Methodologies to evaluate HIV / AIDS programmes.
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Acquired Immunodeficiency Syndrome↗
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Results for “Evaluation Methodology”
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
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Cost-effectiveness analyses in obstetrics & gynecology. Evaluation of methodologic quality and trends.
OBJECTIVE: To evaluate methodologic quality and trends of cost-effectiveness analyses (CEAs) published in Obstetrics & Gynecology. STUDY DESIGN: Ten methodologic principles that should be incorporated in CEAs are used to evaluate CEAs published in Obstetrics & Gynecology from 1966 through 1999. We included articles that were cost-effectiveness or cost-benefit analyses or performed such analyses as part of their studies. RESULTS: Thirty-four CEAs met our inclusion criteria. Seven (20%) analyses adhered to 10, five (15%) to 9, and two (6%) to 8 of the 10 methodologic principles. The mean (+/- SD, median) number of principles to which studies adhered was 5.7 (+/- 3.3, 4). Studies had high compliance (> or = 85%) with principles of research questions, probabilities and effectiveness measures. Studies significantly improved over time in adherence to principles of time frame, perspective, costs, incremental analysis, sensitivity analysis, discounting and total score (all P < .05). CONCLUSION: The CEAs evaluated adhered to approximately half the methodologic principles for performing CEAs but showed significant improvements in quality over time. Understanding the methodology of CEAs is critical for researchers, editors and readers to accurately interpret the results of the growing body of CEA studies.
Cost-Benefit Analysis↗
INFORM: European survey of computers in intensive care units.
The aims of this study were (a) to survey and evaluate the impact of information technology applications in High Dependency Environments (HDEs) on organizational, psychological and cost-effectiveness factors, (b) to contribute information and design requirements to the other workpackages in the INFORM Project, and (c) to develop useful evaluation methodologies. The evaluation methodologies used were: questionnaires, case studies, objective findings (keystroke) and literature search and review. Six questionnaires were devised covering organizational impact, cost-benefit impact and perceived advantages and disadvantages of computerized systems in HDE (psychological impact). The general conclusion was that while existing systems have been generally well received, they are not yet designed in such a developed and integrated way as to yield their full potential. Greater user involvement in design and implementation and more emphasis on training emerged as strong requirements. Lack of reliability leading to parallel charting was a major problem with the existing systems. It proved difficult to assess cost effectiveness due to a lack of detailed accounting costs; however, it appeared that in the short term, computerisation in HDEs tended to increase costs. It is felt that through a better stock control and better decision making, costs may be reduced in the longer run and effectiveness increased; more detailed longitudinal studies appear to be needed on this subject.
Case-Control Studies↗
A methodology for evaluation of enumerator's performance under sample registration.
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Data Collection↗
A methodology for chair evaluation.
A methodology for evaluating a single chair, rather than making a comparison among chairs, was developed from previous chair studies. The methodology was found to be rapid and effective when applied to a prototype chair, giving information to the manufacturer on overall comfort and good and bad points in the design. Testing took place on three tasks and showed that chair comfort is influenced by the task as well as the chair.
Journal Article↗
Evaluation of diagnostic tests for cancer; methodology of evaluation and review of suggested diagnostic procedures.
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Diagnostic Tests, Routine↗
[Evaluation of medication risk in pregnant women: methodology of evaluation and risk management].
This round table discussion was devoted to the description of the tools currently available for the evaluation of drug risks and management during pregnancy. Five topics were submitted for discussion: pre-clinical data, methodological tools, benefit/risk ratio before prescription, teratogenic or fetal risk evaluation, legal comments.
Abnormalities, Drug-Induced↗
Adult day health care evaluation study: methodology and implementation. Adult Day Health Care Evaluation Development Group.
The Adult Day Health Care Evaluation Study was developed in response to a congressional mandate to study the medical efficacy and cost effectiveness of the Adult Day Health Care (ADHC) effort in the Department of Veterans Affairs (VA). Four sites providing ADHC in VA facilities are participating in an ongoing randomized controlled trial. Three years of developmental work prior to the study addressed methodological issues that were problematic in previous studies. This developmental work resulted in the methodological approaches described here: (1) a patient recruitment process that actively recruits and screens all potential candidates using empirically developed admission criteria based on predictors of nursing home placement in VA; (2) the selection and development of measures of medical efficacy that assess a wide range of patient and caregiver outcomes with sufficient sensitivity to detect small but clinically important changes; and (3) methods for detailed, accurate, and efficient measurement of utilization and costs of health care within and outside VA. These approaches may be helpful to other researchers and may advance the methodological sophistication of long-term care program evaluation.
