ORCID Profile
0000-0002-1324-4536
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Publisher: Oxford University Press (OUP)
Date: 27-03-2023
Abstract: Sustainable investment in computerized decision support systems (CDSS) requires robust evaluation of their economic impacts compared with current clinical workflows. We reviewed current approaches used to evaluate the costs and consequences of CDSS in hospital settings and presented recommendations to improve the generalizability of future evaluations. A scoping review of peer-reviewed research articles published since 2010. Searches were completed in the PubMed, Ovid Medline, Embase, and Scopus databases (last searched February 14, 2023). All studies reported the costs and consequences of a CDSS-based intervention compared with current hospital workflows. Findings were summarized using narrative synthesis. In idual studies were further appraised against the Consolidated Health Economic Evaluation and Reporting (CHEERS) 2022 checklist. Twenty-nine studies published since 2010 were included. Studies evaluated CDSS for adverse event surveillance (5 studies), antimicrobial stewardship (4 studies), blood product management (8 studies), laboratory testing (7 studies), and medication safety (5 studies). All studies evaluated costs from a hospital perspective but varied based on the valuation of resources affected by CDSS implementation, and the measurement of consequences. We recommend future studies follow guidance from the CHEERS checklist use study designs that adjust for confounders consider both the costs of CDSS implementation and adherence evaluate consequences that are directly or indirectly affected by CDSS-initiated behavior change examine the impacts of uncertainty and differences in outcomes across patient subgroups. Improving consistency in the conduct and reporting of evaluations will enable detailed comparisons between promising initiatives, and their subsequent uptake by decision-makers.
Publisher: JMIR Publications Inc.
Date: 18-10-2023
DOI: 10.2196/45163
Publisher: Wiley
Date: 08-07-2023
DOI: 10.1111/DMCN.15698
Abstract: To identify and map evidence describing components of neurodevelopmental follow‐up care for children with congenital heart disease (CHD). This was a scoping review of studies reporting components of neurodevelopmental follow‐up programmes athways for children with CHD. Eligible publications were identified through database searches, citation tracking, and expert recommendations. Two independent reviewers screened studies and extracted data. An evidence matrix was developed to visualize common characteristics of care pathways. Qualitative content analysis identified implementation barriers and enablers. The review included 33 studies. Twenty‐one described in idual care pathways across the USA ( n = 14), Canada ( n = 4), Australia ( n = 2), and France ( n = 1). The remainder reported surveys of clinical practice across multiple geographical regions. While heterogeneity in care existed across studies, common attributes included enrolment of children at high‐risk of neurodevelopmental delay centralized clinics in children's hospitals referral before discharge periodic follow‐up at fixed ages standardized developmental assessment and involvement of multidisciplinary teams. Implementation barriers included service cost/resourcing, patient burden, and lack of knowledge/awareness. Multi‐level stakeholder engagement and integration with other services were key drivers of success. Defining components of effective neurodevelopmental follow‐up programmes and care pathways, along with enhancing and expanding guideline‐based care across regions and into new contexts, should continue to be priorities.
Publisher: Oxford University Press (OUP)
Date: 03-10-2023
Publisher: Springer Science and Business Media LLC
Date: 24-02-2023
DOI: 10.1186/S13012-023-01261-8
Abstract: The importance of accurately costing implementation strategies is increasingly recognised within the field of implementation science. However, there is a lack of methodological guidance for costing implementation, particularly within digital health settings. This study reports on a systematic review of costing analyses conducted alongside implementation of hospital-based computerised decision support systems. PubMed, Embase, Scopus and CINAHL databases were searched between January 2010 and August 2021. Two reviewers independently screened and selected original research studies that were conducted in a hospital setting, examined the implementation of a computerised decision support systems and reported implementation costs. The Expert Recommendations for Implementing Change Framework was used to identify and categorise implementation strategies into clusters. A previously published costing framework was applied to describe the methods used to measure and value implementation costs. The reporting quality of included studies was assessed using the Consolidated Health Economic Evaluation Reporting Standards checklist. Titles and abstracts of 1836 articles were screened, with nine articles eligible for inclusion in the review. Implementation costs were most frequently reported under the ‘evaluative and iterative strategies’ cluster, followed by ‘provide interactive assistance’. Labour was the largest implementation-related cost in the included papers, irrespective of implementation strategy. Other reported costs included consumables, durable assets and physical space, which was mostly associated with stakeholder training. The methods used to cost implementation were often unclear. There was variation across studies in the overall quality of reporting. A relatively small number of papers have described computerised decision support systems implementation costs, and the methods used to measure and value these costs were not well reported. Priorities for future research should include establishing consistent terminology and appropriate methods for estimating and reporting on implementation costs. The review protocol is registered with PROSPERO (ID: CRD42021272948).
Publisher: Springer Science and Business Media LLC
Date: 05-05-2017
Publisher: Ubiquity Press, Ltd.
