Stroke units: an evidence based approach
Gespeichert in:
| Hauptverfasser: | , |
|---|---|
| Format: | Buch |
| Sprache: | English |
| Veröffentlicht: |
London
BMJ Books
1998
|
| Ausgabe: | 1. publ. |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | XV, 112 S. graph. Darst. |
| ISBN: | 0727912119 |
Internformat
MARC
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| 100 | 1 | |a Langhorne, Peter |e Verfasser |4 aut | |
| 245 | 1 | 0 | |a Stroke units |b an evidence based approach |c Peter Langhorne ; Martin Dennis |
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| 650 | 4 | |a Cerebrovascular Disorders |x therapy | |
| 650 | 4 | |a Cerebrovascular disease |x Therapy | |
| 650 | 4 | |a Hospital Units |x organization & administration | |
| 650 | 4 | |a Hospital wards |x Administration | |
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Datensatz im Suchindex
| _version_ | 1804126719074893824 |
|---|---|
| adam_text | Contents
Authorship ix
Contributors xi
Foreword by Iain Chalmers xiii
Preface xv
1 The stroke unit story 1
History of stroke unit care and its evaluation 1
Early studies 2
Definitions of a stroke unit 3
Stroke intensive care units 4
Later developments 4
The demands of evidence based practice 6
2 How should we evaluate our interventions? 8
Levels of evidence 8
Sources of error 10
Systematic error (bias) 10
Random error 13
Design of a reliable stroke unit trial 13
Why randomised trials may not be enough 14
Systematic reviews of randomised trials 15
Conduct of systematic reviews 15
Sources of bias in systematic reviews 17
Interpretation of systematic reviews 18
3 Assembling evidence about stroke units 20
Formulating the stroke unit question 20
Defining the intervention 20
Denning the patient group 21
Defining the context 22
Defining the outcomes 22
Identifying the relevant trials 23
Locating information from relevant trials 23
The stroke unit trials 24
General comments 24
Stroke unit characteristics 24
Characteristics of different models of stroke unit 29
4 Effectiveness of organised (stroke unit) care 33
v
STROKE UNITS: AN EVIDENCE BASED APPROACH j
Conventions of meta analysis 33
What is meta analysis? 33
What is an odds ratio? 34
Presentation of results 35
Coping with different types of outcome 36
Meta analysis of the stroke unit trials 36
Can the risk of death be reduced? 36
Why were deaths reduced? 38
Preventing death at the expense of increased
dependency among survivors? 40
Is the need for institutional care reduced? 41
Is dependency (disability) among survivors reduced? 42
Is quality of life among survivors improved? 45
What are the absolute benefits of stroke unit care? 45
Subgroup analysis 46
Which patients benefit? 48
What kind of stroke unit is effective? 49
Exploring the diversity of stroke unit trials 50
What general policies should be applied? 51
5 Economics of stroke unit care 56
Economic analysis 56
Methods of economic analysis 56
Terminology 57
Sources of data for economic analysis 57
Costs of stroke 57
Identifying potential costs and benefits 59
Cost effectiveness analysis 59
Potential benefits 59
Potential costs 59
Measuring costs and benefits 60
Economic interpretation of results 62
Economic balance sheet 62
Factors missing from the analysis 64
Implications of the analysis 64
6 Implications for planning stroke services 66
Evidence based stroke care 66
Comprehensive stroke services 67
What kind of stroke unit? 68
Stroke patients only or mixed rehabilitation
service? 68
Stroke ward or mobile stroke team? 68
vi
CONTENTS
Acute or rehabilitation unit? 69
Staffing of the stroke unit 70
In which department should the unit be established? 70
What staff are needed? 71
Stroke unit policies 72
Stroke unit size 72
Patient selection criteria 73
Duration of stay 73
Practices and procedures 74
Communication: Multidisciplinary team 74
Communication: Carers 75
Care pathways 75
Education, training, and beliefs 78
Overcoming resistance to change 78
7 Implications for future research 80
Current state of knowledge 80
Outstanding questions 81
Appendix: Descriptions of stroke unit care 84
Glossary of terms 93
References 100
Index 109
vii
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| spelling | Langhorne, Peter Verfasser aut Stroke units an evidence based approach Peter Langhorne ; Martin Dennis 1. publ. London BMJ Books 1998 XV, 112 S. graph. Darst. txt rdacontent n rdamedia nc rdacarrier Cerebrovascular Disorders therapy Cerebrovascular disease Therapy Hospital Units organization & administration Hospital wards Administration Intensivstation (DE-588)4161965-1 gnd rswk-swf Schlaganfallpatient (DE-588)4133318-4 gnd rswk-swf (DE-588)4143413-4 Aufsatzsammlung gnd-content Schlaganfallpatient (DE-588)4133318-4 s Intensivstation (DE-588)4161965-1 s DE-604 Dennis, Martin Verfasser aut HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=008202828&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Langhorne, Peter Dennis, Martin Stroke units an evidence based approach Cerebrovascular Disorders therapy Cerebrovascular disease Therapy Hospital Units organization & administration Hospital wards Administration Intensivstation (DE-588)4161965-1 gnd Schlaganfallpatient (DE-588)4133318-4 gnd |
| subject_GND | (DE-588)4161965-1 (DE-588)4133318-4 (DE-588)4143413-4 |
| title | Stroke units an evidence based approach |
| title_auth | Stroke units an evidence based approach |
| title_exact_search | Stroke units an evidence based approach |
| title_full | Stroke units an evidence based approach Peter Langhorne ; Martin Dennis |
| title_fullStr | Stroke units an evidence based approach Peter Langhorne ; Martin Dennis |
| title_full_unstemmed | Stroke units an evidence based approach Peter Langhorne ; Martin Dennis |
| title_short | Stroke units |
| title_sort | stroke units an evidence based approach |
| title_sub | an evidence based approach |
| topic | Cerebrovascular Disorders therapy Cerebrovascular disease Therapy Hospital Units organization & administration Hospital wards Administration Intensivstation (DE-588)4161965-1 gnd Schlaganfallpatient (DE-588)4133318-4 gnd |
| topic_facet | Cerebrovascular Disorders therapy Cerebrovascular disease Therapy Hospital Units organization & administration Hospital wards Administration Intensivstation Schlaganfallpatient Aufsatzsammlung |
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