Original Research

Abrahamson, Kathleen; Fox, Rebekah L.; Doebbeling, Bradley N.

doi:10.1097/01.naj.0000415957.46932.bf

Cited by 87 publications

(22 citation statements)

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“…One of the most commonly reported barriers to use of PROs or implementation of other best practice guidelines is a perception of the burden of time required to do so properly [8,9]. The original NDI comprises 10 domains, each with 6 statements that are to be read by the respondent, who then chooses the one statement that most closely represents his/her current functional status within each domain.…”

Section: Introductionmentioning

confidence: 99%

A brief 5-item version of the Neck Disability Index shows good psychometric properties

Walton

MacDermid

2013

Health Qual Life Outcomes

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BackgroundThe purpose of this secondary analysis of clinical databases of people with neck pain was to use a mixed unique conceptual and statistical approach to develop a brief version of the Neck Disability Index (NDI).MethodsAn a priori framework of neck-related function based on the International Classification of Functioning, Disability and Health was used to identify items from the original 10-item NDI that do not conceptually fit. Remaining items were subject to Rasch analysis to identify items that did not statistically fit with axioms of quantitative measurement. Finally, approaches drawn from classical test theory were used to compare stability, responsiveness and concurrent validity of the original NDI, the new brief NDI and the linearly-transformed brief NDI.ResultsConceptual analysis identified 3 items that did not fit with the construct of self-reported ability to perform activity: pain intensity, headache, and sleeping. These items were removed, and responses to the remaining 7 items drawn from an assembled database of 316 physiotherapy patients with neck pain were subject to Rasch analysis. Two items were removed due to either considerable differential item functioning (reading) or statistical redundancy (lifting). The remaining items were considered the NDI-5. Test-retest reliability, responsiveness, sensitivity to change, and concurrent validity were all comparable across the original NDI, NDI-5 and linearly-transformed NDI-5. Sensitivity to change over a 1-month period of physiotherapy was the notable exception, where the linearly-transformed NDI-5 showed superiority over the other two forms.ConclusionsA shortened version of the NDI, the NDI-5, has been constructed that is conceptually and statistically sound. Implications for research and clinical practice are discussed. Comparison with the NDI-8 is provided that suggests overall similar function across the forms, although the latter may be more sensitive to change.

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Section: Introductionmentioning

confidence: 99%

A brief 5-item version of the Neck Disability Index shows good psychometric properties

Walton

MacDermid

2013

Health Qual Life Outcomes

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“…A 2015 summary of systematic reviews of the impact of AH care on stroke rehabilitation outcomes showed significant economic benefits [ 12 ]. Key barriers to implementing evidence-based AH rehabilitation in SA are similar to those reported in high-income countries (for instance lack of workforce, training, support, resources and recognition of effort) [ 8 , 9 , 13 ]. However, there are also unique SA-context facilitators which mediate some of these barriers to improve AH rehabilitation, including the innovative use of resources and informal AH rehabilitation networks with the common goal of improving functioning and quality of life [ 13 ].…”

Section: Introductionmentioning

confidence: 71%

“…Much of this research has focused on why so much difficulty is experienced by policy-makers, managers and clinicians in implementing evidence into practice [ 6 ]. Across health disciplines, there are generally positive attitudes to using evidence in practice, and despite discipline-differences in competencies and scope of practice, similar reasons emerge for not actually doing so [ 7 , 8 ]. Commonly, these are lack of time, ready access to CPGs, understanding about different forms of evidence recommendations (e.g.…”

