WorldWideScience

Sample records for assessment systematic evaluation

  1. [Systematic economic assessment and quality evaluation for traditional Chinese medicines].

    Science.gov (United States)

    Sun, Xiao; Guo, Li-ping; Shang, Hong-cai; Ren, Ming; Lei, Xiang

    2015-05-01

    To learn about the economic studies on traditional Chinese medicines in domestic literatures, in order to analyze the current economic assessment of traditional Chinese medicines and explore the existing problems. Efforts were made to search CNKI, VIP, Wanfang database and CBM by computer and include all literatures about economic assessment of traditional Chinese medicines published on professional domestic journals in the systematic assessment and quality evaluation. Finally, 50 articles were included in the study, and the systematic assessment and quality evaluation were made for them in terms of titles, year, authors' identity, expense source, disease type, study perspective, study design type, study target, study target source, time limit, cost calculation, effect indicator, analytical technique and sensitivity analysis. The finally quality score was 0.74, which is very low. The results of the study showed insufficient studies on economics of traditional Chinese medicines, short study duration and simple evaluation methods, which will be solved through unremitting efforts in the future.

  2. Systematic evaluation of observational methods assessing biomechanical exposures at work

    DEFF Research Database (Denmark)

    Takala, Esa-Pekka; Irmeli, Pehkonen; Forsman, Mikael

    2009-01-01

    by sorting the methods according to the several items evaluated.   Numerous methods have been developed to assess physical workload (biomechanical exposures) in order to identify hazards leading to musculoskeletal disorders, to monitor the effects of ergonomic changes, and for research. No indvidual method...... between observers Potential users NIOSH Lifting Eq. NA X - O, R Arbouw M - - O ACGIH Lifting TLV M - - O MAC - - M O, W(?) ManTRA - - - O, R(?),W(?) NZ Code for MH - - - O, W(?) Washington state ergonomic rule M X M O, W(?) BackEST ML - M R   Correspondence with valid reference: HM = High to moderate, L......), and Washington state model. MAC (UK), ManTRA (Australia), and New Zealand code are widely used for the assessment of risks in MMH but we did not found formal studies on validity of these methods. The inter-observer repeatability of MAC and the Washington state model has been found to be moderate. Back...

  3. Systematic evaluation of observational methods assessing biomechanical exposures at work

    DEFF Research Database (Denmark)

    Takala, Esa-Pekka; Pehkonen, Irmeli; Forsman, Mikael

    2010-01-01

    the use of technical instruments. Generally, the observations showed moderate to good agreement with the corresponding assessments made from video recordings; agreement was the best for large-scale body postures and work actions. Postures of wrist and hand as well as trunk rotation seemed to be more...... difficult to observe correctly. Intra- and inter-observer repeatability were reported for 7 and 17 methods, respectively, and were judged mostly to be good or moderate. CONCLUSIONS: With training, observers can reach consistent results on clearly visible body postures and work activities. Many observational...

  4. Fatigue in patients with low grade glioma: systematic evaluation of assessment and prevalence

    NARCIS (Netherlands)

    E.M.P. Van Coevorden-van Loon (Ellen M. P.); Coomans, M.B. (Marijke B.); M.H. Heijenbrok-Kal (Majanka); G.M. Ribbers (Gerard); M.J. van den Bent (Martin)

    2017-01-01

    textabstractFatigue is the most prevalent and disabling symptom in cancer patients. Yet, scientific literature on this topic is scarce and reports disparate results. This study systematically reviews how fatigue is assessed in patients with low-grade glioma and evaluates its prevalence in LGG

  5. Systematic, Cooperative Evaluation.

    Science.gov (United States)

    Nassif, Paula M.

    Evaluation procedures based on a systematic evaluation methodology, decision-maker validity, new measurement and design techniques, low cost, and a high level of cooperation on the part of the school staff were used in the assessment of a public school mathematics program for grades 3-8. The mathematics curriculum was organized into Spirals which…

  6. Integrated Plant Safety Assessment, Systematic Evaluation Program: Yankee Nuclear Power Station (Docket No. 50-29)

    International Nuclear Information System (INIS)

    1987-10-01

    The US Nuclear Regulatory Commission (NRC) has prepared Supplement 1 to the final Integrated Plant Safety Assessment Report (IPSAR) (NUREG-0825), under the scope of the Systematic Evaluation Program (SEP), for Yankee Atomic Electric Company's Yankee Nuclear Power Station located in Rowe, Massachusetts. The SEP was initiated by the NRC to review the design of older operating nuclear power plants to reconfirm and document their safety. This report documents the review completed under the SEP for those issues that required refined engineering evaluations or the continuation of ongoing evaluations after the Final IPSAR for the Yankee plant was issued. The review has provided for (1) an assessment of the significance of differences between current technical positions on selected safety issues and those that existed when Yankee was licensed, (2) a basis for deciding how these differences should be resolved in an integrated plant review, and (3) a documented evaluation of plant safety. 2 tabs

  7. Quality Assessment of Studies Published in Open Access and Subscription Journals: Results of a Systematic Evaluation.

    Science.gov (United States)

    Pastorino, Roberta; Milovanovic, Sonja; Stojanovic, Jovana; Efremov, Ljupcho; Amore, Rosarita; Boccia, Stefania

    2016-01-01

    Along with the proliferation of Open Access (OA) publishing, the interest for comparing the scientific quality of studies published in OA journals versus subscription journals has also increased. With our study we aimed to compare the methodological quality and the quality of reporting of primary epidemiological studies and systematic reviews and meta-analyses published in OA and non-OA journals. In order to identify the studies to appraise, we listed all OA and non-OA journals which published in 2013 at least one primary epidemiologic study (case-control or cohort study design), and at least one systematic review or meta-analysis in the field of oncology. For the appraisal, we picked up the first studies published in 2013 with case-control or cohort study design from OA journals (Group A; n = 12), and in the same time period from non-OA journals (Group B; n = 26); the first systematic reviews and meta-analyses published in 2013 from OA journals (Group C; n = 15), and in the same time period from non-OA journals (Group D; n = 32). We evaluated the methodological quality of studies by assessing the compliance of case-control and cohort studies to Newcastle and Ottawa Scale (NOS) scale, and the compliance of systematic reviews and meta-analyses to Assessment of Multiple Systematic Reviews (AMSTAR) scale. The quality of reporting was assessed considering the adherence of case-control and cohort studies to STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) checklist, and the adherence of systematic reviews and meta-analyses to Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) checklist. Among case-control and cohort studies published in OA and non-OA journals, we did not observe significant differences in the median value of NOS score (Group A: 7 (IQR 7-8) versus Group B: 8 (7-9); p = 0.5) and in the adherence to STROBE checklist (Group A, 75% versus Group B, 80%; p = 0.1). The results did not change after adjustment

  8. Measurement properties of exsisting clinical assessment methods evaluating scapular positioning and function. A systematic review

    DEFF Research Database (Denmark)

    Larsen, Camilla Marie; Juul-Kristensen, B; Lund, H

    (COSMIN checklist), the methodological quality in the reliability and validity domains was ‘fair’ (57%) to ‘poor’ (43%), with only one study rated as ‘good’. The reliability domain was most often investigated. Fewof the assessment methods in the included studies that had ‘fair’ or ‘good’ measurement......MEASUREMENT PROPERTIES OF EXISTING CLINICAL ASSESSMENT METHODS EVALUATING SCAPULAR POSITIONING AND FUNCTION. A SYSTEMATIC REVIEW1,2Camilla Marie Larsen, 1,3Birgit Juul-Kristensen, 1,3Hans Lund, 1Karen Søgaard1Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark2......,2]. Rehabilitation exercises are aiming at altering abnormal/asymmetric scapular positioning and/or function. Numerous assessment methods have measured the degree of scapular dyskinesis, subjectively by visual evaluation and objectively by measurements of static and dynamic scapular positioning, by either a 3...

  9. Measurement properties of existing clinical assessment methods evaluating scapular positioning and function. A systematic review

    DEFF Research Database (Denmark)

    Larsen, Camilla Marie; Juul-Kristensen, Birgit; Lund, Hans

    %), with only one study rated as ‘good’. The reliability domain was most often investigated. Fewof the assessment methods in the included studies that had ‘fair’ or ‘good’ measurement properties demonstrated acceptable results for both reliability and validity.ConclusionWe found a substantially larger number......ABSTRACT OARSI Measurement properties of existing clinical assessment methods evaluating scapular positioning and function. A systematic review Larsen CM1, Juul-Kristensen B1,2 Lund H1,2, Søgaard K11University of Southern Denmark, Institute of Sports Science and Clinical Biomechanics2Institute...... assessment methods have measured the degree of scapular dyskinesis, subjectively by visual evaluation and objectively by measurements of static and dynamic scapular positioning, by either a 3-dimensional electromagnetic device or 2-dimensional clinically applicable methods. Since advanced equipment (i.e. 3D...

  10. Systematic evaluation of non-animal test methods for skin sensitisation safety assessment.

    Science.gov (United States)

    Reisinger, Kerstin; Hoffmann, Sebastian; Alépée, Nathalie; Ashikaga, Takao; Barroso, Joao; Elcombe, Cliff; Gellatly, Nicola; Galbiati, Valentina; Gibbs, Susan; Groux, Hervé; Hibatallah, Jalila; Keller, Donald; Kern, Petra; Klaric, Martina; Kolle, Susanne; Kuehnl, Jochen; Lambrechts, Nathalie; Lindstedt, Malin; Millet, Marion; Martinozzi-Teissier, Silvia; Natsch, Andreas; Petersohn, Dirk; Pike, Ian; Sakaguchi, Hitoshi; Schepky, Andreas; Tailhardat, Magalie; Templier, Marie; van Vliet, Erwin; Maxwell, Gavin

    2015-02-01

    The need for non-animal data to assess skin sensitisation properties of substances, especially cosmetics ingredients, has spawned the development of many in vitro methods. As it is widely believed that no single method can provide a solution, the Cosmetics Europe Skin Tolerance Task Force has defined a three-phase framework for the development of a non-animal testing strategy for skin sensitization potency prediction. The results of the first phase – systematic evaluation of 16 test methods – are presented here. This evaluation involved generation of data on a common set of ten substances in all methods and systematic collation of information including the level of standardisation, existing test data,potential for throughput, transferability and accessibility in cooperation with the test method developers.A workshop was held with the test method developers to review the outcome of this evaluation and to discuss the results. The evaluation informed the prioritisation of test methods for the next phase of the non-animal testing strategy development framework. Ultimately, the testing strategy – combined with bioavailability and skin metabolism data and exposure consideration – is envisaged to allow establishment of a data integration approach for skin sensitisation safety assessment of cosmetic ingredients.

  11. Economic evaluations of comprehensive geriatric assessment in surgical patients: a systematic review.

    Science.gov (United States)

    Eamer, Gilgamesh; Saravana-Bawan, Bianka; van der Westhuizen, Brenden; Chambers, Thane; Ohinmaa, Arto; Khadaroo, Rachel G

    2017-10-01

    Seniors presenting with surgical disease face increased risk of postoperative morbidity and mortality and have increased treatment costs. Comprehensive Geriatric Assessment (CGA) is proposed to reduce morbidity, mortality, and the cost after surgery. A systematic review of CGA in emergency surgical patients was conducted. The primary outcome was cost-effectiveness; secondary outcomes were length of stay, return of function, and mortality. Inclusion and exclusion criteria were predefined. Systematic searches of MEDLINE, Embase, Cochrane, and National Health Service Economic Evaluation Database were performed. Text screening, bias assessment, and data extraction were performed by two authors. There were 560 articles identified; abstract review excluded 499 articles and full-text review excluded 53 articles. Eight studies were included; one nonorthopedic trauma and seven orthopedic trauma studies. Bias assessment revealed moderate to high risk of bias for all studies. Economic evaluation assessment identified two high-quality studies and six moderate or low quality studies. Pooled analysis from four studies assessed loss of function; loss of function decreased in the experimental arm (odds ratio 0.92, 95% confidence interval [CI]: 0.88-0.97). Pooled results for length of stay from five studies found a significant decrease (mean difference: -1.17, 95% CI: -1.63 to -0.71) after excluding the nonorthopedic trauma study. Pooled mortality was significantly decreased in seven studies (risk ratio: 0.78, 95% CI: 0.67-0.90). All studies decreased cost and improved health outcomes in a cost-effective manner. CGA improved return of function and mortality with reduced cost or improved utility. Our review suggests that CGA is economically dominant and the most cost-effective care model for orthogeriatric patients. Further research should examine other surgical fields. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Evaluation Methods for Assessing Users' Psychological Experiences of Web-Based Psychosocial Interventions: A Systematic Review.

    Science.gov (United States)

    Feather, Jacqueline Susan; Howson, Moira; Ritchie, Linda; Carter, Philip D; Parry, David Tudor; Koziol-McLain, Jane

    2016-06-30

    The use of Web-based interventions to deliver mental health and behavior change programs is increasingly popular. They are cost-effective, accessible, and generally effective. Often these interventions concern psychologically sensitive and challenging issues, such as depression or anxiety. The process by which a person receives and experiences therapy is important to understanding therapeutic process and outcomes. While the experience of the patient or client in traditional face-to-face therapy has been evaluated in a number of ways, there appeared to be a gap in the evaluation of patient experiences of therapeutic interventions delivered online. Evaluation of Web-based artifacts has focused either on evaluation of experience from a computer Web-design perspective through usability testing or on evaluation of treatment effectiveness. Neither of these methods focuses on the psychological experience of the person while engaged in the therapeutic process. This study aimed to investigate what methods, if any, have been used to evaluate the in situ psychological experience of users of Web-based self-help psychosocial interventions. A systematic literature review was undertaken of interdisciplinary databases with a focus on health and computer sciences. Studies that met a predetermined search protocol were included. Among 21 studies identified that examined psychological experience of the user, only 1 study collected user experience in situ. The most common method of understanding users' experience was through semistructured interviews conducted posttreatment or questionnaires administrated at the end of an intervention session. The questionnaires were usually based on standardized tools used to assess user experience with traditional face-to-face treatment. There is a lack of methods specified in the literature to evaluate the interface between Web-based mental health or behavior change artifacts and users. Main limitations in the research were the nascency of the topic

  13. Evaluation Methods for Assessing Users’ Psychological Experiences of Web-Based Psychosocial Interventions: A Systematic Review

    Science.gov (United States)

    Howson, Moira; Ritchie, Linda; Carter, Philip D; Parry, David Tudor; Koziol-McLain, Jane

    2016-01-01

    Background The use of Web-based interventions to deliver mental health and behavior change programs is increasingly popular. They are cost-effective, accessible, and generally effective. Often these interventions concern psychologically sensitive and challenging issues, such as depression or anxiety. The process by which a person receives and experiences therapy is important to understanding therapeutic process and outcomes. While the experience of the patient or client in traditional face-to-face therapy has been evaluated in a number of ways, there appeared to be a gap in the evaluation of patient experiences of therapeutic interventions delivered online. Evaluation of Web-based artifacts has focused either on evaluation of experience from a computer Web-design perspective through usability testing or on evaluation of treatment effectiveness. Neither of these methods focuses on the psychological experience of the person while engaged in the therapeutic process. Objective This study aimed to investigate what methods, if any, have been used to evaluate the in situ psychological experience of users of Web-based self-help psychosocial interventions. Methods A systematic literature review was undertaken of interdisciplinary databases with a focus on health and computer sciences. Studies that met a predetermined search protocol were included. Results Among 21 studies identified that examined psychological experience of the user, only 1 study collected user experience in situ. The most common method of understanding users’ experience was through semistructured interviews conducted posttreatment or questionnaires administrated at the end of an intervention session. The questionnaires were usually based on standardized tools used to assess user experience with traditional face-to-face treatment. Conclusions There is a lack of methods specified in the literature to evaluate the interface between Web-based mental health or behavior change artifacts and users. Main

  14. Measurement properties of existing clinical assessment methods evaluating scapular positioning and function. A systematic review

    DEFF Research Database (Denmark)

    Larsen, Camilla Marie; Juul-Kristensen, Birgit; Lund, Hans

    2014-01-01

    a substantially larger number of clinical scapular assessment methods than previously reported. Using the COSMIN checklist the methodological quality of the included measurement properties in the reliability and validity domains were in general ‘‘fair’’ to ‘‘poor’’. None were examined for all three domains: (1...... utility for clinical practice.......The aims were to compile a schematic overview of clinical scapular assessment methods and critically appraise the methodological quality of the involved studies. A systematic, computerassisted literature search using Medline, CINAHL, SportDiscus and EMBASE was performed from inception to October...

  15. Instruments for the assessment of suicide risk: A systematic review evaluating the certainty of the evidence.

    Directory of Open Access Journals (Sweden)

    Bo Runeson

    Full Text Available Instruments have been developed to facilitate suicide risk assessment. We aimed to evaluate the evidence for these instruments including assessment of risk of bias and diagnostic accuracy for suicide and suicide attempt.PubMed (NLM, PsycInfo, Embase, Cinahl and the Cochrane Library databases were searched until December 2014. We assessed risk of bias with QUADAS-2. The average sensitivity and specificity of each instrument was estimated and the certainty of the evidence was assessed with GRADE. We considered instruments with a sensitivity > 80% and a specificity > 50% to have sufficient diagnostic accuracy.Thirty-five relevant studies were identified but 14 were considered to have high risk of bias, leaving 21 studies evaluating altogether 15 risk assessment instruments. We could carry out meta-analyses for five instruments. For the outcome suicide attempt SAD PERSONS Scale had a sensitivity of 15% (95% CI 8-24 and specificity of 97% (96-98, and the Manchester Self-Harm Rule (MSHR a sensitivity of 97% (97-97 and a specificity of 20% (20-21. ReACT, which is a modification of MSHR, had a similar low specificity, as did the Sodersjukhuset Self Harm Rule. For the outcome suicide, the Beck Hopelessness Scale had a sensitivity of 89% (78-95 and specificity of 42% (40-43.Most suicide risk assessment instruments were supported by too few studies to allow for evaluation of accuracy. Among those that could be evaluated, none fulfilled requirements for sufficient diagnostic accuracy.

  16. Integrated Plant Safety Assessment, Systematic Evaluation Program, Palisades Plant (Docket No. 50-255)

    International Nuclear Information System (INIS)

    1983-11-01

    This report documents the review completed under the SEP for those issues that required refined engineering evaluations or the continuation of ongoing evaluations after the Final IPSAR for the Palisades Plant was issued. The review has provided for (1) an assessment of the significance of differences between current technical positions on selected safety issues and those that existed when the Palisades Plant was licensed, (2) a basis for deciding on how these differences should be resolved in an integrated plant review, and (3) a documented evaluation of plant safety when the supplement to the Final IPSAR and the Safety Evaluation Report for converting the license from a provisional to a full-term license have been issued. The Final IPSAR and its supplement will form part of the bases for considering the conversion of the provisional operating license to a full-term operating license

  17. Measurement properties of existing clinical assessment methods evaluating scapular positioning and function. A systematic review

    DEFF Research Database (Denmark)

    Larsen, Camilla Marie; Juul-Kristensen, Birgit; Lund, Hans

    2014-01-01

    %) to "poor" (43%), with only one study rated as "good". The reliability domain was most often investigated. Few of the assessment methods in the included studies that had "fair" or "good" measurement property ratings demonstrated acceptable results for both reliability and validity. We found a substantially...... larger number of clinical scapular assessment methods than previously reported. Using the COSMIN checklist the methodological quality of the included measurement properties in the reliability and validity domains were in general "fair" to "poor". None were examined for all three domains: (1) reliability...... excluded for evaluation due to no/few clinimetric results, leaving 35 studies for evaluation. Graded according to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN checklist), the methodological quality in the reliability and validity domains was "fair" (57...

  18. Integrated plant safety assessment: systematic evaluation program. Haddam Neck Plant, Connecticut Yankee Atomic Power Company. Docket No. 50-213

    International Nuclear Information System (INIS)

    1983-03-01

    The Systematic Evaluation Program was initiated in February 1977 by the US Nuclear Regulatory Commission to review the designs of older operating nuclear reactor plants to confirm and document their safety. The review provides: (1) an assessment of how these plants compare with current licensing safety requirements relating to selected issues, (2) a basis for deciding on how these differences should be resolved in an integrated plant review, and (3) a documented evaluation of plant safety. This report documents the review of Haddam Neck Plant, operated by Connecticut Yankee Atomic Power Company. The Haddam Neck Plant is one of 10 plants reviewed under Phase II of this program. This report indicates how 137 topics selected for review under Phase I of the program were addressed. Equipment and procedural changes have been identified as a result of the review

  19. Integrated plant safety assessment, Systematic Evaluation Program: Dresden Nuclear Power Station, Unit 2 (Docket No. 50-237)

    International Nuclear Information System (INIS)

    1989-10-01

    The US Nuclear Regulatory Commission (NRC) has prepared Supplement 1 to the final Integrated Plant Safety Assessment Report (IPSAR) (NUREG-0823), under the scope of the Systematic Evaluation Program (SEP), for the Commonwealth Edison Company (CECo) Dresden Nuclear Power Station, Unit 2 located in Grundy County, Illinois. The NRC initiated the SEP to provide the framework for reviewing the design of older operating nuclear reactor plants to reconfirm and document their safety. This report documents the review completed by means of the SEP for those issues that required refined engineering evaluations or the continuation of ongoing evaluations subsequent to issuing the final IPSAR for Dresden Unit 2. The review was provided for (1) an assessment of the significance of differences between current technical positions on selected issues and those that existed when Dresden Unit 2 was licensed, (2) a basis for deciding on how these differences should be resolved in an integrated plant review, and (3) a documented evaluation of plant safety. The final IPSAR and this supplement forms part of the bases for considering the conversion of the existing provisional operating license to a full-term operating license. 83 refs., 9 tabs

  20. Systematic literature review of clinical trials evaluating pharmacotherapy for overactive bladder in elderly patients: An assessment of trial quality.

    Science.gov (United States)

    Kistler, Kristin D; Xu, Yingxin; Zou, Kelly H; Ntanios, Fady; Chapman, Douglass S; Luo, Xuemei

    2018-01-01

    Overactive bladder (OAB) disproportionately affects older-aged adults, yet most randomized controlled trials (RCTs) underrepresent patients ≥65. This systematic literature review (SLR) identified RCTs evaluating β-3 adrenergic agonists or muscarinic antagonists in elderly patients with OAB, and compared study quality across trials. MEDLINE ® , Embase ® , and Cochrane Collaboration Central Register of Clinical Trials databases were searched from inception through April 28, 2015 to identify published, peer-reviewed RCT reports evaluating β-3 adrenergic agonists or muscarinic antagonists in elderly OAB patients (either ≥65 years or study-described as "elderly"). To assess study quality of RCT reports, we focused on internal/external validity, assessed via two scales: the validated Effective Public Health Practice Project [EPHPP]): Quality Assessment Tool for Quantitative Studies, and a tool commissioned by the Agency for Healthcare Research and Quality (AHRQ). Database searches yielded 1380 records that were then screened according to predefined inclusion/exclusion criteria. We included eight papers meeting study criteria. Despite scientific community efforts to improve RCT reporting standards, published reports still include incomplete and inconsistent reporting-of subject attrition, baseline patient characteristics, inclusion/exclusion criteria, and other important details. Only three of the eight OAB RCTs in this review received quality ratings of Strong (EPHPP) or Fair (AHRQ) and were multicenter with large samples. Despite the prevalence of OAB among older age individuals, relatively few RCTs evaluate OAB treatments explicitly among elderly subjects. The findings from this quality assessment suggest some areas for improvement in both conduct and reporting of future RCTs assessing OAB treatment in elderly. © 2017 Wiley Periodicals, Inc.

  1. Intergrated plant safety assessment. Systematic evaluation program. Palisades plant, Consumers Power Company, Docket No. 50-255. Final report

    International Nuclear Information System (INIS)

    1982-10-01

    The Nuclear Regulatory Commission (NRC) has published its Final Integrated Plant Safety Assessment Report (IPSAR) (NUREG-0820), under the scope of the Systematic Evaluation Program (SEP), for Consumers Power Company's Palisades Plant located in Covert, Van Buren County, Michigan. The SEP was initiated by the NRC to review the design of older operating nuclear reactor plants to reconfirm and document their safety. This report documents the review completed under the SEP for the Palisades Plant. The review has provided for (1) as assessment of the significance of differences between current technical positions on selected safety issues and those that existed when the Palisades Plant was licensed, (2) a basis for deciding on how these differences should be resolved in an integrated plant review, and (3) a documented evaluation of plant safety when all supplements to the Final IPSAR and the Safety Evaluation Report for converting the license from a provisional to a full-term license have been issued. The report also addresses the comments and recommendations made by the Advisory Committee on Reactor Safeguards in connection with its review of the Draft Report, issued in April 1982

  2. Integrated plant safety assessment. Systematic evaluation program, Big Rock Point Plant (Docket No. 50-155). Final report

    International Nuclear Information System (INIS)

    1984-05-01

    The Systematic Evaluation Program was initiated in February 1977 by the U.S. Nuclear Regulatory Commission to review the designs of older operating nuclear reactor plants to reconfirm and document their safety. The review provides (1) an assessment of how these plants compare with current licensing safety requirements relating to selected issues, (2) a basis for deciding how these differences should be resolved in an integrated plant review, and (3) a documented evaluation of plant safety when the supplement to the Final Integrated Plant Safety Assessment Report has been issued. This report documents the review of the Big Rock Point Plant, which is one of ten plants reviewed under Phase II of this program. This report indicates how 137 topics selected for review under Phase I of the program were addressed. It also addresses a majority of the pending licensing actions for Big Rock Point, which include TMI Action Plan requirements and implementation criteria for resolved generic issues. Equipment and procedural changes have been identified as a result of the review

  3. The evaluation of family functioning by the family assessment device: a systematic review of studies in adult clinical populations.

    Science.gov (United States)

    Staccini, Laura; Tomba, Elena; Grandi, Silvana; Keitner, Gabor I

    2015-03-01

    A large body of research, documenting the impact of a family's functioning on health outcomes, highlights the importance of introducing the evaluation of patients' family dynamics into clinical judgment. The Family Assessment Device (FAD) is a self-report questionnaire designed to assess specific dimensions of family functioning. This qualitative systematic review, which follows PRISMA guidelines, aimed to identify the FAD's clinimetric properties and to report the incremental utility of its inclusion in clinical settings. A thorough literature search was performed, using both computerized and manual searches, yielding a total of 148 studies that were included in this review. The FAD has been extensively used in a variety of research contexts. In the majority of studies it was able to discriminate between clinical populations and controls and among groups of patients with different illnesses. The FAD also showed good test-retest and concurrent reliability, and modest sensitivity to change after treatment. FAD-dysfunctional family functioning was related to several patient clinical outcomes, including lower recovery rates and adherence to treatment, longer recovery time, poorer quality of life, and increased risk of relapse and drop-out. The present review demonstrates that the FAD is a suitable instrument for the evaluation of family functioning both in clinical and research settings. © 2014 Family Process Institute.

  4. Systematic evaluation of non-animal test methods for skin sensitisation safety assessment

    NARCIS (Netherlands)

    Reisinger, K.; Hoffmann, S.; Alépée, N.; Ashikaga, T.; Barroso, J.; Elcombe, C.; Gellatly, N.; Galbiati, V.; Gibbs, S.; Groux, H.; Hibatallah, J.; Keller, D.; Kern, P.; Klaric, M.; Kolle, S.; Kuehnl, J.; Lambrechts, N.; Lindstedt, M.; Millet, M.; Martinozzi-Teissier, S.; Natsch, A.; Petersohn, D.; Pike, I.; Sakaguchi, H.; Schepky, A.; Tailhardat, M.; Templier, M.; van Vliet, E; Maxwell, G.

    2015-01-01

    The need for non-animal data to assess skin sensitisation properties of substances, especially cosmetics ingredients, has spawned the development of many in vitro methods. As it is widely believed that no single method can provide a solution, the Cosmetics Europe Skin Tolerance Task Force has

  5. A process evaluation of systematic risk and needs assessment for caregivers in specialised palliative care

    DEFF Research Database (Denmark)

    Thomsen, Kia Toft; Guldin, Mai-Britt; Nielsen, Mette Kjærgaard

    2017-01-01

    the feasibility of an intervention based on key elements of the "Bereavement support standards for specialist palliative care services" in a Danish specialised palliative home care team. We followed the UK Medical Research Council's guidelines for the process evaluation of complex interventions. The intervention...... was established according to the intervention blueprint for 62% of caregivers receiving targeted support. After managing initial challenges, palliative care staff reported that the intervention was useful and acceptable. CONCLUSION: The intervention proved feasible and useful. Still, we identified barriers...

  6. Virtual chromoendoscopy for the real-time assessment of colorectal polyps in vivo: a systematic review and economic evaluation.

    Science.gov (United States)

    Picot, Joanna; Rose, Micah; Cooper, Keith; Pickett, Karen; Lord, Joanne; Harris, Petra; Whyte, Sophie; Böhning, Dankmar; Shepherd, Jonathan

    2017-12-01

    Current clinical practice is to remove a colorectal polyp detected during colonoscopy and determine whether it is an adenoma or hyperplastic by histopathology. Identifying adenomas is important because they may eventually become cancerous if untreated, whereas hyperplastic polyps do not usually develop into cancer, and a surveillance interval is set based on the number and size of adenomas found. Virtual chromoendoscopy (VCE) (an electronic endoscopic imaging technique) could be used by the endoscopist under strictly controlled conditions for real-time optical diagnosis of diminutive (≤ 5 mm) colorectal polyps to replace histopathological diagnosis. To assess the clinical effectiveness and cost-effectiveness of the VCE technologies narrow-band imaging (NBI), flexible spectral imaging colour enhancement (FICE) and i-scan for the characterisation and management of diminutive (≤ 5 mm) colorectal polyps using high-definition (HD) systems without magnification. Systematic review and economic analysis. People undergoing colonoscopy for screening or surveillance or to investigate symptoms suggestive of colorectal cancer. NBI, FICE and i-scan. Diagnostic accuracy, recommended surveillance intervals, health-related quality of life (HRQoL), adverse effects, incidence of colorectal cancer, mortality and cost-effectiveness of VCE compared with histopathology. Electronic bibliographic databases including MEDLINE, EMBASE, The Cochrane Library and Database of Abstracts of Reviews of Effects were searched for published English-language studies from inception to June 2016. Bibliographies of related papers, systematic reviews and company information were screened and experts were contacted to identify additional evidence. Systematic reviews of test accuracy and economic evaluations were undertaken in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Meta-analyses were conducted, where possible, to inform the independent

  7. Evaluation of Systematic Assessment of Asthma-Like Symptoms and Tobacco Smoke Exposure in Early Childhood by Well-Child Professionals: A Randomised Trial

    NARCIS (Netherlands)

    Groen, E.; van der Valk, R.J.P.; Mohangoo, A.D.; van der Wouden, J.C.; Duijts, L.; Jaddoe, V.W.; Hofman, A.; Koning, H.J.; de Jongste, J.C.; Raat, H.

    2014-01-01

    Objectives: This study aimed to evaluate the effectiveness of systematic assessment of asthma-like symptoms and environmental tobacco smoke (ETS) exposure during regular preventive well-child visits between age 1 and 4 years by wellchild professionals. Methods: Sixteen well-child centres in

  8. Evaluation of systematic assessment of asthma-like symptoms and tobacco smoke exposure in early childhood by well-child professionals: A randomised trial

    NARCIS (Netherlands)

    Hafkamp-de Groen, E.; Valk, R.J.P. van der; Mohangoo, A.D.; Wouden, J.C. van der; Duijts, L.; Jaddoe, V.W.; Hofman, A.; Koning, H.J. de; Jongste, J.C. de; Raat, H.

    2014-01-01

    Objectives: This study aimed to evaluate the effectiveness of systematic assessment of asthma-like symptoms and environmental tobacco smoke (ETS) exposure during regular preventive well-child visits between age 1 and 4 years by wellchild professionals. Methods: Sixteen well-child centres in

  9. Development of a systematic method to assess similarity between nanomaterials for human hazard evaluation purposes - lessons learnt.

    NARCIS (Netherlands)

    Vdz Park, Margriet; Catalán, Julia; Ferraz, Natalia; Cabellos, Joan; Vanhauten, Ralph; Vázquez-Campos, Socorro; Janer, Gemma

    2018-01-01

    Within the EU FP-7 GUIDEnano project, a methodology was developed to systematically quantify the similarity between a nanomaterial (NM) that has been tested in toxicity studies and the NM for which risk needs to be evaluated, for the purpose of extrapolating toxicity data between the two materials.

  10. Evaluation of Occupational and Environmental Factors in the Assessment of Chronic Cough in Adults: A Systematic Review.

    Science.gov (United States)

    Tarlo, Susan M; Altman, Kenneth W; French, Cynthia T; Diekemper, Rebecca L; Irwin, Richard S

    2016-01-01

    Several recent cough guidelines have advised consideration of occupational or environmental causes for chronic cough, but it is unclear how frequently this recommendation has been routinely applied. Therefore, we undertook a systematic review to address this aspect. Cough guidelines and protocols were reviewed to identify recommendations for assessment of occupational and environmental aspects of chronic cough. The systematic search previously used to identify intervention fidelity to the use of protocols for diagnosis and management of chronic cough in adults was used for this review after extension to June 2015. PubMed, Scopus, and the Cochrane Library were searched using the same search terms and inclusion criteria as previously. Papers that met our criteria were then reviewed to identify methods used to assess occupational and environmental aspects of chronic cough and the outcomes of these assessments. Among the 10 general chronic cough guidelines and protocols identified, only the three published since 2006 included details advising detailed occupational and environmental assessments. One additional cough statement focused entirely on occupational cough. Of the 28 cohort studies of patients with chronic cough that specifically noted that they followed guidelines or protocols, none provided details of occupational and environmental assessments. Despite published recommendations, it is not apparent that occupational and environmental causes for chronic cough are addressed in detail during assessments of patients with chronic cough. This leaves open to speculation whether lack of recognition of an occupational cause may delay important preventive measures, put additional workers at risk, and/or be the reason why a chronic cough may remain unexplained. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  11. Integrated plant-safety assessment, Systematic Evaluation Program: Big Rock Point Plant (Docket No. 50-155)

    International Nuclear Information System (INIS)

    1983-09-01

    The Systematic Evaluation Program was initiated in February 1977 by the US Nuclear Regulatory Commission to review the designs of older operating nuclear reactor plants to reconfirm and document their safety. This report documents the review of the Big Rock Point Plant, which is one of ten plants reviewed under Phase II of this program. This report indicates how 137 topics selected for review under Phase I of the program were addressed. It also addresses a majority of the pending licensing actions for Big Rock Point, which include TMI Action Plan requirements and implementation criteria for resolved generic issues. Equipment and procedural changes have been identified as a result of the review

  12. Assessing harmful effects in systematic Reviews

    Directory of Open Access Journals (Sweden)

    Woolacott Nerys F

    2004-07-01

    Full Text Available Abstract Background Balanced decisions about health care interventions require reliable evidence on harms as well as benefits. Most systematic reviews focus on efficacy and randomised trials, for which the methodology is well established. Methods to systematically review harmful effects are less well developed and there are few sources of guidance for researchers. We present our own recent experience of conducting systematic reviews of harmful effects and make suggestions for future practice and further research. Methods We described and compared the methods used in three systematic reviews. Our evaluation focused on the review question, study designs and quality assessment. Results One review question focused on providing information on specific harmful effects to furnish an economic model, the other two addressed much broader questions. All three reviews included randomised and observational data, although each defined the inclusion criteria differently. Standard methods were used to assess study quality. Various practical problems were encountered in applying the study design inclusion criteria and assessing quality, mainly because of poor study design, inadequate reporting and the limitations of existing tools. All three reviews generated a large volume of work that did not yield much useful information for health care decision makers. The key areas for improvement we identified were focusing the review question and developing methods for quality assessment of studies of harmful effects. Conclusions Systematic reviews of harmful effects are more likely to yield information pertinent to clinical decision-making if they address a focused question. This will enable clear decisions to be made about the type of research to include in the review. The methodology for assessing the quality of harmful effects data in systematic reviews requires further development.

  13. Test Selection, Adaptation, and Evaluation: A Systematic Approach to Assess Nutritional Influences on Child Development in Developing Countries

    Science.gov (United States)

    Prado, Elizabeth L.; Hartini, Sri; Rahmawati, Atik; Ismayani, Elfa; Hidayati, Astri; Hikmah, Nurul; Muadz, Husni; Apriatni, Mandri S.; Ullman, Michael T.; Shankar, Anuraj H.; Alcock, Katherine J.

    2010-01-01

    Background: Evaluating the impact of nutrition interventions on developmental outcomes in developing countries can be challenging since most assessment tests have been produced in and for developed country settings. Such tests may not be valid measures of children's abilities when used in a new context. Aims: We present several principles for the…

  14. Infusion phlebitis assessment measures: a systematic review

    OpenAIRE

    Ray-Barruel, Gillian; Polit, Denise F; Murfield, Jenny E; Rickard, Claire M

    2014-01-01

    Rationale, aims and objectives Phlebitis is a common and painful complication of peripheral intravenous cannulation. The aim of this review was to identify the measures used in infusion phlebitis assessment and evaluate evidence regarding their reliability, validity, responsiveness and feasibility. Method We conducted a systematic literature review of the Cochrane library, Ovid MEDLINE and EBSCO CINAHL until September 2013. All English-language studies (randomized controlled trials, prospecti...

  15. Capturing Budget Impact Considerations Within Economic Evaluations: A Systematic Review of Economic Evaluations of Rotavirus Vaccine in Low- and Middle-Income Countries and a Proposed Assessment Framework.

    Science.gov (United States)

    Carvalho, Natalie; Jit, Mark; Cox, Sarah; Yoong, Joanne; Hutubessy, Raymond C W

    2018-01-01

    In low- and middle-income countries, budget impact is an important criterion for funding new interventions, particularly for large public health investments such as new vaccines. However, budget impact analyses remain less frequently conducted and less well researched than cost-effectiveness analyses. The objective of this study was to fill the gap in research on budget impact analyses by assessing (1) the quality of stand-alone budget impact analyses, and (2) the feasibility of extending cost-effectiveness analyses to capture budget impact. We developed a budget impact analysis checklist and scoring system for budget impact analyses, which we then adapted for cost-effectiveness analyses, based on current International Society for Pharmacoeconomics and Outcomes Research Task Force recommendations. We applied both budget impact analysis and cost-effectiveness analysis checklists and scoring systems to examine the extent to which existing economic evaluations provide sufficient evidence about budget impact to enable decision making. We used rotavirus vaccination as an illustrative case in which low- and middle-income countries uptake has been limited despite demonstrated cost effectiveness. A systematic literature review was conducted to identify economic evaluations of rotavirus vaccine in low- and middle-income countries published between January 2000 and February 2017. We critically appraised the quality of budget impact analyses, and assessed the extension of cost-effectiveness analyses to provide useful budget impact information. Six budget impact analyses and 60 cost-effectiveness analyses were identified. Budget impact analyses adhered to most International Society for Pharmacoeconomics and Outcomes Research recommendations, with key exceptions being provision of undiscounted financial streams for each budget period and model validation. Most cost-effectiveness analyses could not be extended to provide useful budget impact information; cost

  16. Conducting systematic reviews of economic evaluations.

    Science.gov (United States)

    Gomersall, Judith Streak; Jadotte, Yuri Tertilus; Xue, Yifan; Lockwood, Suzi; Riddle, Dru; Preda, Alin

    2015-09-01

    In 2012, a working group was established to review and enhance the Joanna Briggs Institute (JBI) guidance for conducting systematic review of evidence from economic evaluations addressing a question(s) about health intervention cost-effectiveness. The objective is to present the outcomes of the working group. The group conducted three activities to inform the new guidance: review of literature on the utility/futility of systematic reviews of economic evaluations and consideration of its implications for updating the existing methodology; assessment of the critical appraisal tool in the existing guidance against criteria that promotes validity in economic evaluation research and two other commonly used tools; and a workshop. The debate in the literature on the limitations/value of systematic review of economic evidence cautions that systematic reviews of economic evaluation evidence are unlikely to generate one size fits all answers to questions about the cost-effectiveness of interventions and their comparators. Informed by this finding, the working group adjusted the framing of the objectives definition in the existing JBI methodology. The shift is away from defining the objective as to determine one cost-effectiveness measure toward summarizing study estimates of cost-effectiveness and informed by consideration of the included study characteristics (patient, setting, intervention component, etc.), identifying conditions conducive to lowering costs and maximizing health benefits. The existing critical appraisal tool was included in the new guidance. The new guidance includes the recommendation that a tool designed specifically for the purpose of appraising model-based studies be used together with the generic appraisal tool for economic evaluations assessment to evaluate model-based evaluations. The guidance produced by the group offers reviewers guidance for each step of the systematic review process, which are the same steps followed in JBI reviews of other

  17. Vending machine assessment methodology. A systematic review.

    Science.gov (United States)

    Matthews, Melissa A; Horacek, Tanya M

    2015-07-01

    The nutritional quality of food and beverage products sold in vending machines has been implicated as a contributing factor to the development of an obesogenic food environment. How comprehensive, reliable, and valid are the current assessment tools for vending machines to support or refute these claims? A systematic review was conducted to summarize, compare, and evaluate the current methodologies and available tools for vending machine assessment. A total of 24 relevant research studies published between 1981 and 2013 met inclusion criteria for this review. The methodological variables reviewed in this study include assessment tool type, study location, machine accessibility, product availability, healthfulness criteria, portion size, price, product promotion, and quality of scientific practice. There were wide variations in the depth of the assessment methodologies and product healthfulness criteria utilized among the reviewed studies. Of the reviewed studies, 39% evaluated machine accessibility, 91% evaluated product availability, 96% established healthfulness criteria, 70% evaluated portion size, 48% evaluated price, 52% evaluated product promotion, and 22% evaluated the quality of scientific practice. Of all reviewed articles, 87% reached conclusions that provided insight into the healthfulness of vended products and/or vending environment. Product healthfulness criteria and complexity for snack and beverage products was also found to be variable between the reviewed studies. These findings make it difficult to compare results between studies. A universal, valid, and reliable vending machine assessment tool that is comprehensive yet user-friendly is recommended. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. Evaluating Quality of Decision-Making Processes in Medicines' Development, Regulatory Review, and Health Technology Assessment: A Systematic Review of the Literature.

    Science.gov (United States)

    Bujar, Magdalena; McAuslane, Neil; Walker, Stuart R; Salek, Sam

    2017-01-01

    Introduction: Although pharmaceutical companies, regulatory authorities, and health technology assessment (HTA) agencies have been increasingly using decision-making frameworks, it is not certain whether these enable better quality decision making. This could be addressed by formally evaluating the quality of decision-making process within those organizations. The aim of this literature review was to identify current techniques (tools, questionnaires, surveys, and studies) for measuring the quality of the decision-making process across the three stakeholders. Methods: Using MEDLINE, Web of Knowledge, and other Internet-based search engines, a literature review was performed to systematically identify techniques for assessing quality of decision making in medicines development, regulatory review, and HTA. A structured search was applied using key words and a secondary review was carried out. In addition, the measurement properties of each technique were assessed and compared. Ten Quality Decision-Making Practices (QDMPs) developed previously were then used as a framework for the evaluation of techniques identified in the review. Due to the variation in studies identified, meta-analysis was inappropriate. Results: This review identified 13 techniques, where 7 were developed specifically to assess decision making in medicines' development, regulatory review, or HTA; 2 examined corporate decision making, and 4 general decision making. Regarding how closely each technique conformed to the 10 QDMPs, the 13 techniques assessed a median of 6 QDMPs, with a mode of 3 QDMPs. Only 2 techniques evaluated all 10 QDMPs, namely the Organizational IQ and the Quality of Decision Making Orientation Scheme (QoDoS), of which only one technique, QoDoS could be applied to assess decision making of both individuals and organizations, and it possessed generalizability to capture issues relevant to companies as well as regulatory authorities. Conclusion: This review confirmed a general

  19. Integrated Plant Safety Assessment: Systematic Evaluation Program. Yankee Nuclear Power Station, Yankee Atomic Electric Company, Docket No. 50-29. Final report

    International Nuclear Information System (INIS)

    1983-06-01

    The Systematic Evaluation program was initiated in February 1977 by the US Nuclear Regulatory Commission to review the designs of older operating nuclear reactor plants to confirm and document their safety. The review provides: (1) an assessment of how these plants compare with current licensing safety requirements relating to selected issues, (2) a basis for deciding on how these differences should be resolved in an integrated plant review, and (3) a documented evaluation of plant safety. This report documents the review of Yankee Nuclear Power Station, operated by Yankee Atomic Electric Company. The Yankee plant is one of 10 plants reviewed under Phase II of this program. This report indicates how 137 topics selected for review under Phase I of the program were addressed. Equipment and procedural changes have been identified as a result of the review

  20. Integrated plant safety assessment. Systematic Evaluation Program. La Crosse Boiling Water Reactor. Dairyland Power Cooperative, Docket No. 50-409. Final report

    International Nuclear Information System (INIS)

    1983-06-01

    The Systematic Evaluation Program was initiated in February 1977 by the US Nuclear Regulatory Commission to review the designs of older operating nuclear reactor plants to confirm and document their safety. The review provides (1) an assessment of how these plants compare with current licensing safety requirements relating to selected issues, (2) a basis for deciding on how these differences should be resolved in an integrated plant review, and (3) a documented evaluation of plant safety. This report documents the review of the La Crosse Boiling Water Reactor, operated by Dairyland Power Cooperative. The La Crosse plant is one of 10 plants reviewed under Phase II of this program. This report indicates how 137 topics selected for review under Phase I of the program were addressed. Equipment and procedural changes have been identified as a result of the review

  1. Integrated Plant Safety Assessment, Systematic Evaluation Program. Yankee Nuclear Power Station, Yankee Atomic Electric Company, Docket No. 50-29. Draft report

    International Nuclear Information System (INIS)

    1983-02-01

    The Systematic Evaluation Program was initiated in February 1977 by the US Nuclear Regulatory Commission to review the designs of older operating nuclear reactor plants to confirm and document their safety. The review provides (1) an assessment of how these plants compare with current licensing safety requirements relating to selected issues, (2) a basis for deciding on how these differences should be resolved in an integrated plant review, and (3) a documented evaluation of plant safety. This report documents the review of Yankee Nuclear Power Station, operated by Yankee Atomic Electric Company. The Yankee plant is one of 10 plants reviewed under Phase II of this program. This report indicates how 137 topics selected for review under Phase I of the program were addressed. Equipment and procedural changes have been identified as a result of the review

  2. Integrated plant safety assessment: Systematic Evaluation Program. LaCrosse Boiling Water Reactor, Dairyland Power Cooperative, Docket No. 50-409

    International Nuclear Information System (INIS)

    1983-04-01

    The Systematic Evaluation Program was initiated in February 1977 by the US Nuclear Regulatory Commission to review the designs of older operating nuclear reactor plants to confirm and document their safety. The review provides: (1) an assessment of how these plants compare with current licensing safety requirements relating to selected issues, (2) a basis for deciding on how these differences should be resolved in an integrated plant review, and (3) a documented evaluation of plant safety. This report documents the review of the La Crosse Boiling Water Reactor, operated by Dairyland Power Cooperative. The La Crosse plant is one of 10 plants reviewed under Phase II of this program. This report indicates how 137 topics selected for review under Phase I of the program were addresed. Equipment and procedural changes have been identified as a result of the review

  3. Integrated Plant Safety Assessment: Systematic Evaluation Program. Haddam Neck Plant, Connecticut Yankee Atomic Power Company, Docket No. 50-213. Final report

    International Nuclear Information System (INIS)

    1983-01-01

    The Systematic Evaluation Progam was initiated in February 1977 by the US Nuclear Regulatory Commission review the designs of older operating nuclear reactor plants to confirm and document their safety. The review provides: (1) an assessment of how these plants compare with curent licensing safety requirements relating to selected issues, (2) a basis for deciding on how these differences should be resolved in an integrated plant review, and (3) a documented evaluation of plant safety. This report documents the review of Haddam Neck Plant, operated by Connecticut Yankee Atomic Power Company. The Haddam Neck Plant is one of 10 plants reviewed under Phase II of this program. This report indicates how 137 topics selected for review under Phase I of the program were addressed. Equipment and procedural changes have been identified as a result of the review

  4. Evaluation of systematic assessment of asthma-like symptoms and tobacco smoke exposure in early childhood by well-child professionals: a randomised trial.

    Directory of Open Access Journals (Sweden)

    Esther Hafkamp-de Groen

    Full Text Available This study aimed to evaluate the effectiveness of systematic assessment of asthma-like symptoms and environmental tobacco smoke (ETS exposure during regular preventive well-child visits between age 1 and 4 years by well-child professionals.Sixteen well-child centres in Rotterdam, the Netherlands, were randomised into 8 centres where the brief assessment form regarding asthma-like symptoms and ETS exposure was used and 8 centres that applied usual care. 3596 and 4179 children (born between April 2002 and January 2006 and their parents visited the intervention and control centres, respectively. At child's age 6 years, physician-diagnosed asthma ever, wheezing, fractional exhaled nitric oxide (FeNO, airway resistance (Rint, health-related quality of life (HRQOL and ETS exposure at home ever were measured. Linear mixed models were applied.No differences in asthma, wheezing, FeNO, Rint or HRQOL measurements between intervention and control group were found using multilevel regression in an intention-to-treat analysis (p>0.05. Children of whom the parents were interviewed by using the brief assessment form at the intervention well-child centres had a decreased risk on ETS exposure at home ever, compared to children who visited the control well-child centres, in an explorative per-protocol analysis (aOR = 0.71, 95% CI:0.59-0.87.Systematic assessment and counselling of asthma-like symptoms and ETS exposure in early childhood by well-child care professionals using a brief assessment form was not effective in reducing the prevalence of physician-diagnosed asthma ever and wheezing, and did not improve FeNO, Rint or HRQOL at age 6 years. Our results hold some promise for interviewing parents and using information leaflets at well-child centres to reduce ETS exposure at home in preschool children.Controlled-Trials.com ISRCTN15790308.

  5. Evaluation of systematic assessment of asthma-like symptoms and tobacco smoke exposure in early childhood by well-child professionals: a randomised trial.

    Science.gov (United States)

    Hafkamp-de Groen, Esther; van der Valk, Ralf J P; Mohangoo, Ashna D; van der Wouden, Johannes C; Duijts, Liesbeth; Jaddoe, Vincent W; Hofman, Albert; de Koning, Harry J; de Jongste, Johan C; Raat, Hein

    2014-01-01

    This study aimed to evaluate the effectiveness of systematic assessment of asthma-like symptoms and environmental tobacco smoke (ETS) exposure during regular preventive well-child visits between age 1 and 4 years by well-child professionals. Sixteen well-child centres in Rotterdam, the Netherlands, were randomised into 8 centres where the brief assessment form regarding asthma-like symptoms and ETS exposure was used and 8 centres that applied usual care. 3596 and 4179 children (born between April 2002 and January 2006) and their parents visited the intervention and control centres, respectively. At child's age 6 years, physician-diagnosed asthma ever, wheezing, fractional exhaled nitric oxide (FeNO), airway resistance (Rint), health-related quality of life (HRQOL) and ETS exposure at home ever were measured. Linear mixed models were applied. No differences in asthma, wheezing, FeNO, Rint or HRQOL measurements between intervention and control group were found using multilevel regression in an intention-to-treat analysis (p>0.05). Children of whom the parents were interviewed by using the brief assessment form at the intervention well-child centres had a decreased risk on ETS exposure at home ever, compared to children who visited the control well-child centres, in an explorative per-protocol analysis (aOR = 0.71, 95% CI:0.59-0.87). Systematic assessment and counselling of asthma-like symptoms and ETS exposure in early childhood by well-child care professionals using a brief assessment form was not effective in reducing the prevalence of physician-diagnosed asthma ever and wheezing, and did not improve FeNO, Rint or HRQOL at age 6 years. Our results hold some promise for interviewing parents and using information leaflets at well-child centres to reduce ETS exposure at home in preschool children. Controlled-Trials.com ISRCTN15790308.

  6. NRC systematic evaluation program: seismic review

    International Nuclear Information System (INIS)

    Levin, H.A.

    1980-01-01

    The NRC Systematic Evaluation Program is currently making an assessment of the seismic design safety of 11 older nuclear power plant facilities. The general review philosophy and review criteria relative to seismic input, structural response, and equipment functionability are presented, including the rationale for the development of these guidelines considering the significant evolution of seismic design criteria since these plants were originally licensed. Technical approaches thought more realistic in light of current knowledge are utilized. Initial findings for plants designed to early seismic design procedures suggest that with minor exceptions, these plants possess adequate seismic design margins when evaluated against the intent of current criteria. However, seismic qualification of electrical equipment has been identified as a subject which requires more in-depth evaluation

  7. Infusion phlebitis assessment measures: a systematic review.

    Science.gov (United States)

    Ray-Barruel, Gillian; Polit, Denise F; Murfield, Jenny E; Rickard, Claire M

    2014-04-01

    Phlebitis is a common and painful complication of peripheral intravenous cannulation. The aim of this review was to identify the measures used in infusion phlebitis assessment and evaluate evidence regarding their reliability, validity, responsiveness and feasibility. We conducted a systematic literature review of the Cochrane library, Ovid MEDLINE and EBSCO CINAHL until September 2013. All English-language studies (randomized controlled trials, prospective cohort and cross-sectional) that used an infusion phlebitis scale were retrieved and analysed to determine which symptoms were included in each scale and how these were measured. We evaluated studies that reported testing the psychometric properties of phlebitis assessment scales using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines. Infusion phlebitis was the primary outcome measure in 233 studies. Fifty-three (23%) of these provided no actual definition of phlebitis. Of the 180 studies that reported measuring phlebitis incidence and/or severity, 101 (56%) used a scale and 79 (44%) used a definition alone. We identified 71 different phlebitis assessment scales. Three scales had undergone some psychometric analyses, but no scale had been rigorously tested. Many phlebitis scales exist, but none has been thoroughly validated for use in clinical practice. A lack of consensus on phlebitis measures has likely contributed to disparities in reported phlebitis incidence, precluding meaningful comparison of phlebitis rates. © 2014 The Authors. Journal of Evaluation in Clinical Practice published by John Wiley & Sons, Ltd.

  8. Systematic Assessment for University Sexuality Programming.

    Science.gov (United States)

    Westefeld, John S.; Winkelpleck, Judy M.

    1982-01-01

    Suggests systematic empirical assessment is needed to plan university sexuality programing. Proposes the traditional approach of asking about students' attitudes, knowledge, and behavior is useful for developing specific programing content. Presents an assessment model emphasizing assessment of students' desires for sexuality programing in terms…

  9. Estimating functional cognition in older adults using observational assessments of task performance in complex everyday activities: A systematic review and evaluation of measurement properties.

    Science.gov (United States)

    Wesson, Jacqueline; Clemson, Lindy; Brodaty, Henry; Reppermund, Simone

    2016-09-01

    Functional cognition is a relatively new concept in assessment of older adults with mild cognitive impairment or dementia. Instruments need to be reliable and valid, hence we conducted a systematic review of observational assessments of task performance used to estimate functional cognition in this population. Two separate database searches were conducted: firstly to identify instruments; and secondly to identify studies reporting on the psychometric properties of the instruments. Studies were analysed using a published checklist and their quality reviewed according to specific published criteria. Clinical utility was reviewed and the information formulated into a best evidence synthesis. We found 21 instruments and included 58 studies reporting on measurement properties. The majority of studies were rated as being of fair methodological quality and the range of properties investigated was restricted. Most instruments had studies reporting on construct validity (hypothesis testing), none on content validity and there were few studies reporting on reliability. Overall the evidence on psychometric properties is lacking and there is an urgent need for further evaluation of instruments. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Integrated plant safety assessment: Systematic Evaluation Program, San Onofre Nuclear Generating Station, Unit 1 (Docket No. 50-206): Final report

    International Nuclear Information System (INIS)

    1986-12-01

    The Systematic Evaluation Program was initiated in February 1977 by the US Nuclear Regulatory Commission to review the designs of older operating nuclear reactor plants to reconfirm and document their safety. The review provides: (1) an assessment of how these plants compare with current licensing safety requirements relating to selected issues; (2) a basis for deciding on how these differences should be resolved in an integrated plant review; and (3) a documented evaluation of plant safety. This report documents the review of San Onofre Nuclear Generating Station, Unit 1, operated by Southern California Edison Company. The San Onofre plant is one of ten plants reviewed under Phase II of this program. This report indicates how 137 topics selected for review under Phase I of the program were addressed. Equipment and procedural changes have been identified as a result of the review. This report will be one of the bases in considering the issuance of a full-term operating license in place of the existing provisional operating license. This report also addresses the comments and recommendations made by the Advisory Committee on Reactor Safeguards in connection with its review of the draft report issued in April 1985

  11. Integrated plant safety assessment: systematic evaluation program. Oyster Creek nuclear generating station. GPU Nuclear Corporation and Jersey Central Power and Light Company. Docket No. 50-219

    International Nuclear Information System (INIS)

    1982-09-01

    The Systematic Evaluation Program was initiated in February 1978 by the US Nuclear Regulatory Commission to review the designs of older operating nuclear reactor plants to reconfirm and document their safety. The review provides (1) an assessment of how these plants compare with current licensing safety requirements relating to selected issues, (2) a basis for deciding on how these differences should be resolved in an integrated plant review, and (3) a documented evaluation of plant safety. This report documents the review of the Oyster Creek Nuclear Generating Station (located in Ocean County, New Jersey), one of ten plants reviewed under Phase II of this program, and indicates how 137 topics selected for review under Phase I of the program were addressed. Equipment and procedural changes have been identified as a result of the review. It is expected that this report will be one of the bases in considering the issuance of a full-term operating license in place of the existing provisional operating license

  12. Integrated plant safety assessment systematic evaluation program. R.E. Ginna Nuclear Power Plant, Rochester Gas and Electric Corporation, Docket No. 50-244

    International Nuclear Information System (INIS)

    1982-05-01

    The Systematic Evaluation Program was initiated in February 1978 by the US Nuclear Regulatory Commission to review the designs of older operating nuclear reactor plants to reconfirm and document their safety. The review provides (1) an assessment of how these plants compare with current licensing safety requirements relating to selected issues, (2) a basis for deciding on how these differences should be resolved in an integrated plant review, and (3) a documented evaluation of plant safety. This report documents the review of the R.E. Ginna Nuclear Power Plant (located in Wayne County near Rochester, NY), one of ten plants reviewed under Phase II of this program, and indicates how 137 topics selected for review under Phase I of the program were addressed. Equipment and procedural changes have been identified as a result of the review. It is expected that this report will be one of the bases in considering the issuance of a full-term operating license in place of the existing provisional operating license

  13. Integrated-plant-safety assessment Systematic Evaluation program. Millstone Nuclear Power Station, Unit 1, Northeast Nuclear Energy Company, Docket No. 50-245

    International Nuclear Information System (INIS)

    1982-11-01

    The Systematic Evaluation Program was initiated in February 1977 to review the designs of older operating nuclear reactor plants to reconfirm and document their safety. The review provides: (1) an assessment of how these plants compare with current licensing safety requirements relating to selected issues, (2) a basis for deciding on how these differences should be resolved in an integrated plant review, and (3) a documented evaluation of plant safety. This report documents the review of the Millstone Nuclear Power Station, Unit 1, operated by Northeast Nuclear Energy Company (located in Waterford, Connecticut). Millstone Nuclear Power Station, Unit 1, is one of ten plants reviewed under Phase II of this program. This report indicates how 137 topics selected for review under Phase I of the program were addressed. Equipment and procedural changes have been identified as a result of the review. It is expected that this report will be one of the bases in considering the issuance of a full-term operating license in place of the existing provisional operating license

  14. Integrated-plant-safety assessment Systematic Evaluation Program. Dresden Nuclear Power Station, Unit 2, Commonwealth Edison Company, Docket No. 50-237

    International Nuclear Information System (INIS)

    1982-10-01

    The Systematic Evaluation Program was initiated in February 1977 by the US Nuclear Regulatory Commission to review the designs of older operating nuclear reactor plants to reconfirm and document their safety. The review provides: (1) an assessment of how these plants compare with current licensing safety requirements relating to selected issues; (2) a basis for deciding on how these differences should be resolved in an integrated plant review; and (3) a documented evaluation of plant safety. This report documents the review of Dresden Nuclear Generating Station, Unit 2 owned and operated by the Commonwealth Edison Company and located in Grundy County, Illinois. Dresden Unit 2 is one of ten plants reviewed under Phase II of this program, which indicates how 137 topics selected for review under Phase I of the program were addressed. Equipment and procedural changes have been identified as a result of the review. It is expected that this report will be one of the bases in considering the issuance of a full-term operating license in place of the existing provisional operating license

  15. Non-invasive diagnostic assessment tools for the detection of liver fibrosis in patients with suspected alcohol-related liver disease: a systematic review and economic evaluation.

    Science.gov (United States)

    Stevenson, M; Lloyd-Jones, M; Morgan, M Y; Wong, R

    2012-01-01

    Excessive alcohol consumption may lead to the development of alcohol-related liver disease (ALD). Liver biopsy may be used in patients with suspected ALD to confirm the diagnosis, exclude other or additional liver pathologies, and provide accurate staging of the degree of liver injury in order to enable the prediction of prognosis and inform treatment decisions. However, as it is an invasive procedure that carries the risk of morbidity and mortality, current UK guidance recommends that biopsy is not required to confirm the diagnosis in patients with a high clinical suspicion of ALD in whom blood tests have excluded other causes of liver disease, unless it is necessary to confirm a diagnosis of acute alcoholic hepatitis in order to inform specific treatment decisions. To evaluate the diagnostic accuracy, cost-effectiveness, and effect on patient outcomes of four non-invasive tests for liver fibrosis [the Enhanced Liver Fibrosis (ELF™) test (Siemens Healthcare Diagnostic Inc., Tarrytown, NY, USA), FibroTest (BioPredictive, Paris, France), FibroMAX (BioPredictive, Paris, France) and transient elastography (FibroScan(®); produced by EchoSens, Paris, France and distributed in the UK by Artemis Medical Ltd, Kent, UK)] in patients suspected of having ALD. A systematic review was undertaken to identify studies reporting the diagnostic and prognostic accuracy of the ELF test, FibroTest, FibroMAX, and FibroScan for the identification of liver fibrosis and associated conditions in patients with suspected ALD. The following databases were searched in January 2010: MEDLINE (from 1950 to January 2010), MEDLINE In-Process & Other Non-Indexed Citations (from 1950 to January 2010), EMBASE (from 1980 to January 2010), Cochrane Database of Systematic Reviews (from 1996 to January 2010), Cochrane Central Register of Controlled Trials (from 1898 to January 2010), Cochrane Methodology Register (from 1904 to January 2010), Database of Abstracts of Reviews of Effects (from 1995 to

  16. "Assessing the methodological quality of systematic reviews in radiation oncology: A systematic review".

    Science.gov (United States)

    Hasan, Haroon; Muhammed, Taaha; Yu, Jennifer; Taguchi, Kelsi; Samargandi, Osama A; Howard, A Fuchsia; Lo, Andrea C; Olson, Robert; Goddard, Karen

    2017-10-01

    The objective of our study was to evaluate the methodological quality of systematic reviews and meta-analyses in Radiation Oncology. A systematic literature search was conducted for all eligible systematic reviews and meta-analyses in Radiation Oncology from 1966 to 2015. Methodological characteristics were abstracted from all works that satisfied the inclusion criteria and quality was assessed using the critical appraisal tool, AMSTAR. Regression analyses were performed to determine factors associated with a higher score of quality. Following exclusion based on a priori criteria, 410 studies (157 systematic reviews and 253 meta-analyses) satisfied the inclusion criteria. Meta-analyses were found to be of fair to good quality while systematic reviews were found to be of less than fair quality. Factors associated with higher scores of quality in the multivariable analysis were including primary studies consisting of randomized control trials, performing a meta-analysis, and applying a recommended guideline related to establishing a systematic review protocol and/or reporting. Systematic reviews and meta-analyses may introduce a high risk of bias if applied to inform decision-making based on AMSTAR. We recommend that decision-makers in Radiation Oncology scrutinize the methodological quality of systematic reviews and meta-analyses prior to assessing their utility to inform evidence-based medicine and researchers adhere to methodological standards outlined in validated guidelines when embarking on a systematic review. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. A Systematic Approach to Programmatic Assessment

    Science.gov (United States)

    Moffit, Dani M.; Mansell, Jamie L.; Russ, Anne C.

    2016-01-01

    Context: Accrediting bodies and universities increasingly require evidence of student learning within courses and programs. Within athletic training, programmatic assessment has been a source of angst for program directors. While there are many ways to assess educational programs, this article introduces 1 systematic approach. Objective: This…

  18. Assessing sensitivity and specificity of the Manchester Triage System in the evaluation of acute coronary syndrome in adult patients in emergency care: a systematic review protocol.

    Science.gov (United States)

    Nishi, Fernanda Ayache; de Motta Maia, Flávia Oliveira; de Lopes Monteiro da Cruz, Dina Almeida

    2015-11-01

    suspected ACS, several studies have reported the difficulties of evaluating patients with these conditions. Various factors can interfere with the outcome of this process, such as atypical presentation of symptoms, AMI classification, patient age, and professional skill.Primary studies have addressed the issue from different perspectives. Studies have been conducted to evaluate the ability of nurses using MTS to detect high-risk patients with chest pain, the impact of MTS on short-term mortality in AMI, and the sensitivity and specificity of MTS for patients with ACS, and to assess whether the MTS was used effectively in patients admitted to the hospital with a diagnosis of acute coronary syndrome.These studies concluded that use of the MTS by nurses is a sensitive method for identifying high risk cardiac chest pain, but further studies are required to assess whether additional training can improve the sensitivity of MTS. The MTS safeguards patients with typical AMI presentation and ST elevation during myocardial infarction, and who are under 70 years of age. The MTS has a high sensitivity in prioritization (immediate/very urgent) of patients with ACS. Additionally, most patients admitted for ACS are initially triaged as "orange" or "yellow", an indication for prompt assessment in the emergency department. This has a positive effect on time to first medical assessment, but has no effect on time to hospital admission.A systematic review addressing a similar theme was published. The review evaluated the efficacy of MTS for all groups of patients and included studies that evaluated the MTS in relation to different outcomes. This proposed review is different as it will include primary studies with a specific sub-population (patients with ACS). Another important difference lies in the fact that the published review did not include critical appraisal of the primary studies included in review. A systematic review that synthesizes the available evidence on the sensitivity of MTS to

  19. Assessing Technical Competence in Surgical Trainees: A Systematic Review.

    Science.gov (United States)

    Szasz, Peter; Louridas, Marisa; Harris, Kenneth A; Aggarwal, Rajesh; Grantcharov, Teodor P

    2015-06-01

    To systematically examine the literature describing the methods by which technical competence is assessed in surgical trainees. The last decade has witnessed an evolution away from time-based surgical education. In response, governing bodies worldwide have implemented competency-based education paradigms. The definition of competence, however, remains elusive, and the impact of these education initiatives in terms of assessment methods remains unclear. A systematic review examining the methods by which technical competence is assessed was conducted by searching MEDLINE, EMBASE, PsychINFO, and the Cochrane database of systematic reviews. Abstracts of retrieved studies were reviewed and those meeting inclusion criteria were selected for full review. Data were retrieved in a systematic manner, the validity and reliability of the assessment methods was evaluated, and quality was assessed using the Grading of Recommendations Assessment, Development and Evaluation classification. Of the 6814 studies identified, 85 studies involving 2369 surgical residents were included in this review. The methods used to assess technical competence were categorized into 5 groups; Likert scales (37), benchmarks (31), binary outcomes (11), novel tools (4), and surrogate outcomes (2). Their validity and reliability were mostly previously established. The overall Grading of Recommendations Assessment, Development and Evaluation for randomized controlled trials was high and low for the observational studies. The definition of technical competence continues to be debated within the medical literature. The methods used to evaluate technical competence predominantly include instruments that were originally created to assess technical skill. Very few studies identify standard setting approaches that differentiate competent versus noncompetent performers; subsequently, this has been identified as an area with great research potential.

  20. Positron emission tomography (PET) and magnetic resonance imaging (MRI) for the assessment of axillary lymph node metastases in early breast cancer: systematic review and economic evaluation.

