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Biomedical subjects

A Durocher

Publications and source records attributed to A Durocher.

98 records · Page 6Linked to original sources
PubMedDate not supplied

[Value of determining trace elements in septicemia. Clinical correlations, prognostic value].

Among 17 septicemic patients, a statistically decrease of seric oligo-elements is demonstrated. The longitudinal study shows the rapid correction of these perturbations in the surviving group and the lack of correction among the non survivors. The level of phosphorus is the most interesting one. The importance of S.R.E. activity is probably the physiopathologic support of seric oligo-element modifications in sepsis.

Adolescent↗
PubMedDate not supplied

[Consensus conference: methodology and contribution].

A consensus conference is a method used to evaluate a medical process and to elaborate practice guidelines. The goal of consensus conference is to obtain the best possible outcomes for patients. The guidelines are written by a multidisplinary jury which analyses scientific datas and clinical practices. Consensus conference don't resolve all medical problems. It's a good evaluation method for the topics where there are non medical sides, inappropriate medical options or different clinical practices in spite of sufficient scientific datas. Consensus conference use three distinct groups: organization committee, jury and experts. The lectures of the experts and the guidelines must distinguish and clarify which is scientifically proved. Use of biomedical databases and critical analysis of biomedical articles are useful. Practice guidelines must be clear, precise, explicit and useful for clinical practices. Measurement of the real usefulness of consensus conference is difficult: it's the problem of the impact of guidelines on care. Usually it could be realized by survey of clinical practices or drugs consuming. The impact will be better with a large use of media, dissemination of the guidelines in the medical faculties and during professional workshops.

Consensus Statements as Topic↗
PubMedDate not supplied

[Nursing care evaluation, how to measure it and why?].

Quality of care assessment is based on three main prerequisites: to describe precisely patients or case-mix, to measure the level of care, to evaluate the outcomes and finally to consider the relationships between these parameters. Indicators to measure the level of nurses' workload have been developed from different concepts and methodologies: The range of nurses' activities is very wide, such as cares achieved in the presence of patient, cares achieved after medical prescription or specific nurse cares, administrative tasks, research activities, etc. Indicators may take into account a more or less important part of this field, but most of them are usually focused on patient's care. The value of each parameter may be a calculated coefficient or a time unit. If one considers the time as the best unit to measure the intensity of work, it is also an underlying concept to differentiate the actual time, obtained by timing, from the required time, necessary to achieve correctly the action. In the same way, required cares are also the best to consider. Indeed measuring required time for required cares is necessary to reach quality aim. The nurses' workload may be directly calculated with a specific indicator or indirectly estimated from a severity or disability scoring system. The selection of the indicator depends of the purpose of the evaluation process. If the question is to improve and develop quality of care and professional practices, the indicator has to take into account the required cares. The PRN system (Project de Recherche en Nursing) developed in Canada is probably the reference indicator. However this score is complex and cannot be daily used.(ABSTRACT TRUNCATED AT 250 WORDS)

France↗
PubMedDate not supplied

[The educated societies and the development of medical evaluation].

The French National Agency for Medical Evaluation (ANDEM) is regularly cooperating with scientific societies. In 1995, for the clinical guidelines and medical references program, ANDEM sent a request to 167 scientific societies. Societies were asked to select topics in which they had an involvement, to provide their guidelines, or recommendations they published, and to provide experts' names. 73 (44%) out of 167 scientific societies answered: 53 (77%) out of the 73 proposed themes, 20 (27%) sent a documentation, and 53 (73%) provided experts' names. Twenty (27%) out of the 73 wished to cooperate with ANDEM to draft clinical guidelines. Thirty (41%) out of the 73 gave a similar answer with less information. Twelve wished to cooperate but did not show any evidence for such a goal. The answering lag time, the presence of scientific society headings on the letter, the absence of arguments against the request showed that some scientific societies were better organized. It seems that many scientific societies did not have a good organization to efficiently answer to ANDEM request; they have not sufficient resources to afford all their objectives. Learned societies are not well defined, and their functioning is unknown. They wish to be recognized by professionals, institutions and all organizations. The scientific production does not seem to be much developed, even if such production is their first objective.

France↗
PubMedDate not supplied

[How to evaluate nursing practices?].

Assessment of clinical health care focuses on 'what is really done' in order to describe day-to-day practice. These data could be compared with standards or guidelines. The method used, the 'clinical audit', aims to improve the quality of care through specific actions. Finally, a second data collection could assess the efficacy of these actions. Many protocol designs could be used; they are illustrated by two examples in this article. The choice of protocols depends on the field and on the objectives of the work. Most of the time, assessment of clinical health care is included in a continuous quality improvement programme.

Evaluation Studies as Topic↗
PubMedDate not supplied

A methodology for consensus conferences. Société Royale Belge de Gastro-entérologie.

Consensus conference is one of the methods proposed to develop clinical practice guidelines. This method is used when the topic is limited to a small numbers of questions (4 to 6) and when there is a controversy. This process is based on the meeting of a jury which reviews the scientific information provided by the literature and presented by experts. The consensus conference consists of three phases: A preliminary phase during which questions are well defined, experts and jury are chosen by a panel of organizers usually designed by scientific societies. In the jury there are multidisciplinary specialists, generalists practitioners and other people such as nurses, economists, ... Experts conduct the review and analysis of the literature. The jury is informed by organizers about the methodology of a consensus conference and about the quality of scientific information available. The second phase is the plenary session of the consensus conference. It lasts one or two days during which the expert's texts and presentation are discussed by the jury and a public. The third phase is the actual meeting of the jury, behind closed doors, during which conclusions and clinical practice guidelines are formulated. Dissemination of these guidelines is one of the major factors determining the impact of the consensus conference. These guidelines are usually mailed directly to the professionals concerned and published in scientific journals and dissiminated via professional associations, universities, post graduate training bodies, ... The impact of the conference is assessed one or two years after and compared by the same method with the results of a preliminary survey before the conference. This process is long and expensive but is increasingly used because of the necessity for physicians to assimilate and to integrate into their daily clinical practice an increasing mass of scientific information.

Belgium↗