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PubMed2002

[Scientific evaluation and quality assurance in refractive surgical interventions. Evaluation of the Datagraph med computer program].

BACKGROUND: During recent years refractive surgical procedures have been increasingly used to correct refractive errors. Exact saving and assessment of pre-, intra- and postoperative results for scientific evaluation are desired and are necessary for quality management. The purpose of this investigation was to evaluate the database program Datagraph med (version 2.5) which has been developed for data processing and assessment in refractive surgery. MATERIAL AND METHODS: Pre-, intra- and postoperative data of 169 eyes treated with different refractive surgical methods (laser in situ keratomileusis, photorefractive keratectomy, laser thermal keratoplasty, phacic IOL) were collected, entered in the database and then evaluated by the above-mentioned program (with a follow-up of up to 12 months). The exactness of the Datagraph results was compared by means of manual recalculation. RESULTS: Datagraph med was able to precisely process the patient data and save them in a database. Statistics and graphs presented by Datagraph were as data has been entered. Furthermore all standard graphs requested by the international consensus for evaluation of refractive surgical data (stability, predictability, efficacy, safety and complications) could be imaged. CONCLUSIONS: Datagraph med is a helpful and precisely functioning program for processing and evaluation of refractive surgical data. It can be used for both scientific studies and for quality control. A continuous development and improvement of the program as well as the addition of statistical functions will be necessary due to the on-going progress in refractive surgery.

Adult↗
PubMed1984

The feedback research approach to evaluation: a method to increase evaluation utility.

The utilization of evaluation results continues to be a great concern among professionals in the field. To increase the potential usefulness of evaluation, the feedback research approach is proposed as a method that is especially helpful in studies that fail to find program effectiveness. Going beyond the bounds of the evaluation framework and studying the problem for which the program was designed to ameliorate, evaluations that incorporate a feedback research component can provide clients with valuable information to guide further program development. This paper provides a description of the approach and an illustration of its use in an evaluation of a major international corporation's health improvement/stress management program.

Evaluation Studies as Topic↗
PubMedDate not supplied

Evaluation of automated information systems in health care: an approach to classifying evaluative studies.

In this paper we discuss an approach to classifying evaluative studies of automated information systems in health care. Selected literature (76 studies) is classified according to the type of automated information system (based on relationship to the care process), the study design used, the data collection methods used, the effect(s) measured and the type of evaluation (e.g. cost-benefit analysis). First results show that certain types of automated information systems have not been evaluated much, going by the number of studies selected. Furthermore, it is observed that certain study designs (time-series design), data collection methods (modelling and simulation) and effect measures (job satisfaction) are hardly to be found in the literature. Only 10 of 76 selected studies used a type of evaluation for which both consequences and costs are considered. Detailed investigation of the literature may provide information for the development of a general framework for the evaluation of different types of automated information systems.

Classification↗
PubMed1991

Conference evaluation: development of an evaluation tool.

The development and application of an evaluation tool based on Stufflebeam's model is described. This used the four areas of Context, Input, Process and Product as areas to evaluate. The tool was developed for the evaluation of an English National Board national study conference for Mental Health Nursing entitled 'Towards 2000', held at Ripon, 24-27 July 1989. A wealth of data, both quantitative and qualitative, was generated. The use of Stufflebeam's model for evaluation was found to be useful. However, a shorter evaluation form is needed for general use.

Congresses as Topic↗
PubMed2004

Colour evaluation in scars: tristimulus colorimeter, narrow-band simple reflectance meter or subjective evaluation?

