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[PMID]:29183077
[Au] Autor:Khera R; Angraal S; Couch T; Welsh JW; Nallamothu BK; Girotra S; Chan PS; Krumholz HM
[Ad] Endereço:Division of Cardiology, University of Texas Southwestern Medical Center, Dallas.
[Ti] Título:Adherence to Methodological Standards in Research Using the National Inpatient Sample.
[So] Source:JAMA;318(20):2011-2018, 2017 11 28.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: Publicly available data sets hold much potential, but their unique design may require specific analytic approaches. Objective: To determine adherence to appropriate research practices for a frequently used large public database, the National Inpatient Sample (NIS) of the Agency for Healthcare Research and Quality (AHRQ). Design, Setting, and Participants: In this observational study of the 1082 studies published using the NIS from January 2015 through December 2016, a representative sample of 120 studies was systematically evaluated for adherence to practices required by AHRQ for the design and conduct of research using the NIS. Exposures: None. Main Outcomes and Measures: All studies were evaluated on 7 required research practices based on AHRQ's recommendations and compiled under 3 domains: (1) data interpretation (interpreting data as hospitalization records rather than unique patients); (2) research design (avoiding use in performing state-, hospital-, and physician-level assessments where inappropriate; not using nonspecific administrative secondary diagnosis codes to study in-hospital events); and (3) data analysis (accounting for complex survey design of the NIS and changes in data structure over time). Results: Of 120 published studies, 85% (n = 102) did not adhere to 1 or more required practices and 62% (n = 74) did not adhere to 2 or more required practices. An estimated 925 (95% CI, 852-998) NIS publications did not adhere to 1 or more required practices and 696 (95% CI, 596-796) NIS publications did not adhere to 2 or more required practices. A total of 79 sampled studies (68.3% [95% CI, 59.3%-77.3%]) among the 1082 NIS studies screened for eligibility did not account for the effects of sampling error, clustering, and stratification; 62 (54.4% [95% CI, 44.7%-64.0%]) extrapolated nonspecific secondary diagnoses to infer in-hospital events; 45 (40.4% [95% CI, 30.9%-50.0%]) miscategorized hospitalizations as individual patients; 10 (7.1% [95% CI, 2.1%-12.1%]) performed state-level analyses; and 3 (2.9% [95% CI, 0.0%-6.2%]) reported physician-level volume estimates. Of 27 studies (weighted; 218 studies [95% CI, 134-303]) spanning periods of major changes in the data structure of the NIS, 21 (79.7% [95% CI, 62.5%-97.0%]) did not account for the changes. Among the 24 studies published in journals with an impact factor of 10 or greater, 16 (67%) did not adhere to 1 or more practices, and 9 (38%) did not adhere to 2 or more practices. Conclusions and Relevance: In this study of 120 recent publications that used data from the NIS, the majority did not adhere to required practices. Further research is needed to identify strategies to improve the quality of research using the NIS and assess whether there are similar problems with use of other publicly available data sets.
[Mh] Termos MeSH primário: Pesquisa Biomédica/normas
Conjuntos de Dados como Assunto/normas
[Mh] Termos MeSH secundário: Fidelidade a Diretrizes
Seres Humanos
Pacientes Internados/estatística & dados numéricos
Estados Unidos
United States Agency for Healthcare Research and Quality
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171227
[Lr] Data última revisão:
171227
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171129
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.17653


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[PMID]:28369814
[Au] Autor:Davies S; Schultz E; Raven M; Wang NE; Stocks CL; Delgado MK; McDonald KM
[Ad] Endereço:Center for Primary Care and Outcomes Research, Stanford University, Stanford, CA.
[Ti] Título:Development and Validation of the Agency for Healthcare Research and Quality Measures of Potentially Preventable Emergency Department (ED) Visits: The ED Prevention Quality Indicators for General Health Conditions.
[So] Source:Health Serv Res;52(5):1667-1684, 2017 Oct.
