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1.
Int J Technol Assess Health Care ; 37(1): e77, 2021 Jul 16.
Article in English | MEDLINE | ID: covidwho-1315573

ABSTRACT

Emergency preparedness is a continuous quality improvement process through which roles and responsibilities are defined to effectively anticipate, respond to, and recover from the impact of emergencies. This process results in documented plans that provide a backbone structure for developing the core capacities to address health threats. Nevertheless, several barriers can impair an effective preparedness planning, as it needs a 360° perspective to address each component according to the best evidence and practice. Preparedness planning shares common principles with health technology assessment (HTA) as both encompass a multidisciplinary and multistakeholder approach, follow an iterative cycle, adopt a 360° perspective on the impact of intervention measures, and conclude with decision-making support. Our "Perspective" illustrates how each HTA domain can address different component(s) of a preparedness plan that can indeed be seen as a container of multiple HTAs, which can then be used to populate the entire plan itself. This approach can allow one to overcome preparedness barriers, providing an independent, systematic, and robust tool to address the components and ensuring a comprehensive evaluation of their value in the mitigation of the impact of emergencies.


Subject(s)
Civil Defense/organization & administration , Disaster Planning/organization & administration , Technology Assessment, Biomedical/organization & administration , Civil Defense/economics , Civil Defense/standards , Disaster Planning/economics , Disaster Planning/standards , Evidence-Based Practice/standards , Humans
2.
Medicine (Baltimore) ; 100(15): e25435, 2021 Apr 16.
Article in English | MEDLINE | ID: covidwho-1284945

ABSTRACT

BACKGROUND: While this reduced-visit prenatal care model during the COVID-19 pandemic is well-intentioned, there is still a lack of relevant evidence to prove its effectiveness. Therefore, in order to provide new evidence-based medical evidence for clinical treatment, we undertook a systematic review and meta-analysis to assess the efficacy of reduced-visit prenatal care model during the COVID-19 pandemic. METHODS: The online literature will be searched using the following combination of medical subject heading terms: "prenatal care" OR "prenatal nursing" AND "reduced-visit" OR "reduce visit" OR "virtual visit." MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Web of Science will be searched without any language restrictions. A standard data extraction form is used independently by 2 reviewers to retrieve the relevant data from the articles. The outcome measures are as following: pregnancy-related stress, satisfaction with care, quality of care. The present study will be performed by Review Manager Software (RevMan Version 5.3, The Cochrane Collaboration, Copenhagen, Denmark). P < .05 is set as the significance level. RESULTS: It is hypothesized that reduced-visit prenatal care model will provide similar outcomes compared with traditional care model. CONCLUSIONS: The results of our review will be reported strictly following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria and the review will add to the existing literature by showing compelling evidence and improved guidance in clinic settings. OSF REGISTRATION NUMBER: 10.17605/OSF.IO/WYMB7.


Subject(s)
Ambulatory Care , COVID-19 , Evidence-Based Practice , Prenatal Care/organization & administration , Ambulatory Care/methods , Ambulatory Care/statistics & numerical data , COVID-19/epidemiology , COVID-19/prevention & control , Evidence-Based Practice/methods , Evidence-Based Practice/standards , Evidence-Based Practice/trends , Female , Humans , Infection Control/methods , Meta-Analysis as Topic , Pregnancy , Research Design , SARS-CoV-2 , Systematic Reviews as Topic
5.
Hist Philos Life Sci ; 43(2): 66, 2021 Apr 30.
Article in English | MEDLINE | ID: covidwho-1210756

ABSTRACT

The COVID-19 pandemic poses extraordinary public health challenges. In order to respond to such challenges, most democracies have relied on so-called 'evidence-based' policies, which supposedly devolve to science the burden of their justification. However, the biomedical sciences can only provide a theory-laden evidential basis, while reliable statistical data for policy support is often scarce. Therefore, scientific evidence alone cannot legitimise COVID-19 public health policies, which are ultimately based on political decisions. Given this inevitable input on policy-making, the risk of arbitrariness is ubiquitous and democratic scrutiny becomes essential to counter it. During the COVID-19 pandemic, the standards of scientific and democratic scrutiny have been, as a matter of fact, substantially lowered. This erosion potentially damages democracy.


