Journal articles: 'Health policy recommendations'

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Wasson, John H. "Health Recommendations by Interest Group." Journal of Ambulatory Care Management 21, no. 1 (January 1998): 44–45. http://dx.doi.org/10.1097/00004479-199801000-00006.

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Ehret, Phillip J., and David K. Sherman. "Public Policy and Health." Policy Insights from the Behavioral and Brain Sciences 1, no. 1 (October 2014): 222–30. http://dx.doi.org/10.1177/2372732214549472.

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Public policies designed to improve health and well-being are challenged by people’s resistance. A social psychological perspective reveals how health policies can pose a psychological threat to individuals and result in resistance to following health recommendations. Self-affirmation, a brief psychological intervention that has individuals focus on important personal values, can help reduce resistance to behavior change and help promote health and well-being in four health-policy domains: graphic cigarette warning labels designed to get people to quit smoking, community health programs targeted at high-risk populations, alcohol intervention and prevention programs targeted at problem drinkers, and adherence to medical recommendations and treatment regimens among people coping with disease. Using self-affirmation has important strengths and limitations as a tool to help policymakers and practitioners encourage better health choices.

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Draborg, Eva, and Christian Kronborg Andersen. "Recommendations in health technology assessments worldwide." International Journal of Technology Assessment in Health Care 22, no. 2 (March 28, 2006): 155–60. http://dx.doi.org/10.1017/s0266462306050963.

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Objectives:The objective of this study is to analyze statistically the possible determinants and implications of including or not including recommendations in health technology assessments (HTAs).Methods:A sample of 433 HTAs published by eleven leading institutions or agencies in nine countries was reviewed and analyzed statistically by multiple logistic regression.Results:The extent of policy and research recommendations in HTAs varies greatly from country to country. The content and scope of HTAs have some impact on recommendations. Extensive assessment of economic and organizational aspects increases the likelihood of including policy recommendations. Extensive assessment of technological and patient aspects increases the likelihood of including research recommendations, whereas extensive focus on economic aspects is negatively related to research recommendations. The most striking result is that the use of external partners for assessment increases the likelihood of including research recommendations in HTAs but not policy recommendations.Conclusions:HTA commissioners, agencies, institutions, and funding authorities need to be aware of the consequences of the choices they make in advance of assessing health technologies. Outsourcing HTA to external partners suggests a greater likelihood of being told that “more research is needed.” The scope and content of HTAs has an impact on the type of recommendations, and country-specific preferences are strong predictors of recommendations in HTAs.

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Cai, Jesmine, Tina Wang, Neil McAuslane, and Lawrence Liberti. "PP30 Do Conditional Regulatory Pathways Affect Health Technology Assessment Recommendations?" International Journal of Technology Assessment in Health Care 35, S1 (2019): 42. http://dx.doi.org/10.1017/s0266462319001946.

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IntroductionIn an effort to expedite the approval of drugs treating serious illnesses or addressing unmet medical need, conditional approvals have been used by the European Medicines Agency. In this study, the effects of conditional approvals were investigated in terms of health technology assessment (HTA) recommendations and timing in Europe.MethodsFirst HTA recommendations of new active substances (NASs) issued between 2015 and 2017 were collected from the National Institute for Health and Care Excellence (England), Haute Autorité de Santé (France), Institute for Quality and Efficiency in Health Care (Germany), Scottish Medicine Consortium (Scotland) and Tandvårds-Läkemedelförmånsverket (Sweden). The HTA recommendations were then classified into the following categories: positive, positive with restrictions, negative and multiple and if the regulatory approval pathway had been standard or conditional.ResultsOf this cohort of NASs that received an HTA recommendation, eight of 56 in England, 12 of 83 in France, 11 of 77 in Germany, nine of 58 in Scotland and four of 49 in Sweden were approved via a conditional review. Generally, except in England, there were a higher proportion of positive first recommendations for conditional approvals when compared to standard approvals, with Germany showing the largest proportional difference (43 percent) between the two pathways and also a faster time to recommendation. This may relate to the proportion of conditional assessments that were orphan medicines. With the exception of Germany, the time taken from regulatory approval to first HTA recommendation for products with conditional approvals is higher than those for standard approvals, with the largest difference seen in Sweden (241 days longer).ConclusionsConditionally approved NASs showed a variable HTA outcome; although there was generally a higher proportion of positive recommendations thus enabling more likely access in conditional approvals, the timing from regulatory approval to HTA recommendation was longer compared with standard approvals. This warrants a better understanding of the factors and uncertainties underlying these recommendations, supporting timely access of NASs with conditional approval.

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Kendig, Susan. "Addressing the Nursing Shortage:Exploring Needed Health Policy Recommendations." AWHONN Lifelines 5, no. 3 (June 2001): 22–23. http://dx.doi.org/10.1111/j.1552-6356.2001.tb01274.x.

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Scherr, Karen A., Angela Fagerlin, Lillie D. Williamson, J. Kelly Davis, Ilona Fridman, Natalie Atyeo, and Peter A. Ubel. "The Physician Recommendation Coding System (PhyReCS)." Medical Decision Making 37, no. 1 (July 10, 2016): 46–55. http://dx.doi.org/10.1177/0272989x16654692.

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Background. Physicians’ recommendations affect patients’ treatment choices. However, most research relies on physicians’ or patients’ retrospective reports of recommendations, which offer a limited perspective and have limitations such as recall bias. Objective. To develop a reliable and valid method to measure the strength of physician recommendations using direct observation of clinical encounters. Methods. Clinical encounters ( n = 257) were recorded as part of a larger study of prostate cancer decision making. We used an iterative process to create the 5-point Physician Recommendation Coding System (PhyReCS). To determine reliability, research assistants double-coded 50 transcripts. To establish content validity, we used 1-way analyses of variance to determine whether relative treatment recommendation scores differed as a function of which treatment patients received. To establish concurrent validity, we examined whether patients’ perceived treatment recommendations matched our coded recommendations. Results. The PhyReCS was highly reliable (Krippendorf’s alpha = 0.89, 95% CI [0.86, 0.91]). The average relative treatment recommendation score for each treatment was higher for individuals who received that particular treatment. For example, the average relative surgery recommendation score was higher for individuals who received surgery versus radiation (mean difference = 0.98, SE = 0.18, P < 0.001) or active surveillance (mean difference = 1.10, SE = 0.14, P < 0.001). Patients’ perceived recommendations matched coded recommendations 81% of the time. Conclusion. The PhyReCS is a reliable and valid way to capture the strength of physician recommendations. We believe that the PhyReCS would be helpful for other researchers who wish to study physician recommendations, an important part of patient decision making.

