Journal of evaluation in clinical practice最新文献

{"title":"Reassurance for Patients—Essential Not Optional","authors":"Rani Marx","doi":"10.1111/jep.14287","DOIUrl":"10.1111/jep.14287","url":null,"abstract":"<div>\u0000 \u0000 <p>Appropriate patient reassurance is an essential feature of clinical practice. My recent experience as a patient, interpreted via my expertise as a health services researcher, led me to insights on ideal and suboptimal reassurance styles in the context of worrisome symptoms. Reassurance is complex: often poorly defined in the scientific literature, rarely rigorously studied, imperfectly understood, and requiring some adaptation to each patient situation. The type and timing of reassurance, balance with additional testing and referrals, paradoxical effects, and myriad patient factors influence reassurance needs and efficacy. My three health problems, occurring in close succession, required numerous consultations, tests, and procedures extending over months. Explicit medically appropriate reassurance notably reduced my concerns and anxiety. Interactions devoid of key reassurance components (acknowledging concerns, contextualising the problem, providing information on risk and next steps and incorporating discussion) exacted an unnecessary psychic toll. The striking differences among my clinicians' approaches illustrate how more thoughtful and salubrious interactions can occur using straightforward existing guidance on best reassurance practices, even without burdensome training, time, or resources.</p>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142895175","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":"Integrated Care Implemented in the Children's Hospital From the Interwar Period as the Source of Good Practices for the Contemporary Concept of Coordinated Care Based on the WHO Model","authors":"Anna Maria Różalska,&nbsp;Izabella Łęcka","doi":"10.1111/jep.14277","DOIUrl":"10.1111/jep.14277","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Intro</h3>\u0000 \u0000 <p>The article tests the hypothesis that we can draw practical knowledge from the experience of service providers operating in the past. The research questions were formulated: can the historical example of the organization of medical care in the Polish Children's Hospital named after Karol and Maria be used as a viable example today? Is it relevant for contemporary practitioners? And do we still use the knowledge of predecessors? The authors decided to use the interwar Hospital and an operating paediatric ward of the Child-Friendly Hospital for a comparative analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The model of the European Regional Office of the World Health Organization for integrated delivery of health services was adopted as the analysis framework. We based the analysis on descriptive methods, starting with a literature review of routine activities of the Karol and Maria Hospital (historical example) and a paediatric hospital in Poland (contemporary example), then we conducted a comparative transversal study concerning the extent to which integrated care occurs in the WHO model. Finally, the elements of the process evaluation were used in the work.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The research model used enabled us to provide answers to the research questions formulated. The comparative study of a historical hospital and a contemporary one has shown that some problems and ways of solving them constantly reappear in the discussion on the management of evidence-based medical care. Sourcing good practices from the past can be a good research method for current practitioners.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>It seems that while the technical aspects of integrated care initiated in the past are developing perfectly, the approach to the evidence-based medicine is waiting to be developed again.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894980","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":"More Than a Sense: The Sense of Smell and Its Reflection in Mother and Baby: A Comprehensive Review","authors":"Shahla Shafaati Laleh,&nbsp;Mojgan Mirghafourvand,&nbsp;Sevil İnal,&nbsp;Aysu Yildiz Karaahmet","doi":"10.1111/jep.14284","DOIUrl":"10.1111/jep.14284","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The sense of smell is one of the most developed and important senses that forms the bond between the newborn and the mother and allows the newborn to reach the mother's breast. The sense of smell begins to form during intrauterine life, and the sense of smell can be a marking tool for a newborn baby, so that the baby can recognize both his mother and his immediate environment and develop his behaviour accordingly. This is necessary not only for feeding babies but also for them to feel safe and peaceful in their new environment. In the early stages of life, olfactory stimulation (maternal odour, breast milk odour, amniotic fluid odour, smell of people or different environments) plays an important role in adapting to the environment. Smell stimulation, in particular, is critical for newborns' postnatal survival because it supports a wide range of early regulatory functions and motor responses. This review also aims to examine the current evidence in the field of olfactory skills in mother and infant in the development and care of the infant. Another aim is to summarize the research conducted to determine the effect of the sense of smell on the life of the mother and baby.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The article was written as a comprehensive review using certain keywords.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>However, the results on this issue are different. First of all, it is suggested that in the first years of life, the sense of smell can play an important role in social adaptation to the environment, recognition of the environment, mother–infant bonding, and therefore in this case, it is recommended to make olfactory stimulating interventions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>However, more well-designed experimental studies are needed in this regard. We look forward to future studies that closely examine various aspects of how olfactory stimulation affects both mother and baby.