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Kårelind F, Finkel D, Zarit SH, Wijk H, Bielsten T, Johansson L. Post-diagnostic support for persons with young-onset dementia - a retrospective analysis based on data from the Swedish dementia registry SveDem. BMC Health Serv Res 2024; 24:649. [PMID: 38773535 PMCID: PMC11110303 DOI: 10.1186/s12913-024-11108-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 05/14/2024] [Indexed: 05/24/2024] Open
Abstract
BACKGROUND Approximately 3.9 million persons worldwide have young-onset dementia. Symptoms related to young-onset dementia present distinct challenges related to finances, employment, and family. To provide tailored support, it is important to gain knowledge about the formal support available for persons with young-onset dementia. Therefore, this paper aims to describe formal support for persons with young-onset dementia in Sweden and the factors influencing this support. METHODS This retrospective study used data on persons under 65 years of age (n = 284) from The Swedish Registry for Cognitive/Dementia Disorders (SveDem) between 2021 and 2022. SveDem was established to monitor the quality of dementia care in Sweden. Characteristics of participants were obtained, including age, sex, dementia diagnosis, MMSE, medications, accommodation, and care setting. Descriptive statistics and logistic regression were used to test for associations between participant characteristics and post-diagnostic support. RESULTS Information and educational support were usually offered to the person with young-onset dementia (90.1%) and their family (78.9%). Approximately half of the sample were offered contact with a dementia nurse (49.3%), counsellor (51.4%), or needs assessor (47.9%). A minority (28.5%) were offered cognitive aids. Six regression models were conducted based on participant characteristics to predict the likelihood that persons were offered support. Support was not predicted by age, sex, children at home, accommodation, or medications. Lower MMSE scores (p < .05) and home help (p < .05) were significantly associated with offer of a needs assessor. Living together was a significant predictor (p < .01) for information and educational support offered to the family. Care setting significantly predicted (p < .01) an offer of information and educational support for the person and family members, as well as contact with a counsellor. CONCLUSION This study indicates potential formal support shortages for persons with young-onset dementia in some areas of dementia care. Despite equal support across most characteristics, disparities based on care setting highlight the importance of specialised dementia care. Pre-diagnostic support is minimal, indicating challenges for persons with young-onset dementia to access these services before diagnosis. While our study has identified areas in need of improvement, we recommend further research to understand the changing support needs of those with young-onset dementia.
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Affiliation(s)
- Fanny Kårelind
- Studies on Integrated Health and Welfare (SIHW), Institute of Gerontology, School of Health and Welfare, Jönköping University, Jönköping, Sweden.
| | - Deborah Finkel
- Studies on Integrated Health and Welfare (SIHW), Institute of Gerontology, School of Health and Welfare, Jönköping University, Jönköping, Sweden
- Center for Economic and Social Research, University of Southern California, Los Angeles, USA
| | - Steven H Zarit
- Institute of Gerontology, School of Health and Welfare, Jönköping University, Jönköping, Sweden
- Department of Human Development and Family Studies, Penn State University, University Park, USA
| | - Helle Wijk
- Institute of Health and Care Science, The Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden
- Department of Architecture and Civil Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Therese Bielsten
- Studies on Integrated Health and Welfare (SIHW), Institute of Gerontology, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Linda Johansson
- Studies on Integrated Health and Welfare (SIHW), Institute of Gerontology, School of Health and Welfare, Jönköping University, Jönköping, Sweden
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Palmér S, Blomqvist C, Holmqvist M, Lindman H, Lambe M, Ahlgren J. Validation of primary and outcome data quality in a Swedish population-based breast cancer quality registry. BMC Cancer 2024; 24:329. [PMID: 38468209 PMCID: PMC10926626 DOI: 10.1186/s12885-024-12073-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 02/29/2024] [Indexed: 03/13/2024] Open
Abstract
BACKGROUND Population-based cancer quality registries are of great importance for the improvement of cancer care. However, little is known about the quality of recurrence data in cancer quality registries. The aim of this study was to evaluate data quality in the regional Breast Cancer Quality Registry of Central Sweden, with emphasis on the validity of recorded information on recurrence. METHODS Validation by re-abstraction was performed on a random sample of 800 women with primary invasive breast cancer stage I-III diagnosed between 1993 and 2010, of which 400 had at least one registered recurrence and 400 had no registered recurrence. Registry data were compared with data from medical records. Exact agreement, correlation and kappa values, sensitivity and specificity were calculated. RESULTS Seven hundred forty-seven women (93%) were available for analysis. Exact agreement was high for diagnostics, tumor characteristics, surgery, and adjuvant oncological treatment (90% or more for most variables). The registry's sensitivity was low for regional recurrence (47%), but higher for local and distant recurrence (80% and 75%), whereas specificity was overall high (≥ 95%). Combining all recurrence categories irrespective of localization improved sensitivity to 90% with a specificity of 91%. In 87% of women, the date of first recurrence according to medical records fell within ± 90 days of the date recorded in the registry. CONCLUSIONS While the quality of data in the regional Breast Cancer Quality Registry was generally high, data accuracy on recurrences was lower. The overall precision of identifying any recurrence, irrespective of localization, was high. However, the accuracy of classification of recurrences (local, regional or distant) was lower, with evidence of underreporting for each of the recurrence categories. Given the importance of recurrence-related outcomes in the assessment of quality of care, efforts should be made to improve the reporting of recurrences.