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Keech, James, Wei Fang Dai, Maureen Trudeau, Rebecca E. Mercer, Rohini Naipaul, Frances C. Wright, Sarah E. Ferguson, et al. "Impact of rarity on Canadian oncology health technology assessment and funding." International Journal of Technology Assessment in Health Care 36, no. 4 (August 2020): 404–9. http://dx.doi.org/10.1017/s0266462320000483.

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ObjectivesThe pan-Canadian Oncology Drug Review (pCODR) evaluates new cancer drugs for public funding recommendations. While pCODR's deliberative framework evaluates overall clinical benefit and includes considerations for exceptional circumstances, rarity of indication is not explicitly addressed. Given the high unmet need that typically accompanies these indications, we explored the impact of rarity on oncology HTA recommendations and funding decisions.MethodsWe examined pCODR submissions with final recommendations from 2012 to 2017. Incidence rates were calculated using pCODR recommendation reports and statistics from the Canadian Cancer Society. Indications were classified as rare if the incidence rate was lower than 1/100,000 diagnoses, a definition referenced by the Canadian Agency for Drugs and Technologies in Health. Each pCODR final report was examined for the funding recommendation/justification, level of supporting evidence (presence of a randomized control trial [RCT]), and time to funding (if applicable).ResultsOf the ninety-six pCODR reviews examined, 16.6 percent were classified as rare indications per above criteria. While the frequency of positive funding recommendations were similar between rare and nonrare indication (78.6 vs. 75 percent), rare indications were less likely to be presented with evidence from RCT (50 vs. 90 percent). The average time to funding did not differ significantly across provinces.ConclusionRare indications appear to be associated with weaker clinical evidence. There appears to be no association between rarity, positive funding recommendations, and time to funding. Further work will evaluate factors associated with positive recommendations and the real-world utilization of funded treatments for rare indications.

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Bellad, Asha, and Aakriti Gupta. "Process of Development of WHO Guidelines." Indian Journal of Community Health 30, no. 1 (Supp) (April 25, 2018): 95–100. http://dx.doi.org/10.47203/ijch.2018.v30i01supp.014.

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A WHO guideline is any document containing recommendations about health interventions, whether these are clinical, public health or policy recommendations. A recommendation provides information about what policy-makers, health-care providers or patients should do. It implies a choice between different interventions that have an impact on health and that have implications for the use of resources. The purpose of WHO guidelines is to improve the health and well-being of individuals and populations

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Carroll, Christopher, Rumona Dickson, Angela Boland, Rachel Houten, and Matthew Walton. "VP41 NICE Interventional Procedures Advisory Committee Recommendations." International Journal of Technology Assessment in Health Care 35, S1 (2019): 86–87. http://dx.doi.org/10.1017/s0266462319003131.

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IntroductionThis study explores the factors (principally evidential) that predict guidance recommendations by this NICE committee. There are three main types of recommendations: Standard/normal arrangements (can be done without restriction in the NHS); Special arrangements (can be done under certain conditions); and Research only.MethodsThe following data were extracted from all published pieces of Interventional Procedure Guidance (IPGs) produced by this committee: year, IPG number, recommendations, evidence base (numbers and types of included studies, numbers of included patients etc.). All data were extracted independently by two researchers, and any disagreements clarified by consensus. Data were tabulated and descriptive statistics produced. Regression analyses will be performed using these data to identify any statistically significant predictors of recommendations.ResultsIPG recommendations (n = 496); year range: 2003-2018. Proportion of IPGs by each recommendation: 50% Standard; 38% Special; 11% Research Only; 2% Do Not Do. Proportion of IPGs with highest level evidence (i.e. systematic review and/or RCT) by recommendation type: Standard = 64% (152/239); Special = 43% (77/180); Research Only = 48% (26/54); Do Not Do = 75% (6/8). Mean numbers of patients by recommendation type: Standard = 7,838; Special = 3,935; Research Only = 2,423. There is also a clear trend over time: Standard recommendations decrease for all IPGs from 63% in 2003-2009 to 40% in 2014-2018; and the evidence threshold for Standard recommendations increases over time from 56% based on systematic reviews and/or RCTs in 2003-2009 to 85% in 2014-2018; mean numbers of patients per Standard recommendation also increase from 2,002 to 6,098 over this period.ConclusionsHigher levels evidence and numbers of patients increase the likelihood of the most positive recommendation. However, this evidence might still lack sufficient quality or certainty to answer a policy question. The evidence threshold to achieve a Standard recommendation has also increased markedly over time. As with other NICE committees, factors other than cost and perceived hierarchies of evidence clearly act as drivers of decisions.

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COWEN, EMORY L., and JOSEPH A. DURLAK. "Social policy and prevention in mental health." Development and Psychopathology 12, no. 4 (December 2000): 815–34. http://dx.doi.org/10.1017/s0954579400004132.

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This article presents policy recommendations relating to two aspects of primary prevention in mental health: (a) preventing adverse negative outcomes and (b) building health and wellness from the start and maintaining it thereafter. Recommendations for reducing diverse negative outcomes and end states reflect interconnections and bidirectional influences among physical, social–interpersonal, cognitive–academic, and “mental health” outcomes.

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Janssens, A. "CEC Radon Control Policy Recommendations." Radiation Protection Dosimetry 45, no. 1-4 (December 1, 1992): 759–61. http://dx.doi.org/10.1093/oxfordjournals.rpd.a081645.

