Evidence-based Management Research Articles

The disenchanted fairy godmother: comparing how and why evidence-based management and public service professionals influenced policy performance in public school and active labour market policy in Denmark

Background: The aspiration to use evidence to enhance the legitimacy and effectiveness of policies is widely shared but often falls short. A common explanation for failure is the presence of barriers to utilising evidence or the inadequacies of the evidence available to policy makers. Aims and objectives: The article examines how and why evidence-based policies sometimes fail to enhance policy performance, through a comparative analysis of evidence-based management in Danish public school and active labour market policies after 2000. The two cases are characterised by similar policy performance problems but vary in terms of evidence-based management styles and responses from public service professionals. Methods: The article relies on document analysis and expert interviews with civil servants and key stakeholders to explain how and why evidence-based policies fail to improve policy performance in the two cases. Findings: We find that evidence-based policy making did not resolve performance problems in either case, though for different reasons. In public school policy, conflict over the 2014 Public School Reform impacted negatively on its implementation despite efforts to incorporate evidence in its design. In active labour market policy, evidence-based policies were imposed on job centres and institutionalised in key performance indicators, but over time critique of processual requirements and indignified casework accumulated and contributed towards a political decision to reform job centres. Discussion and conclusion: We advocate for setting realistic expectations about the potential of evidence in resolving policy performance problems and caution against overstating the ‘dream’ of evidence-based policy making.

Hospitalize or discharge the emergency department patient with syncope? A systematic review and meta-analysis of direct evidence for SAEM GRACE.

Syncope is a frequent reason for hospitalization from the emergency department (ED), but the benefit of hospitalization is unclear. This systematic review and meta-analysis (SRMA) aims to cohere and synthesize the best current evidence regarding the potential benefit of hospitalization for ED syncope patients for developing an evidence-based ED syncope management guideline. We conducted a SRMA according to the patient-intervention-control-outcome (PICO) framework: In patients 16 years of age or older who present to the ED with syncope (population), does hospitalization (intervention) or direct ED discharge (comparison) improve short-term outcomes (outcome)? The primary outcome was a composite of all adverse events as defined by individual studies, up to 30 days. Two reviewers independently assessed articles for inclusion and methodological quality. We measured heterogeneity among included studies with I-squared statistic and used GRADE criteria to assess the quality of evidence. Our search strategy identified 2140 publications and included 18 publications (510,545 participants) in the analysis. All studies reported higher rates of adverse events in hospitalized patients (0.7%-43.8%) compared to discharged patients (0%-3.7%). Our meta-analysis detected considerable statistical heterogeneity. The GRADE assessment for all adverse events and all-cause mortality revealed risk ratios of >5 favoring ED discharge for both outcomes at a median follow-up of 30 days. However, point estimates are limited by serious risk of bias, inconsistency, imprecision, indirectness, and publication bias. Due to the uncertainty of the available evidence, this SRMA's findings do not support a recommendation for or against hospitalizing patients presenting to ED with syncope. However, discharging low-risk patients with syncope from the ED is associated with a low risk of short-term adverse events.

Structured Scientific Methodologies in Maritime Product and Service Innovation: Enhancing Evidence-Based Decision-Making

The maritime industry is undergoing rapid transformation, requiring systematic, evidence-based methodologies to improve product and service innovation success rates. Traditionally, maritime businesses have relied on intuition-based decision-making, leading to inefficiencies, increased risks, and inconsistent innovation outcomes. This study investigates the role of structured scientific methodologies in maritime innovation management, emphasizing how systematic approaches enhance decision accuracy, minimize risk, and improve long-term sustainability. This research provides original value by evaluating the effectiveness of structured scientific approaches in maritime innovation, an area where limited studies have explored the intersection of philosophy, leadership, and evidence-based decision-making. The study addresses the following research questions: To what extent do structured scientific methodologies improve product and service innovation success? How do industry leaders, lecturers, and students perceive the role of evidence-based decision-making in innovation?Using qualitative research methods, the study collected data from maritime experts, lecturers, and postgraduate students through semi-structured interviews and document analysis, followed by thematic and comparative analysis. Results indicate that structured methodologies significantly improve innovation outcomes, but barriers such as industry reluctance and lack of competency development hinder adoption. The study concludes that integrating scientific reasoning into maritime leadership training can enhance innovation success, mitigate risk, and foster a culture of evidence-based strategic management.