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Affiliation(s)
- Sofia Palmér
- Department of Oncology, Faculty of Medicine and Health, Örebro University Hospital, Örebro University, Örebro, SE-70182, Sweden.
| | - Carl Blomqvist
- Department of Oncology, Faculty of Medicine and Health, Örebro University Hospital, Örebro University, Örebro, SE-70182, Sweden
- Comprehensive Cancer Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Marit Holmqvist
- Regional Cancer Center Central Sweden, Uppsala University Hospital, Uppsala, Sweden
| | - Henrik Lindman
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Mats Lambe
- Regional Cancer Center Central Sweden, Uppsala University Hospital, Uppsala, Sweden
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Johan Ahlgren
- Department of Oncology, Faculty of Medicine and Health, Örebro University Hospital, Örebro University, Örebro, SE-70182, Sweden
- Regional Cancer Center Central Sweden, Uppsala University Hospital, Uppsala, Sweden
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Mikkelsen E, Ingebrigtsen T, Thyrhaug AM, Olsen LR, Nygaard ØP, Austevoll I, Brox JI, Hellum C, Kolstad F, Lønne G, Solberg TK. The Norwegian registry for spine surgery (NORspine): cohort profile. Eur Spine J 2023; 32:3713-3730. [PMID: 37718341 DOI: 10.1007/s00586-023-07929-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 07/28/2023] [Accepted: 08/28/2023] [Indexed: 09/19/2023]
Abstract
PURPOSE To review and describe the development, methods and cohort of the lumbosacral part of the Norwegian registry for spine surgery (NORspine). METHODS NORspine was established in 2007. It is government funded, covers all providers and captures consecutive cases undergoing operations for degenerative disorders. Patients' participation is voluntary and requires informed consent. A set of baseline-, process- and outcome-variables (3 and 12 months) recommended by the International Consortium for Health Outcome Measurement is reported by surgeons and patients. The main outcome is the Oswestry disability index (ODI) at 12 months. RESULTS We show satisfactory data quality assessed by completeness, timeliness, accuracy, relevance and comparability. The coverage rate has been 100% since 2016 and the capture rate has increased to 74% in 2021. The cohort consists of 60,647 (47.6% women) cases with mean age 55.7 years, registered during the years 2007 through 2021. The proportions > 70 years and with an American Society of Anaesthesiologists' Physical Classification System (ASA) score > II has increased gradually to 26.1% and 19.3%, respectively. Mean ODI at baseline was 43.0 (standard deviation 17.3). Most cases were operated with decompression for disc herniation (n = 26,557, 43.8%) or spinal stenosis (n = 26,545, 43.8%), and 7417 (12.2%) with additional or primary fusion. The response rate at 12 months follow-up was 71.6%. CONCLUSION NORspine is a well-designed population-based comprehensive national clinical quality registry. The register's methods ensure appropriate data for quality surveillance and improvement, and research.
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Affiliation(s)
- Eirik Mikkelsen
- Department of Neurosurgery, Ophthalmology and Otorhinolaryngology, University Hospital of North Norway, Tromsø, Norway
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Tor Ingebrigtsen
- Department of Neurosurgery, Ophthalmology and Otorhinolaryngology, University Hospital of North Norway, Tromsø, Norway.
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway.
- The Norwegian Registry for Spine Surgery, University Hospital of North Norway, Tromsø, Norway.
| | - Anette M Thyrhaug
- The Norwegian Registry for Spine Surgery, University Hospital of North Norway, Tromsø, Norway
| | - Lena Ringstad Olsen
- Centre for Clinical Documentation and Evaluation, Northern Norway Regional Health Authority, Tromsø, Norway
| | - Øystein P Nygaard
- The Norwegian Registry for Spine Surgery, University Hospital of North Norway, Tromsø, Norway
- Department of Neuromedicine and Movement Science, The Norwegian University of Science and Technology, Trondheim, Norway
- Department of Neurosurgery, St. Olav's University Hospital, Trondheim, Norway
| | - Ivar Austevoll
- Department of Orthopaedic Surgery, Haukeland University Hospital, Bergen, Norway
| | - Jens Ivar Brox
- Department of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Christian Hellum
- Department of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway
| | - Frode Kolstad
- Department of Neurosurgery, Oslo University Hospital, Oslo, Norway
| | - Greger Lønne
- Department of Neuromedicine and Movement Science, The Norwegian University of Science and Technology, Trondheim, Norway
- Department of Orthopaedic Surgery, Innlandet Hospital Trust, Lillehammer, Norway
| | - Tore K Solberg
- Department of Neurosurgery, Ophthalmology and Otorhinolaryngology, University Hospital of North Norway, Tromsø, Norway
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
- The Norwegian Registry for Spine Surgery, University Hospital of North Norway, Tromsø, Norway
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Sjöström M, Lund B, Sunzel B, Bengtsson M, Magnusson M, Rasmusson L. Starting a Swedish national quality registry for orthognathic surgery: a tool for auditing fundamentals of care. BMC Oral Health 2022; 22:588. [PMID: 36494655 PMCID: PMC9732981 DOI: 10.1186/s12903-022-02568-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Accepted: 11/05/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND National quality registries (NQRs) provide open data for user-directed acquisition. National Quality Registry (NQR) data are often used to analyze the rates of treatment success and adverse events for studies that aim to improve treatment quality and patient satisfaction. Thus, NQRs promote the goal of achieving evidence-based therapies. However, the scientific literature seldom focuses on the complex process of initiating, designing, and implementing an NQR. Starting an NQR may be particularly challenging in a setting where specialized care is decentralized, such as orthognathic surgery in Sweden. The present study describes the initiation and early phases of a new NQR for orthognathic surgery in Sweden. METHODS The initial inventory phase included gaining knowledge on regulations, creating economic plans, and identifying pitfalls in existing NQRs. Next, a crude framework for the registry was achieved. Outcome measures were selected with a nation-wide questionnaire, followed by a Delphi-like process for selecting parameters to include in the NQR. Our inclusive process comprised a stepwise introduction, feedback-based modifications, and preparatory educational efforts. Descriptive data were collected, based on the first 2 years (2018-2019) of registry operation. RESULTS Two years after implementation, 862 patients that underwent 1320 procedures were registered. This number corresponded to a 91% coverage rate. Bimaxillary treatments predominated, and the most common were a Le Fort I osteotomy combined with a bilateral sagittal split osteotomy (n = 275). Reoperations were conducted in 32 patients (3.6%), and the rate of patient satisfaction was 95%. CONCLUSIONS A National Quality Registry should preferentially be started and maintained by an appointed task force of active clinicians. A collaborative, transparent, inclusive process may be an important factor for achieving credibility and high coverage, particularly in a decentralized setting.
