This presentation was given in a Future Health System Consortium organised session at the Global Symposium on Health Systems Research in November 2010. The author is Alex Rowe from the Centers for Disease Control and Prevention.
introduction,history scope and applications of
relation to other fields , bioinformatics,biological databases,computers internet,sequence development, and
introduction to sequence development and alignment
Going for Gold and Greener Pastures: Open Access Explained
Presentation by Lisa Kruesi, Helen Morgan and Andrew Heath from The University of Queensland Scholarly Publishing and Digititisation Service for Open Access Week, October 2012.
This PowerPoint, which was first presented to Indonesian graduate students in Indonesian Embassy Manila last March 1, 2019, aims to describe how to write and publish a research article in reputable international journals and avoid predatory publishing. It describes (1) the major types of paper and their basic structures, (2) the important steps in publishing papers in journals, and (3) the distinction between Web of Science (ISI), Scopus, and predatory journals, and differences between Impact Factor (IF) and Citescore.
introduction,history scope and applications of
relation to other fields , bioinformatics,biological databases,computers internet,sequence development, and
introduction to sequence development and alignment
Going for Gold and Greener Pastures: Open Access Explained
Presentation by Lisa Kruesi, Helen Morgan and Andrew Heath from The University of Queensland Scholarly Publishing and Digititisation Service for Open Access Week, October 2012.
This PowerPoint, which was first presented to Indonesian graduate students in Indonesian Embassy Manila last March 1, 2019, aims to describe how to write and publish a research article in reputable international journals and avoid predatory publishing. It describes (1) the major types of paper and their basic structures, (2) the important steps in publishing papers in journals, and (3) the distinction between Web of Science (ISI), Scopus, and predatory journals, and differences between Impact Factor (IF) and Citescore.
Genomics is a discipline in genetics that applies recombinant DNA, DNA sequencing methods, and bioinformatics to sequence, assemble and analyze the function and structure of genomes
this presentation is about bioinformatics. the contents of bioinformatics are as under:
1.Introduction to bioinformatics.
2.Why bioinformatics is necessary?
3.Goals of bioinformatics
4.Field of bioinformatics
5.Where bioinformatics help?
6.Applications of bioinformatics
7.Software and tools of bioinformatics
8.References
Web of Science and Scopus: Understanding the indexing systemDr. Sharad Chand
In this article, Ii is explained about the Web of Science and Scopus indexing databases and their quality measures. This provides a basic insight into the selection of a good quality journal for publications.
Dear Colleague,
One of the main goals of Research Leap is to increase the productivity of researchers.
To achieve this goal, we create different contents as manuals and presentations on different topics related to academic writing. Recently, we have been wondering what else we can do to help researchers work smarter and be more productive.
To our surprise, we found that not many researchers are interested in the H-index of their research articles. Though, h-index is not just a number. It is also the number of significant works in the career of a researcher. So, comparing the works contributing to the h-index with the other works of the researcher can give an idea about the research behavior of the scientist. Its importance for researchers is growing depending on the country and management practices.
Therefore, “Citation Index: What is it and why do we need it?” presentation had been created to introduce the “citation index” and “h-index” terms as well as showing guidance to the ways of calculating the h-index of the research articles. Moreover, this presentation will also provide the advice and techniques for increasing the h-index of the research articles.
Chances are you already know some of these terms and techniques. Chances are also that you know somebody who knows none of these techniques… So please share and help spread the word.
Research Leap team created “Citation Index: What is it and why do we need it?” presentation to introduce the “citation index” and “h-index” terms as well as showing guidance to the ways of calculating the h-index of the research articles. Moreover, this presentation provides the advice and techniques for increasing the h-index of the research articles.
You can find the Citation Index: What is it and why do we need it? presentation in the attachment below.
You can find the Citation Index: What is it and why do we need it? presentation in the attachment.
Get expert academic writing tips straight to your inbox, and become a better academic writer.
Access more academic resources and subscribe at https://researchleap.com/category/resources/
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Introduction
Overview
Reductionist approach
Holistic approach
What is systems biology?
○ Advantages of Systems Biology
Tools of holistic approach
○ Proteomics, Transcriptomics and Metabolomics
Conclusion
References
Genomics is a discipline in genetics that applies recombinant DNA, DNA sequencing methods, and bioinformatics to sequence, assemble and analyze the function and structure of genomes
this presentation is about bioinformatics. the contents of bioinformatics are as under:
1.Introduction to bioinformatics.
2.Why bioinformatics is necessary?
3.Goals of bioinformatics
4.Field of bioinformatics
5.Where bioinformatics help?
6.Applications of bioinformatics
7.Software and tools of bioinformatics
8.References
Web of Science and Scopus: Understanding the indexing systemDr. Sharad Chand
In this article, Ii is explained about the Web of Science and Scopus indexing databases and their quality measures. This provides a basic insight into the selection of a good quality journal for publications.
Dear Colleague,
One of the main goals of Research Leap is to increase the productivity of researchers.
To achieve this goal, we create different contents as manuals and presentations on different topics related to academic writing. Recently, we have been wondering what else we can do to help researchers work smarter and be more productive.
To our surprise, we found that not many researchers are interested in the H-index of their research articles. Though, h-index is not just a number. It is also the number of significant works in the career of a researcher. So, comparing the works contributing to the h-index with the other works of the researcher can give an idea about the research behavior of the scientist. Its importance for researchers is growing depending on the country and management practices.
Therefore, “Citation Index: What is it and why do we need it?” presentation had been created to introduce the “citation index” and “h-index” terms as well as showing guidance to the ways of calculating the h-index of the research articles. Moreover, this presentation will also provide the advice and techniques for increasing the h-index of the research articles.
Chances are you already know some of these terms and techniques. Chances are also that you know somebody who knows none of these techniques… So please share and help spread the word.
Research Leap team created “Citation Index: What is it and why do we need it?” presentation to introduce the “citation index” and “h-index” terms as well as showing guidance to the ways of calculating the h-index of the research articles. Moreover, this presentation provides the advice and techniques for increasing the h-index of the research articles.
You can find the Citation Index: What is it and why do we need it? presentation in the attachment below.
You can find the Citation Index: What is it and why do we need it? presentation in the attachment.
Get expert academic writing tips straight to your inbox, and become a better academic writer.
Access more academic resources and subscribe at https://researchleap.com/category/resources/
In the meantime, you are welcomed to share our work through Linked in, Facebook, Youtube, Slideshare, Instagram, and Pinterest
Kind regards
Introduction
Overview
Reductionist approach
Holistic approach
What is systems biology?
○ Advantages of Systems Biology
Tools of holistic approach
○ Proteomics, Transcriptomics and Metabolomics
Conclusion
References
Paying for performance to improve the delivery of health interventions in LMICsReBUILD for Resilience
This presentation from Sophie Witter & Karin Diaconu of Queen Margaret University, UK outlines the findings from a Cochrane review undertaken by the team on paying for performance to improve the delivery of health interventions in low and middle-income countries.
Prioritisation in Public Health: Overview of Health Economics ApproachesOlena Nizalova
Overview of Health Economics Approaches Towards Prioritization based on the developments from the NIHR School of Public Health Research project led by Professor David Hunter.
Dr Yen-Fu Chen's presentation on publication bias in service delivery research for the CLAHRC WM Scientific Advisory Group, 10th June 2015, Birmingham, UK
The C. Everett Koop National Health Award recognizes population health promotion and improvement programs. Each year, awards are presented by The Health Project’s leadership to winning organizations as part of the annual HERO Forum each fall. This Thursday Ron Goetzel joins us for an update on the C. Everett Koop National Health Award with information on criteria and how to apply.
Academy Health- Annual Research Meeting - State Policy Interest Groups- 2013scherala
Title: Massachusetts Patient-Centered Medical Home Initiative (MA PCMHI): Impact on Clinical Quality at Midpoint
Authors: Judith Steinberg, Sai Cherala, Christine Johnson, Ann Lawthers.
Research Objective:
To assess the impact on clinical quality of practices’ participation in a Patient-Centered Medical Home (PCMH) demonstration. The MA PCMHI is a statewide, three-year, multi-payer demonstration of PCMH implementation in 45 primary care practices. Practices receive technical assistance including learning collaborative, coaching provided by external facilitators, and feedback of aggregated data, to support their implementation of PCMH processes. This study aims to assess the overall impact of this approach to transformation on a practice’s delivery of selected clinical services, including preventive care, care coordination and care management, and its processes and outcomes of care related to the initiative’s targeted conditions of diabetes and asthma at the midpoint of the initiative.
