Monday, September 13, 2010

[EQ] Expediting systematic reviews: methods and implications of rapid reviews

Expediting systematic reviews: methods and implications of rapid reviews

Rebecca Ganann , Donna Ciliska  and Helen Thomas

School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, Canada

Implementation Science 2010, 5:56doi:10.1186/1748-5908-5-56

Available online at: http://bit.ly/atsQtZ

“….Policy makers and others often require synthesis of knowledge in an area within six months or less. Traditional systematic reviews typically take at least 12 months to conduct. Rapid reviews streamline traditional systematic review methods in order to synthesize evidence within a shortened timeframe. There is great variation in the process of conducting rapid reviews.
This review sought to examine methods used for rapid reviews, as well as implications of methodological streamlining in terms of rigour, bias, and results.

Methods

A comprehensive search strategy--including five electronic databases, grey literature, hand searching of relevant journals, and contacting key informants--was undertaken. All titles and abstracts (n = 1,989) were reviewed independently by two reviewers. Relevance criteria included articles published between 1995 and 2009 about conducting rapid reviews or addressing comparisons of rapid reviews versus traditional reviews. Full articles were retrieved for any titles deemed relevant by either reviewer (n = 70). Data were extracted from all relevant methodological articles (n = 45) and from exemplars of rapid review methods (n = 25).

Results

Rapid reviews varied from three weeks to six months; various methods for speeding up the process were employed. Some limited searching by years, databases, language, and sources beyond electronic searches. Several employed one reviewer for title and abstract reviewing, full text review, methodological quality assessment, and/or data extraction phases. Within rapid review studies, accelerating the data extraction process may lead to missing some relevant information. Biases may be introduced due to shortened timeframes for literature searching, article retrieval, and appraisal.

Conclusions

This review examined the continuum between diverse rapid review methods and traditional systematic reviews. It also examines potential implications of streamlined review methods. More of these rapid reviews need to be published in the peer-reviewed literature with an emphasis on articulating methods employed. While one consistent methodological approach may not be optimal or appropriate, it is important that researchers undertaking reviews within the rapid to systematic continuum provide detailed descriptions of methods used and discuss the implications of their chosen methods in terms of potential bias introduced. Further research comparing full systematic reviews with rapid reviews will enhance understanding of the limitations of these methods.

Objectives

1. What are the methods used for rapid review?

2. Are there any comparisons of rapid versus traditional review methods for the same topic?

3. What are the implications of taking methodological shortcuts from a traditional Cochrane review? What biases increase?



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[EQ] A Snapshot of Medical Student Education in the United States and Canada: Reports from 128 Schools

A Snapshot of Medical Student Education in the United States and Canada:
Reports from 128 Schools

Academic Medicine - September 2010 - Volume 85 - Issue 9 - p S1

Available online at: http://bit.ly/aasIhQ

“………This “Snapshot of Medical Student Education in the United States and Canada,” published as a supplement to the September 2010 issue of Academic Medicine, comes at an important time. It is the 100th anniversary of the release of the Flexner Report, and it has been 10 years since the publication of the first “Snapshot” in a supplement to the September 2000 issue of the journal. As such, this collection of reports has value for both contemporary readers and future historians.

First, the reports are structured to facilitate comparison between the medical student education programs described in the present collection and those described in the 2000 collection, and also to compare the current programs with one another.

Second, both this collection and the one published in 2000 are comprehensive. They include reports from almost every accredited medical education program leading to the MD degree in the United States and Canada.

Third, the reports offer an important picture of advances, innovations, and initiatives in these medical student education programs that can help contemporary readers understand the status of medical student education today, and that can help current and future historians gauge progress over the last decade and century.

Fourth, the reports reveal important similarities and differences among medical student education programs. For example, some schools have specially-designed experiences in research (often called “scholarly concentrations”), while other schools offer students key clinical experiences in rural settings. Some schools have traditional clerkships, while others have longitudinal ones. Several schools have added buildings devoted to medical student education, and many have integrated ethics into the curriculum as a required component. Many schools are expanding their educational programs to additional campuses, and new medical schools are establishing their own innovative educational programs. This set of reports provides ready access to this information.