    Science.gov (United States)

    Cooper, K L; Meng, Y; Harnan, S; Ward, S E; Fitzgerald, P; Papaioannou, D; Wyld, L; Ingram, C; Wilkinson, I D; Lorenz, E

    2011-01-01

    Breast cancer is the most common type of cancer in women. Evaluation of axillary lymph node metastases is important for breast cancer staging and treatment planning. To evaluate the diagnostic accuracy, cost-effectiveness and effect on patient outcomes of positron emission tomography (PET), with or without computed tomography (CT), and magnetic resonance imaging (MRI) in the evaluation of axillary lymph node metastases in patients with newly diagnosed early-stage breast cancer. A systematic review of literature and an economic evaluation were carried out. Key databases (including MEDLINE, EMBASE and nine others) plus research registers and conference proceedings were searched for relevant studies up to April 2009. A decision-analytical model was developed to determine cost-effectiveness in the UK. One reviewer assessed titles and abstracts of studies identified by the search strategy, obtained the full text of relevant papers and screened them against inclusion criteria. Data from included studies were extracted by one reviewer using a standardised data extraction form and checked by a second reviewer. Discrepancies were resolved by discussion. Quality of included studies was assessed using the quality assessment of diagnostic accuracy studies (QUADAS) checklist, applied by one reviewer and checked by a second. Forty-five citations relating to 35 studies were included in the clinical effectiveness review: 26 studies of PET and nine studies of MRI. Two studies were included in the cost-effectiveness review: one of PET and one of MRI. Of the seven studies evaluating PET/CT (n = 862), the mean sensitivity was 56% [95% confidence interval (CI) 44% to 67%] and mean specificity 96% (95% CI 90% to 99%). Of the 19 studies evaluating PET only (n = 1729), the mean sensitivity was 66% (95% CI 50% to 79%) and mean specificity 93% (95% CI 89% to 96%). PET performed less well for small metastases; the mean sensitivity was 11% (95% CI 5% to 22%) for micrometastases (≤ 2 mm

  1. Systematic evaluation program. Status report and initial evaluation

    International Nuclear Information System (INIS)

    1983-06-01

    The MHB Ongoing Systematic Evaluation Program (SEP) Assessment Study was initiated by the Swedish Nuclear Power Inspectorate (SKI) in 1980. This MHB report is a status report and initial evaluation of SEP. The methodology and results of SEP are disscused with particular emphasis on the first two SEP plant reviews - the Palisades and R.E. Ginna nuclear power plants. The comments of cognizant persons in the NRC and the ACRS, as well as private consultants, are included herein. MHBs major findings are as follows: The SEP plant review methodology was acceptable to the NRC Commissioners, the ACRS, and the NRC Staffs consultants who evaluated the first two SEP plant reviews. A concern raised by all who commented on SEP was the absence of Three Mile Island Action Plan Items and Unresolved Safety Issues from current SEP reviews. The SEP reviews of the Palisades and R.E. Ginna plants concluded that the two plant designs were adequate with respect to a majority of safety topics. Several topics remain unresolved in both the Palisades and R.E. Ginna SEP reviews. In the case of the Ginna plant, several related topics have been grouped together in a major structural reevaluation study. In general, due to the number of unresolved and excluded topics, SEP has not at this time produced a plant safety evaluation which can be considered complete and integrated. (author)

  2. Evaluating clinical librarian services: a systematic review.

    Science.gov (United States)

    Brettle, Alison; Maden-Jenkins, Michelle; Anderson, Lucy; McNally, Rosalind; Pratchett, Tracey; Tancock, Jenny; Thornton, Debra; Webb, Anne

    2011-03-01

      Previous systematic reviews have indicated limited evidence and poor quality evaluations of clinical librarian (CL) services. Rigorous evaluations should demonstrate the value of CL services, but guidance is needed before this can be achieved.   To undertake a systematic review which examines models of CL services, quality, methods and perspectives of clinical librarian service evaluations.   Systematic review methodology and synthesis of evidence, undertaken collaboratively by a group of 8 librarians to develop research and critical appraisal skills.   There are four clear models of clinical library service provision. Clinical librarians are effective in saving health professionals time, providing relevant, useful information and high quality services. Clinical librarians have a positive effect on clinical decision making by contributing to better informed decisions, diagnosis and choice of drug or therapy. The quality of CL studies is improving, but more work is needed on reducing bias and providing evidence of specific impacts on patient care. The Critical Incident Technique as part of a mixed method approach appears to offer a useful approach to demonstrating impact.   This systematic review provides practical guidance regarding the evaluation of CL services. It also provides updated evidence regarding the effectiveness and impact of CL services. The approach used was successful in developing research and critical appraisal skills in a group of librarians. © 2010 The authors. Health Information and Libraries Journal © 2010 Health Libraries Group.

  3. Systematic evaluation program, status summary report

    International Nuclear Information System (INIS)

    1983-01-01

    Status reports are presented on the systematic evaluation program for the Big Rock Point reactor, Dresden-1 reactor, Dresden-2 reactor, Ginna-1 reactor, Connecticut Yankee reactor, LACBWR reactor, Millstone-1 reactor, Oyster Creek-1 reactor, Palisades-1 reactor, San Onofre-1 reactor, and Rowe Yankee reactor

  4. Reliability and validity of clinical tests to assess the anatomical integrity of the cervical spine in adults with neck pain and its associated disorders: Part 1-A systematic review from the Cervical Assessment and Diagnosis Research Evaluation (CADRE) Collaboration.

    Science.gov (United States)

    Lemeunier, Nadège; da Silva-Oolup, S; Chow, N; Southerst, D; Carroll, L; Wong, J J; Shearer, H; Mastragostino, P; Cox, J; Côté, E; Murnaghan, K; Sutton, D; Côté, P

    2017-09-01

    To determine the reliability and validity of clinical tests to assess the anatomical integrity of the cervical spine in adults with neck pain and its associated disorders. We updated the systematic review of the 2000-2010 Bone and Joint Decade Task Force on Neck Pain and its Associated Disorders. We also searched the literature to identify studies on the reliability and validity of Doppler velocimetry for the evaluation of cervical arteries. Two independent reviewers screened and critically appraised studies. We conducted a best evidence synthesis of low risk of bias studies and ranked the phases of investigations using the classification proposed by Sackett and Haynes. We screened 9022 articles and critically appraised 8 studies; all 8 studies had low risk of bias (three reliability and five validity Phase II-III studies). Preliminary evidence suggests that the extension-rotation test may be reliable and has adequate validity to rule out pain arising from facet joints. The evidence suggests variable reliability and preliminary validity for the evaluation of cervical radiculopathy including neurological examination (manual motor testing, dermatomal sensory testing, deep tendon reflexes, and pathological reflex testing), Spurling's and the upper limb neurodynamic tests. No evidence was found for doppler velocimetry. Little evidence exists to support the use of clinical tests to evaluate the anatomical integrity of the cervical spine in adults with neck pain and its associated disorders. We found preliminary evidence to support the use of the extension-rotation test, neurological examination, Spurling's and the upper limb neurodynamic tests.

  5. Systematic assessment of environmental risk factors for bipolar disorder

    DEFF Research Database (Denmark)

    Bortolato, Beatrice; Köhler, Cristiano A.; Evangelou, Evangelos

    2017-01-01

    factors supported by high epidemiological credibility. Methods: We searched the Pubmed/MEDLINE, EMBASE and PsycInfo databases up to 7 October 2016 to identify systematic reviews and meta-analyses of observational studies that assessed associations between putative environmental risk factors and BD......Objectives: The pathophysiology of bipolar disorder is likely to involve both genetic and environmental risk factors. In our study, we aimed to perform a systematic search of environmental risk factors for BD. In addition, we assessed possible hints of bias in this literature, and identified risk...... met the inclusion criteria (seven meta-analyses and nine qualitative systematic reviews). Fifty-one unique environmental risk factors for BD were evaluated. Six meta-analyses investigated associations with a risk factor for BD. Only irritable bowel syndrome (IBS) emerged as a risk factor for BD...

  6. Spatial abilities and anatomy knowledge assessment: A systematic review.

    Science.gov (United States)

    Langlois, Jean; Bellemare, Christian; Toulouse, Josée; Wells, George A

    2017-06-01

    Anatomy knowledge has been found to include both spatial and non-spatial components. However, no systematic evaluation of studies relating spatial abilities and anatomy knowledge has been undertaken. The objective of this study was to conduct a systematic review of the relationship between spatial abilities test and anatomy knowledge assessment. A literature search was done up to March 20, 2014 in Scopus and in several databases on the OvidSP and EBSCOhost platforms. Of the 556 citations obtained, 38 articles were identified and fully reviewed yielding 21 eligible articles and their quality were formally assessed. Non-significant relationships were found between spatial abilities test and anatomy knowledge assessment using essays and non-spatial multiple-choice questions. Significant relationships were observed between spatial abilities test and anatomy knowledge assessment using practical examination, three-dimensional synthesis from two-dimensional views, drawing of views, and cross-sections. Relationships between spatial abilities test and anatomy knowledge assessment using spatial multiple-choice questions were unclear. The results of this systematic review provide evidence for spatial and non-spatial methods of anatomy knowledge assessment. Anat Sci Educ 10: 235-241. © 2016 American Association of Anatomists. © 2016 American Association of Anatomists.

  7. Clinical diagnostic evaluation for scaphoid fractures: a systematic review and meta-analysis

    NARCIS (Netherlands)

    Mallee, Wouter H.; Henny, Erik P.; van Dijk, C. Niek; Kamminga, Sjoerd P.; van Enst, Wynanda A.; Kloen, Peter

    2014-01-01

    To provide an overview of available clinical evaluation tests for scaphoid fractures and to compare their diagnostic accuracies. PWe performed a systematic review of all studies assessing diagnostic characteristics of clinical evaluation in scaphoid fractures by searching MEDLINE, EMBASE, Cochrane,

  8. Optimized Heart Sampling and Systematic Evaluation of Cardiac Therapies in Mouse Models of Ischemic Injury: Assessment of Cardiac Remodeling and Semi-Automated Quantification of Myocardial Infarct Size.

    Science.gov (United States)

    Valente, Mariana; Araújo, Ana; Esteves, Tiago; Laundos, Tiago L; Freire, Ana G; Quelhas, Pedro; Pinto-do-Ó, Perpétua; Nascimento, Diana S

    2015-12-02

    Cardiac therapies are commonly tested preclinically in small-animal models of myocardial infarction. Following functional evaluation, post-mortem histological analysis is essential to assess morphological and molecular alterations underlying the effectiveness of treatment. However, non-methodical and inadequate sampling of the left ventricle often leads to misinterpretations and variability, making direct study comparisons unreliable. Protocols are provided for representative sampling of the ischemic mouse heart followed by morphometric analysis of the left ventricle. Extending the use of this sampling to other types of in situ analysis is also illustrated through the assessment of neovascularization and cellular engraftment in a cell-based therapy setting. This is of interest to the general cardiovascular research community as it details methods for standardization and simplification of histo-morphometric evaluation of emergent heart therapies. © 2015 by John Wiley & Sons, Inc. Copyright © 2015 John Wiley & Sons, Inc.

  9. Evaluation of Data with Systematic Errors

    International Nuclear Information System (INIS)

    Froehner, F. H.

    2003-01-01

    Application-oriented evaluated nuclear data libraries such as ENDF and JEFF contain not only recommended values but also uncertainty information in the form of 'covariance' or 'error files'. These can neither be constructed nor utilized properly without a thorough understanding of uncertainties and correlations. It is shown how incomplete information about errors is described by multivariate probability distributions or, more summarily, by covariance matrices, and how correlations are caused by incompletely known common errors. Parameter estimation for the practically most important case of the Gaussian distribution with common errors is developed in close analogy to the more familiar case without. The formalism shows that, contrary to widespread belief, common ('systematic') and uncorrelated ('random' or 'statistical') errors are to be added in quadrature. It also shows explicitly that repetition of a measurement reduces mainly the statistical uncertainties but not the systematic ones. While statistical uncertainties are readily estimated from the scatter of repeatedly measured data, systematic uncertainties can only be inferred from prior information about common errors and their propagation. The optimal way to handle error-affected auxiliary quantities ('nuisance parameters') in data fitting and parameter estimation is to adjust them on the same footing as the parameters of interest and to integrate (marginalize) them out of the joint posterior distribution afterward

  10. Can systematic reviews inform GMO risk assessment and risk management?

    Directory of Open Access Journals (Sweden)

    Christian eKohl

    2015-08-01

    Full Text Available Systematic reviews represent powerful tools to identify, collect, synthesize and evaluate primary research data on specific research questions in a highly standardized and reproducible manner. They enable the defensible synthesis of outcomes by increasing precision and minimizing bias whilst ensuring transparency of the methods used. This makes them especially valuable to inform evidence-based risk analysis and decision making in various topics and research disciplines. Although seen as a gold standard for synthesizing primary research data, systematic reviews are not without limitations as they are often cost, labor and time intensive and the utility of synthesis outcomes depends upon the availability of sufficient and robust primary research data. In this paper we 1 consider the added value systematic reviews could provide when synthesizing primary research data on genetically modified organisms (GMO and 2 critically assess the adequacy and feasibility of systematic review for collating and analyzing data on potential impacts of GMOs in order to better inform specific steps within GMO risk assessment and risk management. The regulatory framework of the EU is used as an example, although the issues we discuss are likely to be more widely applicable.

  11. Can Systematic Reviews Inform GMO Risk Assessment and Risk Management?

    Science.gov (United States)

    Kohl, Christian; Frampton, Geoff; Sweet, Jeremy; Spök, Armin; Haddaway, Neal Robert; Wilhelm, Ralf; Unger, Stefan; Schiemann, Joachim

    2015-01-01

    Systematic reviews represent powerful tools to identify, collect, synthesize, and evaluate primary research data on specific research questions in a highly standardized and reproducible manner. They enable the defensible synthesis of outcomes by increasing precision and minimizing bias whilst ensuring transparency of the methods used. This makes them especially valuable to inform evidence-based risk analysis and decision making in various topics and research disciplines. Although seen as a "gold standard" for synthesizing primary research data, systematic reviews are not without limitations as they are often cost, labor and time intensive and the utility of synthesis outcomes depends upon the availability of sufficient and robust primary research data. In this paper, we (1) consider the added value systematic reviews could provide when synthesizing primary research data on genetically modified organisms (GMO) and (2) critically assess the adequacy and feasibility of systematic review for collating and analyzing data on potential impacts of GMOs in order to better inform specific steps within GMO risk assessment and risk management. The regulatory framework of the EU is used as an example, although the issues we discuss are likely to be more widely applicable.

  12. Humor Assessment and Interventions in Palliative Care: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Lisa M. Linge-Dahl

    2018-06-01

    Full Text Available Background: The central goal of palliative care is to optimize the quality of life of patients suffering from life-limiting illnesses, which includes psychosocial and spiritual wellbeing. Research has demonstrated positive correlations between humor and laughter with life satisfaction and other aspects of wellbeing, and physiological symptoms can be improved by humorous stimuli.Objectives: The aim of this review is to evaluate humor interventions and assessments that have been applied in palliative care and to derive implications for future research.Methods: A systematic review of four databases identified 13 included studies. Criteria for inclusion were peer-reviewed English-language studies on humor interventions or assessments in a palliative care context.Results: Two studies on humor interventions and 11 studies on humor assessment were included in the systematic review. Most of these studies were about the patients' perspective on humor in palliative care. Findings showed that humor had a positive effect on patients, their relatives, and professional caregivers. Humor was widely perceived as appropriate and seen as beneficial to care in all studies.Conclusions: Even though humor interventions seem to be potentially useful in palliative care, descriptions evaluating their use are scarce. Overall, research on humor assessment and interventions in palliative care has remained limited in terms of quantity and quality. More research activities are needed to build a solid empirical foundation for implementing humor and laughter as part of regular palliative care activities.

  13. Intervention quality is not routinely assessed in Cochrane systematic reviews of radiation therapy interventions.

    Science.gov (United States)

    Abdul Rahim, Mohamad R; James, Melissa L; Hickey, Brigid E

    2017-10-01

    The aim of this study was to maximise the benefits from clinical trials involving technological interventions such as radiation therapy. High compliance to the quality assurance protocols is crucial. We assessed whether the quality of radiation therapy intervention was evaluated in Cochrane systematic reviews. We searched 416 published Cochrane systematic reviews and identified 67 Cochrane systematic reviews that investigated radiation therapy or radiotherapy as an intervention. For each systematic review, either quality assurance or quality control for the intervention was identified by a description of such processes in the published systematic reviews. Of the 67 Cochrane systematic reviews studied, only two mentioned quality assurance or quality control. Our findings revealed that 65 of 67 (97%) Cochrane systematic reviews of radiation therapy interventions failed to consider the quality of the intervention. We suggest that advice about the evaluation of intervention quality be added to author support materials. © 2017 The Royal Australian and New Zealand College of Radiologists.

  14. Training and Assessment of Hysteroscopic Skills: A Systematic Review.

    Science.gov (United States)

    Savran, Mona Meral; Sørensen, Stine Maya Dreier; Konge, Lars; Tolsgaard, Martin G; Bjerrum, Flemming

    2016-01-01

    The aim of this systematic review was to identify studies on hysteroscopic training and assessment. PubMed, Excerpta Medica, the Cochrane Library, and Web of Science were searched in January 2015. Manual screening of references and citation tracking were also performed. Studies on hysteroscopic educational interventions were selected without restrictions on study design, populations, language, or publication year. A qualitative data synthesis including the setting, study participants, training model, training characteristics, hysteroscopic skills, assessment parameters, and study outcomes was performed by 2 authors working independently. Effect sizes were calculated when possible. Overall, 2 raters independently evaluated sources of validity evidence supporting the outcomes of the hysteroscopy assessment tools. A total of 25 studies on hysteroscopy training were identified, of which 23 were performed in simulated settings. Overall, 10 studies used virtual-reality simulators and reported effect sizes for technical skills ranging from 0.31 to 2.65; 12 used inanimate models and reported effect sizes for technical skills ranging from 0.35 to 3.19. One study involved live animal models; 2 studies were performed in clinical settings. The validity evidence supporting the assessment tools used was low. Consensus between the 2 raters on the reported validity evidence was high (94%). This systematic review demonstrated large variations in the effect of different tools for hysteroscopy training. The validity evidence supporting the assessment of hysteroscopic skills was limited. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  15. Indices for the assessment of nutritional quality of meals: a systematic review

    NARCIS (Netherlands)

    Gorgulho, B.M.; Pot, G.K.; Sarti, F.M.; Marchioni, D.M.

    2016-01-01

    This systematic review aimed to synthesise information on indices developed to evaluate nutritional quality of meals. A strategy for systematic search of the literature was developed using keywords related to assessment of meal quality. Databases searched included ScienceDirect, PubMed, Lilacs,

  16. Integrated Assessment Model Evaluation

    Science.gov (United States)

    Smith, S. J.; Clarke, L.; Edmonds, J. A.; Weyant, J. P.

    2012-12-01

    Integrated assessment models of climate change (IAMs) are widely used to provide insights into the dynamics of the coupled human and socio-economic system, including emission mitigation analysis and the generation of future emission scenarios. Similar to the climate modeling community, the integrated assessment community has a two decade history of model inter-comparison, which has served as one of the primary venues for model evaluation and confirmation. While analysis of historical trends in the socio-economic system has long played a key role in diagnostics of future scenarios from IAMs, formal hindcast experiments are just now being contemplated as evaluation exercises. Some initial thoughts on setting up such IAM evaluation experiments are discussed. Socio-economic systems do not follow strict physical laws, which means that evaluation needs to take place in a context, unlike that of physical system models, in which there are few fixed, unchanging relationships. Of course strict validation of even earth system models is not possible (Oreskes etal 2004), a fact borne out by the inability of models to constrain the climate sensitivity. Energy-system models have also been grappling with some of the same questions over the last quarter century. For example, one of "the many questions in the energy field that are waiting for answers in the next 20 years" identified by Hans Landsberg in 1985 was "Will the price of oil resume its upward movement?" Of course we are still asking this question today. While, arguably, even fewer constraints apply to socio-economic systems, numerous historical trends and patterns have been identified, although often only in broad terms, that are used to guide the development of model components, parameter ranges, and scenario assumptions. IAM evaluation exercises are expected to provide useful information for interpreting model results and improving model behavior. A key step is the recognition of model boundaries, that is, what is inside

  17. Health economic evaluations in orthodontics: a systematic review.

    Science.gov (United States)

    Sollenius, Ola; Petrén, Sofia; Björnsson, Liselotte; Norlund, Anders; Bondemark, Lars

    2016-06-01

    Economic evaluation is assuming increasing importance as an integral component of health services research. To conduct a systematic review of the literature and assess the evidence from studies presenting orthodontic treatment outcomes and the related costs. The literature review was conducted in four steps, according to Goodman's model, in order to identify all studies evaluating economic aspects of orthodontic interventions. The search covered the databases Medline, Cinahl, Cochrane, Embase, Google Scholar, National Health Service Economic Evaluation Database, and SCOPUS, for the period from 1966 to September 2014. The inclusion criteria were as follows: randomized controlled trials or controlled clinical trials comparing at least two different orthodontic interventions, evaluation of both economic and orthodontic outcomes, and study populations of all ages. The quality of each included study was assessed as limited, moderate, or high. The overall evidence was assessed according to the GRADE system (The Grading of Recommendations Assessment, Development and Evaluation). The applied terms for searches yielded 1838 studies, of which 989 were excluded as duplicates. Application of the inclusion and exclusion criteria identified 26 eligible studies for which the full-text versions were retrieved and scrutinized. At the final analysis, eight studies remained. Three studies were based on cost-effectiveness analyses and the other five on cost-minimization analysis. Two of the cost-minimization studies included a societal perspective, i.e. the sum of direct and indirect costs. The aims of most of the studies varied widely and of studies comparing equivalent treatment methods, few were of sufficiently high study quality. Thus, the literature to date provides an inadequate evidence base for economic aspects of orthodontic treatment. This systematic review disclosed that few orthodontic studies have presented both economic and clinical outcomes. There is currently

  18. Teamwork Assessment Tools in Obstetric Emergencies: A Systematic Review.

    Science.gov (United States)

    Onwochei, Desire N; Halpern, Stephen; Balki, Mrinalini

    2017-06-01

    Team-based training and simulation can improve patient safety, by improving communication, decision making, and performance of team members. Currently, there is no general consensus on whether or not a specific assessment tool is better adapted to evaluate teamwork in obstetric emergencies. The purpose of this qualitative systematic review was to find the tools available to assess team effectiveness in obstetric emergencies. We searched Embase, Medline, PubMed, Web of Science, PsycINFO, CINAHL, and Google Scholar for prospective studies that evaluated nontechnical skills in multidisciplinary teams involving obstetric emergencies. The search included studies from 1944 until January 11, 2016. Data on reliability and validity measures were collected and used for interpretation. A descriptive analysis was performed on the data. Thirteen studies were included in the final qualitative synthesis. All the studies assessed teams in the context of obstetric simulation scenarios, but only six included anesthetists in the simulations. One study evaluated their teamwork tool using just validity measures, five using just reliability measures, and one used both. The most reliable tools identified were the Clinical Teamwork Scale, the Global Assessment of Obstetric Team Performance, and the Global Rating Scale of performance. However, they were still lacking in terms of quality and validity. More work needs to be conducted to establish the validity of teamwork tools for nontechnical skills, and the development of an ideal tool is warranted. Further studies are required to assess how outcomes, such as performance and patient safety, are influenced when using these tools.

  19. Technology-assisted risk of bias assessment in systematic reviews: a prospective cross-sectional evaluation of the RobotReviewer machine learning tool.

    Science.gov (United States)

    Gates, Allison; Vandermeer, Ben; Hartling, Lisa

    2018-04-01

    To evaluate the reliability of RobotReviewer's risk of bias judgments. In this prospective cross-sectional evaluation, we used RobotReviewer to assess risk of bias among 1,180 trials. We computed reliability with human reviewers using Cohen's kappa coefficient and calculated sensitivity and specificity. We investigated differences in reliability by risk of bias domain, topic, and outcome type using the chi-square test in meta-analysis. Reliability (95% CI) was moderate for random sequence generation (0.48 [0.43, 0.53]), allocation concealment (0.45 [0.40, 0.51]), and blinding of participants and personnel (0.42 [0.36, 0.47]); fair for overall risk of bias (0.34 [0.25, 0.44]); and slight for blinding of outcome assessors (0.10 [0.06, 0.14]), incomplete outcome data (0.14 [0.08, 0.19]), and selective reporting (0.02 [-0.02, 0.05]). Reliability for blinding of participants and personnel (P < 0.001), blinding of outcome assessors (P = 0.005), selective reporting (P < 0.001), and overall risk of bias (P < 0.001) differed by topic. Sensitivity and specificity (95% CI) ranged from 0.20 (0.18, 0.23) to 0.76 (0.72, 0.80) and from 0.61 (0.56, 0.65) to 0.95 (0.93, 0.96), respectively. Risk of bias appraisal is subjective. Compared with reliability between author groups, RobotReviewer's reliability with human reviewers was similar for most domains and better for allocation concealment, blinding of participants and personnel, and overall risk of bias. Copyright © 2018 Elsevier Inc. All rights reserved.

  20. Teamwork Assessment Tools in Modern Surgical Practice: A Systematic Review

    Science.gov (United States)

    Whittaker, George; Abboudi, Hamid; Khan, Muhammed Shamim; Dasgupta, Prokar; Ahmed, Kamran

    2015-01-01

    Introduction. Deficiencies in teamwork skills have been shown to contribute to the occurrence of adverse events during surgery. Consequently, several teamwork assessment tools have been developed to evaluate trainee nontechnical performance. This paper aims to provide an overview of these instruments and review the validity of each tool. Furthermore, the present paper aims to review the deficiencies surrounding training and propose several recommendations to address these issues. Methods. A systematic literature search was conducted to identify teamwork assessment tools using MEDLINE (1946 to August 2015), EMBASE (1974 to August 2015), and PsycINFO (1806 to August 2015) databases. Results. Eight assessment tools which encompass aspects of teamwork were identified. The Nontechnical Skills for Surgeons (NOTSS) assessment was found to possess the highest level of validity from a variety of sources; reliability and acceptability have also been established for this tool. Conclusions. Deficits in current surgical training pathways have prompted several recommendations to meet the evolving requirements of surgeons. Recommendations from the current paper include integration of teamwork training and assessment into medical school curricula, standardised formal training of assessors to ensure accurate evaluation of nontechnical skill acquisition, and integration of concurrent technical and nontechnical skills training throughout training. PMID:26425732

  1. Systematic evaluation of skeletal mechanical function.

    Science.gov (United States)

    Smith, Lauren; Bigelow, Erin M R; Jepsen, Karl J

    2013-06-01

    Many genetic and environmental perturbations lead to measurable changes in bone morphology, matrix composition, and matrix organization. The skeletal system is highly adaptive, such that genetic and environmental perturbations affecting one trait are often accompanied by compensatory changes in other traits. This adaptation should be considered when attempting to draw meaningful conclusions about the role of a gene, for example. The challenge is to figure out which alterations can be attributed to the perturbation and which result from adaptive changes associated with establishing mechanical function. The goal of this chapter is to describe straight-forward biomechanical methods that can be used to determine whether a genetic or environmental perturbation affected bone strength. We introduce a systematic method for evaluating how bone strength was altered in the context of morphology and tissue-level mechanical properties, which are determined in large part from matrix composition, matrix organization, and porosity. We present this work as a first step toward screening mice for a phenotypic effect and for establishing the associated biomechanical mechanism by which function was altered. The outcome of these analyses generally provides insight into the next set of experiments required to further connect the cellular perturbation with the functional changes. The protocols were written to enable researchers without a background in engineering to conduct the assays or to enable researchers to better understand the outcomes of similar assays conducted by colleagues knowledgeable in engineering.

  2. Assessment of generalizability, applicability and predictability (GAP) for evaluating external validity in studies of universal family-based prevention of alcohol misuse in young people: systematic methodological review of randomized controlled trials.

    Science.gov (United States)

    Fernandez-Hermida, Jose Ramon; Calafat, Amador; Becoña, Elisardo; Tsertsvadze, Alexander; Foxcroft, David R

    2012-09-01

    To assess external validity characteristics of studies from two Cochrane Systematic Reviews of the effectiveness of universal family-based prevention of alcohol misuse in young people. Two reviewers used an a priori developed external validity rating form and independently assessed three external validity dimensions of generalizability, applicability and predictability (GAP) in randomized controlled trials. The majority (69%) of the included 29 studies were rated 'unclear' on the reporting of sufficient information for judging generalizability from sample to study population. Ten studies (35%) were rated 'unclear' on the reporting of sufficient information for judging applicability to other populations and settings. No study provided an assessment of the validity of the trial end-point measures for subsequent mortality, morbidity, quality of life or other economic or social outcomes. Similarly, no study reported on the validity of surrogate measures using established criteria for assessing surrogate end-points. Studies evaluating the benefits of family-based prevention of alcohol misuse in young people are generally inadequate at reporting information relevant to generalizability of the findings or implications for health or social outcomes. Researchers, study authors, peer reviewers, journal editors and scientific societies should take steps to improve the reporting of information relevant to external validity in prevention trials. © 2012 The Authors. Addiction © 2012 Society for the Study of Addiction.

  3. Economic evaluation of vaccines in Canada: A systematic review.

    Science.gov (United States)

    Chit, Ayman; Lee, Jason K H; Shim, Minsup; Nguyen, Van Hai; Grootendorst, Paul; Wu, Jianhong; Van Exan, Robert; Langley, Joanne M

    2016-05-03

    Economic evaluations should form part of the basis for public health decision making on new vaccine programs. While Canada's national immunization advisory committee does not systematically include economic evaluations in immunization decision making, there is increasing interest in adopting them. We therefore sought to examine the extent and quality of economic evaluations of vaccines in Canada. We conducted a systematic review of economic evaluations of vaccines in Canada to determine and summarize: comprehensiveness across jurisdictions, studied vaccines, funding sources, study designs, research quality, and changes over time. Searches in multiple databases were conducted using the terms "vaccine," "economics" and "Canada." Descriptive data from eligible manuscripts was abstracted and three authors independently evaluated manuscript quality using a 7-point Likert-type scale scoring tool based on criteria from the International Society for Pharmacoeconomics and Outcomes Research (ISPOR). 42/175 articles met the search criteria. Of these, Canada-wide studies were most common (25/42), while provincial studies largely focused on the three populous provinces of Ontario, Quebec and British Columbia. The most common funding source was industry (17/42), followed by government (7/42). 38 studies used mathematical models estimating expected economic benefit while 4 studies examined post-hoc data on established programs. Studies covered 10 diseases, with 28/42 addressing pediatric vaccines. Many studies considered cost-utility (22/42) and the majority of these studies reported favorable economic results (16/22). The mean quality score was 5.9/7 and was consistent over publication date, funding sources, and disease areas. We observed diverse approaches to evaluate vaccine economics in Canada. Given the increased complexity of economic studies evaluating vaccines and the impact of results on public health practice, Canada needs improved, transparent and consistent processes

  4. INSTRUMENTS OF HIGH RISK SEXUAL BEHAVIOR ASSESSMENT: A SYSTEMATIC REVIEW.

    Science.gov (United States)

    Mirzaei, Mojtaba; Ahmadi, Khodabakhsh; Saadat, Seyed-Hassan; Ramezani, Mohammad Arash

    2016-02-01

    Sexual behavior is a complex activity affecting all aspects of human's life. Risky sexual behaviors impose negative outcomes on family, relationships and health. Unsafe sex is the second most leading cause of disability adjusted life years worldwide. Valid and reliable tools for assessment of risky sexual behaviors are necessary for implementing preventive measures. we searched Medline and the Cochrane Library of Systematic Reviews, with the keywords of "risky sexual behavior assessment", "sexual risk assessment", "high risk sexual behavior", "sexual risk taking". By reviewing references of the articles, some complementary studies were added. Assessment can be performed by questionnaire or non-questionnaire instruments. Questionnaires vary depending on their target population, evaluation of risky sexual behavior as a whole or focusing on an associated risk factor. In order to avoid usual biases in self reports, objective biomarker assessment of unprotected sex are employed. These markers include prostate specific antigen, chromosome Y DNA and Seminogelin. Risky sexual behavior can be assessed by various subjective and objective methods. While self-reports are more feasible, objective methods offer a higher degree of reliability. Further studies for finding more feasible methods of using biomarkers are recommended.

  5. Optimizing Caffeine Use and Risk of Bronchopulmonary Dysplasia in Preterm Infants: A Systematic Review, Meta-analysis, and Application of Grading of Recommendations Assessment, Development, and Evaluation Methodology.

    Science.gov (United States)

    Pakvasa, Mitali Atul; Saroha, Vivek; Patel, Ravi Mangal

    2018-06-01

    Caffeine reduces the risk of bronchopulmonary dysplasia (BPD). Optimizing caffeine use could increase therapeutic benefit. We performed a systematic-review and random-effects meta-analysis of studies comparing different timing of initiation and dose of caffeine on the risk of BPD. Earlier initiation, compared to later, was associated with a decreased risk of BPD (5 observational studies; n = 63,049, adjusted OR 0.69; 95% CI 0.64-0.75, GRADE: low quality). High-dose caffeine, compared to standard-dose, was associated with a decreased risk of BPD (3 randomized trials, n = 432, OR 0.65; 95% CI 0.43-0.97; GRADE: low quality). Higher quality evidence is needed to guide optimal caffeine use. Copyright © 2018 Elsevier Inc. All rights reserved.

  6. Systematic review: questionnaires for assessment of gastroesophageal reflux disease.

    Science.gov (United States)

    Bolier, E A; Kessing, B F; Smout, A J; Bredenoord, A J

    2015-01-01

    Numerous questionnaires with a wide variety of characteristics have been developed for the assessment of gastroesophageal reflux disease (GERD). Four well-defined dimensions are noticeable in these GERD questionnaires, which are symptoms, response to treatment, diagnosis, and burden on the quality of life of GERD patients. The aim of this review is to develop a complete overview of all available questionnaires, categorized per dimension of the assessment of GERD. A systematic search of the literature up to January 2013 using the Pubmed database and the Embase database, and search of references and conference abstract books were conducted. A total number of 65 questionnaires were extracted and evaluated. Thirty-nine questionnaires were found applicable for the assessment of GERD symptoms, three of which are generic gastrointestinal questionnaires. For the assessment of response to treatment, 14 questionnaires were considered applicable. Seven questionnaires with diagnostic purposes were found. In the assessment of quality of life in GERD patients, 18 questionnaires were found and evaluated. Twenty questionnaires were found to be used for more than one assessment dimension, and eight questionnaires were found for GERD assessment in infants and/or children. A wide variety of GERD questionnaires is available, of which the majority is used for assessment of GERD symptoms. Questionnaires differ in aspects such as design, validation and translations. Also, numerous multidimensional questionnaires are available, of which the Reflux Disease Questionnaire is widely applicable. We provided an overview of GERD questionnaires to aid investigators and clinicians in their search for the most appropriate questionnaire for their specific purposes. © 2013 International Society for Diseases of the Esophagus.

  7. Pain management in cancer center inpatients: a cluster randomized trial to evaluate a systematic integrated approach—The Edinburgh Pain Assessment and Management Tool

    OpenAIRE

    Fallon, M; Walker, J; Colvin, L; Rodriguez, A; Murray, G; Sharpe, M

    2018-01-01

    Purpose Pain is suboptimally managed in patients with cancer. We aimed to compare the effect of a policy of adding a clinician-delivered bedside pain assessment and management tool (Edinburgh Pain Assessment and management Tool [EPAT]) to usual care (UC) versus UC alone on pain outcomes. Patients and Methods In a two-arm, parallel group, cluster randomized (1:1) trial, we observed pain outcomes in 19 cancer centers in the United Kingdom and then randomly assigned the centers to eithe...

  8. Validity of Dietary Assessment in Athletes: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Louise Capling

    2017-12-01

    Full Text Available Dietary assessment methods that are recognized as appropriate for the general population are usually applied in a similar manner to athletes, despite the knowledge that sport-specific factors can complicate assessment and impact accuracy in unique ways. As dietary assessment methods are used extensively within the field of sports nutrition, there is concern the validity of methodologies have not undergone more rigorous evaluation in this unique population sub-group. The purpose of this systematic review was to compare two or more methods of dietary assessment, including dietary intake measured against biomarkers or reference measures of energy expenditure, in athletes. Six electronic databases were searched for English-language, full-text articles published from January 1980 until June 2016. The search strategy combined the following keywords: diet, nutrition assessment, athlete, and validity; where the following outcomes are reported but not limited to: energy intake, macro and/or micronutrient intake, food intake, nutritional adequacy, diet quality, or nutritional status. Meta-analysis was performed on studies with sufficient methodological similarity, with between-group standardized mean differences (or effect size and 95% confidence intervals (CI being calculated. Of the 1624 studies identified, 18 were eligible for inclusion. Studies comparing self-reported energy intake (EI to energy expenditure assessed via doubly labelled water were grouped for comparison (n = 11 and demonstrated mean EI was under-estimated by 19% (−2793 ± 1134 kJ/day. Meta-analysis revealed a large pooled effect size of −1.006 (95% CI: −1.3 to −0.7; p < 0.001. The remaining studies (n = 7 compared a new dietary tool or instrument to a reference method(s (e.g., food record, 24-h dietary recall, biomarker as part of a validation study. This systematic review revealed there are limited robust studies evaluating dietary assessment methods in athletes. Existing

  9. A Systematic Review of Human Bat Rabies Virus Variant Cases: Evaluating Unprotected Physical Contact with Claws and Teeth in Support of Accurate Risk Assessments.

    Science.gov (United States)

    Dato, Virginia M; Campagnolo, Enzo R; Long, Jonah; Rupprecht, Charles E

    2016-01-01

    In the United States and Canada, the most recent documented cases of rabies have been attributed to bat rabies viruses (RABV). We undertook this systematic review in an effort to summarize and enhance understanding of the risk of infection for individuals who have been potentially exposed to a suspect or confirmed rabid bat. United States rabies surveillance summaries documented a total of 41 human bat-rabies virus variant verified non-transplant cases between 1990 and 2015. All cases were fatal. Seven (17.1%) of 41 cases reported a bite from a bat. Ten (24.3%) cases had unprotected physical contact (UPC); these included seven cases that had a bat land or crawl on them (contact with claws) and one case that touched a bat's teeth. Seven (17.1%) cases had probable UPC. Insectivorous bat teeth are extremely sharp and highly efficient for predation upon arthropod prey. Bats also have sharp claws on the end of their thumbs and feet. One of the most common bat RABV variants has an ability to replicate in non-neural cells. Questioning individuals about unprotected contact with bat teeth and claws (including a bat landing or crawling on a person) may help identify additional exposures.

  10. Systematic assessment of laser safety in otolaryngology

    Science.gov (United States)

    Oswal, V. H.

    2001-01-01

    Risk management of lasers can be broadly define das a process of identification of the risk, assessment of the risk and steps taken to avert the risk. The risk management may be divided into: Risk inherent to the technology and risk in clinical use. Within the National Health Service in the UK, a useful document, which provides hospital laser users with advice on safety, is the 'Guidance on the Safe Use of Lasers in Medical and Dental Practice' issued by the Medical Devices Agency for the Department of Health in the UK. It recommends the appointment of a Laser Protection Adviser (LPA) who is knowledgeable in the evaluation of laser hazards. One of the duties LPA is to ensure that Local Rules are drawn up for each specific application of a laser. A Laser Protection Supervisor (LPS) should also be appointed with responsibility to ensure that the Local Rules are observed. It is a sensible precaution that laser users should be those approved by the Laser Protection Supervisor in consultation with the Laser Protection Advisor. All laser users should sign a statement that they have read and understood the Local Rules.

  11. Content validity of methods to assess malnutrition in cancer patients: a systematic review

    NARCIS (Netherlands)

    Sealy, Martine; Nijholt, Willemke; Stuiver, M.M.; van der Berg, M.M.; Ottery, Faith D.; van der Schans, Cees; Roodenburg, Jan L N; Jager-Wittenaar, Harriët

    Content validity of methods to assess malnutrition in cancer patients: A systematic review Rationale: Inadequate operationalisation of the multidimensial concept of malnutrition may result in inadequate evaluation of nutritional status. In this review we aimed to assess content validity of methods

  12. Evaluation of Health Economics in Radiation Oncology: A Systematic Review

    Energy Technology Data Exchange (ETDEWEB)

    Nguyen, Timothy K.; Goodman, Chris D. [Department of Radiation Oncology, London Regional Cancer Program, London, Ontario (Canada); Boldt, R. Gabriel [London Health Sciences Centre, London, Ontario (Canada); Warner, Andrew; Palma, David A. [Department of Radiation Oncology, London Regional Cancer Program, London, Ontario (Canada); Rodrigues, George B. [Department of Radiation Oncology, London Regional Cancer Program, London, Ontario (Canada); Department of Epidemiology and Biostatistics, Western University, London, Ontario (Canada); Lock, Michael I. [Department of Radiation Oncology, London Regional Cancer Program, London, Ontario (Canada); Mishra, Mark V. [Department of Radiation Oncology, University of Maryland, Baltimore, Maryland (United States); Zaric, Gregory S. [Department of Epidemiology and Biostatistics, Western University, London, Ontario (Canada); Ivey Business School, Western University, London, Ontario (Canada); Louie, Alexander V., E-mail: Dr.alexlouie@gmail.com [Department of Radiation Oncology, London Regional Cancer Program, London, Ontario (Canada); Department of Epidemiology and Biostatistics, Western University, London, Ontario (Canada)

    2016-04-01

    Purpose: Despite the rising costs in radiation oncology, the impact of health economics research on radiation therapy practice analysis patterns is unclear. We performed a systematic review of cost-effectiveness analyses (CEAs) and cost-utility analyses (CUAs) to identify trends in reporting quality in the radiation oncology literature over time. Methods and Materials: A systematic review of radiation oncology economic evaluations up to 2014 was performed, using MEDLINE and EMBASE databases. The Consolidated Health Economic Evaluation Reporting Standards guideline informed data abstraction variables including study demographics, economic parameters, and methodological details. Tufts Medical Center CEA registry quality scores provided a basis for qualitative assessment of included studies. Studies were stratified by 3 time periods (1995-2004, 2005-2009, and 2010-2014). The Cochran-Armitage trend test and linear trend test were used to identify trends over time. Results: In total, 102 articles were selected for final review. Most studies were in the context of a model (61%) or clinical trial (28%). Many studies lacked a conflict of interest (COI) statement (67%), a sponsorship statement (48%), a reported study time horizon (35%), and the use of discounting (29%). There was a significant increase over time in the reporting of a COI statement (P<.001), health care payer perspective (P=.019), sensitivity analyses using multivariate (P=.043) or probabilistic methods (P=.011), incremental cost-effectiveness threshold (P<.001), secondary source utility weights (P=.010), and cost effectiveness acceptability curves (P=.049). There was a trend toward improvement in Tuft scores over time (P=.065). Conclusions: Recent reports demonstrate improved reporting rates in economic evaluations; however, there remains significant room for improvement as reporting rates are still suboptimal. As fiscal pressures rise, we will rely on economic assessments to guide our practice decisions

  13. Evaluation of Health Economics in Radiation Oncology: A Systematic Review

    International Nuclear Information System (INIS)

    Nguyen, Timothy K.; Goodman, Chris D.; Boldt, R. Gabriel; Warner, Andrew; Palma, David A.; Rodrigues, George B.; Lock, Michael I.; Mishra, Mark V.; Zaric, Gregory S.; Louie, Alexander V.

    2016-01-01

    Purpose: Despite the rising costs in radiation oncology, the impact of health economics research on radiation therapy practice analysis patterns is unclear. We performed a systematic review of cost-effectiveness analyses (CEAs) and cost-utility analyses (CUAs) to identify trends in reporting quality in the radiation oncology literature over time. Methods and Materials: A systematic review of radiation oncology economic evaluations up to 2014 was performed, using MEDLINE and EMBASE databases. The Consolidated Health Economic Evaluation Reporting Standards guideline informed data abstraction variables including study demographics, economic parameters, and methodological details. Tufts Medical Center CEA registry quality scores provided a basis for qualitative assessment of included studies. Studies were stratified by 3 time periods (1995-2004, 2005-2009, and 2010-2014). The Cochran-Armitage trend test and linear trend test were used to identify trends over time. Results: In total, 102 articles were selected for final review. Most studies were in the context of a model (61%) or clinical trial (28%). Many studies lacked a conflict of interest (COI) statement (67%), a sponsorship statement (48%), a reported study time horizon (35%), and the use of discounting (29%). There was a significant increase over time in the reporting of a COI statement (P<.001), health care payer perspective (P=.019), sensitivity analyses using multivariate (P=.043) or probabilistic methods (P=.011), incremental cost-effectiveness threshold (P<.001), secondary source utility weights (P=.010), and cost effectiveness acceptability curves (P=.049). There was a trend toward improvement in Tuft scores over time (P=.065). Conclusions: Recent reports demonstrate improved reporting rates in economic evaluations; however, there remains significant room for improvement as reporting rates are still suboptimal. As fiscal pressures rise, we will rely on economic assessments to guide our practice decisions

  14. A systematic self-assessment tool

    OpenAIRE

    Berglund, Anders; Tretten, Phillip; Håkansson, Anders

    2012-01-01

    The Bologna Process has led to fundamental changes in the way students are taught. This in turn has led to new quality assurance systems for teaching. For good outcomes to occur both the teachers and students need to be aware of the intended learning outcome (ILO) and this is made clearer by well defined Teacher/Learner Activities (TLAs). The Systematic Grading Procedure (SGP) has been shown to assist teachers grading student’s 3D-image work, fulfilling a need for assistance in subjects requi...

  15. Systematic evaluation of nuclear operator team skills training

    International Nuclear Information System (INIS)

    Harrington, D.K.; Kello, J.E.

    1991-01-01

    In recent years, the nuclear industry has increasingly recognized with the technical training given its control room operators. As yet, however, little has been done to determine the actual effectiveness of such nontechnical training. Thus, the questions of how team training should be carried out for maximum impact on the safety and efficiency of control room operation and just what the benefits of such training might be remain open. We are in the early stages of establishing a systematic evaluation process that will help nuclear utilities assess the effectiveness of their existing team skills training programs for control room operators. Research focuses on defining the specific behavioral and attitudinal objectives of team skills training. Simply put, what does good practice look like and sound like in the control room environment? What specific behaviors and attitudes should the training be directed toward? Obviously, the answers to the questions have clear implications for the design of nuclear team skills training programs

  16. Evaluation and impact of cardiotocography training programmes: a systematic review.

    Science.gov (United States)

    Pehrson, C; Sorensen, J L; Amer-Wåhlin, I

    2011-07-01

    The interpretation and management of cardiotocography (CTG) tracings are often criticised in obstetric malpractice cases. As a consequence, regular CTG training has been recommended, even though little is known about the effect of CTG training. To perform a systematic review of the existing literature on studies on CTG training in order to assess educational strategies, evaluation of training programmes, and impact of training programmes. The Medline database was searched to identify studies describing and/or evaluating CTG training programmes. The literature search resulted in 409 citations. Twenty studies describing and evaluating CTG training programmes were included. There was no restriction on study design. Data regarding study design, study quality, educational strategies used for training in CTG interpretation and decision making, target groups, number of participants, methods used for evaluation, quality of evaluation, level of evaluation and results of training was extracted from 20 articles, and analysed using Kirkpatrick's four-level model for the evaluation of education. Training was associated with improvements on all Kirkpatrick levels, resulting in increased CTG knowledge and interpretive skills, higher interobserver agreement, better management of intrapartum CTG, and improved quality of care. Computer-based training (CBT) might be less time-consuming than classroom teaching. Clinical skills seem to decrease faster than theoretical knowledge. Training can improve CTG competence and clinical practise. Further research on CBT, test-enhanced learning and long-term retention, evaluation of training and impact on clinical outcomes is recommended. © 2011 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2011 RCOG.

  17. Operating experience review for nuclear power plants in the Systematic Evaluation Program

    International Nuclear Information System (INIS)

    Mays, G.T.; Harrington, K.H.

    1982-01-01

    The Systematic Evaluation Program Branch (SEPB) of the Nuclear Regulatory Commission (NRC) is conducting the Systematic Evaluation Program (SEP) whose purpose is to determine the safety margins of the design and operation of the eleven oldest operating commercial nuclear power plants in the United States. This paper describes the methodology and results of the operational experience review portion of the SEP evaluation. SEPB will combine the results from these operational reviews with other safety topic evaluations to perform an integrated assessment of the SEP plants

  18. A systematic map of ecosystem services assessments around European agroforestry

    DEFF Research Database (Denmark)

    Fagerholm, Nora; Torralba Viorreta, Mario; Burgess, Paul J.

    2016-01-01

    the knowledge field and provide the first systematic synthesis of ecosystem services research in relation to European agroforestry. We reviewed 71 scientific publications from studies conducted in farmland and forest ecosystems with various types of agroforestry management. Each publication was systematically......, typical clusters of similar research approaches were identified. The results show that ecosystem service assessment of European agroforestry is currently focused on the spatially extensive wood pastures in the Mediterranean, Atlantic, and Continental agricultural mosaic landscapes. A specific emphasis has...

  19. Assessment of patient empowerment--a systematic review of measures.

    Directory of Open Access Journals (Sweden)

    Paul J Barr

    Full Text Available Patient empowerment has gained considerable importance but uncertainty remains about the best way to define and measure it. The validity of empirical findings depends on the quality of measures used. This systematic review aims to provide an overview of studies assessing psychometric properties of questionnaires purporting to capture patient empowerment, evaluate the methodological quality of these studies and assess the psychometric properties of measures identified.Electronic searches in five databases were combined with reference tracking of included articles. Peer-reviewed articles reporting psychometric testing of empowerment measures for adult patients in French, German, English, Portuguese and Spanish were included. Study characteristics, constructs operationalised and psychometric properties were extracted. The quality of study design, methods and reporting was assessed using the COSMIN checklist. The quality of psychometric properties was assessed using Terwee's 2007 criteria.30 studies on 19 measures were included. Six measures are generic, while 13 were developed for a specific condition (N=4 or specialty (N=9. Most studies tested measures in English (N=17 or Swedish (N=6. Sample sizes of included studies varied from N=35 to N=8261. A range of patient empowerment constructs was operationalised in included measures. These were classified into four domains: patient states, experiences and capacities; patient actions and behaviours; patient self-determination within the healthcare relationship and patient skills development. Quality assessment revealed several flaws in methodological study quality with COSMIN scores mainly fair or poor. The overall quality of psychometric properties of included measures was intermediate to positive. Certain psychometric properties were not tested for most measures.Findings provide a basis from which to develop consensus on a core set of patient empowerment constructs and for further work to develop a

  20. Financial evaluations of antibiotic stewardship programs - a systematic review

    Directory of Open Access Journals (Sweden)

    Jan-Willem Hendrik Dik

    2015-04-01

    Full Text Available IntroductionThere is an increasing awareness to counteract problems due to incorrect antimicrobial use. Interventions that are implemented are often part of an Antimicrobial Stewardship Program (ASPs. Studies publishing results from these interventions are increasing, including reports on the economical effects of ASPs. This review will look at the economical sections of these studies and the methods that were used. MethodsA systematic review was performed of articles found in the PubMed and EMBASE databases published from 2000 until November 2014. Included studies found were scored for various aspects and the quality of the papers was assessed following an appropriate check list (CHEC criteria list.Results1233 studies were found, of which 149 were read completely. 99 were included in the final review. Of these studies, 57 only mentioned the costs associated with the antimicrobial medication. Others also included operational costs (n=23, costs for hospital stay (n=18 and/or other costs (n=19. 9 studies were further assessed for their quality. These studies scored between 2 and 14 out of a potential total score of 19.ConclusionsThis review gives an extensive overview of the current financial evaluation of ASPs and the quality of these economical studies. We show that there is still major potential to improve financial evaluations of ASPs. Studies do not use similar nor consistent methods or outcome measures, making it impossible draw sound conclusions and compare different studies. Finally, we make some recommendations for the future.

  1. Systematic Review Protocol for the IRIS Chloroform Assessment (Inhalation) (Preliminary Assessment Materials)

    Science.gov (United States)

    In January 2018, EPA released the Systematic Review Protocol for the IRIS Chloroform Assessment (Inhalation). As part of developing a draft IRIS assessment, EPA presents a methods document, referred to as the protocol, for conducting a chemical-specific systematic revie...

  2. A Systematic Methodology for Gearbox Health Assessment and Fault Classification

    Directory of Open Access Journals (Sweden)

    Jay Lee

    2011-01-01

    Full Text Available A systematic methodology for gearbox health assessment and fault classification is developed and evaluated for 560 data sets of gearbox vibration data provided by the Prognostics and Health Management Society for the 2009 data challenge competition. A comprehensive set of signal processing and feature extraction methods are used to extract over 200 features, including features extracted from the raw time signal, time synchronous signal, wavelet decomposition signal, frequency domain spectrum, envelope spectrum, among others. A regime segmentation approach using the tachometer signal, a spectrum similarity metric, and gear mesh frequency peak information are used to segment the data by gear type, input shaft speed, and braking torque load. A health assessment method that finds the minimum feature vector sum in each regime is used to classify and find the 80 baseline healthy data sets. A fault diagnosis method based on a distance calculation from normal along with specific features correlated to different fault signatures is used to diagnosis specific faults. The fault diagnosis method is evaluated for the diagnosis of a gear tooth breakage, input shaft imbalance, bent shaft, bearing inner race defect, and bad key, and the method could be further extended for other faults as long as a set of features can be correlated with a known fault signature. Future work looks to further refine the distance calculation algorithm for fault diagnosis, as well as further evaluate other signal processing method such as the empirical mode decomposition to see if an improved set of features can be used to improve the fault diagnosis accuracy.

  3. Systematic Sustainability Assessment (SSA) Tool for Hydroelectric Project in Malaysia

    Science.gov (United States)

    Turan, Faiz Mohd; Johan, Kartina

    2017-08-01

    Sustainably developed and managed hydropower has enormous potential to contribute to global sustainability goals. It is known that hydroelectricity contributing small amounts to greenhouse gas emissions and other atmospheric pollutants. However, developing the remaining hydroelectric potential offers many challenges, and public pressure and expectations on the environmental and social performance of hydroelectric tend to increase over time. This paper aims to develop Systematic Sustainability Assessment (SSA) Tool that promotes and guides more sustainable hydroelectric projects in the context of Malaysia. The proposed SSA tool which not only provide a quality and quantitative report of sustainability performance but also act as Self-Assessment Report (SAR) to provide roadmap to achieve greater level of sustainability in project management for continuous improvement. It is expected to provide a common language that allow government, civil society, financial institutions and the hydroelectric sector to talk about and evaluate sustainability issues. The advantage of SSA tool is it can be used at any stage of hydroelectric development, from the earliest planning stages right through to operation.

  4. Systematic overview of economic evaluations of health-related rehabilitation.

    Science.gov (United States)

    Howard-Wilsher, Stephanie; Irvine, Lisa; Fan, Hong; Shakespeare, Tom; Suhrcke, Marc; Horton, Simon; Poland, Fiona; Hooper, Lee; Song, Fujian

    2016-01-01

    Health related rehabilitation is instrumental in improving functioning and promoting participation by people with disabilities. To make clinical and policy decisions about health-related rehabilitation, resource allocation and cost issues need to be considered. To provide an overview of systematic reviews (SRs) on economic evaluations of health-related rehabilitation. We searched multiple databases to identify relevant SRs of economic evaluations of health-related rehabilitation. Review quality was assessed by AMSTAR checklist. We included 64 SRs, most of which included economic evaluations alongside randomized controlled trials (RCTs). The review quality was low to moderate (AMSTAR score 5-8) in 35, and high (score 9-11) in 29 of the included SRs. The included SRs addressed various health conditions, including spinal or other pain conditions (n = 14), age-related problems (11), stroke (7), musculoskeletal disorders (6), heart diseases (4), pulmonary (3), mental health problems (3), and injury (3). Physiotherapy was the most commonly evaluated rehabilitation intervention in the included SRs (n = 24). Other commonly evaluated interventions included multidisciplinary programmes (14); behavioral, educational or psychological interventions (11); home-based interventions (11); complementary therapy (6); self-management (6); and occupational therapy (4). Although the available evidence is often described as limited, inconsistent or inconclusive, some rehabilitation interventions were cost-effective or showed cost-saving in a variety of disability conditions. Available evidence comes predominantly from high income countries, therefore economic evaluations of health-related rehabilitation are urgently required in less resourced settings. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  5. Systematic network assessment of the carcinogenic activities of cadmium

    International Nuclear Information System (INIS)

    Chen, Peizhan; Duan, Xiaohua; Li, Mian; Huang, Chao; Li, Jingquan; Chu, Ruiai; Ying, Hao; Song, Haiyun; Jia, Xudong; Ba, Qian; Wang, Hui

    2016-01-01

    Cadmium has been defined as type I carcinogen for humans, but the underlying mechanisms of its carcinogenic activity and its influence on protein-protein interactions in cells are not fully elucidated. The aim of the current study was to evaluate, systematically, the carcinogenic activity of cadmium with systems biology approaches. From a literature search of 209 studies that performed with cellular models, 208 proteins influenced by cadmium exposure were identified. All of these were assessed by Western blotting and were recognized as key nodes in network analyses. The protein-protein functional interaction networks were constructed with NetBox software and visualized with Cytoscape software. These cadmium-rewired genes were used to construct a scale-free, highly connected biological protein interaction network with 850 nodes and 8770 edges. Of the network, nine key modules were identified and 60 key signaling pathways, including the estrogen, RAS, PI3K-Akt, NF-κB, HIF-1α, Jak-STAT, and TGF-β signaling pathways, were significantly enriched. With breast cancer, colorectal and prostate cancer cellular models, we validated the key node genes in the network that had been previously reported or inferred form the network by Western blotting methods, including STAT3, JNK, p38, SMAD2/3, P65, AKT1, and HIF-1α. These results suggested the established network was robust and provided a systematic view of the carcinogenic activities of cadmium in human. - Highlights: • A cadmium-influenced network with 850 nodes and 8770 edges was established. • The cadmium-rewired gene network was scale-free and highly connected. • Nine modules were identified, and 60 key signaling pathways related to cadmium-induced carcinogenesis were found. • Key mediators in the network were validated in multiple cellular models.

  6. Systematic network assessment of the carcinogenic activities of cadmium

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Peizhan; Duan, Xiaohua; Li, Mian; Huang, Chao [Key Laboratory of Food Safety Research, Institute for Nutritional Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai (China); Li, Jingquan; Chu, Ruiai; Ying, Hao; Song, Haiyun [Key Laboratory of Food Safety Research, Institute for Nutritional Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai (China); Key Laboratory of Food Safety Risk Assessment, Ministry of Health, Beijing (China); Jia, Xudong [Key Laboratory of Food Safety Risk Assessment, Ministry of Health, Beijing (China); Ba, Qian, E-mail: qba@sibs.ac.cn [Key Laboratory of Food Safety Research, Institute for Nutritional Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai (China); Key Laboratory of Food Safety Risk Assessment, Ministry of Health, Beijing (China); Wang, Hui, E-mail: huiwang@sibs.ac.cn [Key Laboratory of Food Safety Research, Institute for Nutritional Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai (China); Key Laboratory of Food Safety Risk Assessment, Ministry of Health, Beijing (China); School of Life Science and Technology, ShanghaiTech University, Shanghai (China)

    2016-11-01

    Cadmium has been defined as type I carcinogen for humans, but the underlying mechanisms of its carcinogenic activity and its influence on protein-protein interactions in cells are not fully elucidated. The aim of the current study was to evaluate, systematically, the carcinogenic activity of cadmium with systems biology approaches. From a literature search of 209 studies that performed with cellular models, 208 proteins influenced by cadmium exposure were identified. All of these were assessed by Western blotting and were recognized as key nodes in network analyses. The protein-protein functional interaction networks were constructed with NetBox software and visualized with Cytoscape software. These cadmium-rewired genes were used to construct a scale-free, highly connected biological protein interaction network with 850 nodes and 8770 edges. Of the network, nine key modules were identified and 60 key signaling pathways, including the estrogen, RAS, PI3K-Akt, NF-κB, HIF-1α, Jak-STAT, and TGF-β signaling pathways, were significantly enriched. With breast cancer, colorectal and prostate cancer cellular models, we validated the key node genes in the network that had been previously reported or inferred form the network by Western blotting methods, including STAT3, JNK, p38, SMAD2/3, P65, AKT1, and HIF-1α. These results suggested the established network was robust and provided a systematic view of the carcinogenic activities of cadmium in human. - Highlights: • A cadmium-influenced network with 850 nodes and 8770 edges was established. • The cadmium-rewired gene network was scale-free and highly connected. • Nine modules were identified, and 60 key signaling pathways related to cadmium-induced carcinogenesis were found. • Key mediators in the network were validated in multiple cellular models.

  7. Doctor performance assessment in daily practise: does it help doctors or not? A systematic review.

    NARCIS (Netherlands)

    Overeem, K.; Faber, M.J.; Arah, O.A.; Elwyn, G.; Lombarts, K.M.; Wollersheim, H.C.H.; Grol, R.P.T.M.

    2007-01-01

    CONTEXT: Continuous assessment of individual performance of doctors is crucial for life-long learning and quality of care. Policy-makers and health educators should have good insights into the strengths and weaknesses of the methods available. The aim of this study was to systematically evaluate the

  8. Doctor performance assessment in daily practise: does it help doctors or not? A systematic review

    NARCIS (Netherlands)

    Overeem, Karlijn; Faber, Marjan J.; Arah, Onvebuchi A.; Elwyn, Glyn; Lombarts, Kiki M. J. M. H.; Wollersheim, Hub C.; Grol, Richard P. T. M.

    2007-01-01

    CONTEXT Continuous assessment of individual performance of doctors is crucial for life-long learning and quality of care. Policy makers and health educators should have good insights into the strengths and weaknesses of the methods available. The aim of this study was to systematically evaluate the

  9. Systematic review of model-based cervical screening evaluations.

    Science.gov (United States)

    Mendes, Diana; Bains, Iren; Vanni, Tazio; Jit, Mark

    2015-05-01

    Optimising population-based cervical screening policies is becoming more complex due to the expanding range of screening technologies available and the interplay with vaccine-induced changes in epidemiology. Mathematical models are increasingly being applied to assess the impact of cervical cancer screening strategies. We systematically reviewed MEDLINE®, Embase, Web of Science®, EconLit, Health Economic Evaluation Database, and The Cochrane Library databases in order to identify the mathematical models of human papillomavirus (HPV) infection and cervical cancer progression used to assess the effectiveness and/or cost-effectiveness of cervical cancer screening strategies. Key model features and conclusions relevant to decision-making were extracted. We found 153 articles meeting our eligibility criteria published up to May 2013. Most studies (72/153) evaluated the introduction of a new screening technology, with particular focus on the comparison of HPV DNA testing and cytology (n = 58). Twenty-eight in forty of these analyses supported HPV DNA primary screening implementation. A few studies analysed more recent technologies - rapid HPV DNA testing (n = 3), HPV DNA self-sampling (n = 4), and genotyping (n = 1) - and were also supportive of their introduction. However, no study was found on emerging molecular markers and their potential utility in future screening programmes. Most evaluations (113/153) were based on models simulating aggregate groups of women at risk of cervical cancer over time without accounting for HPV infection transmission. Calibration to country-specific outcome data is becoming more common, but has not yet become standard practice. Models of cervical screening are increasingly used, and allow extrapolation of trial data to project the population-level health and economic impact of different screening policy. However, post-vaccination analyses have rarely incorporated transmission dynamics. Model calibration to country

  10. Assessment of patient empowerment - a systematic review of measures

    NARCIS (Netherlands)

    Barr, P.J.; Scholl, I.; Bravo, P.; Faber, M.J.; Elwyn, G.; Mcallister, M.

    2015-01-01

    BACKGROUND: Patient empowerment has gained considerable importance but uncertainty remains about the best way to define and measure it. The validity of empirical findings depends on the quality of measures used. This systematic review aims to provide an overview of studies assessing psychometric

  11. Assessing variability in results in systematic reviews of diagnostic studies

    NARCIS (Netherlands)

    Naaktgeboren, Christiana A; Ochodo, Eleanor A; Van Enst, Wynanda A; de Groot, Joris A H; Hooft, Lotty; Leeflang, Mariska M G; Bossuyt, Patrick M; Moons, Karel G M; Reitsma, Johannes B

    2016-01-01

    BACKGROUND: To describe approaches used in systematic reviews of diagnostic test accuracy studies for assessing variability in estimates of accuracy between studies and to provide guidance in this area. METHODS: Meta-analyses of diagnostic test accuracy studies published between May and September

  12. Communication Assessment for Individuals with Rett Syndrome: A Systematic Review

    Science.gov (United States)

    Sigafoos, Jeff; Kagohara, Debora; van der Meer, Larah; Green, Vanessa A.; O'Reilly, Mark F.; Lancioni, Giulio E.; Lang, Russell; Rispoli, Mandy; Zisimopoulos, Dimitrios

    2011-01-01

    We reviewed studies that aimed to determine whether behaviors, such as body movements, vocalizations, eye gaze, and facial expressions, served a communicative function for individuals with Rett syndrome. A systematic search identified eight studies, which were summarized in terms of (a) participants, (b) assessment targets, (c) assessment…

  13. Systematic Suicide Risk Assessment for Patients With Schizophrenia

    DEFF Research Database (Denmark)

    Pedersen, Charlotte Gjørup; Wallenstein Jensen, Signe Olrik; Gradus, Jaimie

    2013-01-01

    Objectives: Systematic suicide risk assessment is recommended for patients with schizophrenia; however, little is known about the implementation of suicide risk assessment in routine clinical practice. The study aimed to determine the use of systematic suicide risk assessment at discharge...... and predictors of suicide attempt among hospitalized patients with schizophrenia in Denmark. Methods: A one-year follow-up study was conducted of 9,745 patients with schizophrenia who were discharged from psychiatric wards and registered in a national population-based schizophrenia registry between 2005 and 2009....... Results: The proportion of patients receiving suicide risk assessment at discharge from a psychiatric ward increased from 72% (95% confidence interval [CI]=71%-74%) in 2005, when the national monitoring began, to 89% (CI.89%-90%) in 2009. Within one year after discharge, 1% of all registered patients had...

  14. Indices for the assessment of nutritional quality of meals: a systematic review.

    Science.gov (United States)

    Gorgulho, B M; Pot, G K; Sarti, F M; Marchioni, D M

    2016-06-01

    This systematic review aimed to synthesise information on indices developed to evaluate nutritional quality of meals. A strategy for systematic search of the literature was developed using keywords related to assessment of meal quality. Databases searched included ScienceDirect, PubMed, Lilacs, SciELO, Scopus, Cochrane, Embase and Google Scholar. The literature search resulted in seven different meal quality indices. Each article was analysed in order to identify the following items: authors, country, year, study design, population characteristics, type of meal evaluated, dietary assessment method, characteristics evaluated (nutrients or food items), score range, index components, nutritional references, correlations performed, validation and relationship with an outcome (if existing). Two studies developed instruments to assess the quality of breakfast, three analysed lunch, one evaluated dinner and one was applied to all types of meals and snacks. All meal quality indices reviewed were based on the evaluation of presence or absence of food groups and relative contributions of nutrients, according to food-based guidelines or nutrient references, adapting the daily dietary recommendations to one specific meal. Most of the indices included three items as components for meal quality assessment: (I) total fat or some specific type of fat, (II) fruits and vegetables and (III) cereals or whole grains. This systematic review indicates aspects that need further research, particularly the numerous approaches to assessing meals considering different foods and nutrients, and the need for validation studies of meal indices.

  15. Economic evaluation of emergency obstetric care training: a systematic review.

    Science.gov (United States)

    Banke-Thomas, Aduragbemi; Wilson-Jones, Megan; Madaj, Barbara; van den Broek, Nynke

    2017-12-04

    Training healthcare providers in Emergency Obstetric Care (EmOC) has been shown to be effective in improving their capacity to provide this critical care package for mothers and babies. However, little is known about the costs and cost-effectiveness of such training. Understanding costs and cost-effectiveness is essential in guaranteeing value-for-money in healthcare spending. This study systematically reviewed the available literature on cost and cost-effectiveness of EmOC trainings. Peer-reviewed and grey literature was searched for relevant papers published after 1990. Studies were included if they described an economic evaluation of EmOC training and the training cost data were available. Two reviewers independently searched, screened, and selected studies that met the inclusion criteria, with disagreements resolved by a third reviewer. Quality of studies was assessed using the Consolidated Health Economic Evaluation Reporting Standards statement. For comparability, all costs in local currency were converted to International dollar (I$) equivalents using purchasing power parity conversion factors. The cost per training per participant was calculated. Narrative synthesis was used to summarise the available evidence on cost effectiveness. Fourteen studies (five full and nine partial economic evaluations) met the inclusion criteria. All five and two of the nine partial economic evaluations were of high quality. The majority of studies (13/14) were from low- and middle-income countries. Training equipment, per diems and resource person allowance were the most expensive components. Cost of training per person per day ranged from I$33 to I$90 when accommodation was required and from I$5 to I$21 when training was facility-based. Cost-effectiveness of training was assessed in 5 studies with differing measures of effectiveness (knowledge, skills, procedure cost and lives saved) making comparison difficult. Economic evaluations of EmOC training are limited. There is a

  16. The Design, Implementation, and Evaluation of Online Credit Nutrition Courses: A Systematic Review

    Science.gov (United States)

    Cohen, Nancy L.; Carbone, Elena T.; Beffa-Negrini, Patricia A.