Do community-wide interventions increase population levels of physical activi...Health Evidence™
Dr. Philip Baker, School of Public Health and Social Work, Queensland University of Technology, presents findings from his recently updated Cochrane systematic review:
Baker PRA, Francis DP, Soares J, Weightman AL, Foster C. (2015). Community wide interventions for increasing physical activity. Cochrane Database of Systematic Reviews, 2015(1), Art. No.: CD008366.
For a recording of this webinar, visit: https://www.youtube.com/watch?v=g5hasrqsD0k
Fidelity assessment in cluster randomized trials of public health interventio...valéry ridde
Presentation by Nanor Minoyan and Myriam Cielo (Université de Montréal).
Global Health Workshop: Methods For Implementation Science in Global Health.
http://www.equitesante.org/implementation-science-methods-in-global-health/
Analysis of cross-country changes in health services IDS
This presentation was given in a session at the Global Symposium on Health Systems Research which was organised by the Future Health Systems Consortium. The author is Toru Matsubayashi from Johns Hopkins Bloomberg School of Public Health
The scale and scope of private contributions to health systemsIDS
This presentation was given at a session at the Global Symposium on Health Systems Research in November 2010. Panelists included Ruth Berg, Gerry Bloom, Birger Forsberg, Kara Hanson, Gina Lagomarsino, Dominic Montagu, Stefan Nachuk
Evidence on Improving Health Service Delivery in Developing CountriesIDS
This presentation by David Peters of the Future Health Systems Consortium was given at the Global Symposium on Health Systems Research in November 2010.
Pathways to Scaling up Health Services in Complex Adaptive SystemsIDS
This presentation by Ligia Paina & David Peters was given as part of a Future Health System Consortium session at the Global Symposium on Health Systems Research. It is part of our Beyond Scaling Up stream of work.
Implementing Rapid Medical Security reform in China: Importance of a Learning...IDS
A presentation by Zhenzhong ZHANG and Yunping WANG of the China National Health Development Research Center. This was given at a Future Health Systems Consortium organised event at the Global Symposium on Health System Research.
This presentation was given by Zhenzhong ZHANG and Yunping WANG of the China National Health Development Research Center at the Global Symposium on Health System Research.
Making the right to health a reality to Indigenous People in Brazil IDS
This presentation was given by Vera Schattan Coelho (CEBRAP) and Alex Shankland (Institute of Development Studies) at a Future Health Systems Consortium event at the Global Symposium on Health Systems Research, November, 2010.
This presentation was given at the Global Symposium on Health System Research in November 2010. The authors are L P Singh, Olakunle Alonge, Anubhav Agarwal,
Kayhan Natiq, S D Gupta and David Peters.
What must be done?Capacity building for health systems research in low & mid...IDS
This presentation was given in plenary by Sara Bennett of the Future Health Systems Consortium at the Global Symposium on Health Systems Research, November 2010.
What must be done to ehance capacity for health systems research?IDS
This presentation was written by Sara Bennett, Ligia Paina, Christine Kim, Irene Agyepong, Somsak Chunharas, Di McIntyre and Stefan Nachuk for the Global Symposium on Health Systems Research, November, 2010.
IMPROVING HEALTH SERVICE DELIVERY IN DEVELOPING COUNTRIES: FROM EVIDENCE TO ...IDS
This presentation was given by David Peters, Sameh El-Saharty, Banafsheh Siadat, Katja Janovsky, and Marko Vujicic at the Global Symposium on Health Systems Research, November 2010.