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Ruiz, Pedro. "Access to Health Care for Uninsured Hispanics: Policy Recommendations." Psychiatric Services 44, no. 10 (October 1993): 958–62. http://dx.doi.org/10.1176/ps.44.10.958.

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Hempel, Susanne, Isomi Miake-Lye, Angela G. Brega, Fred Buckhold, Susan Hassell, Mary Patricia Nowalk, Lisa Rubenstein, et al. "Quality Improvement Toolkits: Recommendations for Development." American Journal of Medical Quality 34, no. 6 (January 24, 2019): 538–44. http://dx.doi.org/10.1177/1062860618822102.

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A burgeoning number of toolkits dedicated to improving health care exist but development guidance is lacking. The authors convened a panel of health care stakeholders, including developers, purchasers, users, funders, and disseminators of toolkits. The panel was informed by a literature review that analyzed 44 publications and 27 toolkits. A modified Delphi process established recommendations and suggestions to guide toolkit development. The panel established 12 recommendations for content and 1 recommendation for toolkit development methods. The recommendations are accompanied by 11 suggestions for toolkit content, 9 suggestions for development methods, and 6 suggestions for toolkit evaluation methods. The authors established a set of key recommendations and suggestions addressing the content, development, and evaluation methods of quality improvement toolkits, together with a ready-to use checklist. The guidance aims to advance the value of toolkits as an emerging method to effectively disseminate interventions to improve the quality of care.

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Spencer, Edward M., and Ann E. Mills. "Recommendations On Quality." Health Affairs 21, no. 4 (July 2002): 295. http://dx.doi.org/10.1377/hlthaff.21.4.295.

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Yula, Yuriy, Olexandr Pushko, and Maksym Palienko. "Recommendations for improving the hospital’s marketing policy." Health Economics and Management Review 1, no. 2 (2020): 91–99. http://dx.doi.org/10.21272/hem.2020.2-10.

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This article summarizes the arguments and counterarguments within the scientific discussion on improving the marketing policy of the clinic. The purpose of the study is to improve the marketing policy of the clinic. The urgency of solving the scientific problem lies in need to promote medical services, where marketing activities contribute to establishing relations between providers and consumers of medical services. The authors noted that patients have a low level of awareness in medical services, making it difficult to understand the market of medical services. In turn, public and municipal health care facilities have a passive marketing policy that is not competitive enough with private health care facilities. In most cases, state and municipal medical institutions do not use marketing tools to acquaint consumers with the list of available services, do not inform consumers about the expansion of medical services and the benefits of their medical institution. The object of the study was selected health care management. According to the results of empirical analysis of ways to improve the marketing policy of the clinic, it is established that the reform of the medical sector of Ukraine intensifies the processes of competition in the market. The marketing system of Ukrainian health care has no concept of medical care. Instead of that, there is a market element as medical service or health care service provided to the patient by a health care institution or an individual registered according to the law and possessing the medical business license. Besides, the medical services are paid for by the customer, such as patients, various organizations, local authorities, and the government. Thus, public medical institutions faced the need to fight (particularly with private medical institutions) for the consumer and state funding for the package of primary medical services. The study empirically confirms and theoretically proves the existence of competition between private and public medical institutions in the market of medical services. The results of this study can help improve the marketing policy of public and municipal clinics.

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Poder, Thomas G., Christian A. Bellemare, Suzanne K. Bédard, Jean-François Fisette, and Pierre Dagenais. "IMPACT OF HEALTH TECHNOLOGY ASSESSMENT REPORTS ON HOSPITAL DECISION MAKERS – 10-YEAR INSIGHT FROM A HOSPITAL UNIT IN SHERBROOKE, CANADA: IMPACT OF HEALTH TECHNOLOGY ASSESSMENT ON HOSPITAL DECISIONS." International Journal of Technology Assessment in Health Care 34, no. 4 (2018): 393–99. http://dx.doi.org/10.1017/s0266462318000405.

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Objectives:The overarching goal of this research was to (i) evaluate the impact of reports with recommendations provided by a hospital-based health technology assessment (HB-HTA) unit on the local hospital decision-making processes and implementation activities and (ii) identify the underlying factors of the nonimplementation of recommendations.Methods:All reports produced by the HB-HTA unit between December 2003 and March 2013 were retrieved, and hospital decision makers who requested these reports were solicited for enrolment. Participants were interviewed using a mixed design survey.Results:Twenty reports, associated with fifteen decision makers, fulfilled the study criteria. Nine decision makers accepted to participate, corresponding to thirteen reports and twenty-three recommendations. Of the twenty-three recommendations issued, 65 percent were implemented, 9 percent were accepted for implementation but not implemented, and 26 percent were declined. In terms of the utility of each report to guide decision makers, 92 percent of the reports were considered in the decision-making process; 85 percent had one or more recommendations adopted; and 77 percent had recommendations implemented. The most frequently mentioned reasons for nonimplementation were related to contextual factors (64 percent), production/diffusion process factors (14 percent), content/format factors (14 percent), or other factors (9 percent). Among the contextual factors, the complexity of the changes (i.e., administrative reasons), budget and resources constraints, failure to identify administrative responsibility to carry out the recommendation, and nonpriority status of the HTA recommendation, were provided.Conclusions:This study highlights that although HB-HTA reports are useful to hospital managers in their decision-making processes, certain barriers such as contextual factors need to be better addressed to improve HB-HTA efficiency and usefulness.

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Bodeau-Livinec, Florence, Emmanuelle Simon, Catherine Montagnier-Petrissans, Marie-Eve Joël, and Elisabeth Féry-Lemonnier. "Impact of CEDIT recommendations: An example of health technology assessment in a hospital network." International Journal of Technology Assessment in Health Care 22, no. 2 (March 28, 2006): 161–68. http://dx.doi.org/10.1017/s0266462306050975.

