The management of ADHD in children and adolescents: bringing evidence to the clinic: perspective from the European ADHD Guidelines Group (EAGG)

ADHD is the most common neurodevelopmental disorder presenting to child and adolescent mental health, paediatric, and primary care services. Timely and effective interventions to address core ADHD symptoms and co-occurring problems are a high priority for healthcare and society more widely. While much research has reported on the benefits and adverse effects of different interventions for ADHD, these individual research reports and the reviews, meta-analyses and guidelines summarizing their findings are sometimes inconsistent and difficult to interpret. We have summarized the current evidence and identified several methodological issues and gaps in the current evidence that we believe are important for clinicians to consider when evaluating the evidence and making treatment decisions. These include understanding potential impact of bias such as inadequate blinding and selection bias on study outcomes; the relative lack of high-quality data comparing different treatments and assessing long-term effectiveness, adverse effects and safety for both pharmacological and non-pharmacological treatments; and the problems associated with observational studies, including those based on large national registries and comparing treatments with each other. We highlight key similarities across current international clinical guidelines and discuss the reasons for divergence where these occur. We discuss the integration of these different perspective into a framework for person/family-centered evidence-based practice approach to care that aims to achieve optimal outcomes that prioritize individual strengths and impairments, as well as the personal treatment targets of children and their families. Finally, we consider how access to care for this common and impairing disorder can be improved in different healthcare systems

Evaluating Communication Campaigns

Summarizes presentations from a September 2007 conference on evaluating communication campaigns. Discusses the mechanism of effecting change through communication; the principles of advocacy evaluation; the design, methods, and tools; and lessons learned

Evidence-Based Health Care for Children: What Are We Missing?

Proposes a new framework for evaluating evidence in health care that takes into account interventions in child health promotion, which aim to change children's physical, social, or emotional environment and may take longer for the effects to show

Science Courts, Evidentiary Procedures and Mixed Science-Policy Decisions

This paper analyzes the potential for science courts to address the social need to regulate human carcinogens and concludes that, on balance, it is not high. From this vantage point, Professor Cranor suggests desiderata for application in other areas where science courts might be used

A prospective multiple case study of the impact of emerging scientific evidence on established colorectal cancer screening programs: a study protocol.

BackgroundHealth-policy decision making is a complex and dynamic process, for which strong evidentiary support is required. This includes scientifically produced research, as well as information that relates to the context in which the decision takes place. Unlike scientific evidence, this "contextual evidence" is highly variable and often includes information that is not scientifically produced, drawn from sources such as political judgement, program management experience and knowledge, or public values. As the policy decision-making process is variable and difficult to evaluate, it is often unclear how this heterogeneous evidence is identified and incorporated into "evidence-based policy" decisions. Population-based colorectal cancer screening poses an ideal context in which to examine these issues. In Canada, colorectal cancer screening programs have been established in several provinces over the past five years, based on the fecal occult blood test (FOBT) or the fecal immunochemical test. However, as these programs develop, new scientific evidence for screening continues to emerge. Recently published randomized controlled trials suggest that the use of flexible sigmoidoscopy for population-based screening may pose a greater reduction in mortality than the FOBT. This raises the important question of how policy makers will address this evidence, given that screening programs are being established or are already in place. This study will examine these issues prospectively and will focus on how policy makers monitor emerging scientific evidence and how both scientific and contextual evidence are identified and applied for decisions about health system improvement.MethodsThis study will employ a prospective multiple case study design, involving participants from Ontario, Alberta, Manitoba, Nova Scotia, and Quebec. In each province, data will be collected via document analysis and key informant interviews. Documents will include policy briefs, reports, meeting minutes, media releases, and correspondence. Interviews will be conducted in person with senior administrative leaders, government officials, screening experts, and high-level cancer system stakeholders.DiscussionThe proposed study comprises the third and final phase of an Emerging Team grant to address the challenges of health-policy decision making and colorectal cancer screening decisions in Canada. This study will contribute a unique prospective look at how policy makers address new, emerging scientific evidence in several different policy environments and at different stages of program planning and implementation. Findings will provide important insight into the various approaches that are or should be used to monitor emerging evidence, the relative importance of scientific versus contextual evidence for decision making, and the tools and processes that may be important to support challenging health-policy decisions

Explicating the role of partnerships in changing the health and well-being of local communities in urban regeneration areas: evaluation of the Warnwarth conceptual framework for partnership evaluation

This literature review is one of three outputs from a project: Explicating the role of partnerships in changing the health and well-being of local communities, one of a number of projects in a larger Higher Education Funding Council Strategic Development Fund project (HEFCE) entitled: Urban Regeneration: Making a Difference. This was a collaborative venture between Manchester Metropolitan University, Northumbria University, University of Salford and University of Central Lancashire. Bradford University was an affiliated partner

Measuring the quality of judgement and decision-making in nursing

Aim. This paper discusses measurement of the quality of judgement and decision-making in nursing research. It examines theoretical and research issues surrounding how to measure judgement accuracy as a component of evaluating decision-making in nursing practice. Discussion. Judgement accuracy is discussed with reference to different methods of measurement, including comparing judgements with independent criteria and inter-judge approaches. Existing research on how judgement accuracy has been measured in nursing practice is examined. Evaluation of decisions is then discussed, including consideration of the process of decision-making and evaluating decision outcomes. Finally, existing research on decision-making in nursing is assessed and the strengths and limitations of different types of measurement discussed. Conclusion. We suggests that researchers examining the quality of judgement and decision-making in nursing need to be aware of both the strengths and limitations of existing methods of measurement. We also suggest that researchers need to use a number of different methods, including normative approaches such as Bayes' Theorem and Subjective Expected Utility Theory

Use of computer-aided detection (CAD) tools in screening mammography: a multidisciplinary investigation

We summarise a set of analyses and studies conducted to assess the effects of the use of a computer-aided detection (CAD) tool in breast screening. We have used an interdisciplinary approach that combines: (a) statistical analyses inspired by reliability modelling in engineering; (b) experimental studies of decisions of mammography experts using the tool, interpreted in the light of human factors psychology; and (c) ethnographic observations of the use of the tool both in trial conditions and in everyday screening practice. Our investigations have shown patterns of human behaviour and effects of computer-based advice that would not have been revealed by a standard clinical trial approach. For example, we found that the negligible measured effect of CAD could be explained by a range of effects on experts' decisions, beneficial in some cases and detrimental in others. There is some evidence of the latter effects being due to the experts using the computer tool differently from the intentions of the developers. We integrate insights from the different pieces of evidence and highlight their implications for the design, evaluation and deployment of this sort of computer tool

The role of information alignment and entrepreneurial traits on SME internationalization: a conceptual framework

Purpose – The paper aims to explore the internationalisation decision-making of small- and medium-sized enterprise (SME) owner/managers. Specifically, structural alignment theory (SAT) and regulatory focus theory (RFT) are utilised to examine the concept of opportunity recognition in the context of internationalisation choices. Design/methodology/approach – This paper is conceptual in nature, and an integrative cognitive model of internationalisation choice decisions is developed based on SAT and RFT, underpinned by a critical review of the international entrepreneurship (IE) literature. Findings – Scenarios are identified in which the structure of available information may affect the decision-evaluation process in terms of cognitive resource requirements. Further, the SME owner/manager’s motivational goal orientation is suggested to moderate the role of the information structure in line with IE literature. A conceptual model and propositions are presented. Research limitations/implications – The conceptual model and the propositions arising from the discussion in this paper offer new directions of research to explore SME internationalisation. Originality/value – This paper offers a cognitive perspective of SME internationalisation. This paper offers insights for policymakers, SME owner/managers, practitioners and researchers alike. For internationalisation decisions, this paper highlights the potential impact of the structure of information that is made available to SME owner/managers by industry or policy bodies; further, the moderating influence of motivational goal orientation may inform policy on how information should be presented to SME owner/managers to aid their decision-making.</p