Routine data and opportunities to improve patient outcomes Iain Chalmers Coordinator, James Lind Initiative National Institute of Health Research National.

Slides:

Advertisements

Similar presentations

Characteristics of research. Designed to derive generalisable new knowledge.

Advertisements

 may be efective in preventing SGA birth in women at high risk of preeclampsia although the effect size is small. (c)

Primary Care Management of Urinary Tract Infection in Pregnant Women Dr. Charlotte Cooke Northumbria Healthcare NHS Foundation.

The premature newborn infant

Research group in Global health: Ethics, economics and culture End-of-life decisions as bedside rationing An ethical analysis of life support restrictions.

NHS Evidence – provided by NICE Where can treatment uncertainties come from, and what do we do with them? Mark Fenton James Lind Initiative, Oxford Editor,

Umbilical cord clamping in term deliveries: the RCOG perspective Dr Anna David Reader and Consultant in Obstetrics and Maternal Fetal Medicine UCL Institute.

A systematic review of interventions for children with cerebral palsy: state of the evidence Rohini R Rattihalli

Newborn Health Scale Up Framework for Zambia

Drug Utilization Review (DUR)

University of DundeeSchool of Medicine Best practice in managing pneumonia: Scottish National Audit Project – Community Acquired Pneumonia (SNAP-CAP) Peter.

Progesterone Therapy for Preterm Labor Perinatal Conference April 14, 2006.

IMCI Dr. Bulemela Janeth (Mmed. Pead) 1IMCI for athens.

Hugo A. Navarro, M.D. Medical Director SCN Alamance Regional Medical Center Assistant Professor DUMC.

Risk factors for Incident Trichomonas vaginalis among Women Recruited in RESPECT-2, an HIV Prevention Trial D Helms 1, D Mosure 1, T Peterman 1, C Metcalf.

Smoking Cessation for Pregnancy and Beyond: Virtual Clinic Companion Slides Catherine A. Powers, EdD, LSW PACE – Tobacco Prevention and Cessation Education.

Premature Babies Presentation Arianna Xiong Technology.

Long-Term Effects of Continuing Adjuvant Tamoxifen to 10 Years versus Stopping at 5 Years After Diagnosis of Oestrogen Receptor- Positive Breast Cancer:

1 Evidence and the next stage of health care reform: Why consumer engagement is so important Steven D. Pearson, MD, MSc President, Institute for Clinical.

Evidence Based Practice

The ORACLE Children Study Sara Kenyon University of Leicester Peter Brocklehurst University of Oxford Neil Marlow University College London David Taylor.

Preventing Surgical Complications Prevent Harm from High Alert Medication- Anticoagulants in Primary Care Insert Date here Presenter:

Biostat 215 Clarifying the Causal Question Thomas B. Newman, MD, MPH.

Evidence Based Medication Use in the NICU: Erythropoietin Dan Ellsbury MD Director, Continuous Quality Improvement Pediatrix Medical Group.

Name of the project and Sub-Objective of the PEOPLE project DH WHOLE SYSTEM LONG TERM CONDITIONS DEMONSTRATOR (WSD) PROGRAMME - KENT SITE E-health & independence.

Smear negative TB and HIV: urgent research priorities to inform a rolling global policy Haileyesus Getahun, MD, MPH, PhD Stop TB Department WHO/HQ.

 1. A care plan is developed for each of the patient's medical conditions being managed with pharmacotherapy.  2. A goal of therapy is the desired response.

Retinopathy of Prematurity: A Neglected Public Health Issue Krishnendu Sarkar Professor Regional Institute of Ophthalmology Kolkata.

Periodontal Health and Birth Outcomes Secretary’s Advisory Committee on Infant Mortality – SACIM November 30, 2006 M. Ann Drum, DDS, MPH, Director Department.

Experimental studies Jean-François Boivin 25 October 2010.

Using PPOR to Address Low Birthweight Bill Ulmer, MPH, MA Director, Community Health Chattanooga-Hamilton County Health Department.

Preterm Birth Hazem Al-Mandeel, M.D Course 481 Obstetrics and Gynecology Rotation.

Dr. Gautam Ghosh NEO-PULMONOLOGY Evidence – Based –Med. Dr. Gautam Ghosh IAP Resarch Fellow Ped. Pulmonology.

March of Dimes National Prematurity Campaign and the PREEMIE Act (Public Law ) Dr. Jennifer L. Howse President, March of Dimes Secretary’s Advisory.

James Lind Initiative Database of Uncertainties about the Effects of Treatments (DUETs) what gaps in the evidence matter to patients and doctors? Iain.

Recommendation Methods Advisory Committee on Heritable Disorders and Genetic Diseases of Newborns and Children Ned Calonge, M.D., M.P.H.

Changing Prevalence of Cerebral Palsy Coleen Boyle, Ph.D. National Center on Birth Defects and Developmental Disabilities Centers for Disease Control and.

MANAGEMENT OF PRETERM LABOR WITH INTACT MEMBRANES by Dr. Elmizadeh.

An Evidence-Based Approach to Transfusion of the Preterm Infant

Department of Social Informatics Graduate School of Informatics Kyoto University, Japan July 8, 2004 The Social Informatics of Healthcare Infrastructure.

SIFT A multi-centre randomised controlled trial of two speeds of daily increment of milk feeding in very preterm or very low birth weight infants Milk.

