Resena de la obra de Don A. Dillman, Jolene D. Smyth y Leah Melani Christian: Internet, Phone, Mail and Mixed-Mode Surveys. The Tailored Design Method. New Jersey: John Wiley and Sons

https://dialnet.unirioja.es/descarga/articulo/7287796.pdf

Internet, phone, mail and mixed-mode surveys: the tailored design method: reseña

https://journal.chestnet.org/article/S0012-3692(16)30215-X/pdf

Pulmonary Rehabilitation: Joint ACCP/AACVPR Evidence-Based Clinical Practice Guidelines

These guidelines provide a practical and evidence-based resource for the management of patients with Barrett's oesophagus and related early neoplasia. The Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument was followed to provide a methodological strategy for the guideline development. A systematic review of the literature was performed for English language articles published up until December 2012 in order to address controversial issues in Barrett's oesophagus including definition, screening and diagnosis, surveillance, pathological grading for dysplasia, management of dysplasia, and early cancer including training requirements. The rigour and quality of the studies was evaluated using the SIGN checklist system. Recommendations on each topic were scored by each author using a five-tier system (A+, strong agreement, to D+, strongly disagree). Statements that failed to reach substantial agreement among authors, defined as >80% agreement (A or A+), were revisited and modified until substantial agreement (>80%) was reached. In formulating these guidelines, we took into consideration benefits and risks for the population and national health system, as well as patient perspectives. For the first time, we have suggested stratification of patients according to their estimated cancer risk based on clinical and histopathological criteria. In order to improve communication between clinicians, we recommend the use of minimum datasets for reporting endoscopic and pathological findings. We advocate endoscopic therapy for high-grade dysplasia and early cancer, which should be performed in high-volume centres. We hope that these guidelines will standardise and improve management for patients with Barrett's oesophagus and related neoplasia.

https://gut.bmj.com/content/gutjnl/63/1/7.full.pdf

British Society of Gastroenterology guidelines on the diagnosis and management of Barrett's oesophagus

Background 
There is an increasing international interest in patient and public involvement (PPI) in research, yet relatively little robust evidence exists about its impact on health and social care research.
 
Objective
 
To identify the impact of patient and public involvement on health and social care research.
 
Design
 
A systematic search of electronic databases and health libraries was undertaken from 1995 to 2009. Data were extracted and quality assessed utilizing the guidelines of the NHS Centre for Reviews and Dissemination 2009 and the Critical Appraisal Skills Programme (CASP). Grey literature was assessed using the Dixon-Woods et al. (2005) checklist.
 
Inclusion criteria
 
All study types that reported the impact PPI had on the health and/or social care research study.
 
Main results
 
A total of 66 studies reporting the impact of PPI on health and social care research were included. The positive impacts identified enhanced the quality and appropriateness of research. Impacts were reported for all stages of research, including the development of user-focused research objectives, development of user-relevant research questions, development of user-friendly information, questionnaires and interview schedules, more appropriate recruitment strategies for studies, consumer-focused interpretation of data and enhanced implementation and dissemination of study results. Some challenging impacts were also identified.
 
Conclusion
 
This study provides the first international evidence of PPI impact that has emerged at all key stages of the research process. However, much of the evidence base concerning impact remains weak and needs significant enhancement in the next decade.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1369-7625.2012.00795.x

Mapping the impact of patient and public involvement on health and social care research: a systematic review

Objective. —To determine whether carotid endarterectomy provides protection against subsequent cerebral ischemia in men with ischemic symptoms in the distribution of significant (>50%) ipsilateral internal carotid artery stenosis. Design. —Prospective, randomized, multicenter trial. Setting. —Sixteen university-affiliated Veterans Affairs medical centers. Patients. —Men who presented within 120 days of onset of symptoms that were consistent with transient ischemic attacks, transient monocular blindness, or recent small completed strokes between July 1988 and February 1991. Among 5000 patients screened, 189 individuals were randomized with angiographic internal carotid artery stenosis greater than 50% ipsilateral to the presenting symptoms. Forty-eight eligible patients who refused entry were followed up outside of the trial. Outcome Measures. —Cerebral infarction or crescendo transient ischemic attacks in the vascular distribution of the original symptoms or death within 30 days of randomization. Intervention. —Carotid endarterectomy plus the best medical care (n = 91) vs the best medical care alone (n=98). Results. —At a mean follow-up of 11.9 months, there was a significant reduction in stroke or crescendo transient ischemic attacks in patients who received carotid endarterectomy (7.7%) compared with nonsurgical patients (19.4%), or an absolute risk reduction of 11.7% (P=.011). The benefit of surgery was more profound in patients with internal carotid artery stenosis greater than 70% (absolute risk reduction, 17.7%;P=.004). The benefit of surgery was apparent within 2 months after randomization, and only one stroke was noted in the surgical group beyond the 30-day perioperative period. Conclusions. —For a selected cohort of men with symptoms of cerebral or retinal ischemia in the distribution of a high-grade internal carotid artery stenosis, carotid endarterectomy can effectively reduce the risk of subsequent ipsilateral cerebral ischemia. The risk of cerebral ischemia in this subgroup of patients is considerably higher than previously estimated. (JAMA. 1991;266:3289-3294)

Carotid endarterectomy and prevention of cerebral ischemia in symptomatic carotid stenosis. Commentary

