Journal of evaluation in clinical practice最新文献

{"title":"The Illness Experience of Patients With Knee Osteoarthritis: A Qualitative Study","authors":"Qingsong Zou,&nbsp;Nuo Chen,&nbsp;Jingqin Cheng,&nbsp;Wei Jiang,&nbsp;Mingyang Qian,&nbsp;Chao Lin,&nbsp;Hong Jin,&nbsp;Qian Cheng","doi":"10.1111/jep.70235","DOIUrl":"https://doi.org/10.1111/jep.70235","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study employed descriptive qualitative research methods to explore the experiences of patients with knee osteoarthritis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Semi-structured interviews were conducted with 20 patients diagnosed with knee osteoarthritis and scheduled for joint replacement at a tertiary hospital in Shanghai between January 2024 and June 2024. Thematic content analysis was utilised to analyse the interview data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The findings were categorised into four main themes and 10 sub-themes: (1) Experience of illness and treatment; (2) The effect of symptoms on the patient; (3) Experience of Negative Emotions; (4) Need for External Support. This study offers an in-depth examination of the experiences and needs of individuals with knee osteoarthritis concerning disease management and treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Through interviews, we identified multilevel challenges faced by patients in terms of their illness experiences, treatment decisions, lifestyle modifications, and emotional responses. These findings will serve as a valuable reference for developing interventions aimed at improving treatment outcomes and enhancing the quality of life for patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 5","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144773549","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 Correlation Between the Level of Commitment to Ethical Values and Moral Sensitivity of Associate Degree Students","authors":"Zümrüt Akgün Şahin,&nbsp;Volkan Kina","doi":"10.1111/jep.70225","DOIUrl":"https://doi.org/10.1111/jep.70225","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The purpose of this study is to determine the association between the level of commitment to ethical values and moral sensitivity of associate degree students.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This is a descriptive and cross-sectional study. The study included 365 students enrolled in associate degree programmes at a university between October and June 2023. Data were collected using a Personal Information Form, the Moral Sensitivity Questionnaire, and the Ethical Values Scale for Students Studying in Health Sciences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In this study, it was found that the ethical values and moral sensitivities of the students were high. The age, gender, mother's and father's educational level, and father's employment background of the students affected moral sensitivity. Also, age, gender, number of siblings, and mother's and father's educational level affected students' ethical values.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A positive and statistically significant correlation was determined between students' moral sensitivity and ethical values.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 5","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144773547","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":"Epidemiologic Patterns of Musculoskeletal Disorders by Body Region Across 1.2 Million Orthopedic Visits: A 15-Year Experience From a Middle-Income Country","authors":"Nuri Koray Ülgen,&nbsp;Ali Said Nazlıgül,&nbsp;Nihat Yiğit,&nbsp;Sadık Emre Erginoğlu,&nbsp;Mehmet Orçun Akkurt","doi":"10.1111/jep.70230","DOIUrl":"https://doi.org/10.1111/jep.70230","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Musculoskeletal problems occupy an important place among outpatient clinical applications. The International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10), has facilitated the understanding of disease diagnoses in a common language worldwide and the processing of data. However, studies examining all orthopedic diagnoses in a large population are limited. In this study, we analyzed over 1.2 million ICD-10-coded orthopedic visits over 15 years in a secondary-level hospital located in a low-income, working-class district of Türkiye, providing a regional diagnostic overview and a basis for global comparison.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The distribution of 1,242,058 applications to the orthopedics and traumatology polyclinic of a regional hospital serving a population of approximately 500,000 between 01 January, 2010, and 31 December, 2024, was according to body parts based on ICD-10 diagnosis codes. Trauma- and nontrauma-related diagnoses were also evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the total applications, 43.8% were trauma-related. Sprain and strain of the ankle, fracture of the lower end of the radius, and sprain and strain of the wrist were the most common diagnoses. In terms of sex, there was a 60.7% female predominance in the distribution of the applications. Further, 996,011 applications included an expression wherein the anatomical region in the ICD-10 diagnosis code was specified. The most common diagnosis among the nontrauma-related cases was primary gonarthrosis. The most common regions in the upper extremities for which diagnoses were recorded were the hands and wrists. On the other hand, the most common regions in the lower extremities for which diagnoses were recorded were the knees, feet, and ankles. The most common diagnosis involving the spine was low back pain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In the context of musculoskeletal disorders, which occupy a large part of the outpatient health services, it is important to know the number of diagnoses and their regional distribution to estimate the level of need for health services and determine the necessary number of healthcare personnel, service buildings, and examination devices. Understanding the prevalence of these diseases will help determine the curriculum for training orthopedic and traumatology assistants. Our