Optimal Management of the Inpatient With Decompensated Cirrhosis.

Over the past several years, there has been a wealth of new data pertaining to the management of complications of cirrhosis, resulting in several important updates to best practices and consensus guidelines. Despite these advancements and numerous recent targeted quality initiatives, hospitalizations resulting from complications of cirrhosis remain frequent, costly and associated with poor patient outcomes. An emphasis on evidence-based management of hospitalized patients with decompensated cirrhosis has the potential to decrease readmission rates and length of stay while improving overall patient outcomes. Herein, we provide an updated, evidence-based overview of the optimal inpatient management of the most frequently encountered complications associated with cirrhosis.

Hydrological Dynamics and Climate Variability in the Sava River Basin: Streamflow Reconstructions Using Tree-Ring-Based Paleo Proxies

This study reconstructs historical streamflow in the Sava River Basin (SRB), focusing on hydrological variability over extended timescales. Using a combination of Machine Learning (ML) and Deep Learning (DL) models, streamflow patterns were reconstructed from self-calibrated Palmer Drought Severity Index (scPDSI) proxies. The analysis included nine ML models and two DL architectures, with a post-prediction bias correction applied uniformly using the RQUANT method. Results indicate that ensemble methods, such as Random Forest and Gradient Boosted Tree, along with a six-layer DL model, effectively captured streamflow dynamics. Bias correction improved predictive consistency, particularly for models exhibiting greater initial variability, aligning predictions more closely with observed data. The findings reveal that the 2000–2022 period ranks as the lowest 23-year flow interval in the observed record and one of the driest over the past ~500 years, offering historical context for prolonged low-flow events in the region. This study demonstrates the value of integrating advanced computational methods with bias correction techniques to extend hydrological records and enhance the reliability of reconstructions. By addressing data limitations, this approach provides a foundation for supporting evidence-based water resource management in Southeastern Europe under changing climatic conditions.

Clinical decision support to improve primary care obesity management in adults with diabetes: Clinic-randomized study design.

To promote use of lifestyle, pharmacologic, and surgical weight management options for adults with body mass index (BMI) ≥35 kg/m2 and type 2 diabetes (T2D), this project implements and evaluates a weight loss clinical decision support (WL-CDS) intervention that provides patient-specific estimates of the risks and benefits of evidence-based obesity management options to primary care clinicians (PCCs) and patients at primary care clinical encounters. We randomize 38 primary care clinics to either (a) usual care (UC), or (b) the WL- CDS intervention that provides patients and PCCs recommendations for lifestyle changes and patient-specific obesity management options and estimates of benefits and risks of weight loss medications, or metabolic bariatric surgery (MBS) when indicated. Outcomes assessed at 18-months after a patient-specific index date are (a) referral of eligible patients for MBS evaluation; (b) initiation or active management of FDA-approved medications for weight loss; and (c) weight trajectory. Outcomes measured within 1 month of index date are patient-reported (d) shared decision making about weight loss options, and (e) intention to engage in weight loss. This study will deepen our understanding of how patients and PCCs use WL-CDS generated information to inform selection of obesity care options for adults with T2D and BMI ≥35 kg/m2.

Risk-directed management of chronic kidney disease.

The timely and rational institution of therapy is a key step towards reducing the global burden of chronic kidney disease (CKD). CKD is a heterogeneous entity with varied aetiologies and diverse trajectories, which include risk of kidney failure but also cardiovascular events and death. Developments in the past decade include substantial progress in CKD risk prediction, driven in part by the accumulation of electronic health records data. In addition, large randomized clinical trials have demonstrated the effectiveness of sodium-glucose co-transporter 2 inhibitors, glucagon-like peptide1 receptor agonists and mineralocorticoid receptor antagonists in reducing adverse events in CKD, greatly expanding the options for effective therapy. Alongside angiotensin-converting enzyme inhibitors and angiotensin receptor blockers, these classes of medication have been proposed to be the four pillars of CKD pharmacotherapy. However, all of these drug classes are underutilized, even in individuals at high risk. Leveraging prognostic estimates to guide therapy could help clinicians to prescribe CKD-related therapies to those who are most likely to benefit from their use. Risk-based CKD management thus aligns patient risk and care, allowing the prioritization of absolute benefit in determining therapeutic selection and timing. Here, we discuss CKD prognosis tools, evidence-based management and prognosis-guided therapies.

