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PubMed1988

Increasing the relevancy and usefulness of programme evaluation: a comprehensive evaluation.

Most organizations implement evaluation research to determine how to improve a programme or to decide if a programme should be continued. However, evaluation research can be used to help organizations make relevant and valid decisions for the cycle of programme planning, programme development, programme implementation, and programme operation. This paper describes a "comprehensive evaluation model" which will provide a framework for understanding the importance of evaluation activities at all programme phases (i.e. planning, development, implementation, and operation). Four sequential evaluation stages are presented as being the framework for the "comprehensive evaluation model". It is argued that these stages are essential to the organization and the evaluator in helping them adequately provide an assessment of a programme's efficiency and effectiveness.

Evaluation Studies as Topic↗
PubMed1990

Faculty evaluation: a closer look at peer evaluation.

As long as there have been academic institutions, administrators, faculty, and students, there have been evaluations. Evaluation involves placing a value or making a judgement about some aspect(s) of performance. Evaluation in nursing education has been studied extensively with respect to nursing students' academic and clinical performance. However, it is only in the last 2 decades that the issue of faculty evaluation has gained increased attention. Trends in nursing education with respect to the development of the overall concept and sources of input for evaluation of the nurse educator are discussed in this paper. Specific attention is focused on the process of peer evaluation and a tool to facilitate the peer evaluation process is included.

Employee Performance Appraisal↗
PubMed1989

From rarity to evaluative extremity: effects of prevalence information on evaluations of positive and negative characteristics.

Experiments showed a scarcity principle in evaluative judgments such that the identical characteristic is evaluated more extremely the lower its perceived prevalence. In Study 1, Ss evaluated a fictitious medical condition that was described as either beneficial or detrimental to health and as occurring in either 30% or in one half of 1% of a test population. The condition was evaluated more extremely--as as a more positive health asset or a more negative health liability--in the low-prevalence than in the high-prevalence conditions. Study 2 demonstrated the same effect in self-evaluations and with a different manipulation of perceived prevalence. Ss were told that they actually had the fictitious medical condition, that it was either beneficial or detrimental to their health, and either that they were the only 1 of 5 Ss who had it or that 4 of the 5 did. Low-prevalence Ss exhibited more extreme evaluative, affective, and behavioral reactions to the medical condition than did high-prevalence Ss. The origins and validity of the scarcity principle are discussed, as are its implications for uniqueness theory, reactance theory, and social evaluation theories.

Adult↗
PubMed2003

[Study of acute physiology and chronic health evaluation III and multiple organ dysfunction syndrome score in evaluating severity of intensive care units patient].

OBJECTIVE: To evaluate the value of acute physiology and chronic health evaluation(APACHE)III and multiple organ dysfunction syndrome(MODS) score introduced to evaluate the severity of intensive care unit(ICU) patient. METHODS: Seventy of ICU patients were scored by APACHE III and MODS scoring system respectively after admission for 24 hours. Area under of the receiver operating characteristic curve(ROC) was used to scale the ability of APACHE III and MODS scoring systems evaluating severity and predicting outcomes of ICU patient. The areas were compared among APACHE III, MODS and the score of APACHE III adding MODS. Discriminant was built between the scores and outcomes of patient, and coefficients were compared among the three scoring systems. RESULTS: The areas under of the ROC of APACHE III, MODS and the score of APACHE III adding MODS were 0.765, 0.643 and 0.753 respectively; coefficients of discriminant of them were 0.998, 0.892 and 0.568 respectively. CONCLUSION: APACHE III is superior to MODS scoring system in evaluating severity of ICU patient, and APACHE III add MODS score can't increase the evaluating effectiveness compared to APACHE III and MODS score respectively in evaluating severity of ICU patient.

APACHE↗
PubMed2006

Ethnographically informed community evaluation: a framework and approach for evaluating community-based initiatives.