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Affiliation(s)
- Mats Sjöström
- grid.412215.10000 0004 0623 991XOral and Maxillofacial Surgery, Umeå University Hospital, Umeå, Sweden ,grid.12650.300000 0001 1034 3451Department of Odontology, Umeå University, Umeå, Sweden
| | - Bodil Lund
- grid.4714.60000 0004 1937 0626Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden ,grid.24381.3c0000 0000 9241 5705Medical Unit of Plastic Surgery and Oral and Maxillofacial Surgery, Department for Oral and Maxillofacial Surgery and Jaw Orthopedics, Karolinska University Hospital, Stockholm, Sweden
| | - Bo Sunzel
- grid.32995.340000 0000 9961 9487Dep Oral and Maxillofacial surgery Public Dental health Växjö, Malmö University, Malmö, Sweden
| | - Martin Bengtsson
- grid.4514.40000 0001 0930 2361Department of Clinical Sciences, Faculty of Medicine, Lund University, Lund, Sweden ,grid.411843.b0000 0004 0623 9987Department of Oral & Maxillofacial Surgery, Skåne University Hospital, Lund, Sweden
| | - Mikael Magnusson
- Department of Specialist Dentistry, Oral and Maxillofacial Surgery, Colloseum and Smile AB, Stockholm, Sweden
| | - Lars Rasmusson
- grid.8761.80000 0000 9919 9582Department of Oral and Maxillofacial Surgery, The Sahlgrenska Academy and hospital, University of Gothenburg, Gothenburg, Sweden
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Alberga AJ, Stangenberger VA, de Bruin JL, Wever JJ, Wilschut JA, van den Brand CL, Verhagen HJM, W J M Wouters M. Administrative healthcare data as an addition to the Dutch surgaical aneurysm audit to evaluate mid-term reinterventions following abdominal aortic aneurysm repair: A pilot study. Int J Med Inform 2022; 164:104806. [PMID: 35671586 DOI: 10.1016/j.ijmedinf.2022.104806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 05/01/2022] [Accepted: 05/28/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND The Dutch Surgical Aneurysm Audit (DSAA) is a nationwide mandatory quality registry that evaluates the perioperative outcomes of abdominal aortic aneurysms (AAAs). The DSAA includes perioperative outcomes that occur up to 30 days, but various complications following AAA repair occur after this period. Administrative healthcare data yield the possibility to evaluate later occuring outcomes such as reinterventions, without increasing the registration burden. The aim of this study is to assess the feasibility and the potential benefit of administrative healthcare data to evaluate mid-term reinterventions following intact AAA repair. METHOD All patients that underwent primary endovascular aneurysm repair (EVAR) or open surgical repair (OSR) for an intact infrarenal AAA between January 2017 and December 2018 were selected from the DSAA. Subsequently, these patients were identified in a database containing reimbursement data. Healthcare activity codes that refer to reinterventions following AAA repair were examined to assess reinterventions within 12 and 15 months following EVAR and OSR. RESULTS We selected 4043 patients from the DSAA, and 2059 (51%) patients could be identified in the administrative healthcare database. Reintervention rates of 10.4% following EVAR and 9.5% following OSR within 12 months (p = 0.719), and 11.5% following EVAR and 10.8% following OSR within 15 months (p = 0.785) were reported. CONCLUSION Administrative healthcare data as an addition to the DSAA is potentially beneficial to evaluate mid-term reinterventions following intact AAA repair without increasing the registration burden for clinicians. Further validation is necessary before reliable implementation of this tool is warranted.
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Affiliation(s)
- Anna J Alberga
- Scientific Bureau, Dutch Institute for Clinical Auditing, Leiden, The Netherlands; Department of Vascular Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands.
| | | | - Jorg L de Bruin
- Department of Vascular Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Jan J Wever
- Department of Vascular Surgery, Haga Teaching Hospital, The Hague, The Netherlands
| | - Janneke A Wilschut
- Scientific Bureau, Dutch Institute for Clinical Auditing, Leiden, The Netherlands
| | | | - Hence J M Verhagen
- Department of Vascular Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Michel W J M Wouters
- Scientific Bureau, Dutch Institute for Clinical Auditing, Leiden, The Netherlands; Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands
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Timmermans MJC, Houterman S, Daeter ED, Danse PW, Li WW, Lipsic E, Roefs MM, van Veghel D. Using real-world data to monitor and improve quality of care in coronary artery disease: results from the Netherlands Heart Registration. Neth Heart J 2022; 30:546-556. [PMID: 35389133 PMCID: PMC8988537 DOI: 10.1007/s12471-022-01672-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2022] [Indexed: 11/30/2022] Open
Abstract
Worldwide, quality registries for cardiovascular diseases enable the use of real-world data to monitor and improve the quality of cardiac care. In the Netherlands Heart Registration (NHR), cardiologists and cardiothoracic surgeons register baseline, procedural and outcome data across all invasive cardiac interventional, electrophysiological and surgical procedures. This paper provides insight into the governance and processes as organised by the NHR in collaboration with the hospitals. To clarify the processes, examples are given from the percutaneous coronary intervention and coronary artery bypass grafting registries. Physicians who are mandated by their hospital to instruct the NHR to process their data are united in registration committees. The committees determine standard sets of variables and periodically discuss the completeness and quality of data and patient-relevant outcomes. In the case of significant variation in outcomes, processes of healthcare delivery are discussed and good practices are shared in a non-competitive and safe setting. To create new insights for further improvement in patient-relevant outcomes, quality projects are initiated on, for example, multivessel disease treatment, cardiogenic shock and diagnostic intracoronary procedures. Moreover, possibilities are explored to expand the quality registries through additional relevant indicators, such as resource use before and after the procedure, by enriching NHR data with other existing data resources.
