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The EVIDEM framework and its usefulness for priority setting across a broad range of health interventions
Sitaporn Youngkong, Noor Tromp, Dereck Chitama
Cost Effectiveness and Resource Allocation , 2011, DOI: 10.1186/1478-7547-9-8
Abstract: Goetghebeur et al [1] propose that the EVIDEM can be used to compare various interventions across disease areas in order to prioritize interventions. They suggest that the EVIDEM can analyze single interventions, and the performance of competing interventions can subsequently be compared in a performance matrix. While we value the qualities of the EVIDEM because of its scope and breadth, we have doubts on the results consistency of the EVIDEM to compare competing interventions, particularly when setting priorities across broad healthcare service areas (e.g. in designing the national health benefit package) for two main reasons.First, the EVIDEM framework ignores the contextual nature of priority setting process by assuming a set of universal priority setting criteria [2]. In reality, the priority setting process is context specific and different sets of criteria lead priority setting of health interventions in different contexts. As the examples of studies in Nepal [3], Chile [4], and Ghana [5] show, the set of criteria identified for using in priority setting of health interventions were different between countries. Therefore, we suggest that the setting of prioritization criteria needs to be locally determined or verified, implying that the EVIDEM needs to be flexible to allow change/modification of the components to suit the local context.Secondly, the EVIDEM is vulnerable to interventions ranking inconsistency where performance evaluation of a broad range of competing interventions is mandated. For example, the EVIDEM framework requires different expert panels to assess the performance of every single intervention separately. This may lead to inconsistency of the results as different expert panels may have different considerations across the broad range of interventions to be assessed. As shown in the EVIDEM Turner Syndrome case study [1], the panel of experts estimated growth hormone intervention to achieve 41% of maximum value. However, in the absence of estab
The EVIDEM framework and its usefulness for priority setting across a broad range of health interventions
Sitaporn Youngkong, Noor Tromp, Dereck Chitama
Cost Effectiveness and Resource Allocation , 2011, DOI: 10.1186/1478-7547-9-16
Abstract: The explicit weighing of criteria analyzed from DCE may improve the consistency of priority setting across contexts and over time, but does not solve the more fundamental problem that views of stakeholders, and therefore their expressed weights, may diverge. This is acknowledged by the 'Accountability for Reasonableness' (A4R) framework [2,3] which is based on the believe that any consensus on priority setting weights and subsequent results may be difficult to achieve because of these distinct perspectives of stakeholders. Instead of attempting to resolve the problem of diverse stakeholders' views, the A4R framework proposes to concentrate on a fair priority setting process. On this basis, when conditions of reasonableness, publicity, appeal and enforcement are satisfied, it would lead to decisions that are considered fair and acceptable to stakeholders. In our view, exploring how stakeholders' divergent perspectives on the weighting of criteria can be met fairly, is an object for further research.We regret any inconvenience that these corrections might have caused.
From papers to practices: district level priority setting processes and criteria for family planning, maternal, newborn and child health interventions in Tanzania
Dereck Chitama, Rob Baltussen, Evert Ketting, Switbert Kamazima, Anna Nswilla, Phares GM Mujinja
BMC Women's Health , 2011, DOI: 10.1186/1472-6874-11-46
Abstract: We conducted an exploratory study mixing both qualitative and quantitative methods to capture and analyse the priority setting for FMNCH at district level, and identify the criteria for priority setting. We purposively sampled the participants to be included in the study. We collected the data using the nominal group technique (NGT), in-depth interviews (IDIs) with key informants and documentary review. We analysed the collected data using both content analysis for qualitative data and correlation analysis for quantitative data.We found a number of shortfalls in the district's priority setting processes and criteria which may lead to inefficient and unfair priority setting decisions in FMNCH. In addition, participants identified the priority setting criteria and established the perceived relative importance of the identified criteria. However, we noted differences exist in judging the relative importance attached to the criteria by different stakeholders in the districts.In Tanzania, FMNCH contents in both general development policies and sector policies are well articulated. However, the current priority setting process for FMNCH at district levels are wanting in several aspects rendering the priority setting process for FMNCH inefficient and unfair (or unsuccessful). To improve district level priority setting process for the FMNCH interventions, we recommend a fundamental revision of the current FMNCH interventions priority setting process. The improvement strategy should utilize rigorous research methods combining both normative and empirical methods to further analyze and correct past problems at the same time use the good practices to improve the current priority setting process for FMNCH interventions. The suggested improvements might give room for efficient and fair (or successful) priority setting process for FMNCH interventions.The importance of reproductive health (RH- see appendix, footnote 1) is well recognized [1-3] and articulated in the Programme of A
XXI Congreso ACMI-ACP: Resolviendo controversias y paradigmas - Papel del internista XXI ACMI-ACP Congress: Solving controversies and paradigms - Role of the internist
Dereck De La Rosa Barranco
Acta Medica Colombiana , 2007,
Tools for Attacking Layer 2 Network Infrastructure