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142895000","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":"Practical Application of Value-Based Medicine in Chronic Pelvic Pain: A Qualitative Study","authors":"M. C. Wissing,&nbsp;S. E. I. van der Wal,&nbsp;M. van de Haterd,&nbsp;P. R. de Reuver,&nbsp;L. Dick,&nbsp;Y. Engels,&nbsp;K. C. P. Vissers,&nbsp;K. B. Kluivers,&nbsp;K. J. B. Notten","doi":"10.1111/jep.14295","DOIUrl":"10.1111/jep.14295","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Rationale</h3>\u0000 \u0000 <p>Chronic pelvic pain syndrome (CPPS) is prevalent and a complex multifactorial condition. The incidence is rising. CPPS patients may benefit from multidisciplinary care in a structured care pathway.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim and Objectives</h3>\u0000 \u0000 <p>The aim of this explorative study is to give an overview of patient and healthcare provider perspectives on the current patient journey to implement these perspectives in a CPPS care pathway.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A Qualitative study was performed using nominal group technique. The participants were nine female patients CPPS and fourteen healthcare providers involved in CPPS care. The perspectives of the stakeholder groups on the individual components of the CPPS patient journey were collected.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Five overarching key topics were identified: structured start of the patient journey, execution of the patient journey, follow-up after the patient journey, administration during the patient journey, and communication and education. The following recommendations were formulated based on the prioritised points: implementation of a multidisciplinary approach from the start of the journey, adding a case manager and expanding the multidisciplinary team, providing a collaborative triage, updating the questionnaires, improving communication, developing a rehabilitation programme, and reducing waiting times.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Stakeholder focus groups using the nominal group technique was a pivotal step in the development of our CPPS care pathway. This step led to fundamental recommendations, of which a personalised treatment plan at an earlier stage in the patient journey might be the most impactful. This is now implemented, and we monitor the effects on outcomes, quality of life and patient's satisfaction.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11682562/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142895169","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":"Ideology and Values in Healthcare: A Commentary on Baker's (2025) Medical Lysenkoism","authors":"Mathew Mercuri,&nbsp;Alexandra Calzavara","doi":"10.1111/jep.14292","DOIUrl":"10.1111/jep.14292","url":null,"abstract":"&lt;p&gt;There are many reasons why an individual will engage a physician. The individual may want to learn about the cause of the symptoms they are experiencing and what to expect if there is no intervention, and/or obtain care that gives a reasonable chance to change the course of their health state. The physician is valuable in such cases, as they will often possess expertise that is not otherwise accessible to the individual. What makes that expertise valuable is that claims physicians make in service of their patients are not arbitrary—rather, they are grounded in a system of knowing that produces reliable and valid claims. In a recent paper published in the &lt;i&gt;Journal&lt;/i&gt;, Baker [&lt;span&gt;1&lt;/span&gt;] raises concerns about how ideology can undermine the physician's system of knowing, potentially compromising patient care. Tensions can arise where an ideology that is imposed on the medical community (either through regulation or social pressure) conflicts with what is accepted in the medical knowledge. How physicians navigate that tension can impact both their epistemic authority and the standard of care they provide to their patients. Ideology is frequently used pejoratively to describe beliefs that one opposes. However, ideology can also be understood as a system of beliefs that guides particular actions or applications. As we will highlight in this commentary, the generation and application of medical expertise operate within social institutions, and as such, the impact of ideology is unavoidable. As such, we must be cautious in drawing sharp distinctions between social values, our ontological beliefs about nature, and our epistemic commitments to understanding it—recognizing the central role that humans play in shaping these foundational assumptions. A key question to consider is when does ideology become problematic, and who has the authority to decide?&lt;/p&gt;&lt;p&gt;Baker invokes the term “Medical Lysenkoism” to describe how ideological forces shape medical science, drawing a parallel to the famous case of Soviet biology in the 20th century. Trofim Lysenko was a mid-20th century Russian biologist and proponent of a theory of inheritance of acquired characteristics akin to Lamarckian inheritance, a theory itself discredited by Darwinian evolution and subsequent work in genetics [&lt;span&gt;2&lt;/span&gt;]. Despite its lack of credibility in both the local and international biology community, Lysenko's views gained traction with the Russian government, primarily due to a perceived alignment of the theory with a Stalinist interpretation of Marxist ideology. In what would come to be known as the Lysenko Affair, the biology of Lysenko would be officially adopted by the State, leading to persecution of more than 3000 scientists who did not conform, which included dismissal from their jobs, imprisonment, and even execution [&lt;span&gt;3&lt;/span&gt;]. Adoption of the theory was also devastating for agriculture in the