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Evaluating Interventions (evaluating + intervention)
Selected AbstractsResearching Quality in Emergency MedicineACADEMIC EMERGENCY MEDICINE, Issue 11 2002Kenneth E. Bizovi MD Research aimed at promoting quality of medical care must be quality research. This paper addresses issues of study design that can affect the validity of such research. The authors draw on previous research about medical errors,recognizing that issues of study design pertaining to medical errors apply to other research on quality of care and, indeed, to clinical research in general. The November 2000 Special Issue of Academic Emergency Medicine addressed medical errors in emergency medicine. In that issue, Kyriacou and Coben described three categories of research on medical errors: 1) research aimed at describing the magnitude of the problem; 2) research identifying causal factors for medical errors; and 3) research evaluating interventions aimed at improving quality of care. These three categories correspond to research methodologies that are, respectively, 1) descriptive; 2) qualitative; and 3) analytic. This article discusses challenges to the validity of each type of research and suggests some possible solutions to these problems. In addition, the article reviews projects that illustrate important issues in research quality. Three research projects are discussed: 1) a published project evaluating an intervention aimed at improving quality; 2) a quality improvement project that is transformed into a research project; and 3) a quality monitoring research project that exemplifies how a statistical technique borrowed from industry can offer a unique solution to quality challenges in medicine. Each of these projects demonstrates some of the challenges in researching quality and their solutions. [source] The role of nurses in preventing adverse events related to respiratory dysfunction: literature reviewJOURNAL OF ADVANCED NURSING, Issue 6 2005Julie Considine BN MN RN RM FRCNA Aims., This paper reports a literature review examining the relationship between specific clinical indicators of respiratory dysfunction and adverse events, and exploring the role of nurses in preventing adverse events related to respiratory dysfunction. Background., Adverse events in hospital are associated with poor patient outcomes such as increased mortality and permanent disability. Many of these adverse events are preventable and are preceded by a period during which the patient exhibits clearly abnormal physiological signs. The role of nurses in preserving physiological safety by early recognition and correction of physiological abnormality is a key factor in preventing adverse events. Methods., A search of the Medline and CINAHL databases was conducted using the following terms: predictors of poor outcome, adverse events, mortality, cardiac arrest, emergency, oxygen, supplemental oxygen, oxygen therapy, oxygen saturation, oxygen delivery, assessment, patient assessment, physical assessment, dyspnoea, hypoxia, hypoxaemia, respiratory assessment, respiratory dysfunction, shortness of breath and pulse oximetry. The papers reviewed were research papers that demonstrated a relationship between adverse events and various clinical indicators of respiratory dysfunction. Results., Respiratory dysfunction is a known clinical antecedent of adverse events such as cardiac arrest, need for medical emergency team activation and unplanned intensive care unit admission. The presence of respiratory dysfunction prior to an adverse event is associated with increased mortality. The specific clinical indicators involved are alterations in respiratory rate, and the presence of dyspnoea, hypoxaemia and acidosis. Conclusions., The way in which nurses assess, document and use clinical indicators of respiratory dysfunction is influential in identifying patients at risk of an adverse event and preventing adverse events related to respiratory dysfunction. If such adverse events are to be prevented, nurses must not only be able to recognise and interpret signs of respiratory dysfunction, but must also take responsibility for initiating and evaluating interventions aimed at correcting respiratory dysfunction. [source] A systematic review of controlled trials evaluating interventions in adult literacy and numeracyJOURNAL OF RESEARCH IN READING, Issue 2 2005Carole Torgerson This paper reports a systematic review of the quasi-experimental literature in the field of adult literacy and numeracy, published between 1980 and 2002. We included 27 controlled trials (CTs) that evaluated strategies and pedagogies designed to increase adult literacy and numeracy: 18 CTs with no effect sizes (incomplete data) and 9 CTs with full data. These nine trials are examined in detail for this paper. Of these nine trials, six evaluated interventions in literacy and three evaluated interventions in literacy and numeracy. Three of the nine trials showed a positive effect for the interventions, five trials showed no difference and one trial showed a positive effect for the control treatment. The quality of the trials was variable, but many of them had some methodological problems. There was no evidence of publication bias in the review. There have been few attempts to expose common adult literacy or numeracy programmes to rigorous evaluation and therefore in terms of policy and practice it is difficult to make any recommendations