Subject(s)
COVID-19/epidemiology , Evidence-Based Practice , Health Policy , Policy Making , COVID-19/prevention & control , Democracy , Evidence-Based Practice/standards , Government , Humans
6.
7.
Medicine (Baltimore) ; 100(15): e25435, 2021 Apr 16.
Article in English | MEDLINE | ID: covidwho-1180672

ABSTRACT

BACKGROUND: While this reduced-visit prenatal care model during the COVID-19 pandemic is well-intentioned, there is still a lack of relevant evidence to prove its effectiveness. Therefore, in order to provide new evidence-based medical evidence for clinical treatment, we undertook a systematic review and meta-analysis to assess the efficacy of reduced-visit prenatal care model during the COVID-19 pandemic. METHODS: The online literature will be searched using the following combination of medical subject heading terms: "prenatal care" OR "prenatal nursing" AND "reduced-visit" OR "reduce visit" OR "virtual visit." MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Web of Science will be searched without any language restrictions. A standard data extraction form is used independently by 2 reviewers to retrieve the relevant data from the articles. The outcome measures are as following: pregnancy-related stress, satisfaction with care, quality of care. The present study will be performed by Review Manager Software (RevMan Version 5.3, The Cochrane Collaboration, Copenhagen, Denmark). P < .05 is set as the significance level. RESULTS: It is hypothesized that reduced-visit prenatal care model will provide similar outcomes compared with traditional care model. CONCLUSIONS: The results of our review will be reported strictly following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria and the review will add to the existing literature by showing compelling evidence and improved guidance in clinic settings. OSF REGISTRATION NUMBER: 10.17605/OSF.IO/WYMB7.


Subject(s)
Ambulatory Care , COVID-19 , Evidence-Based Practice , Prenatal Care/organization & administration , Ambulatory Care/methods , Ambulatory Care/statistics & numerical data , COVID-19/epidemiology , COVID-19/prevention & control , Evidence-Based Practice/methods , Evidence-Based Practice/standards , Evidence-Based Practice/trends , Female , Humans , Infection Control/methods , Meta-Analysis as Topic , Pregnancy , Research Design , SARS-CoV-2 , Systematic Reviews as Topic
8.
Prev Chronic Dis ; 18: E19, 2021 03 04.
Article in English | MEDLINE | ID: covidwho-1154769

ABSTRACT

INTRODUCTION: Communication networks among professionals can be pathways for accelerating the diffusion of innovations if some local health departments (LHDs) drive the spread of knowledge. Such a network could prove valuable during public health emergencies such as the novel coronavirus disease 2019 (COVID-19) pandemic. Our objective was to determine whether LHDs in the United States were tied together in an informal network to share information and advice about innovative community health practices, programs, and policies. METHODS: In January and February 2020, we conducted an online survey of 2,303 senior LHD leaders to ask several questions about their sources of advice. We asked respondents to rank up to 3 other LHDs whose practices informed their work on new public health programs, evidence-based practices, and policies intended to improve community health. We used a social network analysis program to assess answers. RESULTS: A total of 329 LHDs responded. An emergent network appeared to operate nationally among 740 LHDs. Eleven LHDs were repeatedly nominated by peers as sources of advice or examples (ie, opinion leaders), and 24 acted as relational bridges to hold these emergent networks together (ie, boundary spanners). Although 2 LHDs played both roles, most LHDs we surveyed performed neither of these roles. CONCLUSION: Opinion leading and boundary spanning health departments can be accessed to increase the likelihood of affecting the rate of interest in and adoption of innovations. Decision makers involved in disseminating new public health practices, programs, or policies may find our results useful both for emergencies and for practice-as-usual.


