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Web-Based Patient Education

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53661. Population-Based Modeling of Cholesterol Lowering in the United States

Population-Based Modeling of Cholesterol Lowering in the United States Population-Based Modeling of Cholesterol Lowering in the United States - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Population-Based (...) Diseases Coronary Disease Hypercholesterolemia Detailed Description: BACKGROUND: The study was part of an Institute-initiated Request for Applications (RFA) titled "Cost-Effective Strategies of Cholesterol-Lowering" released by the NHLBI in 1990. The RFA was stimulated by the controversy concerning costs and cost-effectiveness that followed the 1987 report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults

2000 Clinical Trials

53662. Predictors of Hospital-Based Care in Asthma

. These studies were of limited value for the practicing physician who sees the vast majority of patients with asthma. Results from this study should, for the first time, enable a profile to be constructed of the high risk patient with asthma which includes identification of modifiable risk factors. These results can be used for physician and patient education programs as well as to target medical intervention. DESIGN NARRATIVE: The study developed a key piece of information needed for outpatient care (...) Predictors of Hospital-Based Care in Asthma Predictors of Hospital-Based Care in Asthma - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Predictors of Hospital-Based Care in Asthma The safety and scientific

2000 Clinical Trials

53663. Meditation-Based Treatment for Binge Eating Disorder

Health (NCCIH) Study Details Study Description Go to Brief Summary: The purpose of this study is to assess the relative effectiveness of a mindfulness meditation-based intervention for binge eating disorder in comparison to a psycho-educational intervention and a waiting-list control group. Condition or disease Intervention/treatment Phase Binge Eating Disorder Obesity Behavioral: Meditation Phase 2 Phase 3 Detailed Description: As many as 30% of individuals seeking treatment for obesity meet (...) (NCCIH): binge eating disorder human therapy evaluation meditation obesity nutrition education psychotherapy racial /ethnic difference adult human alternative medicine patient oriented research Additional relevant MeSH terms: Layout table for MeSH terms Disease Feeding and Eating Disorders Binge-Eating Disorder Bulimia Pathologic Processes Mental Disorders Hyperphagia Signs and Symptoms, Digestive Signs and Symptoms

2002 Clinical Trials

53664. Implementing practice guidelines for diabetes care using problem-based learning. A prospective controlled trial using firm systems. (PubMed)

made up > 75% of the patients. Doctors and staff in one of the clinics were trained in the use of a clinical practice guideline based on Staged Diabetes Management. A problem-based learning educational program was instituted to reach consensus on a stepped intensification scheme for glycemic control and to determine the standards of care used in the clinic. HbA1c was obtained at baseline and at 9 and 15 months after enrollment.At 9 months, there was a mean -0.90% within-subject change in HbA1c (...) Implementing practice guidelines for diabetes care using problem-based learning. A prospective controlled trial using firm systems. A controlled trial with 15-month follow-up was conducted in two outpatient clinics to study the effects of using the problem-based learning technique to implement a diabetes clinical practice guideline.A total of 144 patients with type 2 diabetes aged 25-65 years in two internal medicine outpatient clinics were enrolled in the study. African-Americans and Hispanics

1999 Diabetes Care

53665. Implementing Guidelines for Smoking Cessation: A Randomized Trial of Evidence-Based Quality Improvement

. The objective of this study was to evaluate the effectiveness of evidence-based quality improvement (EBQI)�an expert-designed and locally implemented clinical reorganization of smoking cessation care�on changes in smoking cessation (SC) practice among primary care providers and health outcomes among veteran smokers. Methods: An evidence-based quality improvement intervention comprising provision of physician and patient educational materials, local priority setting with leadership and providers, and local (...) implementation, namely evidence-based quality improvement, which is directly relevant to the translation of efficacious treatments into enhancements in VA health care policy and practice. Evidence-Based Quality Improvement (EBQI) focuses on improved provider adherence to smoking cessation guidelines and a decrease in patient smoking rates in a manner designed to produce short- and long-term health improvements and cost benefits at the organizational level. Condition or disease Intervention/treatment Phase

2001 Clinical Trials

53666. A Pilot Study of the Short-Term Effects of Antiretroviral Management Based on Plasma Genotypic Antiretroviral Resistance Testing (GART) Compared With Antiretroviral Management Without Plasma GART

