Appraisal of clinical effectiveness — an ACE approach to promoting evidence‐based therapy

1998 ◽  
Vol 3 (4) ◽  
pp. 146-150 ◽  
Author(s):  
Barbara Richardson ◽  
Christina Jerosch‐Herold
Keyword(s):  
Clinical Effectiveness ◽  
Evidence Based ◽  
Evidence Based Therapy

scholarly journals Brief Behavioural Activation (Brief BA) for Adolescent Depression: A Pilot Study

2017 ◽  
Vol 46 (2) ◽  
pp. 182-194 ◽  
Author(s):  
Laura Pass ◽  
Carl W. Lejuez ◽  
Shirley Reynolds
Keyword(s):  
Mental Health ◽  
Pilot Study ◽  
Young People ◽  
Adolescent Depression ◽  
Psychological Intervention ◽  
Clinical Effectiveness ◽  
Evidence Based ◽  
Behavioural Activation ◽  
Evidence Based Treatments ◽  
The Uk

Background: Depression in adolescence is a common and serious mental health problem. In the UK, access to evidence-based psychological treatments is limited, and training and employing therapists to deliver these is expensive. Brief behavioural activation for the treatment of depression (BATD) has great potential for use with adolescents and to be delivered by a range of healthcare professionals, but there is limited empirical investigation with this group. Aims: To adapt BATD for depressed adolescents (Brief BA) and conduct a pilot study to assess feasibility, acceptability and clinical effectiveness. Method: Twenty depressed adolescents referred to the local NHS Child and Adolescent Mental Health service (CAMHs) were offered eight sessions of Brief BA followed by a review around one month later. Self- and parent-reported routine outcome measures (ROMs) were collected at every session. Results: Nineteen of the 20 young people fully engaged with the treatment and all reported finding some aspect of Brief BA helpful. Thirteen (65%) required no further psychological intervention following Brief BA, and both young people and parents reported high levels of acceptability and satisfaction with the approach. The pre–post effect size of Brief BA treatment was large. Conclusions: Brief BA is a promising innovation in the treatment of adolescent depression. This approach requires further evaluation to establish effectiveness and cost effectiveness compared with existing evidence-based treatments for adolescent depression. Other questions concern the effectiveness of delivery in other settings and when delivered by a range of professionals.

scholarly journals Isolated Dysphagia in a Patient with Medial Medullary Infarction – Effects of Evidence-Based Dysphagia Therapy: A Case Report

2021 ◽  
pp. 190-199
Author(s):  
Samra Hamzic ◽  
Patrick Schramm ◽  
Hassan Khilan ◽  
Tibo Gerriets ◽  
Martin Juenemann
Keyword(s):  
Case Report ◽  
Vascular Occlusion ◽  
Evidence Based ◽  
Severe Dysphagia ◽  
First Case ◽  
Jaw Opening ◽  
Medial Medullary Infarction ◽  
Dysphagia Therapy ◽  
Evidence Based Therapy ◽  
Medullary Infarction

Medial medullary infarction (MMI) is a vascular occlusion in the medulla oblongata leading to certain constellations of neurological symptoms and seriously affecting the patient. Effective evidence-based treatment of severe dysphagia as sole symptom of MMI has not yet been reported. This case study aims to report successful effects of evidence-based therapy based on findings of dysphagia symptoms and pathophysiology of swallowing by flexible endoscopic evaluation of swallowing (FEES) in severe isolated dysphagia after MMI. FEES was performed to evaluate swallowing pathophysiology and dysphagia symptoms in a 57-year-old male with severe dysphagia after MMI. On the basis of FEES findings, simple and high-frequent evidence-based exercises for improvement of swallowing were implemented: thermal stimulation of faucial arches, Jaw Opening Exercise, and Jaw Opening Against Resistance. After 7 weeks of high-frequent evidence-based therapy and regular FEES evaluation the patient was set on full oral diet with no evidence of aspiration risk. In a first case report of isolated dysphagia in MMI our case illustrates that high-frequent evidence-based dysphagia therapy in combination with FEES as the method to evaluate and monitor swallowing pathophysiology can lead to successful and quick rehabilitation of severely affected dysphagic patients.

