The effects of a pediatric unilateral inguinal hernia clinical pathway on quality and cost

Application of the APSA evidence-based guidelines for isolated liver or spleen injuries: a single institution experience

“…There have been several recent examples in the pediatric surgical literature demonstrating their safety and efficacy. [4][5][6] In 2000, Stylianos and the APSA Trauma Committee published evidence-based guidelines for the care of hemodynamically stable children with isolated liver or spleen injuries. 7 This was first shown to be safe and efficacious in a multicenter trial published in 2002.…”

Quality assessment of economic evaluation studies in pediatric surgery: A systematic review

“…For inguinal hernia, the cost of surgical management may be reduced by better selection of patients [16]. Furthermore, systematic pathological analysis of inguinal hernia sacs increased the cost of surgery (by $21.41 per specimen) [17].…”

Are the outcomes of clinical pathways evidence‐based? A critical appraisal of clinical pathway evaluation research

“…In half of the study sample (49.6%), the inclusion and exclusion criteria of patients were obscure and difficult to relate to the population’s characteristics. According to our findings, only 12 retrospective studies (10.4%) controlled for selection bias by matching, out of which three studies matched a random sample from a clinical pathway group with controls from the pre‐pathway period group [25,30,48,50,58,79,81,107,110,111,122,129].…”

“…In relation to the internal and external validity of the studies in the sample, our analysis revealed several factors that influenced the quality of clinical pathway evaluation. Most studies in our sample concerned non-randomly selected small patient populations without a power analysis [19,23,25,36,52,54,56,58,59,61,76,81,[86][87][88]91,99,107,111,118,122,123,126,128].…”

“…We detected 12 retrospective studies (10.4%) that controlled for confounding through matching, of which three studies used a random sample from a clinical pathway group which was matched with controls from the pre-pathway period [25,30,48,50,58,79,81,107,110,111,122,129]. Furthermore, 10 randomized controlled studies were found, of which two studies randomly assigned hospitals either to implement a clinical pathway or to remain on standard care [45,127].…”