Biomedical subjects

P Zoë Stavri

Publications and source records attributed to P Zoë Stavri.

7 recordsLinked to original sources

PubMed2004

A categorization and analysis of the criticisms of Evidence-Based Medicine.

The major criticisms and limitations of Evidence-Based Medicine (EBM) appearing in the literature over the past decade can be summarized and categorized into five recurring themes. The themes include: reliance on empiricism, narrow definition of evidence, lack of evidence of efficacy, limited usefulness for individual patients, and threats to the autonomy of the doctor/patient relationship. Analysis of EBM according to these themes leads to the conclusion that EBM can be a useful tool, but has severe drawbacks when used in isolation in the practice of individual patient care. Modern medicine must strive to balance an extremely complex set of priorities. To be an effective aid in achieving this balance, the theory and practice of EBM must expand to include new methods of study design and integration, and must adapt to the needs of both patients and the health care system in order to provide patients with the best care at the lowest cost.

Attitude to Health↗

PubMed2003

Does failure breed success: narrative analysis of stories about computerized provider order entry.

OBJECTIVE: To assess the definitions of success and failure as defined by the participants of the Menucha Consensus Conference on Computerized Provider Order Entry (CPOE). DESIGN: Thirteen experts from various fields participated in Menucha Consensus Conference. Though they belonged to different fields, all of them had some kind of experience in CPOE implementation. MEASUREMENTS: The stories of these experts were analyzed using a constant comparison method and partially ordered display. RESULTS: Each participant told a success and a failure story. Definitions of success and failure, as well as variables contributing to the success and failure of CPOE implementations, were extracted from the transcripts. CONCLUSION: Analysis reveals that what is considered a failure is context dependent and that it often is an antecedent to success.

Decision Support Systems, Clinical↗

PubMed2003

Implementing computerized physician order entry: the importance of special people.

OBJECTIVE: To articulate important lessons learned during a study to identify success factors for implementing computerized physician order entry (CPOE) in inpatient and outpatient settings. DESIGN: Qualitative study by a multidisciplinary team using data from observation, focus groups, and both formal and informal interviews. Data were analyzed using a grounded approach to develop a taxonomy of patterns and themes from the transcripts and field notes. RESULTS: The theme we call Special People is explored here in detail. A taxonomy of types of Special People includes administrative leaders, clinical leaders (champions, opinion leaders, and curmudgeons), and bridgers or support staff who interface directly with users. CONCLUSION: The recognition and nurturing of Special People should be among the highest priorities of those implementing computerized physician order entry. Their education and training must be a goal of teaching programs in health administration and medical informatics.

Focus Groups↗

PubMed2003

Principles for a successful computerized physician order entry implementation.

To identify success factors for implementing computerized physician order entry (CPOE), our research team took both a top-down and bottom-up approach and reconciled the results to develop twelve overarching principles to guide implementation. A consensus panel of experts produced ten Considerations with nearly 150 sub-considerations, and a three year project using qualitative methods at multiple successful sites for a grounded theory approach yielded ten general themes with 24 sub-themes. After reconciliation using a meta-matrix approach, twelve Principles, which cluster into groups forming the mnemonic CPOE emerged. Computer technology principles include: temporal concerns; technology and meeting information needs; multidimensional integration; and costs. Personal principles are: value to users and tradeoffs; essential people; and training and support. Organizational principles include: foundational underpinnings; collaborative project management; terms, concepts and connotations; and improvement through evaluation and learning. Finally, Environmental issues include the motivation and context for implementing such systems.

Costs and Cost Analysis↗

PubMed2003

Perception of quality and trustworthiness of Internet resources by personal health information seekers.

OBJECTIVES: This paper focuses on one dimension of personal health information seeking: perception of quality and trustworthiness of information sources. DESIGN: Intensive interviews were conducted using a conversational, unstructured, exploratory interview style. SETTING: Interviews were conducted at 3 publicly accessible library sites in Arizona, Hawaii and Nevada. PARTICIPANTS: Thirty-eight non-experts were interviewed. RESULTS: Three separate and distinct methods used to identify credible health information resources were identified. Consumers may have strong opinions about what they mistrust; use fairly rigorous evaluation protocols; or filter information based on intuition or common sense, eye appeal or an authoritative sounding sponsor or title. CONCLUSIONS: Many people use a mix of rational and/or intuitive criteria to assess the health information they use.

Consumer Behavior↗

PubMed2003

Scheduling software in public health practice: from book to bytes and back.

Although greater emphasis is being placed on public health information transfer, little is known about its implementation in the field. To better understand the information needs of the public health workforce, semi-structured interviews were conducted at a country public health department. Preliminary investigation revealed the underutilization of available scheduling software in this setting. Privacy concerns and idiosyncratic scheduling patterns may have interfered with the adoption of commercially available scheduling software.

Ambulatory Care Facilities↗

PubMed2002

In their own words? A terminological analysis of e-mail to a cancer information service.

OBJECTIVE: To better understand the terms used by consumers to describe their health information needs and determine if this "consumer terminology"differs from those used by health care professionals. METHODS: Features and findings identified in 139 e-mail messages to the University of Pittsburgh Cancer Institute's Cancer Information and Referral Service were coded and matched against the 2001 Unified Medical Language System Metathesaurus. RESULTS: 504 unique terms were identified. 185 (36%) were exact matches to concepts in the 2001 UMLS Metathesaurus (MTH). 179 (35%) were partial string matches; 119 (24%) were known synonyms for MTH concepts; and 2 (<1%) were lexical variants. Only 19,or 4% of the total terms, were not found to be present in the 2001 MT1H. CONCLUSION: 96% of the clinical findings and features mentioned in e-mail by correspondents who did not self-identify as healthcare professionals were described using terms from controlled healthcare terminologies. The notion of a paradigmatic "consumer" who uses a particular vocabulary specific to her "consumer" status may be ill-founded.

Electronic Mail↗