Research into the quality of cancer screening programs often lacks the perspective of clinicians, missing insights into the performance of individual hospitals. This retrospective cohort study aimed to identify guideline deviation (specifically, overtreatment and undertreatment) related to the cervical cancer screening program in Dutch hospitals by deterministically linking nationwide insurance data with pathology data for cervical intraepithelial neoplasia (CIN). We then constructed quality indicators using the Dutch CIN guideline and National Health Care Institute recommendations to assess compliance with CIN management, treatment outcomes, and follow-up, using an empirical Bayes shrinkage model to correct for case-mix variation and hospitals with few observations. Data were linked for 115,899 of 125,751 (92%) eligible women. Overtreatment was observed in the see-and-treat approach (immediate treatment) for women with low-grade referral cytology (4%; hospital range, 0%-25%), CIN ≤ 1 treatment specimens (26%; hospital range, 10%-55%), and follow-up cervix cytology ≥2 months before the guideline recommendation after treatment for CIN 2 (2%; hospital range, 0%-9%) or CIN 3 (5%; hospital range, 0%-19%). By contrast, undertreatment was observed for treatment within 3 months after a CIN 3 biopsy result (90%; hospital range 59%-100%) and follow-up ≥2 months beyond the guideline recommendation after treatments for CIN 2 (21%, hospital range 7%-48%) and CIN 3 (20%, hospital range 7%-90%). In conclusion, we found evidence of CIN overtreatment and undertreatment in all measured domains at the hospital level. Guideline adherence could be improved by implementing the developed indicators in an audit and feedback instrument for use by healthcare professionals in routine practice.
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http://dx.doi.org/10.1016/j.pmedr.2023.102134 | DOI Listing |
Trials
December 2024
Second Department of Internal Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama City, 641-0012, Japan.
Background: Gastrointestinal subepithelial lesions (SELs) range from benign to malignant. Endoscopic ultrasound (EUS)-guided fine-needle biopsy (EUS-FNB) is used widely for pathological diagnosis of SELs. Early diagnosis and treatment are important because all Gastrointestinal stromal tumors (GISTs) have some degree of malignant potential.
View Article and Find Full Text PDFBMC Womens Health
December 2024
Department of Physical Medicine and Rehabilitation,, Montefiore Medical Center, Bronx, NY, USA.
Background: Endometriosis, a condition that significantly impacts the quality of life for affected women, manifests with a spectrum of symptoms ranging from mild discomfort to severe pelvic pain, dysmenorrhea, dyspareunia, and infertility. A previous single-center study suggested an elevated prevalence of endometriosis in Jordan, prompting the need for larger studies to confirm these findings.
Methods: We conducted a cross-sectional study involving a sample of 866 women who underwent various laparoscopic procedures for different indications at the Department of Obstetrics and Gynecology at Jordan University Hospital and Al-Karak Governmental Hospital, two tertiary referral hospitals in Jordan between January 2015 and March 2023.
BMC Microbiol
December 2024
Department of Microbiology and Virology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
Background: Pseudomonas aeruginosa is a major cause of healthcare-associated infections (HAIs), particularly in immunocompromised patients, leading to high morbidity and mortality rates. This study aimed to investigate the antimicrobial resistance patterns, virulence gene profiles, and genetic diversity among P. aeruginosa isolates from hospitalized patients in Mazandaran, Iran.
View Article and Find Full Text PDFBMC Pregnancy Childbirth
December 2024
Department of Obstetrics & Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria.
Background: An important indicator of mothers' satisfaction with their care is birth satisfaction. Maternal health care can only be deemed to be of good quality if mothers are satisfied with the care they received. This increases maternal joy.
View Article and Find Full Text PDFOral Surg Oral Med Oral Pathol Oral Radiol
October 2024
Department of Biomedical Engineering, Ankara University, Ankara, Turkey.
Objective: The production of 3-dimensional models and materials according to preoperative virtual surgical planning is a time-consuming process and causes high costs. We aimed to demonstrate the navigation mediated reconstruction of the patients who underwent the removal of a tumoral mass in midfacial region according to their preoperatively prepared surgical plannings.
Study Design: Patients who underwent the removal of tumoral mass and reconstruction in their midfacial region were included in the study.
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