Subject(s)
COVID-19 , Evidence-Based Practice/standards , Health Information Systems , Information Dissemination/methods , Information Systems/organization & administration , COVID-19/epidemiology , COVID-19/therapy , Communication , Diffusion of Innovation , Health Information Systems/organization & administration , Health Information Systems/trends , Health Knowledge, Attitudes, Practice , Humans , Knowledge Bases , Quality Improvement , SARS-CoV-2 , United States/epidemiology
9.
Prev Chronic Dis ; 18: E19, 2021 03 04.
Article in English | MEDLINE | ID: covidwho-1117489

ABSTRACT

INTRODUCTION: Communication networks among professionals can be pathways for accelerating the diffusion of innovations if some local health departments (LHDs) drive the spread of knowledge. Such a network could prove valuable during public health emergencies such as the novel coronavirus disease 2019 (COVID-19) pandemic. Our objective was to determine whether LHDs in the United States were tied together in an informal network to share information and advice about innovative community health practices, programs, and policies. METHODS: In January and February 2020, we conducted an online survey of 2,303 senior LHD leaders to ask several questions about their sources of advice. We asked respondents to rank up to 3 other LHDs whose practices informed their work on new public health programs, evidence-based practices, and policies intended to improve community health. We used a social network analysis program to assess answers. RESULTS: A total of 329 LHDs responded. An emergent network appeared to operate nationally among 740 LHDs. Eleven LHDs were repeatedly nominated by peers as sources of advice or examples (ie, opinion leaders), and 24 acted as relational bridges to hold these emergent networks together (ie, boundary spanners). Although 2 LHDs played both roles, most LHDs we surveyed performed neither of these roles. CONCLUSION: Opinion leading and boundary spanning health departments can be accessed to increase the likelihood of affecting the rate of interest in and adoption of innovations. Decision makers involved in disseminating new public health practices, programs, or policies may find our results useful both for emergencies and for practice-as-usual.


Subject(s)
COVID-19 , Evidence-Based Practice/standards , Health Information Systems , Information Dissemination/methods , Information Systems/organization & administration , COVID-19/epidemiology , COVID-19/therapy , Communication , Diffusion of Innovation , Health Information Systems/organization & administration , Health Information Systems/trends , Health Knowledge, Attitudes, Practice , Humans , Knowledge Bases , Quality Improvement , SARS-CoV-2 , United States/epidemiology
10.
Best Pract Res Clin Anaesthesiol ; 35(3): 437-448, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1116288

ABSTRACT

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), also known as COVID-19, emerged in late 2019 in Wuhan, China. The World Health Organization declared the virus a pandemic on March 11, 2020. Disease progression from COVID-19 infection has shown significant symptom manifestations within organ systems beyond the respiratory system. The literature has shown increasing evidence of cardiovascular involvement during disease course and an associated increase in mortality among infected patients. Although the understanding of this novel virus is continually evolving, it is currently proposed that the mechanism by which the SARS-CoV-2 virus contributes to cardiovascular manifestations involves the ACE2 transmembrane protein. The protein ACE2 is highly expressed in blood vessel pericytes, and infection can result in microvascular dysfunction and subsequent acute coronary syndromes. Complications involving the cardiovascular system include myocardial infarction, arrhythmias, shock, and heart failure. In this evidence-based review, we discuss risk factors of cardiovascular involvement in COVID-19 infection, pathophysiology of COVID-19-related cardiovascular infection, and injury, COVID-19 effects on the cardiovascular system and corresponding treatments, and hematologic effects of COVID-19 and COVID-19 in heart transplant patients. Clinicians managing COVID-19 patients should appreciate the potential cardiovascular effects related to the disease process.


Subject(s)
COVID-19/epidemiology , Cardiovascular Diseases/epidemiology , Cardiovascular Diseases/virology , Cardiovascular System/virology , Evidence-Based Practice/methods , COVID-19/therapy , Cardiovascular Diseases/therapy , Delivery of Health Care/methods , Delivery of Health Care/standards , Evidence-Based Practice/standards , Humans , Risk Factors
11.
Aust Health Rev ; 45(1): 74-76, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-1057742

ABSTRACT

The global focus on nation states' responses to the COVID-19 pandemic has rightly highlighted the importance of science and evidence as the basis for policy action. Those with a lifelong passion for evidence-based policy (EBP) have lauded Australia's and other nations' policy responses to COVID-19 as a breakthrough moment for the cause. This article reflects on the complexity of the public policy process, the perspectives of its various actors, and draws on Alford's work on the Blue, Red and Purple zones to propose a more nuanced approach to advocacy for EBP in health. We contend that the pathway for translation of research evidence into routine clinical practice is relatively linear, in contrast to the more complex course for translation of evidence to public policy - much to the frustration of health researchers and EBP advocates. Cairney's description of the characteristics of successful policy entrepreneurs offers useful guidance to advance EBP and we conclude with proposing some practical mechanisms to support it. Finally, we recommend that researchers and policy makers spend more time in the Purple zone to enable a deeper understanding of, and mutual respect for, the unique contributions made by research, policy and political actors to sound public policy.


