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Biomedical subjects

D B Kamerow

Publications and source records attributed to D B Kamerow.

At least 19 recordsLinked to original sources
PubMed1996

Developing evidence-based clinical practice guidelines: lessons learned by the US Preventive Services Task Force.

The US Preventive Services Task Force is an expert panel established by the federal government in 1984 to develop evidence-based practice guidelines on screening tests and other preventive services. Its recommendations are published elsewhere. This article explores the lessons learned in the process of developing and disseminating the recommendations. Topics include project organization (analytic philosophy, project sponsorship, panel composition, topic selection); the review of evidence (selecting outcome measures for judging effectiveness, constructing "causal pathways," searching the literature, rating the evidence, synthesizing the results); crafting recommendations (extrapolation, assessing magnitude, balancing risks and benefits, addressing costs, dealing with insufficient data, separating science from policy); peer review; collaboration with other groups; evaluating impact on clinicians' knowledge, attitudes, and behavior; updating recommendations; and defining a research agenda. The lessons learned suggest potential refinements in the future work of the task force and other groups engaged in guideline development.

Diffusion of Innovation↗
PubMed1995

Put prevention into practice: a systematic approach.

Use of a systematic program, such as Put Prevention Into Practice (PPIP), to improve the delivery of clinical preventive services by public health nurses is recommended. The Public Health Service, a part of the U.S. Department of Health and Human Services, designed PPIP to help achieve the goals of Healthy People 2000. PPIP is a research-based team approach using a kit of materials targeted at patients, providers, and the office/clinic system. It includes pocket-sized patient booklets, a Clinician's Handbook of Clinical Preventive Services, posters for the waiting and examination rooms, flowcharts and alert stickers for medical records, prescription pads, and reminder postcards. Sources of the materials, implementation and evaluation strategies, and groups implementing the program are discussed.

Delivery of Health Care↗
PubMed1994

Put prevention into practice: implementing preventive care. U.S. Department of Health and Human Services.

Delivery rates for many preventive services are low in the U.S., often falling below 50%. Many factors contribute to this shortcoming, a number of which are within the control of the practicing clinician. This section discusses two important aspects of the delivery of clinical preventive services--establishing a preventive care protocol and implementing it in practice--and reviews basic principles of screening, immunization, and counseling. The references serve as a basic bibliography on the implementation of preventive services in primary care settings.

Adult↗
PubMed1989

Epidemiologic study of sleep disturbances and psychiatric disorders. An opportunity for prevention?

As part of the National Institute of Mental Health Epidemiologic Catchment Area study, 7954 respondents were questioned at baseline and 1 year later about sleep complaints and psychiatric symptoms using the Diagnostic Interview Schedule. Of this community sample, 10.2% and 3.2% noted insomnia and hypersomnia, respectively, at the first interview. Forty percent of those with insomnia and 46.5% of those with hypersomnia had a psychiatric disorder compared with 16.4% of those with no sleep complaints. The risk of developing new major depression was much higher in those who had insomnia at both interviews compared with those without insomnia (odds ratio, 39.8; 95% confidence interval, 19.8 to 80.0). The risk of developing new major depression was much less for those who had insomnia that had resolved by the second visit (odds ratio, 1.6; 95% confidence interval, 0.5 to 5.3). Further research is needed to determine if early recognition and treatment of sleep disturbances can prevent future psychiatric disorders.

Adolescent↗