OBJECTIVES: This paper describes ethnographically informed community evaluation (EICE), a framework for evaluating complex community-based interventions, and illustrates its use in the evaluation of Baltimore City Healthy Start, a federally funded infant mortality prevention project. EICE, which is influenced by cultural anthropology and assets-based community assessment, supports continuous program improvement, resident involvement, and measurement of community-level change. This approach takes into account both individual and contextual levels of analysis. METHODS: The evaluation coupled a participatory approach with qualitative and survey research methods to study community context and how it might contribute to infant mortality and influence program implementation, and to assess community change resulting from the program. Data collection included focus groups, key informant interviews, surveys, neighborhood mapping, journaling, and a study of community problem-solving. RESULTS: The evaluation provided program-related feedback to staff, contributed to a collective understanding of the local context, validated and augmented outcome findings, and imparted skills and a sense of empowerment to the neighborhood. Results reveal a community burdened by crime and social problems, yet showing great diversity in physical and social conditions when examined at the census block group level. Nevertheless, these social and physical hazards in the community are more salient than any specific health issue such as infant mortality. CONCLUSIONS: EICE is a powerful evaluation approach able to respond to the complexities of community-based maternal and child health initiatives designed to institute changes across multiple domains. EICE may be used, in whole or in part, as a supplement to traditional designs.

Anthropology, Cultural↗
PubMed1994

The CTFA Evaluation of Alternatives Program: an evaluation of in vitro alternatives to the Draize primary eye irritation test. (Phase II) oil/water emulsions.

The Cosmetic, Toiletry and Fragrance Association (CTFA) Evaluation of Alternatives Program is an evaluation of the relationship between Draize ocular safety test data and comparable data from a selection of in vitro tests. In Phase II, 18 representative oil/water-based personal-care formulations were subjected to the Draize primary eye safety test and 30 in vitro assay protocols (14 different types of in vitro endpoints were evaluated; the remainder were protocol variations). Correlation of in vitro with in vivo data was evaluated using analysis of sensitivity/specificity and statistical analysis of the relationship between maximum average Draize score (MAS) and in vitro endpoint. Regression modelling is the primary approach adopted in the CTFA Program for evaluating in vitro assay performance. The objective of regression analysis is to predict MAS for a given test material (and to place upper and lower prediction interval bounds on the range in which the MAS is anticipated to fall with high probability) conditional on observing an in vitro assay score for that material. The degree of confidence in prediction is quantified in terms of the relative widths of prediction intervals constructed about the fitted regression curves: the narrower the prediction interval, the more predictive of the Draize score is the in vitro test result. 16 assays were shown to have the greatest agreement with the Draize procedure and were therefore selected for regression analysis. Based on the magnitude of the 95% prediction bounds of each of the 16 selected assays over the range of test data, it may be inferred that prediction of MAS values from experimentally determined in vitro scores is more accurate for oil/water-based formulations with lower rather than higher irritancy potential. The assays selected for modelling in Phase II generally exhibited weaker relationships with MAS than those selected in Phase I (evaluated using hydroalcoholic formulations), even though several assays were common to both Phases.

3T3 Cells↗
PubMed2000

Faculty evaluation by residents in an emergency medicine program: a new evaluation instrument.

OBJECTIVE: Evaluation of preceptors in training programs is essential; however, little research has been performed in the setting of the emergency department (ED). The goal of this pilot study was to determine the validity and reliability of a faculty evaluation instrument-the Emergency Rotation (ER) scale-developed specifically for use in emergency medicine (EM). METHODS: A prospective study comparing the ER scale with two alternative faculty evaluation instruments was completed in three of the five EDs affiliated with an EM teaching program, where emergency physicians are members of the clinical teaching faculty. The participants were 18 residents (postgraduate years 1, 2, and 3) who were completing four-week clinical rotations in EM. Residents at the end of the rotation recorded their evaluations of each emergency physician with whom they had clinical encounters on the following evaluation tools: the ER scale, a longer validated scale (Irby), and a global assessment scale (GAS). Domain scores were correlated with the previously validated scale and the GAS to determine validity using a multitrait-multimethod matrix. The reliability of the ER scale was measured using a Chronbach's alpha coefficient. RESULTS: Forty-eight preceptor evaluations were completed on 29 individual preceptors. The rating of preceptors was high using the ER scale (median: 16 of 20; IQR: 13, 18), Irby (median: 300 of 378; IQR: 267, 321), or GAS (mean: 7.8 of 10; SD: 1.3). Domain scores for each tool were used in the multitrait-multimethod matrix and the correlations between a previously validated tool and the ER scale were found to be high (>0.70) in the various domains. The internal consistency of the ER scale was also high (r = 0.85). CONCLUSIONS: The ER scale appears to be valid and reliable. It performs well when compared with previously psychometrically tested tools. It is a sensible, well-adapted tool for the teaching environment offered by EM.

Alberta↗
PubMed2004

[Evaluative research and epidemiology: trends and synthesis in the health programs evaluation process].

