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  1 / 4103 MEDLINE  
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[PMID]:29480833
[Au] Autor:Goel S; Angeli F; Singla N; Ruwaard D
[Ad] Endereço:School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
[Ti] Título:Measuring the reasons that discourage medical students from working in rural areas: Development and validation of a new instrument.
[So] Source:Medicine (Baltimore);97(2):e9448, 2018 Jan.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The sharply uneven distribution of human resources for health care across urban and rural areas has been a long-standing concern globally. The present study aims to develop and validate an instrument measuring the factors deterring final year students of Bachelor of Medicine and Bachelor of Surgery (MBBS) in 3 northern states of India, from working in rural areas.The medical student's de-motivation to work in rural India (MSDRI) scale was developed using extensive literature review followed by Delphi technique. The psychometric properties of the questionnaire were assessed in terms of content validity, construct validity, data quality and reliability. Exploratory factor analysis (EFA) followed by confirmatory factor analysis (CFA) was performed to identify the primary deterrents.Thirty-three items were generated from literature search followed by Delphi exercise. After assessing psychometric properties, the final instrument included 29 items whereas the EFA and CFA highlighted 5 main factors, namely lack of professional challenge, social segregation, socio-cultural gap, hostile professional environment, and lack of financial incentives as underpinning students' demotivation towards working in rural areas.The MSDRI instrument is the first valid and reliable measure for identifying deterring factors for MBBS students to work in rural areas of India. The use of it may be very helpful for policymakers as well as healthcare organizations in formulating effective measures to encourage medical students to work in rural areas, which suffer from a chronic shortage of medical personnel.
[Mh] Termos MeSH primário: Escolha da Profissão
Motivação
Saúde da População Rural/recursos humanos
Estudantes de Medicina/psicologia
Inquéritos e Questionários
[Mh] Termos MeSH secundário: Adulto
Técnica Delfos
Análise Fatorial
Feminino
Seres Humanos
Índia
Masculino
Projetos Piloto
Psicometria
Reprodutibilidade dos Testes
População Rural
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW; VALIDATION STUDIES
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180227
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009448


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[PMID]:29293635
[Au] Autor:Knight S; Aggarwal R; Agostini A; Loundou A; Berdah S; Crochet P
[Ad] Endereço:Department of Obstetrics and Gynecology, Assistance Publique-Hôpitaux de Marseille, La Conception Hospital, Marseille, Aix Marseille Université, France.
[Ti] Título:Development of an objective assessment tool for total laparoscopic hysterectomy: A Delphi method among experts and evaluation on a virtual reality simulator.
[So] Source:PLoS One;13(1):e0190580, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Total Laparoscopic hysterectomy (LH) requires an advanced level of operative skills and training. The aim of this study was to develop an objective scale specific for the assessment of technical skills for LH (H-OSATS) and to demonstrate feasibility of use and validity in a virtual reality setting. MATERIAL AND METHODS: The scale was developed using a hierarchical task analysis and a panel of international experts. A Delphi method obtained consensus among experts on relevant steps that should be included into the H-OSATS scale for assessment of operative performances. Feasibility of use and validity of the scale were evaluated by reviewing video recordings of LH performed on a virtual reality laparoscopic simulator. Three groups of operators of different levels of experience were assessed in a Marseille teaching hospital (10 novices, 8 intermediates and 8 experienced surgeons). Correlations with scores obtained using a recognised generic global rating tool (OSATS) were calculated. RESULTS: A total of 76 discrete steps were identified by the hierarchical task analysis. 14 experts completed the two rounds of the Delphi questionnaire. 64 steps reached consensus and were integrated in the scale. During the validation process, median time to rate each video recording was 25 minutes. There was a significant difference between the novice, intermediate and experienced group for total H-OSATS scores (133, 155.9 and 178.25 respectively; p = 0.002). H-OSATS scale demonstrated high inter-rater reliability (intraclass correlation coefficient [ICC] = 0.930; p<0.001) and test retest reliability (ICC = 0.877; p<0.001). High correlations were found between total H-OSATS scores and OSATS scores (rho = 0.928; p<0.001). CONCLUSION: The H-OSATS scale displayed evidence of validity for assessment of technical performances for LH performed on a virtual reality simulator. The implementation of this scale is expected to facilitate deliberate practice. Next steps should focus on evaluating the validity of the scale in the operating room.
[Mh] Termos MeSH primário: Histerectomia/métodos
Laparoscopia/métodos
Realidade Virtual
[Mh] Termos MeSH secundário: Competência Clínica
Técnica Delfos
Estudos de Viabilidade
Feminino
Seres Humanos
Reprodutibilidade dos Testes
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180221
[Lr] Data última revisão:
180221
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180103
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0190580


  3 / 4103 MEDLINE  
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[PMID]:29390500
[Au] Autor:Li W; Zeng L; Li J; Huang L; Gui G; Song J; Chen L; Jiang L; Zhang L
[Ad] Endereço:Department of Pharmacy.
[Ti] Título:Development of indicators for assessing rational drug use to treat community-acquired pneumonia in children in hospitals and clinics: A modified Delphi study.
[So] Source:Medicine (Baltimore);96(51):e9308, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Community-acquired pneumonia (CAP) is a common infectious disease in children. Rational drug use (RDU) is an important approach to reducing the disease burden and mortality rate of CAP in children. There are no monitoring indicators for assessing RDU in children. This study aimed to develop a set of indicators to assess RDU to treat CAP in children in hospitals and clinics using a modified Delphi method.Initial indicators were generated based on a systematic review of guidelines and studies investigating CAP in children. A 3-round modified Delphi process in the form of an email survey combined with round-table discussion was then carried out, and an analytic hierarchy process (AHP) was applied to determine the weight of each indicator.A total of 24 and 8 experts were invited to participate in the email survey and round-table discussion, respectively. A consensus was reached after 3 rounds of the Delphi survey. Three first-rank indicators and 23 second-rank indicators were developed, and each indicator was weighted. The first-rank indicators comprised drug choice (45.5%), drug usage and dosage (36.4%), and the duration of drug therapy (18.2%); the second-rank indicators were indicators related to antibiotics (63.6%), antiviral agents (18.2%), traditional Chinese medicines (4.5%), and adjuvant drugs (13.6%). The weight value of drug selection was the highest, followed by the values of drug usage and dosage and the duration of drug therapy.The developed indicator set constitutes the first set intended to assess RDU to treat CAP in children in hospitals (including community hospitals) and clinics. The indicators were based on drug selection, drug usage and dosage and duration of drug therapy, which are associated with most therapeutic drugs for CAP in children. Monitoring these indicators will guide people towards the promotion of RDU in the absence of drug monitoring indicators for CAP. Furthermore, the indicator set constitutes a methodological reference for the development of other indicator sets.
[Mh] Termos MeSH primário: Antibacterianos/uso terapêutico
Antivirais/uso terapêutico
Pneumonia/tratamento farmacológico
Indicadores de Qualidade em Assistência à Saúde
[Mh] Termos MeSH secundário: Instituições de Assistência Ambulatorial
Criança
China/epidemiologia
Infecções Comunitárias Adquiridas/tratamento farmacológico
Técnica Delfos
Hospitais
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Antiviral Agents)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009308


  4 / 4103 MEDLINE  
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[PMID]:29304126
[Au] Autor:Xue J; Liu Y; Sun K; Wu L; Liao K; Xia Y; Hou P; Xue H; Shi H
[Ad] Endereço:Medical Academy, Yangzhou University, Yangzhou, Jiangsu Province, China.
[Ti] Título:Validation of a newly adapted Chinese version of the Newest Vital Sign instrument.
[So] Source:PLoS One;13(1):e0190721, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To develop a Chinese version of the Newest Vital Sign (NVS-CHN) instrument and evaluate its psychometric properties. METHODS: To deal with cross-cultural adaptation problems, after translation of the NVS into Chinese, the Delphi method was used for experts and cognitive testing was used for participants. A cross-sectional study including 351 participants was conducted to assess the validity of the NVS-CHN. Internal reliability, criterion validity, and known-groups validity were investigated. The NVS-CHN was further validated against a suitable standard, the Chinese Citizen Health Literacy Questionnaire (CCHLQ). RESULTS: The validity of the NVS-CHN was established by conducting a Delphi survey (three rounds) and cognitive testing (three rounds). Cronbach's alpha was 0.71, indicating that internal consistency was acceptable. A Spearman's correlation coefficient of 0.68 between the NVS-CHN and CCHLQ revealed excellent criterion validity. Differences in NVS-CHN scores by education level confirmed known-groups validity. A receiver operating characteristics analysis showed that the area under the curve was 0.81, indicating that the NVS-CHN was an accurate health literacy assessment tool. A score ≥ 4 out of 6 best identified participants with adequate health literacy. CONCLUSIONS: The NVS-CHN has excellent psychometrical reliability and validity, which make it a suitable tool to evaluate health literacy in China.
[Mh] Termos MeSH primário: Alfabetização em Saúde
[Mh] Termos MeSH secundário: Adulto
Idoso
Área Sob a Curva
China
Estudos Transversais
Técnica Delfos
Escolaridade
Feminino
Rotulagem de Alimentos
Seres Humanos
Masculino
Meia-Idade
Psicometria
Curva ROC
Reprodutibilidade dos Testes
Traduções
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T; VALIDATION STUDIES
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180210
[Lr] Data última revisão:
180210
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180106
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0190721


  5 / 4103 MEDLINE  
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[PMID]:28470770
[Au] Autor:Davey CJ; Slade SV; Shickle D
[Ad] Endereço:Academic Unit of Public Health, University of Leeds, Leeds, UK.
[Ti] Título:A proposed minimum data set for international primary care optometry: a modified Delphi study.
[So] Source:Ophthalmic Physiol Opt;37(4):428-439, 2017 07.
[Is] ISSN:1475-1313
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To identify a minimum list of metrics of international relevance to public health, research and service development which can be extracted from practice management systems and electronic patient records in primary optometric practice. METHODS: A two stage modified Delphi technique was used. Stage 1 categorised metrics that may be recorded as being part of a primary eye examination by their importance to research using the results from a previous survey of 40 vision science and public health academics. Delphi stage 2 then gauged the opinion of a panel of seven vision science academics and achieved consensus on contentious metrics and methods of grading/classification. RESULTS: A consensus regarding inclusion and response categories was achieved for nearly all metrics. A recommendation was made of 53 metrics which would be appropriate in a minimum data set. CONCLUSIONS: This minimum data set should be easily integrated into clinical practice yet allow vital data to be collected internationally from primary care optometry. It should not be mistaken for a clinical guideline and should not add workload to the optometrist. A pilot study incorporating an additional Delphi stage prior to implementation is advisable to refine some response categories.
[Mh] Termos MeSH primário: Técnica Delfos
Registros Eletrônicos de Saúde/organização & administração
Modelos Organizacionais
Optometria/estatística & dados numéricos
Atenção Primária à Saúde/organização & administração
Saúde Pública
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Cooperação Internacional
Masculino
Projetos Piloto
Inquéritos e Questionários
Reino Unido
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1709
[Cu] Atualização por classe:180206
[Lr] Data última revisão:
180206
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE
[do] DOI:10.1111/opo.12372


  6 / 4103 MEDLINE  
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[PMID]:29362800
[Au] Autor:McInnes MDF; Moher D; Thombs BD; McGrath TA; Bossuyt PM; Clifford T; Cohen JF; Deeks JJ; Gatsonis C; Hooft L; Hunt HA; Hyde CJ; Korevaar DA; Leeflang MMG; Macaskill P; Reitsma JB; Rodin R; Rutjes AWS; Salameh JP; Stevens A; Takwoingi Y; Tonelli M; Weeks L; Whiting P; Willis BH; the PRISMA-DTA Group
[Ad] Endereço:Department of Radiology, University of Ottawa, Ottawa, Ontario, Canada.
[Ti] Título:Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies: The PRISMA-DTA Statement.
[So] Source:JAMA;319(4):388-396, 2018 01 23.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: Systematic reviews of diagnostic test accuracy synthesize data from primary diagnostic studies that have evaluated the accuracy of 1 or more index tests against a reference standard, provide estimates of test performance, allow comparisons of the accuracy of different tests, and facilitate the identification of sources of variability in test accuracy. Objective: To develop the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) diagnostic test accuracy guideline as a stand-alone extension of the PRISMA statement. Modifications to the PRISMA statement reflect the specific requirements for reporting of systematic reviews and meta-analyses of diagnostic test accuracy studies and the abstracts for these reviews. Design: Established standards from the Enhancing the Quality and Transparency of Health Research (EQUATOR) Network were followed for the development of the guideline. The original PRISMA statement was used as a framework on which to modify and add items. A group of 24 multidisciplinary experts used a systematic review of articles on existing reporting guidelines and methods, a 3-round Delphi process, a consensus meeting, pilot testing, and iterative refinement to develop the PRISMA diagnostic test accuracy guideline. The final version of the PRISMA diagnostic test accuracy guideline checklist was approved by the group. Findings: The systematic review (produced 64 items) and the Delphi process (provided feedback on 7 proposed items; 1 item was later split into 2 items) identified 71 potentially relevant items for consideration. The Delphi process reduced these to 60 items that were discussed at the consensus meeting. Following the meeting, pilot testing and iterative feedback were used to generate the 27-item PRISMA diagnostic test accuracy checklist. To reflect specific or optimal contemporary systematic review methods for diagnostic test accuracy, 8 of the 27 original PRISMA items were left unchanged, 17 were modified, 2 were added, and 2 were omitted. Conclusions and Relevance: The 27-item PRISMA diagnostic test accuracy checklist provides specific guidance for reporting of systematic reviews. The PRISMA diagnostic test accuracy guideline can facilitate the transparent reporting of reviews, and may assist in the evaluation of validity and applicability, enhance replicability of reviews, and make the results from systematic reviews of diagnostic test accuracy studies more useful.
[Mh] Termos MeSH primário: Lista de Checagem
Técnicas e Procedimentos Diagnósticos/normas
Guias como Assunto
Metanálise como Assunto
Literatura de Revisão como Assunto
[Mh] Termos MeSH secundário: Conferências de Consenso como Assunto
Técnica Delfos
Reprodutibilidade dos Testes
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180131
[Lr] Data última revisão:
180131
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180125
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.19163


  7 / 4103 MEDLINE  
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[PMID]:28468646
[Au] Autor:Galbraith K; Ward A; Heneghan C
[Ad] Endereço:Centre for Evidence-based Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Primary Care Building, Radcliffe Observatory Quarter, Oxford, OX2 6GG, UK. kevin.galbraith@kellogg.ox.ac.uk.
[Ti] Título:A real-world approach to Evidence-Based Medicine in general practice: a competency framework derived from a systematic review and Delphi process.
[So] Source:BMC Med Educ;17(1):78, 2017 May 03.