Classification of the Type of Contact Between Primary Molars as an Indicator of the Likelihood of Future Caries

Background/Objectives: Contact areas between first and second primary molars, shaped by concave/convex proximal surface morphology, are associated with proximal caries with concave surfaces linked to biofilm stagnation. This study aimed to evaluate the accuracy and clinical feasibility of a scoring system for classifying contact types (concave–concave, concave–convex, convex–convex, convex–concave) for dental practitioners. Methods: Following ethical approval and informed consent, 116 4–5-year-old children were enrolled. A calibrated examiner assessed caries on the distal of first molars and mesial of second molars using ICDAS-merged criteria and scored 464 proximal contacts clinically and radiographically. Stone models from silicone impressions were also scored by 17 trained practitioners, who repeated scoring a week later and assessed contacts clinically in six children. Practitioners completed a feasibility and satisfaction questionnaire. Results: Convex–convex contacts were most prevalent (58.6%), followed by convex–concave (32.6%). Contact type significantly correlated with caries (OR = 13.5; 95% CI: 6.4–28.3). Inter- and intra-examiner reproducibility ranged from 0.71 to 0.82. Most practitioners felt very (64.7%) or moderately (35.3%) capable of applying the system, found it low in difficulty (70.6%), and expressed high satisfaction (82.4%). Conclusions: The study indicated that it is possible for dental practitioners to classify the proximal contact types between primary molars both in an accurate and clinically feasible way. The system exhibited high reproducibility and practitioner satisfaction, indicating its potential as a valuable tool for identifying caries-prone surfaces and supporting evidence-based caries management.

P-2005. Long-term complications of COVID-19 in pediatric population in Lima, Peru

Abstract Background Peru is the eighth country in South America with most COVID-19 cases (134 684 cases per million population) and the first country in the world with most COVID-19 deaths (6 595 deaths per million population). However, is lacking data on the long term complications of COVID-19 in children and adolescents. Peru does not have guidelines for the diagnosis and management of long-term complications of COVID-19. Thus, studies are needed to develop evidence-based management and to propose the necessary infrastructure to provide comprehensive care. Methods A multicenter study was carried out in 16 hospitals from Lima to describe the long-term complications of COVID-19 in subjects under 18 years and to compare with subjects without a history of COVID-19 (controls). A history of COVID-19 episode was defined by a positive laboratory test or presence of symptoms with a confirmed household case. The comparison group included subjects with no history of COVID-19 symptoms, no history of COVID-19 epidemiological contact and/or negative laboratory tests. Enrolled patients were screened using a survey from the Long-COVID Clinic of Miami. If the screening was positive the Yorkshire Test was applied during a medical evaluation. Results 2,954 cases and 1,500 controls were enrolled, from which 2,558 cases and 1,452 controls completed the screening survey. A higher positive screening for long-term symptoms was found in subjects with COVID-19 history (1,389/2,558, 54.3%) in comparison with subjects without COVID-19 history (251/1452, 17.3%). Among subjects with a positive screening, 439 (31.6%) cases and 53 (21.1%) controls completed a medical evaluation; 381 (86.8%) cases had at least one new symptom posterior to COVID-19 that lasted at least 3 months (positive Yorkshire Rehabilitation Scale) and 32 (60.4%) among controls. (Tab 1) The most common symptoms were cough (53% vs 26%), pain (48% vs 21%), gastrointestinal symptoms (48% vs 16%), and anxiety (44% vs 30) among cases and controls, respectively. (Tab 2) Conclusion More than half of pediatric patients with COVID-19 have long-term symptoms. Study limitations are: recall bias, not all subjects with a positive screening were evaluated by a physician, and we could be overestimating the frequency of symptoms since we enrolled subjects in hospitals. Disclosures Rafaella Navarro, n/a, Pfizer: Grant/Research Support Theresa Ochoa, PhD, Pfizer: Grant/Research Support Gabriel Carrasco, n/a, Pfizer: Grant/Research Support Brian Peña, n/a, Pfizer: Grant/Research Support

