Use Of Outcome Indicators Research Articles

Outcome indicators in clinical trials on traditional Chinese medicine treatment of microvascular angina

This study reviewed the current status of the use of outcome indicators in randomized controlled trial(RCT) on traditional Chinese medicine(TCM) treatment of microvascular angina(MVA) and analyzed the existing problems and possible solutions, aiming to provide a basis for the design of high-quality RCT and the establishment of core outcome sets for MVA. CNKI, Wanfang, VIP, SinoMed, PubMed, EMbase, Cochrane Library, Web of Science, and 2 clinical trial registries were searched for the RCT on TCM treatment of MVA according to pre-defined criteria. The Cochrane's risk of bias assessment tool was used to evaluate the methodological quality of the included RCT and the use of outcome indicators was summarized. A total of 69 RCTs were included, from which 100 outcome indicators were extracted, with the frequency of 430. The extracted outcome indicators belonged to 8 domains: response rate, symptoms and signs, physical and chemical examinations, TCM efficacy, safety, quality of life, economic evaluation, and long-term prognosis. The indicators of physical and chemical examinations were the most(70 indicators with the frequency of 211), followed by those of response rate(7 indicators with the frequency of 73) and symptoms and signs(7 indicators with the frequency of 54). The outcome indicators with higher frequency were adverse reactions, angina attack frequency, clinical efficacy, endothelin-1, total duration of treadmill exercise, and hypersensitive C-reactive protein. The RCT on TCM treatment of MVA had the following problems: irregular reporting of adverse reactions, diverse indicators with low frequency, lack of attention to the application of endpoint indicators, insufficient use of TCM differentiation and efficacy indicators, non-standard evaluation criteria and failure to reflect the basic characteristics of TCM. A unified MVA syndrome differentiation standard should be established, on the basis of which an MVA treatment efficacy evaluation system and core outcome indicator set that highlights the characteristics of TCM with patient-reported outcomes as the starting point should be established to improve the clinical research and research value.

Analysis of Medico-Legal Complaint Data: A Retrospective Study of Three Large Italian University Hospitals.

(1) Background: Identifying hospital-related critical, and excellent, areas represents the main goal of this paper, in both a national and local setting. Information was collected and organized for an internal company's reports, regarding civil litigation that has been affecting the hospital, to relate the obtained results with the phenomenon of medical malpractice on a national scale. This is for the development of targeted improvement strategies, and for investing available resources in a proficient way. (2) Methods: In the present study, data from claims management in Umberto I General Hospital, Agostino Gemelli University Hospital Foundation and Campus Bio-Medico University Hospital Foundation, from 2013 to 2020 were collected. A total of 2098 files were examined, and a set of 13 outcome indicators in the assessment of "quality of care" was proposed. (3) Results: From the total number, only 779 records (37.1%) were attributable to the categories indexable for the present analysis. This data highlights how, following a correct and rigorous categorization of hospital events, it is possible to analyze these medico-legal aspects using a small number of indicators. Furthermore, it is important to consider how a consistent percentage of remaining events was difficult to index, and was also of poor scientific interest. (4) Conclusions: The proposed indicators do not require standards to be compared to, but provide a useful instrument for comparative purposes. In fact, in addition to comparative assessment between different business realities distributed throughout the territory, the use of outcome indicators allows for a longitudinal analysis evaluating the performance of an individual structure over time.

Analysis of status quo of outcome indicators of randomized controlled trials in treatment of acute ischemic stroke with acupuncture in recent three years

To analyze the use of outcome indicators of randomized controlled trial(RCT) of acupuncture in the treatment of acute ischemic stroke in recent three years, so as to provide a basis for building a study on the core outcome indicators for the treatment of acute ischemic stroke with acupuncture. The RCTs of acupuncture treatment for acute ischemic stroke in recent three years were collec-ted through computer retrieval of eight Chinese and English databases and two clinical trial registries at home and abroad. Literature was screened out, and data was extracted. Risk of assessment bias tool Cochrane 6.1 was used for bias risk assessment, outcome indicators were summarized and analyzed. A total of 47 RCTs were included, and 3 studies were trials registration scheme. Outcome indicators were divided into 6 categories according to functional attributes, namely physical symptoms/signs, physical and chemical examination, quality of life, traditional Chinese medicine symptoms/syndromes, safety events and long-term prognosis. The study found that in addition to the common problems in previous studies covered by the status quo of outcome indicators selection of RCT of acupuncture in the treatment of acute ischemic stroke, there were also the other problems as follows: emphasis on macroscopic efficacy indicators but neglect of acupuncture specific indicators, lack of characteristic indicators and economic indicators of traditional Chinese medicine therapy, and unification of indicators measurement tool and measurement time point. In the future, the outcome indicators set for the treatment of acute ischemic stroke with acupuncture shall be established, and the core outcome indicators set shall be in line with the characteristics of traditional Chinese medicine treatment.