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Objectives: The objective of this study is to assess the impact of CEDIT (French Committee for the Assessment and Dissemination of Technological Innovations) recommendations on the introduction of technological innovations within the AP-HP (Assistance Publique–Hôpitaux de Paris), the French hospital network to which this body is attached.Methods: In 2002, a study based on semidirective interviews of fourteen people affected by these recommendations and a case study relating to thirteen recommendations issued between 1995 and 1998 were conducted.Results: The CEDIT is very scientifically reputable among interviewees. There is generally widespread interest for the recommendations. They are used as decision-making tools by administrative staff and as negotiating instruments by doctors in their dealings with management. Based on the case study, ten of thirteen recommendations had an impact on the introduction of the technology in health establishments. One recommendation appears not to have had an impact. Furthermore, the impact of two technologies was impossible to assess.Conclusions: This study highlights the significant impact of recommendations arising from a structure that is attached to a hospital network and the good match between CEDIT's objectives and its assignments.

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Jackson, L. W., N. L. Lee, and J. M. Samet. "Frequency of policy recommendations in epidemiologic publications." American Journal of Public Health 89, no. 8 (August 1999): 1206–11. http://dx.doi.org/10.2105/ajph.89.8.1206.

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Anwar, Mohammad A., Aldo A. Barrera-Machuca, Nadya Calderon, Windy Wang, Daniel Tausan, Thara Vayali, David Wishart, Pieter Cullis, and Robert Fraser. "Value-based healthcare delivery through metabolomics-based personalized health platform." Healthcare Management Forum 33, no. 3 (February 20, 2020): 126–34. http://dx.doi.org/10.1177/0840470420904733.

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Type 2 diabetes is routinely identified in clinical practice by tests that rely on a hyperglycemic index. However, people at risk for developing type 2 diabetes may not present with hyperglycemia. We identified several underlying risks for type 2 diabetes, insulin resistance, and associated co-morbidities, using a liquid chromatography mass spectrometry–based analysis of blood metabolites, in participants with normoglycemia and no clinical symptoms. Personalized lifestyle recommendations, including diet, exercise, and nutritional supplement recommendations, were conveyed to these participants by a web-based platform, and after 100 days of following their recommendations, these participants reported reductions in the health risks associated with type 2 diabetes and associated diseases. Our comprehensive metabolite-based assay can be used for type 2 diabetes risk stratification, and our personalized lifestyle recommendation system could be deployed as a preventative treatment option to improve health outcomes, reduce the incidence of chronic disease, and live healthier lives in an evidence-based way.

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Brady, Benjamin R., Jennifer S. De La Rosa, Uma S. Nair, and Scott J. Leischow. "Electronic Cigarette Policy Recommendations: A Scoping Review." American Journal of Health Behavior 43, no. 1 (January 1, 2019): 88–104. http://dx.doi.org/10.5993/ajhb.43.1.8.

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Gao, Xiaohui, Yu Wu, Yali Luo, Naixing Zhang, Weimin Fang, and Yukai Du. "Living status and support system of children orphaned by AIDS in central China—Description and policy recommendations." Health 04, no. 11 (2012): 1062–67. http://dx.doi.org/10.4236/health.2012.411162.

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McAuslane, Neil, Tina Wang, and Lawrence Liberti. "VP155 Synchronization Of Regulatory Approval And Health Technology Assessment Recommendation Timing." International Journal of Technology Assessment in Health Care 33, S1 (2017): 220. http://dx.doi.org/10.1017/s0266462317003956.

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INTRODUCTION:Minimizing the delay between regulatory approval and Health Technology Assessment (HTA) recommendation is critical to ensure patients access to medicines of therapeutic value. The aim of this study was to evaluate the level of synchronization between the regulatory decision and HTA recommendation.METHODS:Data were collected from the public domain for new active substances that were first appraised by the HTA agency in Scotland (SMC - Scottish Medicines Consortium), France (HAS - Haute Autorité de Santé), Germany (IQWIG - Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen), Australia (PBAC - Pharmaceutical Benefits Advisory Committee) and Canada (CADTH - Canadian Agency for Drugs and Technologies), and that reached an outcome in 2014 and 2015. The year the product was approved by the European Medicines Agency (EMA), Australian Therapeutic Goods Administration (TGA) and Health Canada were also assessed.RESULTS:In 2014 and 2015, fifty-one products with HTA recommendations were identified for SMC and IQWIG, forty-two for HAS, forty for PBAC and thirty-eight for CADTH.Of the HTA agencies studied, CADTH had the lowest percentage of HTA recommendations occurring the same year as jurisdictional regulatory approval. Of the products with CADTH recommendations in 2014, only 7 percent were approved by Health Canada in the same year. By comparison, all of the products with PBAC recommendations in 2015 were approved by TGA in the same year.For 2014 and 2015, comparing the percentage of HTA recommendations with the jurisdictional regulatory agency approval the same year showed 7 percent (2014) versus 29 percent (2015) for CADTH: 35 percent versus 37 percent for SMC: 35 percent versus 44 percent for HAS; 56 percent versus 57 percent for IQWIG; and 91 percent versus 100 percent for PBAC.CONCLUSIONS:This study shows that the parallel submission mechanism to enable synchronizing HTA and regulatory decision making is effective in Australia, whilst there remains a synchronization disconnect in other countries; although this may be improving. The extent of decision timing disconnect, influence of company strategy and type of HTA outcome were also studied. This initial analysis suggests gaps between the timing of regulatory approval and HTA recommendation for HTA agencies outside of Australia.

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Eunice Fuh, Manka, and Brice Wilfried Obiang-Obounou. "Overview of Migrant Women’s Health in South Korea: Policy Recommendations." Journal of Social Sciences Research, no. 53 (March 10, 2019): 709–14. http://dx.doi.org/10.32861/jssr.53.709.714.

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Every year, the Republic of Korea (Korea) welcomes new immigrants, thereby transitioning from a homogenous society to a multicultural country. Of these immigrants, migrant workers represent the largest group, followed by women who immigrate as spouses to Korean men. One great concern of Korea’s policymakers and healthcare providers is how Korea’s healthcare system can handle the deterioration of health observed among married Asian female immigrants. The health care system, mediated by the competitive relationship between local clinics and hospitals exacerbate the problem. The authors present possible solutions to the problems through a conceptual model of the relationship between socioeconomic status (SES), Korean healthcare system, food insecurity (FI), and health status. Different policies are proposed including: before you/she come (s) policy, foreign women workforce participation policy, poverty alleviation policy, health insurance policy for migrant women, health professional training policy, food insecurity policy and dietary acculturation policy. More government owned hospitals or private clinics should be built in rural areas. Married migrant women with good income seem to enjoy better health. Developing rural areas though economic empowerment will certainly create job opportunities.