/mm3. Upon randomization, clinicians determine a treatment strategy with supplied baseline GART results (GART arm) or without them (no-GART arm). All patients remain on the triple antiretroviral regimen initiated at the randomization visit until at least the 8-week visit. At this time, changes in treatment will be allowed based on an inadequate response to therapy. [AS PER AMENDMENT 9/17/97: 128 patients are randomized to therapy based on GART results or therapy not based on these results. Patients (...) are stratified into 8 groups defined by current antiretroviral regimen (ZDV/3TC/IDV vs. ZDV/3TC/SQV vs. ZDV/3TC/RTV vs. d4T/3TC/IDV) and screening CD4+ count (50-199 vs. 200-500). Management of patients assigned to the GART group is based on recommendations of study virologists after independent review of patient plasma GART results in addition to current clinical practice. Up to four different treatment regimens using only licensed drugs may be recommended, ranked but considered approximately

1999 Clinical Trials

53667. The cost/benefits of outpatient-based pulmonary rehabilitation. (PubMed)

The cost/benefits of outpatient-based pulmonary rehabilitation. To evaluate the outcomes of an inexpensive outpatient pulmonary rehabilitation program for stable patients with chronic obstructive pulmonary disease (COPD).Before-and-after trial.Private, ambulatory setting with carryover to the home.Forty-six stable COPD patients, from 45 to 80 years of age.A pulmonary rehabilitation program consisting of education, training, group therapy, and an individualized regimen of home-based extremity (...) decreased during the performance of activities of daily living (ADL) (p < .05). There was no significant change in forced expiratory volume in 1 second (FEV1). The cost of the 10 outpatient sessions was $650.An inexpensive outpatient/home-based pulmonary rehabilitation program provided largely by a specifically trained therapist under physician supervision can significantly improve parameters associated with quality of life for patients with COPD.

1997 Archives of physical medicine and rehabilitation

53668. Status epilepticus in a population-based cohort with childhood-onset epilepsy in Finland. (PubMed)

Status epilepticus in a population-based cohort with childhood-onset epilepsy in Finland. Little is known about the time course over which status epilepticus occurs in childhood-onset epilepsy and its impact on long-term prognosis. A population-based cohort of 150 children younger than age 16 years with new onset epilepsy between 1961 and 1964 residing in the catchment area of Turku University Hospital was observed prospectively until 1997. The occurrence of status epilepticus and recurrent (...) status epilepticus, risk factors for status epilepticus, and the impact of status epilepticus on prognosis were examined. Of the 150 cases, 41 patients (27%) experienced an episode of status epilepticus of whom 22 patients (56%) had two or more episodes. The risk of status epilepticus was highest at the onset of the disorder with 30 (73%) cases occurring before (n = 12) or at (n = 18) onset and 37 (90%) cases within 2 years of onset. On multivariable analysis, risk factors for status epilepticus

2002 Annals of Neurology

53669. Socioeconomic prognosis after a newly diagnosed unprovoked epileptic seizure in adults: a population-based case-control study. (PubMed)

Socioeconomic prognosis after a newly diagnosed unprovoked epileptic seizure in adults: a population-based case-control study. To investigate the socioeconomic prognosis after a newly diagnosed unprovoked epileptic seizure in adults.Sixty-three patients 17 years or older with a newly diagnosed unprovoked epileptic seizure from 1985 through 1987 and 107 sex- and age- matched controls were followed up for 10 years to 1996. Studied variables were income, source of income, sickness periods (...) during follow-up time. There was no difference between patients and controls regarding education.After a newly diagnosed unprovoked epileptic seizure in adults, no negative development regarding employment and education occurs. Income development is positive unless refractory seizures evolve. However, income is lower among patients with epilepsy than among controls, and this difference can be related to overall morbidity.

