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Concept mapping to promote clinical reasoning in multimorbidity: a mixed methods study in undergraduate family medicine.
BMC Med Educ
December 2024
Comprehensive Health Research Centre (CHRC), NOVA Medical School, NOVA University, Lisbon, Portugal.
Background: Clinical reasoning significantly impacts physicians' performance and patient care quality. Research into learning transfer within clinical reasoning education, especially in managing multimorbidity in Family Medicine, is crucial. This study evaluates the impact of concept maps (CMs) on promoting clinical reasoning skills among undergraduate students, compared to traditional teaching methods (TM).
View Article and Find Full Text PDFThe Implementation Outcomes and Population Impact of a Statewide IT Deployment for Family Caregivers: Mixed Methods Study.
JMIR Aging
December 2024
Family Caregiver Alliance, San Franciscio, CA, United States.
Background: In 2022, the US Department of Health and Human Services released the first National Strategy to Support Family Caregivers, identifying actions for both government and the private sector. One of the major goals is to expand data, research, and evidence-based practices to support family caregivers. While IT tools are widely deployed in health care settings, they are rarely available at scale in community agencies.
View Article and Find Full Text PDFApplying the estimand framework to clinical pharmacology trials with a case study in bioequivalence.
Br J Clin Pharmacol
November 2024
Statistical Innovation, Respiratory and Immunology Biometrics and Statistical Innovation, Biopharmaceuticals R&D, AstraZeneca, Cambridge, UK.
The International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use has published an addendum on estimands and sensitivity analysis in clinical trials along with related training materials. These define an estimand as a precise description of the treatment effect that reflects the scientific question of interest. In December 2022, the US Food and Drug Administration released draft guidance recommending estimands of interest be specified in bioequivalence trial protocols.
View Article and Find Full Text PDFEarly Operative Risk Assessment Using the Modified Mannheim Peritonitis Index in Patients With Generalised Peritonitis at a Tertiary Hospital in Abuja, Nigeria.
Cureus
September 2024
Department of Surgery, National Hospital Abuja, Abuja, NGA.
Introduction The use of validated prognostic scoring tools in resource-poor environments has been hampered by the cost of procuring and maintaining devices, such as arterial blood gas analysers, to measure critical physiological derangements. Attempts need to be made to adapt these applicable risk stratification tools so they can be easily adopted in developing countries like Nigeria. Aim This study assessed the usefulness of a modified Mannheim peritonitis index (mMPI) as a risk stratification tool in predicting surgical outcomes in managing patients with generalised peritonitis in Abuja, Nigeria.
View Article and Find Full Text PDFApplication of the estimand framework for an emulated trial using reference based multiple imputation to investigate informative censoring.
BMC Med Res Methodol
October 2024
Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK.
Background: The ICH E9 (R1) addendum on Estimands and Sensitivity analysis in Clinical trials proposes a framework for the design and analysis of clinical trials aimed at improving clarity around the definition of the targeted treatment effect (the estimand) of a study.
Methods: We adopt the estimand framework in the context of a study using "trial emulation" to estimate the risk of pneumocystis pneumonia, an opportunistic disease contracted by people living with HIV and AIDS having a weakened immune system, when considering two antibiotic treatment regimes for stopping antibiotic prophylaxis treatment against this disease. A "while on treatment" strategy has been implemented for post-randomisation (intercurrent) events.
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