Journal of evaluation in clinical practice最新文献

{"title":"Cross-Sectional Analysis of Research and Non-Research Payments From the Medical Device Industry to Healthcare Professionals and Organisations in Japan in 2022","authors":"Anju Murayama","doi":"10.1111/jep.70066","DOIUrl":"https://doi.org/10.1111/jep.70066","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Rationale</h3>\u0000 \u0000 <p>Financial relationships between healthcare professionals (HCPs), healthcare organisations (HCOs) and the medical device industry in Japan may lead to conflicts of interest. Limited transparency in these relationships has raised concerns regarding their potential influence on clinical decision-making and patient care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims and Objectives</h3>\u0000 \u0000 <p>This study aimed to assess the scope and magnitude of financial payments from medical device companies to HCPs and HCOs in Japan, focusing on publicly disclosed data from the 2022 fiscal year.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional analysis of publicly available payment disclosures from 169 medical device companies, including all members of the Japan Federation of Medical Devices Associations (JFMDA) and several major non-JFMDA affiliated companies, was conducted. Descriptive statistics were calculated to summarise payment data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 169 medical device companies, 32.5% (55 companies) did not disclose payment information and 6 companies disclosed payment records in aggregated amounts with their group companies, leaving 108 companies for analysis. In total, $245.2 million in payments were made in 2022, with only 23.9% ($58.7 million) to research and development. Of the total, 34.6% ($84.9 million) was allocated to non-research payments to HCOs for sponsoring HCOs’ activities, and 19.6% ($49.0 million) were paid for lecturing and consulting fees, typically to individual HCPs. More than 80% of companies allocated a greater share of payments to non-research activities than to research.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study reveals substantial financial relationships between medical device companies and HCPs/HCOs in Japan, predominantly for non-research purposes. Improved transparency regulations, including a uniform, government-run database, are necessary to better oversee these financial interactions with medical device industry in Japan.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jep.70066","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143698736","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":"Family Peace of Mind of Individuals Over 65 Years of Age With Chronic Diseases: A Cross-Sectional Study","authors":"Emre Birinci,&nbsp;Ceyda Bayram,&nbsp;Ayşe Özkaraman","doi":"10.1111/jep.70063","DOIUrl":"https://doi.org/10.1111/jep.70063","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The purpose of this study was to assess the level of family peace among people over 65 who have chronic diseases and to look at the level of peace in relation to specific factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>This cross-sectional study was conducted between 1 July and 31 October 2023 in Internal Medicine policlinics and clinics of a hospital in Eskişehir/Türkiye. The data were collected using the ‘Introduction Form’, ‘Self-Efficacy Scale’ and ‘Family Peace Scale’. While the data were given in the form of number, percentage, mean and percantage, Mann–Whitney <i>U</i> and Kruskal–Wallis <i>T</i> tests and Spearman's correlation analysis were applied in statistical analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The total mean score of the family peace scale was 64.82 ± 9.041, the deep wear sub-dimension score was 34.11 ± 5.66, and the general contentment sub-dimension score was 30.71 ± 4.64. Age of the patients showed a significantly favourable association with the overall family peace score (<i>r</i> = 0.149; <i>p</i> = 0.019) (Table 4). Individual with dependents had statistically significantly lower total and sub-dimension scores of family peace (<i>p</i> = 0.004, <i>p</i> = 0.030, <i>p</i> = 0.007, respectively). It was found that family peace increased significantly in the positive direction as the level of self-efficacy of the patients increased (<i>r</i> = 0.389, <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Family peace of mind is strongly associated with age, dependents and self-efficacy perceptions of individuals.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jep.70063","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143698989","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":"Alternate Choice Organ Counselling in Altruistic Non-Directed Solid Organ Donation: An Ethical Analysis","authors":"Richard C. Armitage","doi":"10.1111/jep.70055","DOIUrl":"https://doi.org/10.1111/jep.70055","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Currently, recruitment of non-directed altruistic (NDA) kidney and liver lobe donors in the UK regards these individuals as potential NDA donors of the particular organ type they initially express an interest in donating. Conceptualising these individuals instead as potential NDA donors of either a kidney or a liver lobe would require them to be counselled on both kidney donation and liver lobe donation. This can be referred to as ‘alternate choice organ counselling’.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This paper conducts an ethical analysis of alternate choice organ counselling using the ethical framework of Principlism, and suggests changes to current policy and practice, accordingly.