findings may also serve as a reference point for musculoskeletal health planning in similar low- to middle-income settings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 5","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144740563","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":"Practices and Perceptions of Community Health Centres Professionals Toward Evaluation: A Qualitative Study","authors":"Madeleine Capiau,&nbsp;David Buetti,&nbsp;Jean Macq,&nbsp;Sophie Thunus","doi":"10.1111/jep.70179","DOIUrl":"https://doi.org/10.1111/jep.70179","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Objective</h3>\u0000 \u0000 <p>Evaluation plays a critical role in improving the quality and efficiency of services in multidisciplinary primary care organizations, such as community health centers. Despite growing interest in developing tailored evaluation theories for multidisciplinary primary care non-profit organizations, little is known about how evaluation is practiced and perceived by professionals in community health centers. This paper explores both evaluation practices and professionals' perspectives in Belgian community health centers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted semi-structured interviews with 21 professionals from 12 Belgian community health centers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The results highlight the complementarity of formal and informal evaluation practices in understanding how evaluation is conducted and used in community health centers. The results highlighted how conflicting considerations regarding relevance, utility, and feasibility that arise in formal evaluation practices lead community health centers to informal evaluation practices. Professionals perceive informal evaluation practices as more aligned with the values of community health centers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>These results highlight the need to adopt a hybrid approach to evaluation, which combines formal and informal practices in a complementary rather than opposing manner. Drawing inspiration from care ethics embedded in informal practices could help reimagine formal evaluation practices in a more human-centered and context-sensitive way.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 5","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jep.70179","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144740565","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":"Diagnostic Reasoning in Surgical Pathology","authors":"Ahti-Veikko Pietarinen,&nbsp;Donald E. Stanley","doi":"10.1111/jep.70219","DOIUrl":"https://doi.org/10.1111/jep.70219","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Rationale</h3>\u0000 \u0000 <p>Diagnostic reasoning in surgical pathology is critical for accurate disease identification, particularly for rare conditions. Despite advancements in methodologies, the diagnostic lag remains significant, highlighting the need for improved reasoning skills.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims and Objectives</h3>\u0000 \u0000 <p>This study examines the role of abductive reasoning in diagnostic processes within surgical pathology. A theoretical framework that integrates abduction with deduction and induction to increase diagnostic accuracy and expedite therapeutic interventions is proposed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This paper employs a qualitative analysis of the diagnostic reasoning process, emphasizing the interconnectedness of abduction, deduction and induction. It draws on historical philosophical perspectives, particularly those of Charles S. Peirce, to explore how these reasoning types contribute to effective clinical decision-making.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The findings underscore the importance of abductive reasoning in generating testable hypotheses, even when initial conclusions may be incorrect. The study reveals that while induction and deduction provide structure, abduction fosters creativity and broadens the scope of possible diagnoses, particularly in cases of uncertainty.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The integration of abductive reasoning into surgical pathology practices is essential for improving diagnostic outcomes. By emphasizing the generative potential of abduction, this framework aims to reduce diagnostic delays and enhance clinical decision-making, ultimately benefiting patient care. The study advocates the incorporation of this reasoning approach into medical profession to better equip healthcare professionals in navigating complex diagnostic scenarios.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 5","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jep.70219","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144751680","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":"Competency Perceptions of Operating Room Nurses and Opinions of the Surgical Team on Factors Facilitating Competency Acquisition: A Mixed-Methods Study","authors":"Ayşe Uçak,&nbsp;Fatma Cebeci","doi":"10.1111/jep.70233","DOIUrl":"https://doi.org/10.1111/jep.70233","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study examined the perceptions of operating room nurses about perioperative competency and the views of the surgical team on factors that facilitate competency acquisition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A convergent, parallel, mixed-methods study design was used, wherein quantitative and qualitative data were collected simultaneously, analyzed independently, and then integrated during interpretation to provide a comprehensive understanding of the phenomenon.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting and Participants</h3>\u0000 \u0000 <p>The study was conducted between March and August 2020 in 17 university, public, and private hospitals across three cities. The quantitative phase included 224 operating room nurses, while the qualitative phase involved 54 surgical team members, including surgeons, anesthesiologists, and technicians.