Process of evaluation and its importance.
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Education, Nursing↗
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The process of evaluation.
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Education, Nursing↗
Systematic Review of Pharmacologic Treatment for Migraine Prevention in Adults: Report of the AAN Guidelines Subcommittee and the American Headache Society.
BACKGROUND AND OBJECTIVES: This systematic review (SR) provides updated evidence-based conclusions regarding the use of pharmacologic migraine prevention in adults to inform a new joint American Academy of Neurology (AAN) and American Headache Society practice guideline. METHODS: A multidisciplinary panel conducted an SR following the 2017 AAN Clinical Practice Guideline Process Manual. Randomized controlled trials evaluating pharmacologic preventive treatments for adults with episodic or chronic migraine were included. Searches encompassed MEDLINE, Embase, and ClinicalTrials.gov from database inception through June 6, 2024. Studies were screened in duplicate, with dual independent risk-of-bias assessment. Outcomes included change in monthly headache days, ≥50% responder rate, and validated patient-reported quality of life (QOL) measures. Raw mean differences, standardized mean differences, and risk ratios were calculated. A modified Grading of Recommendations Assessment, Development, and Evaluation process was used to classify certainty of evidence. RESULTS: A total of 217 studies met inclusion criteria. For episodic migraine, high-confidence evidence showed that galcanezumab and erenumab are more effective than placebo in reducing headache frequency. Moderate-confidence evidence supported benefit from atogepant, eptinezumab, fremanezumab, propranolol, topiramate, and valproate. Several additional oral agents including amitriptyline, bisoprolol, flunarizine, fluoxetine, levetiracetam, metoprolol, nifedipine, pizotifen, and telmisartan had low-confidence evidence suggesting possible benefit. For chronic migraine, high-confidence evidence supported reductions in headache frequency with fremanezumab, galcanezumab, and onabotulinumtoxinA. Moderate-confidence evidence supported benefit from atogepant, eptinezumab, erenumab, topiramate and valproate. Across both episodic and chronic migraine populations, erenumab, fremanezumab, galcanezumab, eptinezumab, rimegepant, atogepant, topiramate and onabotulinumtoxinA demonstrated improvements in patient-reported QOL outcomes on validated instruments. Evidence comparing active treatments was limited and generally of low or very low confidence, restricting conclusions about comparative effectiveness. DISCUSSION: This SR provides a comprehensive synthesis of evidence on pharmacologic migraine prevention in adults. High- and moderate-confidence findings confirm the efficacy of several established and newer preventive therapies and demonstrate improvements in patient-reported outcomes across multiple validated measures. These conclusions informed the development of evidence-based recommendations, presented in a companion publication, to guide clinicians in selecting preventive medications for adults with episodic and chronic migraine.
Humans↗
Automatic processing quality assurance program: impact on a radiology department.
A method for evaluating processing variability as well as quantitative data on a quality assurance program tested at a radiology department are presented. Thirty per cent of all retakes due to improper overall density could be attributed to processing variation; these could be prevented through a QA program which is highly cost-effective in both monetary and patient-care terms.
Cost-Benefit Analysis↗
wgatools: an ultrafast toolkit for manipulating whole-genome alignments.
SUMMARY: With the rapid development of long-read sequencing technologies, the era of individual complete genomes is approaching. We have developed wgatools, a cross-platform, ultrafast toolkit that supports a range of whole-genome alignment formats, offering practical tools for conversion, processing, evaluation, and visualization of alignments, thereby facilitating population-level genome analysis and advancing functional and evolutionary genomics. AVAILABILITY AND IMPLEMENTATION: wgatools supports diverse formats and can process, filter, and statistically evaluate alignments, perform alignment-based variant calling, and visualize alignments both locally and genome-wide. Built with Rust for efficiency and safe memory usage, it ensures fast performance and can handle large datasets consisting of hundreds of genomes. wgatools is published as free software under the MIT open-source license, and its source code is freely available at https://github.com/wjwei-handsome/wgatools and https://zenodo.org/records/14882797.
Software↗
Predoctoral education in family medicine: a ten-year perspective.