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Affiliation(s)
| | | | - Edgar D Daeter
- Department of Cardiothoracic Surgery, St Antonius Hospital, Nieuwegein, The Netherlands
| | - Peter W Danse
- Department of Cardiology, Rijnstate Hospital, Arnhem, The Netherlands
| | - Wilson W Li
- Department of Cardiothoracic Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Erik Lipsic
- Department of Cardiology, University Medical Centre Groningen, Groningen, The Netherlands
| | - Maaike M Roefs
- Netherlands Heart Registration, Utrecht, The Netherlands
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Ebbevi D, Hasson H, Lönnroth K, Augustsson H. Challenges to ensuring valid and useful waiting time monitoring - a qualitative study in Swedish specialist care. BMC Health Serv Res 2021; 21:1024. [PMID: 34583698 PMCID: PMC8478272 DOI: 10.1186/s12913-021-07021-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 09/13/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Access to health care is an essential health policy issue. In several countries, waiting time guarantees mandate set time limits for assessment and treatment. High-quality waiting time data are necessary to evaluate and improve waiting times. This study's aim was to investigate health care providers and administrative management professionals' perceptions of validity and usefulness of waiting time reporting in specialist care. METHODS Semi-structured interviews (n = 28) were conducted with administrative management and care professionals (line managers and care providers) in specialized clinics in the Stockholm Region, Sweden. Clinic-specific data from the waiting time registry was used in the care provider interviews to assess face validity. Clinics were purposefully sampled for maximum variation in complexity of care, volume of production, geographical location, private or public ownership, and local waiting times. Thematic analysis was used. RESULTS The waiting time registry was perceived to have low validity and usefulness. Perceived validity and usefulness were interconnected, with mechanisms that reinforced the connection. Structural and cognitive barriers to validity included technical and procedural errors, errors caused by role division, misinterpretation of guidelines, diverging interpretations of nonregulated cases and extensive willful manipulation of data. CONCLUSIONS We identify four misconceptions underpinning the current waiting time reporting system: passive dissemination of guidelines is sufficient as implemented, cognitive load of care providers to report waiting times is negligible, soft-law regulation and presentation of outcome data is sufficient to drive improvement, and self-reported data linked to incentives poses a low risk of data corruption. To counter low validity and usefulness, we propose the following for policy makers and administrative management when developing and implementing waiting time monitoring: communicate guidelines with instructions for operationalization, address barriers to implementation, ensure quality through monitoring of implementation and adherence to guidelines, develop IT ontology together with professionals, avoid parallel measurement infrastructures, ensure waiting times are presented to suit management needs, provide timely waiting time data, enable the study of single cases, minimize manual data entry, and perform spot-checks or external validity checks. Several of these strategies should be transferable to waiting time monitoring in other contexts.
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Affiliation(s)
- David Ebbevi
- Unit for implementation and evaluation, Center for Epidemiology and Community Medicine Stockholm Regional Council, Stockholm, Sweden.
- Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.
| | - Henna Hasson
- Unit for implementation and evaluation, Center for Epidemiology and Community Medicine Stockholm Regional Council, Stockholm, Sweden
- Medical Management Centre, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - Knut Lönnroth
- Unit for implementation and evaluation, Center for Epidemiology and Community Medicine Stockholm Regional Council, Stockholm, Sweden
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Hanna Augustsson
- Unit for implementation and evaluation, Center for Epidemiology and Community Medicine Stockholm Regional Council, Stockholm, Sweden
- Medical Management Centre, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
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Bäck M, Leosdottir M, Hagström E, Norhammar A, Hag E, Jernberg T, Wallentin L, Lindahl B, Hambraeus K. The SWEDEHEART secondary prevention and cardiac rehabilitation registry (SWEDEHEART CR registry). Eur Heart J Qual Care Clin Outcomes 2021; 7:431-437. [PMID: 34097023 DOI: 10.1093/ehjqcco/qcab039] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 05/06/2021] [Accepted: 05/11/2021] [Indexed: 11/14/2022]
Abstract
AIMS The quality registry SWEDEHEART covers data across the patient pathway after an acute myocardial infarction (MI), from hospital care to secondary prevention. Although cardiac rehabilitation (CR) is strongly recommended after an MI, there is still heterogeneity regarding standards, uptake, and adherence rates. The aim of the SWEDEHEART-CR registry is to provide continuous information on secondary prevention and CR performance to support the audit and development of evidence-based practice. To facilitate quality improvement and research initiatives, a description of the characteristics and development of the SWEDEHEART-CR registry is needed. METHODS AND RESULTS The SWEDEHEART-CR registry starts with data obtained during hospital care and then collects data at out-patient visits 2 months and 1-year after discharge, and at start and end of an exercise-based CR programme. The registry data covers comorbidities, biochemistry, blood pressure, anthropometric variables, medication, psychosocial- and lifestyle variables, readmissions, patient-reported outcome measures, attendance in CR-related programmes, and physical fitness variables. Over 100 000 patients with MI have been included in the SWEDEHEART-CR registry since its start in 2005. From initially covering 35 centres (47%) and 2200 patients annually (27%), SWEDEHEART-CR has developed to a nation-wide registry with 75 centres (100%) and 8800 patients annually (80%) in 2020. CONCLUSION The SWEDEHEART-CR registry includes a high proportion of the national MI population entering a CR programme and is a powerful tool for quality audit, improvement, and research. The registry provides insights into the characteristics, treatment, and outcomes of evidence-based secondary preventive practice, ultimately leading to better cardiovascular health.