Associations between hospital deaths (HSMR), readmission and length of stay (LOS): a longitudinal assessment of performance results and facility characteristics of teaching and large-sized hospitals in Canada between 2013–2014 and 2017–2018

ObjectivesTo examine the association between hospital deaths (hospital standardised mortality ratio, HSMR), readmission, length of stay (LOS) and eight hospital characteristics.DesignLongitudinal observational study.SettingA total of 119 teaching and large-sized hospitals...

Do Nonprofit Hospitals Evaluate Their Community Benefit Activities?

Nonprofit hospitals in the United States are required to conduct a community health needs assessment (CHNA) every 3 years to identify the most pressing health issues in their community and then develop an implementation strategy for addressing these health issues. CHNA reports must include "evaluation of the impact of any actions that were taken to address the significant health needs identified in the immediately preceding CHNA." To determine whether and how nonprofit hospitals are responding to the requirement to evaluate their implementation strategies addressing their community's priority health needs. Using content analysis, we reviewed CHNA reports of all Minnesota nonprofit hospitals (n = 96) since regulations were finalized in December 2014. Nonprofit hospitals in Minnesota. Reports were coded to determine whether hospitals are responding to the evaluation requirement and the types of evaluation measures (process vs outcome indicators) used to assess hospitals' activities. Most of the reports (116 of 136 reports, or 85.3%) include narrative evaluating community benefit programs, showing widespread conformity with the IRS (Internal Revenue Service) mandate. All of the evaluations use process indicators, such as the number of individuals reached. More than half of the evaluations (64 of 116 reports, or 55.2%) also use outcome indicators, with many reporting short- and medium-term changes in health-related knowledge and behaviors. Use of outcome indicators increased substantially in CHNAs in the 2017-2020 period compared with 2015-2016. In general, Minnesota hospitals are using program evaluation to assess their community benefit implementation strategies, although the extent to which they evaluate their strategies varies considerably between hospitals. While the use of outcome indicators of impact has increased over time, levels of use suggest the importance of incorporating public health expertise in CHNA work.

Monitoring and evaluation of sport-based HIV/AIDS awareness programmes: Strengthening outcome indicators

There are number of Non-Governmental Organisations (NGOs) in South Africa that use sport as a tool to respond to Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS), however, little is reported about the outcomes and impact of these programmes. The aim of this study is to contribute to a generic monitoring and evaluation framework by improving the options for the use of outcome indicators of sport-based HIV/AIDS awareness programmes of selected NGOs in South Africa. A qualitative method study was carried out with seven employees of five selected NGOs that integrate sport to deliver HIV/AIDS programmes in South Africa. The study further involved six specialists/experts involved in the field of HIV/AIDS and an official from Sport Recreation South Africa (SRSA). Multiple data collection instruments including desktop review, narrative systematic review, document analysis, one-on-one interviews and focus group interview were used to collect information on outcomes and indicators for sport-based HIV/AIDS awareness programmes. The information was classified according to the determinants of HIV/AIDS. The overall findings revealed that the sport-based HIV/AIDS awareness programmes of five selected NGOs examined in this study focus on similar HIV prevention messages within the key priorities highlighted in the current National Strategic Plan for HIV/AIDS, STIs and TB of South Africa. However, monitoring and evaluating outcomes of sport-based HIV/AIDS programmes of the selected NGOs remains a challenge. A need exists for the improvement of the outcome statements and indicators for their sport-based HIV/AIDS awareness programmes. This study proposed a total of 51 generic outcome indicators focusing on measuring change in the knowledge of HIV/AIDS and change in attitude and intention towards HIV risk behaviours. In addition, this study further proposed a total of eight generic outcome indicators to measure predictors of HIV risk behaviour. The selected NGOs can adapt the proposed generic outcomes and indicators based on the settings of their programmes. A collaborative approach by all stakeholders is required, from international organisations, funders, governments, NGOs and communities to strengthening monitoring and evaluation of sport-based HIV/AIDS awareness programmes including other development programmes. This will assist the NGOs that use sport for development to be able to reflect accurately the information about their HIV/AIDS activities and also be able to contribute to on-going monitoring activities at a national and global level as well as to the Sustainable Development Goals.

