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21. Continual Long-Term Physiotherapy After Stroke

therapy. 5 March 2020 Ontario Health Technology Assessment Series; Vol. 20: No. 7, pp. 1–70, March 2020 8 Health Service Under Review Physiotherapy After Stroke Physiotherapy (also sometimes known as physical rehabilitation) is delivered by physiotherapists (also sometimes known as physical therapists) in many different practice settings, including acute care and rehabilitation hospitals, outpatient clinics, long-term care homes, and primary care facilities. The goal of therapy after stroke (...) to address upper and lower extremity weakness, as well as hemiplegic shoulder pain. 6 Ontario Context In Ontario, physiotherapy is commonly delivered in acute care, inpatient, and outpatient settings, as well as in home and community care settings. After a stroke, physiotherapy typically begins in acute care with a focus on comprehensive assessment, and early mobilization to optimize safe and independent capacity for bed mobility, transfers, and walking. Patients transferred to inpatient rehabilitation

2020 Health Quality Ontario

22. Gene Expression Profiling Tests for Early-Stage Invasive Breast Cancer

status), molecular subtype, or specific gene expression. The most common staging system for breast cancer is the TNM system from the American Joint Committee on Cancer (AJCC), which factors the size of the tumour and its extension (T), the lymph node involvement (N), and the metastasis (M). 2 The TNM system recognizes five stages of breast cancer 2 : • Stage 0 (noninvasive): abnormal cells are present but have not spread to nearby tissue; also known as carcinoma in situ • Stage 1 (invasive): cancer (...) is compared with each of the four molecular subtypes to determine the degree of similarity. The results are combined with a proliferation score and tumour size to establish the Risk of Recurrence (ROR) score. 23 The ROR score is correlated with the 10-year probability of distant recurrence, with risk groups categorized as low ( 20%) ROR. 24 Regulatory Information Gene expression profiling tests are considered laboratory-developed tests and therefore do not require Health Canada approval unless

2020 Health Quality Ontario

23. Implantable Devices for Single-Sided Deafness and Conductive or Mixed Hearing Loss

e,m High f,l Low High Abbreviation: ROBIS, Risk of Bias in Systematic Reviews. a Possible risk of bias levels: low, high, unclear. b Single reviewer for data extraction and study quality assessment, with data from 10% of the studies being extracted by two reviewers. c Single reviewer for study selection with another assessing those studies over which there was doubt. d Single reviewer for data extraction and checked by a second reviewer. e Unclear on the number of reviewers for study selection (...) Risk of Bias in the Review University of Alberta, 2011 47 Low Low High b Low Low Appachi et al, 2017 44 Low Low Low Low Low Australia Medical Services Advisory Committee, 2010 34 Low High c High d Low High Bezdjian et al, 2017 48 Low Low Low Low Low Colquitt et al, 2011 49 Low Low Low Low Low Danhauer et al, 2010 50 Low High e High f Low High Ernst et al, 2016 51 Low High g Low Low Low Kim et al, 2017 45 Low Low High h Low Low Kiringoda and Lustig, 2013 56 Low High e High f Low High Kitterick et al

2020 Health Quality Ontario

24. Colorectal cancer screening with faecal immunochemical testing, sigmoidoscopy or colonoscopy Full Text available with Trip Pro

for the majority, but not for everyone. Strong All or nearly all informed people would likely want this option. Benefits outweigh harms for almost everyone. Visit the MAGICapp multiple comparison tool to compare and choose options Evidence summaries Screening options should be chosen in shared decision making, based on a person’s individual risk of cancer For a person with a 2% risk of colorectal cancer within 15 years Colorectal cancer mortality No screening FIT every year Sigmoidoscopy FIT every two years (...) and preferences FIT Sigmoidoscopy Done at home every year or every two years for 15 years Done once in 15 years at an outpatient clinic/hospital Stool from one bowel movement is collected with a stick and mailed for analysis Preparation with bowel enema on the day of the procedure. Sometimes combined with oral laxatives Preparation with oral laxatives starting the day before procedure Individuals with a positive test are offered colonoscopy Usually performed with no sedation, so no recovery time necessary