    2011-01-01

    Objective: To assess how postsecondary online nutrition education courses (ONEC) are delivered, determine ONEC effectiveness, identify theoretical models used, and identify future research needs. Design: Systematic search of database literature. Setting: Postsecondary education. Participants: Nine research articles evaluating postsecondary ONEC.…

  17. A systematic review of bioenergy life cycle assessments

    International Nuclear Information System (INIS)

    Muench, Stefan; Guenther, Edeltraud

    2013-01-01

    Highlights: • We conducted a systematic literature review of bioenergy LCAs. • We provide a detailed overview of GWP, AP, and EP for biomass electricity and heat. • We discuss methodological choices that can lead to variations in results. • Relevant choices are functional unit, allocation method, system boundary, and carbon modelling. - Abstract: On a global scale, bioenergy is highly relevant to renewable energy options. Unlike fossil fuels, bioenergy can be carbon neutral and plays an important role in the reduction of greenhouse gas emissions. Biomass electricity and heat contribute 90% of total final biomass energy consumption, and many reviews of biofuel Life Cycle Assessments (LCAs) have been published. However, only a small number of these reviews are concerned with electricity and heat generation from biomass, and these reviews focus on only a few impact categories. No review of biomass electricity and heat LCAs included a detailed quantitative assessment. The failure to consider heat generation, the insufficient consideration of impact categories, and the missing quantitative overview in bioenergy LCA reviews constitute research gaps. The primary goal of the present review was to give an overview of the environmental impact of biomass electricity and heat. A systematic review was chosen as the research method to achieve a comprehensive and minimally biased overview of biomass electricity and heat LCAs. We conducted a quantitative analysis of the environmental impact of biomass electricity and heat. There is a significant variability in results of biomass electricity and heat LCAs. Assumptions regarding the bioenergy system and methodological choices are likely reasons for extreme values. The secondary goal of this review is to discuss influencing methodological choices. No general consensus has been reached regarding the optimal functional unit, the ideal allocation of environmental impact between co-products, the definition of the system boundary

  18. ERESYE - a expert system for the evaluation of uncertainties related to systematic experimental errors

    International Nuclear Information System (INIS)

    Martinelli, T.; Panini, G.C.; Amoroso, A.

    1989-11-01

    Information about systematic errors are not given In EXFOR, the data base of nuclear experimental measurements: their assessment is committed to the ability of the evaluator. A tool Is needed which performs this task in a fully automatic way or, at least, gives a valuable aid. The expert system ERESYE has been implemented for investigating the feasibility of an automatic evaluation of the systematic errors in the experiments. The features of the project which led to the implementation of the system are presented. (author)

  19. A practical, systematic and structured approach to piping vibration assessment

    International Nuclear Information System (INIS)

    Sukaih, Naren

    2002-01-01

    The main aim of this paper is to present a systematic and structured approach to piping vibration assessment and control. Piping vibration assessment is a complex subject, since there are no general analytical methods for dealing with vibration problems. It was noted that most existing vibrating piping systems had poor or degraded support arrangements. This approach therefore focuses mainly on vibration control through assessing and improving the supporting systems. Vibration theory has not been covered in any detail. A simplified procedure is presented for the Integrity custodian to determine when a simple assessment may be carried out and when specialist/consultant services are required. The assessment techniques are based on simplifying assumptions, good rules of thumb and available literature and current practices. A typical case study is used to illustrate the use and the flexibility of the above approach. A standard sheet is proposed to record and document the assessment and recommendations

  20. Factor Analysis in Assessing the Research Methodology Quality of Systematic Reviews

    Directory of Open Access Journals (Sweden)

    Andrada Elena URDA-CÎMPEAN

    2011-12-01

    Full Text Available Introduction: Many high quality systematic reviews available from medical journals, data bases and other electronic sources differ in quality and provide different answers to the same question. The literature recommended the use of a checklist type approach, which exceeds many of the problems associated with measurements. Aim: This study proposes to identify in a checklist type approach the most commonly used factors (from a methodological point of view in assessing the quality of systematic reviews, and then mirror the actual stage of medical writing. We want to analyze the factors’ occurrence and / or their development in the text and in the abstract of systematic reviews published in 2011. Methods: The present study randomly selected only free full text systematic reviews published in 2011, systematic reviews found in Pubmed and in Cochrane Database. The most commonly used factors were identified in PRISMA statement and quality measurement tools. Results: The evaluated systematic reviews mentioned or developed several of the factors studied. Only 78% of the papers surveyed have used the correct IMRAD format and 59% of them have mentioned the sample size used. The correspondence between the content of the paper and its abstract is summarized in the proportion of 54.63% and 51.85% for the two sets of factors, and it can lead to scarce appreciation of the article provided that only abstracts are read. Conclusions: Researchers do not properly take into consideration scientific articles and assessment tools used for quality evaluation. They should place more value over methodological factors which help assess systematic review quality, while journals form the only party who can enforce quality standards in medical writing.

  1. Systematic safety evaluation of old nuclear power plants

    International Nuclear Information System (INIS)

    Dredemis, G.; Fourest, B.

    1984-01-01

    The French safety authorities have undertaken a systematic evaluation of the safety of old nuclear power plants. Apart from a complete revision of safety documents (safety analysis report, general operating rules, incident and accident procedures, internal emergency plan, quality organisation manual), this examination consisted of analysing the operating experience of systems frequently challenged and a systematic examination of the safety-related systems. This paper is based on an exercise at the Ardennes Nuclear Power Plant which has been in operation for 15 years. This paper also summarizes the main surveys and modifications relating to this power plant. (orig.)

  2. Initial assessment in the management of adult epistaxis: systematic review.

    Science.gov (United States)

    Khan, M; Conroy, K; Ubayasiri, K; Constable, J; Smith, M E; Williams, R J; Kuhn, I; Smith, M; Philpott, C

    2017-12-01

    The initial assessment of epistaxis patients commonly includes: first aid measures, observations, focused history taking, and clinical examinations and investigations. This systematic review aimed to identify evidence that informs how the initial assessment of these patients should be conducted. A systematic review of the literature was performed using a standardised methodology and search strategy. Seventeen articles were included. Factors identified were: co-morbidity, intrinsic patient factors, coagulation screening and ice pack use. Hypertension and anticoagulant use were demonstrated to adversely affect outcomes. Coagulation screening is useful in patients on anticoagulant medication. Four studies could not be accessed. Retrospective methodology and insufficient statistical analysis limit several studies. Sustained ambulatory hypertension, anticoagulant therapy and posterior bleeding may be associated with recurrent epistaxis, and should be recorded. Oral ice pack use may decrease severity and can be considered as first aid. Coagulation studies are appropriate for patients with a history of anticoagulant use or bleeding diatheses.

  3. Historical data summary of the Systematic Assessment of Licensee Performance

    International Nuclear Information System (INIS)

    Johnson, M.R.; Waterman, D.K.

    1987-04-01

    This report presents a history of Systematic Assessment of Licensee Performance (SALP) ratings for nuclear power plant facilities in operation and under construction. The SALP results are listed by NRC region in three sections: the most recent report, operating facilities, and facilities under construction. The historical data summary report has been prepared by the NRC Office of Inspection and Enforcement (IE). Information contained in this report has been updated to include those published SALP reports received before March 13, 1987

  4. Historical data summary of the systematic assessment of licensee performance

    International Nuclear Information System (INIS)

    1986-10-01

    This report presents a history of Systematic Assessment of Licensee Performance (SALP) ratings for nuclear power plant facilities in operation and under construction. The SALP results are listed by NRC region in three sections: the most recent report, operating facilities, and facilities under construction. The historical data summary report has been prepared by the NRC Office of Inspection and Enforcement (IE). Information contained in this report has been updated to include those published SALP reports received before September 16, 1986

  5. Systematic evaluation of candidate blood markers for detecting ovarian cancer.

    Directory of Open Access Journals (Sweden)

    Chana Palmer

    2008-07-01

    Full Text Available Epithelial ovarian cancer is a significant cause of mortality both in the United States and worldwide, due largely to the high proportion of cases that present at a late stage, when survival is extremely poor. Early detection of epithelial ovarian cancer, and of the serous subtype in particular, is a promising strategy for saving lives. The low prevalence of ovarian cancer makes the development of an adequately sensitive and specific test based on blood markers very challenging. We evaluated the performance of a set of candidate blood markers and combinations of these markers in detecting serous ovarian cancer.We selected 14 candidate blood markers of serous ovarian cancer for which assays were available to measure their levels in serum or plasma, based on our analysis of global gene expression data and on literature searches. We evaluated the performance of these candidate markers individually and in combination by measuring them in overlapping sets of serum (or plasma samples from women with clinically detectable ovarian cancer and women without ovarian cancer. Based on sensitivity at high specificity, we determined that 4 of the 14 candidate markers--MUC16, WFDC2, MSLN and MMP7--warrant further evaluation in precious serum specimens collected months to years prior to clinical diagnosis to assess their utility in early detection. We also reported differences in the performance of these candidate blood markers across histological types of epithelial ovarian cancer.By systematically analyzing the performance of candidate blood markers of ovarian cancer in distinguishing women with clinically apparent ovarian cancer from women without ovarian cancer, we identified a set of serum markers with adequate performance to warrant testing for their ability to identify ovarian cancer months to years prior to clinical diagnosis. We argued for the importance of sensitivity at high specificity and of magnitude of difference in marker levels between cases and

  6. Dual-Task Assessment Protocols in Concussion Assessment: A Systematic Literature Review.

    Science.gov (United States)

    Kleiner, Michelle; Wong, Lynne; Dubé, Alexandra; Wnuk, Katie; Hunter, Susan W; Graham, Laura J

    2018-02-01

    Study Design Systematic review. Background When assessed in isolation, balance and neurocognitive testing may not be sufficiently responsive to capture changes that occur with concussion. Normal daily activities require simultaneous cognitive and physical demands. Therefore, a dual-task assessment paradigm should be considered to identify performance deficits. Objectives To evaluate the literature and to identify dual-task testing protocols associated with changes in gait after concussion. Methods A systematic review of articles of individuals with concussion who underwent dual-task testing with a combination of motor and cognitive tasks was conducted. The AMED, CINAHL, Embase, PsycINFO, PubMed, Scopus, SPORTDiscus, and Web of Science databases and gray literature were searched from inception to January 29, 2017. Title and abstract, full-text, and quality review and data abstraction were performed by 2 independent reviewers. Results Twenty-four articles met the inclusion criteria. Eleven articles reported decreased gait velocity and increased medial-lateral displacement for individuals with concussion during dual-task conditions. Overall, included articles were of poor to moderate methodological quality. Fifteen articles used the same participants and data sets, creating a threat to validity and limiting the ability to make conclusions. Conclusion A deterioration in gait performance during dual-task testing is present among people with concussion. Specific recommendations for the use of a dual-task protocol to assess individuals with suspected concussion injury in a clinical setting have yet to be determined. J Orthop Sports Phys Ther 2018;48(2):87-103. Epub 7 Nov 2017. doi:10.2519/jospt.2018.7432.

  7. Systematic reviews in Library and Information Science: analysis and evaluation of the search process

    Directory of Open Access Journals (Sweden)

    José Antonio Salvador-Oliván

    2018-05-01

    Full Text Available Objective: An essential component of a systematic review is the development and execution of a literature search to identify all available and relevant published studies. The main objective of this study is to analyse and evaluate whether the systematic reviews in Library and Information Science (LIS provide complete information on all the elements that make up the search process. Methods: A search was launched in WOS, Scopus, LISTA, Library Science Database, Medline databases and a wiki published from 2000 to February 2017, in order to find and identify systematic reviews. The search was designed to find those records whose titles included the words “systematic review” and/or “meta-analysis”. A list was created with the twelve items recommended from of the main publication guides, to assess the information degree on each of them. Results and conclusions: Most of the reviews in LIS are created by information professionals. From the 94 systematic reviews selected for analysis, it was found that only a 4.3% provided the complete reporting on the search method. The most frequently included item is the name of the database (95.6% and the least one is the name of the host (35.8%. It is necessary to improve and complete the information about the search processes in the complete reports from LIS systematic reviews for reproducibility, updating and quality assessment improvement.

  8. Historical data summary of the systematic assessment of licensee performance

    International Nuclear Information System (INIS)

    Allenspach, F.

    1992-08-01

    The Historical Data Summary of the Systematic Assessment of Licensee Performance (SALP) is produced periodically by the US Nuclear Regulatory Commission. This summary provides the results of the assessment for each facility by NRC region and is further divided into the following-sections: Section I presents the most recent SALE report ratings for facilities in operation and under construction. Section 2 presents a chronological listing of all SALE report ratings for each operating facility. Section 3 presents a chronological listing of all SALP report ratings for each facility under construction. For historical purposes, past construction ratings for facilities that recently have been licensed also are listed in Section 3

  9. Historical data summary of the systematic assessment of licensee performance

    International Nuclear Information System (INIS)

    Allenspach, F.

    1991-08-01

    The Historical Data Summary of the Systematic Assessment of Licensee Performance (SALP) is produced periodically by the US Nuclear Regulatory Commission. This summary provides the results of the assessment for each facility by NRC region and is further divided into the following sections: Section 1 presents the most recent SALP report ratings for facilities in operation and under construction. Section 2 presents a chronological listing of all SALP report ratings for each operating facility. Section 3 presents a chronological listing of all SALP report ratings for each facility under construction. For historical purposes, past construction ratings for facilities that recently have been licensed also are listed in Section 3

  10. Historical data summary of the systematic assessment of licensee performance

    International Nuclear Information System (INIS)

    Allenspach, F.

    1993-02-01

    The Historical Data Summary of the Systematic Assessment of Licensee Performance (SALP) is produced periodically by the US Nuclear Regulatory Commission. This summary provides the results of the assessment for each facility by NRC region and is further divided into the following-sections: Section 1 presents the most recent SALP report ratings for facilities in operation and under construction. Section 2 presents a chronological listing of all SALP report ratings for each operating facility. Section 3 for each facility under construction. For historical purposes, past construction ratings for facilities that recently have been licensed also are listed in Section 3

  11. Historical data summary of the systematic assessment of licensee performance

    International Nuclear Information System (INIS)

    Allenspach, F.; Wharton, R.

    1990-08-01

    The Historical Data Summary of the Systematic Assessment of Licensee Performance (SALP) is produced periodically by the US Nuclear Regulatory Commission. This summary provides the results of the assessment for each facility by NRC region and is further divided into the following sections: Section 1 presents the most recent SALP report ratings for facilities in operation and under construction. Section 2 presents a chronological listing of all SALP report ratings for each operating facility. Section 3 presents a chronological listing of all SALP report ratings for each facility under construction. For historical purposes, past construction ratings for facilities that recently have been licensed also are listed in Section 3

  12. Historical data summary of the Systematic Assessment of Licensee Performance

    International Nuclear Information System (INIS)

    Allenspach, F.

    1993-08-01

    The Historical Data Summary of the Systematic Assessment of Licensee Performance (SALP) is produced periodically by the US Nuclear Regulatory Commission. This summary provides the results of the assessment for each facility by NRC region and is further divided into the following sections: Section 1 presents the most recent SALP report ratings for facilities in operation and under construction. Section 2 presents a chronological listing of all SALP report ratings for each operating facility. Section 3 presents a chronological listing of all SALP report ratings for each facility under construction. For historical purposes, past construction ratings for facilities that recently have been licensed also are listed in Section 3

  13. Historical data summary of the systematic assessment of licensee performance

    International Nuclear Information System (INIS)

    Allenspach, F.

    1992-02-01

    The Historical Data Summary of the Systematic Assessment of Licensee Performance (SALP) is produced periodically by the US Nuclear Regulatory Commission. This summary provides the results of the assessment for each facility by NRC region and is further divided into the following sections: Section 1 presents the most recent SALP report ratings for facilities in operation and under construction. Section 2 presents a chronological listing of all SALP report ratings for each operating facility. Section 3 presents a chronological listing of all SALP report ratings for each facility under construction. For historical purposes, past construction ratings for facilities that recently have been licensed also are listed in Section 3

  14. Historical data summary of the systematic assessment of licensee performance

    International Nuclear Information System (INIS)

    1988-05-01

    The Historical Data Summary of the Systematic Assessment of Licensee Performance (SALP) is produced periodically by the US Nuclear Regulatory Commission. This summary provides the results of the assessment for each facility by NRC region and is further divided into the following three sections: Section 1 presents the most recent SALP report ratings for facilities under construction and in operation. Section 2 presents a chronological listing of all SALP report ratings for each operating facility. Section 3 presents a chronological listing of all SALP report ratings for each facility under construction. For historical purposes, past construction SALP ratings for facilities that recently have been licensed also are listed in Section 3

  15. Historical data summary of the Systematic Assessment of Licensee Performance

    International Nuclear Information System (INIS)

    Allenspach, F.; Nease, R.

    1990-02-01

    The Historical Data Summary of the Systematic Assessment of Licensee Performance (SALP) is produced periodically by the US Nuclear Regulatory Commission. This summary provides the results of the assessment for each facility by NRC region and is further divided into the following sections: Section 1 presents the most recent SALP report ratings for facilities in operation and under construction. Section 2 presents a chronological listing of all SALP report ratings for each operating facility. Section 3 presents a chronological listing of all SALP report ratings for each facility under construction. For historical purposes, past construction ratings for facilities that recently have been licensed also are listed in Section 3

  16. Historical data summary of the Systematic Assessment of Licensee Performance

    International Nuclear Information System (INIS)

    Ramey-Smith, A.M.

    1987-10-01

    The Historical Data Summary of the Systematic Assessment of Licensee Performance (SALP) is produced periodically by the US Nuclear Regulatory Commission. This summary provides the results of the assessment for each facility by NRC region and is further divided into the following three sections: the most recent SALP report ratings for facilities under construction and in operation, a chronological listing of all SALP report ratings for each operating facility, a chronological listing of all SALP report ratings for each facility under construction. For historical purposes, past construction SALP ratings for facilities that recently have been licensed also are listed

  17. Historical data summary of the systematic assessment of licensee performance

    International Nuclear Information System (INIS)

    Allenspach, F.

    1991-02-01

    The Historical Data Summary of the Systematic Assessment of Licensee Performance (SALP) is produced periodically by the US Nuclear Regulatory Commission. This summary provides the results of the assessment for each facility by NRC region and is further divided into the following sections: Section 1 presents the most recent SALP report ratings for facilities in operation and under construction. Section 2 presents a chronological listing of all SALP report ratings for each operating facility. Section 3 presents a chronological listing of all SALP report ratings for each facility under construction. For historical purposes, past construction ratings for facilities that recently have been licensed also are listed in Section 3

  18. Cost assessment of robotics in gynecologic surgery: a systematic review.

    Science.gov (United States)

    Iavazzo, Christos; Papadopoulou, Eleni K; Gkegkes, Ioannis D

    2014-11-01

    The application of robotics is an innovation in the field of gynecologic surgery. Our objective was to evaluate the currently available literature on the cost assessment of robotic surgery of various operations in the field of gynecologic surgery. PubMed and Scopus databases were systematically searched in order to retrieve the included studies in our review. We retrieved 23 studies on a variety of gynecologic operations. The mean cost for robotic, open and laparoscopic surgery ranged from 1731 to 48,769, 894 to 20,277 and 411 to 41,836 Euros, respectively. Operative charges, in hysterectomy, for robotic, open and laparoscopic technique ranged from 936 to 33,920, 684 to 25,616 and 858 to 25,578 Euros, respectively. In sacrocolpopexy, these costs ranged from 2067 to 7275, 2904 to 69,792 and 1482 to 2000 Euros, respectively. Non-operative charges ranged from 467 to 39,121 Euros. The mean total costs for myomectomy ranged from 27,342 to 42,497 and 13,709 to 20,277 Euros, respectively, for the robotic and open methods, while the mean total cost of the laparoscopic technique was 26,181 Euros. Conversions to laparotomy were present in 79/36,185 (0.2%) cases of laparoscopic surgery and in 21/3345 (0.62%) cases of robotic technique. Duration of robotic, open and laparoscopic surgery ranged from 50 to 445, 83.7 to 701 and 74 to 330 min, respectively. Robotic surgery has the potential to become cost-effective in centers with many patients while industry competition could reduce the cost of the robotic instrumentation, making robotic technology more affordable and cost-effective. © 2014 The Authors. Journal of Obstetrics and Gynaecology Research © 2014 Japan Society of Obstetrics and Gynecology.

  19. User Experience Evaluations in Rehabilitation Video Games for Children: A Systematic Mapping of the Literature.

    Science.gov (United States)

    Rico-Olarte, Carolina; López, Diego M; Blobel, Bernd; Kepplinger, Sara

    2017-01-01

    In recent years, the interest in user experience (UX) evaluation methods for assessing technology solutions, especially in health systems for children with special needs like cognitive disabilities, has increased. Conduct a systematic mapping study to provide an overview in the field of UX evaluations in rehabilitation video games for children. The definition of research questions, the search for primary studies and the extraction of those studies by inclusion and exclusion criteria lead to the mapping of primary papers according to a classification scheme. Main findings from this study include the detection of the target population of the selected studies, the recognition of two different ways of evaluating UX: (i) user evaluation and (ii) system evaluation, and UX measurements and devices used. This systematic mapping specifies the research gaps identified for future research works in the area.

  20. A quality assessment of systematic reviews on telerehabilitation: what does the evidence tell us?

    Directory of Open Access Journals (Sweden)

    Marco Rogante

    2015-03-01

    Full Text Available Aims. To evaluate the quality of systematic reviews on telerehabilitation. Methods. The AMSTAR - Assessment of Multiple Systematic Reviews - checklist was used to appraise the evidence related to the systematic reviews. Results. Among the 477 records initially identified, 10 systematic reviews matched the inclusion criteria. Fifty percent were of high quality; anyway the majority of them did not report the following aspects: i analysis of the grey literature; ii a list of the excluded studies and their characteristics; iii the identification of possible source of bias and the assessment of its likehood; iv an appropriate method to combine the findings of the included studies addressing the heterogeneity as well. From the main findings of the high-scored systematic reviews telerehabilitation resulted at least as effective as usual care: 1 in the short term treatment of mental health related to people affected by spinal cord injury; 2 in rural communities for treating patients affected by chronic conditions; 3 in treating common pathologies (mainly asthma affecting children and adolescents. As for stroke, evidence is currently insufficient to reach conclusions about its effectiveness. As for costs, there is insufficient evidence to confirm that telerehabilitation is a cost-saving or cost-effective solution. Conclusions. In the authors' knowledge this is the first attempt to evaluate the quality of systematic reviews on telerehabilitation. This work also identified the main findings related to the high-scored systematic reviews; the analysis confirms that there is a mounting evidence concerning the effectiveness of telerehabilitation, at least for some pathologies.

  1. Conducting Systematic Outcome Assessment in Private Addictions Treatment Settings

    Directory of Open Access Journals (Sweden)

    Gerard J Connors

    2017-07-01

    Full Text Available Systematic outcome assessment is central to ascertaining the impact of treatment services and to informing future treatment initiatives. This project was designed to be conducted within the clinical operations of 4 private addictions treatment centers. A structured interview was used to assess patients’ alcohol and other drug use and related variables (on treatment entry and at 1, 3, and 6 months following treatment discharge. The primary outcomes were percentage of days abstinent (PDA from alcohol and drugs, PDA from alcohol, and PDA from other drugs. Collateral reports during follow-up also were gathered. A total of 280 patients (56% men across the 4 programs participated. Percentage of days abstinent for each outcome increased significantly from baseline to the 1-month follow-up assessment, and this change was maintained at the 3- and 6-month follow-up assessments. Collateral reports mirrored the patient follow-up reports. Secondary outcomes of patient ratings of urges/cravings, depression, anxiety, and general life functioning all indicated significant improvement from baseline over the course of the follow-up. The results suggest the feasibility of conducting systematic outcome assessment in freestanding private addictions treatment environments.

  2. Intelligence Assessment Instruments in Adult Prison Populations: A Systematic Review.

    Science.gov (United States)

    van Esch, A Y M; Denzel, A D; Scherder, E J A; Masthoff, E D M

    2017-10-01

    Detection of intellectual disability (ID) in the penitentiary system is important for the following reasons: (a) to provide assistance to people with ID in understanding their legal rights and court proceedings; (b) to facilitate rehabilitation programs tailored to ID patients, which improves the enhancement of their quality of life and reduces their risk of reoffending; and (c) to provide a reliable estimate of the risk of offence recidivism. It requires a short assessment instrument that provides a reliable estimation of a person's intellectual functioning at the earliest possible stage of this process. The aim of this systematic review is (a) to provide an overview of recent short assessment instruments that provide a full-scale IQ score in adult prison populations and (b) to achieve a quality measurement of the validation studies regarding these instruments to determine which tests are most feasible in this target population. The Preferred Reporting Items for Systematic reviews and Meta-Analyses Statement is used to ensure reliability. The Satz-Mögel, an item-reduction short form of the Wechsler Adult Intelligence Scale, shows the highest correlation with the golden standard and is described to be most reliable. Nevertheless, when it comes to applicability in prison populations, the shorter and less verbal Quick Test can be preferred over others. Without affecting these conclusions, major limitations emerge from the present systematic review, which give rise to several important recommendations for further research.

  3. LNG Safety Assessment Evaluation Methods

    Energy Technology Data Exchange (ETDEWEB)

    Muna, Alice Baca [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); LaFleur, Angela Christine [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2015-05-01

    Sandia National Laboratories evaluated published safety assessment methods across a variety of industries including Liquefied Natural Gas (LNG), hydrogen, land and marine transportation, as well as the US Department of Defense (DOD). All the methods were evaluated for their potential applicability for use in the LNG railroad application. After reviewing the documents included in this report, as well as others not included because of repetition, the Department of Energy (DOE) Hydrogen Safety Plan Checklist is most suitable to be adapted to the LNG railroad application. This report was developed to survey industries related to rail transportation for methodologies and tools that can be used by the FRA to review and evaluate safety assessments submitted by the railroad industry as a part of their implementation plans for liquefied or compressed natural gas storage ( on-board or tender) and engine fueling delivery systems. The main sections of this report provide an overview of various methods found during this survey. In most cases, the reference document is quoted directly. The final section provides discussion and a recommendation for the most appropriate methodology that will allow efficient and consistent evaluations to be made. The DOE Hydrogen Safety Plan Checklist was then revised to adapt it as a methodology for the Federal Railroad Administration’s use in evaluating safety plans submitted by the railroad industry.

  4. A Systematic Review of Urban Sustainability Assessment Literature

    Directory of Open Access Journals (Sweden)

    Matthew Cohen

    2017-11-01

    Full Text Available As the world rapidly urbanizes, there is much focus on achieving sustainability outcomes within cities. Accomplishing this goal requires not only envisioning sustainable cities and implementing strategies, but it also demands assessing progress towards sustainable urban development. Despite a growing literature on sustainability assessment, there is room to further understand the application of sustainability assessment in urban contexts. This paper presents a systematic review of urban sustainability assessment literature to (1 identify the most common methods used for urban sustainability assessment, (2 identify the most common framings for urban sustainability assessment, and (3 identify the most common categories for organizing indicators that measure urban sustainability. This research finds that urban sustainability assessment in general lacks a unifying framing and that it could be better aligned with common sustainability principles. The paper provides recommendations for future urban sustainability assessment research, including the employment of mixed-methods research among other strategies. In closing, this research offers a generic framework around which to structure urban sustainability assessment and within which to assign indicators for measuring progress towards sustainable urban development.

  5. Sequential assessment via daphnia and zebrafish for systematic toxicity screening of heterogeneous substances.

    Science.gov (United States)

    Jang, Gun Hyuk; Park, Chang-Beom; Kang, Benedict J; Kim, Young Jun; Lee, Kwan Hyi

    2016-09-01

    Environment and organisms are persistently exposed by a mixture of various substances. However, the current evaluation method is mostly based on an individual substance's toxicity. A systematic toxicity evaluation of heterogeneous substances needs to be established. To demonstrate toxicity assessment of mixture, we chose a group of three typical ingredients in cosmetic sunscreen products that frequently enters ecosystems: benzophenone-3 (BP-3), ethylhexyl methoxycinnamate (EHMC), and titanium dioxide nanoparticle (TiO2 NP). We first determined a range of nominal toxic concentration of each ingredient or substance using Daphnia magna, and then for the subsequent organismal level phenotypic assessment, chose the wild-type zebrafish embryos. Any phenotype change, such as body deformation, led to further examinations on the specific organs of transgenic zebrafish embryos. Based on the systematic toxicity assessments of the heterogeneous substances, we offer a sequential environmental toxicity assessment protocol that starts off by utilizing Daphnia magna to determine a nominal concentration range of each substance and finishes by utilizing the zebrafish embryos to detect defects on the embryos caused by the heterogeneous substances. The protocol showed additive toxic effects of the mixtures. We propose a sequential environmental toxicity assessment protocol for the systematic toxicity screening of heterogeneous substances from Daphnia magna to zebrafish embryo in-vivo models. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. The Sport Concussion Assessment Tool: a systematic review.

    Science.gov (United States)

    Yengo-Kahn, Aaron M; Hale, Andrew T; Zalneraitis, Brian H; Zuckerman, Scott L; Sills, Allen K; Solomon, Gary S

    2016-04-01

    OBJECTIVE Over the last 2 decades, sport-related concussion (SRC) has garnered significant attention. Even with increased awareness and athlete education, sideline recognition and real-time diagnosis remain crucial. The need for an objective and standardized assessment of concussion led to the eventual development of the Sport Concussion Assessment Tool (SCAT) during the Second International Conference on Concussion in Sport in 2004, which is now in its third iteration (SCAT3). In an effort to update our understanding of the most well-known sideline concussion assessment, the authors conducted a systematic review of the SCAT and the evidence supporting its use to date. METHODS English-language titles and abstracts published between 1995 and October 2015 were searched systematically across 4 electronic databases and a review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines adapted for the review of a heterogeneous collection of study designs. Peer-reviewed journal articles were included if they reported quantitative data on any iteration of the SCAT, Standardized Assessment of Concussion (SAC), or modified Balance Error Scoring System (mBESS) data at baseline or following concussion in an exclusively athlete population with any portion older than 13 years of age. Studies that included nonathletes, only children less than 13 years old, exclusively BESS data, exclusively symptom scale data, or a non-SCAT-related assessment were excluded. RESULTS The database search process yielded 549 abstracts, and 105 full-text articles were reviewed with 36 meeting criteria for inclusion. Nineteen studies were associated with the SAC, 1 was associated with the mBESS exclusively, and 16 studies were associated with a full iteration of the SCAT. The majority of these studies (56%) were prospective cohort studies. Male football players were the most common athletes studied. An analysis of the studies focused on

  7. Methods for systematic reviews of health economic evaluations: a systematic review, comparison, and synthesis of method literature.

    Science.gov (United States)

    Mathes, Tim; Walgenbach, Maren; Antoine, Sunya-Lee; Pieper, Dawid; Eikermann, Michaela

    2014-10-01

    The quality of systematic reviews of health economic evaluations (SR-HE) is often limited because of methodological shortcomings. One reason for this poor quality is that there are no established standards for the preparation of SR-HE. The objective of this study is to compare existing methods and suggest best practices for the preparation of SR-HE. To identify the relevant methodological literature on SR-HE, a systematic literature search was performed in Embase, Medline, the National Health System Economic Evaluation Database, the Health Technology Assessment Database, and the Cochrane methodology register, and webpages of international health technology assessment agencies were searched. The study selection was performed independently by 2 reviewers. Data were extracted by one reviewer and verified by a second reviewer. On the basis of the overlaps in the recommendations for the methods of SR-HE in the included papers, suggestions for best practices for the preparation of SR-HE were developed. Nineteen relevant publications were identified. The recommendations within them often differed. However, for most process steps there was some overlap between recommendations for the methods of preparation. The overlaps were taken as basis on which to develop suggestions for the following process steps of preparation: defining the research question, developing eligibility criteria, conducting a literature search, selecting studies, assessing the methodological study quality, assessing transferability, and synthesizing data. The differences in the proposed recommendations are not always explainable by the focus on certain evaluation types, target audiences, or integration in the decision process. Currently, there seem to be no standard methods for the preparation of SR-HE. The suggestions presented here can contribute to the harmonization of methods for the preparation of SR-HE. © The Author(s) 2014.

  8. Systematic assessment of environmental risk factors for bipolar disorder: an umbrella review of systematic reviews and meta-analyses.

    Science.gov (United States)

    Bortolato, Beatrice; Köhler, Cristiano A; Evangelou, Evangelos; León-Caballero, Jordi; Solmi, Marco; Stubbs, Brendon; Belbasis, Lazaros; Pacchiarotti, Isabella; Kessing, Lars V; Berk, Michael; Vieta, Eduard; Carvalho, André F

    2017-03-01

    The pathophysiology of bipolar disorder is likely to involve both genetic and environmental risk factors. In our study, we aimed to perform a systematic search of environmental risk factors for BD. In addition, we assessed possible hints of bias in this literature, and identified risk factors supported by high epidemiological credibility. We searched the Pubmed/MEDLINE, EMBASE and PsycInfo databases up to 7 October 2016 to identify systematic reviews and meta-analyses of observational studies that assessed associations between putative environmental risk factors and BD. For each meta-analysis, we estimated its summary effect size by means of both random- and fixed-effects models, 95% confidence intervals (CIs), the 95% prediction interval, and heterogeneity. Evidence of small-study effects and excess of significance bias was also assessed. Sixteen publications met the inclusion criteria (seven meta-analyses and nine qualitative systematic reviews). Fifty-one unique environmental risk factors for BD were evaluated. Six meta-analyses investigated associations with a risk factor for BD. Only irritable bowel syndrome (IBS) emerged as a risk factor for BD supported by convincing evidence (k=6; odds ratio [OR]=2.48; 95% CI=2.35-2.61; P<.001), and childhood adversity was supported by highly suggestive evidence. Asthma and obesity were risk factors for BD supported by suggestive evidence, and seropositivity to Toxoplasma gondii and a history of head injury were supported by weak evidence. Notwithstanding that several environmental risk factors for BD were identified, few meta-analyses of observational studies were available. Therefore, further well-designed and adequately powered studies are necessary to map the environmental risk factors for BD. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  9. Nutritional risk assessment in critically ill cancer patients: systematic review

    Science.gov (United States)

    Fruchtenicht, Ana Valéria Gonçalves; Poziomyck, Aline Kirjner; Kabke, Geórgia Brum; Loss, Sérgio Henrique; Antoniazzi, Jorge Luiz; Steemburgo, Thais; Moreira, Luis Fernando

    2015-01-01

    Objective To systematically review the main methods for nutritional risk assessment used in critically ill cancer patients and present the methods that better assess risks and predict relevant clinical outcomes in this group of patients, as well as to discuss the pros and cons of these methods according to the current literature. Methods The study consisted of a systematic review based on analysis of manuscripts retrieved from the PubMed, LILACS and SciELO databases by searching for the key words “nutritional risk assessment”, “critically ill” and “cancer”. Results Only 6 (17.7%) of 34 initially retrieved papers met the inclusion criteria and were selected for the review. The main outcomes of these studies were that resting energy expenditure was associated with undernourishment and overfeeding. The high Patient-Generated Subjective Global Assessment score was significantly associated with low food intake, weight loss and malnutrition. In terms of biochemical markers, higher levels of creatinine, albumin and urea were significantly associated with lower mortality. The worst survival was found for patients with worse Eastern Cooperative Oncologic Group - performance status, high Glasgow Prognostic Score, low albumin, high Patient-Generated Subjective Global Assessment score and high alkaline phosphatase levels. Geriatric Nutritional Risk Index values < 87 were significantly associated with mortality. A high Prognostic Inflammatory and Nutritional Index score was associated with abnormal nutritional status in critically ill cancer patients. Among the reviewed studies that examined weight and body mass index alone, no significant clinical outcome was found. Conclusion None of the methods reviewed helped to define risk among these patients. Therefore, assessment by a combination of weight loss and serum measurements, preferably in combination with other methods using scores such as Eastern Cooperative Oncologic Group - performance status, Glasgow Prognostic

  10. An evaluation of the comparative effectiveness of geriatrician-led comprehensive geriatric assessment for improving patient and healthcare system outcomes for older adults: a protocol for a systematic review and network meta-analysis.

    Science.gov (United States)

    Soobiah, Charlene; Daly, Caitlin; Blondal, Erik; Ewusie, Joycelyne; Ho, Joanne; Elliott, Meghan J; Yue, Rossini; Holroyd-Leduc, Jayna; Liu, Barbara; Marr, Sharon; Basran, Jenny; Tricco, Andrea C; Hamid, Jemila; Straus, Sharon E

    2017-03-24

    Comprehensive geriatric assessment (CGA) is an integrated model of care involving a geriatrician and an interdisciplinary team and can prioritize and manage complex health needs of older adults with multimorbidity. CGAs differ across healthcare settings, ranging from shared care conducted in primary care settings to specialized inpatient units in acute care. Models of care involving geriatricians vary across healthcare settings, and it is unclear which CGA model is most effective. Our objective is to conduct a systematic review and network meta-analysis (NMA) to examine the comparative effectiveness of various geriatrician-led CGAs and to identify which models improve patient and healthcare system level outcomes. An integrated knowledge translation approach will be used and knowledge users (KUs) including patients, caregivers, geriatricians, and healthcare policymakers will be involved throughout the review. Electronic databases including MEDLINE, EMBASE, Cochrane library, and Ageline will be searched from inception to November 2016 to identify relevant studies. Randomized controlled trials of older adults (≥65 years of age) that examine geriatrician-led CGAs compared to any intervention will be included. Primary and secondary outcomes will be selected by KUs to ensure the results are relevant to their decision-making. Two reviewers will independently screen the search results, extract data, and assess risk of bias. Data will be synthesized using an NMA to allow for multiple comparisons using direct (head-to-head) as well as indirect evidence. Interventions will be ranked according to their effectiveness using surface under the cumulative ranking curve (SUCRA). As the proportion of older adults grows worldwide, the demand for specialized geriatric services that help manage complex health needs of older adults with multimorbidity will increase in many countries. Results from this systematic review and NMA will enhance decision-making and the efficient allocation

  11. Robotics in general surgery: A systematic cost assessment

    OpenAIRE

    Gkegkes, Ioannis D.; Mamais, Ioannis A.; Iavazzo, Christos

    2017-01-01

    The utilisation of robotic-assisted techniques is a novelty in the field of general surgery. Our intention was to examine the up to date available literature on the cost assessment of robotic surgery of diverse operations in general surgery. PubMed and Scopus databases were searched in a systematic way to retrieve the included studies in our review. Thirty-one studies were retrieved, referring on a vast range of surgical operations. The mean cost for robotic, open and laparoscopic ranged from...

  12. Novel sensing technology in fall risk assessment in older adults: a systematic review.

    Science.gov (United States)

    Sun, Ruopeng; Sosnoff, Jacob J

    2018-01-16

    Falls are a major health problem for older adults with significant physical and psychological consequences. A first step of successful fall prevention is to identify those at risk of falling. Recent advancement in sensing technology offers the possibility of objective, low-cost and easy-to-implement fall risk assessment. The objective of this systematic review is to assess the current state of sensing technology on providing objective fall risk assessment in older adults. A systematic review was conducted in accordance to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement (PRISMA). Twenty-two studies out of 855 articles were systematically identified and included in this review. Pertinent methodological features (sensing technique, assessment activities, outcome variables, and fall discrimination/prediction models) were extracted from each article. Four major sensing technologies (inertial sensors, video/depth camera, pressure sensing platform and laser sensing) were reported to provide accurate fall risk diagnostic in older adults. Steady state walking, static/dynamic balance, and functional mobility were used as the assessment activity. A diverse range of diagnostic accuracy across studies (47.9% - 100%) were reported, due to variation in measured kinematic/kinetic parameters and modelling techniques. A wide range of sensor technologies have been utilized in fall risk assessment in older adults. Overall, these devices have the potential to provide an accurate, inexpensive, and easy-to-implement fall risk assessment. However, the variation in measured parameters, assessment tools, sensor sites, movement tasks, and modelling techniques, precludes a firm conclusion on their ability to predict future falls. Future work is needed to determine a clinical meaningful and easy to interpret fall risk diagnosis utilizing sensing technology. Additionally, the gap between functional evaluation and user experience to technology should be addressed.

  13. Acknowledging patient heterogeneity in economic evaluation : a systematic literature review.

    Science.gov (United States)

    Grutters, Janneke P C; Sculpher, Mark; Briggs, Andrew H; Severens, Johan L; Candel, Math J; Stahl, James E; De Ruysscher, Dirk; Boer, Albert; Ramaekers, Bram L T; Joore, Manuela A

    2013-02-01

    Patient heterogeneity is the part of variability that can be explained by certain patient characteristics (e.g. age, disease stage). Population reimbursement decisions that acknowledge patient heterogeneity could potentially save money and increase population health. To date, however, economic evaluations pay only limited attention to patient heterogeneity. The objective of the present paper is to provide a comprehensive overview of the current knowledge regarding patient heterogeneity within economic evaluation of healthcare programmes. A systematic literature review was performed to identify methodological papers on the topic of patient heterogeneity in economic evaluation. Data were obtained using a keyword search of the PubMed database and manual searches. Handbooks were also included. Relevant data were extracted regarding potential sources of patient heterogeneity, in which of the input parameters of an economic evaluation these occur, methods to acknowledge patient heterogeneity and specific concerns associated with this acknowledgement. A total of 20 articles and five handbooks were included. The relevant sources of patient heterogeneity (demographics, preferences and clinical characteristics) and the input parameters where they occurred (baseline risk, treatment effect, health state utility and resource utilization) were combined in a framework. Methods were derived for the design, analysis and presentation phases of an economic evaluation. Concerns related mainly to the danger of false-positive results and equity issues. By systematically reviewing current knowledge regarding patient heterogeneity within economic evaluations of healthcare programmes, we provide guidance for future economic evaluations. Guidance is provided on which sources of patient heterogeneity to consider, how to acknowledge them in economic evaluation and potential concerns. The improved acknowledgement of patient heterogeneity in future economic evaluations may well improve the

  14. Systematic evaluations of probabilistic floor response spectrum generation

    International Nuclear Information System (INIS)

    Lilhanand, K.; Wing, D.W.; Tseng, W.S.

    1985-01-01

    The relative merits of the current methods for direct generation of probabilistic floor response spectra (FRS) from the prescribed design response spectra (DRS) are evaluated. The explicit probabilistic methods, which explicitly use the relationship between the power spectral density function (PSDF) and response spectra (RS), i.e., the PSDF-RS relationship, are found to have advantages for practical applications over the implicit methods. To evaluate the accuracy of the explicit methods, the root-mean-square (rms) response and the peak factor contained in the PSDF-RS relationship are systematically evaluated, especially for the narrow-band floor spectral response, by comparing the analytical results with simulation results. Based on the evaluation results, a method is recommended for practical use for the direct generation of probabilistic FRS. (orig.)

  15. Undiscovered resource evaluation: Towards applying a systematic approach to uranium

    International Nuclear Information System (INIS)

    Fairclough, M.; Katona, L.

    2014-01-01

    Evaluations of potential mineral resource supply range from spatial to aspatial, and everything in between across a range of scales. They also range from qualitative to quantitative with similar hybrid examples across the spectrum. These can compromise detailed deposit-specific reserve and resource calculations, target generative processes and estimates of potential endowments in a broad geographic or geological area. All are estimates until the ore has been discovered and extracted. Contemporary national or provincial scale evaluations of mineral potential are relatively advanced and some include uranium, such as those for South Australia undertaken by the State Geological Survey. These play an important role in land-use planning as well as attracting exploration investment and range from datato knowledge-driven approaches. Studies have been undertaken for the Mt Painter region, as well as for adjacent basins. The process of estimating large-scale potential mineral endowments is critical for national and international planning purposes but is a relatively recent and less common undertaking. In many cases, except at a general level, the data and knowledge for a relatively immature terrain is lacking, requiring assessment by analogy with other areas. Commencing in the 1980s, the United States Geological Survey, and subsequently the Geological Survey of Canada evaluated a range of commodities ranging from copper to hydrocarbons with a view to security of supply. They developed innovative approaches to, as far as practical, reduce the uncertainty and maximise the reproducibility of the calculations in information-poor regions. Yet the approach to uranium was relatively ad hoc and incomplete (such as the US Department of Energy NURE project). Other historic attempts, such as the IAEA-NEA International Uranium Resource Evaluation Project (IUREP) in the 1970s, were mainly qualitative. While there is still no systematic global evaluation of undiscovered uranium resources

  16. Systematic evaluation of clinical practice guidelines for pharmacogenomics.

    Science.gov (United States)

    Beckett, Robert D; Kisor, David F; Smith, Thomas; Vonada, Brooke

    2018-06-01

    To systematically assess methodological quality of pharmacogenomics clinical practice guidelines. Guidelines published through 2017 were reviewed by at least three independent reviewers using the AGREE II instrument, which consists of 23 items grouped into 6 domains and 2 items representing an overall assessment. Items were assessed on a seven-point rating scale, and aggregate quality scores were calculated. 31 articles were included. All guidelines were published as peer-reviewed articles and 90% (n = 28) were endorsed by professional organizations. Mean AGREE II domain scores (maximum score 100%) ranged from 46.6 ± 11.5% ('applicability') to 78.9 ± 11.4% ('clarity of presentation'). Median overall quality score was 72.2% (IQR: 61.1-77.8%). Quality of pharmacogenomics guidelines was generally high, but variable, for most AGREE II domains.

  17. Systematic Review of Health Economic Impact Evaluations of Risk Prediction Models : Stop Developing, Start Evaluating

    NARCIS (Netherlands)

    van Giessen, Anoukh; Peters, Jaime; Wilcher, Britni; Hyde, Chris; Moons, Carl; de Wit, Ardine; Koffijberg, Erik

    2017-01-01

    Background: Although health economic evaluations (HEEs) are increasingly common for therapeutic interventions, they appear to be rare for the use of risk prediction models (PMs). Objectives: To evaluate the current state of HEEs of PMs by performing a comprehensive systematic review. Methods: Four

  18. A proposed framework for the systematic review and integrated assessment (SYRINA) of endocrine disrupting chemicals

    DEFF Research Database (Denmark)

    Vandenberg, Laura N.; Agerstrand, Marlene; Beronius, Anna

    2016-01-01

    of evidence (epidemiology, wildlife, laboratory animal, in vitro, and in silico data) that are relevant in assessing EDCs.Methods: We have developed a framework for the systematic review and integrated assessment (SYRINA) of EDC studies. The framework was designed for use with the International Program......Background: The issue of endocrine disrupting chemicals (EDCs) is receiving wide attention from both the scientific and regulatory communities. Recent analyses of the EDC literature have been criticized for failing to use transparent and objective approaches to draw conclusions about the strength...... of evidence linking EDC exposures to adverse health or environmental outcomes. Systematic review methodologies are ideal for addressing this issue as they provide transparent and consistent approaches to study selection and evaluation. Objective methods are needed for integrating the multiple streams...

  19. A systematic review of economic evaluations of cardiac rehabilitation

    Directory of Open Access Journals (Sweden)

    Wong Wai

    2012-08-01

    Full Text Available Abstract Background Cardiac rehabilitation (CR, a multidisciplinary program consisting of exercise, risk factor modification and psychosocial intervention, forms an integral part of managing patients after myocardial infarction (MI, revascularization surgery and percutaneous coronary interventions, as well as patients with heart failure (HF. This systematic review seeks to examine the cost-effectiveness of CR for patients with MI or HF and inform policy makers in Singapore on published cost-effectiveness studies on CR. Methods Electronic databases (EMBASE, MEDLINE, NHS EED, PEDro, CINAHL were searched from inception to May 2010 for published economic studies. Additional references were identified through searching bibliographies of included studies. Two independent reviewers selected eligible publications based on the inclusion/exclusion criteria. Quality assessment of economic evaluations was undertaken using Drummond’s checklist. Results A total of 22 articles were selected for review. However five articles were further excluded because they were cost-minimization analyses, whilst one included patients with stroke. Of the final 16 articles, one article addressed both centre-based cardiac rehabilitation versus no rehabilitation, as well as home-based cardiac rehabilitation versus no rehabilitation. Therefore, nine studies compared cost-effectiveness between centre-based supervised CR and no CR; three studies examined that between centre- and home based CR; one between inpatient and outpatient CR; and four between home-based CR and no CR. These studies were characterized by differences in the study perspectives, economic study designs and time frames, as well as variability in clinical data and assumptions made on costs. Overall, the studies suggested that: (1 supervised centre-based CR was highly cost-effective and the dominant strategy when compared to no CR; (2 home-based CR was no different from centre-based CR; (3 no difference existed

  20. Evaluation Studies of Robotic Rollators by the User Perspective: A Systematic Review.

    Science.gov (United States)

    Werner, Christian; Ullrich, Phoebe; Geravand, Milad; Peer, Angelika; Hauer, Klaus

    2016-01-01

    Robotic rollators enhance the basic functions of established devices by technically advanced physical, cognitive, or sensory support to increase autonomy in persons with severe impairment. In the evaluation of such ambient assisted living solutions, both the technical and user perspectives are important to prove usability, effectiveness and safety, and to ensure adequate device application. The aim of this systematic review is to summarize the methodology of studies evaluating robotic rollators with focus on the user perspective and to give recommendations for future evaluation studies. A systematic literature search up to December 31, 2014, was conducted based on the Cochrane Review methodology using the electronic databases PubMed and IEEE Xplore. Articles were selected according to the following inclusion criteria: evaluation studies of robotic rollators documenting human-robot interaction, no case reports, published in English language. Twenty-eight studies were identified that met the predefined inclusion criteria. Large heterogeneity in the definitions of the target user group, study populations, study designs and assessment methods was found across the included studies. No generic methodology to evaluate robotic rollators could be identified. We found major methodological shortcomings related to insufficient sample descriptions and sample sizes, and lack of appropriate, standardized and validated assessment methods. Long-term use in habitual environment was also not evaluated. Apart from the heterogeneity, methodological deficits in most of the identified studies became apparent. Recommendations for future evaluation studies include: clear definition of target user group, adequate selection of subjects, inclusion of other assistive mobility devices for comparison, evaluation of the habitual use of advanced prototypes, adequate assessment strategy with established, standardized and validated methods, and statistical analysis of study results. Assessment

  1. Systematic assessment of constipation on plain abdominal radiographs in children

    International Nuclear Information System (INIS)

    Bosch, Maurice van den; Graafmans, Doortje; Nievelstein, Rutger; Beek, Erik

    2006-01-01

    Constipation in childhood is common and its clinical assessment is often difficult. Plain abdominal radiography is simple and used to quantify constipation. Three scoring systems, those of Barr et al., Leech et al. and Blethyn et al., have been developed to quantify fecal loading on the abdominal radiograph. In order to determine which method is the most useful in clinical practice, we assessed the reproducibility of the three scoring systems. Plain abdominal radiographs from 40 clinically constipated children were retrospectively reviewed by two paediatric radiologists on two separate occasions. The radiographs were scored according to three different systems developed by Barr et al., Leech et al., Blethyn et al. Intraobserver variability and interobserver reproducibility were determined for each system. Kappa coefficients were calculated as indicators of inter- and intraobserver agreement for categorical outcome variables. The Leech score showed the highest reproducibility: the intraobserver agreement was high for both observers (κ values of 0.88 and 1.00, respectively, P<0.05). Furthermore, the interobserver agreement was also high: κ 0.91 in the first round and 0.84 in the second. The Leech score proved to be a highly reproducible tool for assessment of childhood constipation and is of value in clinical practice for systematic assessment of constipation on plain abdominal radiographs in children. (orig.)

  2. Systematic assessment of constipation on plain abdominal radiographs in children

    Energy Technology Data Exchange (ETDEWEB)

    Bosch, Maurice van den; Graafmans, Doortje [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Nievelstein, Rutger; Beek, Erik [Wilhelmina Children' s Hospital, Department of Paediatric Radiology, Utrecht (Netherlands)

    2006-03-15

    Constipation in childhood is common and its clinical assessment is often difficult. Plain abdominal radiography is simple and used to quantify constipation. Three scoring systems, those of Barr et al., Leech et al. and Blethyn et al., have been developed to quantify fecal loading on the abdominal radiograph. In order to determine which method is the most useful in clinical practice, we assessed the reproducibility of the three scoring systems. Plain abdominal radiographs from 40 clinically constipated children were retrospectively reviewed by two paediatric radiologists on two separate occasions. The radiographs were scored according to three different systems developed by Barr et al., Leech et al., Blethyn et al. Intraobserver variability and interobserver reproducibility were determined for each system. Kappa coefficients were calculated as indicators of inter- and intraobserver agreement for categorical outcome variables. The Leech score showed the highest reproducibility: the intraobserver agreement was high for both observers ({kappa} values of 0.88 and 1.00, respectively, P<0.05). Furthermore, the interobserver agreement was also high: {kappa} 0.91 in the first round and 0.84 in the second. The Leech score proved to be a highly reproducible tool for assessment of childhood constipation and is of value in clinical practice for systematic assessment of constipation on plain abdominal radiographs in children. (orig.)

  3. Frameworks to assess health systems governance: a systematic review.

    Science.gov (United States)

    Pyone, Thidar; Smith, Helen; van den Broek, Nynke

    2017-06-01

    Governance of the health system is a relatively new concept and there are gaps in understanding what health system governance is and how it could be assessed. We conducted a systematic review of the literature to describe the concept of governance and the theories underpinning as applied to health systems; and to identify which frameworks are available and have been applied to assess health systems governance. Frameworks were reviewed to understand how the principles of governance might be operationalized at different levels of a health system. Electronic databases and web portals of international institutions concerned with governance were searched for publications in English for the period January 1994 to February 2016. Sixteen frameworks developed to assess governance in the health system were identified and are described. Of these, six frameworks were developed based on theories from new institutional economics; three are primarily informed by political science and public management disciplines; three arise from the development literature and four use multidisciplinary approaches. Only five of the identified frameworks have been applied. These used the principal-agent theory, theory of common pool resources, North's institutional analysis and the cybernetics theory. Governance is a practice, dependent on arrangements set at political or national level, but which needs to be operationalized by individuals at lower levels in the health system; multi-level frameworks acknowledge this. Three frameworks were used to assess governance at all levels of the health system. Health system governance is complex and difficult to assess; the concept of governance originates from different disciplines and is multidimensional. There is a need to validate and apply existing frameworks and share lessons learnt regarding which frameworks work well in which settings. A comprehensive assessment of governance could enable policy makers to prioritize solutions for problems identified

  4. Dimensions of sensation assessed in urinary urgency: a systematic review.

    Science.gov (United States)

    Das, Rebekah; Buckley, Jonathan; Williams, Marie

    2013-10-01

    Urinary urgency is an adverse sensory experience. Confirmation of the multidimensional nature of other adverse sensory experiences such as pain and dyspnea has improved the understanding of neurophysiological and perceptual mechanisms leading to innovations in assessment and treatment. It has been suggested that the sensation of urgency may include multiple dimensions such as intensity, suddenness and unpleasantness. In this systematic review we determine which dimensions of sensation have been assessed by instruments used to measure urinary urgency. A systematic search was undertaken of MEDLINE, Embase, AMED, CINAHL, Ageline, Web of Science, InformIT Health and Scopus databases to identify studies that included assessments of urinary urge or urgency. Articles were included in the analysis if they were primary studies that described the method used to measure urge/urgency in adults and published in English in peer reviewed publications since January 1, 2000. Articles were excluded from study if urgency was measured only in conjunction with other symptoms (eg frequency or incontinence) or if there was no English version of the instrument. Secondary analyses and systematic reviews were retained to hand search references for additional primary studies. Data were extracted for the instruments used to measure urge/urgency. For each instrument the items specific to urinary urgency were reviewed using a prospectively developed categorization process for the sensory dimension and the measurement metric. Items used to assess urinary urgency were collated in a matrix (sensory dimensions vs assessment metric). The most frequently used dimensions, metrics and combinations were descriptively analyzed. After removal of duplicate articles 1,048 full text articles were screened and 411 were excluded, leaving 637 eligible articles from which data were extracted. A total of 216 instruments were identified which were 1 of 6 types, namely 1) wider symptom questionnaires, 2) urgency

  5. Systematic Evaluation of Uncertainty in Material Flow Analysis

    DEFF Research Database (Denmark)

    Laner, David; Rechberger, Helmut; Astrup, Thomas Fruergaard

    2014-01-01

    Material flow analysis (MFA) is a tool to investigate material flows and stocks in defined systems as a basis for resource management or environmental pollution control. Because of the diverse nature of sources and the varying quality and availability of data, MFA results are inherently uncertain....... Uncertainty analyses have received increasing attention in recent MFA studies, but systematic approaches for selection of appropriate uncertainty tools are missing. This article reviews existing literature related to handling of uncertainty in MFA studies and evaluates current practice of uncertainty analysis......) and exploratory MFA (identification of critical parameters and system behavior). Whereas mathematically simpler concepts focusing on data uncertainty characterization are appropriate for descriptive MFAs, statistical approaches enabling more-rigorous evaluation of uncertainty and model sensitivity are needed...

  6. Motor assessment instruments and psychometric procedures: A systematic review

    Directory of Open Access Journals (Sweden)

    Pâmella de Medeiros

    2017-03-01

    Full Text Available It was our objective to identify the psychometric elements to an epistemological reflection through a systematic review of cross-cultural validation procedures of TGMD-2 batteries, MABC-2 and KTK. Searches were carried out by two evaluators independently without year and language restrictions in six databases: Web of Science, Science Direct, Lilacs, Scopus, Pubmed and The ScientificElectronic Library Online - SciELO. The key words used were: "MABC", "TGMD" and "KTK" all of them combined with the word "validity". There was a total of 734 articles, of which, after the exclusion criteria, remained only 11 studies. It was found that there are differences between the authors in relation to the psychometric factors taken into account in cross-cultural validation. So that there was a lack of unanimity of the validation criteria of all studies in this field.

  7. Quality Assessment of TPB-Based Questionnaires: A Systematic Review

    Science.gov (United States)

    Oluka, Obiageli Crystal; Nie, Shaofa; Sun, Yi

    2014-01-01

    Objective This review is aimed at assessing the quality of questionnaires and their development process based on the theory of planned behavior (TPB) change model. Methods A systematic literature search for studies with the primary aim of TPB-based questionnaire development was conducted in relevant databases between 2002 and 2012 using selected search terms. Ten of 1,034 screened abstracts met the inclusion criteria and were assessed for methodological quality using two different appraisal tools: one for the overall methodological quality of each study and the other developed for the appraisal of the questionnaire content and development process. Both appraisal tools consisted of items regarding the likelihood of bias in each study and were eventually combined to give the overall quality score for each included study. Results 8 of the 10 included studies showed low risk of bias in the overall quality assessment of each study, while 9 of the studies were of high quality based on the quality appraisal of questionnaire content and development process. Conclusion Quality appraisal of the questionnaires in the 10 reviewed studies was successfully conducted, highlighting the top problem areas (including: sample size estimation; inclusion of direct and indirect measures; and inclusion of questions on demographics) in the development of TPB-based questionnaires and the need for researchers to provide a more detailed account of their development process. PMID:24722323

  8. Usability evaluation techniques in mobile commerce applications: A systematic review

    Science.gov (United States)

    Hussain, Azham; Mkpojiogu, Emmanuel O. C.

    2016-08-01

    Obviously, there are a number of literatures concerning the usability of mobile commerce (m-commerce) applications and related areas, but they do not adequately provide knowledge about usability techniques used in most of the empirical usability evaluation for m-commerce application. Therefore, this paper is aimed at producing the usability techniques frequently used in the aspect of usability evaluation for m-commerce applications. To achieve the stated objective, systematic literature review was employed. Sixty seven papers were downloaded in usability evaluation for m-commerce and related areas; twenty one most relevant studies were selected for review in order to extract the appropriate information. The results from the review shows that heuristic evaluation, formal test and think aloud methods are the most commonly used methods in m-commerce application in comparison to cognitive walkthrough and the informal test methods. Moreover, most of the studies applied control experiment (33.3% of the total studies); other studies that applied case study for usability evaluation are 14.28%. The results from this paper provide additional knowledge to the usability practitioners and research community for the current state and use of usability techniques in m-commerce application.

  9. Evaluation of patient self-management outcomes in health care: a systematic review.

    Science.gov (United States)

    Du, S; Yuan, C

    2010-06-01

    The importance of self-management and its intervention for improving the ability and skill of self-management has been discussed in literatures. It is, however, unclear how to choose the fitted, objective and accurate evaluation system when assessing the outcome. The aim of this article was to establish a general evaluation system for skill and ability of self-management in chronic diseases through systematic review on different evaluation indicators and scales. A systematic search of six electronic databases was conducted. Two authors independently reviewed each qualified study for relevance and significance. Subsequently, main evaluation indicators and scales were identified and categorized into themes and sub-themes. Nineteen articles were identified in this review. Among them, six main evaluation indicators of self-management, including frequently used scales, were extracted and tabulated. Self-efficacy, health behaviour/attitude, health status, health service utilization, quality of life and psychological indicators were the main indicators in evaluating self-management outcome, and they could be used alone or in combination flexibly according to the different goals of programmes. Accurate evaluation of skill and ability of self-management is crucial not only in baseline data collection but also in proving the effectiveness of intervention. The outcomes of this study provide future researchers or caregivers with a better understanding and a series of good choices in self-management outcome evaluation.

  10. Evaluation and Assessment in Early Social Science

    Science.gov (United States)

    Hus, Vlasta; Matjašic, Jasmina

    2017-01-01

    Authenticity is an important element in the newer models of teaching, evaluation and assessment. Due to the fact that it is quite unclear how authentic evaluation and assessment should be implemented into practice, teachers still cling too much to traditional forms of knowledge evaluation and assessment. First, some basic theoretical facts on…

  11. Applicability and feasibility of systematic review for performing evidence-based risk assessment in food and feed safety

    DEFF Research Database (Denmark)

    Aiassa, E.; Higgins, J.P.T.; Frampton, G. K.

    2015-01-01

    for answering questions in health care, and can be implemented to minimise biases in food and feed safety risk assessment. However, no methodological frameworks exist for refining risk assessment multi-parameter models into questions suitable for systematic review, and use of meta-analysis to estimate all......Food and feed safety risk assessment uses multi-parameter models to evaluate the likelihood of adverse events associated with exposure to hazards in human health, plant health, animal health, animal welfare and the environment. Systematic review and meta-analysis are established methods...... parameters in the risk model. This approach to planning and prioritising systematic review seems to have useful implications for producing evidence-based food and feed safety risk assessment....

  12. A Systematic Review of Tools Used to Assess Team Leadership in Health Care Action Teams.

    Science.gov (United States)

    Rosenman, Elizabeth D; Ilgen, Jonathan S; Shandro, Jamie R; Harper, Amy L; Fernandez, Rosemarie

    2015-10-01

    To summarize the characteristics of tools used to assess leadership in health care action (HCA) teams. HCA teams are interdisciplinary teams performing complex, critical tasks under high-pressure conditions. The authors conducted a systematic review of the PubMed/MEDLINE, CINAHL, ERIC, EMBASE, PsycINFO, and Web of Science databases, key journals, and review articles published through March 2012 for English-language articles that applied leadership assessment tools to HCA teams in all specialties. Pairs of reviewers assessed identified articles for inclusion and exclusion criteria and abstracted data on study characteristics, tool characteristics, and validity evidence. Of the 9,913 abstracts screened, 83 studies were included. They described 61 team leadership assessment tools. Forty-nine tools (80%) provided behaviors, skills, or characteristics to define leadership. Forty-four tools (72%) assessed leadership as one component of a larger assessment, 13 tools (21%) identified leadership as the primary focus of the assessment, and 4 (7%) assessed leadership style. Fifty-three studies (64%) assessed leadership at the team level; 29 (35%) did so at the individual level. Assessments of simulated (n = 55) and live (n = 30) patient care events were performed. Validity evidence included content validity (n = 75), internal structure (n = 61), relationship to other variables (n = 44), and response process (n = 15). Leadership assessment tools applied to HCA teams are heterogeneous in content and application. Comparisons between tools are limited by study variability. A systematic approach to team leadership tool development, evaluation, and implementation will strengthen understanding of this important competency.

  13. A systematic review of clinical supervision evaluation studies in nursing.

    Science.gov (United States)

    Cutcliffe, John R; Sloan, Graham; Bashaw, Marie

    2018-02-15

    According to the international, extant literature published during the last 20 years or so, clinical supervision (CS) in nursing is now a reasonably common phenomenon. Nevertheless, what appears to be noticeably 'thin on the ground' in this body of literature are empirical evaluations of CS, especially those pertaining to client outcomes. Accordingly, the authors undertook a systematic review of empirical evaluations of CS in nursing to determine the state of the science. Adopting the approach documented by Stroup et al. (JAMA, 283, 2000, 2008), the authors searched for reports of evaluation studies of CS in nursing - published during the years 1995 to 2015. Keywords for the search were 'clinical supervision', 'evaluation', 'efficacy', 'nursing', and combinations of these keywords. Electronic databases used were CINAHL, MEDLINE, PsychLIT, and the British Nursing Index. The research evidence from twenty-eight (28) studies reviewed is presented, outlining the main findings with an overview of each study presented. The following broad themes were identified and are each discussed in the study: narrative/anecdotal accounts of positive outcomes for clinical supervision, narrative/anecdotal accounts of negative outcomes for clinical supervision, empirical positive outcomes reported by supervisee, and empirical findings showing no effect by supervisee. © 2018 Australian College of Mental Health Nurses Inc.

  14. Feasibility and reliability of frailty assessment in the critically ill: a systematic review.

    Science.gov (United States)

    Pugh, Richard J; Ellison, Amy; Pye, Kate; Subbe, Christian P; Thorpe, Chris M; Lone, Nazir I; Clegg, Andrew

    2018-02-26

    For healthcare systems, an ageing population poses challenges in the delivery of equitable and effective care. Frailty assessment has the potential to improve care in the intensive care setting, but applying assessment tools in critical illness may be problematic. The aim of this systematic review was to evaluate evidence for the feasibility and reliability of frailty assessment in critical care. Our primary search was conducted in Medline, Medline In-process, EMBASE, CINAHL, PsycINFO, AMED, Cochrane Database of Systematic Reviews, and Web of Science (January 2001 to October 2017). We included observational studies reporting data on feasibility and reliability of frailty assessment in the critical care setting in patients 16 years and older. Feasibility was assessed in terms of timing of evaluation, the background, training and expertise required for assessors, and reliance upon proxy input. Reliability was assessed in terms of inter-rater reliability. Data from 11 study publications are included, representing 8 study cohorts and 7761 patients. Proxy involvement in frailty assessment ranged from 58 to 100%. Feasibility data were not well-reported overall, but the exclusion rate due to lack of proxy availability ranged from 0 to 45%, the highest rate observed where family involvement was mandatory and the assessment tool relatively complex (frailty index, FI). Conventional elements of frailty phenotype (FP) assessment required modification prior to use in two studies. Clinical staff tended to use a simple judgement-based tool, the clinical frailty scale (CFS). Inter-rater reliability was reported in one study using the CFS and although a good level of agreement was observed between clinician assessments, this was a small and single-centre study. Though of unproven reliability in the critically ill, CFS was the tool used most widely by critical care clinical staff. Conventional FP assessment required modification for general application in critical care, and an FI

  15. Lessons learned from NRC systematic evaluation program seismic review

    International Nuclear Information System (INIS)

    Cheng, T.M.; Hermann, R.A.; Russell, W.T.

    1983-01-01

    In October 1977, the Nuclear Regulatory Commission approved initiation of Phase II of the Systematic Evaluation Program (SEP) which consists of a plant-specific reassessment of the safety of 11 older operating nuclear reactors. Many safety criteria have rapidly evolved since the time of initial licensing of these plants. The purpose of the SEP is to develop a current documented basis for the safety of these older facilities by comparing them to current criteria. Phase I of the SEP developed a comprehensive list of 137 topics of safety significance which collectively affect the plant's capability to respond to various Design Basis Events (DBEs). Seismic Design Consideration is one of the 137 safety topics. (orig./GL)

  16. Constructing a Validity Argument for the Objective Structured Assessment of Technical Skills (OSATS): A Systematic Review of Validity Evidence

    Science.gov (United States)

    Hatala, Rose; Cook, David A.; Brydges, Ryan; Hawkins, Richard

    2015-01-01

    In order to construct and evaluate the validity argument for the Objective Structured Assessment of Technical Skills (OSATS), based on Kane's framework, we conducted a systematic review. We searched MEDLINE, EMBASE, CINAHL, PsycINFO, ERIC, Web of Science, Scopus, and selected reference lists through February 2013. Working in duplicate, we selected…

  17. Assessing medical professionalism: A systematic review of instruments and their measurement properties

    Science.gov (United States)

    Li, Honghe; Liu, Yang; Wen, Deliang

    2017-01-01

    Background Over the last three decades, various instruments were developed and employed to assess medical professionalism, but their measurement properties have yet to be fully evaluated. This study aimed to systematically evaluate these instruments’ measurement properties and the methodological quality of their related studies within a universally acceptable standardized framework and then provide corresponding recommendations. Methods A systematic search of the electronic databases PubMed, Web of Science, and PsycINFO was conducted to collect studies published from 1990–2015. After screening titles, abstracts, and full texts for eligibility, the articles included in this study were classified according to their respective instrument’s usage. A two-phase assessment was conducted: 1) methodological quality was assessed by following the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) checklist; and 2) the quality of measurement properties was assessed according to Terwee’s criteria. Results were integrated using best-evidence synthesis to look for recommendable instruments. Results After screening 2,959 records, 74 instruments from 80 existing studies were included. The overall methodological quality of these studies was unsatisfactory, with reasons including but not limited to unknown missing data, inadequate sample sizes, and vague hypotheses. Content validity, cross-cultural validity, and criterion validity were either unreported or negative ratings in most studies. Based on best-evidence synthesis, three instruments were recommended: Hisar’s instrument for nursing students, Nurse Practitioners’ Roles and Competencies Scale, and Perceived Faculty Competency Inventory. Conclusion Although instruments measuring medical professionalism are diverse, only a limited number of studies were methodologically sound. Future studies should give priority to systematically improving the performance of existing

  18. Meta-evaluation of published studies on evaluation of health disaster preparedness exercises through a systematic review.