Oncology Advanced Nurses' Use of Outcome Indicators and Perception of Outcome Evaluation

Purpose: The purpose of this study was to explore the use of outcome indicators and perception of outcome evaluation of oncology advanced practice nurses (APNs). Method: A total of 111 oncology APNs from hospitals which have over 400 beds were surveyed. The participants' use of outcome indicators and perception of outcome evaluation were collected using a questionnaire including 84 outcome indicators for APNs developed by Sung et al. and 13 items on APNs' contribution to the hospitals developed by Kleinpell (2005). Data were analyzed using descriptive statistics, t-test, and test. Result: Twelve items out of 84 outcome indicators were used over 50% of the time and 57 items could be used in the future by the participants. Seven of the 10 top-ranking outcome indicators in use were education related and were also expected to be used frequently in the future. The score for participants' perception of outcome evaluation was average-high, 3.82 out of 5. Conclusions: The results of the study show that the main outcome indicator for oncology APNs is education related, and thus the use of education related outcome indicators is recommended to make oncology APNs' activities be more visible.

The concept of sustainability and the use of outcome indicators. A case study to continue a successful health counselling intervention

To ensure the continuation of a successful pilot programme, the change process and the concept of sustainability need to be elaborated. So far, there are different theories on organizational change and sustainability but its practical application stay far behind. To test the practical application of a theory-based concept of sustainability and to assess the role of the change agent. A health counselling programme for high-risk cardiovascular patients, called Heartbeat 2, was used as a case study. Outcome indicators were assessed based on the questions: Why should health counselling be sustained? How should this be done and by whom? How much needs to occur and by when? Data were derived from registrations, reports and focus group interviews. The results indicate a need for a linkage system in the final stages of change so that the programme is maintained. Limitations of the external change agent are described. The outcome indicators appeared to be an adequate operationalization to monitor sustainability. The change process leading up to sustainability appeared to be highly complex due to unpredictable and unforeseen external factors. Our concept of sustainability appeared to be an adequate tool for the change agent to assess the extent of sustainability. An external change agent has limited influence on the management's decision-making processes during the sustainability stage. As long as the context is changing, definite choices to sustain the innovative service of health counselling in hospitals will not be made, which inherently means an ongoing change process to sustainability.

Preparing for Program Accreditation Review Under ABET Engineering Criteria 2000: Choosing Outcome Indicators

AbstractThis paper examines a variety of outcome indicators that might be used by an engineering program in meeting the assessment requirements of ABET Engineering Criteria 2000. Several categories of indicator are identified and key characteristics of these means of assessment are discussed. Also noted are some of the engineering applications of outcome indicators documented on the World Wide Web. Finally, the results of a recent telephone/fax survey on the use of outcome indicators in engineering program assessment are summarized.

Health-related quality of life: an indicator of quality of care?

There is an increasing interest in the use of outcome indicators to monitor the quality of care. Traditionally, outcome indicators have been based mainly on biological indicators reflecting death or disease. Now that various instruments for health status measurement have become available, questions have been raised as to the potential application of health status scores in monitoring the quality of care. This paper identifies conditions which should be fulfilled before such applications can be recommended. Firstly, the relationship between care delivery processes and health status outcomes must be established. In order to achieve this, health status measures which are clearly able to detect health status variations between groups of patients (i.e. discriminative ability) and variations over time (i.e. sensitivity to change) are needed. Secondly, health status data should be available, preferably from established data collection registries (e.g. computerized hospital records or national registries) where data relating to the description of variations in health status (between physicians, hospitals, regions, etc.) are routinely collected. Thirdly, methods should be found to collect additional data, including 'case-mix' information and health status reference data, in order to enable the interpretation of variations in health status. Because most of these conditions are currently not being fulfilled, we conclude that the state-of-the-art of health status measurement has not yet matured sufficiently to allow for the use of health status as an indicator of quality of care. The present paper provides a framework for both future research and data collection that is needed to improve the applicability of health status measures as quality-of-care indicators.

Quality assurance in Swiss University Hospitals: a survey among clinical department heads.

To obtain information to help design and implement quality improvement programmes. Questionnaire survey. Swiss University Hospitals. Clinical Department heads. Attitudes towards quality assurance and percentage of departments with procedures for measurement and improvement of structure, process and outcome of medical care. Among 138 departments responding, 69 indicated a designated person or group in charge of quality and 57 were involved in collaborative quality improvement programmes. Mortality data at the level of the department was unavailable to 33% of respondents, and data on adverse treatment effects to 67% of them. Most respondents (69%) favoured the use of outcome indicators for quality control; only 13% favoured indicators pertaining to process or structure of care. Among indicators of outcome, patient satisfaction was the preferred indicator (25% of respondents), followed by morbidity (16%) and mortality (12%) data. Although the quality of medical care in Switzerland enjoys an excellent reputation, this study highlights important gaps in the information system and the processes necessary to evaluate quality.