Aged↗
Evaluation of community-based oral health promotion and oral disease prevention--WHO recommendations for improved evidence in public health practice.
Systematic evaluation is an integral part of the organisation and delivery of community oral health care programmes, ensuring the effectiveness of these community-based interventions. As for general health promotion programmes the common problems from effectiveness reviews of oral health interventions relate to the quality and validity of programme evaluations. Problems identified mostly refer to the quality of outcome measures, short-term timescales to assess change, inadequate evaluation methodologies and inappropriate evaluation of programme implementation and processes. It remains a challenge to oral health professionals to integrate community oral health programmes into a wider health agenda. Public health research focusing on the development of evaluation methodologies has identified a variety of issues including the importance of using pluralistic evaluation approaches (quantitative and/or qualitative), limitations of the randomised controlled trial (RCT) design for evaluation of public health interventions, the need to match evaluation methods with the nature of intervention, development of outcome measures appropriate for the nature of intervention, importance of developing workforce capacity in evaluation techniques, and the need for development of partnerships between health practitioners and academics in conducting evaluations. In June 2003, the WHO Oral Health Programme at Headquarters organised a two-day workshop to take forward the development and documentation of the evaluation of oral health promotion and oral disease prevention programmes. The aims of the workshop were to: (1) identify common problems and challenges in evaluating community-based oral health interventions; (2) explore developments in the evaluation approaches in public health; (3) share experiences in evaluating oral health intervention programmes implemented at national or community levels in developing and developed countries and (4) develop guidelines for quality evaluation of national and community oral health programmes. Twenty-two invitees from 15 countries attended in addition to WHO staff. The first day was devoted to presentations of oral health promotion and oral disease prevention programmes from around the world. During the second day, WHO staff at Headquarters in Geneva discussed aspects of evaluation of public health programmes. Two working groups were formed to discuss agreed topics, and the reports from their deliberations, together with the general discussion, resulted in the presentation of emerging key issues and recommendations. In summary, it was agreed that evaluation of oral health promotion and disease prevention programmes should integrate, whenever possible, with general health programmes. While the design and advantages of RCTs in clinical evaluations are well documented, the relevance of this design in evaluation of community oral disease preventive programmes and oral health promotion programmes are much less clearly defined. Subsequently, the conduct of such programmes may be inappropriately evaluated in systematic reviews. There is a need for more research into appropriate immediate, interim and ultimate outcome measures, as well as process evaluation, an assessment that is poorly understood and practised less often than outcome evaluation. Guidance on potential design, conduct, and especially the evaluation, of community oral disease prevention programmes and oral health promotion programmes should be developed and updated regularly. WHO Collaborating Centres could have a role in promoting good practice, training and collaboration between teams throughout the world. Centres undertaking systematic reviews should consider the guidelines given in the proposed WHO document when defining their evaluation criteria.
Community Health Services↗
Evaluation of methodologies including immunofluorescent assay (IFA) and the polymerase chain reaction (PCR) for detection of human pathogenic microsporidia in water.
Microsporidia is a term used to describe a group of emerging protozoan pathogens whose environmental occurrence has only recently been documented due to lack of detection methodologies. This study evaluates and describes current methods for detection of microsporidia in water. Standard methods, for the collection and processing of large volumes of water to detect protozoa, showed only a 4.8% recovery, of microsporidia spores, from 100 l volumes of tap. Immunofluorescent assay (IFA) analysis was assessed using two different antibodies specific for human pathogenic microsporidia. Results indicated that the use of IFA for routine screening of water for microsporidia was not an acceptable approach. The antibodies tested for the IFA resulted in false positives and false negatives and did not react with Enterocytozoon bieneusi, which is an important human pathogenic microsporidia. Finally, the small sizes of the human pathogenic microsporidia prevent confirmation and species determination by light microscopic methods. Two methods for isolating microsporidia DNA from water for use in polymerase chain reaction (PCR) amplification of microsporidia target sequences were assessed. Both of these DNA isolation methods when combined with the PCR showed the ability to detect less than ten spores in purified water concentrates. Thus, this study represents the first documentation and evaluation of current methods for the detection of human pathogenic microsporidia in water.
