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NR 505 Advance Research Method: Evidence-based Practice
NR 505 Advance Research Method: Evidence-based Practice
- NR 505 Week 3 Assignment; Research Summary Table – Injuries of Children with Non-Helmet Use
- NR 505 Week 3 Assignment; Research Summary Table – Rodents and Associated Health Risks to Humans
Develop a research summary table on the issue you studied for the community committee. Follow the guidelines for this assignment located in Course Resources and submit your finished product to the Week 3 Dropbox
- NR 505 Week 5 Assignment; Critique of a Systematic Research Review
Critique a systematic research review related to bicycle safety or one of the issues identified in Week 1. Follow the guidelines for this assignment located in Course Resources and submit your finished product to the Week 5 Dropbox.
- NR 505 Week 7 Assignment; Analysis and Application of a Clinical Practice Guideline
Select (1) one of the issues identified in Week 1, (2) the bicycle safety issue, or (3) the surgical infection issue and find a very recent (no more than 5 years) clinical practice guideline related to that issue. Follow the guidelines for this assignment located in Course Resources and submit your finished product to the Week 7 Dropbox.
CPGs are systematically designed decision aids for service providers and patients that allow them to handle specific health problems in the most appropriate way possible.
Their goal is to make patient care better.
A comprehensive examination of the data and an assessment of the benefits and harms of different treatment choices influence their recommendations [191,221].
CPGs can be used to describe normative standards in many aspects of health care, including diagnosis, treatment, rehabilitation, and aftercare.
These health-care standards provide crucial information on the level of care that should be provided in a health-care system.
A important precondition for making conclusions about the quality of care in a health-care system is determining a health-care standard.
The identification and description of health-care standards using high-quality CPGs serves as the foundation for other scientific analyses, such as the establishment and updating of DMPs (see Section 5.3).
Similarly, gaps in health care and opportunities for improvement can be identified by comparing these criteria to specific health care organizations, processes, and outcomes (see Section 5.4).
This is referred to as a “health care analysis” in the following text.
This type of analysis allows for judgments on service quality and efficiency issues within the SHI framework (see 139a SGB V (3) No. 2).
The emphasis is on delivering a comprehensive picture of a condition.
Individual techniques or technologies may also be investigated, for example as a foundation for future evaluation in systematic reviews.
The goal is to present current (or lacking) health care standards to decision makers and other players in the health care system, and to compare them to the specific health care situation, depending on the research question, in order to enable well-founded decisions to improve the quality of care in the health care system.
Go to: 5.2. Clinical practice guidelines for the identification of health-care standards
5.2.1. Clinical practice guidelines include health-care standards.
Medical practice that is recognized in the profession based on medical and scientific facts and/or clinical experience is regarded as a medical standard [248].
A CPG is a method of scientifically and institutionally establishing a medical standard.
In our department’s reports, evidence-based CPGs are frequently used to answer queries about health-care standards.
Evidence-based CPGs are those whose recommendations are based on a systematic literature search and are linked to a level of evidence (LoE) and/or grade of recommendation (GoR), as well as citations of the underlying primary and/or secondary literature (modified according to AGREE27 [4]).
A CPG that is evidence-based does not assume that each suggestion is linked to a high LoE.
In general, recommendations based on a weak evidence base are included in CPGs that were created consistently and publicly, and so are evidence-based [557].
5.2.2. Evaluation of clinical practice guidelines from a methodological standpoint
The steps specified in Chapter 7 are followed for retrieving information.
On a global scale, many methods are utilized to assess the methodological quality of CPGs [577].
The AGREE instrument [4,374] and its upgraded version, AGREE II [5,72-74], were created and validated by a network of researchers and health policymakers, and are the most widely used instruments worldwide.
The DELB28 instrument, developed by the Association of Scientific Medical Professional Societies (AWMF29) and the Agency for Quality in Medicine (ZQ30), is based on the AGREE Collaboration’s appraisal tool.
AGREE is utilized as a norm in the Institute’s methodological review of CPGs to simplify any future comparisons between the results of a CPG appraisal by the Institute and CPG appraisals reported in other research.
The Institute is actively involved in the DELB instrument’s continued development.
The Institute specifies a priori whether a methodological appraisal of CPGs with the AGREE instrument shall be done on the basis of a research topic when creating the report plan [5].
This tool is made up of 23 important things that are rated on a scale and arranged into six domains.
Each domain focuses on a different aspect of CPG quality:
Domain 1 is about the scope and aim of the project.
Stakeholder involvement is the second domain.
Domain three: development rigor
Domain 4: presentation and clarity
Applicability is the fifth domain.
Editorial independence is the sixth domain.
Each CPG appraisal is carried out by two evaluators who work independently of one another.
A. Domain ratings that are standardized
Because domain scores are independent of one another, cumulative scores for each CPG are calculated independently for each domain.
A normalization of the calculated domain scores is performed as described in the AGREE instrument for better comparison between domains.
As the reports, these are given in tables.
The instrument does not allow for domain assessment thresholds to be specified.
Individual standardized domain ratings, on the other hand, can be used to compare CPGs.
B. Evaluation of the methodological quality of clinical practice recommendations as a whole
The AGREE instrument [5] can be used to do an overall assessment of CPG quality in addition to calculating the standardized domain scores according to the processes stated in the report plan.
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