[Is] ISSN:1472-6920
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Evidence-Based Medicine (EBM) skills have been included in general practice curricula and competency frameworks. However, GPs experience numerous barriers to developing and maintaining EBM skills, and some GPs feel the EBM movement misunderstands, and threatens their traditional role. We therefore need a new approach that acknowledges the constraints encountered in real-world general practice. The aim of this study was to synthesise from empirical research a real-world EBM competency framework for general practice, which could be applied in training, in the individual pursuit of continuing professional development, and in routine care. We sought to integrate evidence from the literature with evidence derived from the opinions of experts in the fields of general practice and EBM. METHODS: We synthesised two sets of themes describing the meaning of EBM in general practice. One set of themes was derived from a mixed-methods systematic review of the literature; the other set was derived from the further development of those themes using a Delphi process among a panel of EBM and general practice experts. From these two sets of themes we constructed a real-world EBM competency framework for general practice. RESULTS: A simple competency framework was constructed, that acknowledges the constraints of real-world general practice: (1) mindfulness - in one's approach towards EBM itself, and to the influences on decision-making; (2) pragmatism - in one's approach to finding and evaluating evidence; and (3) knowledge of the patient - as the most useful resource in effective communication of evidence. We present a clinical scenario to illustrate how a GP might demonstrate these competencies in their routine daily work. CONCLUSION: We have proposed a real-world EBM competency framework for general practice, derived from empirical research, which acknowledges the constraints encountered in modern general practice. Further validation of these competencies is required, both as an educational resource and as a strategy for actual practice.
[Mh] Termos MeSH primário: Competência Clínica
Medicina Baseada em Evidências
Medicina Geral/educação
Aprendizagem Baseada em Problemas
[Mh] Termos MeSH secundário: Adulto
Técnica Delfos
Feminino
Seres Humanos
Masculino
Meia-Idade
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180123
[Lr] Data última revisão:
180123
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE
[do] DOI:10.1186/s12909-017-0916-1


  8 / 4103 MEDLINE  
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[PMID]:25816185
[Au] Autor:Manganelli J; Threatt A; Brooks JO; Healy S; Merino J; Yanik P; Walker I; Green K
[Ti] Título:Confirming, Classifying, and Prioritizing Needed Over-the-Bed Table Improvements via Methodological Triangulation.
[So] Source:HERD;8(1):94-114, 2014.
[Is] ISSN:1937-5867
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: This article presents the results of a qualitative study that confirmed, classified, and prioritized user needs for the design of a more useful, usable, and actively assistive over-the-bed table. BACKGROUND: Manganelli et al. (2014) generated a list of 74 needs for use in developing an actively assistive over-the-bed table. This present study assesses the value and importance of those needs. METHODS: Fourteen healthcare subject matter experts and eight research and design subject matter experts engaged in a participatory and iterative research and design process. A mixed methods qualitative approach used methodological triangulation to confirm the value of the findings and ratings to establish importance. Open and closed card sorts and a Delphi study were used. Data analysis methods included frequency analysis, content analysis, and a modified Kano analysis. RESULTS: A table demonstrating the needs that are of high importance to both groups of subject matter experts and classification of the design challenges each represents was produced. Through this process, the list of 74 needs was refined to the 37 most important need statements for both groups. CONCLUSIONS: Designing a more useful, usable, and actively assistive over-the-bed table is primarily about the ability to position it optimally with respect to the user for any task, as well as improving ease of use and usability. It is also important to make explicit and discuss the differences in priorities and perspectives demonstrated between research and design teams and their clients.
[Mh] Termos MeSH primário: Decoração de Interiores e Mobiliário/instrumentação
Decoração de Interiores e Mobiliário/métodos
Quartos de Pacientes
[Mh] Termos MeSH secundário: Técnica Delfos
Seres Humanos
Nigéria
Pesquisa Qualitativa
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180123
[Lr] Data última revisão:
180123
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:150328
[St] Status:MEDLINE
[do] DOI:10.1177/193758671400800108


  9 / 4103 MEDLINE  
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[PMID]:28455152
[Au] Autor:Turner S; Seel M; Trotter T; Giuliani M; Benstead K; Eriksen JG; Poortmans P; Verfaillie C; Westerveld H; Cross S; Chan MK; Shaw T
[Ad] Endereço:Department of Radiation Oncology, Westmead Hospital, Sydney, Australia; University of Sydney, Australia. Electronic address: sandra.turner1@optusnet.com.au.
[Ti] Título:Defining a Leader Role curriculum for radiation oncology: A global Delphi consensus study.