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>This paper finds multiple strong ethical reasons to carry out alternate choice organ counselling for potential NDA donors of kidneys or liver lobes: the duty to respect autonomy requires alternate choice organ counselling such that the potential donor's decision to become a NDA donor of a particular organ type is fully informed; the duty of non-maleficence requires alternate choice organ counselling such that the harm subjected to the donor through living donation can be minimised (although such counselling might generate serial NDA donors, which would expose them to greater total harm); the asymmetry in the degree to which the living kidney and living liver lobe donation mechanisms promote justice requires alternate choice organ counselling for potential donors who wish to maximise the utility of their single NDA donation; finally, alternate choice organ counselling is likely to promote beneficence in potential NDA donors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>This paper finds ethical reasons for potential NDA donors to be conceptualised as potential NDA donors of either a kidney or liver lobe, and for these individuals to be provided with alternate choice organ counselling. Suggestions on how this might be delivered in practice are offered, and the necessary further quantitative and qualitative research outlined.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jep.70055","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143698833","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":"The Place of Evidence-Based Practices in Theoretical and Clinical Practice From the Perspective of Midwifery Students: A Qualitative Study","authors":"Feyza Aktaş Reyhan,&nbsp;Elif Dağlı,&nbsp;Havva Yeşildere Sağlam","doi":"10.1111/jep.70067","DOIUrl":"https://doi.org/10.1111/jep.70067","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study was conducted to determine the views of future midwives about the place of evidence-based practices in midwifery education and practice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This descriptive qualitative study was conducted with 28 student midwives who took the course of evidence-based practices in midwifery. Data were collected through in-depth and face-to-face interviews using an interview form. Content analysis technique was used to analyze the data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Four themes and thirteen sub-themes were identified in the data analysis. These themes are belief in evidence-based practice, differences in education and practice, barriers to evidence-based practices and implementation of evidence-based practices.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In the current study, students' awareness of evidence-based midwifery practices and their ability to offer opinions and suggestions are related to the fact that they have taken the evidence-based practices course in their education. In this sense, it is important to increase the knowledge, awareness and skills of midwives by integrating evidence-based practices in the education curricula of future midwives.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jep.70067","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143698893","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":"Analysis of Youtube Videos for Artificial Airway Suctioning Training of Nurses: A Content Analysis","authors":"Sercan Kara,&nbsp;Dilek Yildirim","doi":"10.1111/jep.70053","DOIUrl":"https://doi.org/10.1111/jep.70053","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Artificial airway suctioning is one of the most widespread nursing procedures in clinical practice. Although artificial airway suctioning is frequently applied procedure, it is not easy to perform. It is most important to follow the correct technique to prevent possible complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study aims to assess the content, reliability, and quality of training videos on endotracheal aspiration for nurses. The descriptive and retrospective study was conducted in September 2023 and the videos available on the YouTube platform for artificial airway suctioning training of nurses were evaluated in terms of content, reliability and quality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 36 videos were analyzed. The analysis was conducted by two independent researchers. Video Information Form and Endotracheal or Tracheostomy Tube Aspiration Checklist created in line with the literature were used to evaluate the application steps of the videos. The short form of the DISCERN questionnaire was utilized to assess the reliability of the videos, while the 5-point Global Quality Scale (GQS) was employed to evaluate their quality. The mean DISCERN score for the videos was 2.958 ± 1.513, the mean GQS score was 3.430 ± 1.083, and the mean total score for the Implementation Checklist was 47.166 ± 10.338. A strong agreement was observed between the assessments made by the first and second researchers using the DISCERN, GQS, and Checklist. The videos included in the study were found to be of medium quality. Additionally, it was determined that all videos exhibited deficiencies in the Checklist steps. In addition, there were significant deficiencies in application principles such as compliance with sterile technique, sequence of application stages and recording.