[Is] ISSN:1475-6773
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To develop and validate rates of potentially preventable emergency department (ED) visits as indicators of community health. DATA SOURCES: Agency for Healthcare Research and Quality, Healthcare Cost and Utilization Project 2008-2010 State Inpatient Databases and State Emergency Department Databases. STUDY DESIGN: Empirical analyses and structured panel reviews. METHODS: Panels of 14-17 clinicians and end users evaluated a set of ED Prevention Quality Indicators (PQIs) using a Modified Delphi process. Empirical analyses included assessing variation in ED PQI rates across counties and sensitivity of those rates to county-level poverty, uninsurance, and density of primary care physicians (PCPs). PRINCIPAL FINDINGS: ED PQI rates varied widely across U.S. communities. Indicator rates were significantly associated with county-level poverty, median income, Medicaid insurance, and levels of uninsurance. A few indicators were significantly associated with PCP density, with higher rates in areas with greater density. A clinical and an end-user panel separately rated the indicators as having strong face validity for most uses evaluated. CONCLUSIONS: The ED PQIs have undergone initial validation as indicators of community health with potential for use in public reporting, population health improvement, and research.
[Mh] Termos MeSH primário: Serviço Hospitalar de Emergência/utilização
Saúde Pública
Indicadores de Qualidade em Assistência à Saúde/normas
United States Agency for Healthcare Research and Quality/normas
[Mh] Termos MeSH secundário: Doença Aguda
Fatores Etários
Asma/diagnóstico
Asma/terapia
Dor nas Costas/diagnóstico
Dor nas Costas/terapia
Doença Crônica
Pesquisa sobre Serviços de Saúde
Seres Humanos
Medicaid
Pessoas sem Cobertura de Seguro de Saúde
Pobreza
Fatores Sexuais
Doenças Estomatognáticas/diagnóstico
Doenças Estomatognáticas/terapia
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:171027
[Lr] Data última revisão:
171027
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170404
[St] Status:MEDLINE
[do] DOI:10.1111/1475-6773.12687


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[PMID]:28330970
[Au] Autor:Toomey SL; Elliott MN; Zaslavsky AM; Klein DJ; Ndon S; Hardy S; Wu M; Schuster MA
[Ad] Endereço:Division of General Pediatrics, Boston Children's Hospital, Boston, Massachusetts; sara.toomey@childrens.harvard.edu.
[Ti] Título:Variation in Family Experience of Pediatric Inpatient Care As Measured by Child HCAHPS.
[So] Source:Pediatrics;139(4), 2017 Apr.
[Is] ISSN:1098-4275
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Making national comparisons of family experience of inpatient pediatric care has been limited by the lack of a publicly available survey. The Agency for Healthcare Research and Quality and Centers for Medicare & Medicaid Services commissioned development of the Child Hospital Consumer Assessment of Healthcare Providers and Systems Survey to address this gap. Using Child Hospital Consumer Assessment of Healthcare Providers and Systems Survey, we measured performance of hospitals in a national field test. METHODS: We analyzed 17 727 surveys completed from December 2012 to February 2014 by parents of children (<18 years) hospitalized at 69 hospitals in 34 states. For each of 18 survey measures, we calculated a case-mix-adjusted hospital "top-box" score (ie, percentage of respondents selecting the most positive response option). We quantified variation across hospitals by estimating hospital-level SDs for each item with a hierarchical linear probability model. We examined associations of family experience with patient, parent, and hospital characteristics. We compared aggregate performance on each measure across participating hospitals. RESULTS: Mean hospital top-box scores ranged from 55% ("Preventing mistakes and helping you report concerns") to 84% ("Keeping you informed about your child's care in the emergency department"). The mean for overall rating of hospital stay was 73% (SD 7%). "Quietness of hospital room" scores varied most across hospitals (SD 8%). Overall top-box scores were higher for freestanding children's hospitals (74%) and children's hospitals within a hospital (73%) than for pediatric wards within hospitals (68%, = .007). CONCLUSIONS: Family experience of pediatric inpatient care shows substantial room for improvement and varies considerably across hospitals and measures.
[Mh] Termos MeSH primário: Hospitais Pediátricos/normas
Pacientes Internados/estatística & dados numéricos
Pais/psicologia
Satisfação do Paciente/estatística & dados numéricos
Qualidade da Assistência à Saúde/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adolescente
Criança
Pré-Escolar
Grupos Diagnósticos Relacionados
Feminino
Seres Humanos
Lactente
Masculino
Inquéritos e Questionários
Estados Unidos
United States Agency for Healthcare Research and Quality
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:171110
[Lr] Data última revisão:
171110
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170324
[St] Status:MEDLINE


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[PMID]:28209151
[Au] Autor:Smith SA; Yount N; Sorra J
[Ad] Endereço:Westat, 1600 Research Blvd, Rockville, MD, 20850, USA. Scott.al.smith@gmail.com.