Requirements for evidence-based management competency in healthcare: a scoping review

BackgroundIdentifying the essential skills and qualifications for evidence-based managers in healthcare is crucial for decision-makers who aim to select competent managers and design effective training programs. This study reviews the requirements, capabilities, and skills necessary for evidence-based managers in the healthcare sector to accurately utilize and implement evidence.MethodThis scoping review was conducted following the PRISMA-SCR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. A thorough literature search was carried out using relevant keywords across the Web of Science, PubMed, and Scopus databases, with no time restrictions. The selection of articles adhered to predefined inclusion criteria. After eliminating duplicates and reviewing titles, abstracts, and full texts, six articles were included in the final analysis.ResultsThe study identified several competencies required for effective evidence-based management in healthcare, including professional and technical knowledge, leadership, personal traits and attitudes, communication skills, information management, self-management, critical thinking, research skills, and the ability to apply evidence effectively.DiscussionGiven the ongoing transformations in healthcare, including the emergence of new technologies and the generation of extensive data, evidence-based managers must continually enhance their skills to access and evaluate evidence. They should also work on improving both their interpersonal and intrapersonal skills. The authors advocate for further applied research to deepen our understanding of the competencies required for evidence-based managers within the healthcare and treatment contexts.

A review on amino acids as proxies for organic matter degradation in aquatic ecosystems: implications for nutrient cycling, climate change, and ecosystem management.

The fate and degradation of organic matter in aquatic systems is a vital link in nutrient cycling and sedimentation processes influenced by exogenous and endogenous factors, such as inputs from upstream sources, sediment suspension, and the decomposition of aquatic organisms. The interplay of organic carbon, microbes, and environmental factors shapes the distribution and degradation of organic matter. Characterizing the source distribution of sedimentary organic matter in aquatic systems using novel proxies can unravel new insights into the mechanisms that control its dispersal, preservation and fate, which is essential to understanding the global carbon and nitrogen cycles. Therefore, the present review critically investigated amino acids as crucial markers for assessing the degradation status in lacustrine and marine sediments and highlighted the pivotal function of biotic and abiotic determinants that influence the mineralization of organic matter. The review thoroughly discussed studies on the spatio-temporal distribution patterns of amino acids and their bio-refractory nature to overcome the challenges in evaluating sediment organic matter degradation in aquatic systems. Recognizing the paramount impact of climate change on aquatic ecosystems, the review further elucidated how integrating amino acid-based data into climate models is essential for predicting complex interplay between degradation processes and evolving environmental dynamics. Finally, the specific needs for further research and recommendations for developing efficient and sustainable strategies to study organic matter degradation were highlighted. The present review will deliver fresh inferences to researchers, ecologists, and policymakers for a better understanding of source distribution and degradation status of organic matter for evidence-based conservation and management strategies.

Advanced Detection and Classification of Kelp Habitats Using Multibeam Echosounder Water Column Point Cloud Data

Kelps are important habitat-forming species in shallow marine environments, providing critical habitat, structure, and productivity for temperate reef ecosystems worldwide. Many kelp species are currently endangered by myriad pressures, including changing water temperatures, invasive species, and anthropogenic threats. This situation necessitates advanced methods to detect kelp density, which would allow tracking density changes, understanding ecosystem dynamics, and informing evidence-based management strategies. This study introduces an innovative approach to detect kelp density with multibeam echosounder water column data. First, these data are filtered into a point cloud. Then, a range of variables are derived from these point cloud data, including average acoustic energy, volume, and point density. Finally, these variables are used as input to a Random Forest model in combination with bathymetric variables to classify sand, bare rock, sparse kelp, and dense kelp habitats. At 5 m resolution, we achieved an overall accuracy of 72.5% with an overall Area Under the Curve of 0.874. Notably, our method achieved high accuracy across the entire multibeam swath, with only a 1 percent point decrease in model accuracy for data falling within the part of the multibeam water column data impacted by sidelobe artefact noise, which significantly expands the potential of this data type for wide-scale monitoring of threatened kelp ecosystems.

Evidence-Based Surgical Guidelines for Treating Children With Rhabdomyosarcoma.