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Affiliation(s)
- Maria Bäck
- Department of Health, Medicine and Caring Sciences, Unit of Physiotherapy, Linköping University, 581 83 Linköping, Sweden.,Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden.,Department of Physiotherapy, Sahlgrenska University Hospital, Vita Stråket 13, 413 45 Gothenburg, Sweden
| | - Margret Leosdottir
- Department of Clinical Sciences Malmö, Faculty of Medicine, Lund University, 205 02 Malmö, Sweden.,Department of Cardiology, Skane University Hospital, Jan Waldenströms gata 35, 214 28 Malmö, Sweden
| | - Emil Hagström
- Department of Medical Sciences, Uppsala University, 751 85 Uppsala, Sweden.,Uppsala Clinical Research Centre, Uppsala University, Dag Hammarskjölds väg 38, 751 85 Uppsala, Sweden
| | - Anna Norhammar
- Department of Medicine K2, Unit of Cardiology, Karolinska Institutet, Karolinska University Hospital, Solna, 17176 Stockholm and Capio S:t Görans hospital, Stockholm, Sweden
| | - Emma Hag
- Department of Internal Medicine, County Hospital Ryhov, 551 11 Jönköping, Sweden
| | - Tomas Jernberg
- Department of Clinical Sciences, Danderyd Hospital, Karolinska Institute, 182 88 Stockholm, Sweden
| | - Lars Wallentin
- Department of Medical Sciences, Uppsala University, 751 85 Uppsala, Sweden.,Uppsala Clinical Research Centre, Uppsala University, Dag Hammarskjölds väg 38, 751 85 Uppsala, Sweden
| | - Bertil Lindahl
- Department of Medical Sciences, Uppsala University, 751 85 Uppsala, Sweden.,Uppsala Clinical Research Centre, Uppsala University, Dag Hammarskjölds väg 38, 751 85 Uppsala, Sweden
| | - Kristina Hambraeus
- Department of Cardiology, Falu Hospital, Åsgatan 41, 791 71 Falun, Sweden
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Dongelmans DA, Pilcher D, Beane A, Soares M, Del Pilar Arias Lopez M, Fernandez A, Guidet B, Haniffa R, Salluh JIF. Linking of global intensive care (LOGIC): An international benchmarking in critical care initiative. J Crit Care 2020; 60:305-310. [PMID: 32979689 DOI: 10.1016/j.jcrc.2020.08.031] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 08/06/2020] [Accepted: 08/30/2020] [Indexed: 12/14/2022]
Abstract
Benchmarking is a common and effective method for measuring and analyzing ICU performance. With the existence of national registries, objective information can now be obtained to allow benchmarking of ICU care within and between countries. The present manuscript briefly describes the current status of benchmarking in healthcare and critical care and presents the LOGIC project, an initiative to promote international benchmarking for intensive care units. Currently 13 registries have joined LOGIC. We showed large differences in the utilization of ICU as well as resources and in outcomes. Despite the need for careful interpretation of differences due to variation in definitions and limited risk adjustment, LOGIC is a growing worldwide initiative that allows access to insightful epidemiologic data from ICUs in multiple databases and registries.
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Affiliation(s)
- D A Dongelmans
- Amsterdam UMC, University of Amsterdam, Department of Intensive Care Medicine, Meibergdreef 9, Amsterdam, the Netherlands; National Intensive Care Evaluation (NICE) foundation, Amsterdam, the Netherlands; Department of Intensive Care, The Alfred Hospital, Commercial Road, Prahran VIC 3004, Australia.
