Evidence and information.
Health, National Forum on.
Evidence and information. - 1st ed. - 1 online resource (660 pages)
First Cover -- Foreword -- Table of contents -- Evidence -- Factors That Influence Evidence-Based Decision Making -- Table of contents -- Section I - Project report -- WHAT FACTORS INFLUENCE EVIDENCE-BASED DECISION MAKING WITHIN THE CANADIAN HEALTH CARE SYSTEM? -- Background -- Factors Influencing Evidence Adoption -- Nature of Evidence -- Nature of Evidence Adoption -- Methods -- Case Study Design -- Primary Case Selection -- Embedded Case Selection -- Multistage Key Informant Sampling -- Measures -- Findings Reported across Clinical and Administrative Realms -- Sample -- Range of Adoption of Evidence -- Quality of the Evidence -- Dissemination -- Environmental Factors -- Administrative -- Economic Conditions -- Political Factors -- Liability -- Consumer Influence -- Personal/Professional Factors -- Summary of Findings -- Conclusions -- Recommendations -- Bibliography -- SECTION II - Primary CASE SYNOPSES -- Clinical Practice Case Synopses -- Routine Electronic Fetal Surveillance and Use of Cesarean Section -- Selection of Cases for Carotid Endarterectomy -- Selection of BPH Cases for Prostatectomy -- Implementation of the Ottawa Ankle Rules -- Pharmaceutical Case Synopses -- Promoting Appropriate Medication Use by Elderly Persons -- Appropriate Timing of Thrombolysis Therapy in Acute Myocardial Infarction -- Health Care Delivery Case Synopses -- Implementation of Second-Dose Measles Vaccine -- Implementation of Addiction Treatment Programs for Aboriginal People -- Implementation of Breast-Screening Programs -- Implementation of Acupuncture Programs -- Heath Care Management Case Synopses -- Hospital Closures -- Labour Substitution in Acute Care Nursing -- Bibliography -- Decision Support Tools in Health Care -- Table of contents -- Decision Support Tools in Health Care -- Guiding statement -- Introduction and definition. Evidence-based health care -- Decision support tools -- Conceptual Model -- Developmental History of Decision Support Tools -- Growth of DSTs -- The Evolution of Information Technology and DSTs -- The Scope of Decision Support in Health Care -- Purported Benefits to Be Derived from the Use of DSTs in Health Care -- Limitations of DSTs in Health Care -- Theoretical Limitations -- People-Related Limitations -- Technical Limitations -- Evaluation Limitations -- Cost Limitations -- Scope of Present and Future Applications -- Methodology -- Audit of DSTs -- Survey of Health Care DST Use -- Results -- DST Audit Results -- Survey Results -- Discussion -- The Future of DSTs: The Clinical Practice and Institutional Management Perspective -- The Ideal DST Project -- The Future of DST Development: The Market Perspective -- The Future of DSTs in Policy and Management: An Organizational Behaviour Perspective -- Introduction -- Relevant Concepts from the Administrative and Policy Literature -- Discussion -- The Projected Future of DSTs -- Conclusion -- Recommendations -- System-Level Support for DST Development -- Methodological Issues in DST Development -- Industrial/Commercial Partnerships -- Articles included in the DST audit data base -- APPENDICES -- Apendix 1. List of General References to DSTs and Decision Support -- Apendix 2. Cover Letter and Survey Tool -- Apendix 3. Contact List for Survey Distribution -- Building a National Health Information Network -- Table of Contents -- Introduction -- Objectives -- Methods -- Identification of Initiatives -- Screening of Initiatives for In-Depth Review -- In-Depth Review of Population-Based Health Information Systems -- Results -- Identification and Screening of Initiatives -- General Review of Information Systems -- Review of Content Domains -- Linkages across Domains -- Comparative Focus -- Reporting Mechanism. Role in Providing Evidence for Decision Making -- Major Strengths and Weaknesses across Information Systems -- Discussion -- Findings in Relation to Objectives -- Recommendations -- Bibliography -- APPENDICES -- Apendix 1. Key Contacts for Initiatives -- Apendix 2. Initiatives Considered for Review -- Foundations for Evidence-Based Decision Making -- Table of Contents -- Introduction -- The Nature of Evidence -- The Structure of This Paper -- Distinction between Problem Solving and Decision Making -- "Good" or Justified Decisions -- Evidence -- The Roles of Evidence -- Confidence -- Description and the Inference to Causality (Observation and Experimentation) -- Types of Decisions, Types of Evidence -- Scientific Evidence and a Bias toward Traditional Medicine -- Evaluating Evidence -- Experimental Evidence -- Observation -- Theory -- Authority -- Personal Experience -- Using Evidence -- Interests and objectives -- Introduction -- Decision