Journal of evaluation in clinical practice最新文献

{"title":"Knowledge, Attitude and Practice of Medical Students Towards Insomnia and Traditional Chinese Medicine Treatment","authors":"Liping Wang,&nbsp;Lan Luo,&nbsp;Lan Liu,&nbsp;Haoqing Shao,&nbsp;Qiuying Li,&nbsp;Ting Zhang,&nbsp;Xiaoying Tian,&nbsp;Shuoxuan Chen","doi":"10.1111/jep.14309","DOIUrl":"10.1111/jep.14309","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>To assess the Knowledge, Attitude, and Practice (KAP) of medical students at Hunan Medicine College towards insomnia and TCM treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study included 676 medical students. More than half were female (64.20%), and 33.8% reported experiencing insomnia for over a week. Participants' KAP scores were evaluated on insomnia and TCM treatment using a scale.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean KAP scores for insomnia were 58.93%, 73.75%, and 64.94%, respectively, indicating insufficient knowledge but positive attitudes and moderate practices. TCM treatment scores were 78.18%, suggesting better awareness. Overall, 67.60% of medical students would choose TCM for insomnia treatment. Multivariable analysis revealed associations between choosing TCM and higher knowledge (OR = 1.30), positive attitude (OR = 1.46), better practice (OR = 3.44), and being in a later academic year (OR = 2.397).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The study underscores the need for targeted educational interventions to enhance understanding and promote effective practices among medical students, potentially improving their well-being and addressing insomnia more comprehensively.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measuring the Work Relative Value of Common Nursing Items for the General Departments of Tertiary Hospitals: A Descriptive Study","authors":"Yingli Wang,&nbsp;Cong Wang,&nbsp;Hongfei Ren,&nbsp;Ling Mao,&nbsp;Fenjiao Chen,&nbsp;Taoyun Liang,&nbsp;Yuqin Luo,&nbsp;Yan Jiang","doi":"10.1111/jep.14280","DOIUrl":"10.1111/jep.14280","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim(s)</h3>\u0000 \u0000 <p>This study aims to evaluate the workload of clinical nurses by measuring the work relative value (work RVU) of common nursing items based on the resource-based relative value scale in China.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Various single measurements have been employed to measure the nursing workload, but no comprehensive method has yet to be developed in China.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A descriptive study was conducted to construct a common item set for nursing work in general wards on the basis of the 2019 History Information System nursing database from Class A tertiary hospitals to identify the time associated with each service. Data cleaning methods, expert consensus meetings, observational methods, Delphi consensus methods and the analytic hierarchy processes were employed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A common item set for nursing work was established, which contained 2 first-level indexes, 8 secondary-level indexes and 79 third-level indexes. The average working hours of the common items ranged from 1.38 to 23.76 min. The top three nursing items identified were: extra large dressing change, cleaning enema, and nasal feeding catheterization.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The common nursing items used in general wards were universal. The work RVU of common items comprehensively evaluates clinical nurses' workload, which can better meet the needs of management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications</h3>\u0000 \u0000 <p>The work RVU of common items will facilitate effective and comprehensive allocation of nursing human resources and performance assessment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Reporting Method</h3>\u0000 \u0000 <p>We have adhered to relevant EQUATOR guidelines and named the reporting method.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determinants of Problem-Solving Skills of Nursing Students: Solution-Focused Thinking Skills and Emotional Intelligence","authors":"Alime Selçuk Tosun,&nbsp;Nurcan Akgül Gündoğdu,&nbsp;Dilek Avci,&nbsp;Emine Selda Gündüz","doi":"10.1111/jep.14312","DOIUrl":"10.1111/jep.14312","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Problem-solving skills are some of the leading strategies for dynamism in the content and quality of nursing care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The present study is aimed at determining nursing students' problem-solving, solution-focused thinking, and emotional intelligence levels and investigating the relationship between their problem-solving skills and these variables.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study comprised 305 nursing students in Turkey. Data were collected between May and June 2021, using the personal information form, problem-solving inventory, solution-focused inventory and Schutte emotional intelligence scale. One-way ANOVA, <i>t</i>-test and multiple regression were used for data analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean age of the participants was 21.81 ± 5.93 years, 75.7% of them were women, 35.1% were senior students and 58.0% perceived their academic achievement as moderate. The mean scores from the overall problem-solving inventory, solution-focused inventory, and emotional intelligence scale were 92.93 ± 19.30, 50.26 ± 8.43 and 128.22 ± 14.11, respectively. Variables such as sex, perceived academic achievement, emotional intelligence and solution-focused thinking levels affected problem-solving skills (<i>p</i> &lt; 0.01). The effective predictive factors accounted for 50.2% of the change in participants' problem-solving skill levels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>For this reason, revising the national nursing curriculum with programmes that develop emotional intelligence and solution-focused thinking skills will enable nursing students to better manage the nursing process in clinical and field practices.