[Ti] Título:Exploring relationships between hospital patient safety culture and Consumer Reports safety scores.
[So] Source:BMC Health Serv Res;17(1):143, 2017 Feb 16.
[Is] ISSN:1472-6963
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: A number of private and public companies calculate and publish proprietary hospital patient safety scores based on publicly available quality measures initially reported by the U.S. federal government. This study examines whether patient safety culture perceptions of U.S. hospital staff in a large national survey are related to publicly reported patient safety ratings of hospitals. METHODS: The Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture (Hospital SOPS) assesses provider and staff perceptions of hospital patient safety culture. Consumer Reports (CR), a U.S. based non-profit organization, calculates and shares with its subscribers a Hospital Safety Score calculated annually from patient experience survey data and outcomes data gathered from federal databases. Linking data collected during similar time periods, we analyzed relationships between staff perceptions of patient safety culture composites and the CR Hospital Safety Score and its five components using multiple multivariate linear regressions. RESULTS: We analyzed data from 164 hospitals, with patient safety culture survey responses from 140,316 providers and staff, with an average of 856 completed surveys per hospital and an average response rate per hospital of 56%. Higher overall Hospital SOPS composite average scores were significantly associated with higher overall CR Hospital Safety Scores (ß = 0.24, p < 0.05). For 10 of the 12 Hospital SOPS composites, higher patient safety culture scores were associated with higher CR patient experience scores on communication about medications and discharge. CONCLUSION: This study found a relationship between hospital staff perceptions of patient safety culture and the Consumer Reports Hospital Safety Score, which is a composite of patient experience and outcomes data from federal databases. As hospital managers allocate resources to improve patient safety culture within their organizations, their efforts may also indirectly improve consumer-focused, publicly reported hospital rating scores like the Consumer Reports Hospital Safety Score.
[Mh] Termos MeSH primário: Atitude do Pessoal de Saúde
Cultura Organizacional
Segurança do Paciente/estatística & dados numéricos
Recursos Humanos em Hospital/psicologia
[Mh] Termos MeSH secundário: Adulto
Comunicação
Feminino
Pesquisas sobre Serviços de Saúde
Hospitais/estatística & dados numéricos
Seres Humanos
Pacientes Internados/estatística & dados numéricos
Masculino
Organizações sem Fins Lucrativos/estatística & dados numéricos
Percepção
Gestão da Segurança
Inquéritos e Questionários
Estados Unidos
United States Agency for Healthcare Research and Quality
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170731
[Lr] Data última revisão:
170731
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170218
[St] Status:MEDLINE
[do] DOI:10.1186/s12913-017-2078-6


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[PMID]:28008629
[Au] Autor:Hanba C; Svider PF; Jacob JT; Guthikonda M; Liu JK; Eloy JA; Folbe AJ
[Ad] Endereço:Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, U.S.A.
[Ti] Título:Lower airway disease and pituitary surgery: Is there an association with postoperative cerebrospinal fluid leak?
[So] Source:Laryngoscope;127(7):1543-1550, 2017 Jul.
[Is] ISSN:1531-4995
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES/HYPOTHESIS: To explore the relationship between lower airway disease and postoperative cerebrospinal fluid (CSF) rhinorrhea among patients undergoing pituitary surgery STUDY DESIGN: Retrospective review. METHODS: A retrospective review of the Healthcare Cost and Utilization Project's 2013 National Inpatient Sample was conducted to characterize the hospital stay and surgical outcomes of patients undergoing pituitary surgery. Patients with lower airway disease (including chronic obstructive pulmonary disease and asthma) were compared to a disease-free population identifying demographics and complications over-represented in the lower airway group. RESULTS: The majority of hypophysectomies (92.1%) were performed via a transsphenoidal approach. Among transsphenoidal patients, individuals with asthma (92.8% of the lower airway disease cohort) harbored a greater postoperative CSF leak rate (4.7% vs. 2.7%, P = .022), and were more likely to develop postoperative diabetes insipidus (6.2% vs. 4.1%, P = .024) and neurological complications (13.0% vs. 9.6%, P = .010) when compared to a lower airway disease-free cohort. Patients with CSF rhinorrhea had longer lengths of stay (7.8 days vs. 4.5 days, P < .001) and higher discharge costs ($148,309 vs. $76,246, P < .001). A binary logistic regression model identified having asthma (P = .042), being female (P = .011), and having gastroesophageal reflux disease (P = .006) as independent predictors of postoperative CSF rhinorrhea. CONCLUSIONS: Several patient comorbidities including asthma are associated with a greater risk of postoperative CSF rhinorrhea. Perioperative lower airway assessment and disease control may potentially decrease one's risk of this complication, although further inquiry is urgently needed to identify optimal preventive strategies. LEVEL OF EVIDENCE: 2c. Laryngoscope, 127:1543-1550, 2017.
