness; Humans; Outcome Assessment, Health Care; Survivors; Syndrome
PubMed: 31361684
DOI: 10.1097/MCC.0000000000000648 -
Journal of the American Academy of... Jun 1997During the past few years there has been significant interest in studying methods that document outcomes of medical care. Outcomes management should result in higher... (Review)
Review
During the past few years there has been significant interest in studying methods that document outcomes of medical care. Outcomes management should result in higher quality health care at lower cost. However, what does outcomes research mean and how does it apply to dermatology and specifically to the individual dermatologist? This article reviews the evolution of medical outcomes research and presents the status of the current instruments, indices, and methods.
Topics: Dermatology; Humans; Outcome Assessment, Health Care; Quality Assurance, Health Care; Quality of Life; Skin Diseases
PubMed: 9204068
DOI: 10.1016/s0190-9622(97)80286-1 -
Journal of Surgical Oncology Oct 2014Outcomes research uses diverse inputs to examine innovative end results aimed to deliver quality patient care. Yet defining "outcomes research" remains a challenge, and... (Review)
Review
Outcomes research uses diverse inputs to examine innovative end results aimed to deliver quality patient care. Yet defining "outcomes research" remains a challenge, and its interpretation is often nuanced. In this review, we discuss the definition of outcomes research in the context of its historical evolution along with the rise of other similar types of research. We then discuss key considerations in interpreting the results of outcomes analysis.
Topics: Comparative Effectiveness Research; Databases, Factual; Health Services Research; History, 20th Century; History, 21st Century; Outcome Assessment, Health Care; Risk
PubMed: 24996156
DOI: 10.1002/jso.23710 -
International Journal of Technology... Jun 2023The Patient-Centered Outcomes Research Institute (PCORI) is a nonprofit, nongovernmental organization established by the U.S. Congress to fund comparative clinical... (Review)
Review
The Patient-Centered Outcomes Research Institute (PCORI) is a nonprofit, nongovernmental organization established by the U.S. Congress to fund comparative clinical effectiveness research focusing on patient-centered outcomes through the engagement of stakeholders. Evaluation of emerging healthcare innovations is one of PCORI's five National Priorities for Health. One such initiative is PCORI's Emerging Technologies and Therapeutics Reports program, established to provide timely overviews of evidence on new drugs and other healthcare technologies. This article provides an overview of completed and ongoing Emerging Technologies and Therapeutics Reports including lessons learned to date. In addition to systematic searches, systematic selection of studies, and transparent reporting of the available evidence, informed by a select number of stakeholders (i.e., key informants), these reports focus on contextual factors shaping the diffusion of emerging technologies that are often not reported in the medical literature. This article also compares processes and methodologies of health technology assessments (HTAs) from a selected number of national and international publicly funded agencies with a goal toward potential future enhancement of PCORI's Emerging Technologies and Therapeutics Reports program. HTAs vary considerably in terms of funding, types of assessments, the role of manufacturers, stakeholder engagement, timeline to complete from the start to the finish of a draft report publication, and communication of uncertainty for informed decision making. Future Emerging Technologies and Therapeutics Reports may focus on rapid reports to support a more expedient development of evidence. Future research could explore the role of contextual factors identified in these reports on targeted evidence generation.
Topics: Humans; Patient Outcome Assessment; Outcome Assessment, Health Care; Health Facilities; Delivery of Health Care; Academies and Institutes
PubMed: 37336780
DOI: 10.1017/S0266462323000284 -
Rheumatic Diseases Clinics of North... Nov 2013This article provides an introduction to key aspects of outcomes research in pediatric rheumatology, focusing on arthritis. Patient-centered outcomes research addresses... (Review)
Review
This article provides an introduction to key aspects of outcomes research in pediatric rheumatology, focusing on arthritis. Patient-centered outcomes research addresses questions of interest to multiple stakeholders in order to guide the best health care decisions suited to a particular patient's circumstances and preferences. Discussion includes the importance of maintaining high-quality longitudinal patient registries and use of valid clinical and patient-reported outcome measures. Rapid, reliable translation of research on best practices into clinical care, as facilitated by quality improvement learning networks, leads to timely and meaningful improvement in patient outcomes.
Topics: Arthritis, Juvenile; Autoimmune Diseases; Child; Humans; Outcome Assessment, Health Care; Patient Outcome Assessment; Pediatrics; Registries; Rheumatology
PubMed: 24182861
DOI: 10.1016/j.rdc.2013.07.004 -
Seminars in Respiratory and Critical... Feb 2010Outcomes research is a life sciences field that focuses on patient-oriented outcomes, which are important to a wide range of stakeholders, including patients,... (Review)
Review
Outcomes research is a life sciences field that focuses on patient-oriented outcomes, which are important to a wide range of stakeholders, including patients, physicians, health care systems and payers, and society. An important emphasis of outcomes research is assessment of medical processes and interventions in "real world" settings rather than under experimental conditions. A condition of this approach is that many studies are observational in design. This article reviews the methodologies that are typical of outcomes research and discusses the strengths and weaknesses of these methodologies. Controversial topics in respiratory diseases such as intensive care unit (ICU) organization and relationships of hospital volume to patient mortality are discussed to illustrate how different study designs and analytic techniques can lead to discrepant study results. Outcomes research will increase in importance and application as health care systems and payers become more interested in maximizing patient outcomes relative to resources used. Resources should be made available to enhance the training of new investigators and provide sufficient expertise for the design and analysis of influential studies.
Topics: Health Facility Size; Hospital Mortality; Humans; Intensive Care Units; Outcome Assessment, Health Care; Patient-Centered Care; Research Design; Respiratory Tract Diseases
PubMed: 20101542
DOI: 10.1055/s-0029-1246281 -
World Journal of Urology Feb 2011
Topics: Health Services; Humans; Outcome Assessment, Health Care; Patient Participation; Treatment Outcome; Urologic Diseases; Urology
PubMed: 21120504
DOI: 10.1007/s00345-010-0624-5 -
Journal of the American Society of... Sep 1998
Review
Topics: Echocardiography; Heart Diseases; Humans; Outcome Assessment, Health Care
PubMed: 9758386
DOI: 10.1016/s0894-7317(98)70014-8 -
The Journal of Allergy and Clinical... Sep 2023
Topics: Humans; Outcome Assessment, Health Care
PubMed: 37684077
DOI: 10.1016/j.jaip.2023.05.018