The educational goals chosen by teachers of family medicine for predoctoral students a decade ago differ substantially from the present goals. The original goals were to increase the number of family physicians, provide them with the basic knowledge and skills to practice, integrate the concepts of family medicine into the total medical school curriculum, and develop the "attitudes and ideals" of the good family physician. A series of basic learning principles were evolved to attain these goals. These included: teach in a practice setting, focus on persons rather than disease processes, use a team approach to teaching, involve students in the planning and evaluation process, and recognize curriculum development as a dynamic process. The present curriculum has an increased emphasis on clinical skills in family practice and on integration of behavioral science; there is a new emphasis on the role of the physician in the community and a better understanding of health care systems. Future directions for family medicine include increasing the emphasis on interpersonal communications, clinical synthesis, and clinical assessment.
Clinical Competence↗
[Effect of various processes on the protein quality of food based on corn and soybeans].
The present study deals with the effect of various processing methods on the protein values of Maisoy, a blend of 30% whole soybean and 70% corn. The processes evaluated were: a) lime cooking using calcium hydroxide; b) toasting, and c) extrusion cooking, using an equipment known as the Brady Crop Cooker. The same blend of soybean/corn was processed by the same three methods. In addition, a sample of Maisoy--blend produced in Bolivia with the extrusion equipment previously indicated--was also evaluated. The evaluation of all products was carried out using the protein efficiency ratio method (PER). The capacity of two of the blends, with and without amino acid supplementation, of causing changes of deoxiribonucleic acid, ribonucleic acid, and protein in the content of muscle and liver was also measured. Lime cooking as well as extrusion cooking yielded a food with a protein efficiency ratio which varied from 2.30 to 2.60. Both processes destroyed the antiphysiological factors of soybean.
Animals↗
Program evaluation for effective resource management and accountability.
A means of determining the effectiveness of public programs as a basis for justifying resource allocation to these programs is urgently needed. Program evaluation can provide the data base required for program decision-making and modification. A ten-step model for planning and carrying out an evaluation is suggested as a guideline for program personnel who may be assigned to evaluation responsibilities. Nutrition professionals must become aware of the increasing need for evaluation and of the procedures for conducting the evaluation process within programs for which they are responsible. Failure to provide documentation of adequate, on-going evaluation of effectiveness may lead to a loss of resources for the program and, ultimately, to the demise of the nutritional care program.
Evaluation Studies as Topic↗
Men's experiences of multiple long-term conditions and/or disability in the UK Game of Stones weight management trial: a mixed-methods evaluation.
OBJECTIVES: To explore experiences, health outcomes and retention of men with multiple long-term conditions (MLTCs) and/or disability within the Game of Stones weight management randomised controlled trial (RCT). DESIGN: Mixed-methods process evaluation within an RCT where secondary outcomes included the Weight Self-Stigma Questionnaire, EuroQol 5-Dimension 5-Level (EQ-5D-5L), EQ-5D-5L anxiety and depression subscale, Patient Health Questionnaire-4 and retention. Semistructured interviews were conducted at 12 months and analysed using the framework method. SETTING: Conducted across three UK trial centres: Belfast, Bristol and Glasgow. PARTICIPANTS: 585 men with obesity (mean (SD) age, 50.7 (13.3) years) were randomised to one of three groups: behavioural text messages with financial incentives, texts alone or waiting-list control. Interviews were conducted with 54 participants from the two intervention groups. RESULTS: 235 (40%) participants lived with MLTCs, 181 (31%) had a single condition, 167 (29%) had no conditions and 165 (29%) had a disability. Of those with MLTCs, 99 were disabled and 93 were living in deprived areas. Participants with MLTCs and/or disability were older, fewer had a degree-level qualification and fewer were in full-time work. Retention at 12 months was higher for men with disability (76%) or no long-term conditions (75%) and lower for men with diabetes (65%). Self-reported weight stigma, well-being and quality-of-life scores improved or stayed the same for men living with MLTCs in the intervention groups; however, results for anxiety and depression screening scores were inconsistent. Participant experiences indicated complex dynamic health, social and life situations which could provide motivation to lose weight for some but not others. Hospitalisation and poor mobility, with inability to exercise, were demotivating for making changes to reach weight loss targets. CONCLUSIONS: Men living with MLTCs and/or disability varied from very successful weight loss and improved health to not prioritising or feeling helped by the programme or disengagement due to immobility or diabetes. TRIAL REGISTRATION NUMBER: isrctn.org Identifier: ISRCTN91974895.