This article focuses on antecedents in the evaluation of health programs and highlights the diversity of theories and methods applied to the field. In order to provide support for evaluative research in HIV/AIDS, the article discusses several classical principles in epidemiology, particularly the theory of causal inference and its limits for approaching infectious diseases. The article contends that recent debates concerning the logic and applicability of ecological studies establish convergent interests between epidemiology and evaluative research, concerned with incorporating contextual variables into the analytical models. The principles and typologies of contemporary evaluative research are explained with a view towards defending an analytical model for health-disease processes from the perspective of evaluating actions and programs. The article concludes by highlighting common proposals and convergent trends in epidemiology and evaluative research, serving as the framework for discussion on the limits and potentialities of the proposed model.

Acquired Immunodeficiency Syndrome↗
PubMed2005

Introducing economic evaluation as a policy tool in Korea: will decision makers get quality information? : a critical review of published Korean economic evaluations.

Interest in the use of economic evaluations in Korea as an aid for healthcare decision makers has been growing rapidly since the financial crisis of the Korean National Health Insurance fund and the separation in 2000 of the roles of prescribing and dispensing drugs. The Korean Health Insurance Review Agency (HIRA) is considering making it mandatory for pharmaceutical companies to submit the results of an economic evaluation when demanding reimbursement of new pharmaceuticals. The usefulness of the results of economic evaluations depends highly on the quality of the studies. The purpose of this paper, therefore, is to provide a critical review of economic evaluations of healthcare technologies published in the Korean context. Our results show that many studies did not meet international standards. Study designs were suboptimal, study perspectives and types were often stated incompletely, time periods were often too short, and outcome measures were often less than ideal. In addition, some articles did not distinguish between measurement and valuation of resource use. Capital, overhead and productivity costs were often omitted. Only half of the studies performed sensitivity analyses. In order to further rationalise resource allocation in the Korean healthcare sector, the quality of the information provided through economic evaluations needs to improve. Developing clear guidelines and educating and training researchers in performing economic evaluations is necessary.

Cost-Benefit Analysis↗
PubMed2005

Economic evaluations of healthcare programmes and decision making: the influence of economic evaluations on different healthcare decision-making levels.

Given the potential role of economic information in healthcare decision making, it is of interest to assess its influence on decisions at a national or regional level (macro level), at a healthcare facility level (meso level) and at the healthcare provider level (micro level). This literature review summarises 36 empirical studies that examined the influence of economic evaluations on these three healthcare decision-making levels. Economic evaluations are considered useful and important; however, their direct influence on decision making (instrumental use) is moderate, especially at the macro and micro levels. A major influence was observed at the meso level, leading to the conclusion that economic evaluations have the most pronounced influence on decision making within healthcare organisations. However, unexpectedly, our literature search did not reveal an empirical study analysing the considerable influence of economic evaluations on decisions by the National Institute of Health and Clinical Excellence in the UK. Our findings indicate that results of economic evaluations cannot be considered the dominant decision criterion for healthcare decision makers at either the macro, meso or micro levels. Enlightenment use (where scientific evidence provides a background of information, ideas and concepts that affect the way policy makers view problems and solutions) of economic evaluations in decision making remains to be proven.

Decision Making↗
PubMedDate not supplied

Psychometric evaluation of the Program Evaluation Instrument.

Most continuing education program evaluations are developed informally with little attention paid to psychometric properties. Rigorous evaluation of continuing education programs should measure quality and allow valid comparisons across programs. The Program Evaluation Instrument (PEI), which evaluates continuing education programs, was tested in this study to further evaluate its psychometric properties. The 19-item instrument consists of four theoretical subscales: program objectives, learner objectives, teacher behavior, and program satisfaction. Participants (N = 566) completed the instrument after a variety of hospital continuing education programs. Principal components factor analysis with Varimax rotation revealed two interpretable factors, Preparation and Presentation, and Usefulness. Coefficient alphas for the two factors were .94 and .70 respectively. The findings suggest item revision and further psychometric evaluation.

Education, Nursing, Continuing↗
PubMed2000

Clinical benefit of glycoprotein IIb/IIIa blockade with Abciximab is independent of gender: pooled analysis from EPIC, EPILOG and EPISTENT trials. Evaluation of 7E3 for the Prevention of Ischemic Complications. Evaluation in Percutaneous Transluminal Coronary Angioplasty to Improve Long-Term Outcome with Abciximab GP IIb/IIIa blockade. Evaluation of Platelet IIb/IIIa Inhibitor for Stent.