The evaluation of scar colour is, at present, usually limited to an assessment according to a scar assessment scale. Although useful, these assessment scales only evaluate subjectively the degree of scar colour. In this study, the reliability of the subjective assessment of scar colour by observers is compared to the reliability of the measurements of two objective colour measurement instruments. Four independent observers subjectively assessed the vascularisation and pigmentation of 49 scar areas in 20 patients. The degree of vascularisation and pigmentation was scored according to a scale ranging from '1', when it appeared to be like healthy skin, to '10', which corresponds to the worst imaginable outcome of vascularisation or pigmentation. The observers also scored the pigmentation categories of the scar (hypopigmention, hyperpigmention or mixed pigmentation). Finally, each observer measured the scar areas with a tristimulus colorimeter (Minolta Chromameter) and a narrow-band simple reflectance meter (DermaSpectrometer). A single observer could reliably carry out measurements of the DermaSpectrometer and the Minolta Chromameter for the evaluation of scar colour (r = 0.72). The vascularisation of scars could also be assessed reliably with a single observer (r = 0.76) whereas for a reliable assessment of pigmentation at least three observers were necessary (r > or = 0.77). The agreement between the observers for the pigmentation categories also turned out to be unacceptably low (k = 0.349). This study shows that an overall evaluation of scar colour with the DermaSpectrometer and the Minolta Chromameter is more reliable than the evaluation of scar colour with observers. Of both instruments for measuring scar colour, we prefer, because of its feasibility, the DermaSpectrometer.

Adolescent↗
PubMedDate not supplied

Evaluating food stamp nutrition education: a view from the field of program evaluation.

The purpose of this paper is to review current approaches and issues in the field of program evaluation that apply to the effort of improving the evaluation of Food Stamp Nutrition Education (FSNE). As nutrition educators respond to increasing demands for accountability and measuring results, there are challenges to consider, as well as opportunities to capture. This paper includes a focus on the internal and external functions of evaluation, with attention given to evaluation's internal use and value in improving practice. A list of 10 building blocks is offered as essential for planning useful and credible evaluation of FSNE.

Community Health Services↗
PubMed1997

Evaluations of road accident blackspot treatment: a case of the Iron Law of Evaluation Studies?

Numerous evaluation studies have reported large accident reductions when road accident blackspots are treated. A critical examination of these studies reveals that many of them do not account for the effects of well known confounding factors, like the regression-to-the-mean effect that is likely to occur at road accident blackspots. This paper shows that the more confounding factors evaluation studies account for, the smaller becomes the accident reduction attributed to blackspot treatment. Studies that account for both regression-to-the-mean and a possible accident migration to neighbouring untreated sites do not show any net accident reduction at all. This tendency conforms to the so called Iron Law of evaluation studies, which states that the more confounding factors an evaluation study accounts for, the less likely it is to show beneficial effects of the programme evaluated. Possible explanations of accident migration are discussed in the paper.

Accidents, Traffic↗
PubMed1988

Difficulties and bonuses of evaluation: evaluating New Zealand's Children's Nightclothes Act 1977.

Difficulties and bonuses of evaluating injury prevention programmes are illustrated by reference to an evaluation of the New Zealand's Children's Nightclothes Act 1977. It is demonstrated that despite the difficulties encountered in that evaluation, and the equivocal results, there were significant bonuses which more than justified the resources devoted to the evaluation. The paper is presented in an attempt to encourage others to evaluate thermal injury countermeasures who may be hesitant to do so because of the difficulties they foresee.

Burns↗
PubMed2000

The U.K. NHS economic evaluation database. Economic issues in evaluations of health technology.

OBJECTIVE: The U.K. NHS Economic Evaluation Database (EED) project is commissioned to identify papers on economic evaluations of health technologies and to disseminate their findings to NHS decision makers by means of structured abstracts that are available through a public database and the Cochrane Library. This paper discusses current issues relating to the economic aspects of producing NHS EED abstracts. METHODS: A review of NHS EED was undertaken between 1994 and 1999 to determine the methodologies adopted and issues that influence the usefulness of economic evaluations. Methods adopted to improve the quality of NHS EED abstracts are also reported. RESULTS: Eighty-five percent of NHS EED abstracts are cost-effectiveness analyses (CEAs), 9.3% are cost-utility analyses (CUAs), and only 1.4% are cost-benefit analyses (CBAs). Of the total abstracts, 65.9% are based on single studies, 19.5% on reviews, 3.9% on estimates of effectiveness, and 10.7% on combinations of these sources. Models are utilized in 16.7% of CEAs, 60.2% of CUAs, and 20% of CBAs. Analyses of CBA studies reveal a degree of misuse of well-established definitions. NHS EED internal control mechanisms are reported that provide a means of ensuring that abstracts are based on sound academic principles. CONCLUSIONS: Most economic evaluations are conducted by means of CEA, followed by CUA, while CBA accounts for an extreme minority of cases. Single studies form the principal source of effectiveness data, although models are widely used, principally in CUA. The structure of NHS EED abstracts provides decision makers with the principal results and an interpretation of the relative strengths and weaknesses of economic evaluations.

