Reliability and validity of the evidence-based practice confidence (EPIC) scale.

Introduction: The reliability, minimal detectable change (MDC), and construct validity of the evidence-based practice confidence (EPIC) scale were evaluated among physical therapists (PTs) in clinical practice.

Methods: A longitudinal mail survey was conducted. Internal consistency and test-retest reliability were estimated using Cronbach's alpha and the intraclass correlation coefficient (ICC), respectively.

Predictors of laparotomy and mortality in polytrauma patients with pelvic fractures.

BACKGROUND: The decision to perform laparotomy in blunt trauma patients is often difficult owing to pelvic fractures; however, once the decision is made, delay or failure to perform laparotomy could affect morbidity and mortality. We sought to identify predictors of laparotomy and mortality in polytrauma patients with pelvic fractures. METHODS: We divided 390 blunt polytrauma patients (Injury Severity Score [ISS] >/= 16) with pelvic fractures into laparotomy (n = 56) and nonlaparotomy (n = 334) groups.

The standardized live patient and mechanical patient models--their roles in trauma teaching.

Background: We have previously demonstrated improved medical student performance using standardized live patient models in the Trauma Evaluation and Management (TEAM) program. The trauma manikin has also been offered as an option for teaching trauma skills in this program. In this study, we compare performance using both models.

The simulated Trauma Patient Teaching Module--does it improve student performance?

Background: Student feedback from the old TEAM (Trauma Evaluation and Management) program prompted introduction of simulated trauma patient models in the new program. Performance after the new and old programs was compared to assess the impact of the simulated patient models.

Methods: Final year medical students randomly assigned to control and experimental groups completed a 20-item trauma multiple choice questionnaire examination (MCQE).

Youth and young adults with cerebral palsy: their use of physician and hospital services.

Objectives: To examine patterns of health care utilization among youth and young adults who have cerebral palsy (CP) and to provide information to guide the development of health services for adults who have CP.

Design: This study analyzed health insurance data for outpatient physician visits and hospital admissions for a 4-year period.

Setting: Six children's treatment centers in Ontario, Canada.

A prospective population-based study of the predictors of undergoing total joint arthroplasty.

Objective: To examine prospectively the predictors of time to total joint arthroplasty (TJA).

Methods: This was a prospective cohort study with a median followup time of 6.1 years.

Socioeconomic status and mortality after acute myocardial infarction.

Background: Gradients that link socioeconomic status and cardiovascular mortality have been observed in many populations, including those of countries that provide publicly funded comprehensive medical coverage. The intermediary causes of such gradients remain poorly elucidated.

Objective: To examine the relationships among socioeconomic status, other health factors, and 2-year mortality rates after acute myocardial infarction (MI).

Determinants of survival in children with congenital abnormalities: a long-term population-based cohort study.

Background: Today more children with birth defects survive early childhood because of improved medical care; however, little information is available about patterns of long-term mortality and survival in this population. In particular, it is not clear whether other birth characteristics, apart from birth defects, have any role in their mortality.

Methods: Two large cohorts of children with and without birth defects were followed for up to 17 years.

Trauma base knowledge and the effect of the trauma evaluation and management program among senior medical students in seven countries.

Background: We compared base trauma knowledge and the impact of the Trauma Evaluation and Management (TEAM) program among senior medical students in seven countries.

Methods: We compared pre- and post-TEAM multiple choice question scores of fourth-year students in Jamaica (n = 32), Trinidad (n = 32), Costa Rica (n = 64), Australia (n = 35), United Arab Emirates (n = 68), Toronto (n = 29) and Pennsylvania (n = 34). Means and degree of improvement were compared by analysis of variance (p < 0.

Trauma evaluation and management: who benefits among medical students?

Background: This study examines whether or not the ACS ATLS Subcommittee's Trauma Evaluation and Management (TEAM) course is more appropriate for third (Y3) or fourth year (Y4) medical students.

Materials And Methods: Y3 and Y4 students were divided into control (CTL: 41 Y3, 17 Y4) and experimental (EXP: 39 Y3, 17 Y4) groups. The EXP groups had a 20-item, multiple-choice question exam before, and a similar exam after TEAM.

Congenital abnormalities and childhood cancer.

Background: The examination of specific characteristics of neoplasms diagnosed in children have suggested that a significant proportion can be attributed to a genetic mutation or genetic predisposition. Although the study of a genetic predisposition to cancer in children remains in the early stages, congenital abnormalities could provide essential information for mapping predisposing lesions in children with cancer.

Methods: In the current study, 2 large cohorts of children with and without congenital abnormalities were followed for the occurrence of cancer and death up to 18 years.

Provider volume and other predictors of outcome after total knee arthroplasty: a population study in Ontario.

Introduction: Because of rationing of the limited pool of health care resources, access to total knee arthroplasty (TKA) is limited, but investigation of variables that predict complications, length of hospital stay, cost and outcomes of TKA may allow us to optimize the available resources. The objective of this study was to examine the effect of various factors on complication rates after TKA in patients managed in Ontario.

Methods: Patients who had undergone an elective TKA between 1993 and 1996, as captured in the Canadian Institute for Health Information (CIHI) database, formed the study cohort.

Healthy-year equivalents in major joint replacement. Can patients provide meaningful responses?

Objectives: Healthy-years equivalents (HYEs) have been proposed as an evaluative measure with advantages over quality-adjusted life-years (QALYs). The main purpose was to assess the feasibility of eliciting HYEs from patients who have undergone major joint replacement; a secondary objective was to examine relationships with postsurgical health status.

Methods: Pre- and postsurgical reports of perceived comorbidity and current arthritic burden were obtained from 194 patients, using a comorbidity checklist, summary scores from the Western Ontario/McMaster Osteoarthritis Questionnaire (WOMAC), summary scores derived from six Likert scales, and holistic utility scores for the same attributes.

Teaching effectiveness of the trauma evaluation and management module for senior medical students.

Background: The Trauma Evaluation and Management (TEAM) module was devised by the American College of Surgeons for teaching senior medical students trauma management principles. This article reports on the teaching effectiveness of this module.

Method: Cognitive skills (by 20 item multiple-choice question examination on trauma topics) and clinical trauma management skills performance, using the Objective Structured Clinical Examination, were compared between two groups of 16 randomly selected final year medical students who had completed the standard curriculum including trauma topics.

Arthroscopic débridement of the knee for osteoarthritis in patients fifty years of age or older: utilization and outcomes in the Province of Ontario.

Background: There is little available information regarding the effectiveness of arthroscopic knee débridement for the treatment of arthritis. The purpose of this study was to evaluate patterns of utilization of arthroscopic knee débridement and outcomes following that procedure for the treatment of degenerative arthritis in persons fifty years of age or older in the Province of Ontario.

Methods: All patients fifty years of age or older who underwent elective arthroscopic knee débridement for the treatment of degenerative arthritis between 1992 and 1996 were identified from administrative data sets.