This important book enables physicians to take full advantage of recent scientific progress to develop new, more effective treatment options. Orthopaedic surgeons, cell and molecular biologists, and bioengineers define current clinical issues and knowledge.
Properly performing health care systems require concepts and methods that match their complexity. Resilience engineering provides that capability. It focuses on a system’s overall ability to sustain required operations under both expected and unexpected conditions rather than on individual features or qualities. This book contains contributions from international experts in health care, organisational studies and patient safety, as well as resilience engineering. Whereas current safety approaches primarily aim to reduce the number of things that go wrong, Resilient Health Care aims to increase the number of things that go right.
This volume, developed by the Observatory together with OECD, provides an overall conceptual framework for understanding and applying strategies aimed at improving quality of care. Crucially, it summarizes available evidence on different quality strategies and provides recommendations for their implementation. This book is intended to help policy-makers to understand concepts of quality and to support them to evaluate single strategies and combinations of strategies.
Written and edited by internationally recognised leaders in the field, the new edition of the Oxford Textbook of Oncology has been fully revised and updated, taking into consideration the advancements in each of the major therapeutic areas, and representing the multidisciplinary management of cancer. Structured in six sections, the book provides an accessible scientific basis to the key topics of oncology, examining how cancer cells grow and function, as well as discussing the aetiology of cancer, and the general principles governing modern approaches to oncology treatment. The book examines the challenges presented by the treatment of cancer on a larger scale within population groups, and the importance of recognising and supporting the needs of individual patients, both during and after treatment. A series of disease-oriented, case-based chapters, ranging from acute leukaemia to colon cancer, highlight the various approaches available for managing the cancer patient, including the translational application of cancer science in order to personalise treatment. The advice imparted in these cases has relevance worldwide, and reflects a modern approach to cancer care. The Oxford Textbook of Oncology provides a comprehensive account of the multiple aspects of best practice in the discipline, making it an indispensable resource for oncologists of all grades and subspecialty interests.
Data sharing can accelerate new discoveries by avoiding duplicative trials, stimulating new ideas for research, and enabling the maximal scientific knowledge and benefits to be gained from the efforts of clinical trial participants and investigators. At the same time, sharing clinical trial data presents risks, burdens, and challenges. These include the need to protect the privacy and honor the consent of clinical trial participants; safeguard the legitimate economic interests of sponsors; and guard against invalid secondary analyses, which could undermine trust in clinical trials or otherwise harm public health. Sharing Clinical Trial Data presents activities and strategies for the responsible sharing of clinical trial data. With the goal of increasing scientific knowledge to lead to better therapies for patients, this book identifies guiding principles and makes recommendations to maximize the benefits and minimize risks. This report offers guidance on the types of clinical trial data available at different points in the process, the points in the process at which each type of data should be shared, methods for sharing data, what groups should have access to data, and future knowledge and infrastructure needs. Responsible sharing of clinical trial data will allow other investigators to replicate published findings and carry out additional analyses, strengthen the evidence base for regulatory and clinical decisions, and increase the scientific knowledge gained from investments by the funders of clinical trials. The recommendations of Sharing Clinical Trial Data will be useful both now and well into the future as improved sharing of data leads to a stronger evidence base for treatment. This book will be of interest to stakeholders across the spectrum of research-from funders, to researchers, to journals, to physicians, and ultimately, to patients.
This book contains the proceedings of the XIIIth International Bile Acid Meeting (Falk Symposium 80), an official satellite meeting of the World Congress of Gastroenterology, held in San Diego, California, U.S.A., September 30--October 2, 1994. It begins with presentations of major advances in bile acid chemistry, biology and pharmacology. The new structure proposed for the mixed micelles present in bile is reviewed, as are the properties of new synthetic analogues of bile acids. The mechanisms by which bile acids interact with cell membranes are discussed in order to provide insight into the hepatotoxic effects of bile acids in cholestatic liver disease. The book further shows the exciting progress in the molecular biology of bile acid transport by the hepatocyte and enterocyte, and concludes with a consensus on the use of ursodeoxycholic acid in cholestatic liver disease and as an adjunct to immunosuppressive therapy after liver transplantation, and to interferon therapy in chronic viral hepatitis.
Advances in medical, biomedical and health services research have reduced the level of uncertainty in clinical practice. Clinical practice guidelines (CPGs) complement this progress by establishing standards of care backed by strong scientific evidence. CPGs are statements that include recommendations intended to optimize patient care. These statements are informed by a systematic review of evidence and an assessment of the benefits and costs of alternative care options. Clinical Practice Guidelines We Can Trust examines the current state of clinical practice guidelines and how they can be improved to enhance healthcare quality and patient outcomes. Clinical practice guidelines now are ubiquitous in our healthcare system. The Guidelines International Network (GIN) database currently lists more than 3,700 guidelines from 39 countries. Developing guidelines presents a number of challenges including lack of transparent methodological practices, difficulty reconciling conflicting guidelines, and conflicts of interest. Clinical Practice Guidelines We Can Trust explores questions surrounding the quality of CPG development processes and the establishment of standards. It proposes eight standards for developing trustworthy clinical practice guidelines emphasizing transparency; management of conflict of interest ; systematic review-guideline development intersection; establishing evidence foundations for and rating strength of guideline recommendations; articulation of recommendations; external review; and updating. Clinical Practice Guidelines We Can Trust shows how clinical practice guidelines can enhance clinician and patient decision-making by translating complex scientific research findings into recommendations for clinical practice that are relevant to the individual patient encounter, instead of implementing a one size fits all approach to patient care. This book contains information directly related to the work of the Agency for Healthcare Research and Quality (AHRQ), as well as various Congressional staff and policymakers. It is a vital resource for medical specialty societies, disease advocacy groups, health professionals, private and international organizations that develop or use clinical practice guidelines, consumers, clinicians, and payers.
The anthrax incidents following the 9/11 terrorist attacks put the spotlight on the nation's public health agencies, placing it under an unprecedented scrutiny that added new dimensions to the complex issues considered in this report. The Future of the Public's Health in the 21st Century reaffirms the vision of Healthy People 2010, and outlines a systems approach to assuring the nation's health in practice, research, and policy. This approach focuses on joining the unique resources and perspectives of diverse sectors and entities and challenges these groups to work in a concerted, strategic way to promote and protect the public's health. Focusing on diverse partnerships as the framework for public health, the book discusses: The need for a shift from an individual to a population-based approach in practice, research, policy, and community engagement. The status of the governmental public health infrastructure and what needs to be improved, including its interface with the health care delivery system. The roles nongovernment actors, such as academia, business, local communities and the media can play in creating a healthy nation. Providing an accessible analysis, this book will be important to public health policy-makers and practitioners, business and community leaders, health advocates, educators and journalists.