Makers, Levels of Decision, and Interests -- Constraints on, and Biases in, Decision Making -- Levels of Decision Making in Health -- Broader Determinants of Health -- Macroallocation Decisions -- Mesoallocation Decisions -- Microallocation Decisions -- Decision Makers -- Clients or Users -- Care Providers -- Administrators -- Policymakers -- Situation-Decision context -- Evidence and Risk -- Other Options -- Evidence for Change -- Scarcity of Resources -- Short literature review -- General -- Evidence-Based Medicine as a Practical Problem of Implementation -- Reviewing Medical Evidence -- Review by Expert Advisory Groups -- Metanalysis -- Conclusion and policy implications -- Conclusion -- Policy Implications -- The Culture of Evaluation -- The Diversity of Evidence -- A Whole-Person, Whole-Life Concept of Health -- Using Evidence -- BIBLIOGRAPHY -- APPENDIX -- Decision/Evidence. Civic Lessons: Strategies to Increase Consumer Involvement in Health Policy Development -- Table of contents -- Introduction -- Rationale for Increased Consumer Involvement -- What consumers could bring to the reform process -- Analytical frameworks -- Some current and emerging opportunities for consumer involvement -- Regionalization -- The Cochrane Collaboration and Consumer Network -- Consumer Representation on Health Professions' Regulatory Bodies in Ontario -- Introduction to the case studies -- Case study no. 1: Consumers and long-term care in ontario -- Background -- Evidence of Policy Influence -- Other Issues: Who Is a Legitimate Consumer? How Are They Accountable? Whom Do They Represent? -- Other Issues: Resources -- Relevance to the Analytic Frameworks -- Case study NO. 2: The influence of consumers on breast cancer policy -- Background -- Evidence of Policy Influence -- Other Issues: Who Is a legitimate Consumer? How Are They Accountable? Whom Do They Represent? What Issues Can They Tackle? -- Other Issues: Resources -- Relevance to the Analytic Frameworks -- Case study NO. 3: The consumers' health forum of australia -- Background -- Evidence of Policy Influence -- Other Issues: Who Is a Legitimate Consumer? How Are They Accountable? Whom Do They Represent? What Issues Can They Tackle? -- Other Issues: Resources -- Relevance to the Analytical Frameworks -- Lessons from the case studies -- What government can do -- Conclusions -- Bibliography -- Appendix -- The Issue of Values -- Research on Canadian Values in Relation to Health and the Health Care System -- Table of contents -- Introduction -- Study Objectives -- Organization of This Report -- QUALITATIVE FINDINGS -- Focus Group Methodology -- Location and Composition of Groups -- Focus Group Implementation -- Caveat: Some Limitations of This Study -- Findings. Perceptions of the Health Care System -- Scenario 1: Alternative Treatments and Medicines -- Scenario 2: Emphasizing Prevention or Acute Care? -- Scenario 3: Shifting Resources from Health Care to Long-Term Prevention -- Scenario 4: Prevention vs. Treatment -- Scenario 5: Meeting the Needs of the Dying Compared to Delivering Acute Care -- Scenario 6: Guidelines to Encourage the Use of Less-Expensive Drugs -- Scenario 7: Increasing the Level of Responsibility That Families Have for Taking Care of Their Own -- Scenario 8: Principles of the Health Care System -- Summary of Focus Group with Aboriginal Canadians -- QUANTITATIVE FINDINGS -- Background -- Methodology -- Findings -- Survey Findings -- Differences between Participants and Nonparticipants of Focus Group -- Influence of Participating Focus Group Session (Pre- and Postsurvey) -- Influence of Deliberative Exercise (Pre- and Postsurvey) -- Conclusions -- Pride in the Canadian Approach to Health Care -- Concerns about Future Viability -- A Reluctant Willingness to Consider Change -- Values and Change -- Health Care Is Fundamentally about Acute Care -- Health Care Is Whatever Works -- The Line-Up Starts with the Most III -- What Does It Mean to Be Canadian and Can We Afford It? -- The Evolving Context and Implications for Communications -- Appendices -- APPENDIX 1. Scenarios -- APPENDIX 2. Moderator's guide -- APPENDIX 3. Deliberative Information -- APPENDIX 4. Survey Questionnaire -- APPENDIX 5. Verbatim Comments -- The Feasibility of a National Canadian Advisory Committee on Ethics: Points to Consider -- Table of contents -- Introduction -- Preliminary: International and Supranational Initiatives -- Section 1 - UNESCO's International Bioethics Committee -- Section 2 - European Ethics Boards -- The Group of Advisers on the Ethical Implications of Biotechnology (GAEB). The Steering Committee on Bioethics (CDBI).
9782895442141
Public health -- Canada.
Medicine, Preventive -- Canada.
Children -- Health and hygiene -- Canada.
Adulthood -- Health and hygiene -- Canada.
Electronic books.