PVL_COUNTRY_DATE00/1 Département santé et recherche génésiquesDepartment of reproductive health and research Day 3 - Session 2 DAY (3) Session 2 Presentation:

Safety of Albumin Revisited Blood Products Advisory Committee Meeting March 17, 2005 Laurence Landow MD, FRCPC.

Long-term mortality and thrombolysis therapy after a first acute ischemic stroke: gender differences. Ebrictus II Study. Authors & Affiliations Clua-Espuny.

Supplementary Prescribing in a neonatal ICU

HTA Efficient Study Designs Peter Davidson Head of HTA at NETSCC.

South Carolina Birth Outcomes Initiative To reduce the number of low birth weight babies in South Carolina November 10, 2011.

Why are systematic reviews important? Iain Chalmers Editor, James Lind Library Cochrane Workshop Independent University, Bangladesh.

CR-1 Candesartan in HF Benefit/Risk James B. Young, MD Cleveland Clinic Foundation.

Meeting the ACGME Milestones through Group Prenatal Care INTRODUCTION Mila D'Cunha MD. MSc., Anastasia Kolasa-Lenarz MD. MPH., Karolina Lis MD., Kimberly.

1 Health Needs Assessment Workshop Sue Cavanagh Keith Chadwick.

Critical Appraisal of a Paper Feedback. Critical Appraisal Full Reference –Authors (Surname & Abbreviations) –Year of publication –Full Title –Journal.

Local leadership of health reform Alyson Morley Senior Adviser LGA 21 November

Clinical Trials for Comparative Effectiveness Research Mark Hlatky MD Mark Hlatky MD Stanford University January 10, 2012.

Barbara Schmidt, Kristine Sandberg Knisely Chair in Neonatology

Gregory Sturz1, Howard Gutgesell2, Mark Conaway3 and Peter Dean2

THE UNIVERSITY of TENNESSEE HEALTH SCIENCE CENTER

Strategies to Reduce Antibiotic Resistance and to Improve Infection Control Robin Oliver, M.D., CPE.

Opioids Aware A resource for patients and HCPs to support prescribing of opioid medicines for pain Sue Mulvenna CDAO NHSE S SW March 2016.

2 Birmingham Children’s Hospital, Birmingham

Correlation of developmental outcome with severity of bronchopulmonary dysplasia in extremely low gestational age neonates Karen Belen, Chengqiu Lu, Narges.

Outcomes of Extremely Preterm Infants

Supplementary Prescribing in a neonatal ICU

THE UNIVERSITY of TENNESSEE HEALTH SCIENCE CENTER

Chapter 12 Diagnosing Dr. James Pelletier The Swain Department of Nursing The Citadel.

Chapter 12 Diagnosing Fundamental of nursing Dr. James Pelletier The Swain Department of Nursing The Citadel.

WHO recommendations on interventions to improve preterm birth outcomes

The Newborn Health Initiative

P. G. Davey1, C. E. Bucknall2, A. Patton3

The Ethics of Data Sharing in the Antenatal Corticosteroids Trial

Presentation transcript:

Routine data and opportunities to improve patient outcomes Iain Chalmers Coordinator, James Lind Initiative National Institute of Health Research National Neonatal Audit Programme and Neonatal Data Analysis Unit Collaborators’ Meeting 20 January 2012

For example, how can the risk of cerebral palsy be reduced in children born prematurely?

What are the effects of caffeine for apnoea of prematurity?

Authors' conclusions Five controlled trials studying a total of 192 preterm infants with apnea show that caffeine therapy reduces apnea and artificial ventilation over the first 2- 7 days after birth. The effects of caffeine on longer-term outcomes is being studied in a large ongoing study.

Long-Term Effects of Caffeine Therapy for Apnea of Prematurity Barbara Schmidt, M.D., Robin S. Roberts, M.Sc., Peter Davis, M.D., Lex W. Doyle, M.D., Keith J. Barrington, M.D., Arne Ohlsson, M.D., Alfonso Solimano, M.D., Win Tin, M.D., for the Caffeine for Apnea of Prematurity Trial Group Conclusions Caffeine therapy for apnea of prematurity improves the rate of survival without neurodevelopmental disability at 18 to 21 months in infants with very low birth weight Volume 357: November 8, 2007 Number 19November 8, 2007

What are the effects of giving antibiotics to try to stop premature labour?

This review fails to demonstrate a clear overall benefit from prophylactic antibiotic treatment for preterm labour with intact membranes on neonatal outcomes and raises concerns about increased neonatal mortality for those who received antibiotics… The 17 citations awaiting classification may alter the conclusions of the review once assessed.

Because uncertainties about the long term effects of prescribing caffeine for apnoea of prematurity and antibiotics in spontaneous preterm labour were not investigated 25 years ago, tens of thousands of people are now living with cerebral palsy that might have been prevented.

Why weren ’ t these studies done quarter of a century ago?

We need to confront important uncertainties about the effects of treatment because otherwise: ● patients will be denied unrecognised beneficial care ● patients will be given unrecognised harmful care ● resources will be wasted on useless or unnecessarily expensive care And ‘ we ’ means all of us!

New opportunities Using electronic patient records to run simple randomised evaluations as integral elements of normal health care

The General Practice Research Database Randomised Evaluations of Accepted Choices in Treatment (REACT studies)

How about using a similar approach to address treatment uncertainties in neonatal care?