Carl K Cramer | PubMed Health

PubMed2002

Modified Delphi survey for decision analysis for prophylaxis of post-radiation osteonecrosis.

OBJECTIVES: to augment epidemiological data from the literature, assist Bayesian perspectives and a decision analytic framework for the minimization of post-radiation osteonecrosis (PRON; osteoradionecrosis) and its impacts in irradiated head and neck cancer patients. MATERIALS AND METHODS: a modified Delphi process survey of 15 international clinical experts was used to identify and assess outcome data and factors related to PRON risk, extraction, and factor suitability for formal decision analysis. Clinimetric pain and function outcome scales were created and assessed for relevance to quality of life. RESULTS AND CONCLUSIONS: expert opinion qualitative assessments were generally adequate and consistent between open- and close-ended items, but many quantitative (e.g. PRON risk rate) estimates were not. A research agenda advocated to validate the epidemiological database for minimization of PRON and decision analysis includes: adoption of a uniform definition of PRON, and ICD code for non-experimental databases; more detailed, consistent data reporting in articles; and quality of life studies.

Decision Support Techniques↗

PubMedDate not supplied

Standardized patient training: a modality for teaching interviewing skills.

BACKGROUND: Standardized patient training involves an experiential approach to clinical training, using laypeople acting as patients to provide skills-building opportunities for health care providers. METHOD: Standardized patient training was used for 2 years in combination with a computer-based continuing education program or traditional inservice program to teach two important communication skills: human immunodeficiency virus-related risk assessment and posttest counseling. FINDINGS: Assessments by more than 500 participants in a rural setting were overwhelmingly positive, with increased willingness and ability to perform the risk assessment and counseling in clinical practice. CONCLUSION: Standardized patient training is viewed very positively by participants. Longitudinal observations of clinical behaviors would be necessary to confirm behavior changes.

Computer-Assisted Instruction↗