Subject(s)
COVID-19/therapy , Evidence-Based Practice/standards , Guidelines as Topic , Health Policy , Pandemics/prevention & control , Public Health/legislation & jurisprudence , Public Health/standards , Australia/epidemiology , COVID-19/epidemiology , Humans , SARS-CoV-2
13.
Eur J Cancer ; 140: 86-104, 2020 11.
Article in English | MEDLINE | ID: covidwho-778791

ABSTRACT

Since its first detection in China in late 2019 the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the associated infectious disease COVID-19 continue to have a major impact on global healthcare and clinical practice. Cancer patients, in particular those with haematological malignancies, seem to be at an increased risk for a severe course of infection. Deliberations to avoid or defer potentially immunosuppressive therapies in these patients need to be balanced against the overarching goal of providing optimal antineoplastic treatment. This poses a unique challenge to treating physicians. This guideline provides evidence-based recommendations regarding prevention, diagnostics and treatment of SARS-CoV-2 infection and COVID-19 as well as strategies towards safe antineoplastic care during the COVID-19 pandemic. It was prepared by the Infectious Diseases Working Party (AGIHO) of the German Society for Haematology and Medical Oncology (DGHO) by critically reviewing the currently available data on SARS-CoV-2 and COVID-19 in cancer patients applying evidence-based medicine criteria.


Subject(s)
Antineoplastic Agents/therapeutic use , Betacoronavirus/isolation & purification , Coronavirus Infections/complications , Delivery of Health Care/standards , Evidence-Based Practice/standards , Neoplasms/drug therapy , Pneumonia, Viral/complications , Practice Guidelines as Topic/standards , COVID-19 , Coronavirus Infections/transmission , Coronavirus Infections/virology , Disease Management , Germany/epidemiology , Humans , Neoplasms/epidemiology , Neoplasms/virology , Pandemics , Pneumonia, Viral/transmission , Pneumonia, Viral/virology , Prognosis , SARS-CoV-2 , Societies, Medical
14.
Ann Glob Health ; 86(1): 104, 2020 08 19.
Article in English | MEDLINE | ID: covidwho-740539

ABSTRACT

Despite predictions that the number of deaths in Africa due to COVID-19 will reach 10 million, overall, the continent has reported relatively few cases compared to the rest of the world. Many African countries have been successful in containing initial outbreaks by rapidly using evidence-based interventions through implementation strategies adapted from other countries' COVID-19 response as well as from prior epidemics. However, it is unclear whether these interventions will lead to long-term and complete success in stopping COVID-19 spread. Implementation research is a tool that can be used by countries to learn how to identify and understand contextual factors impacting COVID-19 prevention and control and select evidence-based interventions and strategies known to reduce spread of the virus. We identify seven key contextual factors that are facilitators or barriers to implementation of these interventions, and several strategies that can be leveraged if the factor is present or ones to strengthen if weak to improve implementation. These factors are: a culture of accountability, national coordination, financial stability of the population, culture of innovation, culture and capacity for research, health systems strength, and cross-border economies. Implementation science methods can serve to develop knowledge at a country and regional level on how to identify, utilize, and address these and other contextual factors, and inform relevant evidence-based interventions and implementation strategies. This approach can support African countries' ability to address key challenges as they arise, both in fighting COVID-19 and future health systems challenges.


Subject(s)
Communicable Disease Control , Coronavirus Infections , Evidence-Based Practice , Pandemics , Pneumonia, Viral , Research/organization & administration , Accountable Care Organizations , Africa/epidemiology , Betacoronavirus/isolation & purification , COVID-19 , Communicable Disease Control/methods , Communicable Disease Control/organization & administration , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Diffusion of Innovation , Disease Transmission, Infectious/prevention & control , Evidence-Based Practice/methods , Evidence-Based Practice/standards , Humans , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , SARS-CoV-2 , Socioeconomic Factors
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