scholarly journals Quality of Colonoscopy Performed in Rural Practice: Experience From the Clinical Outcomes Research Initiative and the Oregon Rural Practice-Based Research Network

2017 ◽  
Vol 34 ◽  
pp. s75-s83 ◽  
Author(s):  
Jennifer L. Holub ◽  
Cynthia Morris ◽  
Lyle J. Fagnan ◽  
Judith R. Logan ◽  
LeAnn C. Michaels ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Outcomes Research ◽  
Rural Practice ◽  
Research Network ◽  
Practice Experience ◽  
Research Initiative ◽  
Practice Based Research

scholarly journals Type of sedation and the need for unplanned interventions during ERCP: analysis of the clinical outcomes research initiative national endoscopic database (CORI-NED)

2019 ◽  
Vol 11 (2) ◽  
pp. 104-110
Author(s):  
Zachary L Smith ◽  
Katelin B Nickel ◽  
Margaret A Olsen ◽  
John J Vargo ◽  
Vladimir M Kushnir
Keyword(s):  
Clinical Outcomes ◽  
Outcomes Research ◽  
Population Based ◽  
University Hospitals ◽  
Serious Adverse Events ◽  
Health Maintenance ◽  
Logistic Regression Models ◽  
Research Initiative ◽  
Anaesthesia Care ◽  
The Impact

Background and aimsRecent studies suggest that sedation provided by anaesthesia professionals may be less protective against serious adverse events than previously believed, however, data are lacking regarding endoscopic retrograde cholangiopancreatography (ERCP). Using the clinical outcomes research initiative national endoscopic database (CORI-NED), we aimed to assess whether mode of sedation was associated with rates of unplanned interventions (UIs) during ERCP.Patients and methodsAll subjects from CORI-NED undergoing ERCP from 2004 to 2014 were identified and stratified into three groups based on the initial mode of anaesthesia: endoscopist-directed sedation (EDS), monitored anaesthesia care without an endotracheal tube (MAC-WET) and general endotracheal anaesthesia (GEA). The primary outcome was UIs. To assess the impact of sedation mode on UIs, multivariable logistic regression models were created adjusting for demographic, physician and procedure-level variables.DesignPopulation-based study.Results26 698 ERCPs were analysed (7588 EDS, 8395 MAC-WET, 10 715 GEA). UIs occurred in 320 ERCPs (1.2%). EDS was associated with a higher risk of UIs compared with sedation administered by an anaesthesia professional (OR 1.86, 95% CI 1.44 to 2.42). Additional factors associated with a higher risk of UIs included ASA class IV compared with class II (OR 3.18, 95% CI 2.00 to 5.06) and ERCPs done in community (OR 1.41, 1.04 to 1.91) and health maintenance organisations (OR 3.75, 2.01 to 6.99) hospitals.ConclusionEDS is associated with a higher risk of UIs during ERCP compared with sedation administered by an anaesthesia professional. Higher ASA class and procedures performed in non-university hospitals were also associated with a higher risk of UIs. This study suggests that, when available, sedation using an anaesthesia professional should be utilised for ERCP.

Assessment of oesophageal motor function in patients with dysphagia or chest pain - the Clinical Outcomes Research Initiative experience

2003 ◽  
Vol 18 (11-12) ◽  
pp. 1083-1089 ◽  
Author(s):  
R. Dekel ◽  
T. Pearson ◽  
C. Wendel ◽  
P. De Garmo ◽  
M. B. Fennerty ◽  
...  
Keyword(s):  
Chest Pain ◽  
Clinical Outcomes ◽  
Motor Function ◽  
Outcomes Research ◽  
Research Initiative

scholarly journals Outcomes research shifting the dominant research paradigm in physical therapy

1997 ◽  
Vol 53 (2) ◽  
pp. 4-9
Author(s):  
Alan M. Jette
Keyword(s):  
Quality Of Care ◽  
Clinical Practice ◽  
Physical Therapy ◽  
Clinical Research ◽  
Clinical Outcomes ◽  
Outcomes Research ◽  
Direct Impact ◽  
Research Paradigm ◽  
Care Assessment

This article discusses outcomes research in physical therapy and places its conceptual roots within the work on quality-of-care assessment. An argument is advanced that the outcomes research movement in medicine has stimulated clinical researchers in physical therapy to address disability outcomes in addition to traditional impairment outcomes. If physical therapy clinical research moves beyond this broadening of clinical outcomes to investigate explicitly the hypothesized relationship between impairment and disability, outcomes research will have stimulated a shift in the dominant research paradigm in the profession. The development and testing of theory regarding the pathogenesis of disability will be needed to guide the direction of this type of physical therapy research. Such a shift in the dominant research paradigm in physical therapy could produce dramatic findings that have direct impact on clinical practice.

scholarly journals Characterizing a Practice-based Research Network: Oregon Rural Practice-based Research Network (ORPRN) Survey Tools

2007 ◽  
Vol 20 (2) ◽  
pp. 204-219 ◽  
Author(s):  
L. J. Fagnan ◽  
C. Morris ◽  
S. A. Shipman ◽  
J. Holub ◽  
A. King ◽  
...  
Keyword(s):  
Rural Practice ◽  
Research Network ◽  
Practice Based Research

scholarly journals Project ECHO Integrated Within the Oregon Rural Practice-based Research Network (ORPRN)

2020 ◽  
Vol 33 (5) ◽  
pp. 789-795
Author(s):  
Margaret McLain McDonnell ◽  
Nancy C. Elder ◽  
Ron Stock ◽  
Miriam Wolf ◽  
Anna Steeves-Reece ◽  
...  
Keyword(s):  
Rural Practice ◽  
Research Network ◽  
Project Echo ◽  
Practice Based Research
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