    Science.gov (United States)

    Sheikhbardsiri, Hojjat; Yarmohammadian, Mohammad H; Khankeh, Hamid Reza; Nekoei-Moghadam, Mahmoud; Raeisi, Ahmad Reza

    2018-01-01

    Exercise evaluation is one of the most important steps and sometimes neglected in designing and taking exercises, in this stage of exercise, it systematically identifying, gathering, and interpreting related information to indicate how an exercise has fulfilled its objectives. The present study aimed to assess the most important evaluation techniques applied in evaluating health exercises for emergencies and disasters. This was meta-evaluation study through a systematic review. In this research, we searched papers based on specific and relevant keywords in research databases including ISI web of science, PubMed, Scopus, Science Direct, Ovid, ProQuest, Wiley, Google Scholar, and Persian database such as ISC and SID. The search keywords and strategies are followed; "simulation," "practice," "drill," "exercise," "instrument," "tool," "questionnaire," " measurement," "checklist," "scale," "test," "inventory," "battery," "evaluation," "assessment," "appraisal," "emergency," "disaster," "cricise," "hazard," "catastrophe,: "hospital", "prehospital," "health centers," "treatment centers," were used in combination with Boolean operators OR and AND. The research findings indicate that there are different techniques and methods for data collection to evaluate performance exercises of health centers and affiliated organizations in disasters and emergencies including debriefing inventories, self-report, questionnaire, interview, observation, shooting video, and photographing, electronic equipment which can be individually or collectively used depending on exercise objectives or purposes. Taking exercise in the health sector is one of the important steps in preparation and implementation of disaster risk management programs. This study can be thus utilized to improve preparedness of different sectors of health system according to the latest available evaluation techniques and methods for better implementation of disaster exercise evaluation stages.

  19. Approach for systematic evaluation of transuranic waste management alternatives

    International Nuclear Information System (INIS)

    Hong, K.; Koebnick, B.; Kotek, T.

    1994-01-01

    This paper describes an approach for systematic evaluation of management alternatives that are being considered for the treatment, storage, and disposal of transuranic waste (TRUW) at U.S. Department of Energy sites. The approach, which is currently under development, would apply WASTE-MGMT, a database application model developed at Argonne National Laboratory, to estimate projected environmental releases and would evaluate impact measures such as health risk and costs associated with each of the waste management alternatives. The customized application would combine site-specific TRUW inventory and characterization data with treatment and transportation parameters to estimate the quantities and characteristics of the wastes to be treated, emissions of hazardous substances from the treatment facilities, and the quantities and characteristics of the wastes to be shipped between sites. These data would then be used to estimate for several TRUW management scenarios the costs and health risks of constructing and operating the required treatment facilities and of transporting TRUW for treatment and final disposal. Treatment, storage, and disposal of TRUW at DOE sites is composed of many variables and options at each stage. The approach described in this paper would provide for efficient consideration of all of these facets when evaluating potentially feasible TRUW management alternatives. By expanding existing databases, this model could eventually be adapted to accommodate the introduction of new treatment technologies, updated TRUW characterization data, and/or revised waste acceptance criteria

  20. Automatic Evaluations and Exercising: Systematic Review and Implications for Future Research.

    Science.gov (United States)

    Schinkoeth, Michaela; Antoniewicz, Franziska

    2017-01-01

    The general purpose of this systematic review was to summarize, structure and evaluate the findings on automatic evaluations of exercising. Studies were eligible for inclusion if they reported measuring automatic evaluations of exercising with an implicit measure and assessed some kind of exercise variable. Fourteen nonexperimental and six experimental studies (out of a total N = 1,928) were identified and rated by two independent reviewers. The main study characteristics were extracted and the grade of evidence for each study evaluated. First, results revealed a large heterogeneity in the applied measures to assess automatic evaluations of exercising and the exercise variables. Generally, small to large-sized significant relations between automatic evaluations of exercising and exercise variables were identified in the vast majority of studies. The review offers a systematization of the various examined exercise variables and prompts to differentiate more carefully between actually observed exercise behavior (proximal exercise indicator) and associated physiological or psychological variables (distal exercise indicator). Second, a lack of transparent reported reflections on the differing theoretical basis leading to the use of specific implicit measures was observed. Implicit measures should be applied purposefully, taking into consideration the individual advantages or disadvantages of the measures. Third, 12 studies were rated as providing first-grade evidence (lowest grade of evidence), five represent second-grade and three were rated as third-grade evidence. There is a dramatic lack of experimental studies, which are essential for illustrating the cause-effect relation between automatic evaluations of exercising and exercise and investigating under which conditions automatic evaluations of exercising influence behavior. Conclusions about the necessity of exercise interventions targeted at the alteration of automatic evaluations of exercising should therefore

  1. A Systematic Approach for Real-Time Operator Functional State Assessment

    Science.gov (United States)

    Zhang, Guangfan; Wang, Wei; Pepe, Aaron; Xu, Roger; Schnell, Thomas; Anderson, Nick; Heitkamp, Dean; Li, Jiang; Li, Feng; McKenzie, Frederick

    2012-01-01

    A task overload condition often leads to high stress for an operator, causing performance degradation and possibly disastrous consequences. Just as dangerous, with automated flight systems, an operator may experience a task underload condition (during the en-route flight phase, for example), becoming easily bored and finding it difficult to maintain sustained attention. When an unexpected event occurs, either internal or external to the automated system, the disengaged operator may neglect, misunderstand, or respond slowly/inappropriately to the situation. In this paper, we discuss an approach for Operator Functional State (OFS) monitoring in a typical aviation environment. A systematic ground truth finding procedure has been designed based on subjective evaluations, performance measures, and strong physiological indicators. The derived OFS ground truth is continuous in time compared to a very sparse estimation of OFS based on an expert review or subjective evaluations. It can capture the variations of OFS during a mission to better guide through the training process of the OFS assessment model. Furthermore, an OFS assessment model framework based on advanced machine learning techniques was designed and the systematic approach was then verified and validated with experimental data collected in a high fidelity Boeing 737 simulator. Preliminary results show highly accurate engagement/disengagement detection making it suitable for real-time applications to assess pilot engagement.

  2. Assessing personal talent determinants in young racquet sport players: a systematic review.

    Science.gov (United States)

    Faber, Irene R; Bustin, Paul M J; Oosterveld, Frits G J; Elferink-Gemser, Marije T; Nijhuis-Van der Sanden, Maria W G

    2016-01-01

    Since junior performances have little predictive value for future success, other solutions are sought to assess a young player's potential. The objectives of this systematic review are (1) to provide an overview of instruments measuring personal talent determinants of young players in racquet sports, and (2) to evaluate these instruments regarding their validity for talent development. Electronic searches were conducted in PubMed, PsychINFO, Web of Knowledge, ScienceDirect and SPORTDiscus (1990 to 31 March 2014). Search terms represented tennis, table tennis, badminton and squash, the concept of talent, methods of testing and children. Thirty articles with information regarding over 100 instruments were included. Validity evaluation showed that instruments focusing on intellectual and perceptual abilities, and coordinative skills discriminate elite from non-elite players and/or are related to current performance, but their predictive validity is not confirmed. There is moderate evidence that the assessments of mental and goal management skills predict future performance. Data on instruments measuring physical characteristics prohibit a conclusion due to conflicting findings. This systematic review yielded an ambiguous end point. The lack of longitudinal studies precludes verification of the instrument's capacity to forecast future performance. Future research should focus on instruments assessing multidimensional talent determinants and their predictive value in longitudinal designs.

  3. A systematic review of studies evaluating diffusion and dissemination of selected cancer control interventions.

    Science.gov (United States)

    Ellis, Peter; Robinson, Paula; Ciliska, Donna; Armour, Tanya; Brouwers, Melissa; O'Brien, Mary Ann; Sussman, Jonathan; Raina, Parminder

    2005-09-01

    With this review, the authors sought to determine what strategies have been evaluated (including the outcomes assessed) to disseminate cancer control interventions that promote the uptake of behavior change. Five topic areas along the cancer care continuum (smoking cessation, healthy diet, mammography, cervical cancer screening, and control of cancer pain) were selected to be representative. A systematic review was conducted of primary studies evaluating dissemination of a cancer control intervention. Thirty-one studies were identified that evaluated dissemination strategies in the 5 topic areas. No strong evidence currently exists to recommend any one dissemination strategy as effective in promoting the uptake of cancer control interventions. The authors conclude that there is a strong need for more research into dissemination of cancer control interventions. Future research should consider methodological issues such as the most appropriate study design and outcomes to be evaluated. (c) 2005 APA, all rights reserved

  4. Communication skills assessment in the final postgraduate years to established practice: a systematic review.

    Science.gov (United States)

    Gillis, Amy E; Morris, Marie C; Ridgway, Paul F

    2015-01-01

    Communication breakdown is a factor in the majority of all instances of medical error. Despite the importance, a relative paucity of time is invested in communication skills in postgraduate curricula. Our objective is to systematically review the literature to identify the current tools used to assess communication skills in postgraduate trainees in the latter 2 years of training and in established practice. Two reviewers independently reviewed the literature identifying communication skill assessment tools, for postgraduate trainees in the latter 2 years of training and in established practice following Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework, and inclusion/exclusion criteria from January 1990 to 15 August 2014. PubMed/CINAHL/ERIC/EMBASE/PsycInfo/Psyc Articles/Cochrane. 222 articles were identified; after review, 34 articles fulfilled criteria for complete evaluation; the majority (26) had a high level of evidence scoring 3 or greater on the Best Evidence Medical Education guide. 22 articles used objective structured clinical examination/standardised patient (SP)-based formats in an assessment or training capacity. Evaluation tools included author-developed questionnaires and validated tools. Nineteen articles demonstrated an educational initiative. The reviewed literature is heterogeneous for objectives and measurement techniques for communication. Observed interactions, with patients or SPs, is the current favoured method of evaluation using author-developed questionnaires. The role of self-evaluation of skill level is questioned. The need for a validated assessment tool for communication skills is highlighted. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  5. NURE quadrangle evaluation and assessment

    International Nuclear Information System (INIS)

    Horton, R.C.

    1979-01-01

    The NURE program effort will continue to generate and employ improvements in assessment technology. Assessment procedures in current use are carefully documented to the extent that a useful audit trail is available; these data extend from the actual recording of field observations and identification of favorability areas to the selection of the proper control areas and application to the actual assessment function. BFEC is confident that the basic system of assessment of the unknown by analogy to the known is fully tenable. And, BFEC is proud to be a contributing party to the NURE program which is of a magnitude not hitherto undertaken by any government or private organization

  6. Anterior process calcaneal fractures: a systematic evaluation of associated conditions

    Energy Technology Data Exchange (ETDEWEB)

    Petrover, David [NYU Hospital for Joint Disease, Radiology Department, New York, NY (United States); Hopital Beaujon, Service de Radiologie, Paris (France); Schweitzer, Mark E. [NYU Hospital for Joint Disease, Radiology Department, New York, NY (United States); Laredo, J.D. [Hopital Lariboisiere, Service de Radiologie, Paris (France)

    2007-07-15

    The objective was to evaluate the association, by MRI, of anterior calcaneal process fractures with tarsal coalitions, ankle sprains, and bifurcate ligament abnormalities. A retrospective review of 1,479 foot and ankle MR images was performed, over a period of 5 years, for isolated anterior process fractures of the calcaneus. Fifteen 1.5-T MR examinations were systematically evaluated by two radiologists in consensus. Marrow edema patterns, presence of a calcaneonavicular coalition, as well as bifurcate and anterior talofibular ligaments, were evaluated. There were 15 fractures of the anterior calcaneal process with an incidence of 1%. The average patient age was 51 years (range 25-82). Twelve patients were women and 3 were men. The majority of the fractures (14 out of 15) presented as an edema pattern on T2-weighted images, either diffuse (9 out of 15), or vertical (5 out of 15). One case did not show marrow edema, but rather a hypointense line. Nine patients (60%) demonstrated calcaneonavicular coalition and anterior calcaneal process fracture. In 6 patients (50%) the anterior talofibular ligament (ATFL) was thickened. Three patients did not have axial images, and were classified as non-conclusive for the ATFL evaluation. The bifurcate ligament was thickened with hyperintense signal demonstrating a sprain in 9 out of 13 (69%). Only 2 patients (16.5%) had an anterior calcaneal process fracture without any associated abnormality. We believe that there is a probable association of anterior process fractures and calcaneonavicular coalitions. We also feel, based on our results and the prior literature that there is likely also an association with both ATFL injuries and bifurcate ligament injuries. (orig.)

  7. Anterior process calcaneal fractures: a systematic evaluation of associated conditions

    International Nuclear Information System (INIS)

    Petrover, David; Schweitzer, Mark E.; Laredo, J.D.

    2007-01-01

    The objective was to evaluate the association, by MRI, of anterior calcaneal process fractures with tarsal coalitions, ankle sprains, and bifurcate ligament abnormalities. A retrospective review of 1,479 foot and ankle MR images was performed, over a period of 5 years, for isolated anterior process fractures of the calcaneus. Fifteen 1.5-T MR examinations were systematically evaluated by two radiologists in consensus. Marrow edema patterns, presence of a calcaneonavicular coalition, as well as bifurcate and anterior talofibular ligaments, were evaluated. There were 15 fractures of the anterior calcaneal process with an incidence of 1%. The average patient age was 51 years (range 25-82). Twelve patients were women and 3 were men. The majority of the fractures (14 out of 15) presented as an edema pattern on T2-weighted images, either diffuse (9 out of 15), or vertical (5 out of 15). One case did not show marrow edema, but rather a hypointense line. Nine patients (60%) demonstrated calcaneonavicular coalition and anterior calcaneal process fracture. In 6 patients (50%) the anterior talofibular ligament (ATFL) was thickened. Three patients did not have axial images, and were classified as non-conclusive for the ATFL evaluation. The bifurcate ligament was thickened with hyperintense signal demonstrating a sprain in 9 out of 13 (69%). Only 2 patients (16.5%) had an anterior calcaneal process fracture without any associated abnormality. We believe that there is a probable association of anterior process fractures and calcaneonavicular coalitions. We also feel, based on our results and the prior literature that there is likely also an association with both ATFL injuries and bifurcate ligament injuries. (orig.)

  8. A systematic review of epidemiologic studies assessing condom use and risk of syphilis.

    Science.gov (United States)

    Koss, Catherine A; Dunne, Eileen F; Warner, Lee

    2009-07-01

    Although systematic reviews of epidemiologic studies have been conducted for condom use and the risk of several sexually transmitted diseases, there have been no such reviews for condom use and syphilis. A systematic literature review of epidemiologic studies published from 1972 to 2008 was conducted to evaluate study methods and measures of association reported for condom use and risk of syphilis. All 12 included studies had significant methodologic limitations. Nine (75%) studies were cross-sectional. Although 11 (92%) studies assessed consistent condom use, no studies assessed correct use or condom use problems, nor did any document exposure to a partner infected with syphilis. Ten studies had insufficient information to distinguish prevalent from incident infections. Two studies that assessed both incident infection and consistent condom use suggested a reduced risk of syphilis with consistent condom use; 1 study was statistically significant. Significant methodologic limitations exist for all reviewed studies of syphilis and condom use. Among the 2 most rigorously designed studies, both suggested a reduced risk of syphilis with consistent condom use. Additional studies incorporating rigorous methods are needed to further assess the effect of condom use on risk of syphilis.

  9. Smartphone apps for calculating insulin dose: a systematic assessment.

    Science.gov (United States)

    Huckvale, Kit; Adomaviciute, Samanta; Prieto, José Tomás; Leow, Melvin Khee-Shing; Car, Josip

    2015-05-06

    Medical apps are widely available, increasingly used by patients and clinicians, and are being actively promoted for use in routine care. However, there is little systematic evidence exploring possible risks associated with apps intended for patient use. Because self-medication errors are a recognized source of avoidable harm, apps that affect medication use, such as dose calculators, deserve particular scrutiny. We explored the accuracy and clinical suitability of apps for calculating medication doses, focusing on insulin calculators for patients with diabetes as a representative use for a prevalent long-term condition. We performed a systematic assessment of all English-language rapid/short-acting insulin dose calculators available for iOS and Android. Searches identified 46 calculators that performed simple mathematical operations using planned carbohydrate intake and measured blood glucose. While 59% (n = 27/46) of apps included a clinical disclaimer, only 30% (n = 14/46) documented the calculation formula. 91% (n = 42/46) lacked numeric input validation, 59% (n = 27/46) allowed calculation when one or more values were missing, 48% (n = 22/46) used ambiguous terminology, 9% (n = 4/46) did not use adequate numeric precision and 4% (n = 2/46) did not store parameters faithfully. 67% (n = 31/46) of apps carried a risk of inappropriate output dose recommendation that either violated basic clinical assumptions (48%, n = 22/46) or did not match a stated formula (14%, n = 3/21) or correctly update in response to changing user inputs (37%, n = 17/46). Only one app, for iOS, was issue-free according to our criteria. No significant differences were observed in issue prevalence by payment model or platform. The majority of insulin dose calculator apps provide no protection against, and may actively contribute to, incorrect or inappropriate dose recommendations that put current users at risk of both catastrophic overdose and more

  10. Systematic Review of Health Economic Evaluation Studies Developed in Brazil from 1980 to 2013.

    Science.gov (United States)

    Decimoni, Tassia Cristina; Leandro, Roseli; Rozman, Luciana Martins; Craig, Dawn; Iglesias, Cynthia P; Novaes, Hillegonda Maria Dutilh; de Soárez, Patrícia Coelho

    2018-01-01

    Brazil has sought to use economic evaluation to support healthcare decision-making processes. While a number of health economic evaluations (HEEs) have been conducted, no study has systematically reviewed the quality of Brazilian HEE. The objective of this systematic review was to provide an overview regarding the state of HEE research and to evaluate the number, characteristics, and quality of reporting of published HEE studies conducted in a Brazilian setting. We systematically searched electronic databases (MEDLINE, EMBASE, Latin American, and Caribbean Literature on Health Sciences Database, Scientific Electronic Library Online, NHS Economic Evaluation Database, health technology assessment Database, Bireme, and Biblioteca Virtual em Saúde Economia da Saúde ); citation indexes (SCOPUS, Web of Science), and Sistema de Informação da Rede Brasileira de Avaliação de Tecnologia em Saúde . Partial and full HEEs published between 1980 and 2013 that referred to a Brazilian setting were considered for inclusion. In total, 535 studies were included in the review, 36.8% of these were considered to be full HEE. The category of healthcare technologies more frequently assessed were procedures (34.8%) and drugs (28.8%) which main objective was treatment (72.1%). Forty-four percent of the studies reported their funding source and 36% reported a conflict of interest. Overall, the full HEE quality of reporting was satisfactory. But some items were generally poorly reported and significant improvement is required: (1) methods used to estimate healthcare resource use quantities and unit costs, (2) methods used to estimate utility values, (3) sources of funding, and (4) conflicts of interest. A steady number of HEE have been published in Brazil since 1980. To improve their contribution to inform national healthcare policy efforts need to be made to enhance the quality of reporting of HEEs and promote improvements in the way HEEs are designed, implemented (i.e., using sound

  11. Health technology assessment. Evaluation of biomedical innovative technologies.

    Science.gov (United States)

    Turchetti, Giuseppe; Spadoni, Enza; Geisler, Eliezer Elie

    2010-01-01

    This article describes health technology assessment (HTA) as an evaluation tool that applies systematic methods of inquiry to the generation and use of health technologies and new products. The focus of this article is on the contributions of HTA to the management of the new product development effort in the biomedical organization. Critical success factors (CSFs) are listed, and their role in assessing success is defined and explained. One of the conclusions of this article is that HTA is a powerful tool for managers in the biomedical sector, allowing them to better manage their innovation effort in their continuing struggle for competitiveness and survival.

  12. Smartphone-Based Self-Assessment of Stress in Healthy Adult Individuals: A Systematic Review.

    Science.gov (United States)

    Þórarinsdóttir, Helga; Kessing, Lars Vedel; Faurholt-Jepsen, Maria

    2017-02-13

    Stress is a common experience in today's society. Smartphone ownership is widespread, and smartphones can be used to monitor health and well-being. Smartphone-based self-assessment of stress can be done in naturalistic settings and may potentially reflect real-time stress level. The objectives of this systematic review were to evaluate (1) the use of smartphones to measure self-assessed stress in healthy adult individuals, (2) the validity of smartphone-based self-assessed stress compared with validated stress scales, and (3) the association between smartphone-based self-assessed stress and smartphone generated objective data. A systematic review of the scientific literature was reported and conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. The scientific databases PubMed, PsycINFO, Embase, IEEE, and ACM were searched and supplemented by a hand search of reference lists. The databases were searched for original studies involving healthy individuals older than 18 years, measuring self-assessed stress using smartphones. A total of 35 published articles comprising 1464 individuals were included for review. According to the objectives, (1) study designs were heterogeneous, and smartphone-based self-assessed stress was measured using various methods (e.g., dichotomized questions on stress, yes or no; Likert scales on stress; and questionnaires); (2) the validity of smartphone-based self-assessed stress compared with validated stress scales was investigated in 3 studies, and of these, only 1 study found a moderate statistically significant positive correlation (r=.4; P<.05); and (3) in exploratory analyses, smartphone-based self-assessed stress was found to correlate with some of the reported smartphone generated objective data, including voice features and data on activity and phone usage. Smartphones are being used to measure self-assessed stress in different contexts. The evidence of the validity of

  13. Evaluation of thermal risk assessment

    International Nuclear Information System (INIS)

    Loos, J.J.; Perry, E.S.

    1993-01-01

    Risk assessment was done in 1983 to estimate the ecological hazard of increasing the generating load and thermal output of an electric generating station. Subsequently, long-term monitoring in the vicinity of the station allowed verification of the predictions made in the risk assessment. This presentation will review the efficacy of early risk assessment methods in producing useful predictions from a resource management point of view. In 1984, the Chalk Point Generating facility of the Potomac Electric Power Company increased it's median generating load by 100%. Prior to this operational change, the Academy of Natural Sciences of Philadelphia synthesized site specific data, model predictions, and results from literature to assess the risk of additional waste heat to the Patuxent River subestuary of Chesapeake Bay. Risk was expressed as the number of days per year that various species of fish and the blue crab would be expected to avoid the discharge vicinity. Accuracy of these predictions is assessed by comparing observed fish and crab distributions and their observed frequencies of avoidance to those predicted. It is concluded that the predictions of this early risk assessment were sufficiently accurate to produce a reliable resource management decision

  14. Multidimensional Assessment of Interoceptive Awareness (MAIA applications: Systematic Review

    Directory of Open Access Journals (Sweden)

    Joana Machorrinho

    2017-04-01

    Full Text Available Objectives: To assess the available evidence on different applications of MAIA. Methods: This research followed three sequenced moments, done by two independent re- searchers. Included only published adult population studies (18-65 years old, which used complete MAIA survey, not only for translation and validation purposes. Data were extracted to predefined tables, showed as a flowchart from PRISMA Statement. Levels of evidence and methodological quality was also assessed. Results: From 66 original studies obtained only 7 were included for analysis. 5 was observational studies, while 2 were experimental and from all, 4 have a strong methodological quality. MAIA was used in both health and clinical samples, at 7 countries from 2 continents. Mostly it was used for interoceptive awareness assessment, as a global concept but also for is subdimensions analysis. Conclusion: We suggest more studies with larger and more heterogeneous samples. Weconcluded that MAIA, when compared with previous questionnaires for interoception assessment, allowed for a more complete and specialized evaluation, but some authors still suggest it can be more complex than it is now. We explore some recommendations for future clinical and scientific applications of MAIA.

  15. Assessment of trust in physician: a systematic review of measures.

    Directory of Open Access Journals (Sweden)

    Evamaria Müller

    Full Text Available Over the last decades, trust in physician has gained in importance. Studies have shown that trust in physician is associated with positive health behaviors in patients. However, the validity of empirical findings fundamentally depends on the quality of the measures in use. Our aim was to provide an overview of trust in physician measures and to evaluate the methodological quality of the psychometric studies and the quality of psychometric properties of identified measures. We conducted an electronic search in three databases (Medline, EMBASE and PsycInfo. The secondary search strategy included reference and citation tracking of included full texts and consultation of experts in the field. Retrieved records were screened independently by two reviewers. Full texts that reported on testing of psychometric properties of trust in physician measures were included in the review. Study characteristics and psychometric properties were extracted. We evaluated the quality of design, methods and reporting of studies with the COnsensus based Standards for the selection of health status Measurement INstruments (COSMIN checklist. The quality of psychometric properties was assessed with Terwee's 2007 quality criteria. After screening 3284 records and assessing 169 full texts for eligibility, fourteen studies on seven trust in physician measures were included. Most of the studies were conducted in the USA and used English measures. All but one measure were generic. Sample sizes range from 25 to 1199 participants, recruited in very heterogeneous settings. Quality assessments revealed several flaws in the methodological quality of studies. COSMIN scores were mainly fair or poor. The overall quality of measures' psychometric properties was intermediate. Several trust in physician measures have been developed over the last years, but further psychometric evaluation of these measures is strongly recommended. The methodological quality of psychometric property studies

  16. Assessing teamwork performance in obstetrics: A systematic search and review of validated tools.

    Science.gov (United States)

    Fransen, Annemarie F; de Boer, Liza; Kienhorst, Dieneke; Truijens, Sophie E; van Runnard Heimel, Pieter J; Oei, S Guid

    2017-09-01

    Teamwork performance is an essential component for the clinical efficiency of multi-professional teams in obstetric care. As patient safety is related to teamwork performance, it has become an important learning goal in simulation-based education. In order to improve teamwork performance, reliable assessment tools are required. These can be used to provide feedback during training courses, or to compare learning effects between different types of training courses. The aim of the current study is to (1) identify the available assessment tools to evaluate obstetric teamwork performance in a simulated environment, and (2) evaluate their psychometric properties in order to identify the most valuable tool(s) to use. We performed a systematic search in PubMed, MEDLINE, and EMBASE to identify articles describing assessment tools for the evaluation of obstetric teamwork performance in a simulated environment. In order to evaluate the quality of the identified assessment tools the standards and grading rules have been applied as recommended by the Accreditation Council for Graduate Medical Education (ACGME) Committee on Educational Outcomes. The included studies were also assessed according to the Oxford Centre for Evidence Based Medicine (OCEBM) levels of evidence. This search resulted in the inclusion of five articles describing the following six tools: Clinical Teamwork Scale, Human Factors Rating Scale, Global Rating Scale, Assessment of Obstetric Team Performance, Global Assessment of Obstetric Team Performance, and the Teamwork Measurement Tool. Based on the ACGME guidelines we assigned a Class 3, level C of evidence, to all tools. Regarding the OCEBM levels of evidence, a level 3b was assigned to two studies and a level 4 to four studies. The Clinical Teamwork Scale demonstrated the most comprehensive validation, and the Teamwork Measurement Tool demonstrated promising results, however it is recommended to further investigate its reliability. Copyright © 2017

  17. Systematic Review: Aesthetic Assessment of Breast Reconstruction Outcomes by Healthcare Professionals.

    Science.gov (United States)

    Maass, Saskia W M C; Bagher, Shaghayegh; Hofer, Stefan O P; Baxter, Nancy N; Zhong, Toni

    2015-12-01

    Achieving an aesthetic outcome following postmastectomy breast reconstruction is both an important goal for the patient and plastic surgeon. However, there is currently an absence of a widely accepted, standardized, and validated professional aesthetic assessment scale following postmastectomy breast reconstruction. A systematic review was performed to identify all articles that provided professional assessment of the aesthetic outcome following postmastectomy, implant- or autologous tissue-based breast reconstruction. A modified version of the Scientific Advisory Committee's Medical Outcomes Trust (MOT) criteria was used to evaluate all professional aesthetic assessment scales identified by our systematic review. The criteria included conceptual framework formation, reliability, validity, responsiveness, interpretability, burden, and correlation with patient-reported outcomes. A total of 120 articles were identified: 52 described autologous breast reconstruction, 37 implant-based reconstruction, and 29 both. Of the 12 different professional aesthetic assessment scales that exist in the literature, the most commonly used scale was the four-point professional aesthetic assessment scale. The highest score on the modified MOT criteria was assigned to the ten-point professional aesthetic assessment scale. However, this scale has limited clinical usefulness due to its poor responsiveness to change, lack of interpretability, and wide range of intra- and inter-rater agreements (Veiga et al. in Ann Plast Surg 48(5):515-520, 2002). A "gold standard" professional aesthetic assessment scale needs to be developed to enhance the comparability of breast reconstruction results across techniques, surgeons, and studies to aid with the selection of procedures that produce the best aesthetic results from both the perspectives of the surgeon and patients.

  18. Advances in Remote Respiratory Assessments for People with Chronic Obstructive Pulmonary Disease: A Systematic Review.

    Science.gov (United States)

    Baroi, Sidney; McNamara, Renae J; McKenzie, David K; Gandevia, Simon; Brodie, Matthew A

    2018-06-01

    Chronic obstructive pulmonary disease (COPD) is a leading cause of mortality. Advances in remote technologies and telemedicine provide new ways to monitor respiratory function and improve chronic disease management. However, telemedicine does not always include remote respiratory assessments, and the current state of knowledge for people with COPD has not been evaluated. Systematically review the use of remote respiratory assessments in people with COPD, including the following questions: What devices have been used? Can acute exacerbations of chronic obstructive pulmonary disease (AECOPD) be predicted by using remote devices? Do remote respiratory assessments improve health-related outcomes? The review protocol was registered (PROSPERO 2016:CRD42016049333). MEDLINE, EMBASE, and COMPENDEX databases were searched for studies that included remote respiratory assessments in people with COPD. A narrative synthesis was then conducted by two reviewers according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Fifteen studies met the inclusion criteria. Forced expiratory volume assessed daily by using a spirometer was the most common modality. Other measurements included resting respiratory rate, respiratory sounds, and end-tidal carbon dioxide level. Remote assessments had high user satisfaction. Benefits included early detection of AECOPD, improved health-related outcomes, and the ability to replace hospital care with a virtual ward. Remote respiratory assessments are feasible and when combined with sufficient organizational backup can improve health-related outcomes in some but not all cohorts. Future research should focus on the early detection, intervention, and rehabilitation for AECOPD in high-risk people who have limited access to best care and investigate continuous as well as intermittent monitoring.

  19. Robotics in general surgery: A systematic cost assessment.

    Science.gov (United States)

    Gkegkes, Ioannis D; Mamais, Ioannis A; Iavazzo, Christos

    2017-01-01

    The utilisation of robotic-assisted techniques is a novelty in the field of general surgery. Our intention was to examine the up to date available literature on the cost assessment of robotic surgery of diverse operations in general surgery. PubMed and Scopus databases were searched in a systematic way to retrieve the included studies in our review. Thirty-one studies were retrieved, referring on a vast range of surgical operations. The mean cost for robotic, open and laparoscopic ranged from 2539 to 57,002, 7888 to 16,851 and 1799 to 50,408 Euros, respectively. The mean operative charges ranged from 273.74 to 13,670 Euros. More specifically, for the robotic and laparoscopic gastric fundoplication, the cost ranged from 1534 to 2257 and 657 to 763 Euros, respectively. For the robotic and laparoscopic colectomy, it ranged from 3739 to 17,080 and 3109 to 33,865 Euros, respectively. For the robotic and laparoscopic cholecystectomy, ranged from 1163.75 to 1291 and from 273.74 to 1223 Euros, respectively. The mean non-operative costs ranged from 900 to 48,796 from 8347 to 8800 and from 870 to 42,055 Euros, for robotic, open and laparoscopic technique, respectively. Conversions to laparotomy were present in 34/18,620 (0.18%) cases of laparoscopic and in 22/1488 (1.5%) cases of robotic technique. Duration of surgery robotic, open and laparoscopic ranged from 54.6 to 328.7, 129 to 234, and from 50.2 to 260 min, respectively. The present evidence reveals that robotic surgery, under specific conditions, has the potential to become cost-effective. Large number of cases, presence of industry competition and multidisciplinary team utilisation are some of the factors that could make more reasonable and cost-effective the robotic-assisted technique.

  20. Are cardiovascular disease risk assessment and management programmes cost effective? A systematic review of the evidence.

    Science.gov (United States)

    Lee, John Tayu; Lawson, Kenny D; Wan, Yizhou; Majeed, Azeem; Morris, Stephen; Soljak, Michael; Millett, Christopher

    2017-06-01

    The World Health Organization recommends that countries implement population-wide cardiovascular disease (CVD) risk assessment and management programmes. The aim of this study was to conduct a systematic review to evaluate whether this recommendation is supported by cost-effectiveness evidence. Published economic evaluations were identified via electronic medical and social science databases (including Medline, Web of Science, and the NHS Economic Evaluation Database) from inception to March 2016. Study quality was evaluated using a modified version of the Consolidated Health Economic Evaluation Reporting Standards. Fourteen economic evaluations were included: five studies based on randomised controlled trials, seven studies based on observational studies and two studies using hypothetical modelling synthesizing secondary data. Trial based studies measured CVD risk factor changes over 1 to 3years, with modelled projections of longer term events. Programmes were either not, or only, cost-effective under non-verified assumptions such as sustained risk factor changes. Most observational and hypothetical studies suggested programmes were likely to be cost-effective; however, study deigns are subject to bias and subsequent empirical evidence has contradicted key assumptions. No studies assessed impacts on inequalities. In conclusion, recommendations for population-wide risk assessment and management programmes lack a robust, real world, evidence basis. Given implementation is resource intensive there is a need for robust economic evaluation, ideally conducted alongside trials, to assess cost effectiveness. Further, the efficiency and equity impact of different delivery models should be investigated, and also the combination of targeted screening with whole population interventions recognising that there multiple approaches to prevention. Copyright © 2017. Published by Elsevier Inc.

  1. A systematic review of childhood maltreatment assessments in population-representative surveys since 1990.

    Science.gov (United States)

    Hovdestad, Wendy; Campeau, Aimée; Potter, Dawn; Tonmyr, Lil

    2015-01-01

    Population-representative surveys that assess childhood maltreatment and health are a valuable resource to explore the implications of child maltreatment for population health. Systematic identification and evaluation of such surveys is needed to facilitate optimal use of their data and to inform future research. To inform researchers of the existence and nature of population-representative surveys relevant to understanding links between childhood maltreatment and health; to evaluate the assessment of childhood maltreatment in this body of work. We included surveys that: 1) were representative of the non-institutionalized population of any size nation or of any geopolitical region ≥ 10 million people; 2) included a broad age range (≥ 40 years); 3) measured health; 4) assessed childhood maltreatment retrospectively; and 5) were conducted since 1990. We used Internet and database searching (including CINAHL, Embase, ERIC, Global Health, MEDLINE, PsycINFO, Scopus, Social Policy and Practice: January 1990 to March 2014), expert consultation, and other means to identify surveys and associated documentation. Translations of non-English survey content were verified by fluent readers of survey languages. We developed checklists to abstract and evaluate childhood maltreatment content. Fifty-four surveys from 39 countries met inclusion criteria. Sample sizes ranged from 1,287-51,945 and response rates from 15%-96%. Thirteen surveys assessed neglect, 15 emotional abuse; 18 exposure to family violence; 26 physical abuse; 48 sexual abuse. Fourteen surveys assessed more than three types; six of these were conducted since 2010. In nine surveys childhood maltreatment assessments were detailed (+10 items for at least one type of maltreatment). Seven surveys' assessments had known reliability and/or validity. Data from 54 surveys can be used to explore the population health relevance of child maltreatment. Assessment of childhood maltreatment is not comprehensive but there is

  2. A Systematic Review of Economic Evaluations of Pacemaker Telemonitoring Systems.

    Science.gov (United States)

    López-Villegas, Antonio; Catalán-Matamoros, Daniel; Martín-Saborido, Carlos; Villegas-Tripiana, Irene; Robles-Musso, Emilio

    2016-02-01

    Over the last decade, telemedicine applied to pacemaker monitoring has undergone extraordinary growth. It is not known if telemonitoring is more or less efficient than conventional monitoring. The aim of this study was to carry out a systematic review analyzing the available evidence on resource use and health outcomes in both follow-up modalities. We searched 11 databases and included studies published up until November 2014. The inclusion criteria were: a) experimental or observational design; b) studies based on complete economic evaluations; c) patients with pacemakers, and d) telemonitoring compared with conventional hospital monitoring. Seven studies met the inclusion criteria, providing information on 2852 patients, with a mean age of 81 years. The main indication for device implantation was atrioventricular block. With telemonitoring, cardiovascular events were detected and treated 2 months earlier than with conventional monitoring, thus reducing length of hospital stay by 34% and reducing routine and emergency hospital visits as well. There were no significant intergroup differences in perceived quality of life or number of adverse events. The cost of telemonitoring was 60% lower than that of conventional hospital monitoring. Compared with conventional monitoring, cardiovascular events were detected earlier and the number or hospitalizations and hospital visits was reduced with pacemaker telemonitoring. In addition, the costs associated with follow-up were lower with telemonitoring. Copyright © 2015 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  3. Evaluating the core microbiota in complex communities: A systematic investigation.

    Science.gov (United States)

    Astudillo-García, Carmen; Bell, James J; Webster, Nicole S; Glasl, Bettina; Jompa, Jamaluddin; Montoya, Jose M; Taylor, Michael W

    2017-04-01

    The study of complex microbial communities poses unique conceptual and analytical challenges, with microbial species potentially numbering in the thousands. With transient or allochthonous microorganisms often adding to this complexity, a 'core' microbiota approach, focusing only on the stable and permanent members of the community, is becoming increasingly popular. Given the various ways of defining a core microbiota, it is prudent to examine whether the definition of the core impacts upon the results obtained. Here we used complex marine sponge microbiotas and undertook a systematic evaluation of the degree to which different factors used to define the core influenced the conclusions. Significant differences in alpha- and beta-diversity were detected using some but not all core definitions. However, findings related to host specificity and environmental quality were largely insensitive to major changes in the core microbiota definition. Furthermore, none of the applied definitions altered our perception of the ecological networks summarising interactions among bacteria within the sponges. These results suggest that, while care should still be taken in interpretation, the core microbiota approach is surprisingly robust, at least for comparing microbiotas of closely related samples. © 2017 Society for Applied Microbiology and John Wiley & Sons Ltd.

  4. Assessing Empathy Development in Medical Education: A Systematic Review

    Science.gov (United States)

    Sulzer, Sandra H.; Feinstein, Noah Weeth; Wendland, Claire

    2016-01-01

    Introduction Empathy in doctor-patient relationships is a familiar topic for medical scholars, and a crucial goal for medical educators. Nonetheless, there are persistent disagreements in the research literature concerning how best to evaluate empathy among physicians, and whether empathy declines or increases across medical education. Some researchers have argued that the instruments used to study “empathy” may not be measuring anything meaningful to clinical practice or to patient satisfaction. Methods We performed a systematic review to learn how empathy is conceptualized in medical education research. How do researchers define the central construct of empathy, and what do they choose to measure? How well do definitions and operationalizations match? Results Among the 109 studies that met our search criteria, 20% failed to define the central construct of empathy at all, and only 13% had an operationalization that was well-matched to the definition provided. The majority of studies were characterized by internal inconsistencies and vagueness in both the conceptualization and operationalization of empathy, constraining the validity and usefulness of the research. The methods most commonly used to measure empathy relied heavily on self-report and cognition divorced from action, and may therefore have limited power to predict the presence or absence of empathy in clinical settings. Finally, the large majority of studies treated empathy itself as a black box, using global construct measurements that are unable to shed light on the underlying processes that produce empathic response. Discussion We suggest that future research should follow the lead of basic scientific research that conceptualizes empathy as relational—an engagement between a subject and an object—rather than a personal quality that may be modified wholesale through appropriate training. PMID:26896015

  5. Assessment Tools for Peripheral Neuropathy in Pediatric Oncology: A Systematic Review From the Children's Oncology Group.

    Science.gov (United States)

    Smolik, Suzanne; Arland, Lesley; Hensley, Mary Ann; Schissel, Debra; Shepperd, Barbara; Thomas, Kristin; Rodgers, Cheryl

    Peripheral neuropathy is a known side effect of several chemotherapy agents, including vinca alkaloids and platinum-based chemotherapy. Early recognition and monitoring of this side effect is an important role of the pediatric oncology nurse. There are a variety of peripheral neuropathy assessment tools currently in use, but the usefulness of these tools in identifying and grading neuropathy in children varies, and there is currently no standardized tool in place to evaluate peripheral neuropathy in pediatric oncology. A systematic review was performed to identify the peripheral neuropathy assessment tools that best evaluate the early onset and progression of peripheral neuropathy in pediatric patients receiving vincristine. Because of the limited information available in pediatric oncology, this review was extended to any pediatric patient with neuropathy. A total of 8 studies were included in the evidence synthesis. Based on available evidence, the pediatric-modified Total Neuropathy Scale (ped-m TNS) and the Total Neuropathy Score-pediatric version (TNS-PV) are recommended for the assessment of vincristine-induced peripheral neuropathy in children 6 years of age and older. In addition, several studies demonstrated that subjective symptoms alone are not adequate to assess for vincristine-induced peripheral neuropathy. Nursing assessment of peripheral neuropathy should be an integral and regular part of patient care throughout the course of chemotherapy treatment.

  6. Causal assessment of occupational pushing or pulling and low back pain: results of a systematic review.

    Science.gov (United States)

    Roffey, Darren M; Wai, Eugene K; Bishop, Paul; Kwon, Brian K; Dagenais, Simon

    2010-06-01

    Low back pain (LBP) is a prevalent and expensive musculoskeletal condition that predominantly occurs in working-age individuals of industrialized nations. Although numerous occupational physical activities have been implicated in its etiology, determining the causation of occupational LBP still remains a challenge. To conduct a systematic review evaluating the causal relationship between occupational pushing or pulling and LBP. Systematic review of the literature. Studies reporting an association between occupational pushing or pulling and LBP. Numerical association between exposure to pushing or pulling and the presence of LBP. A systematic review was performed to identify, evaluate, and summarize the literature related to establishing a causal relationship, according to Bradford-Hill criteria for causation for occupational pushing or pulling and LBP. A search was conducted using Medline, EMBASE, CINAHL, Cochrane Library, and OSH-ROM, gray literature, hand-searching occupational health journals, reference lists of included studies, and expert knowledge. Methodological quality was assessed using a modified Newcastle-Ottawa Scale. This search yielded 2,766 citations. Thirteen studies met the inclusion criteria. Eight were high-quality studies and five were low-quality studies. There was conflicting evidence with one high-quality study demonstrating a positive association between occupational pushing or pulling and LBP and five studies showing no relationship. One study reported a nonstatistically significant dose-response trend, four studies discussed temporality of which one indicated a positive finding, two studies discussed the biological plausibility of a causal link between occupational pushing or pulling and LBP, and no evidence was uncovered to assess the experiment criterion. A qualitative summary of existing studies was not able to find any high-quality studies that fully satisfied any of the Bradford-Hill causation criteria for occupational pushing or

  7. Early economic evaluation of emerging health technologies: protocol of a systematic review

    Science.gov (United States)

    2014-01-01

    Background The concept of early health technology assessment, discussed well over a decade, has now been collaboratively implemented by industry, government, and academia to select and expedite the development of emerging technologies that may address the needs of patients and health systems. Early economic evaluation is essential to assess the value of emerging technologies, but empirical data to inform the current practice of early evaluation is limited. We propose a systematic review of early economic evaluation studies in order to better understand the current practice. Methods/design This protocol describes a systematic review of economic evaluation studies of regulated health technologies in which the evaluation is conducted prior to regulatory approval and when the technology effectiveness is not well established. Included studies must report an economic evaluation, defined as the comparative analysis of alternatives with respect to their associated costs and health consequences, and must evaluate some regulated health technology such as pharmaceuticals, biologics, high-risk medical devices, or biomarkers. We will conduct the literature search on multiple databases, including MEDLINE, EMBASE, the Centre for Reviews and Dissemination Databases, and EconLit. Additional citations will be identified via scanning reference lists and author searching. We suspect that many early economic evaluation studies are unpublished, especially those conducted for internal use only. Additionally, we use a chain-referral sampling approach to identify authors of unpublished studies who work in technology discovery and development, starting out with our contact lists and authors who published relevant studies. Citation screening and full-text review will be conducted by pairs of reviewers. Abstracted data will include those related to the decision context and decision problem of the early evaluation, evaluation methods (e.g., data sources, methods, and assumptions used to

  8. Quantitative assessment of course evaluations

    DEFF Research Database (Denmark)

    Sliusarenko, Tamara

    of the student non-response on SETs. In order to utilize information from open-ended qualitative student answers, text-mining methods were applied in order to extract points of students praise and complaints. The methods proposed contribute to the knowledge about student evaluation at the Technical University...

  9. Digital pathology: A systematic evaluation of the patent landscape

    Directory of Open Access Journals (Sweden)

    Ioan C. Cucoranu

    2014-01-01

    Full Text Available Introduction: Digital pathology is a relatively new field. Inventors of technology in this field typically file for patents to protect their intellectual property. An understanding of the patent landscape is crucial for companies wishing to secure patent protection and market dominance for their products. To our knowledge, there has been no prior systematic review of patents related to digital pathology. Therefore, the aim of this study was to systematically identify and evaluate United States patents and patent applications related to digital pathology. Materials and Methods: Issued patents and patent applications related to digital pathology published in the United States Patent and Trademark Office (USPTO database (www.uspto.gov (through January 2014 were searched using the Google Patents search engine (Google Inc., Mountain View, California, USA. Keywords and phrases related to digital pathology, whole-slide imaging (WSI, image analysis, and telepathology were used to query the USPTO database. Data were downloaded and analyzed using the Papers application (Mekentosj BV, Aalsmeer, Netherlands. Results: A total of 588 United States patents that pertain to digital pathology were identified. In addition, 228 patent applications were identified, including 155 that were pending, 65 abandoned, and eight rejected. Of the 588 patents granted, 348 (59.18% were specific to pathology, while 240 (40.82% included more general patents also usable outside of pathology. There were 70 (21.12% patents specific to pathology and 57 (23.75% more general patents that had expired. Over 120 unique entities (individual inventors, academic institutions, and private companies applied for pathology specific patents. Patents dealt largely with telepathology and image analysis. WSI related patents addressed image acquisition (scanning and focus, quality (z-stacks, management (storage, retrieval, and transmission of WSI files, and viewing (graphical user interface (GUI

  10. Digital pathology: A systematic evaluation of the patent landscape.

    Science.gov (United States)

    Cucoranu, Ioan C; Parwani, Anil V; Vepa, Suryanarayana; Weinstein, Ronald S; Pantanowitz, Liron

    2014-01-01

    Digital pathology is a relatively new field. Inventors of technology in this field typically file for patents to protect their intellectual property. An understanding of the patent landscape is crucial for companies wishing to secure patent protection and market dominance for their products. To our knowledge, there has been no prior systematic review of patents related to digital pathology. Therefore, the aim of this study was to systematically identify and evaluate United States patents and patent applications related to digital pathology. Issued patents and patent applications related to digital pathology published in the United States Patent and Trademark Office (USPTO) database (www.uspto.gov) (through January 2014) were searched using the Google Patents search engine (Google Inc., Mountain View, California, USA). Keywords and phrases related to digital pathology, whole-slide imaging (WSI), image analysis, and telepathology were used to query the USPTO database. Data were downloaded and analyzed using the Papers application (Mekentosj BV, Aalsmeer, Netherlands). A total of 588 United States patents that pertain to digital pathology were identified. In addition, 228 patent applications were identified, including 155 that were pending, 65 abandoned, and eight rejected. Of the 588 patents granted, 348 (59.18%) were specific to pathology, while 240 (40.82%) included more general patents also usable outside of pathology. There were 70 (21.12%) patents specific to pathology and 57 (23.75%) more general patents that had expired. Over 120 unique entities (individual inventors, academic institutions, and private companies) applied for pathology specific patents. Patents dealt largely with telepathology and image analysis. WSI related patents addressed image acquisition (scanning and focus), quality (z-stacks), management (storage, retrieval, and transmission of WSI files), and viewing (graphical user interface (GUI), workflow, slide navigation and remote control). An

  11. Photogrammetry as a tool for the postural evaluation of the spine: A systematic review.

    Science.gov (United States)

    Furlanetto, Tássia Silveira; Sedrez, Juliana Adami; Candotti, Cláudia Tarragô; Loss, Jefferson Fagundes

    2016-02-18

    To evaluate the use of photogrammetry and identify the mathematical procedures applied when evaluating spinal posture. A systematic search using keywords was conducted in the PubMed, EMBASE, Scopus, Science and Medicine(®) databases. The following inclusion criteria adopted were: (1) the use of photogrammetry as a method to evaluate spinal posture; (2) evaluations of spinal curvature in the sagittal and/or frontal plane; (3) studies published within the last three decades; and (4) written entirely in English. The exclusion criteria were: (1) studies which objective involved the verification of some aspect of validation of instruments; (2) studies published as abstracts and those published in scientific events; and (3) studies using evaluation of the anteriorization of the head to determine the angular positioning of the cervical spine. The articles in this review were included and evaluated for their methodological quality, based on the Downs and Black scale, by two independent reviewers. Initially, 1758 articles were found, 76 of which were included upon reading the full texts and 29 were included in accordance with the predetermined criteria. In addition, after analyzing the references in those articles, a further six articles were selected, so that 35 articles were included in this review. This systematic review revealed that the photogrammetry has been using in observational studies. Furthermore, it was also found that, although the data collection methodologies are similar across the studies, in relation to aspects of data analysis, the methodologies are very different, especially regarding the mathematical routines employed to support different postural evaluation software. With photogrammetry, the aim of the assessment, whether it is for clinical, research or collective health purposes, must be considered when choosing which protocol to use to evaluate spinal posture.

  12. Economic evaluation studies in reproductive medicine: a systematic review of methodologic quality

    NARCIS (Netherlands)

    Moolenaar, Lobke M.; Vijgen, Sylvia M. C.; Hompes, Peter; van der Veen, Fulco; Mol, Ben Willem J.; Opmeer, Brent C.

    2013-01-01

    To evaluate the methodologic quality of economic analyses published in the field of reproductive medicine. Systematic review. Centers for reproductive care. Infertility patients. We performed a Medline search to identify economic evaluation studies in reproductive medicine. We included studies that

  13. Diagnostic validity of methods for assessment of swallowing sounds: a systematic review.

    Science.gov (United States)

    Taveira, Karinna Veríssimo Meira; Santos, Rosane Sampaio; Leão, Bianca Lopes Cavalcante de; Neto, José Stechman; Pernambuco, Leandro; Silva, Letícia Korb da; De Luca Canto, Graziela; Porporatti, André Luís

    2018-02-03

    Oropharyngeal dysphagia is a highly prevalent comorbidity in neurological patients and presents a serious health threat, which may lead to outcomes of aspiration pneumonia, ranging from hospitalization to death. This assessment proposes a non-invasive, acoustic-based method to differentiate between individuals with and without signals of penetration and aspiration. This systematic review evaluated the diagnostic validity of different methods for assessment of swallowing sounds, when compared to Videofluroscopic of Swallowing Study (VFSS) to detect oropharyngeal dysphagia. Articles in which the primary objective was to evaluate the accuracy of swallowing sounds were searched in five electronic databases with no language or time limitations. Accuracy measurements described in the studies were transformed to construct receiver operating characteristic curves and forest plots with the aid of Review Manager v. 5.2 (The Nordic Cochrane Centre, Copenhagen, Denmark). The methodology of the selected studies was evaluated using the Quality Assessment Tool for Diagnostic Accuracy Studies-2. The final electronic search revealed 554 records, however only 3 studies met the inclusion criteria. The accuracy values (area under the curve) were 0.94 for microphone, 0.80 for Doppler, and 0.60 for stethoscope. Based on limited evidence and low methodological quality because few studies were included, with a small sample size, from all index testes found for this systematic review, Doppler showed excellent diagnostic accuracy for the discrimination of swallowing sounds, whereas microphone-reported good accuracy discrimination of swallowing sounds of dysphagic patients and stethoscope showed best screening test. Copyright © 2018 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  14. The assessment of creativity in creativity/psychopathology research - a systematic review.

    Science.gov (United States)

    Thys, E; Sabbe, B; De Hert, M

    2014-01-01

    The possible link between creativity and psychopathology has been a long time focus of research up to the present day. However, this research is hampered by methodological problems, especially the definition and assessment of creativity. This makes interpretation and comparison of studies difficult and possibly accounts for the contradictory results of this research. In this systematic review of the literature, research articles in the field of creativity and psychopathology were searched for creativity assessment tools. The tools used in the collected articles are presented and discussed. The results indicate that a multitude of creativity assessment tools were used, that many studies only used one tool to assess creativity and that most of these tools were only used in a limited number of studies. A few assessment tools stand out by a more frequent use, also outside psychopathological research, and more solid psychometric properties. Most scales used to evaluate creativity have poor psychometric properties. The scattered methodology to assess creativity compromises the generalizability and validity of this research. The field should creatively develop new validated instruments.

  15. A systematic approach to assessing the clinical significance of genetic variants.

    Science.gov (United States)

    Duzkale, H; Shen, J; McLaughlin, H; Alfares, A; Kelly, M A; Pugh, T J; Funke, B H; Rehm, H L; Lebo, M S

    2013-11-01

    Molecular genetic testing informs diagnosis, prognosis, and risk assessment for patients and their family members. Recent advances in low-cost, high-throughput DNA sequencing and computing technologies have enabled the rapid expansion of genetic test content, resulting in dramatically increased numbers of DNA variants identified per test. To address this challenge, our laboratory has developed a systematic approach to thorough and efficient assessments of variants for pathogenicity determination. We first search for existing data in publications and databases including internal, collaborative and public resources. We then perform full evidence-based assessments through statistical analyses of observations in the general population and disease cohorts, evaluation of experimental data from in vivo or in vitro studies, and computational predictions of potential impacts of each variant. Finally, we weigh all evidence to reach an overall conclusion on the potential for each variant to be disease causing. In this report, we highlight the principles of variant assessment, address the caveats and pitfalls, and provide examples to illustrate the process. By sharing our experience and providing a framework for variant assessment, including access to a freely available customizable tool, we hope to help move towards standardized and consistent approaches to variant assessment. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  16. Drug repurposing: a systematic approach to evaluate candidate oral neuroprotective interventions for secondary progressive multiple sclerosis.

    Directory of Open Access Journals (Sweden)

    Hanna M Vesterinen

    Full Text Available To develop and implement an evidence based framework to select, from drugs already licenced, candidate oral neuroprotective drugs to be tested in secondary progressive multiple sclerosis.Systematic review of clinical studies of oral putative neuroprotective therapies in MS and four other neurodegenerative diseases with shared pathological features, followed by systematic review and meta-analyses of the in vivo experimental data for those interventions. We presented summary data to an international multi-disciplinary committee, which assessed each drug in turn using pre-specified criteria including consideration of mechanism of action.We identified a short list of fifty-two candidate interventions. After review of all clinical and pre-clinical evidence we identified ibudilast, riluzole, amiloride, pirfenidone, fluoxetine, oxcarbazepine, and the polyunsaturated fatty-acid class (Linoleic Acid, Lipoic acid; Omega-3 fatty acid, Max EPA oil as lead candidates for clinical evaluation.We demonstrate a standardised and systematic approach to candidate identification for drug rescue and repurposing trials that can be applied widely to neurodegenerative disorders.

  17. A systematic literature review of open source software quality assessment models.

    Science.gov (United States)

    Adewumi, Adewole; Misra, Sanjay; Omoregbe, Nicholas; Crawford, Broderick; Soto, Ricardo

    2016-01-01

    Many open source software (OSS) quality assessment models are proposed and available in the literature. However, there is little or no adoption of these models in practice. In order to guide the formulation of newer models so they can be acceptable by practitioners, there is need for clear discrimination of the existing models based on their specific properties. Based on this, the aim of this study is to perform a systematic literature review to investigate the properties of the existing OSS quality assessment models by classifying them with respect to their quality characteristics, the methodology they use for assessment, and their domain of application so as to guide the formulation and development of newer models. Searches in IEEE Xplore, ACM, Science Direct, Springer and Google Search is performed so as to retrieve all relevant primary studies in this regard. Journal and conference papers between the year 2003 and 2015 were considered since the first known OSS quality model emerged in 2003. A total of 19 OSS quality assessment model papers were selected. To select these models we have developed assessment criteria to evaluate the quality of the existing studies. Quality assessment models are classified into five categories based on the quality characteristics they possess namely: single-attribute, rounded category, community-only attribute, non-community attribute as well as the non-quality in use models. Our study reflects that software selection based on hierarchical structures is found to be the most popular selection method in the existing OSS quality assessment models. Furthermore, we found that majority (47%) of the existing models do not specify any domain of application. In conclusion, our study will be a valuable contribution to the community and helps the quality assessment model developers in formulating newer models and also to the practitioners (software evaluators) in selecting suitable OSS in the midst of alternatives.

  18. The design, implementation, and evaluation of online credit nutrition courses: a systematic review.

    Science.gov (United States)

    Cohen, Nancy L; Carbone, Elena T; Beffa-Negrini, Patricia A

    2011-01-01

    To assess how postsecondary online nutrition education courses (ONEC) are delivered, determine ONEC effectiveness, identify theoretical models used, and identify future research needs. Systematic search of database literature. Postsecondary education. Nine research articles evaluating postsecondary ONEC. Knowledge/performance outcomes and student satisfaction, motivation, or perceptions. Systematic search of 922 articles and review of 9 articles meeting search criteria. Little research regarding ONEC marketing/management existed. Studies primarily evaluated introductory courses using email/websites (before 2000), or course management systems (after 2002). None used true experimental designs; just 3 addressed validity or reliability of measures or pilot-tested instruments. Three articles used theoretical models in course design; few used theories to guide evaluations. Four quasi-experimental studies indicated no differences in nutrition knowledge/performance between online and face-to-face learners. Results were inconclusive regarding student satisfaction, motivation, or perceptions. Students can gain knowledge in online as well as in face-to-face nutrition courses, but satisfaction was mixed. More up-to-date investigations on effective practices are warranted, using theories to identify factors that enhance student outcomes, addressing emerging technologies, and documenting ONEC marketing, management, and delivery. Adequate training/support for faculty is needed to improve student experiences and faculty time management. Copyright © 2011 Society for Nutrition Education. Published by Elsevier Inc. All rights reserved.

  19. A protocol for a systematic review of the use of process evaluations in knowledge translation research.

    Science.gov (United States)

    Scott, Shannon D; Rotter, Thomas; Hartling, Lisa; Chambers, Thane; Bannar-Martin, Katherine H

    2014-12-23

    Experimental designs for evaluating knowledge translation (KT) interventions for professional behavior change can provide strong estimates of intervention effectiveness but offer limited insight how the intervention worked or not. Furthermore, trials provide little insight into the ways through which interventions lead to behavior change and how they are moderated by different facilitators and barriers. As a result, the ability to generalize the findings from one study to a different context, organization, or clinical problem is severely compromised. Consequently, researchers have started to explore the causal mechanisms in complementary studies (process evaluations) alongside experimental designs for evaluating KT interventions. This study focuses on improving process evaluations by synthesizing current evidence on process evaluations conducted alongside experimental designs for evaluating KT interventions. A medical research librarian will develop and implement search strategies designed to identify evidence that is relevant to process evaluations in health research. Studies will not be excluded based on design. Included studies must contain a process evaluation component aimed at understanding or evaluating a KT intervention targeting professional behavior change. Two reviewers will perform study selection, quality assessment, and data extraction using standard forms. Disagreements will be resolved through discussion or third party adjudication. Data to be collected include study design, details about data collection approaches and types, theoretical influences, approaches to evaluate intervention dose delivered, intervention dose received, intervention fidelity, intervention reach, data analysis, and study outcomes. This study is not registered with PROSPERO. There is widespread acceptance that the generalizability of quantitative trials of KT interventions would be significantly enhanced to other contexts, health professional groups, and clinical conditions

  20. Ultraweak photon emission as a non-invasive health assessment: A systematic review

    NARCIS (Netherlands)

    Ives, J.A.; Wijk, E.P.A. van; Bat, N.; Crawford, C.; Walter, A.; Jonas, W.B.; Wijk, R. van; Greef, J. van der

    2014-01-01

    We conducted a systematic review (SR) of the peer reviewed scientific literature on ultraweak photon emissions (UPE) from humans. The question was: Can ultraweak photon emissions from humans be used as a non-invasive health assessment? A systematic search was conducted across eight relevant

  1. Reliability and validity of the Wii Balance Board for assessment of standing balance: A systematic review.

    Science.gov (United States)

    Clark, Ross A; Mentiplay, Benjamin F; Pua, Yong-Hao; Bower, Kelly J

    2018-03-01

    The use of force platform technologies to assess standing balance is common across a range of clinical areas. Numerous researchers have evaluated the low-cost Wii Balance Board (WBB) for its utility in assessing balance, with variable findings. This review aimed to systematically evaluate the reliability and concurrent validity of the WBB for assessment of static standing balance. Articles were retrieved from six databases (Medline, SCOPUS, EMBASE, CINAHL, Web of Science, Inspec) from 2007 to 2017. After independent screening by two reviewers, 25 articles were included. Two reviewers performed the data extraction and quality assessment. Test-retest reliability was investigated in 12 studies, with intraclass correlation coefficients or Pearson's correlation values showing a range from poor to excellent reliability (range: 0.27 to 0.99). Concurrent validity (i.e. comparison with another force platform) was examined in 21 studies, and was generally found to be excellent in studies examining the association between the same outcome measures collected on both devices. For studies reporting predominantly poor to moderate validity, potentially influential factors included the choice of 1) criterion reference (e.g. not a common force platform), 2) test duration (e.g. balance. Protocol registration number: PROSPERO 2017: CRD42017058122. Copyright © 2018 Elsevier B.V. All rights reserved.

  2. Assessment of the uncertainty associated with systematic errors in digital instruments: an experimental study on offset errors

    International Nuclear Information System (INIS)

    Attivissimo, F; Giaquinto, N; Savino, M; Cataldo, A

    2012-01-01

    This paper deals with the assessment of the uncertainty due to systematic errors, particularly in A/D conversion-based instruments. The problem of defining and assessing systematic errors is briefly discussed, and the conceptual scheme of gauge repeatability and reproducibility is adopted. A practical example regarding the evaluation of the uncertainty caused by the systematic offset error is presented. The experimental results, obtained under various ambient conditions, show that modelling the variability of systematic errors is more problematic than suggested by the ISO 5725 norm. Additionally, the paper demonstrates the substantial difference between the type B uncertainty evaluation, obtained via the maximum entropy principle applied to manufacturer's specifications, and the type A (experimental) uncertainty evaluation, which reflects actually observable reality. Although it is reasonable to assume a uniform distribution of the offset error, experiments demonstrate that the distribution is not centred and that a correction must be applied. In such a context, this work motivates a more pragmatic and experimental approach to uncertainty, with respect to the directions of supplement 1 of GUM. (paper)

  3. Qualitative Evaluation Methods in Ethics Education: A Systematic Review and Analysis of Best Practices.

    Science.gov (United States)

    Watts, Logan L; Todd, E Michelle; Mulhearn, Tyler J; Medeiros, Kelsey E; Mumford, Michael D; Connelly, Shane

    2017-01-01

    Although qualitative research offers some unique advantages over quantitative research, qualitative methods are rarely employed in the evaluation of ethics education programs and are often criticized for a lack of rigor. This systematic review investigated the use of qualitative methods in studies of ethics education. Following a review of the literature in which 24 studies were identified, each study was coded based on 16 best practices characteristics in qualitative research. General thematic analysis and grounded theory were found to be the dominant approaches used. Researchers are effectively executing a number of best practices, such as using direct data sources, structured data collection instruments, non-leading questioning, and expert raters. However, other best practices were rarely present in the courses reviewed, such as collecting data using multiple sources, methods, raters, and timepoints, evaluating reliability, and employing triangulation analyses to assess convergence. Recommendations are presented for improving future qualitative research studies in ethics education.

  4. Standardized assessment of psychosocial factors and their influence on medically confirmed health outcomes in workers: a systematic review.

    Science.gov (United States)

    Rosário, Susel; Fonseca, João A; Nienhaus, Albert; da Costa, José Torres

    2016-01-01

    Previous studies of psychosocial work factors have indicated their importance for workers' health. However, to what extent health problems can be attributed to the nature of the work environment or other psychosocial factors is not clear. No previous systematic review has used inclusion criteria based on specific medical evaluation of work-related health outcomes and the use of validated instruments for the assessment of the psychosocial (work) environment. The aim of this systematic review is to summarize the evidence assessing the relationship between the psychosocial work environment and workers' health based on studies that used standardized and validated instruments to assess the psychosocial work environment and that focused on medically confirmed health outcomes. A systematic review of the literature was carried out by searching the databases PubMed, B-ON, Science Direct, Psycarticles, Psychology and Behavioral Sciences Collection and the search engine (Google Scholar) using appropriate words for studies published from 2004 to 2014. This review follows the recommendations of the Statement for Reporting Systematic Reviews (PRISMA). Studies were included in the review if data on psychosocial validated assessment method(s) for the study population and specific medical evaluation of health-related work outcome(s) were presented. In total, the search strategy yielded 10,623 references, of which 10 studies (seven prospective cohort and three cross-sectional) met the inclusion criteria. Most studies (7/10) observed an adverse effect of poor psychosocial work factors on workers' health: 3 on sickness absence, 4 on cardiovascular diseases. The other 3 studies reported detrimental effects on sleep and on disease-associated biomarkers. A more consistent effect was observed in studies of higher methodological quality that used a prospective design jointly with the use of validated instruments for the assessment of the psychosocial (work) environment and clinical

  5. Systematic approach for assessment of accident risks in chemical and nuclear processing

    International Nuclear Information System (INIS)

    Senne Junior, Murillo

    2003-07-01

    The industrial accidents which occurred in the last years, particularly in the 80's, contributed a significant way to draw the attention of the government, industry and the society as a whole to the mechanisms for preventing events that could affect people's safety and the environment quality. Techniques and methods extensively used the nuclear, aeronautic and war industries so far were adapted to performing analysis and evaluation of the risks associated to other industrial activities, especially in the petroleum, chemistry and petrochemical areas. The risk analysis in industrial facilities is carried out through the evaluation of the probability or frequency of the accidents and their consequences. However, no systematized methodology that could supply the tools for identifying possible accidents likely to take place in an installation is available in the literature. Neither existing are methodologies for the identification of the models for evaluation of the accidents' consequences nor for the selection of the available techniques for qualitative or quantitative analysis of the possibility of occurrence of the accident being focused. The objective of this work is to develop and implement a methodology for identification of the risks of accidents in chemical and nuclear processing facilities as well as for the evaluation of their consequences on persons. For the development of the methodology, the main possible accidents that could occur in such installations were identified and the qualitative and quantitative techniques available for the identification of the risks and for the evaluation of the consequences of each identified accidents were selected. The use of the methodology was illustrated by applying it in two case examples adapted from the literature, involving accidents with inflammable, explosives, and radioactive materials. The computer code MRA - Methodology for Risk Assessment was developed using DELPHI, version 5.0, with the purpose of systematizing

  6. Evaluating the impact of healthcare provider training to improve tuberculosis management: a systematic review of methods and outcome indicators used.

    Science.gov (United States)

    Wu, Shishi; Roychowdhury, Imara; Khan, Mishal

    2017-03-01

    Developing human resources capacity is vital for tuberculosis (TB) control in low- and middle-income countries. Although investments in TB healthcare provider (HCP) training programmes have increased, it is unclear whether these are robustly evaluated. The objective of this systematic review was to synthesize the methods and outcome indicators used to assess TB HCP training programmes. A systematic scoping review of publications reporting on evaluations of training programmes for TB HCPs - including doctors, nurses, paramedics, and lay health workers - was conducted through a search in three electronic databases, Google Scholar, and five websites of non-profit organizations. Data on the study location, population trained, outcomes assessed, and evaluation approach were extracted. After screening 499 unique publications, 21 were eligible for inclusion in the analysis. The majority of evaluations were conducted in Africa. The most common evaluation methods were a review of patient records (n=8, 38%) and post-training interview with trainees (n=7, 33%). In terms of outcomes, more than half of the studies (n=12, 57%) evaluated knowledge acquisition of trainees, with only six (29%) assessing on-the-job behaviour change. Even though more funds have been invested in TB HCP training, publications from robust evaluations assessing the impact on quality of care and behaviour change are limited. Copyright © 2016. Published by Elsevier Ltd.