Animals↗
Angiocardiography with the seven-pinhole collimator: evaluation of methodology and accuracy in assessing global and regional left ventricular function.
Determination of left ventricular function with tomographic radionuclide angiocardiography using a seven-pinhole collimator was evaluated by comparing results of invasive contrast studies and planar multigated blood pool imaging to the tomographic study of 25 patients. LAO, seven-pinhole multigated blood pool acquisition was reconstructed to produce eight slices from apex to base in each of eight segments of the cardiac cycle. After applying an edge detection routine, three-dimensional reconstruction of perimeters allowed cyclic viewing of the left ventricular angiogram in any projection. When planar and tomographic radionuclide techniques were compared to contrast studies, sensitivity and specificity for identification of segmental wall motion abnormalities were not different (93% and 90% for both). Ejection fraction was determined from tomography by integration of slices to produce a noncalibrated volume and from planar blood pool imaging and contrast ventriculograms by standard techniques. Ejection fraction as compared to contrast studies was accurately determined on the planar angiogram (R = .87, P less than .001) with tomographic analysis showing similar significant correlation (R = .79, P less than .001). Methodologic evaluation indicated that the tomographic study was readily positioned and acquired and provided the advantage of requiring little operator interaction. It suffers, however, from the disadvantage of long reconstruction times with current software and occasional difficulties in defining the superior extent of the left ventricle.
Evaluation Studies as Topic↗
Evaluating clinical programs: methodological guidelines.
Evaluations can be defined as investigations of the merits of clinical programs, and they provide information about program goals/objectives, processes, outcomes, impact, and costs. How can reliable and credible evaluations be conducted? In this article, criteria are given for posing evaluation questions; selecting samples and research designs; collecting, analyzing, interpreting, and reporting data.
Drug Information Services↗
UCLA hospice evaluation study. Methodology and instrumentation.
An unbiased evaluation of hospice effectiveness requires a randomized controlled trial (RCT), but the implementation of such a design is difficult. This paper describes the methods of the only RCT to date and reports on the validity and reliability of scales selected or developed to assess attainment of hospice goals. The patients involved are those in a VA hospital in Los Angeles who have cancer and a prognosis of about 6 months and who consent. They and their significant others are interviewed periodically until the patient's death to measure such hospice variables as pain, depression, anxiety, satisfaction with care and the environment, activities of daily living, and bereavement effects. Many of the scales, including McGill Pain, CES-D Depression, and Satisfaction with Care scales, have been validated in other studies with similar samples. The authors' test-retest reliability analyses show that these scales are reliable with advanced cancer patients and their significant others with coefficients ranging from 0.77 to 0.97.
California↗
Methodology for evaluating the Monroe-Livingston capitation system.
This paper presents the methodology for evaluating the Monroe-Livingston demonstration project's capitation payment system (CPS), based in Rochester, New York, for chronic mentally ill patients. To allow for both patient and provider choice within the experimental design, 1,587 CPS-eligible patients were randomly assigned at the start of the study to control or experimental conditions, with the intent of capturing in the experimental group a significant number of patients who would later be enrolled in the CPS. Protocols, which included measures of symptomatology, functioning, and resource utilization, were completed at baseline for 422 of the 605 patients contacted for inclusion in the study. The baseline control group included 143 patients; the experimental group included 279 patients, 153 of whom were eventually enrolled in the CPS.
Adolescent↗
[Review of published works on Spanish youth health promotion].