This presentation was given at the 'Beyond Scaling Up: Pathways to Universal Access' workshop which was held at the Institute of Development Studies, Brighton on the 24-25 May, 2010. This event was co-sponsored by the Future Health Systems Research Programme Consortium and the STEPS Centre. Mackintosh presented on supply chains.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
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micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Presentation on the literature review of interventions to improve health care provider performance
1. Contact for this presentation:
Alexander K. Rowe, MD, MPH
Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health
Centers for Disease Control and Prevention
Mailstop F22
4770 Buford Highway
Atlanta, GA 30341
United States
Telephone: 1-770-488-3588
Fax: 1-770-488-7761
Email: axr9@cdc.gov
Presentation on the literature review of interventions
to improve health care provider performance
(for the First Global Symposium on Health Systems Research, Session on
Evidence on Improving Health Service Delivery, November 18, 2010)
2. Early results of a systematic review
of strategies to improve health care
provider performance in low- and
middle-income countries
Alexander K. Rowe (Malaria Branch, Centers for Disease
Control and Prevention [CDC])
Samantha Y. Rowe (CDC)
David H. Peters (Johns Hopkins University)
Kathleen A. Holloway (World Health Organization)
John Chalker (Management Sciences for Health)
Dennis Ross-Degnan (Harvard Medical School)
3. Background
• Health care providers (HCPs) play key roles
in improving quality and coverage of health
interventions
• In low- and middle-income countries (LMICs),
however, HCP performance often inadequate
• Most existing reviews* of strategies to
improve performance are outdated or have
important methodological limitations
* Two new reviews on community/lay health workers
4. Objectives
Conduct systematic review of strategies to
improve HCP performance and related health
outcomes in LMICs, produce:
1. Library & database of studies on improving HCP
performance, for policy-makers and researchers
2. Detailed report and summary articles on
effectiveness and costs of strategies
3. Evidence-based policy recommendations
(i.e., guidance on implementing clinical
guidelines in LMICs) and associated
research agenda
5. Methods: inclusion and exclusion criteria
• Source of studies. Published and unpublished
• Timing. For electronic databases, studies by May 2006;
for other methods (e.g., gray literature), no a priori end
of search date (i.e., some studies after 2006)
• Setting. LMICs, as per World Bank
6. Methods: inclusion and exclusion criteria
• Source of studies. Published and unpublished
• Timing. For electronic databases, studies by May 2006;
for other methods (e.g., gray literature), no a priori end
of search date (i.e., some studies after 2006)
• Setting. LMICs, as per World Bank
• Type of health condition. No exclusions; performance
related to any health condition is acceptable
• HCPs. Facility- or community-based health workers,
pharmacists, shopkeepers who sell medicines, and
private sector health workers; only exclusions were
household providers (e.g., patient’s family)
7. • Types of outcomes
– Direct measures of HCP behavior (e.g., tasks related
to diagnosis, treatment, counseling)
– Patient outcomes (e.g., mortality, health care utilization)
– Other (e.g., economic outcomes, HCP knowledge)
Methods: inclusion and exclusion criteria
8. • Types of outcomes
– Direct measures of HCP behavior (e.g., tasks related
to diagnosis, treatment, counseling)
– Patient outcomes (e.g., mortality, health care utilization)
– Other (e.g., economic outcomes, HCP knowledge)
• Sample size. >20 observations per study group and
time point
• Language of the study. No exclusions
Methods: inclusion and exclusion criteria
9. Methods: classification of study design
• “Adequate” study designs for primary analysis:
– Pre-post with comparison (+/- randomization)
– Post-only with randomized comparison group
– Interrupted time series (>3 data points before
and after intervention)
10. Methods: classification of study design
• “Adequate” study designs for primary analysis:
– Pre-post with comparison (+/- randomization)
– Post-only with randomized comparison group
– Interrupted time series (>3 data points before
and after intervention)
• Despite interest in other study designs, due to
very large number of reports, focus on studies
with adequate designs
11. Methods: literature search strategy
• Searched: 15 electronic databases (e.g., MEDLINE,
CINHL, EPOC specialized register, etc.)
• Bibliographies of 510 previous reviews & other articles
• Document inventories and websites of 29 organizations
involved with HCP performance (e.g., MSH, BASICS,
Core Project, DFID, PAHO, QAP, USAID, World Bank)
• INRUD Bibliography and WHO Rational Use of Drugs
database
• Asked colleagues for references & unpublished studies
12. Methods: data abstraction
• Double, independent abstraction with
20-page abstraction form
• Data entered into Access database
• Queries to study investigators
(clarifications, details on contextual factors,
etc.)
13. • Effect size in terms of %-point change
• If outcome is a percentage, effect size =
(%POST – %PRE)intervention
– (%POST – %PRE)control
• Calculate effect size such that positive = success
• If >1 outcome, take median effect size (MES) of
primary outcomes
Methods: analysis of effect size
15. • >105,000 citations screened
• After removing duplicates: 2,430 reports
identified for abstraction (all study designs)
Results: Literature search
16. Early results: data abstraction
• From August 2007, studies with “adequate”
designs prioritized to be abstracted first
(851 reports on about 425 distinct studies)
• To date, 463 reports double-abstracted on
275 distinct studies
• Studies from >60 LMICs (50% low-income)
• Wide range of health conditions addressed by
HCPs: nutrition; antenatal care; treatment of
ARI, diarrhea, or malaria; family planning, etc.