Section: Introductionmentioning

confidence: 99%

Standardising evidence strength grading for recommendations from multiple clinical practice guidelines: a South African case study

et al. 2018

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BackgroundSignificant resources are required to write de novo clinical practice guidelines (CPGs). There are many freely-available CPGs internationally, for many health conditions. Developing countries rarely have the resources for de novo CPGs, and there could be efficiencies in using CPGs developed elsewhere. This paper outlines a novel process developed and tested in a resource-constrained country (South Africa) to synthesise findings from multiple international CPGs on allied health (AH) stroke rehabilitation.MethodsMethodologists, policy-makers, content experts and consumers collaborated to describe the pathway of an ‘average’ stroke patient through the South African public healthcare system and pose questions about best-practice stroke rehabilitation along this pathway. A comprehensive search identified international guidance documents published since January 2010. These were scanned for relevance to the South African AH stroke rehabilitation questions and critically appraised for methodological quality. Recommendations were extracted from guidance documents for each question. Strength of the body of evidence (SoBE) gradings underpinning recommendations were standardised, and composite recommendations were developed using qualitative synthesis. An algorithm was developed to guide assignment of overall SoBE gradings to composite recommendations.ResultsSixteen CPGs were identified, and all were included, as they answered different project questions differently. Methodological quality varied and was unrelated to currency. Seven clusters, outlining 20 composite recommendations were proposed (organise for best practice rehabilitation, operationalise strategies for best practice communication throughout the patient journey, admit to an acute hospital, refer to inpatient rehabilitation, action inpatient rehabilitation, discharge from inpatient rehabilitation and longer-term community-based rehabilitation).ConclusionThe methodological development process, tested by writing a South African AH stroke rehabilitation guideline from existing evidence sources, took 9 months. The process was efficient, collaborative, effective, rewarding and positive. Using the proposed methods, similar synthesis of existing evidence could be conducted in shorter time periods, in other resource-constrained countries, avoiding the need for expensive and time-consuming de novo CPG development.Electronic supplementary materialThe online version of this article (10.1186/s13012-018-0803-0) contains supplementary material, which is available to authorized users.

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“…It is known that not only the content is important for delivering proper care, but the protocol must be feasible and have a clear structure for the direct caregivers as well [ 19 ]. Improved compliance with protocols is found if there are comprehensive protocols, especially if nurses are involved in the development of these protocols [ 1 ]. In our study the structure of the studied protocols differed greatly whereas the TH scored lower than the other two types of hospitals.…”

Section: Discussionmentioning

confidence: 99%

From Postpartum Haemorrhage Guideline to Local Protocol: A Study of Protocol Quality

Woiski

Vugt

Dijkman

et al. 2016

Matern Child Health J

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Objective Postpartum hemorrhage (PPH) has a continuously rising incidence worldwide, suggesting suboptimal care. An important step in optimizing care is the translation of evidence-based guidelines into comprehensive hospital protocols. However, knowledge about the quality of these protocols is lacking. The objective of this study was to evaluate the quality of PPH-protocols on structure and content in the Netherlands. Methods We performed an observational multicenter study. Eighteen PPH-protocols from 3 University Hospitals (UH), 8 Teaching Hospitals (TH) and 7 Non-Teaching hospitals (NTH) throughout the Netherlands were acquired. The structure of the PPH-protocols was assessed using the Appraisal of Guidelines for Research and Evaluation (AGREE-II) Instrument. The content was appraised using previously developed quality indicators, based on international guidelines and Advance-Trauma-Life-Support (ATLS)-based course instructions. Results The quality of the protocols for postpartum hemorrhage for both structure and content varied widely between different hospitals, but all of them showed room for improvement. The protocols scored mainly below average on the different items of the AGREE-II instrument (8 of the 10 items scored <4 on a 1–7 scale). Regarding the content, adoption of guideline recommendations in protocols was 46 %. In addition, a timely indication of ‘when to perform’ a recommendation was lacking in three-fourths of the items. Conclusion This study shows that the quality of the PPH-protocols for both structure and content in the Netherlands is suboptimal. This makes adherence to the guideline and ATLS-based course instructions difficult.

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Original Research

Cited by 87 publications

References 0 publications

A brief 5-item version of the Neck Disability Index shows good psychometric properties

A brief 5-item version of the Neck Disability Index shows good psychometric properties

Standardising evidence strength grading for recommendations from multiple clinical practice guidelines: a South African case study

From Postpartum Haemorrhage Guideline to Local Protocol: A Study of Protocol Quality

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