Humans↗
The process of product selection in the medical instrument market.
Medical instrumentation is supplied by commercial organizations. Because the costs and risks of bringing new or advanced products to the market are high, the selection and evaluation process is critical. Moreover, the peculiarities of the medical instrumentation market add extra costs and risks. Major factors to be considered include the presence of a need, market acceptance, financial and technical viability, development time, internal resources, and the effect of FDA regulations. During the 5 to 7 years required to develop a new product, the difficulty of overcoming problems and the state of the market must be continually monitored. FDA documentation may necessitate 2 more years of effort. Market introduction includes proper market education, an appropriate plan of action, and constant monitoring of market reaction. Despite all these precautions, 70% of new products do not reach the market or do not survive in the market.
Commerce↗
Relational care in community mental health: Evaluating staff experiences in Intensive Community Care Services (ICCS) vs treatment as usual.
BACKGROUND: The quality of healthcare delivery relies heavily on building strong relationships between healthcare providers (HCPs) and clients. This study presents the results of a process evaluation for a Randomised Controlled Trial (RCT) examining the effectiveness of Intensive Community Care Service (ICCS) vs Treatment as Usual (TAU; inpatient or core community CAMHS). METHODS: Thirty-four semi-structured interviews were conducted with staff across various services, including 20 from ICCS and 14 other TAU services. A thematic decomposition analysis was conducted on the data, and specific themes relevant to staff experiences of young people's engagement with services and overall recovery. RESULTS: Three main themes were observed in the HCP data (1. Relational Ecologies: barriers and enablers to engagement, 2. flexibility of approach amidst systemic pressures and 3. the web of trust in the relationship-building process). HCPs highlighted the necessity of developing trust and rapport through non-clinical engagement strategies, such as informal visits and personalised interactions. HCPs emphasised that without trust, treatment effectiveness diminishes, necessitating a tailored approach rather than a one-size-fits-all model. The flexibility in duration of treatment and methods of engagement was noted as crucial in accommodating individual client needs and fostering an open, trusting environment necessary for long-term recovery. CONCLUSION: The findings highlight the vital importance of relational care models, especially ICCS, in addressing the complex needs of Children and Young People (CYP). Flexible, family-centred approaches improve trust, engagement, and long-term recovery outcomes. Recommendations include tackling systemic barriers and expanding relational care models within CAMHS to meet increasing mental health demands effectively. Further research should investigate scalable strategies for integrating these insights into wider mental health service frameworks.
Humans↗
Media for an integrated nursing curriculum.
In conclussion, the media decision-making process for an integrated nursing curriculum is based upon the following steps: - An analysis of the philosophy and unifying strands in the conceptual framework of the curriculum model, - An evaluation of currently owned media in terms of the theoretical framework and educational objectives of the model, - An assessment of commercial media with realistic planning for purchase and/or production, and - The development of a systematic ongoing evaluation process by students, faculty, and nursing service personnel. The focus of this discussion has been clarification of the assessment and planning steps necessary in the media decision-making process for an integrated nursing curriculum. While these steps are applicable to any educational model, they have particular relevance to a curriculum model in which concept learning and interrelationships are stressed.
Audiovisual Aids↗
A survey of dental radiology evaluation in American dental schools.
The variety of evaluation methods used in American dental schools illustrates that little uniformity exists. Only through a continuing program of evaluation can the strengths and weaknesses of any course be identified. Few generalizations can be made that are valid for all dental schools; this suggests that each school and its faculty members utilize methods of evaluation that are developed on a local level. The lack of uniformity in the evaluation process of the schools surveyed may also serve as an indicator for the lack of uniformaty of cirriculum. Development of clearly defined objectives would be beneficial in establishing reliable methods of evaluation. When such evaluations are analyzed, the need for changes in the curriculum becomes apparent. It should be noted that with every change, whether it be in the students, the faculty, or the cirriculum, a new evaluation becomes necessary.
Audiovisual Aids↗
AMTEC: a cooperative effort in medical technology education.