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low Attainment of Treatment Targets for Cardiovascular Risk Factors in Indonesian Adults With Established Coronary Artery Disease","authors":"Dian Sidik Arsyad,&nbsp;Nurul Qalby,&nbsp;Andriany Qanitha,&nbsp;Idar Mappangara,&nbsp;Wilis Milayanti,&nbsp; Wahiduddin,&nbsp; Ansariadi,&nbsp;Frank L. J. Visseren,&nbsp;Maarten J. Cramer,&nbsp;Pieter A. Doevendans,&nbsp;Steven H. J. Hageman","doi":"10.1111/jep.14311","DOIUrl":"10.1111/jep.14311","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Rationale</h3>\u0000 \u0000 <p>Established coronary artery disease (CAD) patients are at increased risk for recurrence of cardiovascular events and mortality due to non-attainment of recommended risk factor control targets.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>We aimed to evaluate the attainment of treatment targets for risk factor control among CAD patients as recommended in the Indonesian CVD prevention guidelines.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients were consecutively recruited from the Makassar Cardiac Center at Wahidin Sudirohusodo Hospital, Indonesia. Targets for systolic blood pressure (SBP &lt; 140 mmHg), low-density lipoprotein-cholesterol (LDL-C &lt; 1.8 mmol/L), body mass index (BMI: 20–25 kg/m²), non-smoking status and antithrombotic use were assessed according to the national guideline. Attainment levels were evaluated in CAD population subgroups using logistic regression to identify patients who required more intensive monitoring.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 395 CAD patients (median age: 57 years (IQR: 49–65), 63.8% men) were recruited between February and June 2021. We observed that 1.8% of the CAD patients met all risk factor treatment targets. LDL-C had the lowest attainment level (5.1%), followed by BMI (59.7%), SBP (62.8%), antithrombotic usage (76.7%) and non-smoking status (94.4%). Apart from lower attainment of SBP control in the 50+ years age group (aOR: 0.57, 95% CI: 0.35–0.94) and women (aOR: 0.53, 95% CI: 0.34–0.83), the attainment levels of other risk factors were consistently low across age, sex, marital status and educational subgroups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>These findings emphasize the urgent need for effective management and heightened awareness, particularly for controlling LDL-C in the CAD population. Action to address this issue is crucial for mitigating the CVD burden, particularly in low- and middle-income countries such as Indonesia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11726404/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing surgical education: An evaluation of laparoscopic simulation training for medical students","authors":"Wenbin Zhang MD,&nbsp;Lijun Qu MD, PhD,&nbsp;Prince Last Mudenda Zilundu PhD,&nbsp;Yuanyuan Xu MD,&nbsp;Meiying Chen MD,&nbsp;Guangyin Yu PhD,&nbsp;Xuefeng Zheng MD, PhD,&nbsp;Guoqing Guo MD, PhD,&nbsp;Jifeng Zhang MD, PhD","doi":"10.1111/jep.14225","DOIUrl":"10.1111/jep.14225","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objective&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;To examine the medical students' awareness of laparoscopic surgery as well as assess the perceived importance of laparoscopic simulation training, and its impact on students' confidence, career aspirations, proficiency, spatial skills, and physical tolerance.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Design&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Descriptive and comparative study using pre- and post-training assessments.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Setting&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Simulation training sessions centred on laparoscopic surgery techniques.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Participants&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Medical students in year three (&lt;i&gt;n&lt;/i&gt; = 49) participated in laparoscopic simulation training sessions.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Before the simulation training, 85.7% of students were unaware of laparoscopy, with females being less familiar than males (96.3% vs. 72.8%). 85.7% believed mastering laparoscopy was crucial before training, and 81.6% believed simulation training could enhance surgical skills. A disparity existed in this belief between the sexes, with 91% of males and 74.1% of females seeing the value in such training for skill improvement. Pretraining, males (54.5%) were more confident than females (26%) in mastering laparoscopy. Post-training, confidence increased for both groups, and the percentage of students wishing to pursue a surgical career also rose from 50% to 72.7%. Despite initial disparities in the time spent on training modules between males and females, both groups achieved similar proficiency levels by the end of the training. Although females initially lagged in spatial awareness and skills, post-training results showed significant improvement, matching their male counterparts. 26.5% of students experienced physical fatigue post-training, with a higher percentage of females (33.3%) reporting fatigue than males (18.2%). Regarding concentration during simulations, 81.8% of males could maintain focus compared to 48.2% of females.