Fifth, the reports include information on the governance and management structure of educational programs, which situates the curriculum within the context of a school and provides key insights about how decisions are made…….”     [Kanter, Steven L. MD]

Content:

 

Foreword

Medical Education in the U.S. and Canada, 2010

Flexner and Medical Education Reform

Calls for Change in Medical Education

Competing Models of Competence Development

The 21st Century Faculty Member

Preparing Medical Students to Improve Health Care

The Reports: United States: Alabama

The Reports: United States: Arizona

The Reports: United States: Arkansas

The Reports: United States: California

The Reports: United States: Colorado

The Reports: United States: Connecticut

The Reports: United States: District of Columbia

The Reports: United States: Florida

The Reports: United States: Georgia

The Reports: United States: Hawaii

The Reports: United States: Illinois

The Reports: United States: Indiana

The Reports: United States: Iowa

The Reports: United States: Kansas

The Reports: United States: Kentucky

The Reports: United States: Louisiana

The Reports: United States: Maryland

The Reports: United States: Massachusetts

The Reports: United States: Michigan

The Reports: United States: Minnesota

The Reports: United States: Missouri

The Reports: United States: Nebraska

The Reports: United States: Nevada

The Reports: United States: New Hampshire

The Reports: United States: New Jersey

The Reports: United States: New Mexico

The Reports: United States: New York

The Reports: United States: North Carolina

The Reports: United States: North Dakota

The Reports: United States: Ohio

The Reports: United States: Oklahoma

The Reports: United States: Oregon

The Reports: United States: Pennsylvania

The Reports: United States: Puerto Rico

The Reports: United States: Rhode Island

The Reports: United States: South Carolina

The Reports: United States: Tennessee

The Reports: United States: Texas

The Reports: United States: Utah

The Reports: United States: Vermont

The Reports: United States: Virginia

The Reports: United States: Washington

The Reports: United States: West Virginia

The Reports: United States: Wisconsin


The Reports: Canada: Alberta

The Reports: Canada: British Columbia

The Reports: Canada: Nova Scotia

The Reports: Canada: Ontario

The Reports: Canada: Quebec


Glossary



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This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
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Website: http://journals.lww.com/academicmedicine/toc/2010/09001

 

Skip Navigation LinksSeptember 2010 - Volume 85 - Issue 9

 

 

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[EQ] International benchmarking of specialty hospitals. A series of case studies on comprehensive cancer centres

International benchmarking of specialty hospitals.
A series of case studies on comprehensive cancer centres

Wineke AM van Lent , Relinde D de Beer  and Wim H van Harten

A Division of Psychosocial Research and Epidemiology Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital –Amsterdam The Netherlands

B Ministry of Health, Welfare and Sport, The Hague The Netherlands

C Department of Health Technology Services Research School of Management and Governance University of Twente, Enschede, The Netherlands

BMC Health Services Research – August 2010, 10:253doi:10.1186/1472-6963-10-253

Available online PDF [28p.] at: http://bit.ly/aaC5ua

Benchmarking is one of the methods used in business that is applied to hospitals to improve the management of their operations. International comparison between hospitals can explain performance differences. As there is a trend towards specialization of hospitals, this study examines the benchmarking process and the success factors of benchmarking in international specialized cancer centres.

Methods

Three independent international benchmarking studies on operations management in cancer centres were conducted.
The first study included three comprehensive cancer centres (CCC), three chemotherapy day units (CDU) were involved in the second study and four radiotherapy departments were included in the final study.
Per multiple case study a research protocol was used to structure the benchmarking process.
After reviewing the multiple case studies, the resulting description was used to study the research objectives.

Results

We adapted and evaluated existing benchmarking processes through formalizing stakeholder involvement and verifying the comparability of the partners. We also devised a framework to structure the indicators to produce a coherent indicator set and better improvement suggestions. Evaluating the feasibility of benchmarking as a tool to improve hospital processes led to mixed results. Case study 1 resulted in general recommendations for the organizations involved. In case study 2, the combination of benchmarking and lean management led in one CDU to a 24% increase in bed utilization and a 12% increase in productivity. Three radiotherapy departments of case study 3, were considering implementing the recommendations. Additionally, success factors, such as a well-defined and small project scope, partner selection based on clear criteria, stakeholder involvement, simple and well-structured indicators, analysis of both the process and its results and, adapt the identified better working methods to the own setting, were found.

Conclusions

The improved benchmarking process and the success factors can produce relevant input to improve the operations management of specialty hospitals.

 

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This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics;
Information Technology - Virtual libraries; Research & Science issues.  [DD/ KMC Area]

“Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings
and interpretations included in the Materials are those of the authors and not necessarily of The Pan American
Health Organization PAHO/WHO or its country members”.
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