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Determination of a Testing Threshold for Lumbar Puncture in the Diagnosis of Subarachnoid Hemorrhage after a Negative Head Computed Tomography: A Decision Analysis
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Adherence to an Accelerated Diagnostic Protocol for Chest Pain: Secondary Analysis of the HEART Pathway Randomized Trial
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Simon A. Mahler MD MS Robert F. Riley MD Gregory B. Russell MS Brian C. Hiestand MD MPH James W. Hoekstra MD Cedric W. Lefebvre MD Bret A. Nicks MD David M. Cline MD Kim L. Askew MD John Bringolf MD Stephanie B. Elliott David M. Herrington MD MHS Gregory L. Burke MD MSc Chadwick D. Miller MD MS 《Academic emergency medicine》2016,23(1):70-77
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Lisa Kane Low PhD CNM FAAN Beverly Rosa Williams PhD Deepa R. Camenga MD MHS Jeni Hebert‐Beirne PhD MPH Sonya S. Brady PhD Diane K. Newman DNP ANP‐BC FAAN Aimee S. James PhD MPH Cecilia T. Hardacker MSN RN CNL Jesse Nodora DrPH Sarah E. Linke PhD MPH Kathryn L. Burgio PhD 《Journal of advanced nursing》2019,75(11):3111-3125
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Cynthia M. Boyd MD MPH Lisa Reider MHS Katherine Frey MPH Daniel Scharfstein ScD Bruce Leff MD Jennifer Wolff PhD Carol Groves RN MPA Lya Karm MD Stephen Wegener PhD Jill Marsteller MPP PhD Chad Boult MD MPH MBA 《Journal of general internal medicine》2010,25(3):235-242
BACKGROUND
The quality of health care for older Americans with chronic conditions is suboptimal.OBJECTIVE
To evaluate the effects of “Guided Care” on patient-reported quality of chronic illness care.DESIGN
Cluster-randomized controlled trial of Guided Care in 14 primary care teams.PARTICIPANTS
Older patients of these teams were eligible to participate if, based on analysis of their recent insurance claims, they were at risk for incurring high health-care costs during the coming year. Small teams of physicians and their at-risk older patients were randomized to receive either Guided Care (GC) or usual care (UC).INTERVENTION
“Guided Care” is designed to enhance the quality of health care by integrating a registered nurse, trained in chronic care, into a primary care practice to work with 2–5 physicians in providing comprehensive chronic care to 50–60 multi-morbid older patients.MEASUREMENTS
Eighteen months after baseline, interviewers blinded to group assignment administered the Patient Assessment of Chronic Illness Care (PACIC) survey by telephone. Logistic and linear regression was used to evaluate the effect of the intervention on patient-reported quality of chronic illness care.RESULTS
Of the 13,534 older patients screened, 2,391 (17.7%) were eligible to participate in the study, of which 904 (37.8%) gave informed consent and were cluster-randomized. After 18 months, 95.3% and 92.2% of the GC and UC recipients who remained alive and eligible completed interviews. Compared to UC recipients, GC recipients had twice greater odds of rating their chronic care highly (aOR = 2.13, 95% CI = 1.30–3.50, p = 0.003).CONCLUSION
Guided Care improves self-reported quality of chronic health care for multi-morbid older persons.KEY WORDS: quality of care, chronic illness, older 相似文献89.
Gregory M. Pontone MD James R. Williams MHS Karen E. Anderson MD Gary Chase PhD Susanne A. Goldstein MD Stephen Grill MD PhD Elaina S. Hirsch BS Susan Lehmann MD John T. Little MD Russell L. Margolis MD Peter V. Rabins MD Howard D. Weiss MD Laura Marsh MD 《Movement disorders》2009,24(9):1333-1338
Anxiety disorders are common in Parkinson's disease (PD), but are not well characterized. This study determined the prevalence and clinical correlates of all DSM‐IV‐TR anxiety disorder diagnoses in a sample of 127 subjects with idiopathic PD who underwent comprehensive assessments administered by a psychiatrist and neurologist. A panel of six psychiatrists with expertise in geriatric psychiatry and/or movement disorders established by consensus all psychiatric diagnoses. Current and lifetime prevalence of at least one anxiety disorder diagnosis was 43% (n = 55) and 49% (n = 63), respectively. Anxiety disorder not otherwise specified, a DSM diagnosis used for anxiety disturbances not meeting criteria for defined subtypes, was the most common diagnosis (30% lifetime prevalence, n = 38). Compared with nonanxious subjects, panic disorder (n = 13) was associated with earlier age of PD onset [50.3 (12.2) vs. 61.0 (13.7) years, P < 0.01], higher rates of motor fluctuations [77% (10/13) vs. 39% (25/64), P = 0.01] and morning dystonia [38% (5/13) vs. 13% (8/62), P < 0.03]. This high prevalence of anxiety disorders, including disturbances often not meeting conventional diagnostic criteria, suggests that anxiety in PD is likely underdiagnosed and undertreated and refined characterization of anxiety disorders in PD is needed. In addition, certain anxiety subtypes may be clinically useful markers associated with disease impact in PD. © 2009 Movement Disorder Society 相似文献