RA449 -- .M355 1998eb
362.10971
Evidence and information. - 1st ed. - 1 online resource (660 pages)
First Cover -- Foreword -- Table of contents -- Evidence -- Factors That Influence Evidence-Based Decision Making -- Table of contents -- Section I - Project report -- WHAT FACTORS INFLUENCE EVIDENCE-BASED DECISION MAKING WITHIN THE CANADIAN HEALTH CARE SYSTEM? -- Background -- Factors Influencing Evidence Adoption -- Nature of Evidence -- Nature of Evidence Adoption -- Methods -- Case Study Design -- Primary Case Selection -- Embedded Case Selection -- Multistage Key Informant Sampling -- Measures -- Findings Reported across Clinical and Administrative Realms -- Sample -- Range of Adoption of Evidence -- Quality of the Evidence -- Dissemination -- Environmental Factors -- Administrative -- Economic Conditions -- Political Factors -- Liability -- Consumer Influence -- Personal/Professional Factors -- Summary of Findings -- Conclusions -- Recommendations -- Bibliography -- SECTION II - Primary CASE SYNOPSES -- Clinical Practice Case Synopses -- Routine Electronic Fetal Surveillance and Use of Cesarean Section -- Selection of Cases for Carotid Endarterectomy -- Selection of BPH Cases for Prostatectomy -- Implementation of the Ottawa Ankle Rules -- Pharmaceutical Case Synopses -- Promoting Appropriate Medication Use by Elderly Persons -- Appropriate Timing of Thrombolysis Therapy in Acute Myocardial Infarction -- Health Care Delivery Case Synopses -- Implementation of Second-Dose Measles Vaccine -- Implementation of Addiction Treatment Programs for Aboriginal People -- Implementation of Breast-Screening Programs -- Implementation of Acupuncture Programs -- Heath Care Management Case Synopses -- Hospital Closures -- Labour Substitution in Acute Care Nursing -- Bibliography -- Decision Support Tools in Health Care -- Table of contents -- Decision Support Tools in Health Care -- Guiding statement -- Introduction and definition. Evidence-based health care -- Decision support tools -- Conceptual Model -- Developmental History of Decision Support Tools -- Growth of DSTs -- The Evolution of Information Technology and DSTs -- The Scope of Decision Support in Health Care -- Purported Benefits to Be Derived from the Use of DSTs in Health Care -- Limitations of DSTs in Health Care -- Theoretical Limitations -- People-Related Limitations -- Technical Limitations -- Evaluation Limitations -- Cost Limitations -- Scope of Present and Future Applications -- Methodology -- Audit of DSTs -- Survey of Health Care DST Use -- Results -- DST Audit Results -- Survey Results -- Discussion -- The Future of DSTs: The Clinical Practice and Institutional Management Perspective -- The Ideal DST Project -- The Future of DST Development: The Market Perspective -- The Future of DSTs in Policy and Management: An Organizational Behaviour Perspective -- Introduction -- Relevant Concepts from the Administrative and Policy Literature -- Discussion -- The Projected Future of DSTs -- Conclusion -- Recommendations -- System-Level Support for DST Development -- Methodological Issues in DST Development -- Industrial/Commercial Partnerships -- Articles included in the DST audit data base -- APPENDICES -- Apendix 1. List of General References to DSTs and Decision Support -- Apendix 2. Cover Letter and Survey Tool -- Apendix 3. Contact List for Survey Distribution -- Building a National Health Information Network -- Table of Contents -- Introduction -- Objectives -- Methods -- Identification of Initiatives -- Screening of Initiatives for In-Depth Review -- In-Depth Review of Population-Based Health Information Systems -- Results -- Identification and Screening of Initiatives -- General Review of Information Systems -- Review of Content Domains -- Linkages across Domains -- Comparative Focus -- Reporting Mechanism. Role in Providing Evidence for Decision Making -- Major Strengths and Weaknesses across Information Systems -- Discussion -- Findings in Relation to Objectives -- Recommendations -- Bibliography -- APPENDICES -- Apendix 1. Key Contacts for Initiatives -- Apendix 2. Initiatives Considered for Review -- Foundations for Evidence-Based Decision Making -- Table of Contents -- Introduction -- The Nature of Evidence -- The Structure of This Paper -- Distinction between Problem Solving and Decision Making -- "Good" or Justified Decisions -- Evidence -- The Roles of Evidence -- Confidence -- Description and the Inference to Causality (Observation and Experimentation) -- Types of Decisions, Types of Evidence -- Scientific Evidence and a Bias toward Traditional Medicine -- Evaluating Evidence -- Experimental Evidence -- Observation -- Theory -- Authority -- Personal Experience -- Using Evidence -- Interests and objectives -- Introduction -- Decision Makers, Levels of Decision, and