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Lat, Ishaq, Christopher Paciullo, Mitchell J. Daley, Robert MacLaren, Scott Bolesta, Jennifer McCann, Joanna L. Stollings, et al. "Position Paper on Critical Care Pharmacy Services (Executive Summary): 2020 Update." American Journal of Health-System Pharmacy 77, no. 19 (August 20, 2020): 1619–24. http://dx.doi.org/10.1093/ajhp/zxaa217.

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Abstract Objectives Provide a multiorganizational statement to update the statement from a paper in 2000 about critical care pharmacy practice and make recommendations for future practice. Design The Society of Critical Care Medicine, American College of Clinical Pharmacy Critical Care Practice and Research Network, and the American Society of Health-System Pharmacists convened a joint task force of 15 pharmacists representing a broad cross-section of critical care pharmacy practice and pharmacy administration, inclusive of geography, critical care practice setting, and roles. The Task Force chairs reviewed and organized primary literature, outlined topic domains, and prepared the methodology for group review and consensus. A modified Delphi method was used until consensus (>66% agreement) was reached for each practice recommendation. Previous position statement recommendations were reviewed and voted to either retain, revise, or retire. Recommendations were categorized by level of ICU service to be applicable by setting, and grouped into five domains: patient care, quality improvement, research and scholarship, training and education, and professional development. Main Results There are 82 recommendation statements: forty-four original recommendations and 38 new recommendation statements. Thirty-four recommendations were made for patient care, primarily relating to critical care pharmacist duties and pharmacy services. In the quality improvement domain, 21 recommendations address the role of the critical care pharmacist in patient and medication safety, clinical quality programs, and analytics. Nine recommendations were made in the domain of research and scholarship. Ten recommendations are in the domain of training and education and eight recommendations regarding professional development. Conclusions The statements recommended by this taskforce delineate the activities of a critical care pharmacist and the scope of pharmacy services within the ICU. Effort should be made from all stakeholders to implement the recommendations provided, with continuous effort toward improving the delivery of care for critically ill patients.

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Lambert, Laurie, Lucy Boothroyd, Leila Azzi, Caroline Collette, Philippe Brouillard, Marie-Pascale Pomey, Monique Fournier, et al. "PP04 Co-Constructing Recommendations With Patients And Health Professionals." International Journal of Technology Assessment in Health Care 34, S1 (2018): 67. http://dx.doi.org/10.1017/s0266462318001812.

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Introduction:Decision-making about replacement or modification of an implantable cardioverter defibrillator (ICD) must be patient-centered and clinically appropriate. We engaged both patients and health care professionals in a multi-method approach in order to recommend structures and processes that facilitate informed and shared decision-making.Methods:A systematic literature review (2000 to 2017) was performed focusing on the patient's perspective and the optimal organization of structures and processes for decision-making. A province-wide field evaluation based on medical chart review was carried out to provide ‘real world’ evidence in Québec's six ICD implanting centers (1 July to 31 December, 2016; N = 418). Patients and health care professionals reviewed the findings of the review and field evaluation, and deliberated recommendations in an anonymous manner by electronic mail. A joint meeting focused on proposed recommendations concerning shared decision-making.Results:The patients provided feedback on the literature review based on their ICD experience, and highlighted the need for better and more interactive decision aids, clinical information and time, and a private space for sensitive discussions. The field evaluation underlined the variability of treatment choices at the time of replacement and that more than one in ten patients had undergone ICD deactivation. Proposed recommendations focus on multi-disciplinary, integrated follow-up of patients and outline best practice for incorporating patient wishes and life objectives when discussing treatment options. The multi-round consultation process allowed both patients and professionals to co-construct recommendations with our evaluation team.Conclusions:This multi-method approach enriched our interpretation of literature and ‘real world’ data and facilitated identification and prioritization of important themes. Partnership with both patients and clinicians added a new and energizing dynamic to our evaluation and recommendation processes. We acknowledge the contribution of the members of the patient committee and the clinical experts committee.

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Mandava, Lakshmi, John Powell, Kevin Harris, and Anastasia Chalkidou. "OP92 Impact Of Real-World Evidence On Health Technology Assessment And National Guidance For Interventional Procedures: A UK Perspective." International Journal of Technology Assessment in Health Care 38, S1 (December 2022): S34—S35. http://dx.doi.org/10.1017/s0266462322001386.

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IntroductionThe National Institute for Health and Care Excellence (NICE) interventional procedures programme (IPP) issues guidance on the safety and efficacy of new interventional procedures (IPS). The IPP considers a range of evidence from randomized controlled trials (RCTs) to case series to make final recommendations. Real-world evidence (RWE) can provide additional information on long-term outcomes and patient population characteristics that are not easily captured by RCTs. This study explores the impact of RWE in complementing RCTs on long-term safety and efficacy for national guidance development.MethodsWe review the impact of RWE in IPS guidance (IPG) updates and change in guidance recommendations in the last 5 years. This is done by analyzing NICE guidance updates and supporting evidence. A range of RWE was considered in the supporting evidence, for example, registries and clinical audits.ResultsThe addition of RWE evidence to IPP guidance update has led to significant changes in the recommendations. For example, in one recent IPG, standard arrangements recommendation based on short-term RCT evidence was changed to a research recommendation when RWE showed an increase in long-term adverse effects. In another recent IPG update, special arrangements recommendation based on short-term RCT evidence was changed to a research recommendation when RWE reported long-term inferior efficacy and safety for the new intervention compared to current standard of care. A complete overview of results of the last 5 years will also be presented at the meeting.ConclusionsThese findings indicate that increased availability of RWE in HTA has the potential to impact national guidance recommendations. In addition, it shows how RWE can fill the evidence base gaps created by RCTs. Such data can confirm or contradict the findings of RCTs, or generate questions needing further research, or support disinvestment in non-effective technologies.