country, leading to decreased crop yields and subsequent famine for","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11682540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142895038","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":"Association Does Not Mean Causation, When Observational Data Were Misinterpreted as Causal: The Observational Interpretation Fallacy","authors":"Filippo D'Amico,&nbsp;Marilena Marmiere,&nbsp;Martina Fonti,&nbsp;Mariarita Battaglia,&nbsp;Alessandro Belletti","doi":"10.1111/jep.14288","DOIUrl":"10.1111/jep.14288","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The differentiation between association and causation is a significant challenge in medical research, often further complicated by cognitive biases that erroneously interpret coincidental observational data as indicative of causality. Such misinterpretations can lead to misguided clinical guidelines and healthcare practice, potentially endangering patient safety and leading to inefficient use of resources.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted an extensive search of PubMed, Cochrane, and Embase databases up to March 2024, identifying circumstances where associations from observational studies were incorrectly deemed causal. These instances led to changes in clinical practice, embodying what we have termed the <i>‘observational interpretation fallacy</i>’.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Our search identified 16 notable cases where observational study-derived associations, initially thought to influence clinical practices and guidelines positively, were later contradicted by findings from randomised controlled trials or further studies, necessitating significant revisions in clinical practice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In many cases, misinterpretation of observational finding negatively affecting patient care and public health policies. Addressing and rectifying the observational interpretation fallacy is crucial for the progression of medical research and the maintenance of safe and effective clinical practice. It is imperative for health policymakers, clinicians, and the lay public to critically assess research outcomes and make health-related decisions based on a foundation of evidence-based medicine. This approach ensures the alignment of medical practices with the most current and robust scientific evidence, safeguarding patient welfare and optimising resource allocation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903256","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":"Illnesses Associated With Increased Length of Stay for Individuals Experiencing Homelessness: A Retrospective Cohort Study of Emergency Department Visits and Hospitalisations","authors":"S. Monty Ghosh,&nbsp;Khokan C. Sikdar,&nbsp;Adetola Koleade,&nbsp;Jordan Ross,&nbsp;William Rioux,&nbsp;Eddy S. Lang,&nbsp;Geoff Messier,&nbsp;Robert Tanguay,&nbsp;Stephen E. Congly,&nbsp;Stephanie Van den Berg,&nbsp;Karen L. Tang","doi":"10.1111/jep.14236","DOIUrl":"10.1111/jep.14236","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Individuals experiencing homelessness (IEH) tend to have increased length of stay (LOS) in acute care settings, which negatively impacts health care costs and resource utilisation. It is unclear however, what specific factors account for this increased LOS. This study attempts to define which diagnoses most impact LOS for IEH and if there are differences based on their demographics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective cohort study was conducted looking at ICD-10 diagnosis codes and LOS for patients identified as IEH seen in Emergency Departments (ED) and also for those admitted to hospital. Data were stratified based on diagnosis, gender, and age. Statistical analysis was conducted to determine which ICD-10 diagnoses were significantly associated with increased ED and inpatient LOS for IEH compared to housed individuals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Homelessness was associated with increased LOS regardless of gender or age group. The absolute mean difference of LOS between IEH and housed individuals was 1.62 h [95% CI 1.49–1.75] in the ED and 3.02 days [95% CI 2.42–3.62] for inpatients. Males age 18–24 years spent on average 7.12 more days in hospital, and females aged 25–34 spent 7.32 more days in hospital compared to their housed counterparts. Thirty-one diagnoses were associated with increased LOS in EDs for IEH compared to their housed counterparts; maternity concerns and coronary artery disease were associated with significantly increased inpatient LOS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Homelessness significantly increases the LOS of individuals within both ED and inpatient settings. We have identified several diagnoses that are associated with increased LOS in IE; these should inform the prioritisation and development of targeted interventions to improve the health of IEH.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11682563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903286","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":"Lack of Prescription Drug Benefit Knowledge and Problems Paying Medical Bills Among Medicare Beneficiaries","authors":"McKayla Massey,&nbsp;Kathryn Litten,&nbsp;Samuel D. Towne Jr.,&nbsp;Vasiliki Beleri,&nbsp;Chanhyun Park,&nbsp;Boon Peng Ng","doi":"10.1111/jep.14290","DOIUrl":"10.1111/jep.14290","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims and Objectives</h3>\u0000 \u0000 <p>Approximately 50% of Americans report having low health insurance literacy, leading to uncertainty when choosing their insurance coverage to best meet their healthcare needs. Therefore, we aimed to evaluate the association between lack of prescription drug benefit knowledge and problems paying medical bills among Medicare beneficiaries.