2019 BMJ Rapid Recommendations

25. Recommendations for good practice in Ultrasound: Oocyte retrieval Full Text available with Trip Pro

search navigation Article Navigation 2019 Article Contents Article Navigation Recommendations for good practice in ultrasound: oocyte pick up The ESHRE Working Group on Ultrasound in ART Search for other works by this author on: , Arianna D’Angelo Wales Fertility Institute , University Hospital of Wales, Cardiff University, Cardiff, UK Correspondence address. Wales Fertility Institute, University Hospital of Wales, Heath Park, Cardiff CF14 4XW, UK. E-mail: , Search for other works by this author (...) and volume of follicles. Caution should be taken in correlating these new parameters with oocyte maturity in comparison with conventional mean follicular diameter. The transvaginal transducer, or probe, should have a frequency range of 5–8 MHz and an abdominal transducer with a frequency range of 2–6 MHz, or their contemporaneous equivalents at the time of purchase. An appropriate protocol for transducer disinfection should be established, in accordance with manufacturer’s instructions. OPU operators

2020 European Society of Human Reproduction and Embryology

26. Effectiveness of mental health electronic medical records

) Automation through e-prescribing has, on the other hand, resulted in improved care quality and safety, especially in clinical contexts where effective socio-technical systems have been established. (11) However, the mismatch between what “off-the-shelf” EMRs offer and what clinicians need is well recognised. (12) The impacts of EMRs have seldom been systematically studied, measured and reported in the peer-reviewed literature related to mental health service delivery. To maximise the benefits of EMRs (...) EMRs – Columbia Suicide Severity Rating Scale 300 evaluations performed by 36 psychiatry residents Quantitative: chart review Not specified Xiao & Acosta (2016) USA Adult outpatient psychiatric clinic e-charting custom developed for use in the clinic, included intake notes, evaluation/assessment, progress notes and e- medication monitoring 105 charts review pre- implementation and 141 charts reviewed post- implementation Quantitative: chart review Not specified Literature reviews relevant to EMRs

2020 Sax Institute Evidence Check

27. Suicide aftercare services

Suggested Citation: Shand F, Woodward A, McGill K, Larsen M, Torok M et al. Suicide aftercare services: an Evidence Check rapid review brokered by the Sax Institute (www.saxinstitute.org.au) for the NSW Ministry of Health, 2019. Disclaimer: This Evidence Check Review was produced using the Evidence Check methodology in response to specific questions from the commissioning agency. It is not necessarily a comprehensive review of all literature relating to the topic area. It was current at the time (...) , rather than relying on the person to make contact with the service. It may also require using a range of methods to maintain contact, such as home and other off-site visits, telephone calls and texts. Note SUICIDE AFTERCARE SERVICES | SAX INSTITUTE 7 that not all of aftercare services would be defined as ‘assertive’. Brief interventions typically provide a limited number of sessions (usually fewer than six) and/or the sessions were of limited duration (10-20 minutes). The duration of the effect

2020 Sax Institute Evidence Check

28. Raising the bar on strength and balance: The importance of community-based provision

trained to support instructors during class as well as accompanying instructors on home visits to encourage community-based class attendance. This has been particularly effective in trying to engage older men in SBEP. Wigan: Reaching out to men Work across stakeholder groups Falls need to be everybody’s business, which is why establishing a falls collaborative group that includes representatives from all stakeholder and key influencers, works as an important factor in developing a co-ordinated (...) , accessible homes and connected communities. By focusing on those approaching later life and at risk of missing out, we will create lasting change in society. We are bold and innovative in our approach to improving later lives. We work in partnership with a diverse range of organisations. As a part of the What Works network, we are grounded in evidence. To find out more visit: www.ageing-better.org.uk The Healthy Ageing Research Group at the University of Manchester The Healthy Ageing Research Group