Kai-Hau Yeung,Dereck Fung,Kin-Yeung Wong
Lecture Notes in Engineering and Computer Science , 2008,
Impact of a computerized system for evidence-based diabetes care on completeness of records: a before–after study
Pavel S Roshanov, Hertzel C Gerstein, Dereck L Hunt, Rolf J Sebaldt, R. Brian Haynes
BMC Medical Informatics and Decision Making , 2012, DOI: 10.1186/1472-6947-12-63
Abstract: Using a before–after study design we analyzed the medical record of approximately 10 patients from each of 3 diabetes specialists (total?=?31) who were seen both before and after the implementation of a CDMS. We used a checklist of key clinical data to compare the completeness of information recorded in the CDMS record to both the clinical note sent to the primary care physician based on that same encounter and the clinical note sent to the primary care physician based on the visit that occurred prior to the implementation of the CDMS, accounting for provider effects with Generalized Estimating Equations.The CDMS record outperformed by a substantial margin dictated notes created for the same encounter. Only 10.1% (95% CI, 7.7% to 12.3%) of the clinically important data were missing from the CDMS chart compared to 25.8% (95% CI, 20.5% to 31.1%) from the clinical note prepared at the time (p?<?0.001) and 26.3% (95% CI, 19.5% to 33.0%) from the clinical note prepared before the CDMS was implemented (p?<?0.001). There was no significant difference between dictated notes created for the CDMS-assisted encounter and those created for usual care encounters (absolute mean difference, 0.8%; 95% CI, ?8.5% to 6.8%).The CDMS chart captured information important for the management of diabetes more often than dictated notes created with or without its use but we were unable to detect a difference in completeness between notes dictated in CDMS-associated and usual-care encounters. Our sample of patients and providers was small, and completeness of records may not reflect quality of care.
Bibliometría: conceptos y utilidades para el estudio médico y la formación profesional
Dávila Rodríguez,Manuel; Guzmán Sáenz,Roberto; Macareno Arroyo,Hugo; Pi?eres Herera,Denia; de la Rosa Barranco,Dereck; Caballero-Uribe,Carlo V;
Revista Salud Uninorte , 2009,
Abstract: the growth of scientific research in recent times has needed the development and application of various indicators to help measure the importance of research for the scientific community. in the training of general practitioners and medical's resident, there is often a lack or deficit in handling issues concerning the production, management and publication of scientific information, these issues leads to loss of ideas an projects, which are in many libraries and research labs of universities, waiting to become part of the intellectual development in training or to contribute knowledge beyond the scientific and medical community worldwide. one of the main issues of vital importance to anyone interested in the scientific output, research result in medical journals indexed on databases, which determine the quality of work, is their access as a source of truthful information or as a means ofpublication; this is of great importance to bibliometrics. it is tangible and objective to makes the quality and quantity of scientific production to necessary use bibliometrics as a tool to achieve a measurable outcome of the scientific literature. therefore, a revision is made in the medical literature on the importance of bibliometrics, its history, its concepts and applications, in addition to its technical and bibliometric indicators in order to illustrate and provide incentives to doctors in training to understand the world of production and scientific publication.
Guía práctica para publicar un artículo en revistas latinoamericanas
Mantilla-Villarreal,Andrea; Medina Fontalvo,Jorge; Velasco-Bayuelo,Carlos A; Algarín Gregory,Jorge; Rodelo-Salcedo,Eduardo; de la Rosa Barranco,Dereck; Caballero-Uribe,Carlo V;
Revista Salud Uninorte , 2010,
Abstract: the process of investigation only finish when the researcher publish an article with the results of the investigation. latin american people believe this is a hard work, that′s why there are few people who make research and a little less who ends publishing it successfully. we made a systematic revision on the principal available databases (pub-med, ovid, cochrane, etc) using as keywords “scientific articles”, “how to write” and “scientific papers”, 50 articles published between 2.000 and 2.009 were chosen to obtain the correct information to describe the most important elements of a scientific paper, the correct way to do it and the most common mistakes people makes frequently. this article offers to students, residents and physicians, practical advises for a successful publishing and at the end, acquire local, national and international recognition as an expert researcher.
Bases de datos, motores de búsqueda e índices temáticos: herramientas fundamentales para el ejercicio médico
Castrillón-Estrada,Jaime A; García Domínguez,Juan Camilo; Anaya Taboada,Marco; Rodríguez Berdugo,Deisy; de la Rosa Barranco,Dereck; Caballero-Uribe,Carlo V;
Revista Salud Uninorte , 2008,
Abstract: dissemination of internet has changed traditional ways to transmit and acquire knowledge in every division; medicine, as a signature of constant challenges has not been isolated from this technology. atter advent of informatics, biological and medical sciences have found an efficient way for knowledge globalization. this has improved the training and actualization of medical students and physicians; creating the urge to raise the efficiency of these channels of communication. with the aim to facilitate the access to scientific information through informatics ways, platforms have been developed to compile the information in form of databases, which can be access through other emerging technology such as search engines. each web site has specific characteristics with strengths and weaknesses associated to them; medical students as well as physicians must be aware of this fact to properly take advantage of their use.
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