A committee in the St. Louis Metropolitan area has been established to promote communication and cooperation among the area's existing hospital-based programs in medical technology. Area Medical Technology Education Coordinators (AMTEC) was established three years ago primarily to facilitate the administrative functions of medical technology education and to serve as an instrument for the exchange of ideas. Its primary undertaking has been the central processing of applications to the area programs, as an aid in the admission process. In addition, a continuing education program sponsored by the committee has been established, and various "curriculum sharing" activities have been sponsored for the students enrolled in the schools. Future plans for the committee include sponsoring an on-going evaluation process of graduates by employers, and establishing a criterion-referenced question pool. The authors describe the experiences of the committee to date and plans for the implementation of future goals.
Medical Laboratory Science↗
Program evaluation of Texas mental health and mental retardation centers.
The diversity of programs offered by the 24 mental health and mental retardation centers in Texas required that program evaluation take a management-by-objectives approach, with each center examined as a unique system with its own goals, techniques, and activities. The approach required the centers to develop statements of management objectives, which they did with varying degrees of success. The evaluations were carried out by site-visit teams. The authors describe the evaluation process, the difficulties encountered, and some of the beneficial effects.
Community Mental Health Services↗
Characterization of oxytocin receptors on isolated rat fat cells.
The binding of 3H-labelled neurohypophyseal nonapeptide hormone, oxytocin, to isolated rat fat cells has been measured under conditions where this compound elicits the known activation of glucose oxidation by these cells, called "insulin-like" action. Uptake by the cells of the [3H]peptide as a function of various concentrations of the hormone in the medium indicated the presence of two classes of binding sites with different apparent affinities and capacities. The sites of the first type exhibit a rather high affinity, but low capacity, for oxytocin (5 nM; 3 X 10(4) sited per cell) and appear to be saturable under a reversible process. Evaluation of dose-response relationships suggest that they may be directly related to the measured biological response (i.e. activation of the glucose to 14CO2 conversion). Competition experiments show that [3H]oxytocin binding to the cells remains constant within a large range of insulin concentrations. The apparent capacity of different hormone analogs to compete with oxytocin for binding to this class of receptors has been evaluated and compared with the measured insulin-like activity of these different compounds. The sites of the second category have significantly lower affinity, but higher capacity for oxytocin, and were found to be not saturable under the experimental conditions. [3H]Oxytocin uptake by ghosts prepared from the isolated fat cells showed striking similarities to the binding process described for whole cells, although the affinity and total capacity of the former were found to be slightly lower. The basal and adrenalin-stimulated adenylate cyclase of these fractions appeared to be unaffected by various concentrations of oxytocin. It is concluded that there may exist on the rat fat cell membranes a discrete number of oxytocin receptors possessing high specificity for oxytocin and exhibiting affinities and kinetic behaviour similar to those of other characterized oxytocin receptors. They are believed to be independent of the other hormonal receptors of the rat fact cells.
Adenylyl Cyclases↗
The patient's role in assessing the value of diagnostic tests.
Diagnostic tests are usually evaluated for their informational content and effect on health outcomes. Yet patient attitudes toward taking risks and the morbid sequelae associated with either the diagnostic test or its consequences are seldom considered. The authors present a prototypical model which incorporates patient attitudes into the evaluative process. Based on traditional indices of test efficacy, preoperative searches for occult metastases in patients with presumably operable bronchogenic carcinoma should never be performed. However, if patient attitudes toward perioperative death are considered, many should have preoperative staging tests. The exact percentage of patients benefiting from testing varies with test sensitivity and specificity. This integrative approach is appropriate for oncologic patients who frequently undergo treatment.
Attitude↗
Sleep apnea in hypoxic and normal kittens.
Frequency and characteristics of apneas were studied in 10-, 20-, and 40-day old kittens during several days of exposure to 21%, 10%, or 7% oxygen atmospheres. Ninety-seven percent of all apneas occurred during sleep or at transitions between sleep and waking states. Hypoxic kittens, compared to controls, had greatly decreased apnea frequency, but other characteristics of apneas did not differ significantly. Apneas in both control and hypoxic kittens were normal, stereotyped events and were not considered to represent pathological processes. Evaluation of events preceding apneas indicated that a majority of apneas followed augmented breaths and/or brief arousals. We suggest that apnea, heart rate changes during apnea, and frequently concurrent transitions in sleep-waking state may be causally related to these pre-apnea events. The results of this study and a parallel study of human infants suggest that below-normal apnea frequency may indicate hypoxemia and may be associated with higher risk for Sudden Infant Death Syndrome.
Age Factors↗