65 research outputs found
Outcomes research in the development and evaluation of practice guidelines
BACKGROUND: Practice guidelines have been developed in response to the observation that variations exist in clinical medicine that are not related to variations in the clinical presentation and severity of the disease. Despite their widespread use, however, practice guideline evaluation lacks a rigorous scientific methodology to support its development and application. DISCUSSION: Firstly, we review the major epidemiological foundations of practice guideline development. Secondly, we propose a chronic disease epidemiological model in which practice patterns are viewed as the exposure and outcomes of interest such as quality or cost are viewed as the disease. Sources of selection, information, confounding and temporal trend bias are identified and discussed. SUMMARY: The proposed methodological framework for outcomes research to evaluate practice guidelines reflects the selection, information and confounding biases inherent in its observational nature which must be accounted for in both the design and the analysis phases of any outcomes research study
Brachial approach to emergency cardiac catheterization during thrombolytic therapy for acute Myocardial Infarction
Coronary angioplasty after intravenous streptokinase in acute myocardial infarction: Influence of restenosis on clinical outcome and left ventricular function
Angioplasty in the patient with an evolving myocardial infarction: With and without surgical backup
Variations in the Electrocardiograms of Young Adults: Are Revised Criteria for Thrombolysis Needed?
Implications of Recent Trials Employing Combined Reperfusion Strategies for Acute Myocardial Infarction
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