Surgery remains the cornerstone of treatment for rhabdomyosarcoma (RMS) in children. However, there is considerable variation in surgical management practices worldwide, highlighting the need for standardized Clinical Practice Guidelines (CPG). The CPG development involved assembling a multidisciplinary group, prioritizing 10 key topic areas, conducting evidence searches, and synthesizing findings. Recommendations were voted on using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) methodology. The panel recommended regional lymph node evaluation for patients with paratesticular RMS who are more than 10years old and extremity RMS. Other suggestions included pretreatment re-excision for incompletely resected RMS, preoperative radiation therapy for unresectable tumors, maintaining a 0.5cm resection margin, and tumor bed marking with surgical clips. The panel also suggests resection of residual metastatic disease following chemotherapy, resection of relapsed disease, and the least invasive approach for managing patients presenting with obstruction. This CPG provides evidence-based surgical management recommendations for RMS that can be adapted to diverse resource settings.

Diagnosis and Management of Hypertensive Heart Disease: Incorporating 2023 European Society of Hypertension and 2024 European Society of Cardiology Guideline Updates

Hypertensive heart disease (HHD) continues to be a leading cause of cardiovascular morbidity and mortality worldwide, necessitating the evolution of evidence-based management strategies. This literature review examines the most recent updates from the 2023 and 2024 hypertension guidelines issued by the European Society of Hypertension (ESH) and the European Society of Cardiology (ESC). These guidelines are compared with previous key recommendations, such as the 2017 American College of Cardiology/American Heart Association guidelines and the 2018 ESC/ESH guidelines. The updated recommendations reflect a paradigm shift in the approach to hypertension diagnosis and management, including a stricter systolic blood pressure (BP) target of 120–129 mmHg, which underscores the importance of early and precise BP control. The difference between the classification of “elevated BP” and hypertension in the ESC versus ESH guidelines, particularly, regarding their implications for early detection and prevention of HHD, are critically examined, highlighting areas of clinical and academic debate. The introduction of a new “elevated BP” category (120–139/70–89 mmHg) highlights a proactive strategy aimed at identifying at-risk individuals earlier in the disease course to prevent progression to HHD. Additionally, the divergent roles of hypertension-mediated organ damage (HMOD), including HHD, in risk stratification as recommended by the ESC and ESH are discussed, emphasising their significance in tailoring management approaches. For patients with resistant hypertension, the 2023 and 2024 updates also endorse innovative therapies, such as renal denervation, an interventional procedure that has demonstrated significant promise in managing treatment-resistant cases. This review synthesises these updates, focusing on their implications for clinical practice in diagnosing and managing HHD. By emphasising aggressive intervention and the integration of novel treatment modalities, the review aims to bridge existing gaps in earlier approaches to hypertension management. The critical evaluation of guideline discrepancies and evolving evidence seeks to provide clinicians with a nuanced understanding to optimise outcomes for patients with HHD, particularly considering emerging therapeutic possibilities and more stringent BP control targets.

Retrospective Analysis of the Correlation between Umbilical Blood Flow Index and Maternal and Fetal Outcomes in Pregnant Women with Gestational Diabetes.

Aims/Background Gestational diabetes mellitus (GDM) is a common complication during pregnancy. This retrospective study investigates the correlation between umbilical blood flow index and maternal-fetal outcomes in pregnant women with GDM, aiming to contribute to evidence-based risk assessment and management strategy in this high-risk obstetric population. Methods This retrospective study recruited 119 pregnant women with GDM who were admitted to the Yichang Central People's Hospital, between January 2022 and January 2024. Based on the umbilical blood flow index, the study participants were divided into a normal umbilical blood flow (UBF) index group (n = 56) and a high UBF index group (n = 63). Colour Doppler ultrasound was used to assess umbilical blood flow, and relevant data on maternal, fetal, and neonatal outcomes were obtained from the hospital's electronic medical records. Results We observed that, compared to the normal UBF index group, the high UBF index group exhibited significantly higher rates of adverse pregnancy outcomes, including the cesarean section (p = 0.022), preterm delivery (p = 0.020), gestational hypertension (p = 0.019), neonatal hypoglycemia (p = 0.015), as well as increased incidence of neonatal complications such as respiratory distress syndrome (p = 0.009), neonatal jaundice (p = 0.022), neonatal intensive care unit (NICU) admission (p = 0.015), lower 5-minute Apgar scores (p = 0.013), and neonatal sepsis (p = 0.005). Furthermore, significant differences were observed in fetal biometric parameters and placental morphology between the two groups (fetal weight: p = 0.003; estimated fetal weight percentile: p = 0.017; femur length: p = 0.018; placental weight: p = 0.019; placental volume: p = 0.021). Additionally, correlation analyses indicated significant associations between umbilical blood flow index and maternal and fetal outcomes (p < 0.05). Conclusion We observed a significant correlation between umbilical blood flow indices and maternal and fetal outcomes in pregnant women with gestational diabetes mellitus, implying its utility as a non-invasive parameter for risk stratification and personalized management in this high-risk obstetric population.

