Publications by authors named "Makalapua Motuapuaka"
Background: Cannabis is increasingly available for the treatment of chronic pain, yet its efficacy remains uncertain.
Purpose: To review the benefits of plant-based cannabis preparations for treating chronic pain in adults and the harms of cannabis use in chronic pain and general adult populations.
Data Sources: MEDLINE, Cochrane Database of Systematic Reviews, and several other sources from database inception to March 2017.
Background: Cannabis is available from medical dispensaries for treating posttraumatic stress disorder (PTSD) in many states of the union, yet its efficacy in treating PTSD symptoms remains uncertain.
Purpose: To identify ongoing studies and review existing evidence regarding the benefits and harms of plant-based cannabis preparations in treating PTSD in adults.
Data Sources: MEDLINE, the Cochrane Library, and other sources from database inception to March 2017.
Background: Goals for improving the quality of care for all Veterans and eliminating health disparities are outlined in the Veterans Health Administration Blueprint for Excellence, but the degree to which disparities in utilization, health outcomes, and quality of care affect Veterans is not well understood.
Objectives: To characterize the research on health care disparities in the Veterans Health Administration by means of a map of the evidence.
Research Design: We conducted a systematic search for research studies published from 2006 to February 2016 in MEDLINE and other data sources.
Background: Women are at substantially greater risk for anterior cruciate ligament (ACL) injuries than are men.
Purpose: To conduct a systematic review and meta-analysis of the literature to clarify the effect of the menstrual cycle and contraceptives on the laxity of and noncontact injuries to the ACL.
Study Design: Systematic review; Level of evidence, 4.
Background: There is increasing demand for rapid reviews and timely evidence synthesis. The goal of this project was to understand end-user perspectives on the utility and limitations of rapid products including evidence inventories, rapid responses, and rapid reviews.
Methods: Interviews were conducted with key informants representing: guideline developers (n = 3), health care providers/health system organizations (n = 3), research funders (n = 1), and payers/health insurers (n = 1).
Background: Recent guidelines recommend a systolic blood pressure (SBP) goal of less than 150 mm Hg for adults aged 60 years or older, but the balance of benefits and harms is unclear in light of newer evidence.
Purpose: To systematically review the effects of more versus less intensive BP control in older adults.
Data Sources: Multiple databases through January 2015 and MEDLINE to September 2016.
Background: The benefits of pay-for-performance (P4P) programs are uncertain.
Purpose: To update and expand a prior review examining the effects of P4P programs targeted at the physician, group, managerial, or institutional level on process-of-care and patient outcomes in ambulatory and inpatient settings.
Data Sources: PubMed from June 2007 to October 2016; MEDLINE, PsycINFO, CINAHL, Business Economics and Theory, Business Source Elite, Scopus, Faculty of 1000, and Gartner Research from June 2007 to February 2016.
Background: Atrial fibrillation is an important cause of cardioembolic stroke. Oral anticoagulants (OAC) reduce stroke risk but increase the risk of serious bleeding. Left atrial appendage (LAA) procedures have been developed to isolate the LAA from circulating blood flow, as an alternative to OAC.
View Article and Find Full Text PDFBackground: Over the last decade, various pay-for-performance (P4P) programs have been implemented to improve quality in health systems, including the VHA. P4P programs are complex, and their effects may vary by design, context, and other implementation processes. We conducted a systematic review and key informant (KI) interviews to better understand the implementation factors that modify the effectiveness of P4P.
View Article and Find Full Text PDFBackground: Health systems are faced with a large array of transitional care interventions and patient populations to whom such activities might apply.
Purpose: To summarize the health and utilization effects of transitional care interventions, and to identify common themes about intervention types, patient populations, or settings that modify these effects.
Data Sources: PubMed and Cochrane Database of Systematic Reviews (January 1950-May 2014), reference lists, and technical advisors.
Objectives: Describe characteristics of rapid reviews and examine the impact of methodological variations on their reliability and validity.
Study Design And Setting: We conducted a literature review and interviews with organizations that produce rapid reviews or related products to identify methods, guidance, empiric evidence, and current practices.
Results: We identified 36 rapid products from 20 organizations (production time, 5 minutes to 8 months).
Objectives: As time and cost constraints in the conduct of systematic reviews increase, the need to consider the use of existing systematic reviews also increases. We developed guidance on the integration of systematic reviews into new reviews.
Methods: A workgroup of methodologists from Evidence-based Practice Centers developed consensus-based recommendations.
Rationale: Early warning system (EWS) scores are used by hospital care teams to recognize early signs of clinical deterioration and trigger more intensive care.
Objective: To systematically review the evidence on the ability of early warning system scores to predict a patient's risk of clinical deterioration and the impact of early warning system implementation on health outcomes and resource utilization.
Methods: We searched the MEDLINE, CINAHL, and Cochrane Central Register of Controlled Trials databases through May 2014.
Background: Guidelines recommend routine screening for hepatocellular carcinoma (HCC) in high-risk patients, but the strength of evidence supporting these recommendations is unclear.
Purpose: To review the benefits and harms of HCC screening in patients with chronic liver disease.
Data Sources: MEDLINE, PsycINFO, and ClinicalTrials.