Interests -- Constraints on, and Biases in, Decision Making -- Levels of Decision Making in Health -- Broader Determinants of Health -- Macroallocation Decisions -- Mesoallocation Decisions -- Microallocation Decisions -- Decision Makers -- Clients or Users -- Care Providers -- Administrators -- Policymakers -- Situation-Decision context -- Evidence and Risk -- Other Options -- Evidence for Change -- Scarcity of Resources -- Short literature review -- General -- Evidence-Based Medicine as a Practical Problem of Implementation -- Reviewing Medical Evidence -- Review by Expert Advisory Groups -- Metanalysis -- Conclusion and policy implications -- Conclusion -- Policy Implications -- The Culture of Evaluation -- The Diversity of Evidence -- A Whole-Person, Whole-Life Concept of Health -- Using Evidence -- BIBLIOGRAPHY -- APPENDIX -- Decision/Evidence. Civic Lessons: Strategies to Increase Consumer Involvement in Health Policy Development -- Table of contents -- Introduction -- Rationale for Increased Consumer Involvement -- What consumers could bring to the reform process -- Analytical frameworks -- Some current and emerging opportunities for consumer involvement -- Regionalization -- The Cochrane Collaboration and Consumer Network -- Consumer Representation on Health Professions' Regulatory Bodies in Ontario -- Introduction to the case studies -- Case study no. 1: Consumers and long-term care in ontario -- Background -- Evidence of Policy Influence -- Other Issues: Who Is a Legitimate Consumer? How Are They Accountable? Whom Do They Represent? -- Other Issues: Resources -- Relevance to the Analytic Frameworks -- Case study NO. 2: The influence of consumers on breast cancer policy -- Background -- Evidence of Policy Influence -- Other Issues: Who Is a legitimate Consumer? How Are They Accountable? Whom Do They Represent? What Issues Can They Tackle? -- Other Issues: Resources -- Relevance to the Analytic Frameworks -- Case study NO. 3: The consumers' health forum of australia -- Background -- Evidence of Policy Influence -- Other Issues: Who Is a Legitimate Consumer? How Are They Accountable? Whom Do They Represent? What Issues Can They Tackle? -- Other Issues: Resources -- Relevance to the Analytical Frameworks -- Lessons from the case studies -- What government can do -- Conclusions -- Bibliography -- Appendix -- The Issue of Values -- Research on Canadian Values in Relation to Health and the Health Care System -- Table of contents -- Introduction -- Study Objectives -- Organization of This Report -- QUALITATIVE FINDINGS -- Focus Group Methodology -- Location and Composition of Groups -- Focus Group Implementation -- Caveat: Some Limitations of This Study -- Findings. Perceptions of the Health Care System -- Scenario 1: Alternative Treatments and Medicines -- Scenario 2: Emphasizing Prevention or Acute Care? -- Scenario 3: Shifting Resources from Health Care to Long-Term Prevention -- Scenario 4: Prevention vs. Treatment -- Scenario 5: Meeting the Needs of the Dying Compared to Delivering Acute Care -- Scenario 6: Guidelines to Encourage the Use of Less-Expensive Drugs -- Scenario 7: Increasing the Level of Responsibility That Families Have for Taking Care of Their Own -- Scenario 8: Principles of the Health Care System -- Summary of Focus Group with Aboriginal Canadians -- QUANTITATIVE FINDINGS -- Background -- Methodology -- Findings -- Survey Findings -- Differences between Participants and Nonparticipants of Focus Group -- Influence of Participating Focus Group Session (Pre- and Postsurvey) -- Influence of Deliberative Exercise (Pre- and Postsurvey) -- Conclusions -- Pride in the Canadian Approach to Health Care -- Concerns about Future Viability -- A Reluctant Willingness to Consider Change -- Values and Change -- Health Care Is Fundamentally about Acute Care -- Health Care Is Whatever Works -- The Line-Up Starts with the Most III -- What Does It Mean to Be Canadian and Can We Afford It? -- The Evolving Context and Implications for Communications -- Appendices -- APPENDIX 1. Scenarios -- APPENDIX 2. Moderator's guide -- APPENDIX 3. Deliberative Information -- APPENDIX 4. Survey Questionnaire -- APPENDIX 5. Verbatim Comments -- The Feasibility of a National Canadian Advisory Committee on Ethics: Points to Consider -- Table of contents -- Introduction -- Preliminary: International and Supranational Initiatives -- Section 1 - UNESCO's International Bioethics Committee -- Section 2 - European Ethics Boards -- The Group of Advisers on the Ethical Implications of Biotechnology (GAEB). The Steering Committee on Bioethics (CDBI).
9782895442141
Public health -- Canada.
Medicine, Preventive -- Canada.
Children -- Health and hygiene -- Canada.
Adulthood -- Health and hygiene -- Canada.
Electronic books.
RA449 -- .M355 1998eb
362.10971