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Russell, Louise B. "• Improving the Panel's Recommendations." Medical Decision Making 19, no. 4 (October 1999): 379–80. http://dx.doi.org/10.1177/0272989x9901900403.

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Schwartz, Alan. "Recommendations, Outcomes, and Trust." Medical Decision Making 31, no. 5 (September 2011): 701–2. http://dx.doi.org/10.1177/0272989x11420574.

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Midgley, Georgia, Hayley Smithers-Sheedy, Sarah McIntyre, Nadia Badawi, John Keogh, and Cheryl A. Jones. "Congenital Cytomegalovirus Prevention, Awareness and Policy Recommendations - A Scoping Study." Infectious Disorders - Drug Targets 20, no. 3 (July 20, 2020): 291–302. http://dx.doi.org/10.2174/1871526518666181009093725.

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Background: Congenital cytomegalovirus (cCMV) is known to cause childhood deafness, neurodevelopmental disability and death. Simple hygiene precautions are effective in reducing maternal risk of CMV infection. Objective: To review i) awareness of CMV infection and available primary prevention strategies both in the community and amongst health professionals ii) available cCMV information sources in the literature, grey literature and published professional guidelines. Methods: Scoping study to i) identify literature pertaining to cCMV awareness amongst parents and health professionals using MedLine and CINAHL databases via EBSCO ii) review one high income country’s guidelines and recommendations regarding cCMV infection and pregnancy (example country Australia) iii) grey literature for parental information. Results: Worldwide awareness of cCMV and of available prevention strategies amongst women and health professionals are poor. Findings internationally suggest at least half of maternity care health professionals do not routinely provide advice to women regarding simple hygiene precautions that can reduce their risk of infection during pregnancy. Though information resources regarding cCMV are available, they are frequently not included within general healthy pregnancy advice and require individuals to search for ‘congenital cytomegalovirus’. Conclusion: cCMV is a preventable cause of serious congenital disability and death. Prevention opportunities are being missed because most women are not aware of cCMV or how to reduce their risk of infection in pregnancy, in part due to poor health professional awareness. New strategies to disseminate cCMV information to the community and to support health professionals to embed cCMV advice within routine pregnancy counselling is required.

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Sisirak, Jasmina, and Beth Marks. "Health and Wellness Strand: Recommendations From National Goals Conference 2015." Inclusion 3, no. 4 (December 1, 2015): 242–49. http://dx.doi.org/10.1352/2326-6988-3.4.242.

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Abstract Although a variety of health and wellness initiatives have emerged in the past decade, people with intellectual and developmental disabilities (IDD), their caregivers, and advocates still are facing remarkable challenges in staying healthy and receiving appropriate health services. The National Goals 2015 Conference provided a unique platform and an opportunity to summarize the current state of knowledge, identify national goals in research, practice, and policy, and set the stage for the future directions in health and wellness in IDD field. This article presents an outline to improve the health of people with IDD. The goals identify major health and wellness issues and solutions proposed by a group of disability researchers, policy specialists, advocates, health care providers, and service providers with the aim to set forth an agenda for national, state, and local action to improve the health of people with IDD and include them fully in appropriate health systems.

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Breda, Joao, Jo Jewell, and Amélie Keller. "The Importance of the World Health Organization Sugar Guidelines for Dental Health and Obesity Prevention." Caries Research 53, no. 2 (August 7, 2018): 149–52. http://dx.doi.org/10.1159/000491556.

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The World Health Organization (WHO) recommends a reduced intake of free sugars throughout the life course (strong recommendation) with a reduction of free sugars intake to less than 10% of the total energy intake (strong recommendation) and preferably below 5% of the total energy intake (conditional recommendation) in both adults and children. Available data clearly show that people already consume significantly more sugar than they should, increasing the risk for dental caries, overweight and obesity. The WHO recommendations are intended for use by the policy makers as a benchmark for assessing intake of sugars by populations and as a driving force for policy change. To create a favorable environment, enabling the overall amount of free sugar intake to be as low as possible and to reduce the frequency of consumption of sugar-rich foods, a range of public health interventions is advised.

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Smith, Marissa J., Andrew J. Baxter, Kathryn Skivington, Mark McCann, Shona Hilton, and Srinivasa Vittal Katikireddi. "Examining the sources of evidence in e-cigarette policy recommendations: A citation network analysis of international public health recommendations." PLOS ONE 16, no. 8 (August 4, 2021): e0255604. http://dx.doi.org/10.1371/journal.pone.0255604.

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Background Public health policies and recommendations aim to be informed by the best available evidence. Evidence underpinning e-cigarettes policy recommendations has been necessarily limited due to the novelty of the technology and the lack of long-term epidemiological studies and trials. Some public health bodies have actively encouraged e-cigarette use whilst others have raised concerns over introducing new health risks and renormalising tobacco smoking. Using citation network analysis we investigated the author conflicts of interest and study funding statements within sources of evidence used by public health bodies when making recommendations about e-cigarette policy. Methods We conducted citation network analysis of public health recommendation documents across four purposively selected diverse jurisdictions: WHO, UK, Australia, and USA. We extracted all citations from 15 public health recommendation documents, with more detailed data collected for influential citations (used in 3+ recommendation documents). We analysed the relationships between the sources of evidence used across jurisdictions using block modelling to determine if similar groups of documents were used across different jurisdictions. We assessed the frequency and nature of conflicts of interest. Results 1700 unique citations were included across the 15 public health recommendation documents, with zero to 923 citations per document (median = 63, IQR = 7.5–132). The evidence base underpinning public health recommendations did not systematically differ across jurisdictions. Of the 1700 citations included, the majority were journal articles (n = 1179). Across 1081 journal articles published between 1998–2018, 200 declared a conflict of interest, 288 contained no mention of conflicts of interest, and 593 declared none. Conflicts of interest were reported with tobacco (3%; n = 37 journal articles of 1081), e-cigarette (7%; n = 72), and pharmaceutical companies (12%; n = 127), with such conflicts present even in the most recent years. There were 53 influential citations, the most common study type was basic science research without human subjects (e.g. examination of aerosols and e-liquids) (n = 18) followed by systematic review (n = 10); with randomised control trial being least common (n = 4). Network analysis identified clusters of highly-cited articles with a higher prevalence of conflicts of interest. Conclusion Public health bodies across different jurisdictions drew upon similar sources of evidence, despite articulating different policy approaches to e-cigarettes. The evidence drawn upon, including the most influential evidence, contained substantial conflicts of interest (including relationships with e-cigarette and tobacco industries). Processes to explicitly manage conflicts of interest arising from the underlying evidence base may be required when developing public health recommendations.