Quality Assessment of HTA reports: a Critical Appraisal Toolkit within an institutional HTA program

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
E Bossi ◽  
M Tringali ◽  
P Colombo ◽  
C Mazzali ◽  
G Puleo ◽  
...  
Keyword(s):  
Health Care Professionals ◽  
Critical Appraisal ◽  
Population Aging ◽  
Clinical Effectiveness ◽  
Evidence Based ◽  
Lombardy Region ◽  
Double Blinded ◽  
Sustainable Health ◽  
Local Healthcare

Abstract Issue With population aging, increased demand for healthcare and limited availability of economic and human resources, well-functioning and sustainable health systems have to rely on rigorous and evidence-based assessments of complex technologies' clinical effectiveness and safety. The Lombardy Region in Northern Italy has a well-established HTA program that offers technical support to its hospitals' network to produce and to review Health Technology Assessment (HTA) reports. Description of the Problem To better coordinate the HTA network and to reduce self-referencing of University and Community hospitals, Lombardy Region carried out an intense field training and distance learning from year 2017, with a project aimed at involving health care professionals in an accurate evaluation of technologies in 18 HTA reports. The regional HTA Supporting Centre developed a Toolkit for the critical appraisal of reports and supporting literature to improve the quality of hospital-based reports. Results In compliance with the regional Law DGR XI/1046 17.12.2018 and the framework proposed, during year 2019 hospitals used the Toolkit to help writing complete and good quality HTA reports on 37 different technologies. With a Public Health resident internship, the Toolkit was revised, extended and then used in 2020 by the hospital's HTA network during the double blinded peer review, mandated by the regional Law DGR XI/2672 16.12.2019, of the year 2019 HTA reports. Detailed results will be presented at the conference. Lessons We observed an increase in number of HTA reports from 2018 to 2019, a greater language's and format's homogeneity and an improvement in the quality of some reports, which will be submitted to the Regional HTA Committee for appraisal and reimbursement. Key messages The development and use of a Critical Appraisal Toolkit in an Regional HTA program can help hospitals write complete and good quality HTA reports. A centrally supported quality improvement of distributed assessment activities in a network of hospitals can enhance the production of HTA reports, relevant to the needs of a local healthcare system.

Update on hypnotherapy for psychiatrists

2021 ◽  
pp. 1-7
Author(s):  
Natalie A. Chan ◽  
Zhisong Zhang ◽  
Guoxing Yin ◽  
Zhimeng Li ◽  
Roger C. Ho
Keyword(s):  
Psychiatric Disorders ◽  
Practice Guidelines ◽  
Review Article ◽  
Outcome Studies ◽  
Evidence Based ◽  
High Quality ◽  
Long Time ◽  
Meta Analyses ◽  
Evidence Based Therapy

SUMMARY Although hypnosis has played a part in psychotherapy for a long time, it is not yet seen as an evidence-based therapy and is absent from many practice guidelines when it comes to the treatment of psychiatric disorders. At present, the applications and methods of hypnotherapy are poorly understood and other methods of psychotherapy tend to be favoured. This review article aims to introduce the role of hypnotherapy and its application for certain common psychiatric presentations, as well as examine its efficacy by summarising recent evidence from high-quality outcome studies and meta-analyses.

