Author: Jean-Paul MiraPublisher:
ISBN:
Category :
Languages : en
Pages : 183
Book Description
Improving Clinical Trials in the Critically Ill
Author: Jean-Paul Mira50 Studies Every Intensivist Should Know
Author: Edward A. BittnerPublisher: Oxford University Press
ISBN: 0190467657
Category : Medical
Languages : en
Pages : 361
Book Description
This title presents key studies that have shaped the practice of critical care medicine. Selected using a rigorous methodology, the studies cover topics including: sedation and analgesia, resuscitation, shock, ARDS, nutrition, renal failure, trauma, infection, diabetes, and physical therapy
Evaluating Critical Care
Author: William J. SibbaldPublisher: Springer Science & Business Media
ISBN: 3642567193
Category : Medical
Languages : en
Pages : 387
Book Description
Measuring the quality of a complex service like critical care that combines the highest technology with the most intimate caring is a challenge. Recently, con sumers, clinicians, and payers have requested more formal assessments and comparisons of the quality and costs of medical care [2). Donabedian [1) pro posed a framework for thinking about the quality of medical care that separates quality into three components: structure, process, and outcome. An instructive analogy for understanding this framework is to imagine a food critic evaluating the quality of a restaurant. The critic might comment on the decoration and lighting ofthe restaurant, how close the tables are to each other, the extent ofthe wine list and where the chef trained. These are all evaluations of the restaurant structure. In addition, the critic might comment on whether the service was courteous and timely - measures of process. Finally, the critic might comment on outcomes like customer satisfaction or food poisoning. Similarly, to a health care critic, structure is the physical and human resources used to deliver medi cal care. Processes are the actual treatments offered to patients. Finally,outcomes are what happens to patients, for example, mortality, quality of life,and satisfac tion with care (Table 1). There is a debate about which of these measurements is the most important measure of quality.
Small Clinical Trials
Author: Institute of MedicinePublisher: National Academies Press
ISBN: 0309171148
Category : Medical
Languages : en
Pages : 221
Book Description
Clinical trials are used to elucidate the most appropriate preventive, diagnostic, or treatment options for individuals with a given medical condition. Perhaps the most essential feature of a clinical trial is that it aims to use results based on a limited sample of research participants to see if the intervention is safe and effective or if it is comparable to a comparison treatment. Sample size is a crucial component of any clinical trial. A trial with a small number of research participants is more prone to variability and carries a considerable risk of failing to demonstrate the effectiveness of a given intervention when one really is present. This may occur in phase I (safety and pharmacologic profiles), II (pilot efficacy evaluation), and III (extensive assessment of safety and efficacy) trials. Although phase I and II studies may have smaller sample sizes, they usually have adequate statistical power, which is the committee's definition of a "large" trial. Sometimes a trial with eight participants may have adequate statistical power, statistical power being the probability of rejecting the null hypothesis when the hypothesis is false. Small Clinical Trials assesses the current methodologies and the appropriate situations for the conduct of clinical trials with small sample sizes. This report assesses the published literature on various strategies such as (1) meta-analysis to combine disparate information from several studies including Bayesian techniques as in the confidence profile method and (2) other alternatives such as assessing therapeutic results in a single treated population (e.g., astronauts) by sequentially measuring whether the intervention is falling above or below a preestablished probability outcome range and meeting predesigned specifications as opposed to incremental improvement.
Improving Healthcare Quality in Europe Characteristics, Effectiveness and Implementation of Different Strategies
Author: OECDPublisher: OECD Publishing
ISBN: 9264805907
Category :
Languages : en
Pages : 447
Book Description
This volume, developed by the Observatory together with OECD, provides an overall conceptual framework for understanding and applying strategies aimed at improving quality of care. Crucially, it summarizes available evidence on different quality strategies and provides recommendations for their implementation. This book is intended to help policy-makers to understand concepts of quality and to support them to evaluate single strategies and combinations of strategies.