[Mh] Termos MeSH primário: Asma/complicações
Rinorreia de Líquido Cefalorraquidiano/etiologia
Hipofisectomia
Complicações Pós-Operatórias/etiologia
Doença Pulmonar Obstrutiva Crônica/complicações
[Mh] Termos MeSH secundário: Adolescente
Adulto
Asma/economia
Asma/epidemiologia
Rinorreia de Líquido Cefalorraquidiano/economia
Rinorreia de Líquido Cefalorraquidiano/epidemiologia
Criança
Pré-Escolar
Estudos de Coortes
Comorbidade
Estudos Transversais
Diabetes Insípido/economia
Diabetes Insípido/epidemiologia
Diabetes Insípido/etiologia
Feminino
Seres Humanos
Hipofisectomia/economia
Lactente
Recém-Nascido
Tempo de Internação/economia
Masculino
Meia-Idade
Doenças do Sistema Nervoso/economia
Doenças do Sistema Nervoso/epidemiologia
Doenças do Sistema Nervoso/etiologia
Razão de Chances
Complicações Pós-Operatórias/economia
Complicações Pós-Operatórias/epidemiologia
Doença Pulmonar Obstrutiva Crônica/economia
Doença Pulmonar Obstrutiva Crônica/epidemiologia
Estudos Retrospectivos
Fatores de Risco
Estados Unidos
United States Agency for Healthcare Research and Quality
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170822
[Lr] Data última revisão:
170822
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161224
[St] Status:MEDLINE
[do] DOI:10.1002/lary.26364


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[PMID]:28235173
[Au] Autor:Goode V; Phillips E; DeGuzman P; Hinton I; Rovnyak V; Scully K; Merwin E
[Ad] Endereço:Duke University School of Nursing, Durham, North Carolina.
[Ti] Título:A Patient Safety Dilemma: Obesity in the Surgical Patient.
[So] Source:AANA J;84(6):404-412, 2016 Dec.
[Is] ISSN:0094-6354
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Patient safety and the delivery of quality care are major concerns for healthcare in the United States. Special populations (eg, obese patients) need study in order to support patient safety, quantify risks, advance education for healthcare-workers, and establish healthcare policy. Obesity is a complex chronic disease and is considered the second leading cause of preventable death in the United States with approximately 300,000 deaths per year. Obesity is recognized by the Agency for Healthcare Research and Quality (AHRQ) as a comorbid condition. These concerns emphasize the need to focus further research on the obese patient. Through the use of clinical and administrative data, this study examines the incidence of adverse outcomes in the obese surgical population through AHRQ Patient Safety Indicators (PSI) and allows for the engagement PSIs as measures to guide and improve performance. In this study, the surgical population was overwhelmingly positive for obesity. Body mass index (BMI) was also a significant positive predictor for 2 of 3 postoperative outcomes. This finding suggests that as BMI reaches the classification of obesity, the risk of these adverse outcomes increases. It further suggests there exists a threshold BMI that requires anticipation of alterations to systems and processes to revise outcomes.
[Mh] Termos MeSH primário: Obesidade/epidemiologia
Segurança do Paciente
Complicações Pós-Operatórias/epidemiologia
Procedimentos Cirúrgicos Operatórios/efeitos adversos
[Mh] Termos MeSH secundário: Índice de Massa Corporal
Seres Humanos
Indicadores de Qualidade em Assistência à Saúde
Estados Unidos
United States Agency for Healthcare Research and Quality
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170824
[Lr] Data última revisão:
170824
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:170225
[St] Status:MEDLINE


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[PMID]:27892625
[Au] Autor:Ridgely MS; Greenberg MD; Pillen MB; Bell J
[Ad] Endereço:RAND Corporation, Santa Monica, CA.