Abstracting and Indexing↗
PubMed2004

The interrater reliability of a functional capacity evaluation: the physical work performance evaluation.

The purpose was to evaluate the interrater reliability of the Dynamic Strength, Position Tolerance, and Mobility tasks of the Physical Work Performance Evaluation (PWPE), a Functional Capacity Evaluation often used with workers disabled due to back pain. For each worker's evaluation, two raters were preselected among five trained raters. One of the raters administered the PWPE while the other functioned as a silent rater. A convenience sample of 40 workers disabled due to back pain and referred to an occupational rehabilitation center was used. In general, the reliability was "substantial" (0.61 < or = kappa < or = 0.80) to "almost perfect" (0.81 < or = kappa < or = 1.00) for most of the 21 tasks and three sections of the PWPE evaluated with the exception of three tasks in the Mobility section (ladder climbing (kappa = 0.47), repetitive trunk rotation--standing (kappa = 0.54), and repetitive trunk rotation--sitting (kappa = 0.37)) task and the Mobility section itself (kappa = 0.54). Several reasons could explain the lower agreement on the observation of the physical signs associated with these tasks. Since these tasks involve rotation movements or complex neuromuscular integration, it seemed difficult for the raters to define what are the normal physical signs and when physical signs of maximal functional capacity are present. The criteria for establishing the presence of the physical signs in the PWPE should be improved.

Adolescent↗
PubMed2005

Health and economic benefits of well-designed evaluations: some lessons from evaluating neuroblastoma screening.

BACKGROUND: Well-designed evaluations of health services are frequently made today. However, the extent of the evaluations' benefits and costs is not well documented, creating uncertainty whether their use is optimal from society's perspective. We examined these costs and benefits using data from one well-designed evaluation, the Quebec Neuroblastoma Screening Project (QNSP). It screened most Quebec newborns between 1989 and 1994 for neuroblastoma. As previously reported, the screening did not reduce neuroblastoma mortality and caused adverse health effects. METHODS: We compared the cost of doing the QNSP with its benefits. Had the QNSP not been undertaken, neuroblastoma screening would have been implemented throughout North America. We assume that screening would have started in 1989 and ended in 2002. The QNSP's benefits include the health costs and adverse health effects averted by not using ineffective screening during those 14 years. In our calculations we used neuroblastoma incidence data for the QNSP and for Ontario where there was no screening, detailed data describing the health services used by the patients, and Quebec cost data for those services. RESULTS: The QNSP cost 8.77 million dollars (2002 US dollars). By not implementing similar screening programs between 1989 and 2002, the United States and Canada avoided 574.1 million dollars in health costs, the unnecessary treatment of 9223 children, and false-positive findings for 5003 children screened. CONCLUSIONS: The health care costs and adverse health effects averted by the QNSP justify its costs. These results show that well-designed evaluations can yield--at least sometimes--benefits substantially greater than their high costs. This raises an important policy issue: are these evaluations now being under- or over used?

Canada↗
PubMed2004

Evaluating evaluation forms form.

OBJECTIVES: To provide a tool for evaluating evaluation forms. METHODS: A new form has been developed and tested on itself and a sample of evaluation forms obtained from the graduate medical education offices of several local universities. Additional forms from hospital administration were also subjected to analysis. RESULTS: The new form performed well when applied to itself. The form performed equally well when applied to the other (subject) forms, although their scores were embarrassingly poor. CONCLUSIONS: A new form for evaluating evaluation forms is needed, useful, and now available.

Adult↗
PubMed2003

The Pediatric Economic Database Evaluation (PEDE) Project: establishing a database to study trends in pediatric economic evaluation.