2020 The Centre for Ageing Better

29. Guidance for maternal medicine in the evolving coronavirus (COVID-19) pandemic

for adaptation of maternal medicine services to safely reduce face-to-face contact during the evolving coronavirus pandemic, for example by offering virtual consultations where appropriate, ensuring women are seen in one-stop clinics that cover all medical and obstetric needs in the same visit, avoiding unnecessary hospital admissions and offering new innovations, such as home monitoring of blood pressure, where it is safe to do so. • Specific advice for healthcare professionals caring for pregnant women (...) . A minority of maternal medicine clinic appointments will need to be face-to-face, primarily when the woman is having a physical interaction such as an obstetric scan, an echocardiogram, or an exchange transfusion. Face-to- face interactions should be limited by reviewing the purpose of the appointment in advance (ideally one week earlier) and ensuring that the relevant tests/treatments can all be done in a single visit. For many non-pregnant patients this is already happening as medical specialties adapt

2020 Royal College of Obstetricians and Gynaecologists

30. Remote ECG interpretation consultancy services for cardiovascular disease

and decision-making for people with cardiovascular disease. The inno innovativ vative aspects e aspects are that with remote ECG interpretation, a person does not need to travel to hospital for a consultation with a cardiologist, potentially providing quicker and more accurate diagnoses. The intended place in ther place in therap apy y would be to replace referrals to secondary care for interpreting ECGs from people with suspected cardiovascular disease. The main points from the e main points from (...) disorders. T en electrodes are placed on the skin of the chest and limbs to measure the electrical activity of the heart from 12 angles. The signal is recorded for about 10 seconds. Holter/ambulatory ECG Holter/ambulatory ECG: a monitor is worn for a period ranging from a day to a week, to record heart activity. The number of leads varies between manufacturers. L Loop/e oop/ev vent monitoring ent monitoring: captures unusual heart activity over longer periods, in some cases up to 4 years. An ECG of any

2018 National Institute for Health and Clinical Excellence - Advice

31. Choosing Wisely Canada recommendation - Don’t routinely do screening mammography for average risk women aged 40 – 49. Individual assessment of each woman’s preferences and risk should guide the discussion and decision regarding mammography screening in th

all cases are viral. Though cases of bacterial sinusitis can benefit from antibiotics, evidence of such cases does not typically surface until after at least seven days of illness. Not only are antibiotics rarely indicated for upper respiratory illnesses, but some patients experience adverse effects from such medications. Don’t order screening chest X-rays and ECGs for asymptomatic or low risk outpatients. There is little evidence that detection of coronary artery stenosis in asymptomatic patients (...) . Don’t advise non-insulin requiring diabetics to routinely self-monitor blood sugars between office visits. While self-monitoring of blood glucose (SMBG) for patients with diabetes is recommended by certain groups to help monitor glycemic control, for most adults with type II diabetes who are not using insulin, many studies have shown that routine SMBG does little to control blood sugar over time. Don’t order thyroid function tests in asymptomatic patients. The primary rationale for screening

2019 CPG Infobase

32. Safe nurse staffing levels in acute hospitals

for different types of nursing wards 233 Table 24 – Example of the calculation of safe nurse staffing establishment at ward level 233 16 Safe nurse staffing levels in acute hospitals KCE Report 325 Table 25 – Proposed and implemented patient-to-nurse ratios in California 243 Table 26 – Summary of the impact of the ratio legislation in California 245 Table 27 – Example of the patient-to-nurse minimal staffing ratios as proposed in Act H.R. 2392 in the House of Representatives USA 251 Table 28 – Budget impact (...) care. 38 Although the evidence about healthcare assistants is not as well established as that about nurse staffing levels, it clearly shows that healthcare assistants cannot act as substitutes for RNs. 43 Nursing work environment The complexity of the staffing – outcome relationship is also illustrated by the body of evidence that links factors of the nursing work environment (e.g. shift lengths, physician-nurse relationships, leadership style) with patient outcomes. It is possible