Evidence -Based Therapy Of Acute Renal Failure

1999 ◽  
Vol 54 (5) ◽  
pp. 263-273 ◽  
Author(s):  
N. Lameire ◽  
R. Vanholder ◽  
W. Van Biesen ◽  
A. De Vriese ◽  
A. Dhondt ◽  
...  
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Evidence Based ◽  
Evidence Based Therapy

scholarly journals Incentives and Support Programs to Improve Adherence to Tuberculosis Treatment

2021 ◽  
Vol 1 (2) ◽  
Author(s):  
Charlotte Wells ◽  
Melissa Severn
Keyword(s):  
High Risk ◽  
Methodological Quality ◽  
Clinical Effectiveness ◽  
Conclusive Evidence ◽  
Active Tuberculosis ◽  
Tuberculosis Treatment ◽  
Support Programs ◽  
Evidence Based ◽  
Evidence Based Guidelines

Three overviews of reviews and 11 systematic reviews were identified regarding the clinical effectiveness of adherence incentives in those who require assistance to complete their tuberculosis treatment. Four evidence-based guidelines were identified that provided recommendations regarding the use of adherence incentives in those who require assistance completing their tuberculosis treatment. The reported clinical effectiveness of adherence incentives for patients with tuberculosis was mixed. There were no detrimental effects of providing incentives, but there was also no conclusive evidence pointing to a clinical benefit. The overall quality of the included reviews was moderate to high. The included guidelines recommended that incentives and enablers be included as a part of a patient-centred strategy for treatment and for patients with active tuberculosis or patients at high risk; however, the evidence formulating these recommendations was of low certainty or quality. Two of the included guidelines were of high methodological quality, and 2 were of lower methodological quality.

scholarly journals Cardiac Monitoring for Adolescents With Eating Disorders

2021 ◽  
Vol 1 (11) ◽  
Author(s):  
Kylie Tingley ◽  
Melissa Walter
Keyword(s):  
Eating Disorders ◽  
Relevant Literature ◽  
Clinical Effectiveness ◽  
Cardiac Monitoring ◽  
Evidence Based ◽  
Inpatient Settings ◽  
Evidence Based Guidelines ◽  
Monitoring Devices

No relevant literature was identified regarding the comparative clinical effectiveness of cardiac monitoring devices for adolescents with eating disorders in inpatient settings. No evidence-based guidelines were identified regarding cardiac monitoring for adolescents with eating disorders in inpatient settings.

scholarly journals Clinical Importance of Evidence Based Therapy for Diabetes Type 2

2012 ◽  
Vol 2 (2) ◽  
pp. 21-24
Author(s):  
Mohammad A. Bajubair
Keyword(s):  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Randomized Controlled Trials ◽  
Oral Treatment ◽  
Ischemic Heart ◽  
Controlled Trials ◽  
Evidence Based ◽  
Randomized Controlled ◽  
Evidence Based Therapy

Objectives: Not all practice guidelines on oral treatment of Type 2 diabetes were consistent with available evidences. Our aim was to explore the necessity of following the new clinical evidences in treatment of diabetes mellitus Type 2 in clinical practice and the availability of randomized controlled trials in literature used. Methods: Cross-sectional interview survey of 20 physicians in the Internal Medicine Departments in Althawra Teaching Hospital, University of Sana'a, Yemen, to understand the drug used in T2DM in regards to the clinically evidenced trials. The three commonly used literatures were studied for the availability of randomized controlled trials s and the systematic reviews. Results: Examples of drugs to be considered in special correlation and contradiction were metformin and thiazolidinediones (rosi-, pioglitazone). Fear of lactic acidosis was seen in 45% of physicians. Ischemic Heart disease and failure represent the commonest cause of glitazones avoidance, especially for rosiglitazone (100% vs. 50% for pioglitazone). Example of drugs used were with no agreements of their benefit are gabapentin (35%) and neurobion (30%) for neuropathy prevention. In the side effect consideration, metformin was still considered dangerous, and B-blockers hesitation in ischemic heart disease prevention. The main source of information used by physicians was Davidson's Medicine, British national formulary and pharmaceutical marketing leaflets. Conclusions: Inconsistency between the tested physicians may be improved by better access and implementation of evidence-based therapy and guidelines in T2DM.

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