BACKGROUND: While standard methods for conducting economic evaluations have evolved, little attention has been paid to the conduct of these studies in special populations such as children. OBJECTIVES: To build a database of pediatric economic evaluations and to examine trends in publication characteristics over a 20-year period. RESEARCH DESIGN: The database was created through a multisource search strategy, manual review, application of inclusion/exclusion criteria, data extraction, and reliability assessment. Descriptive statistics were used to summarize trends in publication volume, disease category, intervention type, and age group between 1980 and 1999. RESULTS: From an initial cut of 5600 citations identified from 12 journal databases, 787 were included as full pediatric economic evaluations. Volume of publications increased 7-fold between 1980 to 1984 and 1995 to 1999 from 61 to 440 citations per 5-year period. Most studies were performed in children aged 1 to 12 years, and studies in infants displayed an increasing frequency. The most common disease category was infective/parasitic, comprising 24% of studies. Studies of congenital anomalies and complications of pregnancy were also prominent. Although health prevention studies were the most prevalent, health treatment studies demonstrated an equal frequency in 1995 to 1999. Most studies consisted of malaria control and vaccination strategies for hepatitis B, Haemophilus influenzae type B, measles, and varicella. CONCLUSIONS: The number of pediatric economic evaluations is steadily increasing with most publications representing health prevention interventions. The Pediatric Economic Database Evaluation (PEDE) Project database will be valuable to health researchers working in methods research and conducting systematic reviews.

Age Distribution↗
PubMed2006

Predictors of a successful driver evaluation in stroke patients after discharge based on an acute rehabilitation hospital evaluation.

OBJECTIVE: One of the most common concerns of a stroke patient is the ability to drive. We aimed to determine which neurologic impairments on an acute rehabilitation admission evaluation predict the likelihood of a successful driver evaluation after discharge. DESIGN: Prospective study in an acute stroke rehabilitation unit. RESULTS: A total of 45 stroke patients undertook a driver evaluation at our institution. The mean age +/- standard deviation was 71.0 +/- 9.8 yrs, Mini-Mental State Examination score was 22.7 +/- 8.1, upper limb and lower limb Motricity Index scores were 63.7 +/- 34.8 and 71.8 +/- 24.3, Limb Placement Task was 4.6 +/- 3.6 inches, and admission total FIM score was 68.5 +/- 18. The admission variables differed between those who failed (n = 10) vs. those who passed the in-clinic driver evaluation (n = 29, 75%): Mini-Mental State Examination (17.5 +/- 9.7 vs. 24.6 +/- 6.7, P = 0.004), and upper limb (82 +/- 23.7 vs. 57.4 +/- 36.1, P = 0.05) and lower limb (87.6 +/- 11.8 vs. 66.4 +/- 25.2, P = 0.01) Motricity Index scores. CONCLUSIONS: Patients who undertook and passed the in-clinic driver evaluation had, at admission, higher Mini-Mental State Examination and Motricity Index scores with normal visual field defects.

Aged↗
PubMed1998

The Prevention Minimum Evaluation Data Set (PMEDS). A tool for evaluating teen pregnancy and STD/HIV/AIDS prevention programs.

This article presents the Prevention Minimum Evaluation Data Set (PMEDS), a ready-to-use questionnaire or tool for evaluating teen pregnancy prevention and teen STD/HIV/AIDS prevention programs. Recognizing the diversity of approaches taken by these programs, PMEDS has two parts. Part 1 contains a primary questionnaire applicable to all programs. Part 2 consists of 15 additional supplementary modules for optional use by programs with a more specific target population or intervention approach that matches the module's content. It is hoped that PMEDS will facilitate the conducting of high-quality evaluations, first by highlighting important aspects of a program model that should be included in an evaluation, such as the demographic profile of the target population, the specific aspects of the intervention or treatment received by each participant, and the short-term outcomes and long-term goals that the program is trying to affect; second, by presenting measures for these evaluation constructs that have been extensively pretested and used in large-scale national studies and for which national comparison norms and data exist.

Adolescent↗
PubMed2002

Factors influencing the evaluation of telehealth interventions: preliminary results from a qualitative study of evaluation projects in the UK.