  7. Reliability and Measurement Error of Tensiomyography to Assess Mechanical Muscle Function: A Systematic Review.

    Science.gov (United States)

    Martín-Rodríguez, Saúl; Loturco, Irineu; Hunter, Angus M; Rodríguez-Ruiz, David; Munguia-Izquierdo, Diego

    2017-12-01

    Martín-Rodríguez, S, Loturco, I, Hunter, AM, Rodríguez-Ruiz, D, and Munguia-Izquierdo, D. Reliability and measurement error of tensiomyography to assess mechanical muscle function: A systematic review. J Strength Cond Res 31(12): 3524-3536, 2017-Interest in studying mechanical skeletal muscle function through tensiomyography (TMG) has increased in recent years. This systematic review aimed to (a) report the reliability and measurement error of all TMG parameters (i.e., maximum radial displacement of the muscle belly [Dm], contraction time [Tc], delay time [Td], half-relaxation time [½ Tr], and sustained contraction time [Ts]) and (b) to provide critical reflection on how to perform accurate and appropriate measurements for informing clinicians, exercise professionals, and researchers. A comprehensive literature search was performed of the Pubmed, Scopus, Science Direct, and Cochrane databases up to July 2017. Eight studies were included in this systematic review. Meta-analysis could not be performed because of the low quality of the evidence of some studies evaluated. Overall, the review of the 9 studies involving 158 participants revealed high relative reliability (intraclass correlation coefficient [ICC]) for Dm (0.91-0.99); moderate-to-high ICC for Ts (0.80-0.96), Tc (0.70-0.98), and ½ Tr (0.77-0.93); and low-to-high ICC for Td (0.60-0.98), independently of the evaluated muscles. In addition, absolute reliability (coefficient of variation [CV]) was low for all TMG parameters except for ½ Tr (CV = >20%), whereas measurement error indexes were high for this parameter. In conclusion, this study indicates that 3 of the TMG parameters (Dm, Td, and Tc) are highly reliable, whereas ½ Tr demonstrate insufficient reliability, and thus should not be used in future studies.

  8. The role of feedback in improving the effectiveness of workplace based assessments: a systematic review.

    Science.gov (United States)

    Saedon, Habiba; Salleh, Shizalia; Balakrishnan, Arun; Imray, Christopher H E; Saedon, Mahmud

    2012-05-02

    With recent emphasis placed on workplace based assessment (WBA) as a method of formative performance assessment, there is limited evidence in the current literature regarding the role of feedback in improving the effectiveness of WBA. The aim of this systematic review was to elucidate the impact of feedback on the effectiveness of WBA in postgraduate medical training. Searches were conducted using the following bibliographic databases to identify original published studies related to WBA and the role of feedback: Medline (1950-December 2010), Embase (1980-December 2010) and Journals@Ovid (English language only, 1996-December 2010). Studies which attempted to evaluate the role of feedback in WBA involving postgraduate doctors were included. 15 identified studies met the inclusion criteria and minimum quality threshold. They were heterogeneous in methodological design. 7 studies focused on multi source feedback, 3 studies were based on mini-clinical evaluation exercise, 2 looked at procedural based assessment, one study looked at workplace based assessments in general and 2 studies looked at a combination of 3 to 6 workplace based assessments. 7 studies originated from the United Kingdom. Others were from Canada, the United States and New Zealand. Study populations were doctors in various grades of training from a wide range of specialties including general practice, general medicine, general surgery, dermatology, paediatrics and anaesthetics. All studies were prospective in design, and non-comparative descriptive or observational studies using a variety of methods including questionnaires, one to one interviews and focus groups. The evidence base contains few high quality conclusive studies and more studies are required to provide further evidence for the effect of feedback from workplace based assessment on subsequent performance. There is, however, good evidence that if well implemented, feedback from workplace based assessments, particularly multisource feedback

  9. The role of feedback in improving the effectiveness of workplace based assessments: a systematic review

    Directory of Open Access Journals (Sweden)

    Saedon Habiba

    2012-05-01

    Full Text Available Abstract Background With recent emphasis placed on workplace based assessment (WBA as a method of formative performance assessment, there is limited evidence in the current literature regarding the role of feedback in improving the effectiveness of WBA. The aim of this systematic review was to elucidate the impact of feedback on the effectiveness of WBA in postgraduate medical training. Methods Searches were conducted using the following bibliographic databases to identify original published studies related to WBA and the role of feedback: Medline (1950-December 2010, Embase (1980-December 2010 and Journals@Ovid (English language only, 1996-December 2010. Studies which attempted to evaluate the role of feedback in WBA involving postgraduate doctors were included. Results 15 identified studies met the inclusion criteria and minimum quality threshold. They were heterogeneous in methodological design. 7 studies focused on multi source feedback, 3 studies were based on mini-clinical evaluation exercise, 2 looked at procedural based assessment, one study looked at workplace based assessments in general and 2 studies looked at a combination of 3 to 6 workplace based assessments. 7 studies originated from the United Kingdom. Others were from Canada, the United States and New Zealand. Study populations were doctors in various grades of training from a wide range of specialties including general practice, general medicine, general surgery, dermatology, paediatrics and anaesthetics. All studies were prospective in design, and non-comparative descriptive or observational studies using a variety of methods including questionnaires, one to one interviews and focus groups. Conclusions The evidence base contains few high quality conclusive studies and more studies are required to provide further evidence for the effect of feedback from workplace based assessment on subsequent performance. There is, however, good evidence that if well implemented, feedback from

  10. Cross-cultural validity of standardized motor development screening and assessment tools: a systematic review.

    Science.gov (United States)

    Mendonça, Bianca; Sargent, Barbara; Fetters, Linda

    2016-12-01

    To investigate whether standardized motor development screening and assessment tools that are used to evaluate motor abilities of children aged 0 to 2 years are valid in cultures other than those in which the normative sample was established. This was a systematic review in which six databases were searched. Studies were selected based on inclusion/exclusion criteria and appraised for evidence level and quality. Study variables were extracted. Twenty-three studies representing six motor development screening and assessment tools in 16 cultural contexts met the inclusion criteria: Alberta Infant Motor Scale (n=7), Ages and Stages Questionnaire, 3rd edition (n=2), Bayley Scales of Infant and Toddler Development, 3rd edition (n=8), Denver Developmental Screening Test, 2nd edition (n=4), Harris Infant Neuromotor Test (n=1), and Peabody Developmental Motor Scales, 2nd edition (n=1). Thirteen studies found significant differences between the cultural context and normative sample. Two studies established reliability and/or validity of standardized motor development assessments in high-risk infants from different cultural contexts. Five studies established new population norms. Eight studies described the cross-cultural adaptation of a standardized motor development assessment. Standardized motor development assessments have limited validity in cultures other than that in which the normative sample was established. Their use can result in under- or over-referral for services. © 2016 Mac Keith Press.

  11. A Systematic Review on Existing Measures for the Subjective Assessment of Rehabilitation and Assistive Robot Devices

    Directory of Open Access Journals (Sweden)

    Yiannis Koumpouros

    2016-01-01

    Full Text Available The objective of the current study is to identify and classify outcome measures currently used for the assessment of rehabilitation or assistive robot devices. We conducted a systematic review of the literature using PubMed, MEDLINE, CIRRIE, and Scopus databases for studies that assessed rehabilitation or assistive robot devices from 1980 through January 2016. In all, 31 articles met all inclusion criteria. Tailor-made questionnaires were the most commonly used tool at 66.7%, while the great majority (93.9% of the studies used nonvalidated instruments. The study reveals the absence of a standard scale which makes it difficult to compare the results from different researchers. There is a great need, therefore, for a valid and reliable instrument to be available for use by the intended end users for the subjective assessment of robot devices. The study concludes by identifying two scales that have been validated in general assistive technology devices and could support the scope of subjective assessment in rehabilitation or assistive robots (however, with limited coverage and a new one called PYTHEIA, recently published. The latter intends to close the gap and help researchers and developers to evaluate, assess, and produce products that satisfy the real needs of the end users.

  12. Dietary assessment methods for micronutrient intake in elderly people: a systematic review

    NARCIS (Netherlands)

    Ortiz-Andrellucchi, A.; Sanzech-Villegas, A.; Doreste-Alonso, J.; Vries, de J.H.M.; Groot, de C.P.G.M.; Serra-Majem, L.

    2009-01-01

    The European micronutrient recommendations aligned (EURRECA) Network of Excellence seeks to establish clear guidelines for assessing the validity of reported micronutrient intakes among vulnerable population groups. A systematic literature review identified studies validating the methodology used in

  13. Building Assessment Survey and Evaluation Data (BASE)

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Building Assessment Survey and Evaluation (BASE) study was a five year study to characterize determinants of indoor air quality and occupant perceptions in...

  14. Investigating Key Psychometric Properties of the French Version of the Early Years Evaluation-Teacher Assessment

    Science.gov (United States)

    Laurie, Robert; Sloat, Elizabeth

    2016-01-01

    This research investigates key psychometric properties of the French Early Years Evaluation-Teacher Assessment measure designed to systematically assess kindergarten children across five social and academic developmental domains: awareness of self and environment, social skills and behaviour, cognitive abilities, language and communication, and…

  15. Toward a consensus definition of pathological video-gaming: a systematic review of psychometric assessment tools.

    Science.gov (United States)

    King, Daniel L; Haagsma, Maria C; Delfabbro, Paul H; Gradisar, Michael; Griffiths, Mark D

    2013-04-01

    Pathological video-gaming, or its proposed DSM-V classification of "Internet Use Disorder", is of increasing interest to scholars and practitioners in allied health disciplines. This systematic review was designed to evaluate the standards in pathological video-gaming instrumentation, according to Cicchetti (1994) and Groth-Marnat's (2009) criteria and guidelines for sound psychometric assessment. A total of 63 quantitative studies, including eighteen instruments and representing 58,415 participants, were evaluated. Results indicated that reviewed instrumentation may be broadly characterized as inconsistent. Strengths of available measures include: (i) short length and ease of scoring, (ii) excellent internal consistency and convergent validity, and (iii) potentially adequate data for development of standardized norms for adolescent populations. However, key limitations included: (a) inconsistent coverage of core addiction indicators, (b) varying cut-off scores to indicate clinical status, (c) a lack of a temporal dimension, (d) untested or inconsistent dimensionality, and (e) inadequate data on predictive validity and inter-rater reliability. An emerging consensus suggests that pathological video-gaming is commonly defined by (1) withdrawal, (2) loss of control, and (3) conflict. It is concluded that a unified approach to assessment of pathological video-gaming is needed. A synthesis of extant research efforts by meta-analysis may be difficult in the context of several divergent approaches to assessment. Copyright © 2013 Elsevier Ltd. All rights reserved.

  16. Economic evaluation of pediatric influenza immunization program compared with other pediatric immunization programs: A systematic review.

    Science.gov (United States)

    Gibson, Edward; Begum, Najida; Sigmundsson, Birgir; Sackeyfio, Alfred; Hackett, Judith; Rajaram, Sankarasubramanian

    2016-05-03

    This study compared the economic value of pediatric immunisation programmes for influenza to those for rotavirus (RV), meningococcal disease (MD), pneumococcal disease (PD), human papillomavirus (HPV), hepatitis B (Hep B), and varicella reported in recent (2000 onwards) cost-effectiveness (CE) studies identified in a systematic review of PubMed, health technology, and vaccination databases. The systematic review yielded 51 economic evaluation studies of pediatric immunisation - 10 (20%) for influenza and 41 (80%) for the other selected diseases. The quality of the eligible articles was assessed using Drummond's checklist. Although inherent challenges and limitations exist when comparing economic evaluations of immunisation programmes, an overall comparison of the included studies demonstrated cost-effectiveness/cost saving for influenza from a European-Union-Five (EU5) and United States (US) perspective; point estimates for cost/quality-adjusted life-years (QALY) from dominance (cost-saving with more effect) to ≤45,444 were reported. The economic value of influenza programmes was comparable to the other vaccines of interest, with cost/QALY in general considerably lower than RV, Hep B, MD and PD. Independent of the perspective and type of analysis, the economic impact of a pediatric influenza immunisation program was influenced by vaccine efficacy, immunisation coverage, costs, and most significantly by herd immunity. This review suggests that pediatric influenza immunisation may offer a cost effective strategy when compared with HPV and varicella and possibly more value compared with other childhood vaccines (RV, Hep B, MD and PD).

  17. Industrial Assessment Center Program Impact Evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Martin, M.A.

    2000-01-26

    This report presents the results of an evaluation of the U.S. Department of Energy's Industrial Assessment Center (IAC) Program. The purpose of this program is to conduct energy, waste, and productivity assessments for small to medium-sized industrial firms. Assessments are conducted by 30 university-based industrial assessment centers. The purpose of this project was to evaluate energy and cost savings attributable to the assessments, the trained alumni, and the Websites sponsored by this program. How IAC assessments, alumni, and Web-based information may influence industrial energy efficiency decision making was also studied. It is concluded that appreciable energy and cost savings may be attributed to the IAC Program and that the IAC Program has resulted in more active and improved energy-efficiency decision making by industrial firms.

  18. Process variables in organizational stress management intervention evaluation research: a systematic review

    NARCIS (Netherlands)

    Havermans, B.M.; Schelvis, R.M.C.; Boot, C.R.L.; Brouwers, E.P.M.; Anema, J.R.; Beek, A.J. van der

    2016-01-01

    Objectives This systematic review aimed to explore which process variables are used in stress management intervention (SMI) evaluation research. Methods A systematic review was conducted using seven electronic databases. Studies were included if they reported on an SMI aimed at primary or secondary

  19. Process variables in organizational stress management intervention evaluation research : A systematic review

    NARCIS (Netherlands)

    Havermans, B.M.; Schlevis, Roosmarijn Mc; Boot, Cécile Rl; Brouwers, E.P.M.; Anema, Johannes R; van der Beek, Allard J

    2016-01-01

    OBJECTIVES: This systematic review aimed to explore which process variables are used in stress management intervention (SMI) evaluation research. METHODS: A systematic review was conducted using seven electronic databases. Studies were included if they reported on an SMI aimed at primary or

  20. A systematic review of balance and fall risk assessments with mobile phone technology.

    Science.gov (United States)

    Roeing, Kathleen L; Hsieh, Katherine L; Sosnoff, Jacob J

    2017-11-01

    Falls are a major health concern for older adults. Preventative measures can help reduce the incidence and severity of falls. Methods for assessing balance and fall risk factors are necessary to effectively implement preventative measures. Research groups are currently developing mobile applications to enable seniors, caregivers, and clinicians to monitor balance and fall risk. The following systematic review assesses the current state of mobile health apps for testing balance as a fall risk factor. Thirteen studies were identified and included in the review and analyzed based on study design, population, sample size, measures of balance, main outcome measures, and evaluation of validity and reliability. All studies successfully tested their applications, but only 38% evaluated the validity, and 23% evaluated the reliability of their applications. Of those, all applications were found to accurately and reliably measure balance on select variables. Four of the 13 studies included special populations groups. Out of the 13 studies, 12 reported clinicians as their intended user and seven reported seniors as their intended user. Further research should examine the validity of mobile health applications as well as report on the application's usability. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. Evaluation of a constipation risk assessment scale.

    Science.gov (United States)

    Zernike, W; Henderson, A

    1999-06-01

    This project was undertaken in order to evaluate the utility of a constipation risk assessment scale and the accompanying bowel management protocol. The risk assessment scale was primarily introduced to teach and guide staff in managing constipation when caring for patients. The intention of the project was to reduce the incidence of constipation in patients during their admission to hospital.

  2. Practical Assessment, Research and Evaluation, 2001.

    Science.gov (United States)

    Rudner, Lawrence M., Ed.; Schafer, William D., Ed.

    2001-01-01

    This document consists of articles 23 through 26 published in the electronic journal "Practical Assessment, Research & Evaluation" in 2001: (23) "Effects of Removing the Time Limit on First and Second Language Intelligence Test Performance" (Jennifer Mullane and Stuart J. McKelvie); (24) "Consequences of (Mis)use of the Texas Assessment of…

  3. Wearable Inertial Sensor Systems for Lower Limb Exercise Detection and Evaluation: A Systematic Review.

    Science.gov (United States)

    O'Reilly, Martin; Caulfield, Brian; Ward, Tomas; Johnston, William; Doherty, Cailbhe

    2018-05-01

    Analysis of lower limb exercises is traditionally completed with four distinct methods: (1) 3D motion capture; (2) depth-camera-based systems; (3) visual analysis from a qualified exercise professional; and (4) self-assessment. Each method is associated with a number of limitations. The aim of this systematic review is to synthesise and evaluate studies which have investigated the capacity for inertial measurement unit (IMU) technologies to assess movement quality in lower limb exercises. A systematic review of studies identified through the databases of PubMed, ScienceDirect and Scopus was conducted. Articles written in English and published in the last 10 years which investigated an IMU system for the analysis of repetition-based targeted lower limb exercises were included. The quality of included studies was measured using an adapted version of the STROBE assessment criteria for cross-sectional studies. The studies were categorised into three groupings: exercise detection, movement classification or measurement validation. Each study was then qualitatively summarised. From the 2452 articles that were identified with the search strategies, 47 papers are included in this review. Twenty-six of the 47 included studies were deemed as being of high quality. Wearable inertial sensor systems for analysing lower limb exercises is a rapidly growing field of research. Research over the past 10 years has predominantly focused on validating measurements that the systems produce and classifying users' exercise quality. There have been very few user evaluation studies and no clinical trials in this field to date.

  4. Evaluating the Psychometric Quality of Social Skills Measures: A Systematic Review.

    Science.gov (United States)

    Cordier, Reinie; Speyer, Renée; Chen, Yu-Wei; Wilkes-Gillan, Sarah; Brown, Ted; Bourke-Taylor, Helen; Doma, Kenji; Leicht, Anthony

    2015-01-01

    Impairments in social functioning are associated with an array of adverse outcomes. Social skills measures are commonly used by health professionals to assess and plan the treatment of social skills difficulties. There is a need to comprehensively evaluate the quality of psychometric properties reported across these measures to guide assessment and treatment planning. To conduct a systematic review of the literature on the psychometric properties of social skills and behaviours measures for both children and adults. A systematic search was performed using four electronic databases: CINAHL, PsycINFO, Embase and Pubmed; the Health and Psychosocial Instruments database; and grey literature using PsycExtra and Google Scholar. The psychometric properties of the social skills measures were evaluated against the COSMIN taxonomy of measurement properties using pre-set psychometric criteria. Thirty-Six studies and nine manuals were included to assess the psychometric properties of thirteen social skills measures that met the inclusion criteria. Most measures obtained excellent overall methodological quality scores for internal consistency and reliability. However, eight measures did not report measurement error, nine measures did not report cross-cultural validity and eleven measures did not report criterion validity. The overall quality of the psychometric properties of most measures was satisfactory. The SSBS-2, HCSBS and PKBS-2 were the three measures with the most robust evidence of sound psychometric quality in at least seven of the eight psychometric properties that were appraised. A universal working definition of social functioning as an overarching construct is recommended. There is a need for ongoing research in the area of the psychometric properties of social skills and behaviours instruments.

  5. Evaluating the Psychometric Quality of Social Skills Measures: A Systematic Review

    Science.gov (United States)

    Brown, Ted; Bourke-Taylor, Helen; Doma, Kenji; Leicht, Anthony

    2015-01-01

    Introduction Impairments in social functioning are associated with an array of adverse outcomes. Social skills measures are commonly used by health professionals to assess and plan the treatment of social skills difficulties. There is a need to comprehensively evaluate the quality of psychometric properties reported across these measures to guide assessment and treatment planning. Objective To conduct a systematic review of the literature on the psychometric properties of social skills and behaviours measures for both children and adults. Methods A systematic search was performed using four electronic databases: CINAHL, PsycINFO, Embase and Pubmed; the Health and Psychosocial Instruments database; and grey literature using PsycExtra and Google Scholar. The psychometric properties of the social skills measures were evaluated against the COSMIN taxonomy of measurement properties using pre-set psychometric criteria. Results Thirty-Six studies and nine manuals were included to assess the psychometric properties of thirteen social skills measures that met the inclusion criteria. Most measures obtained excellent overall methodological quality scores for internal consistency and reliability. However, eight measures did not report measurement error, nine measures did not report cross-cultural validity and eleven measures did not report criterion validity. Conclusions The overall quality of the psychometric properties of most measures was satisfactory. The SSBS-2, HCSBS and PKBS-2 were the three measures with the most robust evidence of sound psychometric quality in at least seven of the eight psychometric properties that were appraised. A universal working definition of social functioning as an overarching construct is recommended. There is a need for ongoing research in the area of the psychometric properties of social skills and behaviours instruments. PMID:26151362

  6. Evaluating the Psychometric Quality of Social Skills Measures: A Systematic Review.

    Directory of Open Access Journals (Sweden)

    Reinie Cordier

    Full Text Available Impairments in social functioning are associated with an array of adverse outcomes. Social skills measures are commonly used by health professionals to assess and plan the treatment of social skills difficulties. There is a need to comprehensively evaluate the quality of psychometric properties reported across these measures to guide assessment and treatment planning.To conduct a systematic review of the literature on the psychometric properties of social skills and behaviours measures for both children and adults.A systematic search was performed using four electronic databases: CINAHL, PsycINFO, Embase and Pubmed; the Health and Psychosocial Instruments database; and grey literature using PsycExtra and Google Scholar. The psychometric properties of the social skills measures were evaluated against the COSMIN taxonomy of measurement properties using pre-set psychometric criteria.Thirty-Six studies and nine manuals were included to assess the psychometric properties of thirteen social skills measures that met the inclusion criteria. Most measures obtained excellent overall methodological quality scores for internal consistency and reliability. However, eight measures did not report measurement error, nine measures did not report cross-cultural validity and eleven measures did not report criterion validity.The overall quality of the psychometric properties of most measures was satisfactory. The SSBS-2, HCSBS and PKBS-2 were the three measures with the most robust evidence of sound psychometric quality in at least seven of the eight psychometric properties that were appraised. A universal working definition of social functioning as an overarching construct is recommended. There is a need for ongoing research in the area of the psychometric properties of social skills and behaviours instruments.

  7. Designing systematic conservation assessments that promote effective implementation: best practice from South Africa.

    Science.gov (United States)

    Knight, Andrew T; Driver, Amanda; Cowling, Richard M; Maze, Kristal; Desmet, Philip G; Lombard, Amanda T; Rouget, Mathieu; Botha, Mark A; Boshoff, Andre F; Castley, J Guy; Goodman, Peter S; Mackinnon, Kathy; Pierce, Shirley M; Sims-Castley, Rebecca; Stewart, Warrick I; von Hase, Amrei

    2006-06-01

    Systematic conservation assessment and conservation planning are two distinct fields of conservation science often confused as one and the same. Systematic conservation assessment is the technical, often computer-based, identification of priority areas for conservation. Conservation planning is composed of a systematic conservation assessment coupled with processes for development of an implementation strategy and stakeholder collaboration. The peer-reviewed conservation biology literature abounds with studies analyzing the performance of assessments (e.g., area-selection techniques). This information alone, however can never deliver effective conservation action; it informs conservation planning. Examples of how to translate systematic assessment outputs into knowledge and then use them for "doing" conservation are rare. South Africa has received generous international and domestic funding for regional conservation planning since the mid-1990s. We reviewed eight South African conservation planning processes and identified key ingredients of best practice for undertaking systematic conservation assessments in a way that facilitates implementing conservation action. These key ingredients include the design of conservation planning processes, skills for conservation assessment teams, collaboration with stakeholders, and interpretation and mainstreaming of products (e.g., maps) for stakeholders. Social learning institutions are critical to the successful operationalization of assessments within broader conservation planning processes and should include not only conservation planners but also diverse interest groups, including rural landowners, politicians, and government employees.

  8. Assessment of participation bias in cohort studies: systematic review and meta-regression analysis

    Directory of Open Access Journals (Sweden)

    Sérgio Henrique Almeida da Silva Junior

    2015-11-01

    Full Text Available Abstract The proportion of non-participation in cohort studies, if associated with both the exposure and the probability of occurrence of the event, can introduce bias in the estimates of interest. The aim of this study is to evaluate the impact of participation and its characteristics in longitudinal studies. A systematic review (MEDLINE, Scopus and Web of Science for articles describing the proportion of participation in the baseline of cohort studies was performed. Among the 2,964 initially identified, 50 were selected. The average proportion of participation was 64.7%. Using a meta-regression model with mixed effects, only age, year of baseline contact and study region (borderline were associated with participation. Considering the decrease in participation in recent years, and the cost of cohort studies, it is essential to gather information to assess the potential for non-participation, before committing resources. Finally, journals should require the presentation of this information in the papers.

  9. Evaluation of fire probabilistic safety assessment for a PWR plant

    International Nuclear Information System (INIS)

    Wu, C.H.; Lin, T.J.; Kao, T.M.

    2001-01-01

    The internal fire analysis of the level 1 power operation probability safety assessment (PSA) for Maanshan (PWR) Nuclear Power Plant (MNPP) was updated. The fire analysis adopted a scenario-based PSA approach to systematically evaluate fire and smoke hazards and their associated risk impact to MNPP. The result shows that the core damage frequency (CDF) due to fire is about six times lower than the previous one analyzed by the Atomic Energy Council (AEC), Republic of China in 1987. The plant model was modified to reflect the impact of human events and recovery actions during fire. Many tabulated EXCEL spread-sheets were used for evaluation of the fire risk. The fire-induced CDF for MNPP is found to be 2.1 E-6 per year in this study. The relative results of the fire analysis will provide the bases for further risk-informed fire protection evaluation in the near future. (author)

  10. Assessment of educational games for health professions: a systematic review of trends and outcomes.

    Science.gov (United States)

    Abdulmajed, Hind; Park, Yoon Soo; Tekian, Ara

    2015-04-01

    Traditional lecturing used in teaching has the lowest retention rate; the use of games as part of an instruction method may enhance retention and reinforce learning by creating a dynamic educational environment. This study aims to systematically review the literature on educational games for the health professions to identify trends and investigate assessment tools used to measure its learning outcomes. Seven databases were used in the search: ERIC, Education Research Complete, Medline, Medline Complete, Academic Search Complete, The Cochrane Library and PubMed. The search identified 2865 papers; among them, 1259 were excluded and 22 were evaluated. The selection incorporated five full papers which focused directly on the health professionals. Two studies involved the use of board games and two studies involved card games, crossword puzzles and one study involved a team quiz competition. Overall, studies lacked a strong link between the use of games for both instructional and assessment purposes. Gaming makes a positive impact on the teaching/learning process. However, existing assessment methodologies have been not fully captured the learning that may occur in these games. Robust research is needed to address the use of games that have been assessed objectively.

  11. Instruments to assess self-care among healthy children: A systematic review of measurement properties.

    Science.gov (United States)

    Urpí-Fernández, Ana-María; Zabaleta-Del-Olmo, Edurne; Montes-Hidalgo, Javier; Tomás-Sábado, Joaquín; Roldán-Merino, Juan-Francisco; Lluch-Canut, María-Teresa

    2017-12-01

    To identify, critically appraise and summarize the measurement properties of instruments to assess self-care in healthy children. Assessing self-care is a proper consideration for nursing practice and nursing research. No systematic review summarizes instruments of measurement validated in healthy children. Psychometric review in accordance with the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) panel. MEDLINE, CINAHL, PsycINFO, Web of Science and Open Grey were searched from their inception to December 2016. Validation studies with a healthy child population were included. Search was not restricted by language. Two reviewers independently assessed the methodological quality of included studies using the COSMIN checklist. Eleven studies were included in the review assessing the measurement properties of ten instruments. There was a maximum of two studies per instrument. None of the studies evaluated the properties of test-retest reliability, measurement error, criterion validity and responsiveness. Internal consistency and structural validity were rated as "excellent" or "good" in four studies. Four studies were rated as "excellent" in content validity. Cross-cultural validity was rated as "poor" in the two studies (three instruments) which cultural adaptation was carried out. The evidence available does not allow firm conclusions about the instruments identified in terms of reliability and validity. Future research should focus on generate evidence about a wider range of measurement properties of these instruments using a rigorous methodology, as well as instrument testing on different countries and child population. © 2017 John Wiley & Sons Ltd.

  12. Bruxism is unlikely to cause damage to the periodontium: findings from a systematic literature assessment.

    Science.gov (United States)

    Manfredini, Daniele; Ahlberg, Jari; Mura, Rossano; Lobbezoo, Frank

    2015-04-01

    This paper systematically reviews the MEDLINE and SCOPUS literature to answer the following question: Is there any evidence that bruxism may cause periodontal damage per se? Clinical studies on humans, assessing the potential relationship between bruxism and periodontal lesions (i.e., decreased attachment level, bone loss, tooth mobility/migration, altered periodontal perception) were eligible. Methodologic shortcomings were identified by the adoption of the Critical Appraisal Skills Program quality assessment, mainly concerning the internal validity of findings according to an unspecific bruxism diagnosis. The six included articles covered a high variability of topics, without multiple papers on the same argument. Findings showed that the only effect of bruxism on periodontal structures was an increase in periodontal sensation, whereas a relationship with periodontal lesions was absent. Based on the analysis of Hill criteria, the validity of causation conclusions was limited, mainly owing to the absence of a longitudinal evaluation of the temporal relationship and dose-response effects between bruxism and periodontal lesions. Despite the scarce quantity and quality of the literature that prevents sound conclusions on the causal link between bruxism and the periodontal problems assessed in this review, it seems reasonable to suggest that bruxism cannot cause periodontal damage per se. It is also important to emphasize, however, that because of methodologic problems, particularly regarding sleep bruxism assessment, more high-quality studies (e.g., randomized controlled trials) are needed to further clarify this issue.

  13. Systematic Review of Health Economic Evaluation Studies Developed in Brazil from 1980 to 2013

    Directory of Open Access Journals (Sweden)

    Tassia Cristina Decimoni

    2018-02-01

    Full Text Available BackgroundBrazil has sought to use economic evaluation to support healthcare decision-making processes. While a number of health economic evaluations (HEEs have been conducted, no study has systematically reviewed the quality of Brazilian HEE. The objective of this systematic review was to provide an overview regarding the state of HEE research and to evaluate the number, characteristics, and quality of reporting of published HEE studies conducted in a Brazilian setting.MethodsWe systematically searched electronic databases (MEDLINE, EMBASE, Latin American, and Caribbean Literature on Health Sciences Database, Scientific Electronic Library Online, NHS Economic Evaluation Database, health technology assessment Database, Bireme, and Biblioteca Virtual em Saúde Economia da Saúde; citation indexes (SCOPUS, Web of Science, and Sistema de Informação da Rede Brasileira de Avaliação de Tecnologia em Saúde. Partial and full HEEs published between 1980 and 2013 that referred to a Brazilian setting were considered for inclusion.ResultsIn total, 535 studies were included in the review, 36.8% of these were considered to be full HEE. The category of healthcare technologies more frequently assessed were procedures (34.8% and drugs (28.8% which main objective was treatment (72.1%. Forty-four percent of the studies reported their funding source and 36% reported a conflict of interest. Overall, the full HEE quality of reporting was satisfactory. But some items were generally poorly reported and significant improvement is required: (1 methods used to estimate healthcare resource use quantities and unit costs, (2 methods used to estimate utility values, (3 sources of funding, and (4 conflicts of interest.ConclusionA steady number of HEE have been published in Brazil since 1980. To improve their contribution to inform national healthcare policy efforts need to be made to enhance the quality of reporting of HEEs and promote improvements in the way HEEs are

  14. The Water-Energy-Food Nexus: A systematic review of methods for nexus assessment

    Science.gov (United States)

    Albrecht, Tamee R.; Crootof, Arica; Scott, Christopher A.

    2018-04-01

    The water-energy-food (WEF) nexus is rapidly expanding in scholarly literature and policy settings as a novel way to address complex resource and development challenges. The nexus approach aims to identify tradeoffs and synergies of water, energy, and food systems, internalize social and environmental impacts, and guide development of cross-sectoral policies. However, while the WEF nexus offers a promising conceptual approach, the use of WEF nexus methods to systematically evaluate water, energy, and food interlinkages or support development of socially and politically-relevant resource policies has been limited. This paper reviews WEF nexus methods to provide a knowledge base of existing approaches and promote further development of analytical methods that align with nexus thinking. The systematic review of 245 journal articles and book chapters reveals that (a) use of specific and reproducible methods for nexus assessment is uncommon (less than one-third); (b) nexus methods frequently fall short of capturing interactions among water, energy, and food—the very linkages they conceptually purport to address; (c) assessments strongly favor quantitative approaches (nearly three-quarters); (d) use of social science methods is limited (approximately one-quarter); and (e) many nexus methods are confined to disciplinary silos—only about one-quarter combine methods from diverse disciplines and less than one-fifth utilize both quantitative and qualitative approaches. To help overcome these limitations, we derive four key features of nexus analytical tools and methods—innovation, context, collaboration, and implementation—from the literature that reflect WEF nexus thinking. By evaluating existing nexus analytical approaches based on these features, we highlight 18 studies that demonstrate promising advances to guide future research. This paper finds that to address complex resource and development challenges, mixed-methods and transdisciplinary approaches are needed

  15. Evaluating the effectiveness of impact assessment instruments

    DEFF Research Database (Denmark)

    Cashmore, Matthew; Richardson, Tim; Hilding-Ryedvik, Tuija

    2010-01-01

    to sharpen effectiveness evaluation theory for impact assessment instruments this article critically examines the neglected issue of their political constitution. Analytical examples are used to concretely explore the nature and significance of the politicisation of impact assessment. It is argued......The central role of impact assessment instruments globally in policy integration initiatives has been cemented in recent years. Associated with this trend, but also reflecting political emphasis on greater accountability in certain policy sectors and a renewed focus on economic competitiveness...... that raising awareness about the political character of impact assessment instruments, in itself, is a vital step in advancing effectiveness evaluation theory. Broader theoretical lessons on the framing of evaluation research are also drawn from the political analysis. We conclude that, at least within...

  16. Economic Evaluations of Pharmacogenetic and Pharmacogenomic Screening Tests: A Systematic Review. Second Update of the Literature.

    Directory of Open Access Journals (Sweden)

    Elizabeth J J Berm

    Full Text Available Due to extended application of pharmacogenetic and pharmacogenomic screening (PGx tests it is important to assess whether they provide good value for money. This review provides an update of the literature.A literature search was performed in PubMed and papers published between August 2010 and September 2014, investigating the cost-effectiveness of PGx screening tests, were included. Papers from 2000 until July 2010 were included via two previous systematic reviews. Studies' overall quality was assessed with the Quality of Health Economic Studies (QHES instrument.We found 38 studies, which combined with the previous 42 studies resulted in a total of 80 included studies. An average QHES score of 76 was found. Since 2010, more studies were funded by pharmaceutical companies. Most recent studies performed cost-utility analysis, univariate and probabilistic sensitivity analyses, and discussed limitations of their economic evaluations. Most studies indicated favorable cost-effectiveness. Majority of evaluations did not provide information regarding the intrinsic value of the PGx test. There were considerable differences in the costs for PGx testing. Reporting of the direction and magnitude of bias on the cost-effectiveness estimates as well as motivation for the chosen economic model and perspective were frequently missing.Application of PGx tests was mostly found to be a cost-effective or cost-saving strategy. We found that only the minority of recent pharmacoeconomic evaluations assessed the intrinsic value of the PGx tests. There was an increase in the number of studies and in the reporting of quality associated characteristics. To improve future evaluations, scenario analysis including a broad range of PGx tests costs and equal costs of comparator drugs to assess the intrinsic value of the PGx tests, are recommended. In addition, robust clinical evidence regarding PGx tests' efficacy remains of utmost importance.

  17. An evaluation of the comparative effectiveness of geriatrician-led comprehensive geriatric assessment for improving patient and healthcare system outcomes for older adults: a protocol for a systematic review and network meta-analysis

    OpenAIRE

    Soobiah, Charlene; Daly, Caitlin; Blondal, Erik; Ewusie, Joycelyne; Ho, Joanne; Elliott, Meghan J.; Yue, Rossini; Holroyd-Leduc, Jayna; Liu, Barbara; Marr, Sharon; Basran, Jenny; Tricco, Andrea C.; Hamid, Jemila; Straus, Sharon E.

    2017-01-01

    Background Comprehensive geriatric assessment (CGA) is an integrated model of care involving a geriatrician and an interdisciplinary team and can prioritize and manage complex health needs of older adults with multimorbidity. CGAs differ across healthcare settings, ranging from shared care conducted in primary care settings to specialized inpatient units in acute care. Models of care involving geriatricians vary across healthcare settings, and it is unclear which CGA model is most effective. ...

  18. Systematization of simplified J-integral evaluation method for flaw evaluation at high temperature

    International Nuclear Information System (INIS)

    Miura, Naoki; Takahashi, Yukio; Nakayama, Yasunari; Shimakawa, Takashi

    2000-01-01

    J-integral is an effective inelastic fracture parameter for the flaw evaluation of cracked components at high temperature. The evaluation of J-integral for an arbitrary crack configuration and an arbitrary loading condition can be generally accomplished by detailed numerical analysis such as finite element analysis, however, it is time-consuming and requires a high degree of expertise for its implementation. Therefore, it is important to develop simplified J-integral estimation techniques from the viewpoint of industrial requirements. In this study, a simplified J-integral evaluation method is proposed to estimate two types of J-integral parameters. One is the fatigue J-integral range to describe fatigue crack propagation behavior, and the other is the creep J-integral to describe creep crack propagation behavior. This paper presents the systematization of the simplified J-integral evaluation method incorporated with the reference stress method and the concept of elastic follow-up, and proposes a comprehensive evaluation procedure. The verification of the proposed method is presented in Part II of this paper. (author)

  19. [Evaluation of social medicine expert assessment].

    Science.gov (United States)

    Piechowiak, H

    1989-10-01

    There are only few scientific publications in literature on medical expertising in social medicine. Although this deficit may be explained by several facts, it cannot be justified. Evaluation is a systematic set of data collection and analysis activities undertaken to place social practice on a more rational basis, i.e. greater efficiency and justice. These aims also hold good for social medicine. Evaluation, however, is only the first step within a broader research programme for quality control and quality improvement efforts, which can be successfully performed only in cooperation with the social insurance institutions. Within their medical services these institutions should provide the organisational prerequisites to enable qualified scientific research in practical social medicine.

  20. The quality of instruments to assess the process of shared decision making: A systematic review

    Science.gov (United States)

    Bomhof-Roordink, Hanna; Smith, Ian P.; Scholl, Isabelle; Stiggelbout, Anne M.; Pieterse, Arwen H.

    2018-01-01

    Objective To inventory instruments assessing the process of shared decision making and appraise their measurement quality, taking into account the methodological quality of their validation studies. Methods In a systematic review we searched seven databases (PubMed, Embase, Emcare, Cochrane, PsycINFO, Web of Science, Academic Search Premier) for studies investigating instruments measuring the process of shared decision making. Per identified instrument, we assessed the level of evidence separately for 10 measurement properties following a three-step procedure: 1) appraisal of the methodological quality using the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) checklist, 2) appraisal of the psychometric quality of the measurement property using three possible quality scores, 3) best-evidence synthesis based on the number of studies, their methodological and psychometrical quality, and the direction and consistency of the results. The study protocol was registered at PROSPERO: CRD42015023397. Results We included 51 articles describing the development and/or evaluation of 40 shared decision-making process instruments: 16 patient questionnaires, 4 provider questionnaires, 18 coding schemes and 2 instruments measuring multiple perspectives. There is an overall lack of evidence for their measurement quality, either because validation is missing or methods are poor. The best-evidence synthesis indicated positive results for a major part of instruments for content validity (50%) and structural validity (53%) if these were evaluated, but negative results for a major part of instruments when inter-rater reliability (47%) and hypotheses testing (59%) were evaluated. Conclusions Due to the lack of evidence on measurement quality, the choice for the most appropriate instrument can best be based on the instrument’s content and characteristics such as the perspective that they assess. We recommend refinement and validation of

  1. Quality assessment of systematic reviews on total hip or knee arthroplasty using mod-AMSTAR.

    Science.gov (United States)

    Wu, Xinyu; Sun, Huan; Zhou, Xiaoqin; Wang, Ji; Li, Jing

    2018-03-16

    Increasing numbers of systematic reviews (SRs) on total knee arthroplasty (TKA) and total hip arthroplasty (THA) have been published in recent years, but their quality has been unclear. The purpose of this study is to evaluate the methodological quality of SRs on TKA and THA. We searched Ovid-Medline, Ovid-Embase, Cochrane Databases (including HTA, DARE, and CDSR), CBM, CNKI, Wang Fang, and VIP, from January 2014 to December 2015 for THA and TKA. The quality of SRs was assessed using the modified 25-item "Assessment of Multiple Systematic Reviews" (mod-AMSTAR) tool, which was based on the AMSTAR scale. A T-test, nonparametric test, and linear regression were conducted to assess the relationship between bibliographical characteristics and methodological quality. Sixty-three SRs were included, from which the majority of SRs (50, 79.4%) were conducted in Asia. Only 4 reviews were rated as high quality, and most were weak in providing a priori design (6, 9.5%), not limiting the publication type (8, 13%), providing an excluded primary studies list (4, 6.3%) and reporting support for the included primary studies (1, 1.6%). Reviews published in English journals performed better than did Chinese journals in duplicate data extraction (81.3% vs 46.7%, p = 0.017; 70.8% vs 33.3%, p = 0.009) and providing source of support for the SR (87.5% vs 33.3%, P quality of the included SRs is far from satisfactory. Authors of SRs should conform to the recommendations outlined in the mod-AMSTAR items. Areas needing improvement were providing a priori design, not limiting the publication type, providing an excluded primary studies list, and reporting conflicts of interest.

  2. Methods of blinding in reports of randomized controlled trials assessing pharmacologic treatments: a systematic review.

    Directory of Open Access Journals (Sweden)

    Isabelle Boutron

    2006-10-01

    Full Text Available BACKGROUND: Blinding is a cornerstone of therapeutic evaluation because lack of blinding can bias treatment effect estimates. An inventory of the blinding methods would help trialists conduct high-quality clinical trials and readers appraise the quality of results of published trials. We aimed to systematically classify and describe methods to establish and maintain blinding of patients and health care providers and methods to obtain blinding of outcome assessors in randomized controlled trials of pharmacologic treatments. METHODS AND FINDINGS: We undertook a systematic review of all reports of randomized controlled trials assessing pharmacologic treatments with blinding published in 2004 in high impact-factor journals from Medline and the Cochrane Methodology Register. We used a standardized data collection form to extract data. The blinding methods were classified according to whether they primarily (1 established blinding of patients or health care providers, (2 maintained the blinding of patients or health care providers, and (3 obtained blinding of assessors of the main outcomes. We identified 819 articles, with 472 (58% describing the method of blinding. Methods to establish blinding of patients and/or health care providers concerned mainly treatments provided in identical form, specific methods to mask some characteristics of the treatments (e.g., added flavor or opaque coverage, or use of double dummy procedures or simulation of an injection. Methods to avoid unblinding of patients and/or health care providers involved use of active placebo, centralized assessment of side effects, patients informed only in part about the potential side effects of each treatment, centralized adapted dosage, or provision of sham results of complementary investigations. The methods reported for blinding outcome assessors mainly relied on a centralized assessment of complementary investigations, clinical examination (i.e., use of video, audiotape, or

  3. Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy.

    Science.gov (United States)

    Lumsden, Jim; Edwards, Elizabeth A; Lawrence, Natalia S; Coyle, David; Munafò, Marcus R

    2016-07-15

    Cognitive tasks are typically viewed as effortful, frustrating, and repetitive, which often leads to participant disengagement. This, in turn, may negatively impact data quality and/or reduce intervention effects. However, gamification may provide a possible solution. If game design features can be incorporated into cognitive tasks without undermining their scientific value, then data quality, intervention effects, and participant engagement may be improved. This systematic review aims to explore and evaluate the ways in which gamification has already been used for cognitive training and assessment purposes. We hope to answer 3 questions: (1) Why have researchers opted to use gamification? (2) What domains has gamification been applied in? (3) How successful has gamification been in cognitive research thus far? We systematically searched several Web-based databases, searching the titles, abstracts, and keywords of database entries using the search strategy (gamif* OR game OR games) AND (cognit* OR engag* OR behavi* OR health* OR attention OR motiv*). Searches included papers published in English between January 2007 and October 2015. Our review identified 33 relevant studies, covering 31 gamified cognitive tasks used across a range of disorders and cognitive domains. We identified 7 reasons for researchers opting to gamify their cognitive training and testing. We found that working memory and general executive functions were common targets for both gamified assessment and training. Gamified tests were typically validated successfully, although mixed-domain measurement was a problem. Gamified training appears to be highly engaging and does boost participant motivation, but mixed effects of gamification on task performance were reported. Heterogeneous study designs and typically small sample sizes highlight the need for further research in both gamified training and testing. Nevertheless, careful application of gamification can provide a way to develop engaging and

  4. Cross-cultural assessment of HIV-associated cognitive impairment using the Kaufman assessment battery for children: a systematic review.

    Science.gov (United States)

    van Wyhe, Kaylee S; van de Water, Tanya; Boivin, Michael J; Cotton, Mark F; Thomas, Kevin Gf

    2017-06-14

    Despite improved efficacy of, and access to, combination antiretroviral therapy (cART), HIV-associated cognitive impairments remain prevalent in both children and adults. Neuropsychological tests that detect such impairment can help clinicians formulate effective treatment plans. The Kaufman Assessment Battery for Children (KABC), although developed and standardized in the United States, is used frequently in many different countries and cultural contexts to assess paediatric performance across various cognitive domains. This systematic review investigated the cross-cultural utility of the original KABC, and its 2nd edition (KABC-II), in detecting HIV-associated cognitive impairment in children and adolescents. We entered relevant keywords and MeSH terms into the PubMed, PsycInfo, EBSCOHost, ProQuest, and Scopus databases, with search limits set from 1983-2017. Two independent reviewers evaluated the retrieved abstracts and manuscripts. Studies eligible for inclusion in the review were those that (a) used the KABC/KABC-II to assess cognitive function in children/adolescents aged 2-18 years, (b) featured a definition of cognitive impairment (e.g. >2 SD below the mean) or compared the performance of HIV-infected and uninfected control groups, and (c) used a sample excluded from population on which the instruments were normed. We identified nine studies (eight conducted in African countries, and one in the United Kingdom) to comprise the review's sample. All studies detected cognitive impairment in HIV-infected children, including those who were cART-naïve or who were cART treated and clinically stable. KABC/KABC-II subtests assessing simultaneous processing appeared most sensitive. Evaluation of the methodological quality of the selected studies by two independent reviews suggested that shortcomings included reporting and selection biases. This systematic review provides evidence for the cross-cultural utility of the KABC/KABC-II, particularly the simultaneous

  5. Systematic evaluation program status summary report: November 1-30, 1981

    International Nuclear Information System (INIS)

    1981-12-01

    The Systematic Evaluation Program is intended to examine many safety related aspects of eleven of the older light water reactors. This document provides the existing status of the review process including individual topic and overall completion status

  6. A systematic review evaluating the impact of task shifting on access ...

    African Journals Online (AJOL)

    A systematic review evaluating the impact of task shifting on access to antiretroviral therapy in sub-Saharan Africa. ... Background: Task shifting, defined for this review as the shifting of ART initiation and ... AJOL African Journals Online.

  7. Systematic Evaluation Program (SEP) at Rocky Flats Plant: An overview of practical management issues for evaluation of natural phenomena hazards

    International Nuclear Information System (INIS)

    Badwan, F.M.

    1993-01-01

    Many of the buildings at the Rocky Flats Plant were designed and built before modern standards were developed, including standards for protection against extreme natural phenomenon such as tornadoes, earthquakes, and floods. The purpose of the SEP is to establish an integrated approach to assessing the design adequacy of specific high and moderate hazard Rocky Flats facilities from a safety perspective and to establish a basis for defining any needed facility improvements. The SEP is to be carried out in three Phases. In Phase 1, topics to be evaluated and an evaluation plan for each topic were developed. Any differences between Current Design Requirements (CDR) or acceptance criteria and the design of existing facilities, will be identified during Phase 2 and assessed using an integrated systematic approach during Phase 3. The integrated assessment performed during Phase 3 provides a process for evaluating the differences between existing facility design and CDRs so that decisions on corrective actions can be made on the basis of relative risk reduction and cost effectiveness. These efforts will ensure that a balanced and integrated level of safety is achieved for long-term operation of these buildings. Through appropriate selection of topics and identification of the structures, systems, and components to be evaluated, the SEP will address outstanding design issues related to the prevention and mitigation of design basis accidents, including those arising from natural phenomena. The objective of the SEP is not to bring these buildings into strict compliance with current requirements, but rather to ensure that an adequate level of safety is achieved in an economical fashion

  8. Systematic literature reviews and meta-analyses: part 6 of a series on evaluation of scientific publications.

    Science.gov (United States)

    Ressing, Meike; Blettner, Maria; Klug, Stefanie J

    2009-07-01

    Because of the rising number of scientific publications, it is important to have a means of jointly summarizing and assessing different studies on a single topic. Systematic literature reviews, meta-analyses of published data, and meta-analyses of individual data (pooled reanalyses) are now being published with increasing frequency. We here describe the essential features of these methods and discuss their strengths and weaknesses. This article is based on a selective literature search. The different types of review and meta-analysis are described, the methods used in each are outlined so that they can be evaluated, and a checklist is given for the assessment of reviews and meta-analyses of scientific articles. Systematic literature reviews provide an overview of the state of research on a given topic and enable an assessment of the quality of individual studies. They also allow the results of different studies to be evaluated together when these are inconsistent. Meta-analyses additionally allow calculation of pooled estimates of an effect. The different types of review and meta-analysis are discussed with examples from the literature on one particular topic. Systematic literature reviews and meta-analyses enable the research findings and treatment effects obtained in different individual studies to be summed up and evaluated.

  9. Systematic Differences Across Evaluation Schemes and Educational Choice

    DEFF Research Database (Denmark)

    Rangvid, Beatrice Schindler

    2015-01-01

    Using large-scale register data from Denmark in a difference-in-differences framework, I analyse whether systematic disparities between internal teacher scores and external exam scores in the school-leaving certificates are linked to pupil characteristics. Such differences may mat- ter for post......-school. The corresponding increase for pupils with low educated parents is 4% points, closing 13% of the high-school enrolment gap to pupils with high educated parents....

  10. Systematic Differences across Evaluation Schemes and Educational Choice

    DEFF Research Database (Denmark)

    Rangvid, Beatrice Schindler

    Using large scale register data from Denmark in a difference-in-differences framework, I analyze whether systematic disparities between internal teacher scores and external exam scores in the school leaving certificates are linked to pupil characteristics. Such differences may be particularly con......-SES pupils’ predicted probability to enroll in high-school, closing almost 10% of the high-school enrolment gap to high-SES pupils. Increases for boys and migrant pupils are modest....

  11. Impact of workplace based assessment on doctors' education and performance: a systematic review.

    Science.gov (United States)

    Miller, Alice; Archer, Julian

    2010-09-24

    To investigate the literature for evidence that workplace based assessment affects doctors' education and performance. Systematic review. The primary data sources were the databases Journals@Ovid, Medline, Embase, CINAHL, PsycINFO, and ERIC. Evidence based reviews (Bandolier, Cochrane Library, DARE, HTA Database, and NHS EED) were accessed and searched via the Health Information Resources website. Reference lists of relevant studies and bibliographies of review articles were also searched. Review methods Studies of any design that attempted to evaluate either the educational impact of workplace based assessment, or the effect of workplace based assessment on doctors' performance, were included. Studies were excluded if the sampled population was non-medical or the study was performed with medical students. Review articles, commentaries, and letters were also excluded. The final exclusion criterion was the use of simulated patients or models rather than real life clinical encounters. Sixteen studies were included. Fifteen of these were non-comparative descriptive or observational studies; the other was a randomised controlled trial. Study quality was mixed. Eight studies examined multisource feedback with mixed results; most doctors felt that multisource feedback had educational value, although the evidence for practice change was conflicting. Some junior doctors and surgeons displayed little willingness to change in response to multisource feedback, whereas family physicians might be more prepared to initiate change. Performance changes were more likely to occur when feedback was credible and accurate or when coaching was provided to help subjects identify their strengths and weaknesses. Four studies examined the mini-clinical evaluation exercise, one looked at direct observation of procedural skills, and three were concerned with multiple assessment methods: all these studies reported positive results for the educational impact of workplace based assessment tools

  12. Using health technology assessment to assess the value of new medicines: results of a systematic review and expert consultation across eight European countries.

    Science.gov (United States)

    Angelis, Aris; Lange, Ansgar; Kanavos, Panos

    2018-01-01

    Although health technology assessment (HTA) systems base their decision making process either on economic evaluations or comparative clinical benefit assessment, a central aim of recent approaches to value measurement, including value based assessment and pricing, points towards the incorporation of supplementary evidence and criteria that capture additional dimensions of value. To study the practices, processes and policies of value-assessment for new medicines across eight European countries and the role of HTA beyond economic evaluation and clinical benefit assessment. A systematic (peer review and grey) literature review was conducted using an analytical framework examining: (1) 'Responsibilities and structure of HTA agencies'; (2) 'Evidence and evaluation criteria considered in HTAs'; (3) 'Methods and techniques applied in HTAs'; and (4) 'Outcomes and implementation of HTAs'. Study countries were France, Germany, England, Sweden, Italy, Netherlands, Poland and Spain. Evidence from the literature was validated and updated through two rounds of feedback involving primary data collection from national experts. All countries assess similar types of evidence; however, the specific criteria/endpoints used, their level of provision and requirement, and the way they are incorporated (e.g. explicitly vs. implicitly) varies across countries, with their relative importance remaining generally unknown. Incorporation of additional 'social value judgements' (beyond clinical benefit assessment) and economic evaluation could help explain heterogeneity in coverage recommendations and decision-making. More comprehensive and systematic assessment procedures characterised by increased transparency, in terms of selection of evaluation criteria, their importance and intensity of use, could lead to more rational evidence-based decision-making, possibly improving efficiency in resource allocation, while also raising public confidence and fairness.

  13. Systematic risk assessment methodology for critical infrastructure elements - Oil and Gas subsectors

    Science.gov (United States)

    Gheorghiu, A.-D.; Ozunu, A.

    2012-04-01

    . The criterial evaluation is used as a ranking system in order to establish the priorities for the detailed risk assessment. This criterial analysis stage is necessary because the total number of installations and sections on a site can be quite large. As not all installations and sections on a site contribute significantly to the risk of a major accident occurring, it is not efficient to include all installations and sections in the detailed risk assessment, which can be time and resource consuming. The selected installations are then taken into consideration in the detailed risk assessment, which is the third step of the systematic risk assessment methodology. Following this step, conclusions can be drawn related to the overall risk characteristics of the site. The proposed methodology can as such be successfully applied to the assessment of risk related to critical infrastructure elements falling under the energy sector of Critical Infrastructure, mainly the sub-sectors oil and gas. Key words: Systematic risk assessment, criterial analysis, energy sector critical infrastructure elements

  14. Systematic Review: Concept and Tool Development with Application in the Integrated Risk Information System (IRIS) Assessment Process

    Science.gov (United States)

    Systematic Review: Concept and tool development with application to the National Toxicology Program (NTP) and the Integrated Risk Information System (IRIS) Assessment Processes. There is growing interest within the environmental health community to incorporate systematic review m...

  15. Economic Evaluation of Family Planning Interventions in Low and Middle Income Countries; A Systematic Review.

    Directory of Open Access Journals (Sweden)

    Neily Zakiyah

    Full Text Available A significant number of women in low and middle income countries (L-MICs who need any family planning, experience a lack in access to modern effective methods. This study was conducted to review potential cost effectiveness of scaling up family planning interventions in these regions from the published literatures and assess their implication for policy and future research.A systematic review was performed in several electronic databases i.e Medline (Pubmed, Embase, Popline, The National Bureau of Economic Research (NBER, EBSCOHost, and The Cochrane Library. Articles reporting full economic evaluations of strategies to improve family planning interventions in one or more L-MICs, published between 1995 until 2015 were eligible for inclusion. Data was synthesized and analyzed using a narrative approach and the reporting quality of the included studies was assessed using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS statement.From 920 references screened, 9 studies were eligible for inclusion. Six references assessed cost effectiveness of improving family planning interventions in one or more L-MICs, while the rest assessed costs and consequences of integrating family planning and HIV services, concerning sub-Saharan Africa. Assembled evidence suggested that improving family planning interventions is cost effective in a variety of L-MICs as measured against accepted international cost effectiveness benchmarks. In areas with high HIV prevalence, integrating family planning and HIV services can be efficient and cost effective; however the evidence is only supported by a very limited number of studies. The major drivers of cost effectiveness were cost of increasing coverage, effectiveness of the interventions and country-specific factors.Improving family planning interventions in low and middle income countries appears to be cost-effective. Additional economic evaluation studies with improved reporting quality are necessary

  16. Economic Evaluation of Family Planning Interventions in Low and Middle Income Countries; A Systematic Review.

    Science.gov (United States)

    Zakiyah, Neily; van Asselt, Antoinette D I; Roijmans, Frank; Postma, Maarten J

    2016-01-01

    A significant number of women in low and middle income countries (L-MICs) who need any family planning, experience a lack in access to modern effective methods. This study was conducted to review potential cost effectiveness of scaling up family planning interventions in these regions from the published literatures and assess their implication for policy and future research. A systematic review was performed in several electronic databases i.e Medline (Pubmed), Embase, Popline, The National Bureau of Economic Research (NBER), EBSCOHost, and The Cochrane Library. Articles reporting full economic evaluations of strategies to improve family planning interventions in one or more L-MICs, published between 1995 until 2015 were eligible for inclusion. Data was synthesized and analyzed using a narrative approach and the reporting quality of the included studies was assessed using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement. From 920 references screened, 9 studies were eligible for inclusion. Six references assessed cost effectiveness of improving family planning interventions in one or more L-MICs, while the rest assessed costs and consequences of integrating family planning and HIV services, concerning sub-Saharan Africa. Assembled evidence suggested that improving family planning interventions is cost effective in a variety of L-MICs as measured against accepted international cost effectiveness benchmarks. In areas with high HIV prevalence, integrating family planning and HIV services can be efficient and cost effective; however the evidence is only supported by a very limited number of studies. The major drivers of cost effectiveness were cost of increasing coverage, effectiveness of the interventions and country-specific factors. Improving family planning interventions in low and middle income countries appears to be cost-effective. Additional economic evaluation studies with improved reporting quality are necessary to generate

  17. What domains of clinical function should be assessed after sport-related concussion? A systematic review.

    Science.gov (United States)

    Feddermann-Demont, Nina; Echemendia, Ruben J; Schneider, Kathryn J; Solomon, Gary S; Hayden, K Alix; Turner, Michael; Dvořák, Jiří; Straumann, Dominik; Tarnutzer, Alexander A

    2017-06-01

    Sport-related concussion (SRC) is a clinical diagnosis made after a sport-related head trauma. Inconsistency exists regarding appropriate methods for assessing SRC, which focus largely on symptom-scores, neurocognitive functioning and postural stability. Systematic literature review. MEDLINE, EMBASE, PsycINFO, Cochrane-DSR, Cochrane CRCT, CINAHL, SPORTDiscus (accessed July 9, 2016). Original (prospective) studies reporting on postinjury assessment in a clinical setting and evaluation of diagnostic tools within 2 weeks after an SRC. Forty-six studies covering 3284 athletes were included out of 2170 articles. Only the prospective studies were considered for final analysis (n=33; 2416 athletes). Concussion diagnosis was typically made on the sideline by an (certified) athletic trainer (55.0%), mainly on the basis of results from a symptom-based questionnaire. Clinical domains affected included cognitive, vestibular and headache/migraine. Headache, fatigue, difficulty concentrating and dizziness were the symptoms most frequently reported. Neurocognitive testing was used in 30/33 studies (90.9%), whereas balance was assessed in 9/33 studies (27.3%). The overall quality of the studies was considered low. The absence of an objective, gold standard criterion makes the accurate diagnosis of SRC challenging. Current approaches tend to emphasise cognition, symptom assessment and postural stability with less of a focus on other domains of functioning. We propose that the clinical assessment of SRC should be symptom based and interdisciplinary. Whenever possible, the SRC assessment should incorporate neurological, vestibular, ocular motor, visual, neurocognitive, psychological and cervical aspects. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  18. Systematic comparative and sensitivity analyses of additive and outranking techniques for supporting impact significance assessments

    International Nuclear Information System (INIS)

    Cloquell-Ballester, Vicente-Agustin; Monterde-Diaz, Rafael; Cloquell-Ballester, Victor-Andres; Santamarina-Siurana, Maria-Cristina

    2007-01-01

    Assessing the significance of environmental impacts is one of the most important and all together difficult processes of Environmental Impact Assessment. This is largely due to the multicriteria nature of the problem. To date, decision techniques used in the process suffer from two drawbacks, namely the problem of compensation and the problem of identification of the 'exact boundary' between sub-ranges. This article discusses these issues and proposes a methodology for determining the significance of environmental impacts based on comparative and sensitivity analyses using the Electre TRI technique. An application of the methodology for the environmental assessment of a Power Plant project within the Valencian Region (Spain) is presented, and its performance evaluated. It is concluded that contrary to other techniques, Electre TRI automatically identifies those cases where allocation of significance categories is most difficult and, when combined with sensitivity analysis, offers greatest robustness in the face of variation in weights of the significance attributes. Likewise, this research demonstrates the efficacy of systematic comparison between Electre TRI and sum-based techniques, in the solution of assignment problems. The proposed methodology can therefore be regarded as a successful aid to the decision-maker, who will ultimately take the final decision

  19. L-arginine and L-NMMA for Assessing Cerebral Endothelial Dysfunction in Ischemic Cerebrovascular Disease: A Systematic Review

    DEFF Research Database (Denmark)

    Karlsson, William Kristian; Sørensen, Caspar Godthaab; Kruuse, Christina

    2017-01-01

    Endothelial dysfunction (ED), in particular cerebral ED, may be an essential biomarker for ischaemic cerebrovascular disease. However, there is no consensus on methods to best estimate cerebral ED. In this systematic review, we evaluate the use of l-arginine and NG -monomethyl-l-arginine (l......-NMMA) for assessment of cerebral ED. A systematic search of PubMed, EMBASE and the Cochrane Library was done. We included studies investigating cerebrovascular response to l-arginine or l-NMMA in human subjects with vascular risk factors or ischaemic cerebrovascular disease. Seven studies (315 subjects) were eligible...... cerebrovascular disease. Inconsistencies in results were most likely due to variations in methods and included subject populations. In order to use cerebral ED as a prognostic marker, further studies are required to evaluate the association to cerebrovascular disease....

  20. Framework for the systematic assessment of a material control and accounting system

    International Nuclear Information System (INIS)

    Schechter, R.S.; Sacks, I.J.

    1981-01-01

    Procedures are described for the systematic assessment of a Material Control and Accounting (MC and A) system, in terms of compliance to the proposed MC and A Upgrade Rule. The applicability of these assessment procedures to specific Rule provisions is discussed. Special attention is given to the statistical performance of individual subsystems, and their vulnerability to compromise by insider collusion

  1. Economic evaluation and cost of interventions for cerebral palsy: a systematic review.

    Science.gov (United States)

    Shih, Sophy T F; Tonmukayakul, Utsana; Imms, Christine; Reddihough, Dinah; Graham, H Kerr; Cox, Liz; Carter, Rob

    2018-06-01

    Economic appraisal can help guide policy-making for purchasing decisions, and treatment and management algorithms for health interventions. We conducted a systematic review of economic studies in cerebral palsy (CP) to inform future research. Economic studies published since 1970 were identified from seven databases. Two reviewers independently screened abstracts and extracted data following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Any discrepancies were resolved by discussion. Of 980 identified references, 115 were included for full-text assessment. Thirteen articles met standard criteria for a full economic evaluation, two as partial economic evaluations, and 18 as cost studies. Six were full economic evaluations alongside clinical studies or randomized controlled trials, whereas seven involved modelling simulations. The economic case for administration of magnesium sulfate for imminent preterm birth is compelling, achieving both health gain and cost savings. Current literature suggests intrathecal baclofen therapy and botulinum toxin injection are cost-effective, but stronger evidence for long-term effects is needed. Lifestyle and web-based interventions are inexpensive, but broader measurement of outcomes is required. Prevention of CP would avoid significant economic burden. Some treatments and interventions have been shown to be cost-effective, although stronger evidence of clinical effectiveness is needed. What this paper adds Cost-effectiveness evidence shows prevention is the most significant strategy. Some treatments are cost-effective, but stronger evidence for long-term effectiveness is required. Comparison of treatment costs is challenging owing to variations in methodologies and varying clinical indications. © 2018 Mac Keith Press.

  2. A systematic review and overview of health economic evaluations of emergency laparotomy

    Directory of Open Access Journals (Sweden)

    Sohail Bampoe

    2017-11-01

    Full Text Available Abstract Background Little is known about the economic impact of emergency laparotomy (EL surgery in healthcare systems around the world. The aim of this systematic review is to describe the primary resource utilisation, healthcare economic and societal costs of EL in adults in different countries. Methods MEDLINE, EMBASE, ISI Web of Knowledge, Cochrane Central Register Controlled Trials, Cochrane Database of Systematic Reviews and CINAHL were searched for full and partial economic analyses of EL published between 1 January 1991 and 31 December 2015. Quality of studies was assessed using the Consensus on Health Economic Criteria (CHEC checklist. Results Sixteen studies were included from a range of countries. One study was a full economic analysis. Fifteen studies were partial economic evaluations. These studies revealed that emergency abdominal surgery is expensive compared to similar elective surgery when comparing primary resource utilisation costs, with an important societal impact. Most contemporaneous studies indicate that in-hospital costs for EL are in excess of US$10,000 per patient episode, rising substantially when societal costs are considered. Discussion EL is a high-risk and costly procedure with a disproportionate financial burden for healthcare providers, relative to national funding provisions and wider societal cost impact. There is substantial heterogeneity in the methodologies and quality of published economic evaluations of EL; therefore, the true economic costs of EL are yet to be fully defined. Future research should focus on developing strategies to embed health economic evaluations within national programmes aiming to improve EL care, including developing the required measures and infrastructure. Conclusions Emergency laparotomy is expensive, with a significant cost burden to healthcare and systems and society worldwide. Novel strategies for reducing this econmic burden should urgently be explored if greater access to

  3. A systematic review and overview of health economic evaluations of emergency laparotomy.

    Science.gov (United States)

    Bampoe, Sohail; Odor, Peter M; Ramani Moonesinghe, S; Dickinson, Matthew

    2017-01-01

    Little is known about the economic impact of emergency laparotomy (EL) surgery in healthcare systems around the world. The aim of this systematic review is to describe the primary resource utilisation, healthcare economic and societal costs of EL in adults in different countries. MEDLINE, EMBASE, ISI Web of Knowledge, Cochrane Central Register Controlled Trials, Cochrane Database of Systematic Reviews and CINAHL were searched for full and partial economic analyses of EL published between 1 January 1991 and 31 December 2015. Quality of studies was assessed using the Consensus on Health Economic Criteria (CHEC) checklist. Sixteen studies were included from a range of countries. One study was a full economic analysis. Fifteen studies were partial economic evaluations. These studies revealed that emergency abdominal surgery is expensive compared to similar elective surgery when comparing primary resource utilisation costs, with an important societal impact. Most contemporaneous studies indicate that in-hospital costs for EL are in excess of US$10,000 per patient episode, rising substantially when societal costs are considered. EL is a high-risk and costly procedure with a disproportionate financial burden for healthcare providers, relative to national funding provisions and wider societal cost impact. There is substantial heterogeneity in the methodologies and quality of published economic evaluations of EL; therefore, the true economic costs of EL are yet to be fully defined. Future research should focus on developing strategies to embed health economic evaluations within national programmes aiming to improve EL care, including developing the required measures and infrastructure. Emergency laparotomy is expensive, with a significant cost burden to healthcare and systems and society worldwide. Novel strategies for reducing this econmic burden should urgently be explored if greater access to this type of surgery is to be pursued as a global health target. PROSPERO

  4. Cataract frequency and subtypes involved in workers assessed for their solar radiation exposure: a systematic review.

    Science.gov (United States)

    Modenese, Alberto; Gobba, Fabriziomaria

    2018-04-16

    Cataract is currently the primary cause of blindness worldwide, and one of its main risk factors is solar ultraviolet radiation exposure. According to the localization of lens opacities, three main subtypes of cataract are recognized: nuclear, cortical and posterior subcapsular cataract. One of the main determinants of individual long-term solar radiation exposure is outdoor work. We systematically reviewed scientific literature from the last 20 years to update the recent development of research on the risk of cataract in outdoor workers and on the specific subtypes involved, also investigating the methods applied to evaluate the occupational risk. A total of 15 studies were included in the review, of which 12 showed a positive association. The studies confirm the relationship of long-term occupational solar radiation exposure with cortical cataract and give new support for nuclear cataract, although no substantial new data were available to support a relation with the posterior subcapsular subtype. In most of the studies, the exposure assessment was not adequate to support a representative evaluation of the ocular risk; however, outdoor work is clearly a relevant risk factor for cataract. Further research providing a better evaluation of the relation between solar radiation exposure levels and lens damage in workers is needed and aimed to establish adequate occupational exposure limits and better preventive measures, studying also their effectiveness. © 2018 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  5. Using systematic aging assessments to improve effectiveness of plant maintenance programs

    International Nuclear Information System (INIS)

    Watson, P.; Yang, J.X.; Dam, R.F.; Nickerson, J.H.