17. Early results: study designs (N=275)
• “Adequate” designs (223/275, or 81%)
− 145 randomized studies (54%)
• Other designs (52/275, or 19%), e.g., pre-post
study without controls (not primary focus)
18. Early results: strategies tested (N=275)
• 390 intervention groups (i.e., strategies tested)
• 456 comparisons
− 177 intervention vs. “no intervention” control
− 249 intervention A vs. intervention B
• Most strategies had multiple components
(e.g., training + supervision = 2 components)
• Median of 4 components/strategy (range: 1–17)
• Commonly tested strategies include: training,
supervision or feedback, community activities,
new guideline, printed materials, and job aids
19. Early results on effectiveness:
Analysis of 213 comparisons from
172 studies with adequate design
(all comparisons are:
intervention vs. no intervention control)
(might not represent final dataset)
20. 0
5
10
15
20
25
30
35
Magnitude of effect size (percentage-point change)
No.ofMES
-100
to
-109
-0.1
to
-9
0
to
9
10
to
19
-20
to
-29
-30
to
-39
-10
to
-19
20
to
29
40
to
49
50
to
59
30
to
39
60
or
higher
Distribution of 213 MES from 172 studies with
adequate design (all strategies)
Min = -105
Median = 9
Max = 130
IQR: 3–23
21. 0
5
10
15
20
25
30
35
Magnitude of effect size (percentage-point change)
No.ofMES
-100
to
-109
-0.1
to
-9
0
to
9
10
to
19
-20
to
-29
-30
to
-39
-10
to
-19
20
to
29
40
to
49
50
to
59
30
to
39
60
or
higher
Distribution of 213 MES from 172 studies with
adequate design (all strategies)
50% are small
(<10%-points)
or negative
Min = -105
Median = 9
Max = 130
IQR: 3–23
22. 0
5
10
15
20
25
30
35
Magnitude of effect size (percentage-point change)
No.ofMES
-100
to
-109
-0.1
to
-9
0
to
9
10
to
19
-20
to
-29
-30
to
-39
-10
to
-19
20
to
29
40
to
49
50
to
59
Min = -105
Median = 9
Max = 130
IQR: 3–23
30
to
39
60
or
higher
Distribution of 213 MES from 172 studies with
adequate design (all strategies)
28. • Extreme heterogeneity among studies
– Settings
– Outcomes
– Interventions (e.g., not all “training” is same)
• MES crude summary measure that can
mask variation in effect (improved methods
in development)
• Precision very difficult to assess
Limitations
29. 1. Surprisingly large evidence base on effectiveness
of strategies, with many strategies tested in many
settings
2. Effect sizes vary substantially: half have small
effects, but some have large effects
3. Analyses to identify factors associated with high
effectiveness
Early conclusions (1)
30. 4. Evidence base seems fragmented
– Researchers not building on each others’ work
– Varying methods makes it difficult to put pieces
together
4. Standardizing methods & outcomes would
improve ability to summarize evidence base and
develop effective and practical recommendations;
perhaps coordinated research agenda is needed
5. Final results pending (end of 2012)
Early conclusions (2)
31. Acknowledgments
• Charity Akpala
• Tashana Carty
• Adrijana Corluka
• Didi Cross
• Bhavya Doshi
• Onnalee Gomez
• Meg Griffith
• Karen Herman
• Qing Li
• Connie Liu
• Earl Long
• Eliza McLeod
• Dawn Osterholt
• Gabriel Ponce-de-Léon
• Nancy Pulsipher
• Atiq Rahman
• Nirali Shah
• Banafsheh Siadat
• Sanja Stanojevic
• Savitha Subramanian
• Jeff Willis
• Kindra Willis
• Shannon Wood
• Karen Wosje
• Alicia Wright
• Chunying Xie
• Special thanks to investigators who responded to queries
• Funding: Bill and Melinda Gates Foundation, CDC, World Bank
32. Thanks for your
attention!
“Results! Why, man, I have gotten a lot of results.
I know several thousand things that won’t work.”
Thomas A. Edison (1847–1931)
Editor's Notes
Distribution of 74 median effect sizes (1 per comparison) from 56 studies
Distribution of 74 median effect sizes (1 per comparison) from 56 studies
Distribution of 74 median effect sizes (1 per comparison) from 56 studies
Effect size as a function of number of components in strategy (N=74 comparisons)
Effect size as a function of number of components in strategy (N=74 comparisons)