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Quantitative data were collected using the Perceived Perioperative Competence Scale, and qualitative data were obtained through semi-structured interviews. Data were integrated during interpretation, wherein the findings were compared and contrasted to identify areas of confirmation, expansion, or discrepancy. The STROBE, COREQ, and GRAMMS checklists were employed in reporting the study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The quantitative findings indicated high perceived perioperative competency among nurses, influenced by institutional and experiential factors. The qualitative analysis revealed three main themes influencing competency development: individual characteristics (motivation and desire to learn), institutional structures (management support and team harmony), and structured training programs. The integrated findings confirmed that formal mentoring and supportive environments enhance competency acquisition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The acquisition of competency in operating room nursing can be strengthened through structured institutional mentoring systems, a supportive organizational culture, and comprehensive training. These findings support the design of targeted interventions at both the individual and institutional levels to improve perioperative nursing practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 5","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144751728","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":"Pre-Screening in Clinical Trials: Incentives, Behaviours, Consequences","authors":"Richard C. Armitage","doi":"10.1111/jep.70231","DOIUrl":"https://doi.org/10.1111/jep.70231","url":null,"abstract":"<p>RCTs are prospective studies with the ability to isolate the effect of an intervention by controlling for confounding factors through randomisation and blinding, which eliminates much of the bias inherent to other study designs [<span>1, 2</span>]. This methodological rigour ensures high internal validity and positions RCTs as the reference standard for studying causal relationships between interventions and outcomes.</p><p>One major limitation of many contemporary RCTs is their relatively low external validity. This is largely due to systematic exclusion of substantial proportions of the patient population through highly selective and narrowly defined trial inclusion and exclusion criteria. This exclusion takes place at the screening stage and often results in older adults and patients with multiple comorbidities, polypharmacy, cognitive impairment, or a history of drug reactions being routinely omitted from trials [<span>3</span>]. While such methodologies are designed to promote patient safety and minimise variability, these restrictions generate trial results with limited generalisability to the wider patient population [<span>4</span>], including to those who stand to receive the greatest benefit from the intervention [<span>5</span>].</p><p>Participant screening is the formal process in which potential trial participants are considered for recruitment by evaluation against the protocol's inclusion and exclusion criteria. Pre-screening, however, is the informal step that occurs before formal screening that determines which potential participants are invited to formal screening. It has been noted that pre-screening activities are broadly unstandardised across trial sites and go largely undocumented and unreported by investigators in the scientific literature [<span>6</span>]. The consequence of these behaviours is the systematic exclusion of large proportions of the patient population, many of whom would satisfy the protocol's inclusion and exclusion criteria and be eligible for trial participation if they had progressed to formal screening. This ‘hidden layer’ further confines study populations and goes largely unrecognised in academic discourse [<span>7</span>].</p><p>Examining the incentives that surround the pre-screening stage of clinical trials can help to explain investigator behaviours and elucidate their consequences, and facilitate the offering of recommendations for improvement.</p><p>Several factors influence investigators during the pre-screening stage: study teams face pressure to recruit a pre-committed minimum number of participants by specified deadlines as agreed with sponsors; competition exists between study sites, whether in the same country or internationally, to meet sponsor expectations for participant recruitment; investigators are motivated to recruit participants quickly to enhance their site's reputation for effectiveness, making them more attractive to sponsors for future trial selections; pre-screening activit","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 5","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jep.70231","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144740566","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":"Health Insurance and Basic Public Health Service Coverage Among the Floating Population in Hubei Province, 2014–2017","authors":"Qin Chen,&nbsp;Qin Hu,&nbsp;Li Du,&nbsp;Shu Fang,&nbsp;Si Chen Zhou,&nbsp;Ting Sun,&nbsp;Bing Xiang Yang,&nbsp;Cong Yin,&nbsp;Pei Gang Wang,&nbsp;Yang Zhou,&nbsp;Jie Chen","doi":"10.1111/jep.70237","DOIUrl":"https://doi.org/10.1111/jep.70237","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Rationale</h3>\u0000 \u0000 <p>China's floating population has grown significantly due to rapid economic development and urbanisation. However, this population faces substantial barriers to accessing and utilising health services. Identifying factors affecting health service coverage and access among the floating population is essential for guiding targeted interventions to improve overall population health.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims and Objectives</h3>\u0000 \u0000 <p>This study aims to explore the trends and socio-demographic factors influencing health insurance and public health service coverage among the floating population in Hubei Province from 2014 to 2017.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a trend and regression analysis on data collected from 2014, 2015, 2016 and 2017 in Hubei Province from the China Migrant Population Dynamics Monitoring Survey. The data included socio-demographic and economic characteristics and health insurance coverage. Local health care record establishments and health education access were measured as indicators of basic public health service coverage.