Advanced Practice in Critical Care
Author: Sarah McGloinPublisher: John Wiley & Sons
ISBN: 9781444320459
Category : Medical
Languages : en
Pages : 280
Book Description
Advanced Practice in Critical Care provides experiencedcritical care nurses with a clear and distinct evidence base forcontemporary critical care practice. Central to the book is theapplication of research and evidence to practice and therefore,case studies and key critical care clinical situations are usedthroughout to guide the reader through the patient care trajectory. Each chapter introduces an initial patient scenario and as thechapter progresses, the patient scenario develops with thetheoretical perspectives and application. In this way, it isevident how multi-organ dysfunction develops, impacting upon andinfluencing other body systems, demonstrating the multi-organimpact that is often experienced by the critically ill patient. Inthis way, consequences of critical illness such as acute renalfailure, haemostatic failure and liver dysfunction are explored.Throughout the text, key research findings and critical caretreatment strategies are referred to, applied and evaluated in thecontext of the given patient case study. Advanced assessmenttechniques are explained and the underlying pathophysiology isdiscussed in depth. Advanced Practice in Critical Care is anessential resource for experienced practitioners within criticalcare whom primarily care for patients requiring high dependency orintensive care.
Sharing Clinical Trial Data
Author: Institute of MedicinePublisher: National Academies Press
ISBN: 0309316324
Category : Medical
Languages : en
Pages : 236
Book Description
Data sharing can accelerate new discoveries by avoiding duplicative trials, stimulating new ideas for research, and enabling the maximal scientific knowledge and benefits to be gained from the efforts of clinical trial participants and investigators. At the same time, sharing clinical trial data presents risks, burdens, and challenges. These include the need to protect the privacy and honor the consent of clinical trial participants; safeguard the legitimate economic interests of sponsors; and guard against invalid secondary analyses, which could undermine trust in clinical trials or otherwise harm public health. Sharing Clinical Trial Data presents activities and strategies for the responsible sharing of clinical trial data. With the goal of increasing scientific knowledge to lead to better therapies for patients, this book identifies guiding principles and makes recommendations to maximize the benefits and minimize risks. This report offers guidance on the types of clinical trial data available at different points in the process, the points in the process at which each type of data should be shared, methods for sharing data, what groups should have access to data, and future knowledge and infrastructure needs. Responsible sharing of clinical trial data will allow other investigators to replicate published findings and carry out additional analyses, strengthen the evidence base for regulatory and clinical decisions, and increase the scientific knowledge gained from investments by the funders of clinical trials. The recommendations of Sharing Clinical Trial Data will be useful both now and well into the future as improved sharing of data leads to a stronger evidence base for treatment. This book will be of interest to stakeholders across the spectrum of research-from funders, to researchers, to journals, to physicians, and ultimately, to patients.
Intensive Care Medicine in 10 Years
Author: Mitchell P. FinkPublisher: Springer Science & Business Media
ISBN: 9783540260998
Category : Medical
Languages : en
Pages : 460
Book Description
This book identifies trends in critical care medicine that will form the basis for practice over the next ten years. Predicting the future is always risky. Nevertheless, the ideas articulated in this book are likely to serve as a road map for intensivists, hospital administrators, and governmental leaders interested in healthcare as they seek to improve the quality and efficiency of hospital-based services.
Testing Treatments
Author: Imogen EvansPublisher: Pinter & Martin Publishers
ISBN: 1905177488
Category : Health & Fitness
Languages : en
Pages : 187
Book Description
This work provides a thought-provoking account of how medical treatments can be tested with unbiased or 'fair' trials and explains how patients can work with doctors to achieve this vital goal. It spans the gamut of therapy from mastectomy to thalidomide and explores a vast range of case studies.
Evidence-Based Practice of Critical Care E-book
Author: Clifford S. DeutschmanPublisher: Elsevier Health Sciences
ISBN: 1437737897
Category : Medical
Languages : en
Pages : 743
Book Description
Evidence-Based Practice of Critical Care, edited by Drs. Clifford S. Deutschman and Patrick J. Neligan, provides objective data and expert guidance to help answer the most important questions challenging ICU physicians today. It discusses the clinical options, examines the relevant research, and presents expert recommendations on everything from acute organ failure to prevention issues. An outstanding source for "best practices" in critical care medicine, this book is a valuable framework for translating evidence into practice. Gain valuable evidence-based recommendations on key topics such as acute organ failure, infection, sepsis and inflammation, and prevention issues pointing the way to the most effective approaches. Get an overview of each question, an outline of management options, a review of the relevant evidence, areas of uncertainty, existing management guidelines, and authors’ recommendations. Navigate a full range of challenges from routine care to complicated and special situations. Find the information you need quickly with tables that summarize the available literature and recommended clinical approaches.