A5013964761- Health Systems, Economic Evaluations, Quality of Life
- Healthcare Policy and Management
- Statistical Methods in Clinical Trials
- Emergency and Acute Care Studies
- Hospital Admissions and Outcomes
- Statistical Methods and Bayesian Inference
- Meta-analysis and systematic reviews
- Healthcare cost, quality, practices
- Electronic Health Records Systems
- Liver Disease Diagnosis and Treatment
- Primary Care and Health Outcomes
- Trauma and Emergency Care Studies
- Vitamin C and Antioxidants Research
- Pharmaceutical Economics and Policy
- Advanced Causal Inference Techniques
- Optimal Experimental Design Methods
- Pharmaceutical Practices and Patient Outcomes
- Patient Safety and Medication Errors
- Economic and Environmental Valuation
- Delphi Technique in Research
- Liver Disease and Transplantation
- Health Policy Implementation Science
- Cardiac, Anesthesia and Surgical Outcomes
- Patient Satisfaction in Healthcare
- Vitamin K Research Studies
University of Birmingham
2013-2023
University of Nottingham
2022
Finnish Institute for Health and Welfare
2015
New York University Press
2015
Cambridge University Press
2015
Bridge University
2015
University of Cambridge
2015
Norfolk and Norwich University Hospitals NHS Foundation Trust
2014
Santa Maria Nuova Hospital
2014
Medical Research Council
2014
This report presents the Consolidated Standards of Reporting Trials (CONSORT) extension for stepped wedge cluster randomised trial (SW-CRT). The SW-CRT involves randomisation clusters to different sequences that dictate order (or timing) at which each will switch intervention condition. statement was developed allow unique characteristics this increasingly used study design. guideline using a Delphi survey and consensus meeting; is informed by CONSORT statements individual trials. items...
Cluster randomised controlled trials (CRCTs) are frequently used in health service evaluation. Assuming an average cluster size, required sample sizes readily computed for both binary and continuous outcomes, by estimating a design effect or inflation factor. However, where the number of clusters fixed advance, but it is possible to increase individuals within each cluster, as case evaluation, size formulae have been less well studied. We systematically outline (including randomisation...
Stepped-wedge cluster randomised trials (SW-CRTs) are being used with increasing frequency in health service evaluation. Conventionally, these studies cross-sectional design equally spaced steps, an equal number of clusters at each step and data collected every step. Here we introduce several variations on this consider implications for power. One modification is the incomplete SW-CRT, where varies or some example, implementation transition periods, not collected. We show that parallel CRT...
<b>Objectives</b> To conduct an independent evaluation of the first phase Health Foundation's Safer Patients Initiative (SPI), and to identify net additional effect SPI any differences in changes participating non-participating NHS hospitals. <b>Design</b> Mixed method involving five substudies, before after design. <b>Setting</b> hospitals United Kingdom. <b>Participants</b> Four (one each country UK) (SPI1); 18 control <b>Intervention</b> The SPI1 was a compound (multi-component)...
<b>Objective</b> To assess the validity of case mix adjustment methods used to derive standardised mortality ratios for hospitals, by examining consistency relations between risk factors and across hospitals. <b>Design</b> Retrospective analysis routinely collected hospital data comparing observed deaths with predicted Dr Foster Unit method. <b>Setting</b> Four acute National Health Service hospitals in West Midlands (England) adjusted ranging from 88 140. <b>Participants</b> 96 948 (April...
To independently evaluate the impact of second phase Health Foundation's Safer Patients Initiative (SPI2) on a range patient safety measures. Design A controlled before and after design. Five substudies: survey staff attitudes; review case notes from high risk (respiratory) patients in medical wards; surgical patients; indirect evaluation hand hygiene by measuring hospital use handwashing materials; measurement outcomes (adverse events, mortality among admitted to wards, patients'...
The effect of many cost effective policy and service interventions cannot be detected at the level patient. This new framework could help improve design (especially choice primary end point) interpretation evaluative studies
BackgroundIncreased mortality rates associated with weekend hospital admission (the so-called effect) have been attributed to suboptimum staffing levels of specialist consultants. However, evidence for a causal association is elusive, and the magnitude deficit remains unquantified. This uncertainty could hamper efforts by national health systems introduce 7 day services. We aimed examine preliminary associations between intensity across English National Health Service.MethodsEligible trusts...
In stepped cluster designs the intervention is introduced into some (or all) clusters at different times and persists until end of study. Instances include traditional parallel more recent stepped‐wedge designs. We consider precision offered by such under mixed‐effects models with fixed time random subject effects (including interactions time), explore optimal choice uptake times. The results apply both to cross‐sectional studies where new subjects are observed each time‐point, longitudinal...
This article introduces the Stata menu-driven program steppedwedge, which calculates detectable differences and power for stepped-wedge randomized trials. The command permits continuous, binary, rate outcomes (with normal approximations) comparisons using two-sided tests. allows specification of number clusters at each step, steps average cluster (cell) size, or an incomplete design in user spec-ifies pattern (a matrix with one row per cluster, column time point, entries indicating exposure...
Objective To understand the medium-term consequences of implementing commercially procured computerized physician order entry (CPOE) and clinical decision support (CDS) systems in 'early adopter' hospitals.
To evaluate mildly abnormal liver function test (LFT) results in general practice among patients who do not have known disease.Prospective cohort study of people with LFT identified primary care. Participants were intensively investigated using a common protocol and followed up for 2 years. Substudies the psychological sequelae results, clinicians' reasons testing, decision options when early detection fibrosis.Eleven primary-care practices: eight Birmingham three Lambeth.Adults did...
Medical device companies are under growing pressure to provide health-economic evaluations of their products. Cost-effectiveness analyses commonly undertaken as a one-off exercise at the late stage development new technologies; however, benefits an iterative use economic evaluation during process products have been acknowledged in literature. Furthermore, Bayesian methods within health technology assessment has shown be particular value dynamic framework appraisal when information becomes...
Purchasing and reimbursement decisions in healthcare systems with finite resources are increasingly influenced by formal health economic analysis. It is therefore sensible for a company considering the development of new medical technology to assess its potential cost effectiveness as early possible cycle. This document describes process which an organisation can add rigour about technologies pursue, well creating persuasive argument outside investment. The consists series analyses that...
Clustered randomised controlled trials (CRCTs) are increasingly common in primary care. Outcomes within the same cluster tend to be correlated with one another. In sample size calculations, estimates of intra-cluster correlation coefficient (ICC) needed allow for this nonindependence. studies observations over more than time period, inter-period (IPC) and within-period (WPC) also needed.This is a retrospective cross-sectional study all patients aged 18 or diagnosis type-2 diabetes, from The...
Low ascorbate concentrations in diabetes may be secondary to inadequate dietary vitamin C intake or relate the varied metabolic roles of vitamin. To determine whether is a factor we calculated daily intakes using both questionnaire and 4‐day food diary group 30 patients with Type 2 (mean age 68.8 ± 6.9 yr, 17M/13F) community controls 68.0 5.5 12M/18F)). Measures plasma glucose, serum fructosamine, ascorbic dehydroascorbic acid were obtained from 20 subjects each group. There was no...
Risk-adjustment schemes are used to monitor hospital performance, on the assumption that excess mortality not explained by case mix is largely attributable suboptimal care. We have developed a model estimate proportion of variation in standardised ratios (SMRs) can be accounted for preventable mortality. The was populated with values from literature predictive value SMR this context—specifically those hospitals SMRs among highest 2.5% fall worst extent which reflect rates highly sensitive...