International Consortium for Health Outcomes Measurement (ICHOM): Standardized Patient-Centered Outcomes Measurement Set for Heart Failure Patients

Whereas multiple national, international, and trial registries for heart failure have been created, international standards for clinical assessment and outcome measurement do not currently exist. The working group's objective was to facilitate international comparison in heart failure care, using standardized parameters and meaningful patient-centered outcomes for research and quality of care assessments. The International Consortium for Health Outcomes Measurement recruited an international working group of clinical heart failure experts, researchers, and patient representatives to define a standard set of outcomes and risk-adjustment variables. This was designed to document, compare, and ultimately improve patient care outcomes in the heart failure population, with a focus on global feasibility and relevance. The working group employed a Delphi process, patient focus groups, online patient surveys, and multiple systematic publications searches. The process occurred over 10 months, employing 7 international teleconferences. A 17-item set has been established, addressing selected functional, psychosocial, burden of care, and survival outcome domains. These measures were designed to include all patients with heart failure, whether entered at first presentation or subsequent decompensation, excluding cardiogenic shock. Sources include clinician report, administrative data, and validated patient-reported outcome measurement tools: the Kansas City Cardiomyopathy Questionnaire; the Patient Health Questionnaire-2; and the Patient-Reported Outcomes Measurement Information System. Recommended data included those to support risk adjustment and benchmarking across providers and regions. The International Consortium for Health Outcomes Measurement developed a dataset designed to capture, compare, and improve care for heart failure, with feasibility and relevance for patients and clinicians worldwide

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No abstract available

Family witnessed resuscitation in UK emergency departments: a survey of practice

<p><i>Background and objectives</i>: The American Heart Association guidelines from 2000 recommend that family members be allowed to witness cardiopulmonary resuscitation. This is controversial and opponents fear litigation and family interference during family witnessed resuscitation (FWR). The extent of FWR in UK Emergency Departments is unknown.</p> <p><i>Methods</i>: A telephone survey of a selection of UK Emergency Departments was performed asking about experience with FWR.</p> <p><i>Results</i>: One-hundred-and-sixty-two UK Emergency Departments with an average attendance of 47 000 patients per year participated. FWR was allowed by 128 (79%) for an adult patient and 93% for a child. Of these, 50% invited relatives to witness and only 21% did not permit FWR. The perceived benefits were: accepting that all possible has been done (48%), accepting the death (48%) and help with grieving (38%). Two percent did not think FWR was of help. Few had encountered any problems or interference from the family. Never being asked was the commonest reason not allowing FWR followed by staff reluctance. Most respondents would wish to be present if their child (85%), spouse/partner (64%) or elderly relative (52%) was being resuscitated.</p> <p><i>Conclusions</i>: FWR is common in UK Emergency Departments. It is more common when children are being resuscitated than adults. Further research is needed to demonstrate whether it is of benefit to the patient or relatives and its applicability to other areas such as intensive care.</p&gt

In-flight medical emergencies: response of anaesthetists who were passengers on commercial flights

All consultants and trainees in anaesthesia in a large teaching hospital were surveyed. Details of the number of flights per year and details of any medical emergencies in which they had been involved were recorded. The mean number of flights per year was 7.1 domestic and 3.4 international. Of the 45 anaesthetists surveyed, 14 had dealt with emergencies in flight, four had dealt with more than one. The minor emergencies (12) included transient ischaemic attacks, abdominal pain and otitis media. The seven serious events included seizures, angina, hypoglycaemic coma, respiratory arrest and two fatal cardiac arrests. No flights were diverted. On only two occasions were their medical qualifications checked. Requests for documentation were unusual. On several occasions the equipment which was available was inadequate. All doctors that responded were insured in the UK and most stated that they would assist Americans on American airlines. Medical emergencies were more likely on long haul flights

An analogue of the UP-iteration for constant mean curvature one surfaces in hyperbolic 3-space

SIGLEAvailable from TIB Hannover: RR 1596(461) / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekDEGerman