The Rand/UCLA Appropriateness Method User's Manual PDF Download
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Author: Kathryn Fitch
Publisher: Rand Corporation
ISBN: 9780833029188
Category : History
Languages : en
Pages : 109
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Book Description
Health systems should function in such a way that the amount of inappropriate care is minimized, while at the same time stinting as little as possible on appropriate and necessary care. The ability to determine and identify which care is overused and which is underused is essential to this functioning. To this end, the "RAND/UCLA Appropriateness Method" was developed in the 1980s. It has been further developed and refined in North America and, increasingly, in Europe. The rationale behind the method is that randomized clinical trials--the "gold standard" for evidence-based medicine--are generally either not available or cannot provide evidence at a level of detail sufficient to apply to the wide range of patients seen in everyday clinical practice. Although robust scientific evidence about the benefits of many procedures is lacking, physicians must nonetheless make decisions every day about when to use them. Consequently, a method was developed that combined the best available scientific evidence with the collective judgment of experts to yield a statement regarding the appropriateness of performing a procedure at the level of patient-specific symptoms, medical history, and test results. This manual presents step-by-step guidelines for conceptualising, designing, and carrying out a study of the appropriateness of medical or surgical procedures (for either diagnosis or treatment) using the RAND/UCLA Appropriateness Method. The manual distills the experience of many researchers in North America and Europe and presents current (as of the year 2000) thinking on the subject. Although the manual is self-contained and complete, the authors do not recommend that those unfamiliar with the RAND/UCLA Appropriateness Method independently conduct an appropriateness study; instead, they suggest "seeing one" before "doing one." To this end, contact information is provided to assist potential users of the method.
Author: Kathryn Fitch
Publisher: Rand Corporation
ISBN: 9780833029188
Category : History
Languages : en
Pages : 109
Get Book Here
Book Description
Health systems should function in such a way that the amount of inappropriate care is minimized, while at the same time stinting as little as possible on appropriate and necessary care. The ability to determine and identify which care is overused and which is underused is essential to this functioning. To this end, the "RAND/UCLA Appropriateness Method" was developed in the 1980s. It has been further developed and refined in North America and, increasingly, in Europe. The rationale behind the method is that randomized clinical trials--the "gold standard" for evidence-based medicine--are generally either not available or cannot provide evidence at a level of detail sufficient to apply to the wide range of patients seen in everyday clinical practice. Although robust scientific evidence about the benefits of many procedures is lacking, physicians must nonetheless make decisions every day about when to use them. Consequently, a method was developed that combined the best available scientific evidence with the collective judgment of experts to yield a statement regarding the appropriateness of performing a procedure at the level of patient-specific symptoms, medical history, and test results. This manual presents step-by-step guidelines for conceptualising, designing, and carrying out a study of the appropriateness of medical or surgical procedures (for either diagnosis or treatment) using the RAND/UCLA Appropriateness Method. The manual distills the experience of many researchers in North America and Europe and presents current (as of the year 2000) thinking on the subject. Although the manual is self-contained and complete, the authors do not recommend that those unfamiliar with the RAND/UCLA Appropriateness Method independently conduct an appropriateness study; instead, they suggest "seeing one" before "doing one." To this end, contact information is provided to assist potential users of the method.
Author:
Publisher:
ISBN:
Category : Catalogs, Publishers'
Languages : es
Pages : 990
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Book Description
Author: Miguel A. Mercado, M.d.
Publisher:
ISBN: 9781536170375
Category :
Languages : en
Pages : 216
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Book Description
Shortly after Langenbuch performed the first cholecystectomy in 1877 in Berlin, the first bile duct injury associated to cholecystectomy occurred and was published. For decades frequency maintained low, until the presentation of laparoscopic cholecystectomy, when the number of cases complicated with bile duct injury doubled. Nowadays, it is estimated that this injury occurs in up to every three to six cholecystectomies. In 2019, despite the great efforts, educational programs, simulators and learning curves, injuries continue to happen. In some way, it represents a great emotional burden both for the surgeon and the patient. This text compiles a wide revision of this problem. In the United States, it represents a health issue due to the costs it carries. In Mexico, where the information published by the authors is gathered, there are no official statistics of the problem. The different chapters of the book deeply explore anatomical and physiological aspects of the bile duct, the etiology of the lesions and the mechanisms or tools to approach the patient, as the multidisciplinary outcomes of the injury. This book is addressed to all health professionals, especially surgeons, who are involved in these complex cases directly or not. We intend to approach, in a wide and profound manner, all the situations related to the management of these lesions.