[Ti] Título:Progress at the Intersection of Patient Safety and Medical Liability: Insights from the AHRQ Patient Safety and Medical Liability Demonstration Program.
[So] Source:Health Serv Res;51 Suppl 3:2414-2430, 2016 Dec.
[Is] ISSN:1475-6773
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To identify lessons learned from the experience of the Agency for Healthcare Research and Quality (AHRQ) Patient Safety and Medical Liability (PSML) Demonstration Program. DATA SOURCES/STUDY SETTING: On September 9, 2009, President Obama directed the Secretary of Health and Human Services to authorize demonstration projects that put "patient safety first" with the intent of reducing preventable adverse outcomes and stemming liability costs. Seven demonstration projects received 3 years of funding from AHRQ in the summer of 2010, and the program formally came to a close in June 2015. STUDY DESIGN: The seven grantees implemented complex, broad-ranging innovations addressing both patient safety and medical liability in "real-world" contexts. Some projects featured novel approaches, while others implemented adaptations of existing models. Each project was funded by AHRQ to collect data on the impact of its interventions. In addition, AHRQ funded a cross-cutting qualitative evaluation focused on lessons learned in implementing PSML interventions. DATA COLLECTION/EXTRACTION METHODS: Site visits and follow-up interviews supplemented with material abstracted from formal project reports to AHRQ. PRINCIPAL FINDINGS: The PSML demonstration projects focused on three broad approaches: (1) improving communication around adverse events through disclosure and resolution programs; (2) preventing harm through implementation of clinical "best practices"; and (3) exploring alternative methods of settling claims. Although the demonstration contributed to accumulating evidence that these kinds of interventions can positively affect outcomes, there is also evidence to suggest that these interventions can be difficult to scale. CONCLUSIONS: In addition to producing at least preliminary positive outcomes, the demonstration also lends credence to the idea that targeted interventions that improve some aspect of patient safety or malpractice performance may also contribute more broadly to institutional culture and the alignment of all parties around reducing risk and preventing harm. However, more empirical work needs to be carried out to quantify the effect of such interventions.
[Mh] Termos MeSH primário: Responsabilidade Legal
Segurança do Paciente
[Mh] Termos MeSH secundário: Pesquisa sobre Serviços de Saúde
Seres Humanos
Erros Médicos/prevenção & controle
Modelos Organizacionais
Guias de Prática Clínica como Assunto
Estados Unidos
United States Agency for Healthcare Research and Quality
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170501
[Lr] Data última revisão:
170501
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161129
[St] Status:MEDLINE
[do] DOI:10.1111/1475-6773.12625


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[PMID]:27891603
[Au] Autor:Chen Q; Rosen AK; Borzecki A; Shwartz M
[Ad] Endereço:Center for Healthcare Organization and Implementation Research (CHOIR), VA Boston Healthcare System, Boston, MA.
[Ti] Título:Using Harm-Based Weights for the AHRQ Patient Safety for Selected Indicators Composite (PSI-90): Does It Affect Assessment of Hospital Performance and Financial Penalties in Veterans Health Administration Hospitals?
[So] Source:Health Serv Res;51(6):2140-2157, 2016 Dec.
[Is] ISSN:1475-6773
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To assess whether hospital profiles for public reporting and pay-for-performance, measured by the Agency for Healthcare Research and Quality (AHRQ) Patient Safety for Selected Indicators (PSI-90) composite measure, were affected by using the recently developed harm-based weights. DATA SOURCES/STUDY SETTING: Retrospective analysis of 2012-2014 data from the Veterans Health Administration (VA). STUDY DESIGN: The AHRQ PSI software (v5.0) was applied to obtain the original volume-based PSI-90 scores for 132 acute-care hospitals. We constructed a modified PSI-90 using the harm-based weights developed by AHRQ. We compared hospital profiles for public reporting and pay-for-performance between these two PSI-90s and assessed patterns in these changes. PRINCIPAL FINDINGS: The volume-based and the harm-based PSI-90s were strongly correlated (r = 0.67, p < .0001). The use of the harm-based PSI-90 had a relatively small impact on public reporting (i.e., 5 percent hospitals changed categorization), but it had a much larger impact on pay-for-performance (e.g., 15 percent of hospitals would have faced different financial penalties under the Medicare Hospital-Acquired Condition Reduction Program). Because of changes in weights of specific PSIs, hospital profile changes occurred systematically. CONCLUSIONS: Use of the harm-based weights in PSI-90 has the potential to significantly change payments under pay-for-performance programs. Policy makers should carefully develop transition plans for guiding hospitals through changes in any quality metrics used for pay-for-performance.