2020 Belgian Health Care Knowledge Centre

33. British guideline on the management of asthma

establish whether or not the airflow obstruction reverses to normal with treatment. Evidence of a symptomatic response, ideally using objective measures of asthma control and lung function, should be sought at a follow-up visit. If there is significant reversibility or improvement in symptom scores, confirm the diagnosis of asthma and record the basis on which the diagnosis was made. Continue to treat as asthma, but aim to find the minimum effective dose of therapy. If the patient remains asymptomatic (...) development group 152 17.3 Acknowledgements 154 17.4 Consultation and peer review 154 Abbreviations 156 Annexes 158 References 1721 1 | Introduction 1 Introduction 1.1 The need for a guideline Asthma is a common condition which produces a significant workload for general practice, hospital outpatient clinics and inpatient services. It is clear that much of this morbidity relates to poor management, particularly around the use of preventative medicine. 1.1.1 Background In 1999 the British Thoracic Society

2019 SIGN

34. Towards integrated antenatal care for low-risk pregnancy

: Prenatal Care, Organization and Administration, Prenatal Education, Patient Care Team, Belgium NLM Classification : WQ175 Language : English Format : Adobe® PDF™ (A4) Legal depot : D/2020/10.273/78 ISSN: 2466-6459 Copyright : KCE reports are published under a “by/nc/nd” Creative Commons Licence http://kce.fgov.be/content/about-copyrights-for-kce-publications. How to refer to this document? Benahmed N, Lefèvre M, Christiaens W, Devos C, Stordeur S. Towards integrated antenatal care for low-risk (...) The gynaecologist density is the number of active gynaecologists by 10 000 inhabitants. 21 e These amounts correspond to fees negotiated for midwives on 1 January 2019 No relationship between the use of midwives and the geographical distribution of gynaecologist density d was observed. Very few low-risk pregnant women (0.3%) were exclusively followed by midwives (and possibly by GPs, but not by gynaecologists) and did probably not benefit from ultrasounds; 44% had an exclusive pregnancy follow-up performed

2020 Belgian Health Care Knowledge Centre

35. Inotuzumab ozogamicin for treating relapsed or refractory B-cell acute lymphoblastic leukaemia

model Administr Administration costs based on INO-V ation costs based on INO-VA ATE TE 1022 and 9.5 1022 and 9.5 inpatient da inpatient days in both arms ys in both arms are preferred are preferred 3.13 The company's model assumed that administering inotuzumab ozogamicin would need 3 outpatient visits and no inpatient days per cycle, compared with Inotuzumab ozogamicin for treating relapsed or refractory B-cell acute lymphoblastic leukaemia (TA541) © NICE 2019. All rights reserved. Subject to Notice (...) of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 14 of 31no outpatient visits and 6.2 inpatient days for standard care (based on the summary of product characteristics). The ERG stated that the company's assumptions underestimated the cost of administering inotuzumab ozogamicin because no inpatient days were included. The clinical expert agreed with the ERG and also highlighted that patients having standard care often need an extended stay in hospital. The ERG's

2018 National Institute for Health and Clinical Excellence - Technology Appraisals

36. Optimisation of RIZIV – INAMI lump sums for incontinence

). For women, pregnancy, delivery and parturition factors e.g. instrumental delivery and birth weight, are risk factors for UI in the post- partum period. Further, body mass has been established as an important risk factor for UI while other modifiable factors include smoking, diet, depression, constipation, urine tract infections, and strenuous exercise (e.g. jumping). Although associated with UI, they are not considered established independent risk factors. In older women, physical function and moderate (...) The management of UI is often a combination of options, including conservative, pharmacological and surgical management [13] . The care pathways are described further below. After an initial assessment (history, physical examination, laboratory tests) establishing a presumptive diagnosis, and excluding underlying organ-specific conditions requiring specialist intervention, as well as assessing the level of bother and desire for intervention from information obtained from the patient or caregivers

