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排序方式: 共有10000条查询结果,搜索用时 32 毫秒
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Jacklyn Cho BS Brittany Toffey MD Ariel F. Silva NP Ariel Shalev MD Monika M. Safford MD Erica Phillips MD MS Ann Lee BS Faith Wiggins BS MS Elissa Kozlov PhD Emma K. Tsui PhD MPH Nicola Dell PhD Ariel C. Avgar PhD Susan J. Andreae PhD MPH Madeline R. Sterling MD MPH MS 《Health services research》2023,58(3):697-704
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Aileen Chou PT DPT Joshua K. Johnson DPT PhD Daniel B. Jones PhD Tracey Euloth MPT Beth A. Matcho PT Andrew Bilderback MS Janet K. Freburger PT PhD 《Health services research》2023,58(Z1):51-62
Objective
To assess the effectiveness of a hospital physical therapy (PT) referral triggered by scores on a mobility assessment embedded in the electronic health record (EHR) and completed by nursing staff on hospital admission.Data Sources
EHR and billing data from 12 acute care hospitals in a western Pennsylvania health system (January 2017–February 2018) and 11 acute care hospitals in a northeastern Ohio health system (August 2019–July 2021).Study Design
We utilized a regression discontinuity design to compare patients admitted to PA hospitals with stroke who reached the mobility score threshold for an EHR-PT referral (treatment) to those who did not (control). Outcomes were hospital length of stay (LOS) and 30-day readmission or mortality. Control variables included demographics, insurance, income, and comorbidities. Hospital systems with EHR-PT referrals were also compared to those without (OH hospitals as alternative control). Subgroup analyses based on age were also conducted.Data Extraction
We identified adult patients with a primary or secondary diagnosis of stroke and mobility assessments completed by nursing (n = 4859 in PA hospitals, n = 1749 in OH hospitals) who completed their inpatient stay.Principal Findings
In the PA hospitals, patients with EHR-PT referrals had an 11.4 percentage-point decrease in their 30-day readmission or mortality rates (95% CI −0.57, −0.01) relative to the control. This effect was not observed in the OH hospitals for 30-day readmission (β = 0.01; 95% CI −0.25, 0.26). Adults over 60 years old with EHR-PT referrals in PA had a 26.2 percentage-point (95% CI −0.88, −0.19) decreased risk of readmission or mortality compared to those without. Unclear relationships exist between EHR-PT referrals and hospital LOS in PA.Conclusions
Health systems should consider methodologies to facilitate early acute care hospital PT referrals informed by mobility assessments. 相似文献996.
Xiaoxia Zhou MD Zhenhua Liu MD PhD Xiaoting Zhou MD Yaqin Xiang MD Zhou Zhou MD Yuwen Zhao MD Hongxu Pan MD Qian Xu MD PhD Yase Chen MD PhD Qiying Sun MD PhD Xinyin Wu PhD Hongzhuan Tan PhD Bin Li PhD Kai Yuan PhD Yali Xie MD Weihua Liao MD PhD Shuo Hu PhD Jianping Zhu BS Xuehong Wu PhD Jianhua Li MS Chunyu Wang MD PhD Lifang Lei MD PhD Jiayu Tang MD Yonghong Liu MD Heng Wu MD Wei Huang MD Tao Wang MD Zheng Xue MD Puqing Wang MD Zhentao Zhang MD PhD Ping Xu MD Ling Chen MD Qing Wang MD PhD Xuejing Wang MD PhD Oumei Cheng MD Yuefei Shen MD Weiguo Liu MD Min Ye MD Yong You MD PhD Jinchen Li PhD Xinxiang Yan MD Jifeng Guo MD PhD Beisha Tang MD for Parkinson's Disease & Movement Disorders Multicenter Database Collaborative Network in China 《Movement disorders》2022,37(7):1335-1345
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Emily Behling MD Candidate Luis C. Farhat MD Angeli Landeros-Weisenberger MD Michael H. Bloch MD MS 《Movement disorders》2022,37(4):684-693
Vesicular monoamine transporter type 2 (VMAT2) inhibitors may be an effective therapy for chronic tic disorders (CTD), including Tourette syndrome (TS), but there has not been a meta-analysis compiling available evidence from randomized controlled trials (RCTs). We performed a systematic review and meta-analysis to evaluate the efficacy, acceptability, and tolerability of VMAT2 inhibitors for CTD/TS. PubMed, CENTRAL, and Embase were searched for double-blinded RCTs of VMAT2 inhibitors versus placebo for the treatment of CTD/TS. Change in tic severity measured by the Yale Global Tic Severity Scale (efficacy) and rates of discontinuation attributed to adverse effects (tolerability) or all causes (acceptability) were extracted closest to 12 weeks. Mean difference (MD) and odds ratio (OR) were the effect size indexes for efficacy and acceptability/tolerability, respectively. Data were pooled through random-effects meta-analysis weighted by inverse variance. Five RCTs involving eight comparisons were included. Meta-analysis found a nonsignificant effect on efficacy (k = 8; N = 583; MD = −0.71; 95% confidence interval [CI], −1.93 to 0.50; P = 0.24), and there was certainty that the true effect is nonclinically meaningful (high quality of evidence). Meta-analysis found decreased tolerability (k = 7; N = 626; OR = 2.67; 95% CI, 1.21–5.92; P = 0.01) and decreased acceptability (k = 8; N = 626; OR = 1.90; 95% CI, 1.14–3.18; P = 0.01), although those comparisons were limited because of the relatively small number of events across trials. Meta-analyses did not support the efficacy of VMAT2 inhibitors in the short-term treatment of tic disorders and suggested no clinically meaningful effect of these agents on tic symptoms. © 2022 International Parkinson and Movement Disorder Society 相似文献
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Rosalie M. Grijalva BS Nha Trang Thu Pham BS Qiao Huang PhD Peter R. Martin MS Farwa Ali MD Heather M. Clark PhD Joseph R. Duffy PhD Rene L. Utianski PhD Hugo Botha MD Mary M. Machulda PhD Stephen D. Weigand MS J. Eric Ahlskog PhD MD Dennis W. Dickson MD Keith A. Josephs MD MST MSc Jennifer L. Whitwell PhD 《Movement disorders》2022,37(4):702-712