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Laparoscopic simulation training effectively improved the understanding, confidence, and surgical skills of medical students, with evident benefits in shaping their career aspirations. While both genders exhibited significant gains, female students faced challenges in terms of physical tolerance and initial spatial awareness. However, their post-training achievements mirrored those of their male peers, highlighting the effectiveness and importance of such simulation traini","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Double-Zero-Event Studies in Evidence Synthesis: Evaluating Robustness Using the Fragility Index","authors":"Zelin Wang,&nbsp;Xing Xing,&nbsp;Eun-Young Mun,&nbsp;Chong Wu,&nbsp;Lifeng Lin","doi":"10.1111/jep.14301","DOIUrl":"10.1111/jep.14301","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Rationale</h3>\u0000 \u0000 <p>Zero-event counts are common in clinical studies, particularly when assessing rare adverse events. These occurrences can result from low event rates, short follow-up periods, and small sample sizes. When both intervention and control groups report zero events in a clinical trial, the study is referred to as a double-zero-event study, which presents methodological challenges for evidence synthesis. There has been ongoing debate about whether these studies should be excluded from evidence synthesis, as traditional two-stage meta-analysis methods may not estimate an effect size for them. Recent research suggests that these studies may still contain valuable clinical and statistical information.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims and Objectives</h3>\u0000 \u0000 <p>This study examines the role of double-zero-event studies from the perspective of the fragility index (FI), a popular metric for assessing the robustness of clinical results. We aim to determine how including or excluding double-zero-event studies affects FI derivations in meta-analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted an illustrative case study to demonstrate how double-zero-event studies can impact FI derivations. Additionally, we performed a large-scale analysis of 12,184 Cochrane meta-analyses involving zero-event studies to assess the prevalence and effect of double-zero-event studies on FI calculations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Our analysis revealed that FI derivations in 6608 (54.2%) of these meta-analyses involved double-zero-event studies. Excluding double-zero-event studies could lead to artificially inflated FI values, potentially misrepresenting the results as more robust than they are.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We advocate for retaining double-zero-event studies in meta-analyses and emphasise the importance of carefully considering their role in FI assessments. Including these studies ensures a more accurate evaluation of the robustness of clinical results in evidence synthesis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What is a Good Outcome of an Inpatient Perinatal Mental Health Admission? Developing an Innovative Evaluation Plan for a New Unit","authors":"Sophie Isobel,&nbsp;Alison Green,&nbsp;Sylvia Lim-Gibson","doi":"10.1111/jep.14269","DOIUrl":"10.1111/jep.14269","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Rationale</h3>\u0000 \u0000 <p>Developing a feasible and sensitive evaluation strategy for a new mental health service is a challenge that requires consideration of what a service is trying to achieve and what a ‘good’ outcome might look like. Perinatal mental illnesses are complex in their causes and treatment. Mother Baby Units provide specialist perinatal mental health care to parents experiencing mental illness in the perinatal period, with evaluations demonstrating clinical and social outcomes. There has however been remarkably little research on <i>how</i> MBUs achieve these outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>This paper outlines the process and components of designing an evaluation plan for a new perinatal mental health unit, summarising outcome measures considered and the methodology of the evaluation strategy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A meaningful realist approach was designed. This innovative dualistic methodology is intended to develop theories of what might cause change while also considering what components of interventions parents experience as meaningful.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Articulating the approach to evaluation provides a contribution to evaluation knowledge for others evaluating complex public health interventions. The relational nature of perinatal mental health experiences challenges individualistic approaches to care delivery, funding and evaluation. As part of service establishment, there is a need to consider what a ‘good’ outcome of care might be and to develop evaluation approaches that capture the relational components of recovery as well as the factors that support families to sustain change.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11713845/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Podiatric Clinical Triage in a Foot and Ankle Orthopaedic Clinic: A Randomised Trial","authors":"Tom P. Walsh,&nbsp;Caitlin Swalwell,&nbsp;Greg B. Merlo,&nbsp;Scott C. Wearing,&nbsp;Warren Jacob,&nbsp;Darren Doherty,&nbsp;Margaret Vandermost,&nbsp;Simon Platt","doi":"10.1111/jep.14249","DOIUrl":"10.1111/jep.14249","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Rationale</h3>\u0000 \u0000 <p>Hospitals are increasingly utilising allied-health professionals to provide clinical triage to patients. While these positions are routinely implemented, and several observational studies have reported positive outcomes, the effectiveness of this intervention has been rarely tested in a clinical trial.