2002 Epilepsia

53670. Determining reliable cognitive change after epilepsy surgery: development of reliable change indices and standardized regression-based change norms for the WMS-III and WAIS-III. (PubMed)

Determining reliable cognitive change after epilepsy surgery: development of reliable change indices and standardized regression-based change norms for the WMS-III and WAIS-III. Reliable change indices (RCIs) and standardized regression-based (SRB) change scores norms were established for the recently revised Wechsler Adult Intelligence Scale-III (WAIS-III) and Wechsler Memory Scale-III (WMS-III) in patients with complex partial seizures. Establishment of such standardized change scores can (...) be useful in determining the effects of epilepsy surgery on cognitive functioning independent of test-retest artifacts including practice effects.Forty-two nonoperated-on adult patients with complex partial seizures (primarily of temporal lobe onset) were administered the WMS-III and WAIS-III on two occasions (mean 7-month interval). All patients were receiving stable antiepileptic drug (AED) treatment at both testings. RCI and SRB change scores were calculated. Confidence interval cutoff scores (90

2002 Epilepsia

53671. Midlife income, occupation, APOE status, and dementia: a population-based study. (PubMed)

Midlife income, occupation, APOE status, and dementia: a population-based study. To examine the relationship between socioeconomic factors and APOE carrier status on the development of dementia.Subjects were derived from random, population-based samples previously studied in surveys carried out in 1972, 1977, 1982, and 1987. After an average follow-up of 21 years, 1449 (73%) subjects aged 65 to 79 years were re-examined in 1998. The diagnosis of dementia among the nonparticipants was derived (...) from patient records of the local hospitals and primary health care clinics.Low income level at old age was related to dementia, but low income level at midlife was not a risk factor for dementia. Dementia was also associated with decreasing income level, from midlife to old age 21 years later, when dementia was diagnosed. A sedentary occupation (office, service, or intellectual work) was associated with a decreased risk for dementia among participants; however, when the nonparticipants were

2002 Neurology

53672. Use of lipid-lowering drugs in older adults with and without dementia: a community-based epidemiological study. (PubMed)

Use of lipid-lowering drugs in older adults with and without dementia: a community-based epidemiological study. To compare the use of lipid-lowering drugs in community-dwelling older adults with and without dementia.Comparison of lipid-lowering drug use by demented cases and nondemented controls based on secondary analysis of data from a longitudinal epidemiologic study.Longitudinal study of a largely rural, low- socioeconomic-status, community-based cohort of older persons residing in the mid (...) Clinical Dementia Rating (CDR).One hundred seventy participants (20.1% of total subject cohort) had dementia, with a CDR of 0.5 or greater. Mean ages of demented and nondemented individuals were 83.5 +/- 5.1 and 79.8 +/- 4.2, respectively. Similar proportions, 87.7% and 89.5%, of these groups reported PCP visits in the previous year. Of the total sample, 9.4% (3.5% of the demented and 10.8% of the nondemented) were taking lipid-lowering drugs. After adjustment for age, sex, education, visit with PCP

2002 Journal of the American Geriatrics Society

53673. Hoof kick injuries in unmounted equestrians. Improving accident analysis and prevention by introducing an accident and emergency based relational database. (Full text)

patients sustained contusions of the extremities, the back, and the trunk. In nine patients an isolated facial injury was diagnosed. Five of nine patients needed referrals to the department of plastic surgery because of the complexity of the facial soft tissue wounds. Three underwent maxillofacial surgery.Clinical: the equestrian community may underestimate the risk of severe injuries attributable to hoof kicks, especially while handling the horse. Educational lectures and the distribution (...) Hoof kick injuries in unmounted equestrians. Improving accident analysis and prevention by introducing an accident and emergency based relational database. To assess injury patterns attributable to horse kicks, to raise the issue of preventive measures, and to evaluate the role of modern accident and emergency department computer software.Data analysis using a new kind of full electronic medical record.Seventeen kicked equestrians were unmounted at the time of injury. Eight of seventeen

2002 Emergency Medicine Journal

53674. Definitions and competencies for practice-based learning and improvement. (PubMed)

Definitions and competencies for practice-based learning and improvement. The Outcome Project is a long-term initiative by which the Accreditation Council for Graduate Medical Education (ACGME) is increasing emphasis on educational outcomes in the evaluation of residency programs. The ACGME initiated the Outcome Project to "ensure and improve the quality of graduate medical education." In order to assist program directors in emergency medicine (EM) to begin complying with components (...) of the ACGME Outcome Project, the Council of Residency Directors in Emergency Medicine (CORD-EM) convened a consensus conference in March 2002 in conjunction with several other EM organizations. The working group for the competency of Practice-based Learning and Improvement (PBL) defined the components of PBL as: 1) analyze and assess practice experience and perform practice-based improvement; 2) locate, appraise, and utilize scientific evidence related to the patient's health problems and the larger