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analysed the 2021 Medicare Current Beneficiary Survey Public Use File of 5586 Medicare beneficiaries aged ≥ 65 years. The binary dependent variable was whether beneficiaries had problems paying medical bills in the past year. The categorical independent variable was how much beneficiaries knew about the Medicare prescription drug benefit. A survey-weighted multivariable logit model, adjusted for covariates (e.g., socio-demographics, comorbidities, private insurance coverage, and satisfaction with out-of-pocket costs), was conducted to examine the association between the independent variable and problems paying medical bills.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Approximately 4.3% of study beneficiaries (~2.0 million beneficiaries) reported problems paying medical bills. Of those without and with problems paying medical bills, 27.7% and 39.6%, respectively, reported knowing little/almost nothing about prescription drug benefits. Beneficiaries aged 65–74 years (marginal effect [ME] = 2.1%, <i>p</i> &lt; 0.01), with comorbidities (e.g., ≥ 4 conditions, ME = 3.8%, <i>p</i> &lt; 0.001), dissatisfaction with out-of-pocket costs (ME = 10.1%, <i>p</i> &lt; 0.001), without private insurance (e.g., employer-sponsored insurance, ME = 2.5%, <i>p</i> &lt; 0.01), or with little/almost no knowledge of prescription drug benefits (ME = 1.9%, <i>p</i> &lt; 0.05) were more likely to report problems paying medical bills compared to their counterparts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Tailored programmes aimed at improving beneficiaries' knowledge of prescription drug benefits, reducing out-of-pocket costs and preventing comorbidities may be considered for the at-risk population to address the problem.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894996","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 Lateness: The Ethics of Running Behind Schedule in General Practice","authors":"Richard C. Armitage","doi":"10.1111/jep.14293","DOIUrl":"10.1111/jep.14293","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>GPs, at least in the United Kingdom, often run behind schedule in their clinics. This lateness is an inherently ethical problem due to the negative consequences it generates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The paper outlines these negative consequences, attempts to classify the major reasons for such lateness, explores the ethical status of each of these reasons, and offers suggestions for how the negative consequences might be managed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings and Discussion</h3>\u0000 \u0000 <p>The major reasons for lateness can be classified as GP-related, patient-related, and third party-related. The major negative consequences of lateness in general practice might be classified as the potential disturbance to quality and safe care, the dissatisfaction of and inconvenience to subsequent patients, and the disruption of timely care. These negative consequences must be burdened by some party—either the patient who is related to the reason for the lateness, or other patients who are not. While a strict equality approach to managing such lateness does not consider patients’ clinical needs, GPs compensating by actively ‘catching up’ in their clinics threatens quality and safety of care. The paper argues for minimising the negative consequences of lateness for all parties, while simultaneously promoting equity with regard to patients’ clinical needs. The ethical status of each major reason for lateness in general practice is explored, and suggestions are offered for how each might be managed to minimise the negative consequences and promote equity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11664903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877370","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":"Translation, Cross-Cultural Adaptation and Validation of the Karaduman Chewing Performance Scale for the Italian Paediatric Population","authors":"Francesca Pizza,&nbsp;Marco Tofani,&nbsp;Giorgia Biondo,&nbsp;Carolina Giordani,&nbsp;Cristiana Murgioni,&nbsp;Massimiliano Raponi,&nbsp;Gessica Della Bella,&nbsp;Antonella Cerchiari","doi":"10.1111/jep.14283","DOIUrl":"10.1111/jep.14283","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Chewing is a fundamental motor activity, but there is no specific assessment tool in Italian for paediatric rehabilitation. The Karaduman Chewing Performance Scale (KCPS) is a performance-based assessment tool that allow to classify chewing performance in childhood.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To translate, culturally adapt and assess reliability, criterion validity and cross-cultural validity of the KCPS into Italian in a paediatric population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Following international guidelines, the KCPS was translated and culturally adapted into Italian. Inter-rater reliability was measured using the intraclass correlation coefficient (ICC), the criterion validity using the Pearson correlation coefficient comparing KCPS score with the Paediatric Screening-Priority Evaluation Dysphagia (PS-PED), and cross-cultural validity was examined across diagnostic groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study included 165 children with a mean age of 6.33 with different health conditions, namely autism spectrum disorder, cerebral palsy and genetic syndromes. The analysis revealed that KCPS was reliable measure with a ICC 0.93, and a moderate positive linear correlation with the PS-PED (Pearson 0.48) was found. In each diagnostic group, chewing performance disorders were found, highlighting specific characteristics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Despite limited sample in reliability analysis and the need of exploring the relationship with chewing abilities and severity of diseases, the KCPS was found a reliable and valid tool for determining the level of chewing performance in paediatric population. Now Italian clinicians can use it with more confidence in their clinical practice and research.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864373","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}