| | - David Pilcher
- Department of Intensive Care, The Alfred Hospital, Commercial Road, Prahran VIC 3004, Australia; The Australian and New Zealand Intensive Care Society (ANZICS) Centre for Outcome and Resource Evaluation, Camberwell VIC 3124, Australia; Crit Care Asia, Network for Improving Critical Care Systems and Training, Colombo, Sri Lanka
| | - Abigail Beane
- Department of Intensive Care, The Alfred Hospital, Commercial Road, Prahran VIC 3004, Australia; Mahidol Oxford Tropical Medicine Research Unit, Bangkok, Thailand; Centre for Tropical Medicine and Global Health, University of Oxford, UK; D'Or Institute for Research and Education, Rio de Janeiro, Brazil
| | - Marcio Soares
- Department of Intensive Care, The Alfred Hospital, Commercial Road, Prahran VIC 3004, Australia; Post Graduation Program, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; Argentine Society of Intensive Care (SATI). SATI-Q Program, Buenos Aires, Argentina
| | - Maria Del Pilar Arias Lopez
- Department of Intensive Care, The Alfred Hospital, Commercial Road, Prahran VIC 3004, Australia; Hospital de Niños Ricardo Gutierrez, Buenos Aires, Argentina; Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpital Saint-Antoine, Service de réanimation, F75012 Paris, France
| | - Ariel Fernandez
- Department of Intensive Care, The Alfred Hospital, Commercial Road, Prahran VIC 3004, Australia; Hospital de Niños Ricardo Gutierrez, Buenos Aires, Argentina
| | - Bertrand Guidet
- Department of Intensive Care, The Alfred Hospital, Commercial Road, Prahran VIC 3004, Australia; Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpital Saint-Antoine, Service de réanimation, F75012 Paris, France
| | - Rashan Haniffa
- Department of Intensive Care, The Alfred Hospital, Commercial Road, Prahran VIC 3004, Australia; Mahidol Oxford Tropical Medicine Research Unit, Bangkok, Thailand; Centre for Tropical Medicine and Global Health, University of Oxford, UK; D'Or Institute for Research and Education, Rio de Janeiro, Brazil
| | - Jorge I F Salluh
- Department of Intensive Care, The Alfred Hospital, Commercial Road, Prahran VIC 3004, Australia; Post Graduation Program, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil; Argentine Society of Intensive Care (SATI). SATI-Q Program, Buenos Aires, Argentina
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10
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Eldrup N, Debus ES. International Validation of the Population Based Malta Vascular Registry: A Vascunet Report. EJVES Vasc Forum 2020; 48:5-7. [PMID: 33078161 PMCID: PMC7301168 DOI: 10.1016/j.ejvsvf.2020.05.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 04/20/2020] [Accepted: 05/19/2020] [Indexed: 10/29/2022] Open
Abstract
Introduction Quality registries can be used to study treatment patterns and changes in trends of complications related to procedures and devices. To ensure that such study is possible in registries, there is a need to use standardised variables and the registry must have high internal and external validity. This study was an international external and internal validation of the newly initiated Maltese Vascular Registry. Report Two international vascular registry consultants visited the Maltese Vascular Registry (MVR), and conducted an external validation on all carotid and aortic aneurysm repairs performed in 2017-18. The external validation was conducted by comparing hospital administration lists with the MVR list. Using randomly chosen numbers, an internal validation was conducted of 20 random cases of carotid and 20 aortic aneurysms, 10 from 2017 and 10 from 2018, to validate date of operation and procedure against the patient's medical record. The registry is built as a database using national personal identifier codes, with variables for date and type of procedure, and anaesthetic method used, to which a note is attached describing the indication, intervention, and follow up. Between the hospital registry and the MVR, 111 of 115 cases could be identified correctly, corresponding to 97% external validity. Between the patient case records and the MVR, the dates and procedures of 20/20 carotid and 20/20 aortic aneurysm procedure were identical, indicating 100% internal validity. Discussion The MVR showed an external validity of 97% and internal validity of 100%. Future work should incorporate specific variables for comorbidity, procedures, and outcomes, with the registry aiming to incorporate international recommended variables for comorbidity, procedure, and outcome.
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Affiliation(s)
- Nikolaj Eldrup
- Rigshospitalet, Copenhagen University, Denmark.,Karbase (Danish Vascular Registry), Danish Regions, Aarhus, Denmark
| | - E Sebastian Debus
- University Heart & Vascular Centre, University Hospital Hamburg-Eppendorf, Germany.,GermanVasc, Hamburg, Germany
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11
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Wilcke M, Roginski M, Åström M, Arner M. A registry based analysis of the patient reported outcome after surgery for trapeziometacarpal joint osteoarthritis. BMC Musculoskelet Disord 2020; 21:63. [PMID: 32007093 PMCID: PMC6995059 DOI: 10.1186/s12891-020-3045-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 01/06/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of the study was to evaluate patient reported outcome measures (PROM) before and after trapeziectomy with or without ligament reconstruction and tendon interposition for trapeziometacarpal joint arthritis with special focus on possible differences due to gender, age and surgical method. METHODS Data from the Swedish quality registry for hand surgery (HAKIR) was analyzed preoperatively, 3 months and 1 year postoperatively for 1850 patients (mean age 63 years, 79% women). RESULTS One year postoperatively, mean pain at rest was reduced from 50 to 12 of maximum 100. However, pain on load and weakness had not abated to the same extent (mean 30 and 34 of 100, respectively). The mean improvement in PROM did not differ between age groups or gender. The result was similar after trapeziectomy with ligament reconstruction and tendon interposition (86% of the patients) and simple trapeziectomy but few patients were operated with the latter method. CONCLUSION Pain on load and weakness remains to some extent 1 year after surgery for trapeziometacarpal joint arthritis. The result is similar after trapeziectomy with or without ligament reconstruction and tendon interposition and the same improvement can be expected after surgery regardless of age and gender.
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Affiliation(s)
- Maria Wilcke
- Karolinska Institute, Department of Clinical Science and Education, Södersjukhuset, Stockholm, Sweden. .,Department of Hand surgery, Södersjukhuset, Sjukhusbacken 10, 11883, Stockholm, Sweden.