Author: Rafael Lira
Publisher: Springer
ISBN: 1461466695
Category : Science
Languages : en
Pages : 562
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Book Description
This book reviews the history, current state of knowledge, and different research approaches and techniques of studies on interactions between humans and plants in an important area of agriculture and ongoing plant domestication: Mesoamerica. Leading scholars and key research groups in Mexico discuss essential topics as well as contributions from international research groups that have conducted studies on ethnobotany and domestication of plants in the region. Such a convocation will produce an interesting discussion about future investigation and conservation of regional human cultures, genetic resources, and cultural and ecological processes that are critical for global sustainability.
Author: Jean-François Bonneville
Publisher: Springer
ISBN: 3319290436
Category : Medical
Languages : en
Pages : 382
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Book Description
This clinically oriented book will familiarize the reader with all aspects of the diagnosis of tumors and other disorders of the pituitary gland by means of magnetic resonance imaging (MRI). The coverage includes acromegaly, Cushing’s disease, Rathke cleft cysts, prolactinomas, incidentalomas, nonsecreting adenomas, other lesions of the sellar area, hypophysitis, and central diabetes insipidus. Normal radiologic anatomy and the numerous normal variants are described, and guidance is also provided on difficulties, artifacts, and other pitfalls. The book combines concise text and high-quality images with a question and answer format geared toward the needs of the practitioner. MRI is today considered the cornerstone in the diagnosis of diseases of the hypophyseal-hypothalamic region but the relatively small size of the pituitary gland, its deep location, the many normal anatomic variants, and the often tiny size of lesions can hinder precise evaluation of the anatomic structures and particularly the pituitary gland itself. Radiologists and endocrinologists will find MRI of the Pituitary Gland to be full of helpful information on this essential examination, and the book will also be of interest to internists and neurosurgeons.
Author: Stephen Bertman
Publisher: Greenwood
ISBN: 9780275962050
Category : Speed
Languages : en
Pages : 296
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Book Description
Hyperculture dares to suggest that the cure for our condition lies not in an "information superhighway" or "third wave information revolution," but in the radical and painful process of decelerating our lives enough to reclaim them.
Author: Bruno J. Vellas
Publisher: Karger Medical and Scientific Publishers
ISBN: 3805568037
Category : Medical
Languages : en
Pages : 202
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Book Description
This book is the first of a new series which will present the proceedings of the newly established Nestlé Nutrition Workshop Series: Clinical & Performance Programme aimed at adult nutrition. Undernutrition is a common phenomenon in elderly people, and malnutrition reaches significant levels in those being in hospital, nursing homes or home care programs. Consequences of malnutrition often go unrecognised owing to the lack of specific validated instruments to assess nutritional status in frail elderly persons. The Mini Nutritional Assessment (MNA) provides a single, rapid assessment of nutritional status in the elderly of different degrees of independence, allowing the prevalence of protein-energy malnutrition to be determined and to evaluate the efficacy of nutritional intervention and strategies. Easy, quick and economical to perform, it enables staff to check the nutritional status of elderly people when they enter hospitals or institutions and to monitor changes occurring during their stay. Moreover, the MNA is predictive of the cost of care and length of stay in hospital. This publication will be of immense assistance to heads of geriatric teaching units, teachers in nutrition, clinicians general practitioners and dieticians, enabling them to better detect, recognise and start treatment of malnutrition in the elderly.
Author: June R. Wyman
Publisher:
ISBN:
Category : Multiple sclerosis
Languages : en
Pages : 2
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Book Description
Author: Richard James Gray
Publisher: Lippincott Williams & Wilkins
ISBN: 0781731003
Category : Medical
Languages : en
Pages : 475
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Book Description
Dialysis Access: A Multidisciplinary Approach gives radiologists, nephrologists, and surgeons the complete knowledge base they need to deliver effective, coordinated care to dialysis patients with vascular access needs. This practical guide explains how to implement the National Kidney Foundation's Dialysis Outcomes Quality Initiative (DOQI) guidelines for vascular access and details procedures for creating vascular access...monitoring access failure...treating blocked access...and inserting and using catheters. Dr. Gray is the lead author for the Society of Cardiovascular and Interventional Radiology (SCVIR)'s Dialysis Access Reporting Standards. International contributors are expert interventional radiologists, nephrologists, and vascular access surgeons. Dialysis Access: A Multidisciplinary Approach fully integrates these specialties' perspectives.
Author: Karl H. Krieger
Publisher: Springer Science & Business Media
ISBN: 1461221803
Category : Medical
Languages : en
Pages : 678
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Book Description
Here, two of the foremost cardiothoracic surgeons have brought together many of the top cardiologists and haematologists to produce the most current reference source on all aspects of blood conservation, from an overall clinical approach to the use of erythropoietin and the benefits of post-operative blood salvage. The subject matter covers numerous areas involved in the preoperative considerations in cardiac surgery, the intraoperative decision-making in cardiac surgery, postoperative bleeding and management and a section on the algorithm for bloodless surgery used at the New York Hospital-Cornell Medical Center.