2020 Belgian Health Care Knowledge Centre

37. Canadian guidelines on opioid use disorder among older adults

Disorder Among Older Adults Summary of Recommendations and Grades W e used the GRADE approach (Grading of Recommendations, Assessment, Development and Evaluation) as a method of grading the quality of evidence and the strength of recommendations . In following the GRADE process, the initial step was to grade the quality of available evidence supporting each recommendation . Subsequently, we identified the overall strength of the recommendation taking into account both the quality of the evidence (...) used a similar approach e .g . British Association for Psychopharmacology Guidelines (2012) . While such recommendations lack empirical evidence, we believe they are also useful and important . ***High quality evidence doesn’t necessarily imply strong recommendations, and strong recommendations can arise from low quality evidence. Note: Meta analyses and Randomized Controlled Trials are considered high quality vs. Observational studies which are considered low quality QUALITY OF EVIDENCE STRENGTH

2019 CPG Infobase

38. Health literacy: what lessons can be learned from the experiences of other countries?

in society. One of the conclusions of the IROHLA project was that incorporating health literacy in all policies in the area of health care or healthy ageing, is a precondition for effective health literacy intervention programmes. For example, public health programmes, as well as patient safety and health care quality programmes can benefit from easily understandable health information for the population and more accessible and acceptable e-health and m-health applications. KCE Report 322 Health literacy (...) , and higher odds for rehospitalisation). 3 The same studies revealed that health literacy must be conceived as a much broader concept, as not only reading and writing skills are important to access and interact with the healthcare system. People with low health literacy have problems with establishing contacts with healthcare professionals, accessing healthcare institutions, taking up their part in health related shared decisions, understanding the pathophysiology of a health condition, following

2020 Belgian Health Care Knowledge Centre

39. Canadian guidelines on benzodiazepine receptor agonist use disorder among older adults

the gradual withdrawal and discontinuation of BZRAs should be used. Clinicians and patients should share in: a) planning and applying a gradual dose reduction scheme supported by appropriate education of the patient; b) identifying and optimizing alternatives to manage the underlying health issue(s) that initiated or perpetuated the use of BZRAs; c) developing strategies to minimize acute withdrawal and managing rebound symptoms as needed; and d) establishing a schedule of visits for reviewing progress (...) Committee: Canadian Guidelines on Benzodiazepine Receptor Agonist Use Disorder Among Older Adults Dr. Christopher Frank, MD, FCFP(COE) Professor, Department of Medicine Queen’s University Dr. David Gardner, Pharm. D, MSc Professor of Psychiatry & Pharmacy Dalhousie University, Halifax, NS Morris Goldhar – C.E.T. Retired - Electronic Technologist, Person with Lived Experience Dr. Joanne M-W Ho MD, FRCPC, MSc Assistant Professor, Department of Medicine, Schlegel Clinical Research Scientist, Schlegel

2019 CPG Infobase

40. Oncology Nursing Telepractice Standards

Telemedicine Association. (2014). Core operational Guidelines for Telehealth Services Involving Provider-Patient Interactions. Retrieved from http://www.uwyo.edu/wind/_files/docs/wytn-doc/toolkit- docs/ata_core_provider.pdf 26.Lake, R., Georgiou, A., Li, J., Li, L., Byrne, M., Robinson, M., & Westbrook, J. I. (2017). The quality, safety and governance of telephone triage and advice services–an overview of evidence from systematic reviews. BMC Health Services Research, 17(1), 614. 27.Scott, D., Richard, E (...) Oncology Nursing Telepractice Standards Care Ontario Oncology Nursing Telepractice Standards Oncology Nursing Program August, 2019 Oncology Nursing Telepractice Standards 1 INTRODUCTION In 2017, the Oncology Nursing Program at Cancer Care Ontario completed a current state assessment across the province. The goal of the assessment was to gain a better understanding of the current landscape of oncology nursing in the outpatient setting, including nursing roles and models of nursing care delivery

2019 Cancer Care Ontario

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