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>From 2014 to 2017, 89.01%, 93.45%, 88.49% and 93.37% of respondents, respectively, were covered by at least one type of basic health insurance. During the same period, the establishment of local health records increased from 45.36% in 2014 to 64.52% in 2016, before declining to 36.90% in 2017. Additionally, 83.24%, 90.95%, 89.11%, and 64.11% of respondents, respectively, received health education. While progress was made in improving health service infrastructure, its growth was inconsistent and lacked sustainability. Factors associated with higher local health record coverage included long floating time, individual household employment status, willingness for long-term residence, and medical insurance coverage. Factors influencing access to health education varied annually.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Efforts should be directed towards optimising health insurance policies, adjusting the allocation of medical resources, and strengthening community health services to enhance health care capacity in areas with a high concentration of floating populations. These measures can help improve local public health service coverage and health information access among the floating population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 5","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144751636","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":"Parkinson's Disease Hospital Stay Insights: A Retrospective Analysis of Length of Stay and Contributing Factors at an Australian Tertiary Hospital","authors":"Hoang-Mai Dinh,&nbsp;Vivian Imbriotis,&nbsp;Susan Williams,&nbsp;Nyssa Chennell Dutton,&nbsp;Michal Lubomski,&nbsp;Paul Silberstein","doi":"10.1111/jep.70221","DOIUrl":"https://doi.org/10.1111/jep.70221","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Patients with Parkinson's disease (PD) often experience longer hospital stays, leading to increased medical complications, suffering, and financial costs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study investigates length of stay (LOS) for patients with PD and identifies factors influencing prolonged admissions to inform future preventative strategies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective analysis was conducted on 723 PD patients accounting for 1093 admissions at a tertiary hospital over a 2-year period. Average LOS and readmission rates were compared to the general inpatient population. Multiple linear regression analysis of the hospital stay data was conducted to identify predictors with an independent relationship to LOS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>PD patients had longer average LOS (8.73 days c.f. 3.8 days) and higher readmission rates (11.34% c.f. 6%) than the general cohort. Certain issues, including delirium, hypotension, and adverse drug events, correlated with prolonged LOS, with a more pronounced association for complications occurring during admission rather than at presentation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>PD patients are at higher risk for extended hospital stays and readmissions. These findings highlight potential areas for intervention to reduce LOS. Future research should validate whether there is a causal relationship to inform evidence-based strategies for reducing LOS, ultimately improving patient outcomes and lowering costs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 5","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144714927","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":"Clinical Practice Guidelines for Managing Acute Otitis Media: Literature Review and Systematic Mapping of the Evidence Base","authors":"Amélie Lambert-Hoffert,&nbsp;Vincent Tarazona,&nbsp;Tesnim Ben Romdhane,&nbsp;Ruud G. Nijman,&nbsp;Remy Boussageon,&nbsp;Jérémie F. Cohen,&nbsp;Mathilde Francois","doi":"10.1111/jep.70205","DOIUrl":"https://doi.org/10.1111/jep.70205","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Clinical practice guidelines (CPGs) for managing acute otitis media (AOM) have heterogeneous treatment recommendations. We hypothesized that this variability may be due to differences in the evidence cited to support the recommendations, and we first wanted to investigate whether this difference existed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To analyze the studies on which different national and international CPGs are based regarding the indication for antibiotic therapy in patients with AOM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We included and analysed European and North American CPGs for the management of AOM. For each CPG, we identified the studies cited to justify antimicrobial prescribing. For each individual study, we extracted the main study features, including the study design, and its publication date. Two independent reviewers carried out study selection and data extraction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 15 CPGs for AOM were included. In total, 76 different studies were cited to justify antimicrobial prescribing (median of 8 studies cited, range 1–23). Among these studies, randomized controlled trials were the most frequent (19/76, 25%), followed by systematic reviews with meta-analysis (16/76, 21%). Some CPGs (5/15, 33%) cited more than two systematic reviews with meta-analysis; two CPGs cited no systematic review (with or without meta-analysis). Most studies (53/76, 69%) were cited by only one of the 15 CPGs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In this review of CPGs, we found considerable variability in the quantity and type of studies cited to justify the recommendation to use antibiotics in AOM. These findings question one of the core principles of evidence-based medicine and its application to everyday clinical practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 5","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144714928","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}