Stem Cell Clinics Online: The Direct-to-Consumer Portrayal of Stem Cell Medicine

Background: Greater awareness of sleep-disordered breathing and rising obesity rates have fueled demand for sleep studies. Sleep testing using level 3 portable devices may expedite diagnosis and reduce the costs associated with level 1 in-laboratory polysomnography. We sought to assess the diagnostic accuracy of level 3 testing compared with level 1 testing and to identify the appropriate patient population for each test. Methods: We conducted a systematic review and meta-analysis of comparative studies of level 3 versus level 1 sleep tests in adults with suspected sleep-disordered breathing. We searched 3 research databases and grey literature sources for studies that reported on diagnostic accuracy parameters or disease management after diagnosis. Two reviewers screened the search results, selected potentially relevant studies and extracted data. We used a bivariate mixed-effects binary regression model to estimate summary diagnostic accuracy parameters. Results: We included 59 studies involving a total of 5026 evaluable patients (mostly patients suspected of having obstructive sleep apnea). Of these, 19 studies were included in the meta-analysis. The estimated area under the receiver operating characteristics curve was high, ranging between 0.85 and 0.99 across different levels of disease severity. Summary sensitivity ranged between 0.79 and 0.97, and summary specificity ranged between 0.60 and 0.93 across different apnea–hypopnea cut-offs. We saw no significant difference in the clinical management parameters between patients who underwent either test to receive their diagnosis. Interpretation: Level 3 portable devices showed good diagnostic performance compared with level 1 sleep tests in adult patients with a high pretest probability of moderate to severe obstructive sleep apnea and no unstable comorbidities. For patients suspected of having other types of sleep-disordered breathing or sleep disorders not related to breathing, level 1 testing remains the reference standard.

/pdf/diagnostic-accuracy-of-level-3-portable-sleep-tests-versus-3b71hpkwrh.pdf

Diagnostic accuracy of level 3 portable sleep tests versus level 1 polysomnography for sleep-disordered breathing: a systematic review and meta-analysis

Chronic obstructive pulmonary disease (COPD) is a rapidly growing public health problem in the United States and elsewhere. Although direct costs of COPD are well documented, the impact of COPD and its severity on labor force participation is not well known. Using population-based data from the Third National Health and Nutrition Examination Survey (NHANES III), we determined the adjusted relationship between COPD (and its severity) and labor force participation in the U.S. We used data from 12,436 participants involved in NHANES III; 1,073 of these participants (8.6% of the total) reported COPD. These participants were 3.9% (95% confidence interval, 1.3% to 6.4%) less likely to be in the labor force than those without COPD. Increasing severity of COPD was associated with decreased probability of being in the labor force (p for linear trend = 0.001). Mild, moderate, and severe COPD was associated with a 3.4%, 3.9%, and 14.4% reduction in the labor force participation rate relative to those without COPD. These data suggest that COPD has a considerable adverse impact on work force participation. Based on these data, we estimate that, in 1994, COPD was responsible for work loss of approximately $9.9 billion in the U.S.

The Impact of Chronic Obstructive Pulmonary Disease on Work Loss in the United States

As tensions between payers, responsible for ensuring prudent and principled use of scarce resources, and both providers and patients, who legitimately want access to technologies from which they could benefit, continue to mount, interest in approaches to managing the uncertainty surrounding the introduction of new health technologies has heightened.

Funding the unfundable: mechanisms for managing uncertainty in decisions on the introduction of new and innovative technologies into healthcare systems.

Objectives To assess the feasibility of using a citizens’ jury to elicit public values on health technologies and to develop criteria for setting priorities for health technology assessment (HTA).



Methods  Sixteen individuals were selected from 1600 randomly sampled residents of the Capital Health Region in Alberta, Canada. They participated in a 2½ day jury which comprised presentations by ‘expert witnesses’, who represented innovators, patients, health-care policy-makers and clinicians, as well as a series of small and large group priority-setting exercises based on actual examples of technologies that had recently been considered for assessment by local and national HTA bodies. The session was audio-taped, and transcripts were independently reviewed by two researchers using content analytical techniques in order to ensure that no important concepts expressed by individual jurors were missed during group development of the final list of priority-setting criteria. Jurors evaluated the process by completing self-administered, semi-structured questionnaires at the end of the session. Responses were analysed using qualitative methods.



Results  The jury identified 13 criteria, which they subsequently ranked in order of importance. The top two criteria included ‘potential to benefit a number of people’ and ‘extends life with quality’. Based on feedback from questionnaires, jurors valued the opportunity to become engaged in such a process, and expressed interest in participating in future juries.



Conclusions  Citizens’ juries offer a feasible approach to involving the public in priority-setting for HTA. Furthermore, technologies that may benefit a number of people and improve quality of life appear to be of greatest importance to the public.

/pdf/engaging-the-public-in-priority-setting-for-health-35ktwcpixs.pdf

Tania Stafinski

Papers

Stem Cell Clinics Online: The Direct-to-Consumer Portrayal of Stem Cell Medicine

Diagnostic accuracy of level 3 portable sleep tests versus level 1 polysomnography for sleep-disordered breathing: a systematic review and meta-analysis

The Impact of Chronic Obstructive Pulmonary Disease on Work Loss in the United States

Funding the unfundable: mechanisms for managing uncertainty in decisions on the introduction of new and innovative technologies into healthcare systems.

Engaging the public in priority-setting for health technology assessment: findings from a citizens' jury.