as to the type of adult education that should be supported. In contrast, however, the review does provide a strong steer for the direction to be taken by educational researchers: because of the present inadequate evidence base rigorously designed randomised controlled trials and quasi-experiments are required as a matter of urgency. [source] A systematic review and meta-analysis of randomised controlled trials evaluating interventions in adult literacy and numeracyJOURNAL OF RESEARCH IN READING, Issue 3 2003Carole J. Torgerson This paper reports a systematic review of the trial literature in the field of adult literacy and numeracy. The review was undertaken to investigate the effectiveness of teaching strategies and pedagogies designed to increase adult literacy and numeracy. The objectives were to search for and locate, synthesise and quality appraise all the randomised controlled trials aiming to evaluate interventions in adult literacy and/or numeracy, published between 1980 and 2002. Fifty-nine papers were included in the descriptive map. Twelve papers were included that contained nine randomised controlled trials. All of the trials included in the review were of high quality in the sense that they had adopted an appropriate study design for assessing effectiveness. However, within that study design many of the studies had methodological problems, for example: small sample size and lack of justification of sample size calculation; unclear method of random allocation; high attrition rate and lack of ,intention to teach' analysis. There was evidence of publication bias. Pooling three studies that compared teaching against no teaching showed a strong, positive and statistically significant effect on outcome. Two other studies examined the use of computer-assisted instruction (CAI) on literacy among imprisoned adults. Pooling these two studies showed a modest but not statistically significant benefit. There is a dearth of rigorous RCTs in the field of adult literacy and numeracy. The evidence is suggestive of a benefit of adult literacy and numeracy interventions; however, because of the heterogeneity of studies, the precise role of any intervention is uncertain and this finding may be undermined by the presence of substantial publication bias. We recommend that a series of large, well-designed and well-conducted randomised trials should be undertaken in the field of adult literacy and numeracy. [source] Articles published in four school psychology journals from 2000 to 2005: An analysis of experimental/intervention researchPSYCHOLOGY IN THE SCHOOLS, Issue 6 2008Stacy L. Bliss Using an experimenter-developed system, articles from four school psychology journals for the years 2000,2005 (n = 929) were classified. Results showed that 40% of the articles were narrative, 29% correlational, 16% descriptive, 8% causal-experimental, 4% causal-comparative, and 2% were meta-analytic. Further analysis of the causal-experimental studies suggested that both single-subject and group designs were used to evaluate the effects of interventions delivered in schools (setting data) that improved students' (participant data) academic and/or social behaviors (target behavior data). Although results show that these journals are publishing few experimental studies, the experiments that are published appear to be derived from field-based research evaluating interventions that readers may find useful for remedying problems in school settings. Discussion focuses on factors that may limit experimental studies and recent trends in education and school psychology. © 2008 Wiley Periodicals, Inc. [source] Should children be screened to undergo early treatment for otitis media with effusion?CHILD: CARE, HEALTH AND DEVELOPMENT, Issue 6 2003A systematic review of randomized trials Abstract Background Otitis media with effusion (OME) is the most common cause of acquired hearing loss in childhood and has been associated with delayed language development and behavioural problems. Some have argued that children should be screened and treated early if found to have clinically important OME. The aim of this review was to assess evidence from randomized controlled trials about the effectiveness of screening and treating children with clinically important OME in the first 4 years of their life. The primary outcome was language development. Methods We searched the Cochrane Controlled Trials Register, MEDLINE and EMBASE and reference lists of all included studies in February 2003. We also contacted the first authors of the studies included in this review. Search terms included otitis media; otitis media with effusion; glue ear; OME; screen; children; treatment; language; and behaviour. Data extraction and methodological quality assessment were performed by at least two of us for each study independently, using methods described in the Cochrane Collaboration Handbook. Results From the three included randomized controlled trials evaluating interventions among children with OME identified through screening, we found no evidence of clinically important benefit in language development. Conclusions The identified randomized trials do not show an important benefit on language development from screening the general population of asymptomatic children in the first 4 years of life to undergo early treatment for OME. Screening asymptomatic children in the first 4 years of life for OME is not recommended. [source] | |||||||||||||