2002 Academic Emergency Medicine

53675. Systems-based practice: the sixth core competency. (PubMed)

, and case conferences. With appropriate integration and evaluation of this competency into training programs, it is likely that future generations of physicians and patients will reap the benefits of an educational system that is based on well-defined outcomes and a more systemic view of health care. (...) Systems-based practice: the sixth core competency. Systems-Based Practice (SBP) is the sixth competency defined by the Accreditation Council for Graduate Medical Education (ACGME) Outcome Project. Specifically, SBP requires "Residents [to] demonstrate an awareness of and responsiveness to the larger context and system of health care and the ability to effectively call on system resources to provide care that is of optimal value." This competency can be divided into four subcompetencies, all

2002 Academic Emergency Medicine

53676. Evaluating systems-based practice in emergency medicine. (PubMed)

Evaluating systems-based practice in emergency medicine. The Accreditation Council for Graduate Medical Education has required that training programs initiate an evaluation process to assess resident acquisition of the newly promulgated general competencies (GCs). Certain GCs (e.g., systems-based practice, problem-based learning and improvement) are somewhat more challenging to define and measure than others. Systems-based practice essentially captures the interactions of the emergency medicine (...) resident that expand beyond isolated contact with the patient. Evaluating these various interactions is readily accomplished using a detailed ordinal evaluation form that measures commonly occurring easily identified actions. Examples of measurable items and the method by which they can be integrated into an evaluation device are presented.

2002 Academic Emergency Medicine

53677. A population-based treat-to-target pharmacoeconomic analysis of HMG-CoA reductase inhibitors in hypercholesterolemia. (PubMed)

treat-to-target analysis on the use of monotherapy as first-line treatment, with combination therapy reserved for patients failing to achieve the target LDL-C levels of the US National Cholesterol Education Program Adult Treatment Panel II (NCEP ATP-II) with monotherapy. In the population-based treat-to-target analysis, atorvastatin was the most cost-effective drug for high-risk patients (those with coronary heart disease [CHD]), whereas fluvastatin was the most cost-effective agent for low-risk (...) A population-based treat-to-target pharmacoeconomic analysis of HMG-CoA reductase inhibitors in hypercholesterolemia. The 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors have become the drugs of choice for the treatment of patients with hypercholesterolemia. However, one of the major concerns with these drugs is cost. In an attempt to develop a cost-effective treatment strategy for patients referred to our lipid clinic, we conducted a meta-analysis to estimate the lipid

1999 Clinical therapeutics

53678. An evidence-based evaluation of EMS protocols. (PubMed)

An evidence-based evaluation of EMS protocols. To determine the extent to which prehospital patient care protocols incorporate the findings of the peer-reviewed scientific EMS literature.Using a computerized literature search, articles published from eight institutions known to be active in prehospital care research were identified and obtained from the local health sciences library. Animal or bench research, analysis of administrative practices, evaluation of educational or quality assurance

1999 Prehospital emergency care

53679. Written and computer-based self-help treatments for depression. (PubMed)

Written and computer-based self-help treatments for depression. Patients and health purchasers are demanding the provision of effective and accessible mental health treatments. Psychotherapeutic approaches are popular with patients, but access to specialist psychotherapy services is often limited. Other ways of offering treatment within the time and resources available to most practitioners need to be considered. One possible solution is the use of structured self-help materials that address (...) common mental disorders such as depression. Self-help treatments are available in a variety of formats such as books, CD-ROMS, audio and videotapes. Evidence exists for their effectiveness; however, a relatively neglected area has been a discussion of the educational aspects of such materials. Self-help materials aim to improve patient knowledge and skills in self-management. They require very clear educational goals and a content and structure that is appropriate for those who use them. Such work

2001 British medical bulletin

53680. The amalgam controversy. An evidence-based analysis. (PubMed)

The amalgam controversy. An evidence-based analysis. There are a number of patients and health care professionals who believe dental amalgam restorations are a factor in a host of diseases and conditions. They have been influenced by anecdotal case reports in the medical and dental literature, research published in the refereed literature and media stories concerning the alleged dangers of amalgam restorations.The author uses an evidence-based approach in analyzing the data both supporting (...) educate patients and other health care professionals who may be mistakenly concerned about amalgam safety.

2001 Journal of the American Dental Association

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