| | - Martin Roginski
- Karolinska Institute, Department of Clinical Science and Education, Södersjukhuset, Stockholm, Sweden.,Department of Hand surgery, Södersjukhuset, Sjukhusbacken 10, 11883, Stockholm, Sweden
| | - Mikael Åström
- Region Skåne, Department of Data Analytics and Register Centrum, Lund, Sweden
| | - Marianne Arner
- Karolinska Institute, Department of Clinical Science and Education, Södersjukhuset, Stockholm, Sweden.,Department of Hand surgery, Södersjukhuset, Sjukhusbacken 10, 11883, Stockholm, Sweden
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12
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Skinnars Josefsson M, Nydahl M, Persson I, Mattsson Sydner Y. Adherence to a regulation that aims to prevent and treat malnutrition-The case of Swedish elderly care. Health Policy 2019; 123:688-694. [PMID: 31126706 DOI: 10.1016/j.healthpol.2019.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 02/06/2019] [Accepted: 05/06/2019] [Indexed: 11/29/2022]
Abstract
Malnutrition constitutes a serious and challenging problem in elderly care. In 2015, a Swedish regulation that aims to prevent and treat malnutrition came into effect. This study set out to explore associations between level of adoption of the regulation reported as: no, started, yes, in a previous survey, and registrations in a national quality registry. Registry data on screening and actions extracted from the first trimester in 2014 (n=18967), 2016 (n=20318) and 2017 (n= 25669) represented 209, 197 and 199 of 290 Swedish municipalities respectively. A repeated measures ANOVA showed that there was no effect on screened nutritional status, Pearson's chi-square that there were minor differences in types of actions, and regression analysis that the number of actions increased on average by 0.3 due to a higher level of adoption of the regulation. Over the years studied, five actions were prominent regardless of level of adoption or screened nutritional status. Hence, to date, no firm conclusions regarding effects of the regulation can be drawn. Despite the regulatory nature, it appear as if the regulation and the level of adoption reported so far is routine in theory, although not yet leveraged to an implemented practice visible in the quality registry but instead decoupled from practice.
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Affiliation(s)
| | - Margaretha Nydahl
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Sweden.
| | - Inger Persson
- Department of Statistics, Uppsala University, Sweden.
| | - Ylva Mattsson Sydner
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Sweden.
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13
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Söderlund A, Löfgren M, Stålnacke BM. Predictors before and after multimodal rehabilitation for pain acceptance and engagement in activities at a 1-year follow-up for patients with whiplash-associated disorders (WAD)-a study based on the Swedish Quality Registry for Pain Rehabilitation (SQRP). Spine J 2018; 18:1475-1482. [PMID: 29155342 DOI: 10.1016/j.spinee.2017.11.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Revised: 07/03/2017] [Accepted: 11/09/2017] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Studies have shown that pain acceptance strategies related to psychological flexibility are important in the presence of chronic musculoskeletal pain. However, the predictors of these strategies have not been studied extensively in patients with whiplash-associated disorders (WAD). PURPOSE The purpose of this study was to predict chronic pain acceptance and engagement in activities at 1-year follow-up with pain intensity, fear of movement, perceived responses from significant others, outcome expectancies, and demographic variables in patients with WAD before and after multimodal rehabilitation (MMR). STUDY DESIGN The design of this investigation was a cohort study with 1-year postrehabilitation follow-up. STUDY SETTING The subjects participated in MMR at a Swedish rehabilitation clinic during 2009-2015. PATIENT SAMPLE The patients had experienced a whiplash trauma (WAD grade I-II) and were suffering from pain and reduced functionality. A total of 386 participants were included: 297 fulfilled the postrehabilitation measures, and 177 were followed up at 1 year after MMR. OUTCOME MEASURES Demographic variables, pain intensity, fear of movement, perceived responses from significant others, and outcome expectations were measured at the start and after MMR. Chronic pain acceptance and engagement in activities were measured at follow-up. METHODS The data were obtained from a Swedish Quality Registry for Pain Rehabilitation (SQRPR). RESULTS Outcome expectancies of recovery, supporting and distracting responses of significant others, and fear of (re)injury and movement before MMR were significant predictors of engagement in activities at follow-up. Pain intensity and fear of (re)injury and movement after MMR significantly predicted engagement in activities at follow-up. Supporting responses of significant others and fear of (re)injury and movement before MMR were significant predictors of pain acceptance at the 1-year follow-up. Solicitous responses of significant others and fear of (re)injury and movement at postrehabilitation significantly predicted pain acceptance at follow-up. CONCLUSION For engagement in activities and pain acceptance, the fear of movement appears to emerge as the strongest predictor, but patients' perceived reactions from their spouses need to be considered in planning the management of WAD.
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Affiliation(s)
- Anne Söderlund
- School of Health, Care and Social Welfare, Mälardalen University, Box 883, SE-721 23 Västerås, Sweden.
| | - Monika Löfgren
- Department of Clinical Sciences Karolinska Institutet and Department of Rehabilitation Medicine, Danderyd Hospital AB, Mörbygårdsvägen, SE 182 88 Stockholm, Sweden
| | - Britt-Marie Stålnacke
- Department of Clinical Sciences Karolinska Institutet and Department of Rehabilitation Medicine, Danderyd Hospital AB, Mörbygårdsvägen, SE 182 88 Stockholm, Sweden; Department of Community Medicine and Rehabilitation, Rehabilitation Medicine, Vårdvetarhuset, Umeå University, SE-901 87 Umeå, Sweden
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14
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Prodinger B, Taylor P. Improving quality of care through patient-reported outcome measures (PROMs): expert interviews using the NHS PROMs Programme and the Swedish quality registers for knee and hip arthroplasty as examples. BMC Health Serv Res 2018; 18:87. [PMID: 29415714 PMCID: PMC5803859 DOI: 10.1186/s12913-018-2898-z] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Accepted: 01/29/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Patient reported outcome measures (PROMs) have been integrated in national quality registries or specific national monitoring initiatives to inform the improvement of quality of care on a national scale. However there are many unanswered questions, such as: how these systems are set up, whether they lead to improved quality of care, which stakeholders use the information once it is available. The aim of this study was to examine supporting and hindering factors relevant to integrating patient-reported outcome measures (PROMs) in selected health information systems (HIS) tailored toward improving quality of care across the entire health system. METHODS First, a systematic search and review was conducted to outline previously identified factors relevant to the integration of PROMs in the selected HIS. A social network analysis was performed to identify networks of experts in these systems. Second, expert interviews were conducted to discuss and elaborate on the identified factors. Directive content analysis was applied using a HIS Evaluation Framework as the frame of reference. This framework is structured into four components: Organization, Human, Technology, and Net benefits. RESULTS The literature review revealed 37 papers for the NHS PROMs Programme and 26 papers for the SHPR and SKAR: Five networks of researchers were identified for the NHS PROMs Programme and 1 for the SHPR and SKAR. Seven experts related to the NHS PROMs Programme and 3 experts related to the SKAR and SHPR participated in the study. The main themes which revealed in relation to Organization were Governance and Capacity building; to Human: Reporting and Stakeholder Engagement; to Technology: the Selection and Collection of PROMs and Data linkage. In relation to Net benefits, system-specific considerations are presented. CONCLUSION Both examples succeeded in integrating PROMs into HIS on a national scale. The lack of an established standard on what change PROMs should be achieved by an intervention limits their usefulness for monitoring quality of care. Whether the PROMs data collected within these systems can be used in routine clinical practice is considered a challenge in both countries.