Date: 2022
DOI: 10.5334/IJIC.5997
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-2015
DOI: 10.1161/CIRCOUTCOMES.114.001381
Abstract: Complete reporting of all components of complex interventions is essential for translation of research evidence into clinical practice. Previous work has highlighted deficiencies in the reporting of nonpharmacological interventions however, the reporting quality of exercise-based interventions for coronary heart disease has not been examined. A systematic search strategy was used to identify randomized controlled trials of exercise-based cardiac rehabilitation published until December 2013. Fifty-seven trials were included, reporting on 74 interventions. Intervention description completeness was assessed using the Template for Intervention Description and Replication checklist. Missing intervention details were then sought from additional published material and also by emailing corresponding authors. Only 6 interventions (8%) sufficiently described all required items within the main publication this increased to 11 (15%) after searching for additional published material and 32 (43%) after contacting trial authors. Although location/setting and duration were consistently well reported in publications, complete descriptions of the exercise schedule, as well as details about its tailoring and progression, were missing for over half of interventions (complete for 42% and 36% of interventions, respectively). Although some authors (25/61) were able to provide missing intervention details when contacted, others could not be located (20) or did not respond (16). Inadequate reporting of cardiac rehabilitation interventions is a substantial problem, with essential information frequently missing, and for almost half of all interventions, unobtainable after publication. A conscientious effort to address this problem could facilitate an improvement in the quality of cardiac rehabilitation delivered in clinical practice.
Publisher: JMIR Publications Inc.
Date: 18-12-2022
Publisher: Elsevier BV
Date: 02-2019
Publisher: Wiley
Date: 09-03-2022
DOI: 10.1002/ACR.24514
Abstract: Musculoskeletal conditions of the foot and ankle are common, yet the cost‐effectiveness of the variety of treatments available is not well defined. The aim of this systematic review was therefore to identify, appraise, and synthesize the literature pertaining to the cost‐effectiveness of interventions for musculoskeletal foot and ankle conditions. Electronic databases were searched for studies presenting economic evaluations of nonsurgical and surgical treatments for acute or chronic musculoskeletal conditions of the foot and ankle. Data on cost, incremental cost‐effectiveness, and quality‐adjusted life years for each intervention and comparison were extracted. Risk of bias was assessed using the Drummond checklist for economic studies (range 0–35). Thirty‐six studies were identified reporting nonsurgical interventions (n = 10), nonsurgical versus surgical interventions (n = 14), and surgical interventions (n = 12). The most common conditions were osteoarthritis, ankle fracture, and Achilles tendon rupture. The strongest economic evaluations were for interventions managing end‐stage ankle osteoarthritis, ankle sprain, ankle fracture, calcaneal fracture, and Achilles tendon rupture. Total ankle replacement and ankle arthrodesis for end‐stage ankle osteoarthritis, in particular, have been demonstrated through high‐quality studies to be cost‐effective compared to the nonsurgical alternative. Selected interventions for musculoskeletal foot and ankle conditions dominate comparators, whereas others require thoughtful consideration as they provide better clinical improvements, but at an increased cost. Researchers should consider measuring and reporting costs alongside clinical outcome to provide context when determining the appropriateness of interventions for other foot and ankle symptoms to best inform future clinical practice guidelines.
Publisher: Ubiquity Press, Ltd.
Date: 2022
DOI: 10.5334/IJIC.6980
Publisher: CSIRO Publishing
Date: 21-09-2021
DOI: 10.1071/HC21067
Abstract: ABSTRACT INTRODUCTION The HealthPathways programme is an online health information system used mainly in primary health care to promote a consistent and integrated approach to patient care. AIM The aim of this study is to perform a scoping review of the methodologies used in published impact and outcomes evaluations of HealthPathways programmes. METHODS The review included qualitative, quantitative or mixed-methods evaluations of the impact or outcome of HealthPathways. MEDLINE, Embase, CINAHL and Web of Science databases were searched. Seven programme aims were identified in the impact and outcome evaluation: (1) increased awareness and use of HealthPathways (2) general practitioners are supported to adopt best practice, patient-centred care (3) increased appropriate use of resources and services (4) improved quality of referrals (5) enhanced consistent care and management of health conditions (6) improved patient journeys through the local health system and (7) reduction in health-care cost and increased value for money. RESULTS Twenty-one studies were included in the final review 15 were research papers and six were reports. ‘Increased awareness and use of HealthPathways’ was the most frequent programme aim evaluated (n = 12). Quantitative and qualitative research methodologies, as well as prospective and retrospective data collections, have been adopted to evaluate the impact and outcome of HealthPathways. DISCUSSION Assessing the impacts and outcomes of HealthPathways may be challenging due to limitations in primary data and the interconnectedness of change across the measured aims. Each aim may therefore require specific methodologies sensitive enough to capture the impact that HealthPathways are making over time.
Publisher: Springer Science and Business Media LLC
Date: 13-06-2017
Publisher: BMJ
Date: 06-2019
No related grants have been discovered for Bridget Abell.