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Quality of life : the assessment, analysis, and reporting of patient-reported outcomes
The assessment of patient reported outcomes and health-related quality of life continue to be rapidly evolving areas of research and this new edition reflects the development within the field from an emerging subject to one that is an essential part of the assessment of clinical trials and other clinical studies.
eBook
Outcome assessment in advanced practice nursing
Named a 2013 Doody's Core Title!
Named an AJN Book of the Year! \"This is an excellent and timely tool for advanced practice nurses.\" Score: 100, 5 stars -Doody's Medical Reviews Measuring the results of APN care has become increasingly important as a way to demonstrate the significant impact of APN nurses on practice outcomes. The third edition of this award-winning volume has been updated to provide the most current knowledge, perspectives, and research on assessing outcomes of APN care. It addresses not only the health outcomes of APN practice but the economic impact of APN care as well. Chapters discuss outcome measurement in all areas of advance practice nursing, including identifying outcomes in specialty areas and in community and ambulatory settings. The text provides detailed descriptions of how to conduct outcomes assessments, how to locate the most current instruments and measures for APN assessment, and perspectives on international initiatives in APN assessment. Examples of outcomes studies at the DNP level are culled from the most current published projects. Written by expert practitioners, educators, and researchers in APN outcomes assessment, this book will provide the essential information to help all APNs-regardless of specialty area or practice setting-to increase their skill level in designing outcomes-focused clinical research, selecting instruments, and analyzing outcomes data as critical components of their professional practice role. The third edition is completely updated and expanded to include: A new chapter on assessing outcomes at the DNP level through data gained from the most current research An expanded literature review on outcomes measurement research Guidelines for selecting assessment instruments Perspectives on an international initiative for the development of an APN research data collection toolkit New chapter objectives and critical discussion questions Updated web links
eBook
Measurement in Medicine
The success of the Apgar score demonstrates the astounding power of an appropriate clinical instrument. This down-to-earth book provides practical advice, underpinned by theoretical principles, on developing and evaluating measurement instruments in all fields of medicine. It equips you to choose the most appropriate instrument for specific purposes. The book covers measurement theories, methods and criteria for evaluating and selecting instruments. It provides methods to assess measurement properties, such as reliability, validity and responsiveness, and interpret the results. Worked examples and end-of-chapter assignments use real data and well-known instruments to build your skills at implementation and interpretation through hands-on analysis of real-life cases. All data and solutions are available online. This is a perfect course book for students and a perfect companion for professionals/researchers in the medical and health sciences who care about the quality and meaning of the measurements they perform.
eBook
Extreme intelligence : development, predicaments, implications
\"In this ambitious and highly original book, Sonja Falck explores the idea that a firm correlation has been demonstrated between higher intelligence and various successful life outcomes and achievements, alongside the contradictory documentation of extremely high intelligence being associated with various poor outcomes. Drawing on the author's own research interviews with the highly gifted, the book argues that understanding the dynamics of how extreme intelligence is cultivated, or hampered, interpersonally can facilitate better outcomes. It will be essential reading for anyone supporting or working with the highly gifted, as well as those researching the field of intelligence\"-- Provided by publisher.
Book
Medical nihilism
This book defends medical nihilism, which is the view that we should have little confidence in the effectiveness of medical interventions. If we consider the frequency of failed medical interventions, the extent of misleading evidence in medical research, the thin theoretical basis of many interventions, and the malleability of empirical methods in medicine, and if we employ our best inductive framework, then our confidence in the effectiveness of medical interventions ought to be low. Part I articulates theoretical and conceptual groundwork, which offers a defense of a hybrid theory of disease, which forms the basis of a novel account of effectiveness, and this is applied to pharmacological science and to issues such as medicalization. Part II critically examines details of medical research. Even the very best methods in medical research, such as randomized trials and meta-analyses, are malleable and suffer from various biases. Methods of measuring the effectiveness of medical interventions systematically overestimate benefits and underestimate harms. Part III summarizes the arguments for medical nihilism and what this position entails for medical research and practice. To evaluate medical nihilism with care, the argument is stated in formal terms. Medical nihilism suggests that medical research must be modified, that clinical practice should be less aggressive in its therapeutic approaches, and that regulatory standards should be enhanced.
eBook
Potentially modifiable factors contributing to outcome from acute respiratory distress syndrome: the LUNG SAFE study
Purpose
To improve the outcome of the acute respiratory distress syndrome (ARDS), one needs to identify potentially modifiable factors associated with mortality.
Methods
The large observational study to understand the global impact of severe acute respiratory failure (LUNG SAFE) was an international, multicenter, prospective cohort study of patients with severe respiratory failure, conducted in the winter of 2014 in a convenience sample of 459 ICUs from 50 countries across five continents. A pre-specified secondary aim was to examine the factors associated with outcome. Analyses were restricted to patients (93.1 %) fulfilling ARDS criteria on day 1–2 who received invasive mechanical ventilation.
Results
2377 patients were included in the analysis. Potentially modifiable factors associated with increased hospital mortality in multivariable analyses include lower PEEP, higher peak inspiratory, plateau, and driving pressures, and increased respiratory rate. The impact of tidal volume on outcome was unclear. Having fewer ICU beds was also associated with higher hospital mortality. Non-modifiable factors associated with worsened outcome from ARDS included older age, active neoplasm, hematologic neoplasm, and chronic liver failure. Severity of illness indices including lower pH, lower PaO
2
/FiO
2
ratio, and higher non-pulmonary SOFA score were associated with poorer outcome. Of the 578 (24.3 %) patients with a limitation of life-sustaining therapies or measures decision, 498 (86.0 %) died in hospital. Factors associated with increased likelihood of limitation of life-sustaining therapies or measures decision included older age, immunosuppression, neoplasia, lower pH and increased non-pulmonary SOFA scores.
Conclusions
Higher PEEP, lower peak, plateau, and driving pressures, and lower respiratory rate are associated with improved survival from ARDS.
Trial Registration: ClinicalTrials.gov NCT02010073.
Journal Article