Evaluating the Adoption of Evidence-Based Management Practices in Eye Hospitals

Background: Delivering sustainable, high-quality eye care requires a comprehensive understanding of patient conditions, clinical evidence, patients’ preferences, demand patterns, quality supplies, outcomes, financial sustainability, and satisfaction metrics. Evidence-based management (EBM) offers a structured approach to align actions with evidence, enabling effective decision-making and better organizational outcomes. Evaluating current practices against EBM principles fosters awareness and promotes an EBM culture in eye hospitals, supporting improved and sustainable service delivery. Methods: A descriptive cross-sectional survey was conducted in 2023–2024 among 94 eye hospitals worldwide, selected from two networks, using the Centre for Evidence-Based Management (CEBM) assessment questionnaire. Follow-up reminders resulted in 43 responses. Data analysis utilized frequency distributions and Pearson’s correlation to explore relationships between variables. Results: A strong positive correlation was observed between data accessibility and the capacity to interpret data in fostering evidence-based decision-making (r = 0.69, p &lt; 0.01). Additionally, leveraging internal expertise and engaging stakeholders in assessing and utilizing data showed a moderate association with EBM practices (r = 0.48, p &lt; 0.01). Conclusions: Eye hospitals demonstrate alignment with EBM principles, though regional variations exist. Organizations with robust data utilization systems, analytical expertise, and a commitment to continuous improvement are more effective in practicing EBM. Educational and peer-learning initiatives can further support hospitals in adopting EBM principles, strengthening their capacity for evidence-based decision-making, and enhancing eye care services.

Factors influencing evidence-based cardiovascular disease prevention programming in rural African American communities: a community-engaged concept mapping study

BackgroundAfrican Americans experience cardiovascular disease (CVD) disparities, and the burden is greatest in the rural south. Although evidence-based CVD prevention and management programs have been tailored to this context, implementation has been limited and not sustained long-term. To understand how to implement and sustain evidence-based CVD programs at scale, we must explore the perspectives of organizations serving rural African American communities and situate findings within foundational Implementation Science frameworks.MethodsThis study used group concept mapping (GCM) to elicit and synthesize stakeholder perspectives into an action-focused conceptual model depicting factors influencing implementation of evidence-based CVD programs. Representatives of community-based, faith, and healthcare organizations serving African Americans in five rural North Carolina counties were recruited via purposive sampling techniques. Participants (total n = 31) completed three activities: 1) brainstorming in response to an open-ended prompt (n = 31); 2) sorting brainstorm data into wider concepts and rating each in terms of relative importance and feasibility (n = 26); and 3) collaborative interpretation and refinement of the concept map (n = 19). Multivariate statistical analysis was used to generate a concept map. Absolute pattern matches comparing ratings of the relative importance and feasibility of each factor were generated and depicted via ladder graphs.ResultsThe final concept map included five factors: Accessibility, Community and Social Factors, Education and Training, Financial/Resource Development, and Organization Capacity and Staffing. There was high agreement (r = .98) between ratings of importance and feasibility. Education and Training, both within organizations and the wider community, was rated as the most important and feasible factor and Financial/Resource Development was the least important and feasible.ConclusionsThe concept map emphasizes aspects of organizations (inner setting), their surrounding community (outer setting), and individual stakeholders (participants, implementers) as influencing implementation of evidence-based CVD prevention and management programs in rural African American communities. The nature of the intervention or implementation processes were de-emphasized. Organizations in rural African American communities may feel equipped to implement a range of evidence-based programs, provided strategies address the contextual and structural barriers that impede their success. Group concept mapping helped distill and prioritize initial leverage points for action in our project catchment area by facilitating a community-engaged process of data generation and interpretation.

Integrating Practice-Changing Studies in Gynaecologic Oncology Through Clinical Illustrations.

Advances in gynaecologic oncology research lead to continuous updates in clinical guidelines. However, undergraduate medical education often lacks in-depth coverage of recent developments, limiting students' preparedness for evidence-based management of gynaecological cancers. This study aimed to bridge the educational gap by integrating case-based analyses of practice-changing studies into the undergraduate obstetrics and gynaecology course. We aimed to enhance students' understanding of relevant gynaecologic oncology concepts and improve their skills in analysing scientific literature related to cancer management. An educational method was introduced to 5th-year medical students (n = 46) over a 2-week course. Using clinical case scenarios, students were presented with examples of practice-changing trials along with research findings incorporated into clinical practice. Following the course, 36 students completed a feedback survey evaluating their knowledge and research interpretation skills before and after the course. Descriptive statistical methods and Fisher's exact test were used to assess students' self-reported knowledge improvement. There were significant increases in students' self-reported knowledge level on the covered topics, including a distinction between chemotherapy types (p < 0.0001), surgical treatment (p < 0.0001), maintenance therapy in ovarian cancer (p < 0.0001), molecular classification (p < 0.0001) and immunotherapy in endometrial cancer (p < 0.0001). Understanding of inclusion criteria and endpoints in scientific articles also improved, rising from 22 to 86% (p < 0.0001, OR 21, 95% CI 5.62-78.48). Incorporating practice-changing studies into clinical teaching significantly enhances students' perceived comprehension of gynaecologic oncology and strengthens their self-reported research interpretation skills. This methodological approach highlights the value of connecting case-based learning with current research.

Facilitators and barriers to adopting a multifaceted chlamydia management intervention in general practice: qualitative findings from Management of Chlamydia Cases in Australia (MoCCA)

Background Chlamydia is one of the most common sexually transmissible infections globally and can lead to reproductive complications, including pelvic inflammatory disease and infertility. Interventions to reduce disease burden, including retesting for reinfection, partner management, and early detection of complications, are the focus of the Management of Chlamydia Cases in Australia (MoCCA) study, an implementation and feasibility trial aiming to strengthen chlamydia management in Australian general practice. This study aimed to identify factors influencing participation in and adoption of a multifaceted chlamydia management intervention within the general practice setting. Methods We conducted semi-structured interviews with general practice staff (n = 13) from clinics (n = 9) participating in the MoCCA study. Data were analysed using inductive content analysis to identify facilitators and barriers to study participation and intervention adoption. Results Participants felt that practice champions, motivated staff and interventions that improved workflow efficiency, integrated with existing processes and improved patient interactions, facilitated participation in, and adoption of, study interventions. A perceived lack of staff engagement related to time constraints, competing priorities, staff retention issues and interventions that were less convenient to use or had reduced patient uptake were identified as barriers to participation. Conclusions Identifying perceived facilitators and barriers to successful implementation of a multifaceted chlamydia intervention enables public health practitioners to better support general practice in the ongoing uptake and use of evidence-based chlamydia management strategies, ultimately aiming to reduce the burden of chlamydia and its complications in Australia.

Acute Pancreatitis: An Update of Evidence-Based Management and Recent Trends in Treatment Strategies.

Acute pancreatitis is a common gastrointestinal disease leading to hospitalisation. Recent advancements in its management have primarily focussed on the development of early phase medical interventions targeting inflammatory pathways, optimisation of supportive treatment (including fluid resuscitation, pain management and nutritional management), appropriate use of antibiotics, implementation of minimally invasive interventions for infected necrosis, and the necessity of follow-up for long-term complications. These advancements have significantly improved personalised management and overall outcomes of acute pancreatitis. Despite these efforts, early-phase medical interventions to mitigate disease progression are still lacking and acute pancreatitis remains a heterogeneous disease. Future research and clinical trials are imperative to further optimise current strategies and develop new therapeutic approaches. This review presents an evidence-based approach to the management of acute pancreatitis, highlighting recent developments.