[Mh] Termos MeSH primário: Hospitais de Veteranos/normas
Segurança do Paciente/normas
Indicadores de Qualidade em Assistência à Saúde/normas
Reembolso de Incentivo/economia
[Mh] Termos MeSH secundário: Seres Humanos
Estudos Retrospectivos
Estados Unidos
United States Agency for Healthcare Research and Quality
Saúde dos Veteranos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170516
[Lr] Data última revisão:
170516
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161129
[St] Status:MEDLINE
[do] DOI:10.1111/1475-6773.12596


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[PMID]:27764903
[Au] Autor:Tsou AY; Treadwell JR
[Ad] Endereço:ECRI Institute, Health Technology Information Service and Evidence-based Practice Center, Plymouth Meeting, PA, USA.
[Ti] Título:Quality and clarity in systematic review abstracts: an empirical study.
[So] Source:Res Synth Methods;7(4):447-458, 2016 Dec.
[Is] ISSN:1759-2887
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Systematic review (SR) abstracts are important for disseminating evidence syntheses to inform medical decision making. We assess reporting quality in SR abstracts using PRISMA for Abstracts (PRISMA-A), Cochrane Handbook, and Agency for Healthcare Research & Quality guidance. METHODS: We evaluated a random sample of 200 SR abstracts (from 2014) comparing interventions in the general medical literature. We assessed adherence to PRISMA-A criteria, problematic wording in conclusions, and whether "positive" studies described clinical significance. RESULTS: On average, abstracts reported 60% of PRISMA-A checklist items (mean 8.9 ± 1.7, range 4 to 12). Eighty percent of meta-analyses reported quantitative measures with a confidence interval. Only 49% described effects in terms meaningful to patients and clinicians (e.g., absolute measures), and only 43% mentioned strengths/limitations of the evidence base. Average abstract word count was 274 (SD 89). Word count explained only 13% of score variability. PRISMA-A scores did not differ between Cochrane and non-Cochrane abstracts (mean difference 0.08, 95% confidence interval -1.16 to 1.00). Of 275 primary outcomes, 48% were statistically significant, 32% were not statistically significant, and 19% did not report significance or results. Only one abstract described clinical significance for positive findings. For "negative" outcomes, we identified problematic simple restatements (20%), vague "no evidence of effect" wording (9%), and wishful wording (8%). CONCLUSIONS: Improved SR abstract reporting is needed, particularly reporting of quantitative measures (for meta-analysis), easily interpretable units, strengths/limitations of evidence, clinical significance, and clarifying whether negative results reflect true equivalence between treatments. Copyright © 2016 John Wiley & Sons, Ltd.
[Mh] Termos MeSH primário: Resumos e Indexação como Assunto/normas
Projetos de Pesquisa
Literatura de Revisão como Assunto
[Mh] Termos MeSH secundário: Bases de Dados Bibliográficas
Tomada de Decisões
Pesquisa Empírica
Seres Humanos
Publicações Periódicas como Assunto/normas
Editoração/normas
Controle de Qualidade
Estados Unidos
United States Agency for Healthcare Research and Quality
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170403
[Lr] Data última revisão:
170403
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161021
[St] Status:MEDLINE
[do] DOI:10.1002/jrsm.1221


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[PMID]:27689793
[Au] Autor:Stephenson J
[Ti] Título:AHRQ Director Sets Course for Agency's Health Services Research.
[So] Source:JAMA;316(16):1632-1634, 2016 Oct 25.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: United States Agency for Healthcare Research and Quality
[Mh] Termos MeSH secundário: Pessoal Administrativo
Orçamentos/legislação & jurisprudência
Objetivos Organizacionais
Segurança do Paciente
Estados Unidos
United States Agency for Healthcare Research and Quality/economia
United States Agency for Healthcare Research and Quality/organização & administração
[Pt] Tipo de publicação:INTERVIEW; NEWS
[Em] Mês de entrada:1612
[Cu] Atualização por classe:161230
[Lr] Data última revisão:
161230
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:161001
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2016.12702



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