[So] Source:Radiother Oncol;123(2):331-336, 2017 05.
[Is] ISSN:1879-0887
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND PURPOSE: The need for radiation oncologists and other radiation oncology (RO) professionals to lead quality improvement activities and contribute to shaping the future of our specialty is self-evident. Leadership knowledge, skills and behaviours, like other competencies, can be learned (Blumenthal et al., 2012). The objective of this study was to define a globally applicable competency set specific to radiation oncology for the CanMEDS Leader Role (Frank et al., 2015). METHODS: A modified Delphi consensus process delivering two rounds of on-line surveys was used. Participants included trainees, radiation/clinical oncologists and other RO team members (radiation therapists, physicists, and nurses), professional educators and patients. RESULTS: 72 of 95 (76%) invitees from nine countries completed the Round 1 (R1) survey. Of the 72 respondents to RI, 70 completed Round 2 (R2) (97%). In R1, 35 items were deemed for 'inclusion' and 21 for 'exclusion', leaving 41 'undetermined'. After review of items, informed by participant comments, 14 competencies from the 'inclusion' group went into the final curriculum; 12 from the 'undetermined' group went to R2. In R2, 6 items reached consensus for inclusion. CONCLUSION: This process resulted in 20 RO Leader Role competencies with apparent global applicability. This is the first step towards developing learning, teaching and assessment tools for this important area of training.
[Mh] Termos MeSH primário: Currículo
Técnica Delfos
Radioterapia (Especialidade)/educação
[Mh] Termos MeSH secundário: Competência Clínica
Consenso
Feminino
Seres Humanos
Liderança
Masculino
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180120
[Lr] Data última revisão:
180120
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170430
[St] Status:MEDLINE


  10 / 4103 MEDLINE  
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[PMID]:29267350
[Au] Autor:Smythe T; Wainwright A; Foster A; Lavy C
[Ad] Endereço:International Centre for Evidence in Disability, London School of Hygiene and Tropical Medicine, London, United Kingdom.
[Ti] Título:What is a good result after clubfoot treatment? A Delphi-based consensus on success by regional clubfoot trainers from across Africa.
[So] Source:PLoS One;12(12):e0190056, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Congenital talipes equino-varus (CTEV), also known as clubfoot, is one of the most common congenital musculoskeletal malformations. Despite this, considerable variation exists in the measurement of deformity correction and outcome evaluation. This study aims to determine the criteria for successful clubfoot correction using the Ponseti technique in low resource settings through Africa. METHODS: Using the Delphi method, 18 experienced clubfoot practitioners and trainers from ten countries in Africa ranked the importance of 22 criteria to define an 'acceptable or good clubfoot correction' at the end of bracing with the Ponseti technique. A 10cm visual analogue scale was used. They repeated the rating with the results of the mean scores and standard deviation of the first test provided. The consistency among trainers was determined with the intra-class correlation coefficient (ICC). From the original 22 criteria, ten criteria with a mean score >7 and SD <2 were identified and were rated through a second Delphi round by 17 different clubfoot treatment trainers from 11 countries in Africa. The final definition consisted of all statements that achieved strong agreement, a mean score of >9 and SD<1.5. RESULTS: The consensus definition of a successfully treated clubfoot includes: (1) a plantigrade foot, (2) the ability to wear a normal shoe, (3) no pain, and (4) the parent is satisfied. Participants demonstrated good consistency in rating these final criteria (ICC 0.88; 0.74,0.97). CONCLUSIONS: The consistency of Ponseti technique trainers from Africa in rating criteria for a successful outcome of clubfoot management was good. The consensus definition includes basic physical assessment, footwear use, pain and parent satisfaction.
[Mh] Termos MeSH primário: Pé Torto Equinovaro/terapia
Procedimentos Ortopédicos/métodos
Resultado do Tratamento
[Mh] Termos MeSH secundário: África
Consenso
Técnica Delfos
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180116
[Lr] Data última revisão:
180116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171222
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0190056



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