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These deficiencies are thought to pose a great risk in terms of patient safety. It is recommended that artificial airway suctioning videos available on YouTube be used in nursing education after being checked for content and by experts.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jep.70053","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143646274","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":"Fatigue Related COPD From Patient's Perspectives","authors":"Aysun Kazak Salti,&nbsp;Ayse Özkaraman,&nbsp;Nuran Dudakli","doi":"10.1111/jep.70052","DOIUrl":"https://doi.org/10.1111/jep.70052","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Fatigue is a common symptom in patients with the chronic obstructive pulmonary disease (COPD). The aim of this study was to assess patient-reported fatigue in the COPD and to investigate their attempts to cope with it.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This cross-sectional study was conducted with 62 patients diagnosed with the COPD. Individual Introduction Form, Fatigue Intervention Form and Visual Analog Scale were used to collect research data. The data were presented in the form of numbers, percentages, means and standard deviations, while Chi-Square, Fisher Freeman Halton and Pearson Correlation analysis were applied in statistical analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients have moderate fatigue, with a score of 6.91 ± 2.81 out of 10 and they experience fatigue for 4.95 ± 2.19 days in a week. Patients reported that the most common causes of fatigue were stress, illness and advanced age. They also mentioned feeling unhappy and angry due to fatigue, adopted a sedentary lifestyle, and being unable to do housework. The most common attempts made by patients to cope with fatigue are sleeping, taking a warm shower and using medication, while less frequently used methods include watching movies, praying, getting a massage and listening to music.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Patients diagnosed with the COPD frequently experience moderate fatigue, which can have harmful effects on their daily lives. In response, patients often implement strategies to conserve energy, with the aim of managing the fatigue symptoms. Nurses should routinely assess the fatigue status of the COPD patients and counsel them on coping with fatigue.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jep.70052","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143646273","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":"A Linkage Between 25-Hydroxyvitamin D and Post-Stroke Cognitive Impairment, as Well as the Duration of Hospitalization After a Stroke","authors":"Jianrong Xiong,&nbsp;Yongxiang Li,&nbsp;Jinhui Li,&nbsp;Chenliang Zhao","doi":"10.1111/jep.70039","DOIUrl":"https://doi.org/10.1111/jep.70039","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>A variety of complications can arise following a stroke, with post-stroke cognitive impairment (PSCI) being a prevalent consequence. The objective of the research was to explore the relationship between 25(OH)D levels, PSCI, and the duration of hospitalization.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Serum concentrations of 25(OH)D were measured within the first 24 h of hospital admission. Cognitive impairment in stroke patients was assessed using the Mini-Mental State Examination (MMSE). Functional independence was evaluated on the day of discharge using the Barthel Index (BI). Additionally, the duration of hospitalization for each patient was recorded. Data analysis was performed using SPSS statistical software.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>An observation revealed that levels of 25(OH)D were comparatively reduced in stroke people who suffered from cognitive impairment as opposed to individuals without such impairment (<i>p</i> = 0.022). Patients with cognitive impairment following a stroke demonstrated reduced BI scores (<i>p</i> &lt; 0.001) and longer durations of hospitalization (<i>p</i> = 0.002) in contrast to patients without cognitive impairment. Upon comparing groups with different concentrations of 25(OH)D, it was observed that individuals with low concentrations had longer hospitalization durations (<i>p</i> = 0.03) and higher NIHSS scores (<i>p</i> = 0.003) than those with high concentrations of 25(OH)D. Furthermore, binary logistic regression analysis indicated that a 25(OH)D level of &lt; 25 nmol/L was a significant risk factor for cognitive impairment following a stroke.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The study indicated a potential linkage between reduced levels of 25(OH)D and an escalated susceptibility to cognitive impairment following a stroke. Furthermore, individuals with lower concentrations of 25(OH)D generally experienced longer hospital stays.