The objective of this study is to review the health promotion interventions on spanish youths published in Spanish in the 1995-2000 period and to describe them in accordance with the scope within which they have been carried out, the topics addressed, the methodology, the evaluation design used and the results obtained. Two hundred and fourteen intervention were identified. Illegal drugs were the topic on which the largest number of interventions were focused (29.8%), followed by alcohol (15.9%), the risk-related sexual behaviours (14.6%) and leisure time (12.6%). The activities carried out most often were: participation-based educational methods (30.7%), explanatory education methods (11.5%) and the preparation of educational materials (11%). In 80.8% of the cases, some evaluation of the health promotion activities was found. The type of evaluation employed most often was the process evaluation (73.7%), and the medium-long term results evaluation being those employed the least (2.2%). The evaluation methodologies used most often were questionnaires (28.2%). A combination of qualitative and quantitative methods was employed in 13.2% of the cases. The four interventions in which the medium-long term impact was gauged had the purpose of preventing and reducing cigarette smoking and/or drinking and or marijuana smoking, all of these initiatives achieving a reduction in cigarette smoking. In conclusion, it seems necessary to improve the design of the evaluations of the health promotion initiatives addressed to young people in Spain and to increase the dissemination of the same by way of their publication.
Accident Prevention↗
Regulating the economic evaluation of pharmaceuticals and medical devices: a European perspective.
Throughout the developed world, economic evaluation of costly new pharmaceuticals and medical devices became increasingly widespread and systematic during the 1990s. However, serious concerns remain about the validity and relevance of this economic evidence, and about the transparency and accountability of its use in public sector reimbursement decisions. In this article, we summarise current concerns in Europe, based on interviews with European health economists from industry, universities, research institutes and consulting firms. We identify five challenges for European policy-makers, and conclude that there is considerable scope for improving decision-making without damaging incentives to innovate. The challenges are: (1). full publication of the economic evidence used in reimbursement decisions; (2). the redesign of licensing laws to improve the relevance of economic data available at product launch; (3). harmonisation of economic evaluation methodologies; (4). development of methodologies for evaluation of health inequality impacts; and (5). negotiation of price-performance deals to facilitate the use of economic evidence in post-launch pricing review decisions, as information is gathered from studies of product performance in routine use.
Clinical Trials as Topic↗
Long-term follow-up results of surgery for chronic pancreatitis.
BACKGROUND/AIMS: Based on a mean follow-up period of 86 months, the long-term results of 87 drainage and resection operations performed for chronic pancreatitis between 1990-94 were evaluated. METHODOLOGY: To evaluate the results, two questionnaires were filled out by the patients. The first was related to the pancreatitis and the long-term complications, the second was a Gastrointestinal Quality of Life Index questionnaire. Data of deceased patients were collected with the help of general practitioners. RESULTS: Based on the analysis of disease-related and quality of life questionnaire forms only 34% of the investigated patients could be classified as a group showing good results. There was a high incidence of long-term mortality (25%). Eighty-three percent of the deceased patients (18 patients) died after the seventh postoperative year. The most threatened group seems to be the alcoholic and insulin-dependent diabetic one. The combination of the two pathologies was the cause of death in a third of the cases. Insulin-dependent diabetes mellitus developed in 13 patients after an average of 3.9 years following surgery, mainly as a consequence of the irreversible and progressive nature of disease. The rate of disability was 51%. No significant difference could be demonstrated between the resected and the decompressed group according to either disability or late mortality rate. CONCLUSIONS: Based on these results, the authors wish to emphasize that in chronic pancreatitis the short-term follow-up results may be deceptive, and that the real outcome of the surgical treatment can only be expected five years following surgery.
Adult↗
[Methodology to evaluation the habitual physical activity in men aged 50 years or more].
OBJECTIVE: To describe the methodology for evaluating habitual physical activity that was adopted for a survey among the male population utilizing a questionnaire validated earlier. METHODS: The Baecke questionnaire on habitual physical activity was translated into Portuguese and then back-translated into English by two anglophone teachers. The final version of the questionnaire was applied in a cross-sectional epidemiological study done on 326 men aged 50 years or over. The internal consistency among the questions was evaluated using the Cronbach a statistic. The Spearman correlation coefficients between the habitual physical activity scores were calculated. Partial correlation coefficients with adjustments for age, body mass index and schooling were also calculated. RESULTS: There was satisfactory internal consistency in relation to the magnitudes of occupational physical activity and leisure-time physical exercises. Significant correlation was obtained between all the physical activity scores and the total habitual physical activity score, independent of age, body mass index and schooling. CONCLUSIONS: The Baecke questionnaire was found to be a practical instrument for assessing habitual physical activity that is quickly applied and easily understood, and it is recommended for epidemiological studies in Brazil.
Aged↗