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Affiliation(s)
- Birgit Prodinger
- University of Applied Sciences Rosenheim, Faculty for Applied Health and Social Sciences, Hochschulstr. 1, 83024 Rosenheim, Germany
- Swiss Paraplegic Research, Guido A. Zäch Str. 4, 6207 Nottwil, Switzerland
| | - Paul Taylor
- CHIME, Institute of Health Informatics, 222 Euston Road, London, NW1 2DA UK
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Essén A, Oborn E. The performativity of numbers in illness management: The case of Swedish Rheumatology. Soc Sci Med 2017; 184:134-143. [PMID: 28525782 DOI: 10.1016/j.socscimed.2017.05.026] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 05/05/2017] [Accepted: 05/09/2017] [Indexed: 11/24/2022]
Abstract
While there is a proliferation of numerical data in healthcare, little attention has been paid to the role of numbers in constituting the healthcare reality they are intended to depict. This study explores the performativity of numbers in the microlevel management of rheumatoid disease. We draw on a study of patients' and physicians' use of the numbers in the Swedish Rheumatology Quality Registry, conducted between 2009 and 2014. We show how the numbers performed by constructing the disease across time, and by framing action. The numerical performances influenced patients and physicians in different ways, challenging the former to quantify embodied disease and the latter to subsume the disease into one of many possible trajectory standards. Based on our findings, we provide a model of the dynamic performativity of numbers in the on-going management of illness. The model conceptualises how numbers generate new possibilities; by creating tension and alignment they may open up new avenues for communication between patients and physicians.
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Affiliation(s)
- Anna Essén
- Stockholm School of Economics Institute for Research, Saltmätargatan 13-17, 113 83 Stockholm, Sweden; Medical Management Centre, LIME, Karolinska Institutet Stockholm, Sweden.
| | - Eivor Oborn
- Warwick Business School, The University of Warwick, Coventry, CV4 7AL, UK.
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Faxén-Irving G, Fereshtehnejad SM, Falahati F, Cedergren L, Göranzon H, Wallman K, García-Ptacek S, Eriksdotter M, Religa D. Body Mass Index in Different Dementia Disorders: Results from the Swedish Dementia Quality Registry (SveDem). Dement Geriatr Cogn Dis Extra 2014; 4:65-75. [PMID: 24847345 PMCID: PMC4024511 DOI: 10.1159/000360415] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Background Most patients with dementia lose body weight over the course of the disease and have a lower body mass index (BMI) than subjects with normal cognition. Aims To examine body mass index and how it correlates with cognitive status, age and gender in patients with different dementia disorders. Materials and Methods Data from newly diagnosed dementia patients in the Swedish Dementia Quality Registry (SveDem) and recorded information about age, gender, cognitive status and BMI was analyzed using independent samples t tests and one-way analysis of variance. Results A total of 12,015 patients, 7,121 females and 4,894 males were included in the study. The average BMI was 24. More than a quarter of the patients had a BMI of <22. Females were significantly older (p < 0.001) and males had a significantly higher BMI (p < 0.001) at the time of diagnosis. BMI differed significantly by gender in various dementia disorders and correlated significantly with cognitive status and age. Conclusion At the time of diagnosis, patients with various dementia disorders had a BMI within the normal range. However, a significant number had a BMI in a lower, suboptimal range for older persons stressing the need for nutritional assessment as part of the dementia work up. Further analyses with longitudinal follow-up are needed to investigate BMI changes over time.
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Affiliation(s)
- Gerd Faxén-Irving
- Department of Neurobiology, Care Sciences and Society Karolinska Institutet, Sweden ; Department of Clinical Nutrition and Dietetics, Karolinska University Hospital, Stockholm, Uppsala, Sweden
| | | | - Farshad Falahati
- Department of Neurobiology, Care Sciences and Society Karolinska Institutet, Sweden
| | - Lars Cedergren
- Department of Neurobiology, Care Sciences and Society Karolinska Institutet, Sweden
| | - Helen Göranzon
- Department of Food, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
| | - Kristine Wallman
- Department of Food, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
| | - Sara García-Ptacek
- Department of Neurobiology, Care Sciences and Society Karolinska Institutet, Sweden ; Department of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - Maria Eriksdotter
- Department of Neurobiology, Care Sciences and Society Karolinska Institutet, Sweden ; Department of Geriatric Medicine, Karolinska University Hospital, Stockholm, Uppsala, Sweden
| | - Dorota Religa
- Department of Neurobiology, Care Sciences and Society Karolinska Institutet, Sweden ; Department of Geriatric Medicine, Karolinska University Hospital, Stockholm, Uppsala, Sweden ; Medical Research Centre, Polish Academy of Sciences, Warsaw, Poland
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