OBJECTIVES: We sought to determine the efficacy and safety of platelet glycoprotein IIb/IIIa receptor (GP IIb/IIIa) blockade with abciximab in women undergoing percutaneous coronary intervention. BACKGROUND: Although gender differences in response to platelet glycoprotein IIb/IIIa receptor blockade have been described, there have been no large clinical studies to assess these differences. METHODS: Outcomes were determined using meta-analysis technique. RESULTS: In the pooled analysis, the primary end point of death, myocardial infarction (MI) or urgent revascularization within 30 days was reduced from 11.3% to 5.8% (p<0.001) in men and from 12.7% to 6.5% (p<0.001) in women treated with abciximab. At six months, death, MI or urgent revascularization was reduced from 14.1% to 8.3% (p<0.001) in men and 16.0% to 9.9% (p<0.001) in women receiving abciximab. At one year, mortality was reduced from 2.7% to 1.9% (p = 0.06) in men and 4.0% to 2.5% (p = 0.03) in women treated with abciximab. Major bleeding events occurred in 2.9% versus 3.0% (p = 0.96) of women and 2.7% versus 1.3% (p = 0.003) of men treated with placebo versus abciximab, respectively. Minor bleeding events occurred in 4.7% versus 6.7% (p = 0.01) of women and 2.3% versus 2.2% (p = 0.94) of men treated with placebo versus abciximab, respectively. CONCLUSIONS: This pooled analysis demonstrated no gender difference in protection from major adverse outcomes with GP IIb/IIIa inhibition with abciximab. Although women had higher rates of both major and minor bleeding events with abciximab compared with men, major bleeding in women was similar with and without abciximab. There was a small increased risk of minor bleeding with abciximab in women.

Abciximab↗
PubMed1978

Evaluation of drug treatment in mild hypertension: VA-NHLBI feasibility trial. Plan and preliminary results of a two-year feasibility trial for a multicenter intervention study to evaluate the benefits versus the disadvantages of treating mild hypertension. Prepared for the Veterans Administration-National Heart, Lung, and Blood Institute Study Group for Evaluating Treatment in Mild Hypertension.

A feasibility trial to investigate the practicality of determining the advantages and disadvantages of prompt pharmacologic treatment for mild hypertension was jointly funded by the Veterans Administration and the National Heart, Lung and Blood Institute. Its clinical phase has been completed, and it demonstrated 1. that the required relatively young asymptomatic population could be enrolled in the study and 2. that it could be persuaded to adhere to the protocol for 2 years; however, it was evident that intensive efforts would be required in both areas. The feasibility trial screened almost 120,000 potential subjects over a period of 16 months to randomize about 1,000 subjects at four clinical centers. These men and women were 21 to 50 years old, had diastolic pressures from 85 to 105 mm Hg as outpatients, and had no evidence of cardiovascular renal abnormalities. They were randomized in double-blind fashion into active drug therapy and placebo groups. Stepped care therapy involved 50 mg chlorthalidone (Step 1), 100 mg chlorthalidone (Step 2) and 100 chlorthalidone plus 0.25 mg reserpine (Step 3). Death, myocardial infarction, stroke, angina pectoris, and congestive heart failure were the "major" morbid events that were looked for; also recorded were "minor" morbid events consisting primarily of electrocardiographic arrhythmias. The development of significant hypertension was considered a treatment failure. Side effects were carefully tabulated in both active drug and placebo groups. The study revealed an average drop in diastolic pressure of almost 12 mm Hg for active drug group and less than half of that for the placebo group; once established 6 months after randomization, the new pressure levels persisted almost without change throughout the study. Although the feasibility trial was not designed to answer the primary question regarding the benefits of treatment, the events were tabulated for each group. A total of 12 placebo-treated subjects developed significant hypertension and were put on active drug. There was not a significant difference between the two groups in the incidence of "major" morbid events; a total of eight active and five placebo patients developed myocardial infarction or died suddenly. There, however, was an excess of arrhythmias among the active drug subjects (17 in the active group versus 8 in the placebo group on the basis of preliminary data). Finally, there were twice as many side effects and 20 times as many chemical abnormalities among the active as among the placebo subjects. A protocol for a full scale study of the benefits of pharmacologic therapy in mild hypertensives has been prepared and is ready for implementation as needed; it involves relatively minor modifications of the protocol tested in the feasibility trial.

Adult↗