We have carried out a qualitative study of factors that influence the evaluation of telehealth. The study concerned six telehealth projects that are being tracked over two years. In the first 12 months of the study we carried out semistructured interviews and made observations of the participants in the projects. Each case study involved 5-15 subjects, many of whom were interviewed several times. The results indicate that important issues affecting telehealth evaluation include developing and maintaining the technology, reorganization of clinical and administrative duties, professional dynamics, and the difficulty of integrating service provision and evaluation. The findings suggest that the evaluation of telehealth interventions is highly complex, and that this complexity is often underestimated in the design and conduct of evaluation studies.

Computer Communication Networks↗
PubMedDate not supplied

Should genetic groups be fitted in BLUP evaluation? Practical answer for the French AI beef sire evaluation.

Some analytical and simulated criteria were used to determine whether a priori genetic differences among groups, which are not accounted for by the relationship matrix, ought to be fitted in models for genetic evaluation, depending on the data structure and the accuracy of the evaluation. These criteria were the mean square error of some extreme contrasts between animals, the true genetic superiority of animals selected across groups, i.e. the selection response, and the magnitude of selection bias (difference between true and predicted selection responses). The different statistical models studied considered either fixed or random genetic groups (based on six different years of birth) versus ignoring the genetic group effects in a sire model. Including fixed genetic groups led to an overestimation of selection response under BLUP selection across groups despite the unbiasedness of the estimation, i.e. despite the correct estimation of differences between genetic groups. This overestimation was extremely important in numerical applications which considered two kinds of within-station progeny test designs for French purebred beef cattle AI sire evaluation across years: the reference sire design and the repeater sire design. When assuming a priori genetic differences due to the existence of a genetic trend of around 20% of genetic standard deviation for a trait with h2=0.4, in a repeater sire design, the overestimation of the genetic superiority of bulls selected across groups varied from about 10% for an across-year selection rate p=1/6 and an accurate selection index (100 progeny records per sire) to 75% for p=1/2 and a less accurate selection index (20 progeny records per sire). This overestimation decreased when the genetic trend, the heritability of the trait, the accuracy of the evaluation or the connectedness of the design increased. Whatever the data design, a model of genetic evaluation without groups was preferred to a model with genetic groups when the genetic trend was in the range of likely values in cattle breeding programs (0 to 20% of genetic standard deviation). In such a case, including random groups was pointless and including fixed groups led to a large overestimation of selection response, smaller true selection response across groups and larger variance of estimation of the differences between groups. Although the genetic trend was correctly predicted by a model fitting fixed genetic groups, important errors in predicting individual breeding values led to incorrect ranking of animals across groups and, consequently, led to lower selection response.

Animals↗
PubMed1993

The structured oral self-directed learning evaluation: one method of evaluating the clinical reasoning skills of occupational therapy and physiotherapy students.

The Structured Oral Self-directed Learning Examination (SOSLE) is used to evaluate the clinical reasoning skills of occupational therapy (OT) and physiotherapy (PT) students. It is an oral examination which evaluates a student's problem-solving ability, self-directed learning skills, knowledge level and self-assessment ability. The three parts of the examination are conducted over a 24-hour period. Validation of this instrument was carried out in two groups of OT and PT undergraduate students over two consecutive years (Year 1--n = 20) (Year 2--n = 18). Inter-rater reliability correlations varied from 0.61 to 0.78 the first year to 0.85 to 0.99 in the second year. The results obtained from the SOSLE were also compared to written and tutorial marks obtained in the same course. Pearson Correlation Coefficients (PCC) among mean SOSLE and two written paper scores ranged from 0.0-0.05 (Year 1) to 0.0-0.1 (Year 2). The PCC among the mean SOSLE and tutorial performance scores were 0.57 (Year 1) and 0.0 (Year 2). The results show that good agreement between raters can be reached using this evaluation method. However, the poor correlations between the SOSLE and the other methods of evaluation may show that different skills are being evaluated. Further validity testing needs to be carried out to confirm that this tool is measuring process oriented skills.

Clinical Competence↗