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Larson, James S., and Mylon Winn. "Health Policy and Exercise: A Brief BRFSS Study and Recommendations." Health Promotion Practice 11, no. 2 (May 19, 2008): 268–74. http://dx.doi.org/10.1177/1524839908318287.

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Black, Maureen M. "Nutrition, Health, and Child Development: Research Advances and Policy Recommendations." American Journal of Clinical Nutrition 69, no. 3 (March 1, 1999): 578. http://dx.doi.org/10.1093/ajcn/69.3.578.

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Whitehead, R. G. "Nutrition, health and child development: Research advance and policy recommendations." Transactions of the Royal Society of Tropical Medicine and Hygiene 92, no. 5 (September 1998): 576. http://dx.doi.org/10.1016/s0035-9203(98)90929-4.

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Wang, Yu, and Peilong Liu. "China’s foreign health aid: history, challenges, perspectives, and policy recommendations." China International Strategy Review 1, no. 1 (June 2019): 153–67. http://dx.doi.org/10.1007/s42533-019-00010-1.

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Oja, Pekka, and Sylvia Titze. "Physical activity recommendations for public health: development and policy context." EPMA Journal 2, no. 3 (June 8, 2011): 253–59. http://dx.doi.org/10.1007/s13167-011-0090-1.

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Hailey, David, and Khai Tran. "Quality and relevance of evidence in support of guideline recommendations for sleep laboratory investigations." International Journal of Technology Assessment in Health Care 21, no. 4 (October 2005): 459–63. http://dx.doi.org/10.1017/s0266462305050634.

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Objectives: As part of a review of guidelines for sleep laboratories, this study summarizes the quality and relevance of evidence cited in support of recommendations on investigations for individuals with sleep disorders.Methods: Quality of evidence in support of each recommendation was rated as A (from well-conducted, prospective controlled studies), B (from controlled studies and case series, with minor shortcomings), or C (from case series or case series plus controlled studies with substantial limitations). Relevance of the cited evidence was also rated from A to C, in decreasing order of merit.Results: Of eighty-one recommendations from thirty-seven guidelines, forty-six were supported by evidence from primary studies. Six recommendations were supported by category A evidence, fifteen by category B, and twenty-five recommendations by category C. The cited evidence was highly relevant to eighteen recommendations, of some relevance for twenty-two and of little or no relevance to six. Four recommendations were informed by an absence of available evidence. For the other thirty-one, no evidence was provided in support.Conclusions: The approach used provided a concise overview of recommendations and supporting evidence for decision-makers. Guidelines on the use of sleep laboratory investigations contain much detailed information, but evidence supporting several recommendations is of limited quality and relevance. Furthermore, good-quality studies of many sleep laboratory applications are needed to assist both health policy formulation and clinical practice.

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Parke, Belinda, and Jane McCusker. "Consensus‐based policy recommendations for geriatric emergency care." International Journal of Health Care Quality Assurance 21, no. 4 (June 13, 2008): 385–95. http://dx.doi.org/10.1108/09526860810880199.

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Laing, Glenna, Rume Djebah, Judy Hoff, Robert Shaffer, Sheila Rutledge Harding, Carmen Moga, Stefanie Kletke, and Ann Scott. "OP35 Integrated Knowledge Translation In Policy Development." International Journal of Technology Assessment in Health Care 34, S1 (2018): 14. http://dx.doi.org/10.1017/s0266462318000922.

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Introduction:Immune globulin (IG) is a publicly funded blood product with high utilization rates and rapidly rising costs. Inappropriate use of IG, particularly in dose and treatment duration, is observed in about 10 percent of cases, and the national guidelines for IG treatment are outdated. To develop a utilization management policy for IG, the Alberta, Manitoba and Saskatchewan Ministries of Health collaborated with health technology assessment (HTA) researchers and clinicians to develop evidence-based guideline recommendations for IG treatment to inform an authorization policy for IG utilization in the provinces.Methods:A multidisciplinary committee comprising HTA researchers and 22 physicians from seven medical specialties adapted recommendations from 43 “seed” guidelines into one locally contextualized IG guideline. HTA methods and rapid review products were used extensively to update gaps in the evidence base. The guideline recommendation document was used to develop a provincial IG utilization management policy. The challenges of achieving a methodologically rigorous guideline development process will be discussed.Results:The guideline contained over 60 recommendations for IG use in different medical specialties. The health ministries used the guideline recommendations to develop an IG authorization policy. The clinician-sanctioned review criteria were used to construct a conditional reimbursement system for generating outcome data from controlled off-label IG use for conditions where evidence gaps existed, and were built into policies for benchmarking compliance.Conclusions:Three provinces successfully collaborated to develop an IG utilization management policy. The unique approach involved a credible and transparent process that incorporated key review elements for compliance benchmarking and reimbursement, promoted clinician buy-in, and created a cadre of clinical champions willing to assist in policy development and implementation. The proactive, rather than retroactive, incorporation of clinician-sanctioned benchmarking and review criteria into policy will help bridge the know-do gap and foster a stronger, more direct link between health policy and evidence.