    2003-01-01

    Nuclear plant equipment aging assessment studies provided by AECL include life assessments, condition assessments or systematic assessments of maintenance. AECL has developed several tools to apply the results of aging assessment studies to improve the effectiveness of actual plant maintenance programs. The Systematic Assessment of Maintenance and the SYSTMS tool generate maintenance tasks for a system. The System Maintenance Datastore tool assesses the maintenance resources on a system basis, and can thus quantify the savings realized by optimizing the maintenance program. Long term trends in condition-based maintenance due to component aging can be predicted, and resource savings due to optimum timing of component replacement or general plant refurbishment can be quantified. The System based Adaptive Maintenance Process ensures the maintenance program is continually updated to reflect the latest plant equipment condition and maintenance strategy information. (author)

  6. Assessing value in breast reconstruction: A systematic review of cost-effectiveness studies.

    Science.gov (United States)

    Sheckter, Clifford C; Matros, Evan; Momeni, Arash

    2018-03-01

    Breast reconstruction is one of the most common procedures performed by plastic surgeons and is achieved through various choices in both technology and method. Cost-effectiveness analyses are increasingly important in assessing differences in value between treatment options, which is relevant in a world of confined resources. A thorough evaluation of the cost-effectiveness literature can assist surgeons and health systems evaluate high-value care models. A systematic review of PubMed, Web of Science, and the Cost-Effectiveness Analysis Registry was conducted. Two reviewers independently evaluated all publications up until August 17, 2017. After removal of duplicates, 1996 records were screened, from which 53 studies underwent full text review. All the 13 studies included for final analysis mention an incremental cost-effectiveness ratio. Five studies evaluated the cost-effectiveness of technologies including acellular dermal matrix (ADM) in staged prosthetic reconstruction, ADM in direct-to-implant (DTI) reconstruction, preoperative computed tomography angiography in autologous reconstruction, indocyanine green dye angiography in evaluating anastomotic patency, and abdominal mesh reinforcement in abdominal tissue transfer. The remaining eight studies evaluated the cost-effectiveness of different reconstruction methods. Cost-effective strategies included free vs. pedicled abdominal tissue transfer, DTI vs. staged prosthetic reconstruction, and fascia-sparing variants of free abdominal tissue transfer. Current evidence demonstrates multiple cost-effective technologies and methods in accomplishing successful breast reconstruction. Plastic surgeons should be well informed of such economic models when engaging payers and policymakers in discussions regarding high-value breast reconstruction. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  7. Rapid Health and Needs assessments after disasters: a systematic review

    Directory of Open Access Journals (Sweden)

    Yzermans CJ

    2010-06-01

    Full Text Available Abstract Background Publichealth care providers, stakeholders and policy makers request a rapid insight into health status and needs of the affected population after disasters. To our knowledge, there is no standardized rapid assessment tool for European countries. The aim of this article is to describe existing tools used internationally and analyze them for the development of a workable rapid assessment. Methods A review was conducted, including original studies concerning a rapid health and/or needs assessment. The studies used were published between 1980 and 2009. The electronic databasesof Medline, Embase, SciSearch and Psychinfo were used. Results Thirty-three studies were included for this review. The majority of the studies was of US origin and in most cases related to natural disasters, especially concerning the weather. In eighteen studies an assessment was conducted using a structured questionnaire, eleven studies used registries and four used both methods. Questionnaires were primarily used to asses the health needs, while data records were used to assess the health status of disaster victims. Conclusions Methods most commonly used were face to face interviews and data extracted from existing registries. Ideally, a rapid assessment tool is needed which does not add to the burden of disaster victims. In this perspective, the use of existing medical registries in combination with a brief questionnaire in the aftermath of disasters is the most promising. Since there is an increasing need for such a tool this approach needs further examination.

  8. Economic evaluation of bone stimulation modalities: A systematic review of the literature.

    Science.gov (United States)

    Button, Melissa L; Sprague, Sheila; Gharsaa, Osama; Latouche, Sandra; Bhandari, Mohit

    2009-04-01

    Various bone stimulation modalities are commonly used in treatment of fresh fractures and nonunions; however, the effectiveness and efficiency of these modalities remain uncertain. A systematic review of trials evaluating the clinical and economical outcomes of ultrasounds, electrical stimulation, and extracorporeal sound waves on fracture healing was conducted. We searched four electronic databases for economic evaluations that assessed bone stimulation modalities using ultrasound therapy, electrical stimulation, or extracorporeal shock waves. In addition, we searched the references and related articles of eligible studies, and a content expert was contacted. Information on the clinical and economical outcomes of patients was independently extracted by reviewers. Fourteen studies met the inclusion criteria; therefore, very limited research was found on the cost associated with treatments and the corresponding outcomes. The data available focus primarily on the efficacy of newly introduced treatment methods for bone growth, but failed to incorporate the costs of implementing such treatments. One economic analysis was identified that assessed different treatment paths using ultrasound. A total cost savings of 24-40% per patient occurred when ultrasound was used for fresh fractures and nonunions (grade C recommendation). The results suggest that the ultrasound is a viable alternative for bone stimulation; however, the impacts of the other modalities are left unknown due to the lack of research available. Methodological limitations leave the overall economic and clinical impact of these modalities uncertain. Large, prospective, randomized controlled trials that include cost-effectiveness analyses are needed to further define the clinical effectiveness and financial burden associated with bone stimulation modalities.

  9. Is the smile line a valid parameter for esthetic evaluation? A systematic literature review.

    Science.gov (United States)

    Passia, Nicole; Blatz, Markus; Strub, Jörg Rudolf

    2011-01-01

    The "smile line" is commonly used as a parameter to evaluate and categorize a person's smile. This systematic literature review assessed the existing evidence on the validity and universal applicability of this parameter. The latter was evaluated based on studies on smile perception by orthodontists, general clinicians, and laypeople. A review of the literature published between October 1973 and January 2010 was conducted with the electronic database Pubmed and the search terms "smile," "smile line," "smile arc," and "smile design." The search yielded 309 articles, of which nine studies were included based on the selection criteria. The selected studies typically correlate the smile line with the position of the upper lip during a smile while, on average, 75 to 100% of the maxillary anterior teeth are exposed. A virtual line that connects the incisal edges of the maxillary anterior teeth commonly follows the upper border of the lower lip. Average and parallel smile lines are most common, influenced by the age and gender of a person. Orthodontists, general clinicians, and laypeople have similar preferences and rate average smile lines as most attractive. The smile line is a valid tool to assess the esthetic appearance of a smile. It can be applied universally as clinicians and laypersons perceive and judge it similarly.

  10. Economic evaluation of HIV pre-exposure prophylaxis strategies: protocol for a methodological systematic review and quantitative synthesis.

    Science.gov (United States)

    Thavorn, Kednapa; Kugathasan, Howsikan; Tan, Darrell H S; Moqueet, Nasheed; Baral, Stefan D; Skidmore, Becky; MacFadden, Derek; Simkin, Anna; Mishra, Sharmistha

    2018-03-15

    Pre-exposure prophylaxis (PrEP) with antiretrovirals is an efficacious and effective intervention to decrease the risk of HIV (human immunodeficiency virus) acquisition. Yet drug and delivery costs prohibit access in many jurisdictions. In the absence of guidelines for the synthesis of economic evaluations, we developed a protocol for a systematic review of economic evaluation studies for PrEP by drawing on best practices in systematic reviews and the conduct and reporting of economic evaluations. We aim to estimate the incremental cost per health outcome of PrEP compared with placebo, no PrEP, or other HIV prevention strategies; assess the methodological variability in, and quality of, economic evaluations of PrEP; estimate the incremental cost per health outcome of different PrEP implementation strategies; and quantify the potential sources of heterogeneity in outcomes. We will systematically search electronic databases (MEDLINE, Embase) and the gray literature. We will include economic evaluation studies that assess both costs and health outcomes of PrEP in HIV-uninfected individuals, without restricting language or year of publication. Two reviewers will independently screen studies using predefined inclusion criteria, extract data, and assess methodological quality using the Philips checklist, Second Panel on the Cost-effectiveness of Health and Medicines, and the International Society for Pharmacoeconomics and Outcomes Research recommendations. Outcomes of interest include incremental costs and outcomes in natural units or utilities, cost-effectiveness ratios, and net monetary benefit. We will perform descriptive and quantitative syntheses using sensitivity analyses of outcomes by population subgroups, HIV epidemic settings, study designs, baseline intervention contexts, key parameter inputs and assumptions, type of outcomes, economic perspectives, and willingness to pay values. Findings will guide future economic evaluation of PrEP strategies in terms of

  11. Self-Assessment in the Evaluation Process.

    Science.gov (United States)

    Koehler, Michael

    1990-01-01

    Describes a four-step process to involve teachers in self-evaluation that results in performance ownership. When supervisors incorporate teacher self-assessments into classroom observation reports, teachers are more willing to engage in follow-up professional growth activities and perceive supervisors as helpers in the process. (MLH)

  12. Evaluating Assessment Using N-Dimensional Filtering.

    Science.gov (United States)

    Dron, Jon; Boyne, Chris; Mitchell, Richard

    This paper describes the use of the CoFIND (Collaborative Filter in N Dimensions) system to evaluate two assessment styles. CoFIND is a resource database that organizes itself around its users' needs. Learners enter resources, categorize, then rate them using "qualities," aspects of resources which learners find worthwhile, the n…

  13. Methods for assessing the preventability of adverse drug events: a systematic review.

    Science.gov (United States)

    Hakkarainen, Katja Marja; Andersson Sundell, Karolina; Petzold, Max; Hägg, Staffan

    2012-02-01

    Preventable adverse drug events (ADEs) are common in both outpatient and inpatient settings. However, the proportion of preventable ADEs varies considerably in different studies, even when conducted in the same setting, and methods for assessing the preventability of ADEs are diverse. The aim of this article is to identify and systematically evaluate methods for assessing the preventability of ADEs. Seven databases (Cochrane, CINAHL, EMBASE, IPA, MEDLINE, PsycINFO and Web of Science) were searched in September 2010 utilizing the databases' index terms and other common terminology on preventable ADEs. No limits for the years of publication were set. Reference lists of included original articles and relevant review articles were also screened. After applying predetermined inclusion and exclusion criteria on 4161 unique citations, 142 (3.4%) original research articles were included in the review. One additional article was included from reference lists. Outcome measures of included studies had to include the frequency of ADEs and the assessment of their preventability. Studies were excluded if they focused on individuals with one specific type of treatment, medical condition, medical procedure or ADE. Measurement instruments for determining the preventability of ADEs in each article were extracted and unique instruments were compared. The process of assessing the preventability of ADEs was described based on reported actions taken to standardize and conduct the assessment, and on information about the reliability and validity of the assessment. Eighteen unique instruments for determining the preventability of ADEs were identified. They fell under the following four groups: (i) instruments using a definition of preventability only (n = 3); (ii) instruments with a definition of preventability and an assessment scale for determining preventability (n = 5); (iii) instruments with specific criteria for each preventability category (n = 3); and (iv) instruments

  14. A systematic process for developing and assessing accident management plans

    International Nuclear Information System (INIS)

    Hanson, D.J.; Blackman, H.S.; Meyer, O.R.; Ward, L.W.

    1991-04-01

    This document describes a four-phase approach for developing criteria recommended for use in assessing the adequacy of nuclear power plant accident management plans. Two phases of the approach have been completed and provide a prototype process that could be used to develop an accident management plan. Based on this process, a preliminary set of assessment criteria are derived. These preliminary criteria will be refined and improved when the remaining steps of the approach are completed, that is, after the prototype process is validated through application. 9 refs., 10 figs., 7 tabs

  15. Three-dimensional assessment of facial asymmetry: A systematic review.

    Science.gov (United States)

    Akhil, Gopi; Senthil Kumar, Kullampalayam Palanisamy; Raja, Subramani; Janardhanan, Kumaresan

    2015-08-01

    For patients with facial asymmetry, complete and precise diagnosis, and surgical treatments to correct the underlying cause of the asymmetry are significant. Conventional diagnostic radiographs (submento-vertex projections, posteroanterior radiography) have limitations in asymmetry diagnosis due to two-dimensional assessments of three-dimensional (3D) images. The advent of 3D images has greatly reduced the magnification and projection errors that are common in conventional radiographs making it as a precise diagnostic aid for assessment of facial asymmetry. Thus, this article attempts to review the newly introduced 3D tools in the diagnosis of more complex facial asymmetries.

  16. Protocol: a systematic review of studies developing and/or evaluating search strategies to identify prognosis studies.

    Science.gov (United States)

    Corp, Nadia; Jordan, Joanne L; Hayden, Jill A; Irvin, Emma; Parker, Robin; Smith, Andrea; van der Windt, Danielle A

    2017-04-20

    Prognosis research is on the rise, its importance recognised because chronic health conditions and diseases are increasingly common and costly. Prognosis systematic reviews are needed to collate and synthesise these research findings, especially to help inform effective clinical decision-making and healthcare policy. A detailed, comprehensive search strategy is central to any systematic review. However, within prognosis research, this is challenging due to poor reporting and inconsistent use of available indexing terms in electronic databases. Whilst many published search filters exist for finding clinical trials, this is not the case for prognosis studies. This systematic review aims to identify and compare existing methodological filters developed and evaluated to identify prognosis studies of any of the three main types: overall prognosis, prognostic factors, and prognostic [risk prediction] models. Primary studies reporting the development and/or evaluation of methodological search filters to retrieve any type of prognosis study will be included in this systematic review. Multiple electronic bibliographic databases will be searched, grey literature will be sought from relevant organisations and websites, experts will be contacted, and citation tracking of key papers and reference list checking of all included papers will be undertaken. Titles will be screened by one person, and abstracts and full articles will be reviewed for inclusion independently by two reviewers. Data extraction and quality assessment will also be undertaken independently by two reviewers with disagreements resolved by discussion or by a third reviewer if necessary. Filters' characteristics and performance metrics reported in the included studies will be extracted and tabulated. To enable comparisons, filters will be grouped according to database, platform, type of prognosis study, and type of filter for which it was intended. This systematic review will identify all existing validated

  17. Assessing patient-centred communication in teaching: a systematic review of instruments.

    Science.gov (United States)

    Brouwers, Marianne; Rasenberg, Ellemieke; van Weel, Chris; Laan, Roland; van Weel-Baumgarten, Evelyn

    2017-11-01

    Patient-centred communication is a key component of patient centredness in medical care. Therefore, adequate education in and assessment of patient-centred communication skills are necessary. In general, feedback on communication skills is most effective when it is provided directly and is systematic. This calls for adequate measurement instruments. The aim of this study was to provide a systematic review of existing instruments that measure patient centredness in doctor-patient communication and can be used to provide direct feedback. A systematic review was conducted using an extensive validated search strategy for measurement instruments in PubMed, EMBASE, PsycINFO and CINAHL. The databases were searched from their inception to 1 July 2016. Articles describing the development or evaluation of the measurement properties of instruments that measure patient centredness (by applying three or more of the six dimensions of a published definition of patient centredness) in doctor-patient communication and that can be used for the provision of direct feedback were included. The methodological quality of measurement properties was evaluated using the COSMIN checklist. Thirteen articles describing 14 instruments measuring patient centredness in doctor-patient communication were identified. These studies cover a wide range of settings and patient populations, and vary in the dimensions of patient centredness applied and in methodological quality on aspects of reliability and validity. This review gives a comprehensive overview of all instruments available for the measurement of patient centredness in doctor-patient communication that can be used for the provision of direct feedback and are described in the literature. Despite the widely felt need for valid and reliable instruments for the measurement of patient-centred communication, most of the instruments currently available have not been thoroughly investigated. Therefore, we recommend further research into and

  18. Low health literacy and evaluation of online health information: a systematic review of the literature.

    Science.gov (United States)

    Diviani, Nicola; van den Putte, Bas; Giani, Stefano; van Weert, Julia Cm

    2015-05-07

    Recent years have witnessed a dramatic increase in consumer online health information seeking. The quality of online health information, however, remains questionable. The issue of information evaluation has become a hot topic, leading to the development of guidelines and checklists to design high-quality online health information. However, little attention has been devoted to how consumers, in particular people with low health literacy, evaluate online health information. The main aim of this study was to review existing evidence on the association between low health literacy and (1) people's ability to evaluate online health information, (2) perceived quality of online health information, (3) trust in online health information, and (4) use of evaluation criteria for online health information. Five academic databases (MEDLINE, PsycINFO, Web of Science, CINAHL, and Communication and Mass-media Complete) were systematically searched. We included peer-reviewed publications investigating differences in the evaluation of online information between people with different health literacy levels. After abstract and full-text screening, 38 articles were included in the review. Only four studies investigated the specific role of low health literacy in the evaluation of online health information. The other studies examined the association between educational level or other skills-based proxies for health literacy, such as general literacy, and outcomes. Results indicate that low health literacy (and related skills) are negatively related to the ability to evaluate online health information and trust in online health information. Evidence on the association with perceived quality of online health information and use of evaluation criteria is inconclusive. The findings indicate that low health literacy (and related skills) play a role in the evaluation of online health information. This topic is therefore worth more scholarly attention. Based on the results of this review

  19. Systematic review: questionnaires for assessment of gastroesophageal reflux disease

    NARCIS (Netherlands)

    Bolier, E. A.; Kessing, B. F.; Smout, A. J.; Bredenoord, A. J.

    2015-01-01

    Numerous questionnaires with a wide variety of characteristics have been developed for the assessment of gastroesophageal reflux disease (GERD). Four well-defined dimensions are noticeable in these GERD questionnaires, which are symptoms, response to treatment, diagnosis, and burden on the quality

  20. Meta-Review: Systematic Assessment of Program Review

    Science.gov (United States)

    Harlan, Brian

    2012-01-01

    Over 20 years ago, Robert J. Barak and Barbara E. Breier suggested incorporating a regular assessment of the entire program review system into the review schedule in order to ensure that the system itself is as efficient and effective as the programs under review. Barak and Breier's seminal book on the goals and processes of program review has…

  1. A systematic approach to training: A training needs assessment

    Science.gov (United States)

    Manning, Margaret H.

    1989-01-01

    In an effort to determine the gap between the actual performance and the necessary performance of employees for the effective and efficient accomplishment of an organization's mission and goals, an organization-wide Training Needs Assessment must be conducted. The purpose of this work was to conduct a training needs analysis and prepare a NASA Langley Catalog of On-Site Training programs. The work included developing a Training Needs Assessment Survey, implementing the survey, analyzing and researching the training needs, identifying the courses to meet the needs, and preparing and designing an On-Site Training Catalog. This needs analysis attempted to identify performance weaknesses and deficits; seek out and provide opportunities for improved performance; anticipate and avoid future problems; enhance and create new strengths. The end product is a user-friendly catalog of on-site training available. The results include: top-down approach to needs assessment; improved communication with training coordinators; 98 percent return rate of the Training Needs Assessment survey; complete, newly designed, user-friendly catalog; 167 catalog descriptions advertised; 82 new courses advertised; training logo; and request for the training application form.

  2. Evidence-Based Clinical Voice Assessment: A Systematic Review

    Science.gov (United States)

    Roy, Nelson; Barkmeier-Kraemer, Julie; Eadie, Tanya; Sivasankar, M. Preeti; Mehta, Daryush; Paul, Diane; Hillman, Robert

    2013-01-01

    Purpose: To determine what research evidence exists to support the use of voice measures in the clinical assessment of patients with voice disorders. Method: The American Speech-Language-Hearing Association (ASHA) National Center for Evidence-Based Practice in Communication Disorders staff searched 29 databases for peer-reviewed English-language…

  3. A systematic review of factors influencing student ratings in undergraduate medical education course evaluations.

    Science.gov (United States)

    Schiekirka, Sarah; Raupach, Tobias

    2015-03-05

    Student ratings are a popular source of course evaluations in undergraduate medical education. Data on the reliability and validity of such ratings have mostly been derived from studies unrelated to medical education. Since medical education differs considerably from other higher education settings, an analysis of factors influencing overall student ratings with a specific focus on medical education was needed. For the purpose of this systematic review, online databases (PubMed, PsycInfo and Web of Science) were searched up to August 1st, 2013. Original research articles on the use of student ratings in course evaluations in undergraduate medical education were eligible for inclusion. Included studies considered the format of evaluation tools and assessed the association of independent and dependent (i.e., overall course ratings) variables. Inclusion and exclusion criteria were checked by two independent reviewers, and results were synthesised in a narrative review. Twenty-five studies met the inclusion criteria. Qualitative research (2 studies) indicated that overall course ratings are mainly influenced by student satisfaction with teaching and exam difficulty rather than objective determinants of high quality teaching. Quantitative research (23 studies) yielded various influencing factors related to four categories: student characteristics, exposure to teaching, satisfaction with examinations and the evaluation process itself. Female gender, greater initial interest in course content, higher exam scores and higher satisfaction with exams were associated with more positive overall course ratings. Due to the heterogeneity and methodological limitations of included studies, results must be interpreted with caution. Medical educators need to be aware of various influences on student ratings when developing data collection instruments and interpreting evaluation results. More research into the reliability and validity of overall course ratings as typically used in the

  4. Tools to Assess Behavioral and Social Science Competencies in Medical Education: A Systematic Review

    Science.gov (United States)

    Carney, Patricia A.; Palmer, Ryan T.; Miller, Marissa Fuqua; Thayer, Erin K.; Estroff, Sue E.; Litzelman, Debra K.; Biagioli, Frances E.; Teal, Cayla R.; Lambros, Ann; Hatt, William J.; Satterfield, Jason M.

    2015-01-01

    Purpose Behavioral and social science (BSS) competencies are needed to provide quality health care, but psychometrically validated measures to assess these competencies are difficult to find. Moreover, they have not been mapped to existing frameworks, like those from the Liaison Committee on Medical Education (LCME) and Accreditation Council for Graduate Medical Education (ACGME). This systematic review aimed to identify and evaluate the quality of assessment tools used to measure BSS competencies. Method The authors searched the literature published between January 2002 and March 2014 for articles reporting psychometric or other validity/reliability testing, using OVID, CINAHL, PubMed, ERIC, Research and Development Resource Base, SOCIOFILE, and PsycINFO. They reviewed 5,104 potentially relevant titles and abstracts. To guide their review, they mapped BSS competencies to existing LCME and ACGME frameworks. The final, included articles fell into three categories: instrument development, which were of the highest quality; educational research, which were of the second highest quality; and curriculum evaluation, which were of lower quality. Results Of the 114 included articles, 33 (29%) yielded strong evidence supporting tools to assess communication skills, cultural competence, empathy/compassion, behavioral health counseling, professionalism, and teamwork. Sixty-two (54%) articles yielded moderate evidence and 19 (17%) weak evidence. Articles mapped to all LCME standards and ACGME core competencies; the most common was communication skills. Conclusions These findings serve as a valuable resource for medical educators and researchers. More rigorous measurement validation and testing and more robust study designs are needed to understand how educational strategies contribute to BSS competency development. PMID:26796091

  5. Using systematically observed clinical encounters (SOCEs to assess medical students’ skills in clinical settings

    Directory of Open Access Journals (Sweden)

    George R Bergus

    2010-11-01

    Full Text Available George R Bergus1–3, Jerold C Woodhead4, Clarence D Kreiter2,51Performance Based Assessment Program, Office of Student Affairs and Curriculum, 2Department of Family Medicine, 3Department of Psychiatry, 4Department of Pediatrics, 5Office of Consultation and Research in Medical Education, Roy J and Lucille A Carver College of Medicine, The University of Iowa, Iowa City, IA, USAIntroduction: The Objective Structured Clinical Examination (OSCE is widely used to assess the clinical performance of medical students. However, concerns related to cost, availability, and validity, have led educators to investigate alternatives to the OSCE. Some alternatives involve assessing students while they provide care to patients – the mini-CEX (mini-Clinical Evaluation Exercise and the Long Case are examples. We investigated the psychometrics of systematically observed clinical encounters (SOCEs, in which physicians are supplemented by lay trained observers, as a means of assessing the clinical performances of medical students.Methods: During the pediatrics clerkship at the University of Iowa, trained lay observers assessed the communication skills of third-year medical students using a communication checklist while the students interviewed and examined pediatric patients. Students then verbally presented their findings to faculty, who assessed students’ clinical skills using a standardized form. The reliability of the combined communication and clinical skills scores was calculated using generalizability theory.Results: Fifty-one medical students completed 199 observed patient encounters. The mean combined clinical and communication skills score (out of a maximum 45 points was 40.8 (standard deviation 3.3. The calculated reliability of the SOCE scores, using generalizability theory, from 10 observed patient encounters was 0.81. Students reported receiving helpful feedback from faculty after 97% of their observed clinical encounters.Conclusion: The SOCE can

  6. A Systematic Review of the State of Economic Evaluation for Health Care in India.

    Science.gov (United States)

    Prinja, Shankar; Chauhan, Akashdeep Singh; Angell, Blake; Gupta, Indrani; Jan, Stephen

    2015-12-01

    Economic evaluations are one of the important tools in policy making for rational allocation of resources. Given the very low public investment in the health sector in India, it is critical that resources are used wisely on interventions proven to yield best results. Hence, we undertook this study to assess the extent and quality of evidence for economic evaluation of health-care interventions and programmes in India. A comprehensive search was conducted to search for published full economic evaluations pertaining to India and addressing a health-related intervention or programme. PubMed, Scopus, Embase, ScienceDirect, and York CRD database and websites of important research agencies were identified to search for economic evaluations published from January 1980 to the middle of November 2014. Two researchers independently assessed the quality of the studies based on Drummond and modelling checklist. Out of a total of 5013 articles enlisted after literature search, a total of 104 met the inclusion criteria for this systematic review. The majority of these papers were cost-effectiveness studies (64%), led by a clinician or public-health professional (77%), using decision analysis-based methods (59%), published in an international journal (80%) and addressing communicable diseases (58%). In addition, 42% were funded by an international funding agency or UN/bilateral aid agency, and 30% focussed on pharmaceuticals. The average quality score of these full economic evaluations was 65.1%. The major limitation was the inability to address uncertainties involved in modelling as only about one-third of the studies assessed modelling structural uncertainties (33%), or ran sub-group analyses to account for heterogeneity (36.5%) or analysed methodological uncertainty (32%). The existing literature on economic evaluations in India is inadequate to feed into sound policy making. There is an urgent need to generate awareness within the government of how economic evaluation can

  7. How effects on health equity are assessed in systematic reviews of interventions.

    Science.gov (United States)

    Welch, Vivian; Tugwell, Peter; Petticrew, Mark; de Montigny, Joanne; Ueffing, Erin; Kristjansson, Betsy; McGowan, Jessie; Benkhalti Jandu, Maria; Wells, George A; Brand, Kevin; Smylie, Janet

    2010-12-08

    Enhancing health equity has now achieved international political importance with endorsement from the World Health Assembly in 2009.  The failure of systematic reviews to consider effects on health equity is cited by decision-makers as a limitation to their ability to inform policy and program decisions.  To systematically review methods to assess effects on health equity in systematic reviews of effectiveness. We searched the following databases up to July 2 2010: MEDLINE, PsychINFO, the Cochrane Methodology Register, CINAHL, Education Resources Information Center, Education Abstracts, Criminal Justice Abstracts, Index to Legal Periodicals, PAIS International, Social Services Abstracts, Sociological Abstracts, Digital Dissertations and the Health Technology Assessment Database. We searched SCOPUS to identify articles that cited any of the included studies on October 7 2010. We included empirical studies of cohorts of systematic reviews that assessed methods for measuring effects on health inequalities. Data were extracted using a pre-tested form by two independent reviewers. Risk of bias was appraised for included studies according to the potential for bias in selection and detection of systematic reviews.  Thirty-four methodological studies were included.  The methods used by these included studies were: 1) Targeted approaches (n=22); 2) gap approaches (n=12) and gradient approach (n=1).  Gender or sex was assessed in eight out of 34 studies, socioeconomic status in ten studies, race/ethnicity in seven studies, age in seven studies, low and middle income countries in 14 studies, and two studies assessed multiple factors across health inequity may exist.Only three studies provided a definition of health equity. Four methodological approaches to assessing effects on health equity were identified: 1) descriptive assessment of reporting and analysis in systematic reviews (all 34 studies used a type of descriptive method); 2) descriptive assessment of reporting

  8. Reproducibility of studies on text mining for citation screening in systematic reviews: Evaluation and checklist.

    Science.gov (United States)

    Olorisade, Babatunde Kazeem; Brereton, Pearl; Andras, Peter

    2017-09-01

    Independent validation of published scientific results through study replication is a pre-condition for accepting the validity of such results. In computation research, full replication is often unrealistic for independent results validation, therefore, study reproduction has been justified as the minimum acceptable standard to evaluate the validity of scientific claims. The application of text mining techniques to citation screening in the context of systematic literature reviews is a relatively young and growing computational field with high relevance for software engineering, medical research and other fields. However, there is little work so far on reproduction studies in the field. In this paper, we investigate the reproducibility of studies in this area based on information contained in published articles and we propose reporting guidelines that could improve reproducibility. The study was approached in two ways. Initially we attempted to reproduce results from six studies, which were based on the same raw dataset. Then, based on this experience, we identified steps considered essential to successful reproduction of text mining experiments and characterized them to measure how reproducible is a study given the information provided on these steps. 33 articles were systematically assessed for reproducibility using this approach. Our work revealed that it is currently difficult if not impossible to independently reproduce the results published in any of the studies investigated. The lack of information about the datasets used limits reproducibility of about 80% of the studies assessed. Also, information about the machine learning algorithms is inadequate in about 27% of the papers. On the plus side, the third party software tools used are mostly free and available. The reproducibility potential of most of the studies can be significantly improved if more attention is paid to information provided on the datasets used, how they were partitioned and utilized, and

  9. Systematic Correlation Matrix Evaluation (SCoMaE) - a bottom-up, science-led approach to identifying indicators

    Science.gov (United States)

    Mengis, Nadine; Keller, David P.; Oschlies, Andreas

    2018-01-01

    This study introduces the Systematic Correlation Matrix Evaluation (SCoMaE) method, a bottom-up approach which combines expert judgment and statistical information to systematically select transparent, nonredundant indicators for a comprehensive assessment of the state of the Earth system. The methods consists of two basic steps: (1) the calculation of a correlation matrix among variables relevant for a given research question and (2) the systematic evaluation of the matrix, to identify clusters of variables with similar behavior and respective mutually independent indicators. Optional further analysis steps include (3) the interpretation of the identified clusters, enabling a learning effect from the selection of indicators, (4) testing the robustness of identified clusters with respect to changes in forcing or boundary conditions, (5) enabling a comparative assessment of varying scenarios by constructing and evaluating a common correlation matrix, and (6) the inclusion of expert judgment, for example, to prescribe indicators, to allow for considerations other than statistical consistency. The example application of the SCoMaE method to Earth system model output forced by different CO2 emission scenarios reveals the necessity of reevaluating indicators identified in a historical scenario simulation for an accurate assessment of an intermediate-high, as well as a business-as-usual, climate change scenario simulation. This necessity arises from changes in prevailing correlations in the Earth system under varying climate forcing. For a comparative assessment of the three climate change scenarios, we construct and evaluate a common correlation matrix, in which we identify robust correlations between variables across the three considered scenarios.

  10. Methods for the evaluation of hospital cooperation activities (Systematic review protocol

    Directory of Open Access Journals (Sweden)

    Rotter Thomas

    2012-02-01

    Full Text Available Abstract Background Hospital partnerships, mergers and cooperatives are arrangements frequently seen as a means of improving health service delivery. Many of the assumptions used in planning hospital cooperatives are not stated clearly and are often based on limited or poor scientific evidence. Methods This is a protocol for a systematic review, following the Cochrane EPOC methodology. The review aims to document, catalogue and synthesize the existing literature on the reported methods for the evaluation of hospital cooperation activities as well as methods of hospital cooperation. We will search the Database of Abstracts of Reviews of Effectiveness, the Effective Practice and Organisation of Care Register, the Cochrane Central Register of Controlled Trials and bibliographic databases including PubMed (via NLM, Web of Science, NHS EED, Business Source Premier (via EBSCO and Global Health for publications that report on methods for evaluating hospital cooperatives, strategic partnerships, mergers, alliances, networks and related activities and methods used for such partnerships. The method proposed by the Cochrane EPOC group regarding randomized study designs, controlled clinical trials, controlled before and after studies, and interrupted time series will be followed. In addition, we will also include cohort, case-control studies, and relevant non-comparative publications such as case reports. We will categorize and analyze the review findings according to the study design employed, the study quality (low versus high quality studies and the method reported in the primary studies. We will present the results of studies in tabular form. Discussion Overall, the systematic review aims to identify, assess and synthesize the evidence to underpin hospital cooperation activities as defined in this protocol. As a result, the review will provide an evidence base for partnerships, alliances or other fields of cooperation in a hospital setting. PROSPERO

  11. Systematic assessment of the various controversies, difficulties, and ...

    African Journals Online (AJOL)

    Annals of Medical and Health Sciences Research ... Accurate occlusal plane orientation is an essential factor in the fabrication of complete denture prosthesis. Over the years, it has ... Studies describing research studies, case series and assorted clinical reports were retrieved and evaluated from 1963 to 2013. Most of the ...

  12. [Assessment of Functioning when Conducting Occupational Capacity Evaluations--What is "Evidence-Based"?].

    Science.gov (United States)

    Canela, Carlos; Schleifer, Roman; Dube, Anish; Hengartner, Michael P; Ebner, Gerhard; Seifritz, Erich; Liebrenz, Michael

    2016-03-01

    Occupational capacity evaluations have previously been subject to criticism for lacking in quality and consistency. To the authors' knowledge, there is no clear consensus on the best way to formally assess functioning within capacity evaluations. In this review we investigated different instruments that are used to assess functioning in occupational capacity evaluations. Systematic review of the literature. Though several instruments that assess functional capacity were found in our search, a specific validated instrument assessing occupational capacity as part of a larger psychiatric evaluation was not found. The limitations of the existing instruments on assessing functional capacity are discussed. Medical experts relying on instruments to conduct functional capacity evaluations should be cognizant of their limitations. The findings call for the development and use of an instrument specifically designed to assess the functional and occupational capacity of psychiatric patients, which is also likely to improve the quality of these reports. © Georg Thieme Verlag KG Stuttgart · New York.

  13. Systematic shifts of evaluated charge centroid for the cathode read-out multiwire proportional chamber

    International Nuclear Information System (INIS)

    Endo, I.; Kawamoto, T.; Mizuno, Y.; Ohsugi, T.; Taniguchi, T.; Takeshita, T.

    1981-01-01

    We have investigated the systematic error associtated with the charge centroid evaluation for the cathode read-out multiwire proportional chamber. Correction curves for the systematic error according to six centroid finding algorithms have been obtained by using the charge distribution calculated in a simple electrostatic mode. They have been experimentally examined and proved to be essential for the accurate determination of the irradiated position. (orig.)

  14. How to Systematically Assess Serious Games Applied to Health Care

    Science.gov (United States)

    Graafland, Maurits; Dankbaar, Mary; Mert, Agali; Lagro, Joep; De Wit-Zuurendonk, Laura; Schuit, Stephanie; Schaafstal, Alma

    2014-01-01

    The usefulness and effectiveness of specific serious games in the medical domain is often unclear. This is caused by a lack of supporting evidence on validity of individual games, as well as a lack of publicly available information. Moreover, insufficient understanding of design principles among the individuals and institutions that develop or apply a medical serious game compromises their use. This article provides the first consensus-based framework for the assessment of specific medical serious games. The framework provides 62 items in 5 main themes, aimed at assessing a serious game’s rationale, functionality, validity, and data safety. This will allow caregivers and educators to make balanced choices when applying a serious game for healthcare purposes. Furthermore, the framework provides game manufacturers with standards for the development of new, valid serious games. PMID:25654163

  15. A suggestion for quality assessment in systematic reviews of observational studies in nutritional epidemiology

    Directory of Open Access Journals (Sweden)

    Jong-Myon Bae

    2016-04-01

    Full Text Available OBJECTIVES: It is important to control the quality level of the observational studies in conducting meta-analyses. The Newcastle-Ottawa Scale (NOS is a representative tool used for this purpose. We investigated the relationship between high-quality (HQ defined using NOS and the results of subgroup analysis according to study design. METHODS: We selected systematic review studies with meta-analysis which performed a quality evaluation on observational studies of diet and cancer by NOS. HQ determinations and the distribution of study designs were examined. Subgroup analyses according to quality level as defined by the NOS were also extracted. Equivalence was evaluated based on the summary effect size (sES and 95% confidence intervals computed in the subgroup analysis. RESULTS: The meta-analysis results of the HQ and cohort groups were identical. The overall sES, which was obtained by combining the sES when equivalence was observed between the cohort and case-control groups, also showed equivalence. CONCLUSIONS: The results of this study suggest that it is more reasonable to control for quality level by performing subgroup analysis according to study design rather than by using HQ based on the NOS quality assessment tool.

  16. A systematic review of visual image theory, assessment, and use in skin cancer and tanning research.

    Science.gov (United States)

    McWhirter, Jennifer E; Hoffman-Goetz, Laurie

    2014-01-01

    Visual images increase attention, comprehension, and recall of health information and influence health behaviors. Health communication campaigns on skin cancer and tanning often use visual images, but little is known about how such images are selected or evaluated. A systematic review of peer-reviewed, published literature on skin cancer and tanning was conducted to determine (a) what visual communication theories were used, (b) how visual images were evaluated, and (c) how visual images were used in the research studies. Seven databases were searched (PubMed/MEDLINE, EMBASE, PsycINFO, Sociological Abstracts, Social Sciences Full Text, ERIC, and ABI/INFORM) resulting in 5,330 citations. Of those, 47 met the inclusion criteria. Only one study specifically identified a visual communication theory guiding the research. No standard instruments for assessing visual images were reported. Most studies lacked, to varying degrees, comprehensive image description, image pretesting, full reporting of image source details, adequate explanation of image selection or development, and example images. The results highlight the need for greater theoretical and methodological attention to visual images in health communication research in the future. To this end, the authors propose a working definition of visual health communication.

  17. Assessing Communication Skills of Medical Students in Objective Structured Clinical Examinations (OSCE)--A Systematic Review of Rating Scales.

    Science.gov (United States)

    Cömert, Musa; Zill, Jördis Maria; Christalle, Eva; Dirmaier, Jörg; Härter, Martin; Scholl, Isabelle

    2016-01-01

    Teaching and assessment of communication skills have become essential in medical education. The Objective Structured Clinical Examination (OSCE) has been found as an appropriate means to assess communication skills within medical education. Studies have demonstrated the importance of a valid assessment of medical students' communication skills. Yet, the validity of the performance scores depends fundamentally on the quality of the rating scales used in an OSCE. Thus, this systematic review aimed at providing an overview of existing rating scales, describing their underlying definition of communication skills, determining the methodological quality of psychometric studies and the quality of psychometric properties of the identified rating scales. We conducted a systematic review to identify psychometrically tested rating scales, which have been applied in OSCE settings to assess communication skills of medical students. Our search strategy comprised three databases (EMBASE, PsycINFO, and PubMed), reference tracking and consultation of experts. We included studies that reported psychometric properties of communication skills assessment rating scales used in OSCEs by examiners only. The methodological quality of included studies was assessed using the COnsensus based Standards for the selection of health status Measurement INstruments (COSMIN) checklist. The quality of psychometric properties was evaluated using the quality criteria of Terwee and colleagues. Data of twelve studies reporting on eight rating scales on communication skills assessment in OSCEs were included. Five of eight rating scales were explicitly developed based on a specific definition of communication skills. The methodological quality of studies was mainly poor. The psychometric quality of the eight rating scales was mainly intermediate. Our results reveal that future psychometric evaluation studies focusing on improving the methodological quality are needed in order to yield psychometrically

  18. Assessing Communication Skills of Medical Students in Objective Structured Clinical Examinations (OSCE) - A Systematic Review of Rating Scales

    Science.gov (United States)

    Cömert, Musa; Zill, Jördis Maria; Christalle, Eva; Dirmaier, Jörg; Härter, Martin; Scholl, Isabelle

    2016-01-01

    Background Teaching and assessment of communication skills have become essential in medical education. The Objective Structured Clinical Examination (OSCE) has been found as an appropriate means to assess communication skills within medical education. Studies have demonstrated the importance of a valid assessment of medical students’ communication skills. Yet, the validity of the performance scores depends fundamentally on the quality of the rating scales used in an OSCE. Thus, this systematic review aimed at providing an overview of existing rating scales, describing their underlying definition of communication skills, determining the methodological quality of psychometric studies and the quality of psychometric properties of the identified rating scales. Methods We conducted a systematic review to identify psychometrically tested rating scales, which have been applied in OSCE settings to assess communication skills of medical students. Our search strategy comprised three databases (EMBASE, PsycINFO, and PubMed), reference tracking and consultation of experts. We included studies that reported psychometric properties of communication skills assessment rating scales used in OSCEs by examiners only. The methodological quality of included studies was assessed using the COnsensus based Standards for the selection of health status Measurement INstruments (COSMIN) checklist. The quality of psychometric properties was evaluated using the quality criteria of Terwee and colleagues. Results Data of twelve studies reporting on eight rating scales on communication skills assessment in OSCEs were included. Five of eight rating scales were explicitly developed based on a specific definition of communication skills. The methodological quality of studies was mainly poor. The psychometric quality of the eight rating scales was mainly intermediate. Discussion Our results reveal that future psychometric evaluation studies focusing on improving the methodological quality are needed

  19. Wearable technology for spine movement assessment: A systematic review

    OpenAIRE

    Papi, Enrica; Koh, Woon Senn; McGregor, Alison H.

    2017-01-01

    Continuous monitoring of spine movement function could enhance our understanding of low back pain development. Wearable technologies have gained popularity as promising alternative to laboratory systems in allowing ambulatory movement analysis. This paper aims to review the state of art of current use of wearable technology to assess spine kinematics and kinetics. Four electronic databases and reference lists of relevant articles were searched to find studies employing wearable technologies t...

  20. Developing a Systematic Corrosion Control Evaluation Approach in Flint

    Science.gov (United States)

    Presentation covers what the projects were that were recommended by the Flint Safe Drinking Water Task Force for corrosion control assessment for Flint, focusing on the sequential sampling project, the pipe rigs, and pipe scale analyses.

  1. Evaluating clinical ethics support in mental healthcare: a systematic literature review.

    NARCIS (Netherlands)

    Hem, M.H.; Pedersen, R.; Norvoll, R.; Molewijk, A.C.

    2015-01-01

    A systematic literature review on evaluation of clinical ethics support services in mental healthcare is presented and discussed. The focus was on (a) forms of clinical ethics support services, (b) evaluation of clinical ethics support services, (c) contexts and participants and (d) results. Five

  2. A Systematic Assessment of Smartphone Tools for Suicide Prevention.

    Science.gov (United States)

    Larsen, Mark Erik; Nicholas, Jennifer; Christensen, Helen

    2016-01-01

    Suicide is a leading cause of death globally, and there has been a rapid growth in the use of new technologies such as mobile health applications (apps) to help identify and support those at risk. However, it is not known whether these apps are evidence-based, or indeed contain potentially harmful content. This review examines the concordance of features in publicly available apps with current scientific evidence of effective suicide prevention strategies. Apps referring to suicide or deliberate self-harm (DSH) were identified on the Android and iOS app stores. Systematic review methodology was employed to screen and review app content. App features were labelled using a coding scheme that reflected the broad range of evidence-based medical and population-based suicide prevention interventions. Best-practice for suicide prevention was based upon a World Health Organization report and supplemented by other reviews of the literature. One hundred and twenty-three apps referring to suicide were identified and downloaded for full review, 49 of which were found to contain at least one interactive suicide prevention feature. Most apps focused on obtaining support from friends and family (n = 27) and safety planning (n = 14). Of the different suicide prevention strategies contained within the apps, the strongest evidence in the literature was found for facilitating access to crisis support (n = 13). All reviewed apps contained at least one strategy that was broadly consistent with the evidence base or best-practice guidelines. Apps tended to focus on a single suicide prevention strategy (mean = 1.1), although safety plan apps provided the opportunity to provide a greater number of techniques (mean = 3.9). Potentially harmful content, such as listing lethal access to means or encouraging risky behaviour in a crisis, was also identified. Many suicide prevention apps are available, some of which provide elements of best practice, but none that provide comprehensive evidence

  3. A Systematic Assessment of Smartphone Tools for Suicide Prevention.

    Directory of Open Access Journals (Sweden)

    Mark Erik Larsen

    Full Text Available Suicide is a leading cause of death globally, and there has been a rapid growth in the use of new technologies such as mobile health applications (apps to help identify and support those at risk. However, it is not known whether these apps are evidence-based, or indeed contain potentially harmful content. This review examines the concordance of features in publicly available apps with current scientific evidence of effective suicide prevention strategies.Apps referring to suicide or deliberate self-harm (DSH were identified on the Android and iOS app stores. Systematic review methodology was employed to screen and review app content. App features were labelled using a coding scheme that reflected the broad range of evidence-based medical and population-based suicide prevention interventions. Best-practice for suicide prevention was based upon a World Health Organization report and supplemented by other reviews of the literature.One hundred and twenty-three apps referring to suicide were identified and downloaded for full review, 49 of which were found to contain at least one interactive suicide prevention feature. Most apps focused on obtaining support from friends and family (n = 27 and safety planning (n = 14. Of the different suicide prevention strategies contained within the apps, the strongest evidence in the literature was found for facilitating access to crisis support (n = 13. All reviewed apps contained at least one strategy that was broadly consistent with the evidence base or best-practice guidelines. Apps tended to focus on a single suicide prevention strategy (mean = 1.1, although safety plan apps provided the opportunity to provide a greater number of techniques (mean = 3.9. Potentially harmful content, such as listing lethal access to means or encouraging risky behaviour in a crisis, was also identified.Many suicide prevention apps are available, some of which provide elements of best practice, but none that provide comprehensive

  4. Knee ultrasound from research to real practice: a systematic literature review of adult knee ultrasound assessment feasibility studies.

    Science.gov (United States)

    Peltea, Alexandra; Berghea, Florian; Gudu, Tania; Ionescu, Ruxandra

    2016-12-05

    To identify and analyse existing data regarding knee ultrasound (US) feasibility in clinical practice. Material and methods: A systematic literature review was performed using the terms: ("knee") AND ("ultrasound" OR "ultrasonography") AND ("feasibility" OR "pilot" OR "proof of concept"). Feasibility studies regarding knee US or US aided maneuver involving knee joint, published during 2005-2015, were selected and evaluated against a complex framework constructed around mandatory key areas for feasibility studies: acceptability, demand, implementation, practicality, adaptation, integration and expansion. One hundred and fifty-nine publications were identified, of which 9 were included in the final analysis: 6 dealt with the development and implementation of novel US scores, while the rest focused on implementing MSUS in clinical practice, evaluating the usefulness of articular cartilage US assessment and the feasibility of sonography for intra-articular knee injections, respectively. Six studies quantified feasibility as time spent for the evaluation, with only two addressing areassuch as acceptability, implementation and practicality, although none of these systematically assessed all feasibility domains. Knee US feasibility is still poorly addressed; the time required for US assessment is the main area addressed. This information gap should be properly addressed in future works, in order to ensure the right place for this technique.

  5. Measurement properties of instruments assessing permanent functional impairment of the spine: a systematic review protocol

    Science.gov (United States)

    Trask, Catherine M; Boden, Catherine; Bath, Brenna; Hendrick, Paul; Clay, Lynne; Zeng, Xiaoke; Milosavljevic, Stephan

    2018-01-01

    Introduction Permanent functional impairment (PFI) of the spine is a rating system used by compensation authorities, such as workers compensation boards, to establish an appropriate level of financial compensation for persistent loss of function. Determination of PFI of the spine is commonly based on the assessment of spinal movement combined with other measures of physical and functional impairments; however, the reliability and validity of the measurement instruments used for these evaluations have yet to be established. The aim of this study is to systematically review and synthesise the literature concerning measurement properties of the various and different instruments used for assessing PFI of the spine. Methods Three conceptual groups of terms (1) PFI, (2) spinal disorder and (3) measurement properties will be combined to search Medline, EMBASE, CINAHL, Web of Science, Scopus, PEDro, OTSeeker and Health and Safety Science Abstracts. We will examine peer-reviewed, full-text articles over the full available date range. Two reviewers will independently screen citations (title, abstract and full text) and perform data extraction. Included studies will be appraised as to their methodological quality using the COnsensus-based Standards for the selection of health Measurement INstruments criteria. Findings will be summarised and presented descriptively, with meta-analysis pursued as appropriate. Ethics and dissemination This review will summarise the current level of evidence of measurement properties of instruments used for assessing PFI of the spine. Findings of this review may be applicable to clinicians, policy-makers, workers’ compensation boards, other insurers and health and safety organisations. The findings will likely provide a foundation and direction for future research priorities for assessing spinal PFI. PROSPERO registration number CRD42017060390. PMID:29374671

  6. Measurement properties of instruments assessing permanent functional impairment of the spine: a systematic review protocol.

    Science.gov (United States)

    Goes, Suelen Meira; Trask, Catherine M; Boden, Catherine; Bath, Brenna; Ribeiro, Daniel Cury; Hendrick, Paul; Clay, Lynne; Zeng, Xiaoke; Milosavljevic, Stephan

    2018-01-27

    Permanent functional impairment (PFI) of the spine is a rating system used by compensation authorities, such as workers compensation boards, to establish an appropriate level of financial compensation for persistent loss of function. Determination of PFI of the spine is commonly based on the assessment of spinal movement combined with other measures of physical and functional impairments; however, the reliability and validity of the measurement instruments used for these evaluations have yet to be established. The aim of this study is to systematically review and synthesise the literature concerning measurement properties of the various and different instruments used for assessing PFI of the spine. Three conceptual groups of terms (1) PFI, (2) spinal disorder and (3) measurement properties will be combined to search Medline, EMBASE, CINAHL, Web of Science, Scopus, PEDro, OTSeeker and Health and Safety Science Abstracts. We will examine peer-reviewed, full-text articles over the full available date range. Two reviewers will independently screen citations (title, abstract and full text) and perform data extraction. Included studies will be appraised as to their methodological quality using the COnsensus-based Standards for the selection of health Measurement INstruments criteria. Findings will be summarised and presented descriptively, with meta-analysis pursued as appropriate. This review will summarise the current level of evidence of measurement properties of instruments used for assessing PFI of the spine. Findings of this review may be applicable to clinicians, policy-makers, workers' compensation boards, other insurers and health and safety organisations. The findings will likely provide a foundation and direction for future research priorities for assessing spinal PFI. CRD42017060390. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise

  7. Clinical assessment of effusion in knee osteoarthritis—A systematic review

    Science.gov (United States)

    Maricar, Nasimah; Callaghan, Michael J.; Parkes, Matthew J.; Felson, David T.; O׳Neill, Terence W.

    2016-01-01

    Objective The aim of this systematic review was to determine the validity and inter- and intra-observer reliability of the assessment of knee joint effusion in osteoarthritis (OA) of the knee. Methods MEDLINE, Web of Knowledge, CINAHL, EMBASE, and AMED were searched from their inception to February 2015. Articles were included according to a priori defined criteria: samples containing participants with knee OA; prospective evaluation of clinical tests and assessments of knee effusion that included reliability, sensitivity, and specificity of these tests. Results A total of 10 publications were reviewed. Eight of these considered reliability and four on validity of clinical assessments against ultrasound effusion. It was not possible to undertake a meta-analysis of reliability or validity because of differences in study designs and the clinical tests. Intra-observer kappa agreement for visible swelling ranged from 0.37 (suprapatellar) to 1.0 (prepatellar); for bulge sign 0.47 and balloon sign 0.37. Inter-observer kappa agreement for visible swelling ranged from −0.02 (prepatellar) to 0.65 (infrapatellar), the balloon sign −0.11 to 0.82, patellar tap −0.02 to 0.75 and bulge sign kappa −0.04 to 0.14 or reliability coefficient 0.97. Reliability and diagnostic accuracy tended to be better in experienced observers. Very few data looked at performance of individual clinical tests with sensitivity ranging 18.2–85.7% and specificity 35.3–93.3%, both higher with larger effusions. Conclusion The majority of unstandardized clinical tests to assess joint effusion in knee OA had relatively low intra- and inter-observer reliability. There is some evidence experience improved reliability and diagnostic accuracy of tests. Currently there is insufficient evidence to recommend any particular test in clinical practice. PMID:26581486

  8. The relationship between academic assessment and psychological distress among medical students: a systematic review.

    Science.gov (United States)

    Lyndon, Mataroria P; Strom, Joanna M; Alyami, Hussain M; Yu, Tzu-Chieh; Wilson, Nichola C; Singh, Primal P; Lemanu, Daniel P; Yielder, Jill; Hill, Andrew G

    2014-12-01

    A systematic review was conducted to determine the relationship between academic assessment and medical student psychological distress with the aim of informing assessment practices. A systematic literature search of six electronic databases (Medline, Medline IN PROCESS, PubMed, EMBASE, Psychinfo, ERIC) from 1991 to May 2014 was completed. Articles focusing on academic assessment and its relation to stress or anxiety of medical students were included. From 3,986 potential titles, 82 full-text articles were assessed for eligibility, and 23 studies met review inclusion criteria. Studies focused on assessment stress or anxiety, and assessment performance. Consistent among the studies was the finding that assessment invokes stress or anxiety, perhaps more so for female medical students. A relationship may exist between assessment stress or anxiety and impaired performance. Significant risks of bias were common in study methodologies. There is evidence to suggest academic assessment is associated with psychological distress among medical students. However, differences in the types of measures used by researchers limited our ability to draw conclusions about which methods of assessment invoke greater distress. More rigorous study designs and the use of standardized measures are required. Future research should consider differences in students' perceived significance of assessments, the psychological effects of constant exposure to assessment, and the role of assessment in preparing students for clinical practice.

  9. Systematic Evaluation of Aggressive Air Sampling for Bacillus ...

    Science.gov (United States)

    Report The primary objectives of this project were to evaluate the Aggressive Air Sampling (AAS) method compared to currently used surface sampling methods and to determine if AAS is a viable option for sampling Bacillus anthracis spores.

  10. Regulatory licensing, status summary report; Systematic evaluation program

    International Nuclear Information System (INIS)

    1978-01-01

    This document is part of a management information system presenting a logical flow of events that represent the evaluation of 11 of the older operating nuclear reactors. Information collected will be used to determine the degree to which the 11 plants meet current licensing requirements and to develop an overall balanced position concerning any needed backfitting of the facilities and the documentation of the results of such evaluations

  11. The equity dimension in evaluations of the quality and outcomes framework: a systematic review.

    Science.gov (United States)

    Boeckxstaens, Pauline; Smedt, Delphine De; Maeseneer, Jan De; Annemans, Lieven; Willems, Sara

    2011-08-31

    Pay-for-performance systems raise concerns regarding inequity in health care because providers might select patients for whom targets can easily be reached. This paper aims to describe the evolution of pre-existing (in)equity in health care in the period after the introduction of the Quality and Outcomes Framework (QOF) in the UK and to describe (in)equities in exception reporting. In this evaluation, a theory-based framework conceptualising equity in terms of equal access, equal treatment and equal treatment outcomes for people in equal need is used to guide the work. A systematic MEDLINE and Econlit search identified 317 studies. Of these, 290 were excluded because they were not related to the evaluation of QOF, they lacked an equity dimension in the evaluation, their qualitative research focused on experiences or on the nature of the consultation, or unsuitable methodology was used to pronounce upon equity after the introduction of QOF. None of the publications (n = 27) assessed equity in access to health care. Concerning equity in treatment and (intermediate) treatment outcomes, overall quality scores generally improved. For the majority of the observed indicators, all citizens benefit from this improvement, yet the extent to which different patient groups benefit tends to vary and to be highly dependent on the type and complexity of the indicator(s) under study, the observed patient group(s) and the characteristics of the study. In general, the introduction of QOF was favourable for the aged and for males. Total QOF scores did not seem to vary according to ethnicity. For deprivation, small but significant residual differences were observed after the introduction of QOF favouring less deprived groups. These differences are mainly due to differences at the practice level. The variance in exception reporting according to gender and socio-economic position is low. Although QOF seems not to be socially selective at first glance, this does not mean QOF does not

  12. The equity dimension in evaluations of the quality and outcomes framework: A systematic review

    Directory of Open Access Journals (Sweden)

    Annemans Lieven

    2011-08-01

    Full Text Available Abstract Background Pay-for-performance systems raise concerns regarding inequity in health care because providers might select patients for whom targets can easily be reached. This paper aims to describe the evolution of pre-existing (inequity in health care in the period after the introduction of the Quality and Outcomes Framework (QOF in the UK and to describe (inequities in exception reporting. In this evaluation, a theory-based framework conceptualising equity in terms of equal access, equal treatment and equal treatment outcomes for people in equal need is used to guide the work. Methods A systematic MEDLINE and Econlit search identified 317 studies. Of these, 290 were excluded because they were not related to the evaluation of QOF, they lacked an equity dimension in the evaluation, their qualitative research focused on experiences or on the nature of the consultation, or unsuitable methodology was used to pronounce upon equity after the introduction of QOF. Results None of the publications (n = 27 assessed equity in access to health care. Concerning equity in treatment and (intermediate treatment outcomes, overall quality scores generally improved. For the majority of the observed indicators, all citizens benefit from this improvement, yet the extent to which different patient groups benefit tends to vary and to be highly dependent on the type and complexity of the indicator(s under study, the observed patient group(s and the characteristics of the study. In general, the introduction of QOF was favourable for the aged and for males. Total QOF scores did not seem to vary according to ethnicity. For deprivation, small but significant residual differences were observed after the introduction of QOF favouring less deprived groups. These differences are mainly due to differences at the practice level. The variance in exception reporting according to gender and socio-economic position is low. Conclusions Although QOF seems not to be socially

  13. Wearable technology for spine movement assessment: A systematic review.

    Science.gov (United States)

    Papi, Enrica; Koh, Woon Senn; McGregor, Alison H

    2017-11-07

    Continuous monitoring of spine movement function could enhance our understanding of low back pain development. Wearable technologies have gained popularity as promising alternative to laboratory systems in allowing ambulatory movement analysis. This paper aims to review the state of art of current use of wearable technology to assess spine kinematics and kinetics. Four electronic databases and reference lists of relevant articles were searched to find studies employing wearable technologies to assess the spine in adults performing dynamic movements. Two reviewers independently identified relevant papers. Customised data extraction and quality appraisal form were developed to extrapolate key details and identify risk of biases of each study. Twenty-two articles were retrieved that met the inclusion criteria: 12 were deemed of medium quality (score 33.4-66.7%), and 10 of high quality (score >66.8%). The majority of articles (19/22) reported validation type studies. Only 6 reported data collection in real-life environments. Multiple sensors type were used: electrogoniometers (3/22), strain gauges based sensors (3/22), textile piezoresistive sensor (1/22) and accelerometers often used with gyroscopes and magnetometers (15/22). Two sensors units were mainly used and placing was commonly reported on the spine lumbar and sacral regions. The sensors were often wired to data transmitter/logger resulting in cumbersome systems. Outcomes were mostly reported relative to the lumbar segment and in the sagittal plane, including angles, range of motion, angular velocity, joint moments and forces. This review demonstrates the applicability of wearable technology to assess the spine, although this technique is still at an early stage of development. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  14. Methodologies for Systematic Assessment of Design Simplification. Annex II

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2013-12-15

    Nuclear power plants are sophisticated engineered systems. To achieve a commercial nuclear power plant, its functions, systems and components need to be elaborated from design ideas to technical solutions and to the appropriate hardware over a long period of time. On the way, several design alternatives usually compete for implementation in the final plant. Engineering teams perform assessments, comparing different proposed engineering options in order to select an appropriate solution for the specific plant aimed at specific customers. This is a common process in design evolution. During such assessments, the trade-offs associated with different options are not always as simple as seen at very early design stages. Any requirement (e.g. relevant to safety, availability or competitiveness) usually has several dimensions; therefore, a change in the design aimed at producing the targeted effect (e.g. simplification of passive safety systems) as a rule produces other effects not directly related to the original idea. It means that the assessment needs to be carried out in iterations, not to bypass any meaningful feedback. The assessment then becomes a challenge for those designers who are interested in exploring innovative approaches and simplified systems. Unlike in several developed countries, so far, nuclear energy has been only marginally used in small and medium sized developing countries. One of the important reasons for this has been the lack of competitive commercial nuclear options with small and medium sized reactors (SMRs). Then, the challenge for SMR designers has been to design simpler plants in order to counterbalance the well known penalties of economy of scale. The lack of experience with SMRs in small and medium sized developing countries could be viewed as practical proof of the lack of commercial success of such reactors. Fossil fuelled gas turbine technologies offer very competitive energy options available from tens to hundreds of MW(e), with

  15. Quality Assessment of Clinical Practice Guidelines for Respiratory Diseases in China: A Systematic Appraisal.

    Science.gov (United States)

    Jiang, Mei; Liao, Li-Yue; Liu, Xiao-Qing; He, Wei-Qun; Guan, Wei-Jie; Chen, Hao; Li, Yi-Min

    2015-09-01

    There has been a significant increase in the publication of clinical practice guidelines (CPGs) for respiratory diseases in China. However, little is known about the quality and potential impacts of these CPGs. Our objective was to critically evaluate the quality of Chinese CPGs for respiratory diseases that were published in peer-reviewed medical journals. A systematic search of scientific literature published between 1979 and 2013 was undertaken to identify and select CPGs that were related to respiratory diseases. Four Chinese databases (the Chinese Biomedical Literature database [CBM], the China National Knowledge Infrastructure [CNKI], the VIP database, and the WANFANG database) were used. The quality of eligible guidelines was assessed independently by four reviewers using the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. The overall agreement among reviewers was evaluated using an intraclass correlation coefficient. A total of 109 guidelines published in 27 medical journals from 1979 to 2013 were evaluated. The overall agreement among reviewers was considered good (intraclass correlation coefficient, 0.838; 95% CI, 0.812-0.862). The scores of the six AGREE domains were low: 57.3% for scope and purpose (range, 4.2%-80.5%), 23.8% for stakeholder involvement (range, 2.8%-54.2%), 7.7% for rigor of development (range, 0%-27.1%), 59.8% for clarity and presentation (range, 22.2%-80.6%), 10.9% for applicability (range, 0%-22.9%), and 0.6% for editorial independence (range, 0%-16.7%). Scores for all guidelines were below 60%, and only three guidelines (2.8%) were recommended for clinical practice with modifications. The quality of the guidelines was low, and stakeholder involvement, rigor of development, applicability, and editorial independence should be considered in the future development of CPGs for respiratory diseases in China.

  16. Assessing the environmental health relevance of cooling towers--a systematic review of legionellosis outbreaks.

    Science.gov (United States)

    Walser, Sandra M; Gerstner, Doris G; Brenner, Bernhard; Höller, Christiane; Liebl, Bernhard; Herr, Caroline E W

    2014-03-01

    Bioaerosols from cooling towers are often suspected to cause community-acquired legionellosis outbreaks. Although Legionella infections can mostly be assigned to the emission sources, uncertainty exists about the release and distribution into the air, the occurrence of the respirable virulent form and the level of the infective concentration. Our study aimed to evaluate studies on legionellosis outbreaks attributed to cooling towers published within the last 11 years by means of a systematic review of the literature. 19 legionellosis outbreaks were identified affecting 12 countries. Recurring events were observed in Spain and Great Britain. In total, 1609 confirmed cases of legionellosis and a case-fatality rate of approximately 6% were reported. Duration of outbreaks was 65 days on average. For diagnosis the urinary antigen test was mainly used. Age, smoking, male sex and underlying diseases (diabetes, immunodeficiency) could be confirmed as risk factors. Smoking and underlying diseases were the most frequent risk factors associated with legionellosis in 11 and 10 of the 19 studies, respectively. The meteorological conditions varied strongly. Several studies reported a temporal association of outbreaks with inadequate maintenance of the cooling systems. A match of clinical and environmental isolates by serotyping and/or molecular subtyping could be confirmed in 84% of outbreaks. Legionella-contaminated cooling towers as environmental trigger, in particular in the neighbourhood of susceptible individuals, can cause severe health problems and even death. To prevent and control Legionella contamination of cooling towers, maintenance actions should focus on low-emission cleaning procedures of cooling towers combined with control measurements of water and air samples. Procedures allowing rapid detection and risk assessment in the case of outbreaks are essential for adequate public health measures. Systematic registration of cooling towers will facilitate the

  17. A systematic framework for effective uncertainty assessment of severe accident calculations; Hybrid qualitative and quantitative methodology

    International Nuclear Information System (INIS)

    Hoseyni, Seyed Mohsen; Pourgol-Mohammad, Mohammad; Tehranifard, Ali Abbaspour; Yousefpour, Faramarz

    2014-01-01

    This paper describes a systematic framework for characterizing important phenomena and quantifying the degree of contribution of each parameter to the output in severe accident uncertainty assessment. The proposed methodology comprises qualitative as well as quantitative phases. The qualitative part so called Modified PIRT, being a robust process of PIRT for more precise quantification of uncertainties, is a two step process for identifying and ranking based on uncertainty importance in severe accident phenomena. In this process identified severe accident phenomena are ranked according to their effect on the figure of merit and their level of knowledge. Analytical Hierarchical Process (AHP) serves here as a systematic approach for severe accident phenomena ranking. Formal uncertainty importance technique is used to estimate the degree of credibility of the severe accident model(s) used to represent the important phenomena. The methodology uses subjective justification by evaluating available information and data from experiments, and code predictions for this step. The quantitative part utilizes uncertainty importance measures for the quantification of the effect of each input parameter to the output uncertainty. A response surface fitting approach is proposed for estimating associated uncertainties with less calculation cost. The quantitative results are used to plan in reducing epistemic uncertainty in the output variable(s). The application of the proposed methodology is demonstrated for the ACRR MP-2 severe accident test facility. - Highlights: • A two stage framework for severe accident uncertainty analysis is proposed. • Modified PIRT qualitatively identifies and ranks uncertainty sources more precisely. • Uncertainty importance measure quantitatively calculates effect of each uncertainty source. • Methodology is applied successfully on ACRR MP-2 severe accident test facility

  18. Assessments in outcome evaluation in aphasia therapy

    DEFF Research Database (Denmark)

    Isaksen, Jytte; Brouwer, Catherine E.

    2015-01-01

    Abstract Outcomes of aphasia therapy in Denmark are documented in evaluation sessions in which both the person with aphasia and the speech-language therapist take part. The participants negotiate agreements on the results of therapy. By means of conversation analysis, we study how such agreements...... on therapy outcome are reached interactionally. The sequential analysis of 34 video recordings focuses on a recurrent method for reaching agreements in these outcome evaluation sessions. In and through a special sequence of conversational assessment it is claimed that the person with aphasia has certain...

  19. Evaluating mobile phone applications for health behaviour change: A systematic review.

    Science.gov (United States)

    McKay, Fiona H; Cheng, Christina; Wright, Annemarie; Shill, Jane; Stephens, Hugh; Uccellini, Mary

    2018-01-01

    Introduction Increasing smartphones access has allowed for increasing development and use of smart phone applications (apps). Mobile health interventions have previously relied on voice or text-based short message services (SMS), however, the increasing availability and ease of use of apps has allowed for significant growth of smartphone apps that can be used for health behaviour change. This review considers the current body of knowledge relating to the evaluation of apps for health behaviour change. The aim of this review is to investigate approaches to the evaluation of health apps to identify any current best practice approaches. Method A systematic review was conducted. Data were collected and analysed in September 2016. Thirty-eight articles were identified and have been included in this review. Results Articles were published between 2011- 2016, and 36 were reviews or evaluations of apps related to one or more health conditions, the remaining two reported on an investigation of the usability of health apps. Studies investigated apps relating to the following areas: alcohol, asthma, breastfeeding, cancer, depression, diabetes, general health and fitness, headaches, heart disease, HIV, hypertension, iron deficiency/anaemia, low vision, mindfulness, obesity, pain, physical activity, smoking, weight management and women's health. Conclusion In order to harness the potential of mobile health apps for behaviour change and health, we need better ways to assess the quality and effectiveness of apps. This review is unable to suggest a single best practice approach to evaluate mobile health apps. Few measures identified in this review included sufficient information or evaluation, leading to potentially incomplete and inaccurate information for consumers seeking the best app for their situation. This is further complicated by a lack of regulation in health promotion generally.

  20. Recommendations for Pathologic Evaluation of Reduction Mammoplasty Specimens: A Prospective Study With Systematic Tissue Sampling.

    Science.gov (United States)

    Ambaye, Abiy B; Goodwin, Andrew J; MacLennan, Susan E; Naud, Shelly; Weaver, Donald L

    2017-11-01

    - Breast reduction mammaplasty (RMP) for symptomatic macromastia or correction of asymmetry is performed in more than 100 000 patients per year in the United States. The reported incidence of significant pathologic findings (SPF), that is, carcinoma and atypical hyperplasia, ranges from 0.06% to 12.8%. No standard pathology assessment for RMP exists. - To propose standard sampling for microscopic evaluation in RMP specimens, to evaluate the incidence of occult carcinoma and atypical hyperplasia, and to identify clinical risk factors for SPF in patients undergoing RMP. - All RMP specimens from 2006 to 2013 at a single institution were prospectively examined. After baseline gross and microscopic evaluations, each specimen was subjected to systematic additional sampling. The incidence of SPF was tabulated, and variables such as age, specimen weight, previous history of SPF, and results of preoperative mammogram were examined. Clinical follow-up review was also subsequently undertaken. - A total of 595 patients were evaluated. Significant pathologic findings were present in 9.8% (58 of 595) of patients. No cancer was identified in patients younger than 40 years; the rates of carcinoma were 2.4% (14 of 595) in all patients, 3.6% (14 of 392) in patients aged 40 years or older, and 4.3% (10 of 233) in patients aged 50 years or older. No carcinoma or atypical hyperplasia was identified on preoperative mammogram. Increased sampling was associated with a significantly greater frequency of SPF only in patients aged 40 years or older. - In patients younger than 35 years, gross-only evaluation is sufficient. However, increased sampling may be necessary in patients older than 40 years.