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639258","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 Declaration of Helsinki Must Address the Challenges of Artificial Intelligence","authors":"Richard C. Armitage","doi":"10.1111/jep.70065","DOIUrl":"https://doi.org/10.1111/jep.70065","url":null,"abstract":"","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639259","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":"Lengthy Shifts and Decision Fatigue in Out-of-Hours Primary Care: A Qualitative Study","authors":"Mona Maier,&nbsp;Louisa Lawrie,&nbsp;Daniel Powell,&nbsp;Peter Murchie,&nbsp;Julia L. Allan","doi":"10.1111/jep.70050","DOIUrl":"https://doi.org/10.1111/jep.70050","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Rationale&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Demands on healthcare workers are high: services are stretched, shifts are long and healthcare professionals (HCPs) regularly work lengthy periods without a break. Spending time continuously ‘on task’ changes decision-making in predictable ways, as described by the ‘decision fatigue’ phenomenon where decision-makers progressively shift towards making less cognitively effortful decisions as the time worked without a break increases. This phenomenon has been observed repeatedly in large quantitative observational studies, however, individual healthcare workers' experiences have not been explored.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Aims&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This qualitative study aimed to explore general practitioners' (GPs) and advanced nurse practitioners' (ANPs) experiences of working for lengthy periods in an out-of-hours primary care service in the UK. This included exploration of self-perceived changes in decision-making throughout a work shift, and mitigating strategies used to avoid changes in decision-making over time.&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;Semi-structured interviews were conducted online. An inductive thematic analysis was carried out to identify salient issues articulated by participants.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Setting and Participants&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The interview sample (&lt;i&gt;n&lt;/i&gt; = 10) comprised ANPs (&lt;i&gt;n&lt;/i&gt; = 5) and GPs (&lt;i&gt;n&lt;/i&gt; = 5) who regularly worked within the out-of-hours primary care service across a regional National Health Service (NHS) health board.&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;HCPs (GPs and ANPs) provided insights into their experiences during lengthy shifts and the impact of prolonged periods of work on clinical decision-making. Four main themes were identified and developed: (1) HCPs are aware of decision fatigue effects over the course of a shift; (2) Multiple factors help and hinder stable decision-making quality; (3) HCPs deliberately use strategies to help keep the quality of their decision-making stable; and (4) HCPs are aware of contextual changes, likely related to the decision fatigue phenomenon.&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;The findings of this study underscore the intricate interplay of personal, social and systemic factors in decision-making quality and highlight HCPs' deliberate efforts to mitigate decision fatigue's effects in pr","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jep.70050","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143602747","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":"Comparing Medicaid Enrolment Death Data to State-Wide Death Records in Maine","authors":"Katherine A. Ahrens,&nbsp;Apsara Kumarage,&nbsp;Philip Dubois,&nbsp;David Jorgenson","doi":"10.1111/jep.70049","DOIUrl":"https://doi.org/10.1111/jep.70049","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Rationale</h3>\u0000 \u0000 <p>Death data available in Medicaid enrolment files may be incomplete and lack cause of death information. We sought to compare Medicaid enrolment death data to state-wide death records in Maine.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims and Objectives</h3>\u0000 \u0000 <p>(1) To compare the date of death of Medicaid enrollees in Maine according to the Medicaid enrolment data to the date of death obtained through an ongoing quarterly death certificate-Medicaid linkage for 2016–2023; and (2) using the death certificate-Medicaid linkage data, to perform an analysis of the risk of drug overdose death in 2023 by opioid use disorder (OUD) status in 2023, as part of monitoring activities required for one of Maine's new approaches to delivering Medicaid services.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We used Maine Medicaid enrolment data 2010 through 2023 and claims data 2016 through 2023, and Maine final death certificate data 2016 through 2023 (plus Q1–Q2 2024 provisional data). We estimated the risk of drug overdose death in 2023 by OUD diagnosis among non-elderly adults in 2023 using underlying cause of death information from the death certificate-Medicaid linkage data file.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were 124,510 deaths in Maine among Maine residents from 2016 to 2023. Among Medicaid enrollees each year, there was a slightly higher number of deaths when using the death certificate-Medicaid linkage data than when using current enrolment data (e.g. 12% vs. 11% among 2016 enrollees), but generally, death counts were consistent (90% found in both data sources). In our analysis of death certificate-Medicaid linkage data, we found the risk of drug overdose death in 2023 was 0.68% among those with OUD and 0.11% among those without OUD (risk ratio = 6.1).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Generally, there was good agreement between the two sources on the date of death. However, only ongoing death certificate-Medicaid linkage allows for examination of the cause of death, which is required for monitoring a new approach to delivering Medicaid services in Maine.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 2","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143594883","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}