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Ellenbecker, Carol Hall, Jacqueline Fawcett, Emily J. Jones, Deborah Mahoney, Beth Rowlands, and Ashley Waddell. "A Staged Approach to Educating Nurses in Health Policy." Policy, Politics, & Nursing Practice 18, no. 1 (February 2017): 44–56. http://dx.doi.org/10.1177/1527154417709254.

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Nurse leaders and health-care experts agree that nurses have a responsibility to address the health problems facing the nation by participating in health policy development. However, nurses have not fully realized their potential when it comes to engaging in health policy advocacy and leadership. Nurse leaders, professional nursing organizations, accrediting bodies, and the Institute of Medicine have all identified the need to educate nurses in heath policy. Valuable recommendations for content and learning activities in health policy have been made. We argue that nursing education in health policy and the many recommendations offered have been broad and overly ambitious. This article presents a proposal for a staged approach to educating nurses. This approach would tailor content to the role of the nurse at each level of nursing education. The focus of health policy content would progress from the organizational level to local, state, and finally national level health policies. The goal of this approach is to better prepare all levels of nursing students to participate in shaping effective health policies.

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Jaksa, Ashley, James Wu, Páll Jónsson, Hans-Georg Eichler, Sarah Vititoe, and Nicolle M. Gatto. "Organized structure of real-world evidence best practices: moving from fragmented recommendations to comprehensive guidance." Journal of Comparative Effectiveness Research 10, no. 9 (June 2021): 711–31. http://dx.doi.org/10.2217/cer-2020-0228.

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Decision-makers have become increasingly interested in incorporating real-world evidence (RWE) into their decision-making process. Due to concerns regarding the reliability and quality of RWE, stakeholders have issued numerous recommendation documents to assist in setting RWE standards. The fragmented nature of these documents poses a challenge to researchers and decision-makers looking for guidance on what is ‘high-quality’ RWE and how it can be used in decision-making. We offer researchers and decision-makers a structure to organize the landscape of RWE recommendations and identify consensus and gaps in the current recommendations. To provide researchers with a much needed pathway for generating RWE, we discuss how decision-makers can move from fragmented recommendations to comprehensive guidance.

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Terris, Milton. "The Health Status of Cuba: Recommendations for Epidemiologic Investigation and Public Health Policy." Journal of Public Health Policy 10, no. 1 (1989): 78. http://dx.doi.org/10.2307/3342945.

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Jones, Wanda. "EDICT Policy Recommendations Support Protection of Research Participants." Journal of Cancer Education 24 (January 2009): 52–53. http://dx.doi.org/10.1080/08858190903404510.

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Jones, Wanda K. "EDICT policy recommendations support protection of research participants." Journal of Cancer Education 24, S2 (June 2009): S52—S53. http://dx.doi.org/10.1007/bf03182313.

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van der Wal, Rena, France Bouthillette, and Stephen J. Havlovic. "Recommendations for Managing Hospital Closure." Healthcare Management Forum 11, no. 4 (December 1998): 12–17. http://dx.doi.org/10.1016/s0840-4704(10)61018-6.

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Nease, Robert F., and Yann Bonduelle. "Solid Recommendations from Soft Numbers." Medical Decision Making 7, no. 4 (December 1987): 220–33. http://dx.doi.org/10.1177/0272989x8700700404.

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du Prey, Beatrice, B. Douglas Ford, Assil R. Bassili, and Dick E. Zoutman. "Antimicrobial recommendations by health care providers in Kenya." American Journal of Health-System Pharmacy 61, no. 3 (February 1, 2004): 302. http://dx.doi.org/10.1093/ajhp/61.3.302.

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Powell, Adam C., Teresa L. Rogstad, David E. Winchester, Jon D. Shanser, James W. Long, Uday U. Deshmukh, and Vijay M. Rao. "Discordance in Clinical Recommendations Regarding the Use of Imaging." American Journal of Medical Quality 35, no. 2 (May 21, 2019): 117–24. http://dx.doi.org/10.1177/1062860619851561.

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As physicians strive to provide evidence-based care, challenges arise if different entities disseminate divergent Appropriate Use Criteria (AUC) or clinical guidelines on the same topic. To characterize these challenges in one field, this study reviews the literature on comparisons of clinical recommendations regarding medical imaging. The PubMed database was searched for the years 2013-2018 for studies describing discordance among clinical recommendations regarding the performance of imaging. Of the 406 articles identified, 15 met the selection criteria: 8 qualitative and 7 quantitative. Reasons for discordance varied, with lack of evidence often cited. Quantitative studies often found that different decisions would be reached depending on the clinical recommendation followed. Nonetheless, quantitative studies also tended not to consider one set of recommendations superior to another. The findings of this review might help clinicians seek guidance more thoughtfully and could inform use of guidelines and AUC for quality improvement and clinical decision support.

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Hanquet, Germaine, Pawel Stefanoff, Wiebke Hellenbrand, Sigrid Heuberger, Pierluigi Lopalco, and James M. Stuart. "Strong Public Health Recommendations from Weak Evidence? Lessons Learned in Developing Guidance on the Public Health Management of Meningococcal Disease." BioMed Research International 2015 (2015): 1–10. http://dx.doi.org/10.1155/2015/569235.

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The evidence underpinning public health policy is often of low quality, leading to inconsistencies in recommended interventions. One example is the divergence in national policies across Europe for managing contacts of invasive meningococcal disease. Aiming to develop consistent guidance at the European level, a group of experts reviewed the literature and formulated recommendations. The group defined eight priority research questions, searched the literature, and formulated recommendations using GRADE methodology. Five of the research questions are discussed in this paper. After taking into account quality of evidence, benefit, harm, value, preference, burden on patient of the intervention, and resource implications, we made four strong recommendations and five weak recommendations for intervention. Strong recommendations related not only to one question with very low quality of evidence as well as to two questions with moderate to high quality of evidence. The weak recommendations related to two questions with low and very low quality of evidence but also to one question with moderate quality of evidence. GRADE methodology ensures a transparent process and explicit recognition of additional factors that should be considered when making recommendations for policy. This approach can be usefully applied to many areas of public health policy where evidence quality is often low.

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Journal articles on the topic 'Health policy recommendations'

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