  1. Nuchal translucency and first trimester risk assessment: a systematic review.

    Science.gov (United States)

    Sheppard, Celeste; Platt, Lawrence D

    2007-06-01

    First-trimester risk assessment for fetal aneuploidy using nuchal translucency (NT) measurement is rapidly gaining popularity in the United States. In combination with maternal serum markers in the first trimester, the screening performance is exceptionally good, with detection rates of more than 80% at a screen positive rate of 5%. Recently, the method has been validated for screening for Down syndrome and other aneuploidies in multicenter trials in the United States and elsewhere. Compliance with established criteria for measurement of the NT is essential to achieve uniform reliability and high screening test sensitivity. There is an international consensus about the importance of specific training in the NT examination, conformity to standards of NT measurement, and regular audit for quality assurance. In the United States, the Nuchal Translucency Quality Review program has been developed to administer credentialing and quality review for registered practitioners. The Nuchal Translucency Quality Review credentials signify the proficiency of the sonographer or sonologist in NT measurement and participation in a regular quality assurance audit. We encourage accreditation of clinical sites offering first-trimester risk assessment to ensure the highest quality care.

  2. Assessment methods for the evaluation of vitiligo.

    Science.gov (United States)

    Alghamdi, K M; Kumar, A; Taïeb, A; Ezzedine, K

    2012-12-01

    There is no standardized method for assessing vitiligo. In this article, we review the literature from 1981 to 2011 on different vitiligo assessment methods. We aim to classify the techniques available for vitiligo assessment as subjective, semi-objective or objective; microscopic or macroscopic; and as based on morphometry or colorimetry. Macroscopic morphological measurements include visual assessment, photography in natural or ultraviolet light, photography with computerized image analysis and tristimulus colorimetry or spectrophotometry. Non-invasive micromorphological methods include confocal laser microscopy (CLM). Subjective methods include clinical evaluation by a dermatologist and a vitiligo disease activity score. Semi-objective methods include the Vitiligo Area Scoring Index (VASI) and point-counting methods. Objective methods include software-based image analysis, tristimulus colorimetry, spectrophotometry and CLM. Morphometry is the measurement of the vitiliginous surface area, whereas colorimetry quantitatively analyses skin colour changes caused by erythema or pigment. Most methods involve morphometry, except for the chromameter method, which assesses colorimetry. Some image analysis software programs can assess both morphometry and colorimetry. The details of these programs (Corel Draw, Image Pro Plus, AutoCad and Photoshop) are discussed in the review. Reflectance confocal microscopy provides real-time images and has great potential for the non-invasive assessment of pigmentary lesions. In conclusion, there is no single best method for assessing vitiligo. This review revealed that VASI, the rule of nine and Wood's lamp are likely to be the best techniques available for assessing the degree of pigmentary lesions and measuring the extent and progression of vitiligo in the clinic and in clinical trials. © 2012 The Authors. Journal of the European Academy of Dermatology and Venereology © 2012 European Academy of Dermatology and Venereology.

  3. Survey and evaluation of aging risk assessment methods and applications

    International Nuclear Information System (INIS)

    Sanzo, D.; Kvam, P.; Apostolakis, G.; Wu, J.; Milici, T.; Ghoniem, N.; Guarro, S.

    1994-11-01

    The US Nuclear Regulatory Commission initiated the nuclear power plant aging research program about 6 years ago to gather information about nuclear power plant aging. Since then, this program has collected a significant amount of information, largely qualitative, on plant aging and its potential effects on plant safety. However, this body of knowledge has not yet been integrated into formalisms that can be used effectively and systematically to assess plant risk resulting from aging, although models for assessing the effect of increasing failure rates on core damage frequency have been proposed. This report surveys the work on the aging of systems, structures, and components (SSCs) of nuclear power plants, as well as associated data bases. We take a critical look at the need to revise probabilistic risk assessments (PRAs) so that they will include the contribution to risk from plant aging, the adequacy of existing methods for evaluating this contribution, and the adequacy of the data that have been used in these evaluation methods. We identify a preliminary framework for integrating the aging of SSCs into the PRA and include the identification of necessary data for such an integration

  4. Content Validation and Evaluation of an Endovascular Teamwork Assessment Tool.

    Science.gov (United States)

    Hull, L; Bicknell, C; Patel, K; Vyas, R; Van Herzeele, I; Sevdalis, N; Rudarakanchana, N

    2016-07-01

    To modify, content validate, and evaluate a teamwork assessment tool for use in endovascular surgery. A multistage, multimethod study was conducted. Stage 1 included expert review and modification of the existing Observational Teamwork Assessment for Surgery (OTAS) tool. Stage 2 included identification of additional exemplar behaviours contributing to effective teamwork and enhanced patient safety in endovascular surgery (using real-time observation, focus groups, and semistructured interviews of multidisciplinary teams). Stage 3 included content validation of exemplar behaviours using expert consensus according to established psychometric recommendations and evaluation of structure, content, feasibility, and usability of the Endovascular Observational Teamwork Assessment Tool (Endo-OTAS) by an expert multidisciplinary panel. Stage 4 included final team expert review of exemplars. OTAS core team behaviours were maintained (communication, coordination, cooperation, leadership team monitoring). Of the 114 OTAS behavioural exemplars, 19 were modified, four removed, and 39 additional endovascular-specific behaviours identified. Content validation of these 153 exemplar behaviours showed that 113/153 (73.9%) reached the predetermined Item-Content Validity Index rating for teamwork and/or patient safety. After expert team review, 140/153 (91.5%) exemplars were deemed to warrant inclusion in the tool. More than 90% of the expert panel agreed that Endo-OTAS is an appropriate teamwork assessment tool with observable behaviours. Some concerns were noted about the time required to conduct observations and provide performance feedback. Endo-OTAS is a novel teamwork assessment tool, with evidence for content validity and relevance to endovascular teams. Endo-OTAS enables systematic objective assessment of the quality of team performance during endovascular procedures. Copyright © 2016. Published by Elsevier Ltd.

  5. Kinematic measures for assessing gait stability in elderly individuals: a systematic review.

    Science.gov (United States)

    Hamacher, D; Singh, N B; Van Dieën, J H; Heller, M O; Taylor, W R

    2011-12-07

    Falls not only present a considerable health threat, but the resulting treatment and loss of working days also place a heavy economic burden on society. Gait instability is a major fall risk factor, particularly in geriatric patients, and walking is one of the most frequent dynamic activities of daily living. To allow preventive strategies to become effective, it is therefore imperative to identify individuals with an unstable gait. Assessment of dynamic stability and gait variability via biomechanical measures of foot kinematics provides a viable option for quantitative evaluation of gait stability, but the ability of these methods to predict falls has generally not been assessed. Although various methods for assessing gait stability exist, their sensitivity and applicability in a clinical setting, as well as their cost-effectiveness, need verification. The objective of this systematic review was therefore to evaluate the sensitivity of biomechanical measures that quantify gait stability among elderly individuals and to evaluate the cost of measurement instrumentation required for application in a clinical setting. To assess gait stability, a comparative effect size (Cohen's d) analysis of variability and dynamic stability of foot trajectories during level walking was performed on 29 of an initial yield of 9889 articles from four electronic databases. The results of this survey demonstrate that linear variability of temporal measures of swing and stance was most capable of distinguishing between fallers and non-fallers, whereas step width and stride velocity prove more capable of discriminating between old versus young (OY) adults. In addition, while orbital stability measures (Floquet multipliers) applied to gait have been shown to distinguish between both elderly fallers and non-fallers as well as between young and old adults, local stability measures (λs) have been able to distinguish between young and old adults. Both linear and nonlinear measures of foot

  6. [A systematic evaluation of application of the web-based cancer database].

    Science.gov (United States)

    Huang, Tingting; Liu, Jialin; Li, Yong; Zhang, Rui

    2013-10-01

    In order to support the theory and practice of the web-based cancer database development in China, we applied a systematic evaluation to assess the development condition of the web-based cancer databases at home and abroad. We performed computer-based retrieval of the Ovid-MEDLINE, Springerlink, EBSCOhost, Wiley Online Library and CNKI databases, the papers of which were published between Jan. 1995 and Dec. 2011, and retrieved the references of these papers by hand. We selected qualified papers according to the pre-established inclusion and exclusion criteria, and carried out information extraction and analysis of the papers. Eventually, searching the online database, we obtained 1244 papers, and checking the reference lists, we found other 19 articles. Thirty-one articles met the inclusion and exclusion criteria and we extracted the proofs and assessed them. Analyzing these evidences showed that the U.S.A. counted for 26% in the first place. Thirty-nine percent of these web-based cancer databases are comprehensive cancer databases. As for single cancer databases, breast cancer and prostatic cancer are on the top, both counting for 10% respectively. Thirty-two percent of the cancer database are associated with cancer gene information. For the technical applications, MySQL and PHP applied most widely, nearly 23% each.

  7. Economic Evaluation of Implant-Supported Overdentures in Edentulous Patients: A Systematic Review.

    Science.gov (United States)

    Zhang, Qi; Jin, Xin; Yu, Mengliu; Ou, Guoming; Matsui, Hiroyuki; Liang, Xing; Sasaki, Keiichi

    Edentulous patients benefit significantly from implant-supported overdenture prostheses. The purpose of this systematic review was to evaluate the cost-effectiveness of implant-supported overdentures (IODs) for edentulous patients. The search was limited to studies written in English and included an electronic and manual search through MEDLINE (Ovid, 1946 to November 2015), Embase (Ovid, 1966 to November 2015), Cochrane Central Register of Controlled Trials (CENTRAL) (to November 2015), and PubMed (to November 2015). Two investigators extracted the data and assessed the studies independently. No meta-analysis was conducted due to the high heterogeneity within the literature. Of the initial 583 selected articles, 10 studies involving 802 participants were included. Of these, 6 studies had a high risk of bias and the rest had an unclear risk of bias. Implant-supported prostheses were more cost-effective when compared to conventional dentures and fixed implant-supported prostheses. Overdentures supported by two implants and magnet attachment were reported as cost-effective. Implant-supported overdentures are a cost-effective treatment for edentulous patients. More clinical studies with appropriate scientific vigor are required to further assess the cost-effectiveness of implant-supported overdentures.

  8. Evaluating Chagas disease progression and cure through blood-derived biomarkers: a systematic review.

    Science.gov (United States)

    Requena-Méndez, Ana; López, Manuel Carlos; Angheben, Andrea; Izquierdo, Luis; Ribeiro, Isabela; Pinazo, Maria-Jesús; Gascon, Joaquim; Muñoz, José

    2013-09-01

    This article reviews the usefulness of various types of blood-derived biomarkers that are currently being studied to predict the progression of Chagas disease in patients with the indeterminate form, to assess the efficacy of antiparasitic drugs and to identify early cardiac and gastrointestinal damage. The authors used a search strategy based on MEDLINE, Cochrane Library Register for systematic review, EmBase, Global Health and LILACS databases. Out of 1716 screened articles, only 166 articles were eligible for final inclusion. The authors classified the biomarkers according to their biochemical structure and primary biological activity in four groups: i) markers of inflammation and cellular injury, ii) metabolic biomakers, iii) prothrombotic biomarkers and iv) markers derived from specific antigens of the parasite. Several potential biomarkers might have clinical potential for the detection of early cardiopathy. Such capacity is imperative in order to detect high-risk patients who require intensive monitoring and earlier therapy. Prospective studies with longer follow-ups are needed for the appraisal of biomarkers assessing clinical or microbiological cure after therapy. At the same time, studies evaluating more than one biomarker are useful to compare the efficacy among them given the lack of a recognized gold standard.

  9. Does the technique employed for skin temperature assessment alter outcomes? A systematic review

    International Nuclear Information System (INIS)

    Bach, Aaron J E; Stewart, Ian B; Minett, Geoffrey M; Costello, Joseph T

    2015-01-01

    Skin temperature is an important physiological measure that can reflect the presence of illness and injury as well as provide insight into the localised interactions between the body and the environment. The aim of this systematic review was to analyse the agreement between conductive and infrared means of assessing skin temperature which are commonly employed in in clinical, occupational, sports medicine, public health and research settings.Full-text eligibility was determined independently by two reviewers. Studies meeting the following criteria were included in the review: (1) the literature was written in English, (2) participants were human (in vivo), (3) skin surface temperature was assessed at the same site, (4) with at least two commercially available devices employed—one conductive and one infrared—and (5) had skin temperature data reported in the study.A computerised search of four electronic databases, using a combination of 21 keywords, and citation tracking was performed in January 2015. A total of 8,602 were returned.Methodology quality was assessed by two authors independently, using the Cochrane risk of bias tool.A total of 16 articles (n = 245) met the inclusion criteria.Devices are classified to be in agreement if they met the clinically meaningful recommendations of mean differences within  ±0.5 °C and limits of agreement of  ±1.0 °C.Twelve of the included studies found mean differences greater than  ±0.5 °C between conductive and infrared devices. In the presence of external stimulus (e.g. exercise and/or heat) five studies found exacerbated measurement differences between conductive and infrared devices.This is the first review that has attempted to investigate presence of any systemic bias between infrared and conductive measures by collectively evaluating the current evidence base. There was also a consistently high risk of bias across the studies, in terms of sample size, random sequence generation, allocation

  10. Assessing the tobacco harm reduction (THR debate: a systematic review

    Directory of Open Access Journals (Sweden)

    Yogi Hendlin

    2018-03-01

    Full Text Available Background Tobacco Harm Reduction (THR has become synonymous with substituting alternative tobacco products for cigarettes. However, there exists much dissension among tobacco control professionals regarding accepting harm reduction methods prolonging nicotine addiction and profiting the tobacco, e-cigarette and pharmaceutical industries. We evaluate the influence of these industries on the academic THR literature and debate. Methods We undertook a comprehensive review of all peer-review papers published on the topic of tobacco harm reduction between 1992 and July 2016. Our initial search yielded 5,172 relevant hits, and after screening, we double-coded 1,067 full-text articles. Codes include the article's stand on THR (weakly or strongly pro-, anti-, or neutral/mixed, major themes, product type, country of author origin, article type (letter/commentary, RTC, longitudinal study, etc., journal quality, and funding source. These results were analyzed in STATA. Results Of the 498 articles we have coded so far, 379 were included. The results show that six percent of all articles are editorials, 36% letters or commentaries, and 21% are non-empirical articles while only 31% are original research and 6% reviews. Thirty-three percent of pro-THR articles disclosed some sort of industry funding. Of these, 30% were funded by the tobacco industry, 22% by the E-cigarette industry and 48% were funded by pharmaceutical industries. Conclusions The THR debate has been influenced by scientists funded by tobacco, electronic-cigarette and surprisingly pharmaceutical industries in the favor of product substitution. Moreover, the majority of this debate is occurring over 'opinion pieces' rather than on the basis of empirical research. Thus, more robust and unbiased scientific evidence is needed to evaluate these alternative products before endorsing them for the public.

  11. Demonstration and evaluation of a method for assessing mediated moderation.

    Science.gov (United States)

    Morgan-Lopez, Antonio A; MacKinnon, David P

    2006-02-01

    Mediated moderation occurs when the interaction between two variables affects a mediator, which then affects a dependent variable. In this article, we describe the mediated moderation model and evaluate it with a statistical simulation using an adaptation of product-of-coefficients methods to assess mediation. We also demonstrate the use of this method with a substantive example from the adolescent tobacco literature. In the simulation, relative bias (RB) in point estimates and standard errors did not exceed problematic levels of +/- 10% although systematic variability in RB was accounted for by parameter size, sample size, and nonzero direct effects. Power to detect mediated moderation effects appears to be severely compromised under one particular combination of conditions: when the component variables that make up the interaction terms are correlated and partial mediated moderation exists. Implications for the estimation of mediated moderation effects in experimental and nonexperimental research are discussed.

  12. Bruxism is unlikely to cause damage to the periodontium: findings from a systematic literature assessment

    NARCIS (Netherlands)

    Manfredini, D.; Ahlberg, J.; Mura, R.; Lobbezoo, F.

    2015-01-01

    Background: This paper systematically reviews the MEDLINE and SCOPUS literature to answer the following question: Is there any evidence that bruxism may cause periodontal damage per se? Methods: Clinical studies on humans, assessing the potential relationship between bruxism and periodontal lesions

  13. Omalizumab in patients with chronic spontaneous urticaria : A systematic review and GRADE assessment

    NARCIS (Netherlands)

    Urgert, M. C.; Van Den Elzen, M. T.; Knulst, A. C.; Fedorowicz, Z.; Van Zuuren, E. J.

    2015-01-01

    Summary Chronic spontaneous urticaria (CSU) is characterized by the occurrence of hives, angio-oedema or both for a period of at least 6 weeks. Many patients remain symptomatic despite treatment with H1 antihistamines, even at higher doses. This systematic review assessed the quality of

  14. Systematic adaptive cluster sampling for the assessment of rare tree species in Nepal

    NARCIS (Netherlands)

    Acharya, B.; Bhattarai, G.; Gier, de A.; Stein, A.

    2000-01-01

    Sampling to assess rare tree species poses methodic problems, because they may cluster and many plots with no such trees are to be expected. We used systematic adaptive cluster sampling (SACS) to sample three rare tree species in a forest area of about 40 ha in Nepal. We checked its applicability

  15. Instruments used to assess functional limitations in workers applying for disability benefit : a systematic review

    NARCIS (Netherlands)

    Spanjer, Jerry; Groothoff, Johan W.; Brouwer, Sandra

    2011-01-01

    Purpose. To systematically review the quality of the psychometric properties of instruments for assessing functional limitations in workers applying for disability benefit. Method. Electronic searches of Medline, Embase, CINAHL and PsycINFO were performed to identify studies focusing on the

  16. Assessing personal talent determinants in young racquet sport players : a systematic review

    NARCIS (Netherlands)

    Faber, Irene R.; Bustin, Paul M. J.; Oosterveld, Frits G. J.; Elferink-Gemser, Marije T.; Nijhuis-Van Der Sanden, Maria W. G.

    2016-01-01

    Since junior performances have little predictive value for future success, other solutions are sought to assess a young player's potential. The objectives of this systematic review are (1) to provide an overview of instruments measuring personal talent determinants of young players in racquet

  17. Assessing personal talent determinants in young racquet sport players: a systematic review

    NARCIS (Netherlands)

    Faber, I.R.; Bustin, P.M.; Oosterveld, F.G.; Elferink-Gemser, M.T.; Nijhuis-Van der Sanden, M.W.G.

    2016-01-01

    Since junior performances have little predictive value for future success, other solutions are sought to assess a young player's potential. The objectives of this systematic review are (1) to provide an overview of instruments measuring personal talent determinants of young players in racquet

  18. [Function of the present systematic evaluation in establishment of guidance for clinical practice].

    Science.gov (United States)

    Yang, Jin-Hong; Hu, Jing; Yang, Feng-Chun; Zhang, Ning; Wang, Bing; Li, Xin

    2012-07-01

    Treatment of insomnia with acupuncture is taken as an example to explore the significance and problems existed in the present systematic evaluation in establishment of guidance for clinical practice. Fifteen articles on systematic evaluation of both English and Chinese were retrieved and studied carefully, their basic information was analyzed. Through study on the establishing process of the guidance of clinical practice, researches were focused on the possible significance of the articles to the guidance as well as the notes in the reuse of those articles since problem still existed. It is held that the systematic evaluation has great significance on the establishment of the guidance from the aspects of applicable people, recommended standards of diagnosis and therapeutic evaluation, extended recommendation and methodology. Great importance should also be attached to the direct application of the research result and understanding of the evaluation result. The data should be rechecked when necessary. Great guiding function can be found on the systematic evaluation of articles to the guidance. Moreover, if information needed to be taken into a full play, specific analysis should also be done on the concrete research targets.

  19. Systematic radiographic evaluation of tibial hemimelia with orthopedic implications

    Energy Technology Data Exchange (ETDEWEB)

    Kaplan-List, Katia [Rochester General Hospital, Department of Diagnostic Imaging, Rochester, NY (United States); Klionsky, Nina B. [University of Rochester Medical Center, School of Medicine and Dentistry, Rochester, NY (United States); Golisano Children' s Hospital, Department of Radiology, Rochester, NY (United States); Sanders, James O. [University of Rochester Medical Center, School of Medicine and Dentistry, Rochester, NY (United States); Golisano Children' s Hospital, Department of Orthopaedics, Rochester, NY (United States); Golisano Children' s Hospital, Department of Pediatrics, Rochester, NY (United States); Katz, Michael E. [St. Mary' s Medical Center and Palm Beach Children' s Hospital, Department of Radiology, West Palm Beach, FL (United States)

    2017-04-15

    Tibial hemimelia is a rare lower-extremity pre-axial longitudinal deficiency characterized by complete or partial absence of the tibia. The reported incidence is 1 in 1 million live births. In this pictorial essay, we define tibial hemimelia and describe associated conditions and principles of preoperative imaging assessment for a child with tibial hemimelia. We also indicate the imaging findings that might influence the choice of treatment, describe the most widely used classification systems, and briefly discuss current treatment approaches. (orig.)

  20. Systematic radiographic evaluation of tibial hemimelia with orthopedic implications

    International Nuclear Information System (INIS)

    Kaplan-List, Katia; Klionsky, Nina B.; Sanders, James O.; Katz, Michael E.

    2017-01-01

    Tibial hemimelia is a rare lower-extremity pre-axial longitudinal deficiency characterized by complete or partial absence of the tibia. The reported incidence is 1 in 1 million live births. In this pictorial essay, we define tibial hemimelia and describe associated conditions and principles of preoperative imaging assessment for a child with tibial hemimelia. We also indicate the imaging findings that might influence the choice of treatment, describe the most widely used classification systems, and briefly discuss current treatment approaches. (orig.)

  1. On writing legibly: Processing fluency systematically biases evaluations of handwritten material

    OpenAIRE

    Greifeneder, Rainer; Alt, Alexander; Bottenberg, Konstantin; Seele, Tim; Zelt, Sarah; Wagener, Dietrich

    2010-01-01

    Evaluations of handwritten essays or exams are often suspected of being biased, such as by mood states or individual predilections. Although most of these influences are unsystematic, at least one bias is problematic because it systematically affects evaluations of handwritten materials. Three experiments revealed that essays in legible as compared to less legible handwriting were evaluated more positively. This robust finding was related to a basic judgmental mechanism that builds on the flu...

  2. Assessment of the quality of pharmacoeconomic evaluation literature in China.

    Science.gov (United States)

    Zhang, Fang; He, Xu; Xiang, Wei; Li, Shu Chuen

    2017-05-01

    To evaluate the quality of Chinese pharmacoeconomic-evaluation literature published between 2012-2014 retrieved from the Chinese National Knowledge Infrastructure (CNKI) in order to assess their adherence to recommendations of the Chinese Pharmacoeconomic Guidelines. Identified literature was screened according to pre-specified criteria to access legibility for inclusion. Each included piece of literature was systematically compared against the recommendations proposed by the relevant Chinese guidelines. After culling, 259 studies were included in the comparative analysis. When compared to a previous study evaluating the quality of similar literature published between 1997-2007, the results showed improvements in certain technical aspects over the years. Particularly, an improvement was observed in more diverse evaluation methods being used, increased use of cost-utility analysis (2.43% in 2012-2014 vs 0.26% in 1997-2007) and use of discounting (45% in 2012-2014 vs 4.35% in 1997- 2007). In addition, a small number of studies were starting to apply modeling. The quality of economic evaluation literature has improved in recent years, with more researchers realizing the importance and necessity of using discounting, sensitivity analysis, and modeling when conducting economic evaluation. This study also highlights certain important areas needing further attention when conducting economic evaluations in China. These include the ICER threshold of economic analysis, more detailed guidance in performing sensitivity analysis and modeling, as well as transferability of cost data across different regions. Overall, the results would support the positive contribution of the Chinese Economic Guideline in promoting economic evaluations in China.

  3. A systematic review of instruments for assessing parent satisfaction with family-centred care in neonatal intensive care units.

    Science.gov (United States)

    Dall'Oglio, Immacolata; Mascolo, Rachele; Gawronski, Orsola; Tiozzo, Emanuela; Portanova, Anna; Ragni, Angela; Alvaro, Rosaria; Rocco, Gennaro; Latour, Jos M

    2018-03-01

    This systematic review synthesised and described instruments measuring parent satisfaction with the increasing standard practice of family-centred care (FCC) in neonatal intensive care units. We evaluated 11 studies published from January 2006 to March 2016: two studies validated a parent satisfaction questionnaire, and nine developed or modified previous questionnaires to use as outcome measures in their local settings. Most instruments were not tested on reliability and validity. Only two validated instruments included all six of the FCC principles and could assess parent satisfaction with FCC in neonatal intensive care units and be considered as outcome indicators for further research. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  4. A systematic review of COTS evaluation and selection approaches

    Directory of Open Access Journals (Sweden)

    Rakesh Garg

    2017-11-01

    Full Text Available In the past decades, a number of researchers have made their significant contributions to develop different approaches for solving a very challenging problem of commercial off-the shelf (COTS selection. The development of software with high quality and minimum development time has always been a difficult job for the software developers. Therefore, in today’s scenario, software developers move towards the implementation of component based software engineering that relies on the integration of small pieces of code namely (COTS. In this study, we present a comprehensive descriptive explanation of the various COTS evaluation and selection approaches developed by various researchers in the past to understand the concept of COTS selection. The advantages and disadvantages of each COTS selection approach are also provided, which will give a better prospect to the readers to understand the various existing COTS evaluation and selection approaches.

  5. Systematic Assessment of Neutron and Gamma Backgrounds Relevant to Operational Modeling and Detection Technology Implementation

    Energy Technology Data Exchange (ETDEWEB)

    Archer, Daniel E. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Hornback, Donald Eric [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Johnson, Jeffrey O. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Nicholson, Andrew D. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Patton, Bruce W. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Peplow, Douglas E. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Miller, Thomas Martin [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Ayaz-Maierhafer, Birsen [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2015-01-01

    This report summarizes the findings of a two year effort to systematically assess neutron and gamma backgrounds relevant to operational modeling and detection technology implementation. The first year effort focused on reviewing the origins of background sources and their impact on measured rates in operational scenarios of interest. The second year has focused on the assessment of detector and algorithm performance as they pertain to operational requirements against the various background sources and background levels.

  6. Measurement properties of self-report physical activity assessment tools in stroke: a protocol for a systematic review.

    Science.gov (United States)

    Martins, Júlia Caetano; Aguiar, Larissa Tavares; Nadeau, Sylvie; Scianni, Aline Alvim; Teixeira-Salmela, Luci Fuscaldi; Faria, Christina Danielli Coelho de Morais

    2017-02-13

    Self-report physical activity assessment tools are commonly used for the evaluation of physical activity levels in individuals with stroke. A great variety of these tools have been developed and widely used in recent years, which justify the need to examine their measurement properties and clinical utility. Therefore, the main objectives of this systematic review are to examine the measurement properties and clinical utility of self-report measures of physical activity and discuss the strengths and limitations of the identified tools. A systematic review of studies that investigated the measurement properties and/or clinical utility of self-report physical activity assessment tools in stroke will be conducted. Electronic searches will be performed in five databases: Medical Literature Analysis and Retrieval System Online (MEDLINE) (PubMed), Excerpta Medica Database (EMBASE), Physiotherapy Evidence Database (PEDro), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) and Scientific Electronic Library Online (SciELO), followed by hand searches of the reference lists of the included studies. Two independent reviewers will screen all retrieve titles, abstracts, and full texts, according to the inclusion criteria and will also extract the data. A third reviewer will be referred to solve any disagreement. A descriptive summary of the included studies will contain the design, participants, as well as the characteristics, measurement properties, and clinical utility of the self-report tools. The methodological quality of the studies will be evaluated using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist and the clinical utility of the identified tools will be assessed considering predefined criteria. This systematic review will follow the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) statement. This systematic review will provide an extensive review of the measurement

  7. Measurement properties of self-report physical activity assessment tools in stroke: a protocol for a systematic review

    Science.gov (United States)

    Martins, Júlia Caetano; Aguiar, Larissa Tavares; Nadeau, Sylvie; Scianni, Aline Alvim; Teixeira-Salmela, Luci Fuscaldi; Faria, Christina Danielli Coelho de Morais

    2017-01-01

    Introduction Self-report physical activity assessment tools are commonly used for the evaluation of physical activity levels in individuals with stroke. A great variety of these tools have been developed and widely used in recent years, which justify the need to examine their measurement properties and clinical utility. Therefore, the main objectives of this systematic review are to examine the measurement properties and clinical utility of self-report measures of physical activity and discuss the strengths and limitations of the identified tools. Methods and analysis A systematic review of studies that investigated the measurement properties and/or clinical utility of self-report physical activity assessment tools in stroke will be conducted. Electronic searches will be performed in five databases: Medical Literature Analysis and Retrieval System Online (MEDLINE) (PubMed), Excerpta Medica Database (EMBASE), Physiotherapy Evidence Database (PEDro), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) and Scientific Electronic Library Online (SciELO), followed by hand searches of the reference lists of the included studies. Two independent reviewers will screen all retrieve titles, abstracts, and full texts, according to the inclusion criteria and will also extract the data. A third reviewer will be referred to solve any disagreement. A descriptive summary of the included studies will contain the design, participants, as well as the characteristics, measurement properties, and clinical utility of the self-report tools. The methodological quality of the studies will be evaluated using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist and the clinical utility of the identified tools will be assessed considering predefined criteria. This systematic review will follow the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) statement. Discussion This systematic review will

  8. Reliability of joint count assessment in rheumatoid arthritis: a systematic literature review.

    Science.gov (United States)

    Cheung, Peter P; Gossec, Laure; Mak, Anselm; March, Lyn

    2014-06-01

    Joint counts are central to the assessment of rheumatoid arthritis (RA) but reliability is an issue. To evaluate the reliability and agreement of joint counts (intra-observer and inter-observer) by health care professionals (physicians, nurses, and metrologists) and patients in RA, and the impact of training and standardization on joint count reliability through a systematic literature review. Articles reporting joint count reliability or agreement in RA in PubMed, EMBase, and the Cochrane library between 1960 and 2012 were selected. Data were extracted regarding tender joint counts (TJCs) and swollen joint counts (SJCs) derived by physicians, metrologists, or patients for intra-observer and inter-observer reliability. In addition, methods and effects of training or standardization were extracted. Statistics expressing reliability such as intraclass correlation coefficients (ICCs) were extracted. Data analysis was primarily descriptive due to high heterogeneity. Twenty-eight studies on health care professionals (HCP) and 20 studies on patients were included. Intra-observer reliability for TJCs and SJCs was good for HCPs and patients (range of ICC: 0.49-0.98). Inter-observer reliability between HCPs for TJCs was higher than for SJCs (range of ICC: 0.64-0.88 vs. 0.29-0.98). Patient inter-observer reliability with HCPs as comparators was better for TJCs (range of ICC: 0.31-0.91) compared to SJCs (0.16-0.64). Nine studies (7 with HCPs and 2 with patients) evaluated consensus or training, with improvement in reliability of TJCs but conflicting evidence for SJCs. Intra- and inter-observer reliability was high for TJCs for HCPs and patients: among all groups, reliability was better for TJCs than SJCs. Inter-observer reliability of SJCs was poorer for patients than HCPs. Data were inconclusive regarding the potential for training to improve SJC reliability. Overall, the results support further evaluation for patient-reported joint counts as an outcome measure. © 2013

  9. Toward a consensus definition of pathological video-gaming: a systematic review of psychometric assessment tools

    NARCIS (Netherlands)

    King, D.L.; Haagsma, M.C.; Delfabbro, P.H.; Gradisar, M.; Griffiths, M.D.

    2013-01-01

    Pathological video-gaming, or its proposed DSM-V classification of "Internet Use Disorder", is of increasing interest to scholars and practitioners in allied health disciplines. This systematic review was designed to evaluate the standards in pathological video-gaming instrumentation, according to

  10. Towards a consensus definition of pathological video-gaming: A systematic review of psychometric assessment tools

    NARCIS (Netherlands)

    King, Daniel L.; Haagsma, M.C.; Delfabbro, Paul H.; Gradisar, Michael; Griffiths, Mark D.

    2013-01-01

    Pathological video-gaming, or its proposed DSM-V classification of “Internet Use Disorder”, is of increasing interest to scholars and practitioners in allied health disciplines. This systematic review was designed to evaluate the standards in pathological video-gaming instrumentation, according to

  11. Systematic assessment of microneedle injection into the mouse cornea.

    Science.gov (United States)

    Matthaei, Mario; Meng, Huan; Bhutto, Imran; Xu, Qingguo; Boelke, Edwin; Hanes, Justin; Jun, Albert S

    2012-06-20

    Corneal intrastromal injection is an important mode of gene-vector application to subepithelial layers. In a mouse model, this procedure is substantially complicated by the reduced corneal dimensions. Furthermore, it may be difficult to estimate the corneal area reached by the volume of a single injection. This study aimed to investigate intrastromal injections into the mouse cornea using different microneedles and to quantify the effect of injecting varying volumes. A reproducible injection technique is described. Forty eyes of 20 129 Sv/J mice were tested. India ink was intrastromally injected using 30° beveled 33 G needles, tri-surface 25° beveled 35 G needles, or hand-pulled and 25° beveled glass needles. Each eye received a single injection of a volume of 1 or 2 μL. Corneoscleral buttons were fixed and flat mounted for computer-assisted quantification of the affected corneal area. Histological assessment was performed to investigate the intrastromal location of the injected dye. A mean corneal area of 5.0 ± 1.4 mm(2) (mean ± SD) and 7.7 ± 1.4 mm(2) was covered by intrastromal injections of 1 and 2 μL, respectively. The mean percentage of total corneal area reached ranged from 39% to 53% for 1 μL injections, and from 65% to 81% for 2 μL injections. Injections using the 33 G needles tended to provide the highest distribution area. Perforation rates were 8% for 30° beveled 33 G needles and 44% for tri-surface beveled 35 G needles. No perforation was observed with glass needle; however, intrastromal breakage of needle tips was noted in 25% of these cases. Intracorneal injection using a 30° beveled 33 G needle was safe and effective. The use of tri-surface beveled 35 G needles substantially increased the number of corneal perforations. Glass needles may break inside the corneal stroma. Injections of 1 μL and 2 μL resulted in an overall mean of 49% and 73% respectively of total corneal area involved.

  12. Systematic assessment of microneedle injection into the mouse cornea

    Directory of Open Access Journals (Sweden)

    Matthaei Mario

    2012-06-01

    Full Text Available Abstract Background Corneal intrastromal injection is an important mode of gene-vector application to subepithelial layers. In a mouse model, this procedure is substantially complicated by the reduced corneal dimensions. Furthermore, it may be difficult to estimate the corneal area reached by the volume of a single injection. This study aimed to investigate intrastromal injections into the mouse cornea using different microneedles and to quantify the effect of injecting varying volumes. A reproducible injection technique is described. Methods Forty eyes of 20 129 Sv/J mice were tested. India ink was intrastromally injected using 30° beveled 33 G needles, tri-surface 25° beveled 35 G needles, or hand-pulled and 25° beveled glass needles. Each eye received a single injection of a volume of 1 or 2 μL. Corneoscleral buttons were fixed and flat mounted for computer-assisted quantification of the affected corneal area. Histological assessment was performed to investigate the intrastromal location of the injected dye. Results A mean corneal area of 5.0 ±1.4 mm2 (mean ± SD and 7.7 ±1.4 mm2 was covered by intrastromal injections of 1 and 2 μL, respectively. The mean percentage of total corneal area reached ranged from 39% to 53% for 1 μL injections, and from 65% to 81% for 2 μL injections. Injections using the 33 G needles tended to provide the highest distribution area. Perforation rates were 8% for 30° beveled 33 G needles and 44% for tri-surface beveled 35 G needles. No perforation was observed with glass needle; however, intrastromal breakage of needle tips was noted in 25% of these cases. Conclusions Intracorneal injection using a 30° beveled 33 G needle was safe and effective. The use of tri-surface beveled 35 G needles substantially increased the number of corneal perforations. Glass needles may break inside the corneal stroma. Injections of 1 μL and 2 μL resulted in an overall mean of 49% and 73% respectively

  13. Systematic review on the evaluation criteria of orphan medicines in Central and Eastern European countries.

    Science.gov (United States)

    Zelei, Tamás; Molnár, Mária J; Szegedi, Márta; Kaló, Zoltán

    2016-06-04

    In case of orphan drugs applicability of the standard health technology assessment (HTA) process is limited due to scarcity of good clinical and health economic evidence. Financing these premium priced drugs is more controversial in the Central and Eastern European (CEE) region where the public funding resources are more restricted, and health economic justification should be an even more important aspect of policy decisions than in higher income European countries. To explore and summarize the recent scientific evidence on value drivers related to the health technology assessment of ODs with a special focus on the perspective of third party payers in CEE countries. The review aims to list all potentially relevant value drivers in the reimbursement process of orphan drugs. A systematic literature review was performed; PubMed and Scopus databases were systematically searched for relevant publications until April 2015. Extracted data were summarized along key HTA elements. From the 2664 identified publications, 87 contained relevant information on the evaluation criteria of orphan drugs, but only 5 had direct information from the CEE region. The presentation of good clinical evidence seems to play a key role especially since this should be the basis of cost-effectiveness analyses, which have more importance in resource-constrained economies. Due to external price referencing of pharmaceuticals, the relative budget impact of orphan drugs is expected to be higher in CEE than in Western European (WE) countries unless accessibility of patients remains more limited in poorer European regions. Equity principles based on disease prevalence and non-availability of alternative treatment options may increase the price premium, however, societies must have some control on prices and a rationale based on multiple criteria in reimbursement decisions. The evaluation of orphan medicines should include multiple criteria to appropriately measure the clinical added value of orphan

  14. Environmental scan and evaluation of best practices for online systematic review resources.

    Science.gov (United States)

    Parker, Robin M N; Boulos, Leah M; Visintini, Sarah; Ritchie, Krista; Hayden, Jill

    2018-04-01

    Online training for systematic review methodology is an attractive option due to flexibility and limited availability of in-person instruction. Librarians often direct new reviewers to these online resources, so they should be knowledgeable about the variety of available resources. The objective for this project was to conduct an environmental scan of online systematic review training resources and evaluate those identified resources. The authors systematically searched for electronic learning resources pertaining to systematic review methods. After screening for inclusion, we collected data about characteristics of training resources and assigned scores in the domains of (1) content, (2) design, (3) interactivity, and (4) usability by applying a previously published evaluation rubric for online instruction modules. We described the characteristics and scores for each training resource and compared performance across the domains. Twenty training resources were evaluated. Average overall score of online instructional resources was 61%. Online courses (n=7) averaged 73%, web modules (n=5) 64%, and videos (n=8) 48%. The top 5 highest scoring resources were in course or web module format, featured high interactivity, and required a longer (>5hrs) time commitment from users. This study revealed that resources include appropriate content but are less likely to adhere to principles of online training design and interactivity. Awareness of these resources will allow librarians to make informed recommendations for training based on patrons' needs. Future online systematic review training resources should use established best practices for e-learning to provide high-quality resources, regardless of format or user time commitment.

  15. A six-step protocol to systematic process evaluation of multicomponent cluster-randomised health promoting interventions illustrated by the Boost study

    DEFF Research Database (Denmark)

    Aarestrup, Anne Kristine; Jørgensen, Thea Suldrup; Due, Pernille

    2014-01-01

    BACKGROUND: In multicomponent interventions it is important to examine the implementation of each component to enable valid assessments of the effectiveness of each component. Many studies do not systematically document, evaluate and report the level of implementation and there is a lack of syste...

  16. Implementing assessments of robot-assisted technical skill in urological education: a systematic review and synthesis of the validity evidence.

    Science.gov (United States)

    Goldenberg, Mitchell G; Lee, Jason Y; Kwong, Jethro C C; Grantcharov, Teodor P; Costello, Anthony

    2018-03-31

    To systematically review and synthesise the validity evidence supporting intraoperative and simulation-based assessments of technical skill in urological robot-assisted surgery (RAS), and make evidence-based recommendations for the implementation of these assessments in urological training. A literature search of the Medline, PsycINFO and Embase databases was performed. Articles using technical skill and simulation-based assessments in RAS were abstracted. Only studies involving urology trainees or faculty were included in the final analysis. Multiple tools for the assessment of technical robotic skill have been published, with mixed sources of validity evidence to support their use. These evaluations have been used in both the ex vivo and in vivo settings. Performance evaluations range from global rating scales to psychometrics, and assessments are carried out through automation, expert analysts, and crowdsourcing. There have been rapid expansions in approaches to RAS technical skills assessment, both in simulated and clinical settings. Alternative approaches to assessment in RAS, such as crowdsourcing and psychometrics, remain under investigation. Evidence to support the use of these metrics in high-stakes decisions is likely insufficient at present. © 2018 The Authors BJU International © 2018 BJU International Published by John Wiley & Sons Ltd.

  17. A systematic review of glomerular hyperfiltration assessment and definition in the medical literature.

    Science.gov (United States)

    Cachat, Francois; Combescure, Christophe; Cauderay, Michel; Girardin, Eric; Chehade, Hassib

    2015-03-06

    Evaluation of glomerular hyperfiltration (GH) is difficult; the variable reported definitions impede comparisons between studies. A clear and universal definition of GH would help in comparing results of trials aimed at reducing GH. This study assessed how GH is measured and defined in the literature. Three databases (Embase, MEDLINE, CINAHL) were systematically searched using the terms "hyperfiltration" or "glomerular hyperfiltration". All studies reporting a GH threshold or studying the effect of a high GFR in a continuous manner against another outcome of interest were included. The literature search was performed from November 2012 to February 2013 and updated in August 2014. From 2013 retrieved studies, 405 studies were included. Threshold use to define GH was reported in 55.6% of studies. Of these, 88.4% used a single threshold and 11.6% used numerous thresholds adapted to participant sex or age. In 29.8% of the studies, the choice of a GH threshold was not based on a control group or literature references. After 2004, the use of GH threshold use increased (Psex-matched control group should be used to define a GH threshold. Copyright © 2015 by the American Society of Nephrology.

  18. Systematic development of a communication skills training course for physicians performing work disability assessments: from evidence to practice

    Science.gov (United States)

    2011-01-01

    Background Physicians require specific communication skills, because the face-to-face contact with their patients is an important source of information. Although physicians who perform work disability assessments attend some communication-related training courses during their professional education, no specialised and evidence-based communication skills training course is available for them. Therefore, the objectives of this study were: 1) to systematically develop a training course aimed at improving the communication skills of physicians during work disability assessment interviews with disability claimants, and 2) to plan an evaluation of the training course. Methods A physician-tailored communication skills training course was developed, according to the six steps of the Intervention Mapping protocol. Data were collected from questionnaire studies among physicians and claimants, a focus group study among physicians, a systematic review of the literature, and meetings with various experts. Determinants and performance objectives were formulated. A concept version of the training course was discussed with several experts before the final training course programme was established. The evaluation plan was developed by consulting experts, social insurance physicians, researchers, and policy-makers, and discussing with them the options for evaluation. Results A two-day post-graduate communication skills training course was developed, aimed at improving professional communication during work disability assessment interviews. Special focus was on active teaching strategies, such as practising the skills in role-play. An adoption and implementation plan was formulated, in which the infrastructure of the educational department of the institute that employs the physicians was utilised. Improvement in the skills and knowledge of the physicians who will participate in the training course will be evaluated in a randomised controlled trial. Conclusions The feasibility and

  19. Systematic development of a communication skills training course for physicians performing work disability assessments: from evidence to practice.

    Science.gov (United States)

    van Rijssen, H Jolanda; Schellart, Antonius J M; Anema, Johannes R; de Boer, Wout E L; van der Beek, Allard J

    2011-06-03

    Physicians require specific communication skills, because the face-to-face contact with their patients is an important source of information. Although physicians who perform work disability assessments attend some communication-related training courses during their professional education, no specialised and evidence-based communication skills training course is available for them. Therefore, the objectives of this study were: 1) to systematically develop a training course aimed at improving the communication skills of physicians during work disability assessment interviews with disability claimants, and 2) to plan an evaluation of the training course. A physician-tailored communication skills training course was developed, according to the six steps of the Intervention Mapping protocol. Data were collected from questionnaire studies among physicians and claimants, a focus group study among physicians, a systematic review of the literature, and meetings with various experts. Determinants and performance objectives were formulated. A concept version of the training course was discussed with several experts before the final training course programme was established. The evaluation plan was developed by consulting experts, social insurance physicians, researchers, and policy-makers, and discussing with them the options for evaluation. A two-day post-graduate communication skills training course was developed, aimed at improving professional communication during work disability assessment interviews. Special focus was on active teaching strategies, such as practising the skills in role-play. An adoption and implementation plan was formulated, in which the infrastructure of the educational department of the institute that employs the physicians was utilised. Improvement in the skills and knowledge of the physicians who will participate in the training course will be evaluated in a randomised controlled trial. The feasibility and practical relevance of the communication

  20. Systematic development of a communication skills training course for physicians performing work disability assessments: from evidence to practice

    Directory of Open Access Journals (Sweden)

    Anema Johannes R

    2011-06-01

    Full Text Available Abstract Background Physicians require specific communication skills, because the face-to-face contact with their patients is an important source of information. Although physicians who perform work disability assessments attend some communication-related training courses during their professional education, no specialised and evidence-based communication skills training course is available for them. Therefore, the objectives of this study were: 1 to systematically develop a training course aimed at improving the communication skills of physicians during work disability assessment interviews with disability claimants, and 2 to plan an evaluation of the training course. Methods A physician-tailored communication skills training course was developed, according to the six steps of the Intervention Mapping protocol. Data were collected from questionnaire studies among physicians and claimants, a focus group study among physicians, a systematic review of the literature, and meetings with various experts. Determinants and performance objectives were formulated. A concept version of the training course was discussed with several experts before the final training course programme was established. The evaluation plan was developed by consulting experts, social insurance physicians, researchers, and policy-makers, and discussing with them the options for evaluation. Results A two-day post-graduate communication skills training course was developed, aimed at improving professional communication during work disability assessment interviews. Special focus was on active teaching strategies, such as practising the skills in role-play. An adoption and implementation plan was formulated, in which the infrastructure of the educational department of the institute that employs the physicians was utilised. Improvement in the skills and knowledge of the physicians who will participate in the training course will be evaluated in a randomised controlled trial

  1. Economic evaluation of bone stimulation modalities: A systematic review of the literature

    Directory of Open Access Journals (Sweden)

    Button Melissa

    2009-01-01

    Full Text Available Various bone stimulation modalities are commonly used in treatment of fresh fractures and nonunions; however, the effectiveness and efficiency of these modalities remain uncertain. A systematic review of trials evaluating the clinical and economical outcomes of ultrasounds, electrical stimulation, and extracorporeal sound waves on fracture healing was conducted. We searched four electronic databases for economic evaluations that assessed bone stimulation modalities using ultrasound therapy, electrical stimulation, or extracorporeal shock waves. In addition, we searched the references and related articles of eligible studies, and a content expert was contacted. Information on the clinical and economical outcomes of patients was independently extracted by reviewers. Fourteen studies met the inclusion criteria; therefore, very limited research was found on the cost associated with treatments and the corresponding outcomes. The data available focus primarily on the efficacy of newly introduced treatment methods for bone growth, but failed to incorporate the costs of implementing such treatments. One economic analysis was identified that assessed different treatment paths using ultrasound. A total cost savings of 24-40% per patient occurred when ultrasound was used for fresh fractures and nonunions (grade C recommendation. The results suggest that the ultrasound is a viable alternative for bone stimulation; however, the impacts of the other modalities are left unknown due to the lack of research available. Methodological limitations leave the overall economic and clinical impact of these modalities uncertain. Large, prospective, randomized controlled trials that include cost-effectiveness analyses are needed to further define the clinical effectiveness and financial burden associated with bone stimulation modalities.

  2. The International Endometriosis Evaluation Program (IEEP Study) – A Systematic Study for Physicians, Researchers and Patients

    Science.gov (United States)

    Burghaus, S.; Fehm, T.; Fasching, P. A.; Blum, S.; Renner, S. K.; Baier, F.; Brodkorb, T.; Fahlbusch, C.; Findeklee, S.; Häberle, L.; Heusinger, K.; Hildebrandt, T.; Lermann, J.; Strahl, O.; Tchartchian, G.; Bojahr, B.; Porn, A.; Fleisch, M.; Reicke, S.; Füger, T.; Hartung, C.-P.; Hackl, J.; Beckmann, M. W.; Renner, S. P.

    2016-01-01

    Introduction: Endometriosis is a heterogeneous disease characterized by a range of different presentations. It is usually diagnosed when patients present with pain and/or infertility, but it has also been diagnosed in asymptomatic patients. Because of the different diagnostic approaches and diverse therapies, time to diagnosis can vary considerably and the definitive diagnosis may be delayed, with some cases not being diagnosed for several years. Endometriosis patients have many unmet needs. A systematic registration and follow-up of endometriosis patients could be useful to obtain an insight into the course of the disease. The validation of biomarkers could contribute to the development of diagnostic and predictive tests which could help select patients for surgical assessment earlier and offer better predictions about patients who might benefit from medical, surgical or other interventions. The aim is also to obtain a better understanding of the etiology, pathogenesis and progression of the disease. Material and Methods: To do this, an online multicenter documentation system was introduced to facilitate the establishment of a prospective multicenter case-control study, the IEEP (International Endometriosis Evaluation Program) study. We report here on the first 696 patients with endometriosis included in the program between June 2013 and June 2015. Results: A documentation system was created, and the structure and course of the study were mapped out with regard to data collection and the collection of biomaterials. Conclusion: The documentation system permits the history and clinical data of patients with endometriosis to be recorded. The IEEP combines this information with biomaterials and uses it for scientific studies. The recorded data can also be used to evaluate clinical quality control measures such as the certification parameters used by the EEL (European Endometriosis League) to assess certified endometriosis centers. PMID:27582581

  3. The International Endometriosis Evaluation Program (IEEP Study) - A Systematic Study for Physicians, Researchers and Patients.

    Science.gov (United States)

    Burghaus, S; Fehm, T; Fasching, P A; Blum, S; Renner, S K; Baier, F; Brodkorb, T; Fahlbusch, C; Findeklee, S; Häberle, L; Heusinger, K; Hildebrandt, T; Lermann, J; Strahl, O; Tchartchian, G; Bojahr, B; Porn, A; Fleisch, M; Reicke, S; Füger, T; Hartung, C-P; Hackl, J; Beckmann, M W; Renner, S P

    2016-08-01

    Endometriosis is a heterogeneous disease characterized by a range of different presentations. It is usually diagnosed when patients present with pain and/or infertility, but it has also been diagnosed in asymptomatic patients. Because of the different diagnostic approaches and diverse therapies, time to diagnosis can vary considerably and the definitive diagnosis may be delayed, with some cases not being diagnosed for several years. Endometriosis patients have many unmet needs. A systematic registration and follow-up of endometriosis patients could be useful to obtain an insight into the course of the disease. The validation of biomarkers could contribute to the development of diagnostic and predictive tests which could help select patients for surgical assessment earlier and offer better predictions about patients who might benefit from medical, surgical or other interventions. The aim is also to obtain a better understanding of the etiology, pathogenesis and progression of the disease. To do this, an online multicenter documentation system was introduced to facilitate the establishment of a prospective multicenter case-control study, the IEEP (International Endometriosis Evaluation Program) study. We report here on the first 696 patients with endometriosis included in the program between June 2013 and June 2015. A documentation system was created, and the structure and course of the study were mapped out with regard to data collection and the collection of biomaterials. The documentation system permits the history and clinical data of patients with endometriosis to be recorded. The IEEP combines this information with biomaterials and uses it for scientific studies. The recorded data can also be used to evaluate clinical quality control measures such as the certification parameters used by the EEL (European Endometriosis League) to assess certified endometriosis centers.

  4. Patient autonomy problems in palliative care: systematic development and evaluation of a questionnaire.

    NARCIS (Netherlands)

    Vernooy-Dassen, M.J.F.J.; Osse, B.H.P.; Schade, E.; Grol, R.P.T.M.

    2005-01-01

    No instrument to assess autonomy problems in palliative care is currently available. The purpose of this study was to develop a comprehensive and concise questionnaire to measure autonomy problems in palliative cancer patients and to study its validity and reliability. We systematically developed a

  5. Model evaluation methodology applicable to environmental assessment models

    International Nuclear Information System (INIS)

    Shaeffer, D.L.

    1979-08-01

    A model evaluation methodology is presented to provide a systematic framework within which the adequacy of environmental assessment models might be examined. The necessity for such a tool is motivated by the widespread use of models for predicting the environmental consequences of various human activities and by the reliance on these model predictions for deciding whether a particular activity requires the deployment of costly control measures. Consequently, the uncertainty associated with prediction must be established for the use of such models. The methodology presented here consists of six major tasks: model examination, algorithm examination, data evaluation, sensitivity analyses, validation studies, and code comparison. This methodology is presented in the form of a flowchart to show the logical interrelatedness of the various tasks. Emphasis has been placed on identifying those parameters which are most important in determining the predictive outputs of a model. Importance has been attached to the process of collecting quality data. A method has been developed for analyzing multiplicative chain models when the input parameters are statistically independent and lognormally distributed. Latin hypercube sampling has been offered as a promising candidate for doing sensitivity analyses. Several different ways of viewing the validity of a model have been presented. Criteria are presented for selecting models for environmental assessment purposes

  6. ERESYE - a expert system for the evaluation of uncertainties related to systematic experimental errors; ERESYE - un sistema esperto per la valutazione di incertezze correlate ad errori sperimentali sistematici

    Energy Technology Data Exchange (ETDEWEB)

    Martinelli, T; Panini, G C [ENEA - Dipartimento Tecnologie Intersettoriali di Base, Centro Ricerche Energia, Casaccia (Italy); Amoroso, A [Ricercatore Ospite (Italy)

    1989-11-15

    Information about systematic errors are not given In EXFOR, the data base of nuclear experimental measurements: their assessment is committed to the ability of the evaluator. A tool Is needed which performs this task in a fully automatic way or, at least, gives a valuable aid. The expert system ERESYE has been implemented for investigating the feasibility of an automatic evaluation of the systematic errors in the experiments. The features of the project which led to the implementation of the system are presented. (author)

  7. Reactive endplate marrow changes: a systematic morphologic and epidemiologic evaluation

    International Nuclear Information System (INIS)

    Karchevsky, Michael; Schweitzer, Mark E.; Carrino, John A.; Zoga, Adam; Montgomery, Douglas; Parker, Laurence

    2005-01-01

    To evaluate the morphology and location of vertebral endplate changes, and to analyze their association with age, gender, and body mass index (BMI). At 1.5 T (T1-weighted, T2-weighted/STIR) 100 lumbar spines were evaluated separately by three observers. The readers classified the endplate bone marrow abnormalities on sagittal MR images according to the definitions of Modic et al. Findings were localized by disc segment; whether in the upper and/or lower endplate; and within each endplate divided into 15 segments. Disc space narrowing, as well as disc desiccation, was also noted at each vertebral level. In addition, endplate changes were correlated with age, gender, and BMI (weight(kg)/height(m) 2 ). A total of 15,000 data points were studied and 422 total changes recorded. A total of 99 vertebral levels were affected in 58 patients. Of these, 171 were of type I, 242 were of type II, and 9 were of type III. L4 - L5 and L5 - S1 vertebral levels were most commonly involved, having (142, 4.73%) and (116, 3.87%) changes respectively (P<0.0001). The upper and lower aspects of the endplate were affected similarly. Changes most frequently occurred at the anterior aspect of the endplate (P<0.0001). Endplate marrow changes were associated with increasing age (P<0.0001) and, surprisingly, male gender (P<0.0001). Endplate changes were not associated with BMI. The fatty pattern was most common, with the sclerotic pattern being rare. Endplate marrow changes most often occurred at the anterior aspect of the endplate, particularly at L4 - L5 and L5 - S1 levels. Modic changes occur more frequently with aging, evidence of their degenerative etiology. They were, however, not related to body habitus, but to weight and male gender. (orig.)

  8. Reactive endplate marrow changes: a systematic morphologic and epidemiologic evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Karchevsky, Michael [Hahnemann University Hospital, Department of Radiology, Philadelphia (United States); Thomas Jefferson University Hospital, Department of Radiology, Philadelphia (United States); Schweitzer, Mark E. [Hospital for Joint Diseases, Department of Radiology, New York (United States); Carrino, John A.; Zoga, Adam; Montgomery, Douglas; Parker, Laurence [Thomas Jefferson University Hospital, Department of Radiology, Philadelphia (United States)

    2005-03-01

    To evaluate the morphology and location of vertebral endplate changes, and to analyze their association with age, gender, and body mass index (BMI). At 1.5 T (T1-weighted, T2-weighted/STIR) 100 lumbar spines were evaluated separately by three observers. The readers classified the endplate bone marrow abnormalities on sagittal MR images according to the definitions of Modic et al. Findings were localized by disc segment; whether in the upper and/or lower endplate; and within each endplate divided into 15 segments. Disc space narrowing, as well as disc desiccation, was also noted at each vertebral level. In addition, endplate changes were correlated with age, gender, and BMI (weight(kg)/height(m){sup 2}). A total of 15,000 data points were studied and 422 total changes recorded. A total of 99 vertebral levels were affected in 58 patients. Of these, 171 were of type I, 242 were of type II, and 9 were of type III. L4 - L5 and L5 - S1 vertebral levels were most commonly involved, having (142, 4.73%) and (116, 3.87%) changes respectively (P<0.0001). The upper and lower aspects of the endplate were affected similarly. Changes most frequently occurred at the anterior aspect of the endplate (P<0.0001). Endplate marrow changes were associated with increasing age (P<0.0001) and, surprisingly, male gender (P<0.0001). Endplate changes were not associated with BMI. The fatty pattern was most common, with the sclerotic pattern being rare. Endplate marrow changes most often occurred at the anterior aspect of the endplate, particularly at L4 - L5 and L5 - S1 levels. Modic changes occur more frequently with aging, evidence of their degenerative etiology. They were, however, not related to body habitus, but to weight and male gender. (orig.)

  9. Reach, engagement, and effectiveness: a systematic review of evaluation methodologies used in health promotion via social networking sites.

    Science.gov (United States)

    Lim, Megan S C; Wright, Cassandra J C; Carrotte, Elise R; Pedrana, Alisa E

    2016-02-01

    Issue addressed Social networking sites (SNS) are increasingly popular platforms for health promotion. Advancements in SNS health promotion require quality evidence; however, interventions are often not formally evaluated. This study aims to describe evaluation practices used in SNS health promotion. Methods A systematic review was undertaken of Medline, PsycINFO, Scopus, EMBASE, CINAHL Plus, Communication and Mass Media Complete, and Cochrane Library databases. Articles published between 2006 and 2013 describing any health promotion intervention delivered using SNS were included. Results Forty-seven studies were included. There were two main evaluation approaches: closed designs (n=23), which used traditional research designs and formal recruitment procedures; and open designs (n=19), which evaluated the intervention in a real-world setting, allowing unknown SNS users to interact with the content without enrolling in research. Closed designs were unable to assess reach and engagement beyond their research sample. Open designs often relied on weaker study designs with no use of objective outcome measures and yielded low response rates. Conclusions Barriers to evaluation included low participation rates, high attrition, unknown representativeness and lack of comparison groups. Acceptability was typically assessed among those engaged with the intervention, with limited population data available to accurately assess intervention reach. Few studies were able to assess uptake of the intervention in a real-life setting while simultaneously assessing effectiveness of interventions with research rigour. So what? Through use of quasi-experimental or well designed before-after evaluations, in combination with detailed engagement metrics, it is possible to balance assessment of effectiveness and reach to evaluate SNS health promotion.

  10. Evaluation of Technology-Enhanced Learning Programs for Health Care Professionals: Systematic Review.

    Science.gov (United States)

    Nicoll, Pam; MacRury, Sandra; van Woerden, Hugo C; Smyth, Keith

    2018-04-11

    Technology-enhanced learning (TEL) programs are increasingly seen as the way in which education for health care professionals can be transformed, giving access to effective ongoing learning and training even where time or geographical barriers exist. Given the increasing emphasis on this mode of educational support for health care practitioners, it is vital that we can effectively evaluate and measure impact to ensure that TEL programs are effective and fit for purpose. This paper examines the current evidence base for the first time, in relation to the evaluation of TEL programs for health care professionals. We conducted a systematic review of the current literature relating to the evaluation of TEL programs for health care professionals and critically appraised the quality of the studies. This review employed specific search criteria to identify research studies that included evaluation of TEL for health care professionals. The databases searched included Medline Ovid, Cumulative Index of Nursing and Allied Health Literature Plus Advanced, Applied Social Sciences Index and Abstracts, ZETOC, Institute of Electrical and Electronics Engineers Explore Digital Library, Allied and Complementary Medicine, and Education Resources Information Center between January 2006 and January 2017. An additional hand search for relevant articles from reference lists was undertaken. Each of the studies identified was critically appraised for quality using the Crowe Critical Appraisal Tool. This approach produced a percentage total score for each study across specified categories. A proportion of the studies were independently assessed by an additional two reviewers. The review identified 21 studies that met the inclusion criteria. The studies included scored totals across eight categories within a range of 37%-95% and an average score of 68%. Studies that measured TEL using learner satisfaction surveys, or combined pretest and posttest knowledge score testing with learner

  11. The Eligibility of Surface Electromyography in the Assessment of Paraspinal Muscles Fatigue Following Interventions in Patients with Chronic Low Back Pain: A Systematic Review

    OpenAIRE

    Nahid Rahmani; Mohammad Ali Mohseni-Bandpei; Iraj Abdollahi

    2013-01-01

    Objective: Evaluation of paraspinal muscles endurance in patients with chronic low back pain (LBP) seems to be of great importance. Many studies demonstrated that surface electromyography has merit to assess muscle fatigue using frequency spectrum. The purpose of this study was to systematically review the eligibility of the surface electromyography in the assessment of paraspinal muscles fatigue changes following different interventions in patients with chronic LBP. Materials & Methods: ...

  12. Economic evaluations of follow-up strategies for cancer survivors: a systematic review and quality appraisal of the literature.

    Science.gov (United States)

    Meregaglia, Michela; Cairns, John

    2015-01-01

    The aim of this study was to review and critically assess the health economics literature on post-treatment follow-up for adult cancer survivors. A systematic search was performed using PubMed, EMBASE and the Cochrane Library. The Consolidated Health Economic Evaluation Reporting Standards checklist was adopted to assess the quality of the included studies. Thirty-nine articles met the eligibility criteria. Around two thirds of the studies addressed the most common cancers (i.e., breast, colorectal, cervical and lung); 21 were based on a single clinical study, while the rest were modeling papers. All types of economic evaluations were represented other than cost-benefit analysis. The overall quality was generally high with an average proportion of 74% of checklist criteria fulfilled. The cost-effectiveness results supported the current trend towards less intensive, primary care-based and risk-adapted follow-up schemes.

  13. Tools for evaluation of restriction on auditory participation: systematic review of the literature.

    Science.gov (United States)

    Souza, Valquíria Conceição; Lemos, Stela Maris Aguiar

    2015-01-01

    To systematically review studies that used questionnaires for the evaluation of restriction on auditory participation in adults and the elderly. Studies from the last five years were selected through a bibliographic collection of data in national and international journals in the following electronic databases: ISI Web of Science and Virtual Health Library - BIREME, which includes the LILACS and MEDLINE databases. Studies available fully; published in Portuguese, English, or Spanish; whose participants were adults and/or the elderly and that used questionnaires for the evaluation of restriction on auditory participation. Initially, the studies were selected based on the reading of titles and abstracts. Then, the articles were fully and the information was included in the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist. Three-hundred seventy studies were found in the researched databases; 14 of these studies were excluded because they were found in more than one database. The titles and abstracts of 356 articles were analyzed; 40 of them were selected for full reading, of which 26 articles were finally selected. In the present review, nine instruments were found for the evaluation of restriction on auditory participation. The most used questionnaires for the assessment of the restriction on auditory participation were the Hearing Handicap Inventory for the Elderly (HHIE), Hearing Handicap Inventory for Adults (HHIA), and Hearing Handicap Inventory for the Elderly - Screening (HHIE-S). The use of restriction on auditory participation questionnaires can assist in validating decisions in audiology practices and be useful in the fitting of hearing aids and results of aural rehabilitation.

  14. Systematic review of economic evaluations of preparedness strategies and interventions against influenza pandemics.

    Science.gov (United States)

    Pérez Velasco, Román; Praditsitthikorn, Naiyana; Wichmann, Kamonthip; Mohara, Adun; Kotirum, Surachai; Tantivess, Sripen; Vallenas, Constanza; Harmanci, Hande; Teerawattananon, Yot

    2012-01-01

    Although public health guidelines have implications for resource allocation, these issues were not explicitly considered in previous WHO pandemic preparedness and response guidance. In order to ensure a thorough and informed revision of this guidance following the H1N1 2009 pandemic, a systematic review of published and unpublished economic evaluations of preparedness strategies and interventions against influenza pandemics was conducted. The search was performed in September 2011 using 10 electronic databases, 2 internet search engines, reference list screening, cited reference searching, and direct communication with relevant authors. Full and partial economic evaluations considering both costs and outcomes were included. Conversely, reviews, editorials, and studies on economic impact or complications were excluded. Studies were selected by 2 independent reviewers. 44 studies were included. Although most complied with the cost effectiveness guidelines, the quality of evidence was limited. However, the data sources used were of higher quality in economic evaluations conducted after the 2009 H1N1 pandemic. Vaccination and drug regimens were varied. Pharmaceutical plus non-pharmaceutical interventions are relatively cost effective in comparison to vaccines and/or antivirals alone. Pharmaceutical interventions vary from cost saving to high cost effectiveness ratios. According to ceiling thresholds (Gross National Income per capita), the reduction of non-essential contacts and the use of pharmaceutical prophylaxis plus the closure of schools are amongst the cost effective strategies for all countries. However, quarantine for household contacts is not cost effective even for low and middle income countries. The available evidence is generally inconclusive regarding the cost effectiveness of preparedness strategies and interventions against influenza pandemics. Studies on their effectiveness and cost effectiveness should be readily implemented in forthcoming events that

  15. Evaluating Simulation in Training for Arthroscopic Knee Surgery: A Systematic Review of the Literature.

    Science.gov (United States)

    Hetaimish, Bandar; Elbadawi, Hussein; Ayeni, Olufemi R

    2016-06-01

    To evaluate the reported outcomes for measuring the effectiveness of simulation during knee arthroscopy training and determine the consistency of reporting and validation of simulation used in knee arthroscopy training. Four databases (MEDLINE, Embase, CINAHL, and Cochrane Central Register of Controlled Trials) were screened for studies involving knee arthroscopy simulation training. Inclusion and exclusion criteria were applied to the searched studies, and a quality assessment was completed for included studies. The reviewers searched the references list in each of the eligible studies to identify other relevant studies that was not captured by our search strategy. We identified 13 eligible studies. The mean number of participants per study was 24 (range: 9 to 42 participants). The 3 most commonly reported surgical skills were the mean time to perform the task (100%), the visualization and probing tasks (77%), and the number of cartilage collisions with measurement of the surgical force (46%). The most commonly described measurement instruments included the Simulation Built-In Scoring System (54%), motion analysis system (23%), and Basic Arthroscopic Knee Skill Scoring System global rating scale (15%). The most frequently reported type of validity for the simulator was construct validity (54%) and concurrent validity (31%). Moreover, construct validity (69%) and concurrent validity (54%) were the most commonly reported type of validity for the measurement instrument. There is significant variation in reported learning outcomes and measurement instruments for evaluating the effectiveness of knee arthroscopic simulation-based education. Despite this, time to perform a task was the most commonly reported skill-evaluating outcome of simulation. The included studies in this review were of variable strength in terms of their evidence and methodologic quality. This study highlights the need for consistent outcome reporting after arthroscopic simulation training. Level IV

  16. Systematic review of economic evaluations of preparedness strategies and interventions against influenza pandemics.

    Directory of Open Access Journals (Sweden)

    Román Pérez Velasco

    Full Text Available BACKGROUND: Although public health guidelines have implications for resource allocation, these issues were not explicitly considered in previous WHO pandemic preparedness and response guidance. In order to ensure a thorough and informed revision of this guidance following the H1N1 2009 pandemic, a systematic review of published and unpublished economic evaluations of preparedness strategies and interventions against influenza pandemics was conducted. METHODS: The search was performed in September 2011 using 10 electronic databases, 2 internet search engines, reference list screening, cited reference searching, and direct communication with relevant authors. Full and partial economic evaluations considering both costs and outcomes were included. Conversely, reviews, editorials, and studies on economic impact or complications were excluded. Studies were selected by 2 independent reviewers. RESULTS: 44 studies were included. Although most complied with the cost effectiveness guidelines, the quality of evidence was limited. However, the data sources used were of higher quality in economic evaluations conducted after the 2009 H1N1 pandemic. Vaccination and drug regimens were varied. Pharmaceutical plus non-pharmaceutical interventions are relatively cost effective in comparison to vaccines and/or antivirals alone. Pharmaceutical interventions vary from cost saving to high cost effectiveness ratios. According to ceiling thresholds (Gross National Income per capita, the reduction of non-essential contacts and the use of pharmaceutical prophylaxis plus the closure of schools are amongst the cost effective strategies for all countries. However, quarantine for household contacts is not cost effective even for low and middle income countries. CONCLUSION: The available evidence is generally inconclusive regarding the cost effectiveness of preparedness strategies and interventions against influenza pandemics. Studies on their effectiveness and cost

  17. Evaluation of a new method for librarian-mediated literature searches for systematic reviews

    NARCIS (Netherlands)

    W.M. Bramer (Wichor); Rethlefsen, M.L. (Melissa L.); F. Mast (Frans); J. Kleijnen (Jos)

    2017-01-01

    textabstractObjective: To evaluate and validate the time of completion and results of a new method of searching for systematic reviews, the exhaustive search method (ESM), using a pragmatic comparison. Methods: Single-line search strategies were prepared in a text document. Term completeness was

  18. Measuring Health Literacy in Individuals with Diabetes: A Systematic Review and Evaluation of Available Measures

    Science.gov (United States)

    Al Sayah, Fatima; Williams, Beverly; Johnson, Jeffrey A.