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims and Objectives</h3>\u0000 \u0000 <p>The objectives of this study were to (i) evaluate a podiatry-led orthopaedic triage service using patient-reported outcome measures (PROMs), and (ii) determine if it is cost-effective in terms of incremental cost/quality-adjusted life years (QALYs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This pragmatic, randomised, wait-list-control trial recruited participants referred to an orthopaedic foot and ankle clinic at a tertiary-level health service. Trial registration was 31 March 2020. Participants were randomised to either immediate clinical triage (intervention) or to remain on the waiting-list (control). The primary outcome measure was change in foot pain as measured by the Manchester-Oxford Foot and Ankle Questionnaire (MOxFQ) at 6-months. Core outcome measures for chronic musculoskeletal pain were also measured and cost-effectiveness calculated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>One hundred and forty-eight participants were recruited, randomising 73 people to the intervention and 75 people to the control. No between-group differences in pain or demographics were detected at baseline. Foot pain as measured by the MOxFQ improved in both groups at 6-months follow-up, but no significant between-group differences were identified. Significant between-group differences, however, were detected in the patient global impression of change. Additionally, the intervention resulted in a 30% discharge rate, and is considered cost-effective, with each QALY gain costing &lt; $30,000 in real-world scenarios.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A clinical triage service has minimal impact on PROMS for foot and ankle pain or chronic musculoskeletal pain, but it is generally well-received, is cost-effective, and participants were more likely to report global improvement if they attended.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"On Medical Tourism Overseas: Ethical Analysis of the Duties of NHS Doctors in Managing the Negative Health Consequences of Accessing Medical Treatments Abroad","authors":"Richard C. Armitage","doi":"10.1111/jep.14300","DOIUrl":"10.1111/jep.14300","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>An increasing number of UK residents are travelling overseas to access medical treatments, the negative health consequences of which are largely managed by NHS doctors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This paper performs an ethical analysis, using the ethical framework of principlism, of the duties of NHS doctors in managing these negative health consequences of medical tourism overseas.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>While the doctor's duty to respect patient autonomy contains a negative duty to not interfere with their choice to access medical treatment overseas, it also contains a positive duty to ensure this choice is informed. This requires those considering medical tourism overseas to be counselled on the risks. This should take place directly by counselling, and indirectly through public health messaging. Beneficence requires the doctor to promote the patient's health, therefore obligating them to treat complications of medical tourism overseas, to intervene if poor cosmetic outcomes negatively impact the patient's mental health, and to refer the patient if the necessary aftercare is insufficiently or entirely unavailable on the NHS. Beneficence also requires doctors to remove harm, meaning they must counsel patients about the risks of medical tourism overseas to minimise the risk of negative health consequences. Justice requires NHS doctors to care for patients according to their clinical needs regardless of how that need has arisen, including the negative health consequences of medical tourism abroad, and requires NHS doctors to minimise these negative health consequences to minimise the scarce resources allocated to addressing them. The duty of non-maleficence is not relevant in this context.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Amongst other requirements, this paper finds that NHS doctors must counsel those considering medical tourism overseas on the risks of doing so, and existing efforts to do so should be increased to reflect the increasing prevalence of medical tourism overseas by UK residents and the associated negative health consequences.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11707980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to “Factors Associated With Junior Nurses Ability to Recognise and Respond to Clinical Deterioration: A Cross-Sectional Study in Tertiary Hospitals in Malawi”","authors":"","doi":"10.1111/jep.14297","DOIUrl":"10.1111/jep.14297","url":null,"abstract":"<p>C. Chipeta, P. Lingli, M. Nget, and C. B. Thamala, “Factors Associated With Junior Nurses Ability to Recognise and Respond to Clinical Deterioration: A Cross-Sectional Study in Tertiary Hospitals in Malawi,” <i>Journal of Evaluation in Clinical Practice</i> 31 (2025): e14243. https://doi.org/10.1111/jep.14243.</p><p>In the Discussion section, paragraph 12, the text ‘the Abuja Declaration on Health in 2021’ was incorrect, it should have read ‘the Abuja Declaration on Health in 2001’. We also request a change in the corresponding author for this manuscript. This change is necessary due to the demands of the department which we have just been notified. The corresponding author was:</p><p>Email: <span>[email protected]</span></p><p>The new corresponding author will be:</p><p>Email: <span>[email protected]</span></p><p>We apologize for this error.</p>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jep.14297","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}