Closing Evidence Gaps in Clinical Prevention

Lieu, Tracy A.; Wojtowicz, Alexis; Stratton, Kathleen

doi:10.1001/jama.2022.0849

Cited by 6 publications

(5 citation statements)

References 3 publications

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“…Adherence gaps and practice variation persist despite decades of development and endorsement of CPGs, and efforts have been made to close this gap. 29 Efforts to enhance the quality of guidelines, measure (monitor) and analyse QIs and improve adherence to guidelines are essential for achieving better health service provision. QIs could provide useful information regarding institutionallevel and regional-level disparities in quality of care, which could contribute to updating health policy and improving the health provision system.…”

Section: Discussionmentioning

confidence: 99%

Development of a set of quality indicators in paediatric and perinatal care in Japan with a modified Delphi method

Shinjo,

Ozawa,

Nakadate

et al. 2023

bmjpo

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BackgroundsFew paediatric and perinatal quality indicators (QIs) have been developed in the Japanese setting, and the quality of care is not assured or validated. The aim of this study was to develop QIs in paediatric and perinatal care in Japan using an administrative database and confirm the feasibility and applicability of the indicators using a single-site practice test.MethodsWe used a RAND-modified Delphi method that integrates evidence review with expert consensus development. QI candidates were generated from clinical practice guidelines (CPGs) available in English or Japanese and existing QIs in nine selected paediatric or perinatal conditions. Consensus building was based on independent panel ratings. The performance of QIs was retrospectively assessed using data from an administrative database at the National Children’s Hospital. Data between April 2018 and March 2019 were used, while data between April 2019 and March 2021 were also used for selected condition, considering the small number of patients. Each QI was calculated as follows: number of times the indicator was met/number of participants×100.ResultsFrom the literature review conducted between 2010 and 2020, 124 CPGs and 193 existing indicators were identified to generate QI candidates. Through the consensus-building process, 133 QI candidates were assessed and 79 QIs were accepted. The practice test revealed wide variations in the process-level performance of QIs in four categories: patient safety: median 43.9% (IQR 16.7%–85.6%), general paediatrics: median 98.8% (IQR 84.2%–100%), advanced paediatrics: median 94.4% (IQR 46.0%–100%) and advanced obstetrics: median 80.3% (IQR 59.6%–100%).ConclusionsWe established 79 QIs for paediatric and perinatal care in Japan using an administrative database that can be applied to hospitals nationwide. The practice test confirmed the measurability of the developed QIs. Benchmarking these QIs will be an attractive approach to improving the quality of care.

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Section: Discussionmentioning

confidence: 99%

Development of a set of quality indicators in paediatric and perinatal care in Japan with a modified Delphi method

Shinjo,

Ozawa,

Nakadate

et al. 2023

bmjpo

View full text Add to dashboard Cite

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“…Additional investigations into the effectiveness of recent technological advances for educating and engaging individuals and communities may support the notion that the risks of not screening might outweigh the risks of screening. Commitments by USPSTF and the National Academy of Sciences, Engineering and Medicine to further enhance health equity screening with consideration of risk assessment strategies suggest that, as the nation realigns its resources during COVID-19 recovery to optimize health care delivery, many opportunities are available to improve cancer screening and population health . Evidence is increasing that implementing these changes to address both long-standing and more recent COVID-19–associated individual vulnerabilities and population vulnerabilities is both necessary and feasible.…”

Section: Risk-based Community-engaged Strategies To Enhance Cancer Sc...mentioning

confidence: 99%

Opening the Windows for More Effective and Equitable Cancer Screening

Kahn

2023

JAMA Netw Open

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Amidst a flurry of documentation about diminished use of health services during the COVID-19 pandemic, the cohort study by Doan et al 1 in this issue of JAMA Network Open analyzed the trajectory of national breast cancer screening and lung cancer screening from the COVID-19 pandemic onset through April 2022. Lower-than-expected cancer screening rates were noted for both lung cancer and breast cancer during the late 2020 national COVID-19 infection rate surge and the Delta and Omicron waves in 2021 and 2022. By recognizing this persistent depression in breast cancer screening and lung cancer screening, Doan et al 1 highlighted missed opportunities to improve cancer stage at diagnosis and survival afforded by screening.Doan et al 1 used national Medicare data to support analyses of mammography to screen for breast cancer and low-dose computerized tomography to screen for lung cancer among eligible beneficiaries, accounting for age, sex, race, ethnicity, comorbidities, Medicaid enrollment, primary care physician relationship, and educational attainment. In light of widely-reported, substantial disparities in screening, this recent, national data set provides opportunities to report on disparities in the use of these cancer screening services. This Invited Commentary considers the measurement of COVID-19's effect on established screening processes and opportunities for improving screening by engaging the individuals and communities most impacted by these depressed screening rates.

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“…Readers should also note that our approach is not the only way to conduct knowledge translation. For example, another promising approach to translational research might be to strive to close gaps in the literature that are identified using extensive knowledge synthesis techniques, such as the United States Preventive Services Task Force process (USPSTF; Lieu et al, 2022).…”

Section: Limitationsmentioning

confidence: 99%

Coconstruction of adjunct behavioral interventions to bariatric surgery: The INTER-Change program.

Fortin¹,

Lavoie²,

Ben-Porat³

et al. 2023

Health Psychology

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Closing Evidence Gaps in Clinical Prevention

Abstract: This Viewpoint summarizes a report from the National Academies of Sciences, Engineering, and Medicine that provides a taxonomy of evidence gaps in preventive services and recommendations to close those gaps in clinical prevention research.

Cited by 6 publications

References 3 publications

Development of a set of quality indicators in paediatric and perinatal care in Japan with a modified Delphi method

Development of a set of quality indicators in paediatric and perinatal care in Japan with a modified Delphi method

Opening the Windows for More Effective and Equitable Cancer Screening

Coconstruction of adjunct behavioral interventions to bariatric surgery: The INTER-Change program.

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