    2013-01-01

    Objective: To identify instruments used to measure health literacy and numeracy in people with diabetes; evaluate their use, measurement scope, and properties; discuss their strengths and weaknesses; and propose the most useful, reliable, and applicable measure for use in research and practice settings. Methods" A systematic literature review…

  19. A Systematic Approach to Process Evaluation in the Central Oklahoma Turning Point (COTP) Partnership

    Science.gov (United States)

    Tolma, Eleni L.; Cheney, Marshall K.; Chrislip, David D.; Blankenship, Derek; Troup, Pam; Hann, Neil

    2011-01-01

    Formation is an important stage of partnership development. Purpose: To describe the systematic approach to process evaluation of a Turning Point initiative in central Oklahoma during the formation stage. The nine-month collaborative effort aimed to develop an action plan to promote health. Methods: A sound planning framework was used in the…

  20. Techniques to Evaluate Dental Erosion: A Systematic Review of Literature.

    Science.gov (United States)

    Joshi, Mahasweta; Joshi, Nikhil; Kathariya, Rahul; Angadi, Prabhakar; Raikar, Sonal

    2016-10-01

    This article reviews different techniques for evaluating dental erosion, weighs the advantages and disadvantages of these techniques, and presents the latest trends in the study of dental erosion. In May 2014, an initial search was carried out in the PubMed/MEDLINE database of indexed journals from 1975 to 2013 using the following keywords: dental erosion; dental erosion In-vitro; and dental erosion in-vivo. Bibliographic citations from the papers found were then used to find other useful sources. The authors categorize the techniques into three classes: in-vitro, in-vivo and in-vitro/in-vivo. The article discusses the instrumentation required to use each of these techniques, as well as their rationale, merits and applications. The emergence of in-vitro/in-vivo techniques offers the potential to accurately quantify tooth wear in clinical situations. Cross-sectional as well as longitudinal studies show that these techniques will improve diagnosis, treatment planning and management of dental erosion.

  1. A systematic review and economic evaluation of diagnostic strategies for Lynch syndrome.

    Science.gov (United States)

    Snowsill, Tristan; Huxley, Nicola; Hoyle, Martin; Jones-Hughes, Tracey; Coelho, Helen; Cooper, Chris; Frayling, Ian; Hyde, Chris

    2014-09-01

    Lynch syndrome (LS) is an inherited autosomal dominant disorder characterised by an increased risk of colorectal cancer (CRC) and other cancers, and caused by mutations in the deoxyribonucleic acid (DNA) mismatch repair genes. To evaluate the accuracy and cost-effectiveness of strategies to identify LS in newly diagnosed early-onset CRC patients (aged strategies for individuals in whom LS is identified. Systematic reviews were conducted of the test accuracy of microsatellite instability (MSI) testing or immunohistochemistry (IHC) in individuals with CRC at risk of LS, and of economic evidence relating to diagnostic strategies for LS. Reviews were carried out in April 2012 (test accuracy); and in February 2012, repeated in February 2013 (economic evaluations). Databases searched included MEDLINE (1946 to April week 3, 2012), EMBASE (1980 to week 17, 2012) and Web of Science (inception to 30 April 2012), and risk of bias for test accuracy was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) quality appraisal tool. A de novo economic model of diagnostic strategies for LS was developed. Inconsistencies in study designs precluded pooling of diagnostic test accuracy results from a previous systematic review and nine subsequent primary studies. These were of mixed quality, with significant methodological concerns identified for most. IHC and MSI can both play a part in diagnosing LS but neither is gold standard. No UK studies evaluated the cost-effectiveness of diagnosing and managing LS, although studies from other countries generally found some strategies to be cost-effective compared with no testing. The de novo model demonstrated that all strategies were cost-effective compared with no testing at a threshold of £20,000 per quality-adjusted life-year (QALY), with the most cost-effective strategy utilising MSI and BRAF testing [incremental cost-effectiveness ratio (ICER) = £5491 per QALY]. The maximum health benefit to the

  2. Assessing the questionnaires on perceived oral healthcare need: A systematic review

    Directory of Open Access Journals (Sweden)

    Zahra Yaghoubi

    2017-08-01

    Full Text Available BACKGROUND AND AIM: Perception of the need for oral healthcare plays a key role in creating motivation and demand for utilization of oral healthcare services. Furthermore, while the lack of resources, people with perceived needs to oral healthcare, due to the higher profit potential of services, will be on higher priority for services. The aim of this study was to undertake a systematic review of the existing literature about questionnaires used for assessing the perceived oral healthcare needs. METHODS: The search was conducted in PubMed, ISI and Scopus databases in March 2016. Questionnaire-based and the papers which aimed to determine the perceived need for any type of oral healthcare and dental treatment were included to this study. After determining the appropriate papers, related data were extracted and reviewed. RESULTS: Out of 7069 records found, 190 questionnaire-based papers were included in the review. Ninety-four papers were related to the overall evaluation of oral healthcare need, which did not ask the need for types of oral healthcare service. Sixty-six papers studied the need for a specified dental service, and thirty papers recorded the types of oral healthcare service via asking the open or multiple choices questions. There were not comprehensive and standard questionnaires covering all the common types of oral healthcare services. CONCLUSION: Despite the importance of considering the perception of needs for oral healthcare, there is a lack of the comprehensive and standard questionnaires. Studies aimed to assess perceived oral healthcare needs should use questionnaires which include appropriate items on common types of oral healthcare services based on the characteristics of the target group. Concordance with perceived and normative need is an issue that should be addressed in future researches.

  3. Suicide Risk Assessment and Prevention: A Systematic Review Focusing on Veterans.

    Science.gov (United States)

    Nelson, Heidi D; Denneson, Lauren M; Low, Allison R; Bauer, Brian W; O'Neil, Maya; Kansagara, Devan; Teo, Alan R

    2017-10-01

    Suicide rates in veteran and military populations in the United States are high. This article reviews studies of the accuracy of methods to identify individuals at increased risk of suicide and the effectiveness and adverse effects of health care interventions relevant to U.S. veteran and military populations in reducing suicide and suicide attempts. Trials, observational studies, and systematic reviews relevant to U.S. veterans and military personnel were identified in searches of MEDLINE, PsycINFO, SocINDEX, and Cochrane databases (January 1, 2008, to September 11, 2015), on Web sites, and in reference lists. Investigators extracted and confirmed data and dual-rated risk of bias for included studies. Nineteen studies evaluated accuracy of risk assessment methods, including models using retrospective electronic records data and clinician- or patient-rated instruments. Most methods demonstrated sensitivity ≥80% or area-under-the-curve values ≥.70 in single studies, including two studies based on electronic records of veterans and military personnel, but specificity varied. Suicide rates were reduced in six of eight observational studies of population-level interventions. Only two of ten trials of individual-level psychotherapy reported statistically significant differences between treatment and usual care. Risk assessment methods have been shown to be sensitive predictors of suicide and suicide attempts, but the frequency of false positives limits their clinical utility. Research to refine these methods and examine clinical applications is needed. Studies of suicide prevention interventions are inconclusive; trials of population-level interventions and promising therapies are required to support their clinical use.

  4. A systematic assessment of Cochrane reviews and systematic reviews published in high-impact medical journals related to cancer.

    Science.gov (United States)

    Goldkuhle, Marius; Narayan, Vikram M; Weigl, Aaron; Dahm, Philipp; Skoetz, Nicole

    2018-03-25

    To compare cancer-related systematic reviews (SRs) published in the Cochrane Database of SRs (CDSR) and high-impact journals, with respect to type, content, quality and citation rates. Methodological SR with assessment and comparison of SRs and meta-analyses. Two authors independently assessed methodological quality using an Assessment of Multiple Systematic Reviews (AMSTAR)-based extraction form. Both authors independently screened search results, extracted content-relevant characteristics and retrieved citation numbers of the included reviews using the Clarivate Analytics Web of Science database. Cancer-related SRs were retrieved from the CDSR, as well as from the 10 journals which publish oncological SRs and had the highest impact factors, using a comprehensive search in both the CDSR and MEDLINE. We included all cancer-related SRs and meta-analyses published from January 2011 to May 2016. Methodological SRs were excluded. We included 346 applicable Cochrane reviews and 215 SRs from high-impact journals. Cochrane reviews consistently met more individual AMSTAR criteria, notably with regard to an a priori design (risk ratio (RR) 3.89; 95% CI 3.10 to 4.88), inclusion of the grey literature and trial registries (RR 3.52; 95% CI 2.84 to 4.37) in their searches, and the reporting of excluded studies (RR 8.80; 95% CI 6.06 to 12.78). Cochrane reviews were less likely to address questions of prognosis (RR 0.04; 95% CI 0.02 to 0.09), use individual patient data (RR 0.03; 95% CI 0.01 to 0.09) or be based on non-randomised controlled trials (RR 0.04; 95% CI 0.02 to 0.09). Citation rates of Cochrane reviews were notably lower than those for high-impact journals (Cochrane reviews: mean number of citations 6.52 (range 0-143); high-impact journal SRs: 74.45 (0-652)). When comparing cancer-related SRs published in the CDSR versus those published in high-impact medical journals, Cochrane reviews were consistently of higher methodological quality, but cited less

  5. Performance Evaluation of Bluetooth Low Energy: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Jacopo Tosi

    2017-12-01

    Full Text Available Small, compact and embedded sensors are a pervasive technology in everyday life for a wide number of applications (e.g., wearable devices, domotics, e-health systems, etc.. In this context, wireless transmission plays a key role, and among available solutions, Bluetooth Low Energy (BLE is gaining more and more popularity. BLE merges together good performance, low-energy consumption and widespread diffusion. The aim of this work is to review the main methodologies adopted to investigate BLE performance. The first part of this review is an in-depth description of the protocol, highlighting the main characteristics and implementation details. The second part reviews the state of the art on BLE characteristics and performance. In particular, we analyze throughput, maximum number of connectable sensors, power consumption, latency and maximum reachable range, with the aim to identify what are the current limits of BLE technology. The main results can be resumed as follows: throughput may theoretically reach the limit of ~230 kbps, but actual applications analyzed in this review show throughputs limited to ~100 kbps; the maximum reachable range is strictly dependent on the radio power, and it goes up to a few tens of meters; the maximum number of nodes in the network depends on connection parameters, on the network architecture and specific device characteristics, but it is usually lower than 10; power consumption and latency are largely modeled and analyzed and are strictly dependent on a huge number of parameters. Most of these characteristics are based on analytical models, but there is a need for rigorous experimental evaluations to understand the actual limits.

  6. Assessment of left ventricular function and mass by MR imaging: a stereological study based on the systematic slice sampling procedure.

    Science.gov (United States)

    Mazonakis, Michalis; Sahin, Bunyamin; Pagonidis, Konstantin; Damilakis, John

    2011-06-01

    The aim of this study was to combine the stereological technique with magnetic resonance (MR) imaging data for the volumetric and functional analysis of the left ventricle (LV). Cardiac MR examinations were performed in 13 consecutive subjects with known or suspected coronary artery disease. The end-diastolic volume (EDV), end-systolic volume, ejection fraction (EF), and mass were estimated by stereology using the entire slice set depicting LV and systematic sampling intensities of 1/2 and 1/3 that provided samples with every second and third slice, respectively. The repeatability of stereology was evaluated. Stereological assessments were compared with the reference values derived by manually tracing the endocardial and epicardial contours on MR images. Stereological EDV and EF estimations obtained by the 1/3 systematic sampling scheme were significantly different from those by manual delineation (P sampling intensity of 1/2 (P > .05). For these stereological approaches, a high correlation (r(2) = 0.80-0.93) and clinically acceptable limits of agreement were found with the reference method. Stereological estimations obtained by both sample sizes presented comparable coefficient of variation values of 2.9-5.8%. The mean time for stereological measurements on the entire slice set was 3.4 ± 0.6 minutes and it was reduced to 2.5 ± 0.5 minutes with the 1/2 systematic sampling scheme. Stereological analysis on systematic samples of MR slices generated by the 1/2 sampling intensity provided efficient and quick assessment of LV volumes, function, and mass. Copyright © 2011 AUR. Published by Elsevier Inc. All rights reserved.

  7. The Self, the Peer and the Teacher in the EFL Pronunciation Class: A Comparative Study on Assessment, Perceptions and Systematicity

    Directory of Open Access Journals (Sweden)

    Nuria Edo-Marzá

    2017-10-01

    Full Text Available This pilot study is aimed at describing, analysing and comparing self, peer and teacher quantitative and qualitative assessment (and consequently also perceptions and degree of systematicity when assessing in the English as a Foreign Language (EFL pronunciation class in tertiary education. Accordingly, the main objectives of this study have been to measure, rank and compare the harshness or leniency of the three different types of raters involved and their consistency/systematicity when in this role, as well as to measure the levels of coincidence and/or discrepancy when evaluating from different roles and depending on quantitative or qualitative considerations. The method used for the analysis involves the quantitative and qualitative analyses of the scores obtained in a triple-role assessment task carried out by 16 students and a teacher. The calculation of various statistical measures, the triangulation of the data obtained and the Many-Facet Rasch Measurement analysis of the results have completed the study and constitute the departure point for further larger studies. From the results obtained, it can be highlighted that quantitatively, the self and the teacher’s perceptions seem to be the ones that are more distant or different, whereas the self and the peer's tend to be the most similar. In the same way, qualitative assessments seem to be more lenient, that is to say, slightly higher in mean score and have a lower coefficient of variation than quantitative ones in the three groups analysed. Consistency/systematicity is relatively high but it is still an aspect to be improved on the part of most raters.

  8. Symptoms and side effects in chronic non-cancer pain: patient report vs. systematic assessment

    DEFF Research Database (Denmark)

    Jonsson, Torsten; Christrup, Lona Louring; Højsted, J

    2011-01-01

    relieving distressing symptoms and managing the side effects of analgesics are essential in order to improve quality of life and functional capacity in chronic non-cancer pain patients. A quick, reliable and valid tool for assessing symptoms and side effects is needed in order to optimize treatment....... We aimed to investigate the symptoms reported by chronic non-cancer pain patients after open-ended questioning vs. a systematic assessment using a list of symptoms, and to assess whether the patients could distinguish between the symptoms and the side effects induced by analgesics....

  9. Symptoms and side effects in chronic non-cancer pain:patient report vs. systematic assessment

    DEFF Research Database (Denmark)

    Jonsson, Torsten; Christrup, Lona Louring; Højsted, Jette

    2011-01-01

    relieving distressing symptoms and managing the side effects of analgesics are essential in order to improve quality of life and functional capacity in chronic non-cancer pain patients. A quick, reliable and valid tool for assessing symptoms and side effects is needed in order to optimize treatment....... We aimed to investigate the symptoms reported by chronic non-cancer pain patients after open-ended questioning vs. a systematic assessment using a list of symptoms, and to assess whether the patients could distinguish between the symptoms and the side effects induced by analgesics....

  10. Error evaluation method for material accountancy measurement. Evaluation of random and systematic errors based on material accountancy data

    International Nuclear Information System (INIS)

    Nidaira, Kazuo

    2008-01-01

    International Target Values (ITV) shows random and systematic measurement uncertainty components as a reference for routinely achievable measurement quality in the accountancy measurement. The measurement uncertainty, called error henceforth, needs to be periodically evaluated and checked against ITV for consistency as the error varies according to measurement methods, instruments, operators, certified reference samples, frequency of calibration, and so on. In the paper an error evaluation method was developed with focuses on (1) Specifying clearly error calculation model, (2) Getting always positive random and systematic error variances, (3) Obtaining probability density distribution of an error variance and (4) Confirming the evaluation method by simulation. In addition the method was demonstrated by applying real data. (author)

  11. [Economic evaluation on breast cancer screening in mainland China: a systematic review].

    Science.gov (United States)

    Wang, L; Shi, J F; Huang, H Y; Zhu, J; Li, J; Fang, Y; Dai, M

    2016-12-10

    Objective: To gather available evidence related to the economic evaluation on breast cancer screening in mainland China and to provide reference for further research. Methods: A systematic review was conducted to identify articles in PubMed and three Chinese databases (CNKI, Wanfang and VIP) during 1995-2015. Data related to descriptive characteristics, rates on participation and detection for population-based studies, methods for model-based studies, types of economic evaluation and results, were extracted. A Consolidated Health Economic Evaluation Reporting Standards (CHEERS) was used to assess the reporting quality of included studies. Results: Of the 356 records searched in the databases, 13 studies (all published between 2012 and 2015) were included in the current paper involving 11 population-based studies and 3 model-based evaluations (1 study using both methods). Age of the participants who started to be engaged in the screening program ranged from 18 to 45 years old, but terminated at the age of 59 years or older. The screening modalities included single-used clinical breast examination, mammography and ultrasound or combined applications. Study persepectives were described in 7 studies, with 5 from the healthcare providers, and 2 from societal angles. Only 5 studies discounted cost or effectiveness. Out of 11 papers, 9 showed the results on cost-effectiveness analysis (CEA) that reporting the cost per breast cancer detection, with median as 145.0 thousand Chinese Yuan (CNY), ranging from 49.7 thousand to 2 293.0 thousand CNY. From 4 papers with results of cost-utility analysis (CUA), the cost per quality adjusted life year (QALY) gained or cost per disability adjusted life year (DALY) averted, were evaluated. The incremental cost-effectiveness ratio (ICER) was from 2.9 thousand to 270.7 thousand CNY (GDP per capita of China was CNY 49.3 thousand in 2015). In 13 studies, the quality of reporting varied, with an average score of 14.5 (range: 9.5-21.0). In

  12. Systematic review on measurement properties of questionnaires assessing the neighbourhood environment in the context of youth physical activity behaviour.

    Science.gov (United States)

    Reimers, Anne K; Mess, Filip; Bucksch, Jens; Jekauc, Darko; Woll, Alexander

    2013-05-11

    High-quality measurement instruments for assessing the neighbourhood environment are a prerequisite for identifying associations between the neighbourhood environment and a person's physical activity. The aim of this systematic review was to identify reliable and valid questionnaires assessing neighbourhood environmental attributes in the context of physical activity behaviours in children and adolescents. In addition, current gaps and best practice models in instrumentation and their evaluation are discussed. We conducted a systematic literature search using six databases (Web of Science, Medline, TRID, SportDISCUS, PsycARTICLES and PsycINFO). Two independent reviewers screened the identified English-language peer-reviewed journal articles. Only studies examining the measurement properties of self- or proxy-report questionnaires on any aspects of the neighbourhood environment in children and adolescents aged 3 to 18 years were included. The methodological quality of the included studies was assessed using the COSMIN checklists. We identified 13 questionnaires on attributes of the neighbourhood environment. Most of these studies were conducted in the United States (n = 7). Eight studies evaluated self-report measures, two studies evaluated parent-report measures and three studies included both administration types. While eight studies had poor methodological quality, we identified three questionnaires with substantial test-retest reliability and two questionnaires with acceptable convergent validity based on sufficient evidential basis. Based on the results of this review, we recommend that cross-culturally adapted questionnaires should be used and that existing questionnaires should be evaluated especially in diverse samples and in countries other than the United States. Further, high-quality studies on measurement properties should be promoted and measurement models (formative vs. reflexive) should be specified to ensure that appropriate methods for psychometric

  13. ROBIS: A new tool to assess risk of bias in systematic reviews was developed.

    Science.gov (United States)

    Whiting, Penny; Savović, Jelena; Higgins, Julian P T; Caldwell, Deborah M; Reeves, Barnaby C; Shea, Beverley; Davies, Philippa; Kleijnen, Jos; Churchill, Rachel

    2016-01-01

    To develop ROBIS, a new tool for assessing the risk of bias in systematic reviews (rather than in primary studies). We used four-stage approach to develop ROBIS: define the scope, review the evidence base, hold a face-to-face meeting, and refine the tool through piloting. ROBIS is currently aimed at four broad categories of reviews mainly within health care settings: interventions, diagnosis, prognosis, and etiology. The target audience of ROBIS is primarily guideline developers, authors of overviews of systematic reviews ("reviews of reviews"), and review authors who might want to assess or avoid risk of bias in their reviews. The tool is completed in three phases: (1) assess relevance (optional), (2) identify concerns with the review process, and (3) judge risk of bias. Phase 2 covers four domains through which bias may be introduced into a systematic review: study eligibility criteria; identification and selection of studies; data collection and study appraisal; and synthesis and findings. Phase 3 assesses the overall risk of bias in the interpretation of review findings and whether this considered limitations identified in any of the phase 2 domains. Signaling questions are included to help judge concerns with the review process (phase 2) and the overall risk of bias in the review (phase 3); these questions flag aspects of review design related to the potential for bias and aim to help assessors judge risk of bias in the review process, results, and conclusions. ROBIS is the first rigorously developed tool designed specifically to assess the risk of bias in systematic reviews. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  14. A systematic review and economic evaluation of bisphosphonates for the prevention of fragility fractures.

    Science.gov (United States)

    Davis, Sarah; Martyn-St James, Marrissa; Sanderson, Jean; Stevens, John; Goka, Edward; Rawdin, Andrew; Sadler, Susi; Wong, Ruth; Campbell, Fiona; Stevenson, Matt; Strong, Mark; Selby, Peter; Gittoes, Neil

    2016-10-01

    Fragility fractures are fractures that result from mechanical forces that would not ordinarily result in fracture. To evaluate the clinical effectiveness and safety of bisphosphonates [alendronic acid (Fosamax ® and Fosamax ® Once Weekly, Merck Sharp & Dohme Ltd), risedronic acid (Actonel ® and Actonel Once a Week ® , Warner Chilcott UK Ltd), ibandronic acid (Bonviva ® , Roche Products Ltd) and zoledronic acid (Aclasta ® , Novartis Pharmaceuticals UK Ltd)] for the prevention of fragility fracture and to assess their cost-effectiveness at varying levels of fracture risk. For the clinical effectiveness review, six electronic databases and two trial registries were searched: MEDLINE, EMBASE, The Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, Web of Science and BIOSIS Previews, Clinicaltrials.gov and World Health Organization International Clinical Trials Registry Platform. Searches were limited by date from 2008 until September 2014. A systematic review and network meta-analysis (NMA) of effectiveness studies were conducted. A review of published economic analyses was undertaken and a de novo health economic model was constructed. Discrete event simulation was used to estimate lifetime costs and quality-adjusted life-years (QALYs) for each bisphosphonate treatment strategy and a strategy of no treatment for a simulated cohort of patients with heterogeneous characteristics. The model was populated with effectiveness evidence from the systematic review and NMA. All other parameters were estimated from published sources. A NHS and Personal Social Services perspective was taken, and costs and benefits were discounted at 3.5% per annum. Fracture risk was estimated from patient characteristics using the QFracture ® (QFracture-2012 open source revision 38, Clinrisk Ltd, Leeds, UK) and FRAX ® (web version 3.9, University of Sheffield, Sheffield, UK) tools. The relationship between fracture risk and incremental net benefit (INB) was

  15. Treatments for hyperemesis gravidarum and nausea and vomiting in pregnancy: a systematic review and economic assessment.

    Science.gov (United States)

    O'Donnell, Amy; McParlin, Catherine; Robson, Stephen C; Beyer, Fiona; Moloney, Eoin; Bryant, Andrew; Bradley, Jennifer; Muirhead, Colin; Nelson-Piercy, Catherine; Newbury-Birch, Dorothy; Norman, Justine; Simpson, Emma; Swallow, Brian; Yates, Laura; Vale, Luke

    2016-10-01

    Nausea and vomiting in pregnancy (NVP) affects up to 85% of all women during pregnancy, but for the majority self-management suffices. For the remainder, symptoms are more severe and the most severe form of NVP - hyperemesis gravidarum (HG) - affects 0.3-1.0% of pregnant women. There is no widely accepted point at which NVP becomes HG. This study aimed to determine the relative clinical effectiveness and cost-effectiveness of treatments for NVP and HG. MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature, Cochrane Central Register of Controlled Trials, PsycINFO, Commonwealth Agricultural Bureaux (CAB) Abstracts, Latin American and Caribbean Health Sciences Literature, Allied and Complementary Medicine Database, British Nursing Index, Science Citation Index, Social Sciences Citation Index, Scopus, Conference Proceedings Index, NHS Economic Evaluation Database, Health Economic Evaluations Database, China National Knowledge Infrastructure, Cochrane Database of Systematic Reviews and Database of Abstracts of Reviews of Effects were searched from inception to September 2014. References from studies and literature reviews identified were also examined. Obstetric Medicine was hand-searched, as were websites of relevant organisations. Costs came from NHS sources. A systematic review of randomised and non-randomised controlled trials (RCTs) for effectiveness, and population-based case series for adverse events and fetal outcomes. Treatments: vitamins B6 and B12, ginger, acupressure/acupuncture, hypnotherapy, antiemetics, dopamine antagonists, 5-hydroxytryptamine receptor antagonists, intravenous (i.v.) fluids, corticosteroids, enteral and parenteral feeding or other novel treatment. Two reviewers extracted data and quality assessed studies. Results were narratively synthesised; planned meta-analysis was not possible due to heterogeneity and incomplete reporting. A simple economic evaluation considered the implied values of treatments. Seventy

  16. A systematic review of financial and economic assessments of bovine viral diarrhea virus (BVDV) prevention and mitigation activities worldwide.

    Science.gov (United States)

    Pinior, Beate; Firth, Clair L; Richter, Veronika; Lebl, Karin; Trauffler, Martine; Dzieciol, Monika; Hutter, Sabine E; Burgstaller, Johann; Obritzhauser, Walter; Winter, Petra; Käsbohrer, Annemarie

    2017-02-01

    Infection with bovine viral diarrhea virus (BVDV) results in major economic losses either directly through decreased productive performance in cattle herds or indirectly, such as through expenses for control programs. The aim of this systematic review was to review financial and/or economic assessment studies of prevention and/or mitigation activities of BVDV at national, regional and farm level worldwide. Once all predefined criteria had been met, 35 articles were included for this systematic review. Studies were analyzed with particular focus on the type of financially and/or economically-assessed prevention and/or mitigation activities. Due to the wide range of possible prevention and/or mitigation activities, these activities were grouped into five categories: i) control and/or eradication programs, ii) monitoring or surveillance, iii) prevention, iv) vaccination and v) individual culling, control and testing strategies. Additionally, the studies were analyzed according to economically-related variables such as efficiency, costs or benefits of prevention and/or mitigation activities, the applied financial and/or economic and statistical methods, the payers of prevention and/or mitigation activities, the assessed production systems, and the countries for which such evaluations are available. Financial and/or economic assessments performed in Europe were dominated by those from the United Kingdom, which assessed mostly vaccination strategies, and Norway which primarily carried out assessments in the area of control and eradication programs; whereas among non-European countries the United States carried out the majority of financial and/or economic assessments in the area of individual culling, control and testing. More than half of all studies provided an efficiency calculation of prevention and/or mitigation activities and demonstrated whether the inherent costs of implemented activities were or were not justified. The dairy sector was three times more likely to

  17. Virtual reality in the assessment and treatment of psychosis: a systematic review of its utility, acceptability and effectiveness.

    Science.gov (United States)

    Rus-Calafell, M; Garety, P; Sason, E; Craig, T J K; Valmaggia, L R

    2018-02-01

    Over the last two decades, there has been a rapid increase of studies testing the efficacy and acceptability of virtual reality in the assessment and treatment of mental health problems. This systematic review was carried out to investigate the use of virtual reality in the assessment and the treatment of psychosis. Web of Science, PsychInfo, EMBASE, Scopus, ProQuest and PubMed databases were searched, resulting in the identification of 638 articles potentially eligible for inclusion; of these, 50 studies were included in the review. The main fields of research in virtual reality and psychosis are: safety and acceptability of the technology; neurocognitive evaluation; functional capacity and performance evaluation; assessment of paranoid ideation and auditory hallucinations; and interventions. The studies reviewed indicate that virtual reality offers a valuable method of assessing the presence of symptoms in ecologically valid environments, with the potential to facilitate learning new emotional and behavioural responses. Virtual reality is a promising method to be used in the assessment of neurocognitive deficits and the study of relevant clinical symptoms. Furthermore, preliminary findings suggest that it can be applied to the delivery of cognitive rehabilitation, social skills training interventions and virtual reality-assisted therapies for psychosis. The potential benefits for enhancing treatment are highlighted. Recommendations for future research include demonstrating generalisability to real-life settings, examining potential negative effects, larger sample sizes and long-term follow-up studies. The present review has been registered in the PROSPERO register: CDR 4201507776.

  18. Quality Assessment of Economic Evaluations of Suicide and Self-Harm Interventions

    DEFF Research Database (Denmark)

    Madsen, Lizell Bustamante; Eddleston, Michael; Hansen, Kristian Schultz

    2018-01-01

    Background: Death following self-harm constitutes a major global public health challenge and there is an urgent need for governments to implement cost-effective, national suicide prevention strategies. Aim: To conduct a systematic review and quality appraisal of the economic evaluations...... of interventions aimed at preventing suicidal behavior. Method: A systematic literature search was performed in several literature databases to identify relevant articles published from 2003 to 2016. Drummond's 10-item appraisal tool was used to assess the methodological quality of the included studies. Results....... The discussion of suicide and self-harm prevention should be as nuanced as possible, including health economics along with cultural, social, and political aspects....

  19. Instruments evaluating the quality of the clinical learning environment in nursing education: A systematic review of psychometric properties.

    Science.gov (United States)

    Mansutti, Irene; Saiani, Luisa; Grassetti, Luca; Palese, Alvisa

    2017-03-01

    The clinical learning environment is fundamental to nursing education paths, capable of affecting learning processes and outcomes. Several instruments have been developed in nursing education, aimed at evaluating the quality of the clinical learning environments; however, no systematic review of the psychometric properties and methodological quality of these studies has been performed to date. The aims of the study were: 1) to identify validated instruments evaluating the clinical learning environments in nursing education; 2) to evaluate critically the methodological quality of the psychometric property estimation used; and 3) to compare psychometric properties across the instruments available. A systematic review of the literature (using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines) and an evaluation of the methodological quality of psychometric properties (using the COnsensus-based Standards for the selection of health Measurement INstruments guidelines). The Medline and CINAHL databases were searched. Eligible studies were those that satisfied the following criteria: a) validation studies of instruments evaluating the quality of clinical learning environments; b) in nursing education; c) published in English or Italian; d) before April 2016. The included studies were evaluated for the methodological quality of the psychometric properties measured and then compared in terms of both the psychometric properties and the methodological quality of the processes used. The search strategy yielded a total of 26 studies and eight clinical learning environment evaluation instruments. A variety of psychometric properties have been estimated for each instrument, with differing qualities in the methodology used. Concept and construct validity were poorly assessed in terms of their significance and rarely judged by the target population (nursing students). Some properties were rarely considered (e.g., reliability, measurement error

  20. The reliability of physical examination tests for the clinical assessment of scapular dyskinesis in subjects with shoulder complaints: A systematic review.

    Science.gov (United States)

    Lange, Toni; Struyf, Filip; Schmitt, Jochen; Lützner, Jörg; Kopkow, Christian

    2017-07-01

    Systematic review. The aim of this systematic review was to summarize and evaluate intra- and interrater reliability research of physical examination tests used for the assessment of scapular dyskinesis. Scapular dyskinesis, defined as alteration of normal scapular kinematics, is described as a non-specific response to different shoulder pathologies. A systematic literature search was conducted in MEDLINE, EMBASE, AMED and PEDro until March 20th, 2015. Methodological quality was assessed with the Quality Appraisal of Reliability Studies (QAREL) by two independent reviewers. The search strategy revealed 3259 articles, of which 15 met the inclusion criteria. These studies evaluated the reliability of 41 test and test variations used for the assessment of scapular dyskinesis. This review identified a lack of high-quality studies evaluating intra- as well as interrater reliability of tests used for the assessment of scapular dyskinesis. In addition, reliability measures differed between included studies hindering proper cross-study comparisons. The effect of manual correction of the scapula on shoulder symptoms was evaluated in only one study, which is striking, since symptom alteration tests are used in routine care to guide further treatment. Thus, there is a strong need for further research in this area. Diagnosis, level 3a. Copyright © 2016. Published by Elsevier Ltd.

  1. Evaluation of Role of Myofibroblasts in Oral Cancer: A Systematic Review.

    Science.gov (United States)

    Sekhon, Harjeet K; Sircar, Keya; Kaur, Gurbani; Marwah, Muneet

    2016-01-01

    To conduct a systematic review on the role of myofibroblasts in progression of oral cancer. The myofibroblast is essential for the integrity of the mammalian body by virtue of its role in wound healing, but it also plays a negative role due to their role in promoting tumor development. Systematic review. Bibliographic searches were conducted in several electronic databases using all publications in PubMed, PubMed central, EMBASE, CancerLit, Google scholar, and Cochrane CCTR between 1990 and June 2015. The search of all publications from various electronic databases revealed 1,371 citations. The total number of studies considered for systematic review was 43. The total number of patients included in the studies was 990. Myofibroblasts are a significant component in stroma of oral cancer cases, though not identified in all cases. This systematic review shows that clinical, pathological, and immunohistochemistry tests have correlated the presence of high myofibroblast count in oral cancer cell stroma. Myofibroblasts play a significant role in oral cancer invasion and progression. Various studies have demonstrated their association with oral cancer. This review tends to highlight their role in the pathogenesis of oral cancer over the decade. Sekhon HK, Sircar K, Kaur G, Marwah M. Evaluation of Role of Myofibroblasts in Oral Cancer: A Systematic Review. Int J Clin Pediatr Dent 2016;9(3):233-239.

  2. Standardizing the evaluation criteria on treatment outcomes of mandibular implant overdentures: a systematic review

    Science.gov (United States)

    Kim, Ha-Young; Shin, Sang-Wan

    2014-01-01

    PURPOSE The aim of this review was to analyze the evaluation criteria on mandibular implant overdentures through a systematic review and suggest standardized evaluation criteria. MATERIALS AND METHODS A systematic literature search was conducted by PubMed search strategy and hand-searching of relevant journals from included studies considering inclusion and exclusion criteria. Randomized clinical trials (RCT) and clinical trial studies comparing attachment systems on mandibular implant overdentures until December, 2011 were selected. Twenty nine studies were finally selected and the data about evaluation methods were collected. RESULTS Evaluation criteria could be classified into 4 groups (implant survival, peri-implant tissue evaluation, prosthetic evaluation, and patient satisfaction). Among 29 studies, 21 studies presented implant survival rate, while any studies reporting implant failure did not present cumulative implant survival rate. Seventeen studies evaluating peri-implant tissue status presented following items as evaluation criteria; marginal bone level (14), plaque Index (13), probing depth (8), bleeding index (8), attachment gingiva level (8), gingival index (6), amount of keratinized gingiva (1). Eighteen studies evaluating prosthetic maintenance and complication also presented following items as evaluation criteria; loose matrix (17), female detachment (15), denture fracture (15), denture relining (14), abutment fracture (14), abutment screw loosening (11), and occlusal adjustment (9). Atypical questionnaire (9), Visual analog scales (VAS) (4), and Oral Health Impact Profile (OHIP) (1) were used as the format of criteria to evaluate patients satisfaction in 14 studies. CONCLUSION For evaluation of implant overdenture, it is necessary to include cumulative survival rate for implant evaluation. It is suggested that peri-implant tissue evaluation criteria include marginal bone level, plaque index, bleeding index, probing depth, and attached gingiva

  3. Patient-reported outcome instruments that evaluate adherence behaviours in adults with asthma: A systematic review of measurement properties.

    Science.gov (United States)

    Gagné, Myriam; Boulet, Louis-Philippe; Pérez, Norma; Moisan, Jocelyne

    2018-04-30

    To systematically identify the measurement properties of patient-reported outcome instruments (PROs) that evaluate adherence to inhaled maintenance medication in adults with asthma. We conducted a systematic review of six databases. Two reviewers independently included studies on the measurement properties of PROs that evaluated adherence in asthmatic participants aged ≥18 years. Based on the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN), the reviewers (1) extracted data on internal consistency, reliability, measurement error, content validity, structural validity, hypotheses testing, cross-cultural validity, criterion validity, and responsiveness; (2) assessed the methodological quality of the included studies; (3) assessed the quality of the measurement properties (positive or negative); and (4) summarised the level of evidence (limited, moderate, or strong). We screened 6,068 records and included 15 studies (14 PROs). No studies evaluated measurement error or responsiveness. Based on methodological and measurement property quality assessments, we found limited positive evidence of: (a) internal consistency of the Adherence Questionnaire, Refined Medication Adherence Reason Scale (MAR-Scale), Medication Adherence Report Scale for Asthma (MARS-A), and Test of the Adherence to Inhalers (TAI); (b) reliability of the TAI; and (c) structural validity of the Adherence Questionnaire, MAR-Scale, MARS-A, and TAI. We also found limited negative evidence of: (d) hypotheses testing of Adherence Questionnaire; (e) reliability of the MARS-A; and (f) criterion validity of the MARS-A and TAI. Our results highlighted the need to conduct further high-quality studies that will positively evaluate the reliability, validity, and responsiveness of the available PROs. This article is protected by copyright. All rights reserved.

  4. A systematic review and economic evaluation of exercise referral schemes in primary care: a short report.

    Science.gov (United States)

    Campbell, Fiona; Holmes, Mike; Everson-Hock, Emma; Davis, Sarah; Buckley Woods, Helen; Anokye, Nana; Tappenden, Paul; Kaltenthaler, Eva

    2015-07-01

    , Moxham T, Fox KR, et al. The clinical effectiveness and cost-effectiveness of exercise referral schemes: a systematic review and economic evaluation. Health Technol Assess 2011;15(44)] to give a total of eight studies with 5190 participants. The proportion of individuals achieving 90-150 minutes of at least moderate-intensity activity per week at 6-12 months' follow-up was greater for ERSs than usual care (relative risk 1.12; 95% confidence interval 1.04 to 1.20). Older patients and those referred for CHD risk factors appeared to be more likely than others to increase their levels of physical activity. Qualitative evidence suggests that interventions enabling the development of social support networks are beneficial in promoting uptake and adherence. Exercise referral gained 0.003 quality-adjusted life-years (QALYs) at an additional cost of £225 per person. The estimated mean incremental cost-effectiveness ratio (ICER) in the probabilistic sensitivity analysis was £76,276. In the univariate sensitivity analysis the results were very sensitive (ICERs ranged from  £100,000) to changes in the effect of ERSs on physical activity uptake and the duration of the protective effects and the direct health-related quality-of-life gains attributable to physical activity. Exercise referral schemes result in a small improvement in the number of people who increase their levels of physical activity. The cost-effectiveness analysis indicates that the ICER for ERSs compared with usual care is around £76,000 per QALY, although the cost-effectiveness of ERSs is subject to considerable uncertainty. This study is registered as PROSPERO CRD42013005200. National Institute for Health Research Health Technology Assessment programme.

  5. 77 FR 26292 - Risk Evaluation and Mitigation Strategy Assessments: Social Science Methodologies to Assess Goals...

    Science.gov (United States)

    2012-05-03

    ...] Risk Evaluation and Mitigation Strategy Assessments: Social Science Methodologies to Assess Goals... announcing a public workshop entitled ``Risk Evaluation and Mitigation Strategy Assessments: Social Science... constructive dialogue and information-sharing among regulators, researchers, the pharmaceutical industry...

  6. Identifying approaches for assessing methodological and reporting quality of systematic reviews

    DEFF Research Database (Denmark)

    Pussegoda, Kusala; Turner, Lucy; Garritty, Chantelle

    2017-01-01

    there are potential gaps in research best-practice guidance materials. The aims of this study are to identify reports assessing the methodological quality (MQ) and/or reporting quality (RQ) of a cohort of SRs and to assess their number, general characteristics, and approaches to 'quality' assessment over time......BACKGROUND: The methodological quality and completeness of reporting of the systematic reviews (SRs) is fundamental to optimal implementation of evidence-based health care and the reduction of research waste. Methods exist to appraise SRs yet little is known about how they are used in SRs or where...... or reporting guidelines used as proxy to assess RQ were used in 80% (61/76) of identified reports. These included two reporting guidelines (PRISMA and QUOROM) and five quality assessment tools (AMSTAR, R-AMSTAR, OQAQ, Mulrow, Sacks) and GRADE criteria. The remaining 24% (18/76) of reports developed their own...

  7. Quality of systematic reviews in pediatric oncology--a systematic review.

    Science.gov (United States)

    Lundh, Andreas; Knijnenburg, Sebastiaan L; Jørgensen, Anders W; van Dalen, Elvira C; Kremer, Leontien C M

    2009-12-01

    To ensure evidence-based decision making in pediatric oncology systematic reviews are necessary. The objective of our study was to evaluate the methodological quality of all currently existing systematic reviews in pediatric oncology. We identified eligible systematic reviews through a systematic search of the literature. Data on clinical and methodological characteristics of the included systematic reviews were extracted. The methodological quality of the included systematic reviews was assessed using the overview quality assessment questionnaire, a validated 10-item quality assessment tool. We compared the methodological quality of systematic reviews published in regular journals with that of Cochrane systematic reviews. We included 117 systematic reviews, 99 systematic reviews published in regular journals and 18 Cochrane systematic reviews. The average methodological quality of systematic reviews was low for all ten items, but the quality of Cochrane systematic reviews was significantly higher than systematic reviews published in regular journals. On a 1-7 scale, the median overall quality score for all systematic reviews was 2 (range 1-7), with a score of 1 (range 1-7) for systematic reviews in regular journals compared to 6 (range 3-7) in Cochrane systematic reviews (pmethodological flaws leading to a high risk of bias. While Cochrane systematic reviews were of higher methodological quality than systematic reviews in regular journals, some of them also had methodological problems. Therefore, the methodology of each individual systematic review should be scrutinized before accepting its results.

  8. Evaluation of Cross-Cultural Adaptation and Measurement Properties of STarT Back Screening Tool: A Systematic Review.

    Science.gov (United States)

    Al Zoubi, Fadi M; Eilayyan, Owis; Mayo, Nancy E; Bussières, André E

    2017-10-01

    The purpose of this systematic review was to investigate the extent to which the STarT Back Screening Tool (SBST) has been evaluated for (1) the quality of translation of evidence for cross-cultural adaptation and (2) the measurement properties in languages other than English. A systematic search of 8 databases, including Medline, Embase, CINAHL, PsycINFO, AMED, Scopus, PubMed, and Web of Science, was performed. Electronic databases were searched for the period between 2008 and December 27, 2016. We included studies related to cross-cultural adaptation, including translation and assessment of the measurement properties of SBST. Study selection, translation, methodologic and quality assessments, and data extraction were performed independently by 2 reviewers. Of the 1566 citations retrieved, 17 studies were admissible, representing 11 different SBST versions in 10 languages. The quadratic weighted κ statistics of the 2 reviewers, for the translation, methodologic assessment, and quality assessment were 0.85, 0.76, and 0.83, respectively. For translation, only 2 versions (Belgian-French and Mandarin) fulfilled all requirements. None of the versions had tested all the measurement properties, and when performed, these were found to have been conducted inadequately. With regard to quality assessment, overall, the included versions had a "Poor" total summary score except 2 (Persian and Swiss-German), which were rated as "Fair." Few versions fully met the standard criteria for valid translation, and none of the versions tested all the measurement properties. There is a clear need for more accurate cross-cultural adaptation of SBST and greater attention to the quality of psychometric evaluation of the adapted versions of SBST. At this time, caution is recommended when using SBST in languages other than English. Copyright © 2017. Published by Elsevier Inc.

  9. Evaluation of environmental impact assessment system in Pakistan

    International Nuclear Information System (INIS)

    Nadeem, Obaidullah; Hameed, Rizwan

    2008-01-01

    Environmental impact assessment (EIA) was first introduced in Pakistan based on the Environmental Protection Ordinance 1983. The EIA process was further strengthened under the Pakistan Environmental Protection Act 1997, which became operational under EIA Regulations 2000. Despite a sound legal basis and comprehensive guidelines, evidence suggests that EIA has not yet evolved satisfactorily in Pakistan. An evaluation of the EIA system against systematic evaluation criteria, based on interviews with EIA approval authorities, consulting firms and experts, reveals various shortcomings of the EIA system. These mainly include; inadequate capacity of EIA approval authorities, deficiencies in screening and scoping, poor EIA quality, inadequate public participation and weak monitoring. Overall, EIA is used presently as a project justification tool rather than as a project planning tool to contribute to achieving sustainable development. Whilst shortcomings are challenging, central government has recently shown a high degree of commitment to the environmental protection by making EIA compulsory for all the public sector projects likely to have adverse environmental impacts. The paper identifies opportunities for taking advantage of the current environment for strengthening the EIA process

  10. Assessment of the wish to hasten death in patients with advanced disease: A systematic review of measurement instruments.

    Science.gov (United States)

    Bellido-Pérez, Mercedes; Monforte-Royo, Cristina; Tomás-Sábado, Joaquín; Porta-Sales, Josep; Balaguer, Albert

    2017-06-01

    Patients with advanced conditions may present a wish to hasten death. Assessing this wish is complex due to the nature of the phenomenon and the difficulty of conceptualising it. To identify and analyse existing instruments for assessing the wish to hasten death and to rate their reported psychometric properties. Systematic review based on PRISMA guidelines. The COnsensus-based Standards for the selection of health Measurement INstruments checklist was used to evaluate the methodological quality of validation studies and the measurement properties of the instrument described. The CINAHL, PsycINFO, Pubmed and Web of Science databases were searched from inception to November 2015. A total of 50 articles involving assessment of the wish to hasten death were included. Eight concerned instrument validation and were evaluated using COnsensus-based Standards for the selection of health Measurement INstruments criteria. They reported data for between two and seven measurement properties, with ratings between fair and excellent. Of the seven instruments identified, the Desire for Death Rating Scale or the Schedule of Attitudes toward Hastened Death feature in 48 of the 50 articles. The Schedule of Attitudes toward Hastened Death is the most widely used and is the instrument whose psychometric properties have been most often analysed. Versions of the Schedule of Attitudes toward Hastened Death are available in five languages other than the original English. This systematic review has analysed existing instruments for assessing the wish to hasten death. It has also explored the methodological quality of studies that have examined the measurement properties of these instruments and offers ratings of the reported properties. These results will be useful to clinicians and researchers with an interest in a phenomenon of considerable relevance to advanced patients.

  11. Analysis on evaluation ability of nonlinear safety assessment model of coal mines based on artificial neural network

    Institute of Scientific and Technical Information of China (English)

    SHI Shi-liang; LIU Hai-bo; LIU Ai-hua

    2004-01-01

    Based on the integration analysis of goods and shortcomings of various methods used in safety assessment of coal mines, combining nonlinear feature of mine safety sub-system, this paper establishes the neural network assessment model of mine safety, analyzes the ability of artificial neural network to evaluate mine safety state, and lays the theoretical foundation of artificial neural network using in the systematic optimization of mine safety assessment and getting reasonable accurate safety assessment result.

  12. Critical Assessment of Search Strategies in Systematic Reviews in Endodontics.

    Science.gov (United States)

    Yaylali, Ibrahim Ethem; Alaçam, Tayfun

    2016-06-01

    The aim of this study was to perform an overview of literature search strategies in systematic reviews (SRs) published in 2 endodontic journals, Journal of Endodontics and International Endodontic Journal. A search was done by using the MEDLINE (PubMed interface) database to retrieve the articles published between January 1, 2000 and December 31, 2015. The last search was on January 10, 2016. All the SRs published in the 2 journals were retrieved and screened. Eligible SRs were assessed by using 11 questions about search strategies in the SRs that were adapted from 2 guidelines (ie, AMSTAR checklist and the Cochrane Handbook). A total of 83 SRs were retrieved by electronic search. Of these, 55 were from the Journal of Endodontics, and 28 were from the International Endodontic Journal. After screening, 2 SRs were excluded, and 81 SRs were included in the study. Some issues, such as search of grey literature and contact with study authors, were not fully reported (30% and 25%, respectively). On the other hand, some issues, such as the use of index terms and key words and search in at least 2 databases, were reported in most of the SRs (97% and 95%, respectively). The overall quality of the search strategy in both journals was 61%. No significant difference was found between the 2 journals in terms of evaluation criteria (P > .05). There exist areas for improving the quality of reporting of search strategies in SRs; for example, grey literature should be searched for unpublished studies, no language limitation should be applied to databases, and authors should make an attempt to contact the authors of included studies to obtain further relevant information. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  13. Systematic review and metaanalysis of statins for heterozygous familial hypercholesterolemia in children: evaluation of cholesterol changes and side effects.

    LENUS (Irish Health Repository)

    O'Gorman, Clodagh S

    2012-02-01

    Heterozygous familial hypercholesterolemia (heFH) affects 1 in 500 individuals. Evidence supports the low-density lipoprotein (LDL)-lowering effect of statins for adults with heFH. However, there are concerns regarding the treatment children with heFH. By performing a systematic review and metaanalysis of the published literature, this study aimed to evaluate the efficacy and safety of statins used for children with heFH. A systematic review was performed by searching multiple medical databases and citations to identify reports of randomized controlled trials of statins used to treat children with heFH. The trials were retrieved, reviewed, and subjected to metaanalysis. The search yielded 2,174 titles. Of the 63 studies retrieved and reviewed, 56 were excluded, 7 were included in the systematic review, and 4 were included in the metaanalysis. Significant heterogeneity was detected. The metaanalysis showed significant LDL lowering, high-density lipoprotein (HDL) cholesterol elevation, and increases in height and weight with statins. The metaanalysis could not be performed for many side effects of statins, but individual trials showed no significant side effects. Quality assessment showed methodologic concerns, with potential for bias. For example, six trials analyzed statin effects without intention to treat despite such a stated intention. Metaanalysis shows significant LDL lowering with statin treatment. Further studies, including epidemiologic and multicenter studies, are required.

  14. Quality of systematic reviews in pediatric oncology--a systematic review

    DEFF Research Database (Denmark)

    Lundh, Andreas; Knijnenburg, Sebastiaan L; Jørgensen, Anders W

    2009-01-01

    BACKGROUND: To ensure evidence-based decision making in pediatric oncology systematic reviews are necessary. The objective of our study was to evaluate the methodological quality of all currently existing systematic reviews in pediatric oncology. METHODS: We identified eligible systematic reviews...... through a systematic search of the literature. Data on clinical and methodological characteristics of the included systematic reviews were extracted. The methodological quality of the included systematic reviews was assessed using the overview quality assessment questionnaire, a validated 10-item quality...... assessment tool. We compared the methodological quality of systematic reviews published in regular journals with that of Cochrane systematic reviews. RESULTS: We included 117 systematic reviews, 99 systematic reviews published in regular journals and 18 Cochrane systematic reviews. The average methodological...

  15. Measurement properties of tools used to assess suicidality in autistic and general population adults: A systematic review.

    Science.gov (United States)

    Cassidy, S A; Bradley, L; Bowen, E; Wigham, S; Rodgers, J

    2018-05-05

    Adults diagnosed with autism are at significantly increased risk of suicidal thoughts, suicidal behaviours and dying by suicide. However, it is unclear whether any validated tools are currently available to effectively assess suicidality in autistic adults in research and clinical practice. This is crucial for understanding and preventing premature death by suicide in this vulnerable group. This two stage systematic review therefore aimed to identify tools used to assess suicidality in autistic and general population adults, evaluate these tools for their appropriateness and measurement properties, and make recommendations for appropriate selection of suicidality assessment tools in research and clinical practice. Three databases were searched (PsycInfo, Medline and Web of Knowledge). Four frequently used suicidality assessment tools were identified, and subsequently rated for quality of the evidence in support of their measurement properties using the COSMIN checklist. Despite studies having explored suicidality in autistic adults, none had utilised a validated tool. Overall, there was lack of evidence in support of suicidality risk assessments successfully predicting future suicide attempts. We recommend adaptations to current suicidality assessment tools and priorities for future research, in order to better conceptualise suicidality and its measurement in autism. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

  16. Prioritizing health: a systematic approach to scoping determinants in health impact assessment

    Directory of Open Access Journals (Sweden)

    Lindsay McCallum

    2016-08-01

    Full Text Available The determinants of health are those factors that have the potential to affect health, either positively or negatively, and include a range of personal, social, economic, and environmental factors. In the practice of Health Impact Assessment (HIA, the stage at which the determinants of health are considered for inclusion is during the scoping step. The scoping step is intended to identify how the HIA will be carried out and to set the boundaries (e.g., temporal and geographical for the assessment. There are several factors that can help to inform the scoping process, many of which are considered in existing HIA tools and guidance; however, a systematic method of prioritizing determinants was found to be lacking. In order to analyze existing HIA scoping tools that are available, a systematic literature review was conducted including both primary and grey literature. A total of 10 HIA Scoping tools met the inclusion/exclusion criteria and were carried forward for comparative analysis. The analysis focused on minimum elements and practice standards of HIA scoping that have been established in the field. The analysis determined that existing approaches lack a clear, systematic method of prioritization of health determinants for inclusion in HIA. This finding led to the development of a Systematic HIA Scoping tool that addressed this gap. The decision matrix tool uses factors such as impact, public concern and data availability to prioritize health determinants. Additionally, the tool allows for identification of data gaps and provides a transparent method for budget allocation and assessment planning. In order to increase efficiency and improve utility, the tool was programmed into Microsoft Excel. Future work in the area of HIA methodology development is vital to the ongoing success of the practice and utilization of HIA as a reliable decision-making tool.

  17. Psychometric Properties of Patient-Facing eHealth Evaluation Measures: Systematic Review and Analysis.

    Science.gov (United States)

    Wakefield, Bonnie J; Turvey, Carolyn L; Nazi, Kim M; Holman, John E; Hogan, Timothy P; Shimada, Stephanie L; Kennedy, Diana R

    2017-10-11

    Significant resources are being invested into eHealth technology to improve health care. Few resources have focused on evaluating the impact of use on patient outcomes A standardized set of metrics used across health systems and research will enable aggregation of data to inform improved implementation, clinical practice, and ultimately health outcomes associated with use of patient-facing eHealth technologies. The objective of this project was to conduct a systematic review to (1) identify existing instruments for eHealth research and implementation evaluation from the patient's point of view, (2) characterize measurement components, and (3) assess psychometrics. Concepts from existing models and published studies of technology use and adoption were identified and used to inform a search strategy. Search terms were broadly categorized as platforms (eg, email), measurement (eg, survey), function/information use (eg, self-management), health care occupations (eg, nurse), and eHealth/telemedicine (eg, mHealth). A computerized database search was conducted through June 2014. Included articles (1) described development of an instrument, or (2) used an instrument that could be traced back to its original publication, or (3) modified an instrument, and (4) with full text in English language, and (5) focused on the patient perspective on technology, including patient preferences and satisfaction, engagement with technology, usability, competency and fluency with technology, computer literacy, and trust in and acceptance of technology. The review was limited to instruments that reported at least one psychometric property. Excluded were investigator-developed measures, disease-specific assessments delivered via technology or telephone (eg, a cancer-coping measure delivered via computer survey), and measures focused primarily on clinician use (eg, the electronic health record). The search strategy yielded 47,320 articles. Following elimination of duplicates and non

  18. Measurement Properties of Questionnaires Assessing Complementary and Alternative Medicine Use in Pediatrics: A Systematic Review

    Science.gov (United States)

    Toupin April, Karine; Moher, David; Stinson, Jennifer; Byrne, Ani; White, Meghan; Boon, Heather; Duffy, Ciarán M.; Rader, Tamara; Vohra, Sunita; Tugwell, Peter

    2012-01-01

    Objective Complementary and alternative medicine (CAM) is commonly used by children, but estimates of that use vary widely partly due to the range of questionnaires used to assess CAM use. However, no studies have attempted to appraise measurement properties of these questionnaires. The aim of this systematic review was to critically appraise and summarize measurement properties of questionnaires of CAM use in pediatrics. Study design A search strategy was implemented in major electronic databases in March 2011 and conference websites, scientific journals and experts were consulted. Studies were included if they mentioned a questionnaire assessing the prevalence of CAM use in pediatrics. Members of the team independently rated the methodological quality of the studies (using the COSMIN checklist) and measurement properties of the questionnaires (using the Terwee and Cohen criteria). Results A total of 96 CAM questionnaires were found in 104 publications. The COSMIN checklist showed that no studies reported adequate methodological quality. The Terwee criteria showed that all included CAM questionnaires had indeterminate measurement properties. According to the Cohen score, none were considered to be a well-established assessment, two approached the level of a well-established assessment, seven were promising assessments and the remainder (n = 87) did not reach the score’s minimum standards. Conclusion None of the identified CAM questionnaires have been thoroughly validated. This systematic review highlights the need for proper validation of CAM questionnaires in pediatrics, which may in turn lead to improved research and knowledge translation about CAM in clinical practice. PMID:22768098

  19. Quality indicators for the assessment and management of pain in the emergency department: a systematic review.

    Science.gov (United States)

    Stang, Antonia Schirmer; Hartling, Lisa; Fera, Cassandra; Johnson, David; Ali, Samina

    2014-01-01

    Evidence indicates that pain is undertreated in the emergency department (ED). The first step in improving the pain experience for ED patients is to accurately and systematically assess the actual care being provided. Identifying gaps in the assessment and treatment of pain and improving patient outcomes requires relevant, evidence-based performance measures. To systematically review the literature and identify quality indicators specific to the assessment and management of pain in the ED. Four major bibliographical databases were searched from January 1980 to December 2010, and relevant journals and conference proceedings were manually searched. Original research that described the development or collection of data on one or more quality indicators relevant to the assessment or management of pain in the ED was included. The search identified 18,078 citations. Twenty-three articles were included: 15 observational (cohort) studies; three before-after studies; three audits; one quality indicator development study; and one survey. Methodological quality was moderate, with weaknesses in the reporting of study design and methodology. Twenty unique indicators were identified, with the majority (16 of 20) measuring care processes. Overall, 91% (21 of 23) of the studies reported indicators for the assessment or management of presenting pain, as opposed to procedural pain. Three of the studies included children; however, none of the indicators were developed specifically for a pediatric population. Gaps in the existing literature include a lack of measures reflecting procedural pain, patient outcomes and the pediatric population. Future efforts should focus on developing indicators specific to these key areas.

  20. Gasbuggy Site Assessment and Risk Evaluation

    Energy Technology Data Exchange (ETDEWEB)

    None

    2011-03-01

    contaminant exposure scenario, drilling of natural gas wells near the site. The results of this risk evaluation will guide DOE's future surveillance and monitoring activities in the area to ensure that site conditions are adequately protective of human health. This evaluation is not a comprehensive risk assessment for the site; it is intended to provide assurance that DOE's monitoring approach can detect the presence of site-related contamination at levels well below those that would pose an unacceptable risk to human health.

  1. Insulin resistance in patients with type 1 diabetes assessed by glucose clamp studies: systematic review and meta-analysis

    NARCIS (Netherlands)

    Donga, Esther; Dekkers, Olaf M.; Corssmit, Eleonora P. M.; Romijn, Johannes A.

    2015-01-01

    Objective: The aim of this study was to perform a systematic review and meta-analysis on insulin resistance in adult patients with type 1 diabetes mellitus compared to healthy controls, assessed by hyperinsulinemic euglycemic clamp studies. Design and methods: We conducted a systematic search of

  2. Health related quality of life assessment in metastatic disease of the spine: a systematic review.

    Science.gov (United States)

    Street, John; Berven, Sigurd; Fisher, Charles; Ryken, Timothy

    2009-10-15

    Systematic literature review. To examine the available literature on health related quality of life (HRQOL) assessment in metastatic disease of the spine and identify the optimal functional outcome scales to be used in developing a disease-specific tool. There is a lack of consensus in the use of HRQOL measures in patients with metastatic spine disease. A systematic review was conducted using MEDLINE, EMBASE, the Science Citation Index (ISI), the Cumulative Index to Nursing and Allied Health Literature, the PsycINFO, the Allied and Complementary Medicine (AMED), Cochrane Reviews and Global Health databases for clinical studies addressing metastatic spine disease from 1966 through 2008. The validity of outcome tools was established by linkage analysis with the International Classification of Functioning Disability and Health (ICF). One hundred forty-one clinical studies met inclusion criteria including 10,347 patients. Only 5 moderate grade and 1 high grade study were identified. Thirty- four studies used a patient self-assessment instrument to assess health status. None of the instruments were validated for metastatic spine patients. The most commonly used Pi-by-no tools were SF-36, SIP 5, and the ADL. None of the studies defined health related quality of life (HRQOL) or justified the choice of instrument. The most commonly used cancer-specific tools were ECOG, EORTC QCQ-C30, and EUROQOL 5D. Based on frequency of citation and on correlation with the International Classification of Functioning Disability and Health, the ECOG and SF36 were judged as most valid and reliable. A systematic review of the available evidence suggests that valid and reliable health related quality of life measures exist for the assessment of oncology patients; however, a disease-specific tool for metastatic spine disease awaits development. Until such time as a disease-specific tool is available, we recommend that the ECOG and SF-36 be considered for use in studies addressing the outcome

  3. Assessment and Treatment of Cognition and Communication Skills in Adults With Acquired Brain Injury via Telepractice: A Systematic Review.

    Science.gov (United States)

    Coleman, Jaumeiko J; Frymark, Tobi; Franceschini, Nicole M; Theodoros, Deborah G

    2015-05-01

    This is a systematic review of assessment and treatment of cognitive and communicative abilities of individuals with acquired brain injury via telepractice versus in person. The a priori clinical questions were informed by previous research that highlights the importance of considering any functional implications of outcomes, determining disorder- and setting-specific concerns, and measuring the potential impact of diagnostic accuracy and treatment efficacy data on interpretation of findings. A literature search of multiple databases (e.g., PubMed) was conducted using key words and study inclusion criteria associated with the clinical questions. Ten group studies were accepted that addressed assessment of motor speech, language, and cognitive impairments; assessment of motor speech and language activity limitations/participation restrictions; and treatment of cognitive impairments and activity limitations/participation restrictions. In most cases, equivalence of outcomes was noted across service delivery methods. Limited findings, lack of diagnostic accuracy and treatment efficacy data, and heterogeneity of assessments and interventions precluded robust evaluation of clinical implications for telepractice equivalence and the broader area of telepractice efficacy. Future research is needed that will build upon current knowledge through replication. In addition, further evaluation at the impairment and activity limitation/participation restriction levels is needed.

  4. SustainPro - A tool for systematic process analysis, generation and evaluation of sustainable design alternatives

    DEFF Research Database (Denmark)

    Carvalho, Ana; Matos, Henrique A.; Gani, Rafiqul

    2013-01-01

    the user through the necessary steps according to work-flow of the implemented methodology. At the end the design alternatives, are evaluated using environmental impact assessment tools and safety indices. The extended features of the methodology incorporate Life Cycle Assessment analysis and economic....... The software tool is based on the implementation of an extended systematic methodology for sustainable process design (Carvalho et al. 2008 and Carvalho et al. 2009). Using process information/data such as the process flowsheet, the associated mass / energy balance data and the cost data, SustainPro guides...... analysis. The application and the main features of SustainPro are illustrated through a case study of ß-Galactosidase production....

  5. Process variables in organizational stress management intervention evaluation research: a systematic review.

    Science.gov (United States)

    Havermans, Bo M; Schlevis, Roosmarijn Mc; Boot, Cécile Rl; Brouwers, Evelien Pm; Anema, Johannes; van der Beek, Allard J

    2016-09-01

    This systematic review aimed to explore which process variables are used in stress management intervention (SMI) evaluation research. A systematic review was conducted using seven electronic databases. Studies were included if they reported on an SMI aimed at primary or secondary stress prevention, were directed at paid employees, and reported process data. Two independent researchers checked all records and selected the articles for inclusion. Nielsen and Randall's model for process evaluation was used to cluster the process variables. The three main clusters were context, intervention, and mental models. In the 44 articles included, 47 process variables were found, clustered into three main categories: context (two variables), intervention (31 variables), and mental models (14 variables). Half of the articles contained no reference to process evaluation literature. The collection of process evaluation data mostly took place after the intervention and at the level of the employee. The findings suggest that there is great heterogeneity in methods and process variables used in process evaluations of SMI. This, together with the lack of use of a standardized framework for evaluation, hinders the advancement of process evaluation theory development.

  6. Measurement properties of instruments that assess participation in young people with autism spectrum disorder: a systematic review.

    Science.gov (United States)

    Lami, Francesca; Egberts, Kristine; Ure, Alexandra; Conroy, Rowena; Williams, Katrina

    2018-03-01

    To systematically review the measurement properties of instruments assessing participation in young people with autism spectrum disorder (ASD). A search was performed in MEDLINE, PsycINFO, and PubMed combining three constructs ('ASD', 'test of participation', 'measurement properties'). Results were restricted to articles including people aged 6 to 29 years. The 2539 identified articles were independently screened by two reviewers. For the included articles, data were extracted using standard forms and their risk of bias was assessed. Nine studies (8 cross-sectional) met the inclusion criteria, providing information on seven different instruments. The total sample included 634 participants, with sex available for 600 (males=494; females=106) and age available for 570, with mean age for these participants 140.58 months (SD=9.11; range=36-624). Included instruments were the school function assessment, vocational index, children's assessment of participation and enjoyment/preferences for activities of children, experience sampling method, Pediatric Evaluation of Disability Inventory, Computer Adaptive Test, adolescent and young adult activity card sort, and Patient-Reported Outcomes Measurement Information System parent-proxy peer relationships. Seven studies assessed reliability and validity; good properties were reported for half of the instruments considered. Most studies (n=6) had high risk of bias. Overall the quality of the evidence for each tool was limited. Validation of these instruments, or others that comprehensively assess participation, is needed. Future studies should follow recommended methodological standards. Seven instruments have been used to assess participation in young people with autism. One instrument, with excellent measurement properties in one study, does not comprehensively assess participation. Studies of three instruments that incorporate a more comprehensive assessment of participation have methodological limitations. Overall, limited

  7. Systematic evaluation of a 171Yb optical clock by synchronous comparison between two lattice systems.

    Science.gov (United States)

    Gao, Qi; Zhou, Min; Han, Chengyin; Li, Shangyan; Zhang, Shuang; Yao, Yuan; Li, Bo; Qiao, Hao; Ai, Di; Lou, Ge; Zhang, Mengya; Jiang, Yanyi; Bi, Zhiyi; Ma, Longsheng; Xu, Xinye

    2018-05-22

    Optical clocks are the most precise measurement devices. Here we experimentally characterize one such clock based on the 1 S 0 - 3 P 0 transition of neutral 171 Yb atoms confined in an optical lattice. Given that the systematic evaluation using an interleaved stabilization scheme is unable to avoid noise from the clock laser, synchronous comparisons against a second 171 Yb lattice system were implemented to accelerate the evaluation. The fractional instability of one clock falls below 4 × 10 -17 after an averaging over a time of 5,000 seconds. The systematic frequency shifts were corrected with a total uncertainty of 1.7 × 10 -16 . The lattice polarizability shift currently contributes the largest source. This work paves the way to measuring the absolute clock transition frequency relative to the primary Cs standard or against the International System of Units (SI) second.

  8. Economic evaluation of manual therapy for musculoskeletal diseases: a protocol for a systematic review and narrative synthesis of evidence.

    Science.gov (United States)

    Kim, Chang-Gon; Mun, Su-Jeong; Kim, Ka-Na; Shin, Byung-Cheul; Kim, Nam-Kwen; Lee, Dong-Hyo; Lee, Jung-Han

    2016-05-13

    Manual therapy is the non-surgical conservative management of musculoskeletal disorders using the practitioner's hands on the patient's body for diagnosing and treating disease. The aim of this study is to systematically review trial-based economic evaluations of manual therapy relative to other interventions used for the management of musculoskeletal diseases. Randomised clinical trials (RCTs) on the economic evaluation of manual therapy for musculoskeletal diseases will be included in the review. The following databases will be searched from their inception: Medline, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Econlit, Mantis, Index to Chiropractic Literature, Science Citation Index, Social Science Citation Index, Allied and Complementary Medicine Database (AMED), Cochrane Database of Systematic Reviews (CDSR), National Health Service Database of Abstracts of Reviews of Effects (NHS DARE), National Health Service Health Technology Assessment Database (NHS HTA), National Health Service Economic Evaluation Database (NHS EED), CENTRAL, five Korean medical databases (Oriental Medicine Advanced Searching Integrated System (OASIS), Research Information Service System (RISS), DBPIA, Korean Traditional Knowledge Portal (KTKP) and KoreaMed) and three Chinese databases (China National Knowledge Infrastructure (CNKI), VIP and Wanfang). The evi