onr:"swepub:oai:DiVA.org:liu-67637"
Search: onr:"swepub:oai:DiVA.org:liu-67637" > A Tentative Consens...
- 1 of 1
- Previous record
- Next record
- To hitlist
- Ekerstad, Niklas,1969-Linköpings universitet,Utvärdering och hälsoekonomi,Hälsouniversitetet (author)
A Tentative Consensus-Based Model for Priority Setting : An Example from Elderly Patients with Myocardial Infarction and Multi-morbidity
- Article/chapterEnglish2011
Publisher, publication year, extent ...
- 2011-04-21
- Sage,2011
- printrdacarrier
Numbers
- LIBRIS-ID:oai:DiVA.org:liu-67637
- https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-67637URI
- https://doi.org/10.1177/1403494811405092DOI
- http://kipublications.ki.se/Default.aspx?queryparsed=id:122609643URI
Supplementary language notes
- Language:English
- Summary in:English
Part of subdatabase
- SwePubSwePub
Classification
Notes
- Background: In most Western countries the growing gap between available resources and greater potential for medical treatment has brought evidence-based guidelines into focus. However, such guidelines are difficult to use when the evidence base is weak. Priority setting for frail elderly patients with heart disease illustrates this problem. We have outlined a tentative model for priority setting regarding frail elderly heart patients. The model takes cardiovascular risk, frailty, and comorbidity into account. Objective: Our aim is to validate the model’s components. We want to evaluate the inter-rater reliability of the study experts’ rankings regarding each of the model’s categories. Methods: A confidential questionnaire study consisting of 15 authentic and validated cases was conducted to assess the views of purposefully selected cardiology experts (n = 58). They were asked to rank the cases regarding the need for coronary angiography using their individual clinical experience. The response rate was 71%. Responses were analysed with frequencies and descriptive statistics. The inter-rater reliability regarding the experts’ rankings of the cases was estimated via an intra-class correlation test (ICC). Results: The cardiologists considered the clinical cases to be realistic. The intra-class correlation (two-way random, consistency, average measure) was 0.978 (95% CI 0.958–0.991), which denotes a very good inter-rater reliability on the group level. The model’s components were considered relevant regarding complex cases of non-ST elevation myocardial infarction. Comorbidity was considered to be the most relevant component, frailty the second most relevant, followed by cardiovascular risk. Conclusions: A framework taking comorbidity, frailty, and cardiovascular risk into account could constitute a foundation for consensus-based guidelines for frail elderly heart patients. From a priority setting perspective, it is reasonable to believe that the framework is applicable to other groups of elderly patients with acute disease and complex needs.
Subject headings and genre
- MEDICINE
- MEDICIN
Added entries (persons, corporate bodies, meetings, titles ...)
- Löfmark, RurikKarolinska Institutet (author)
- Andersson, DavidLinköpings universitet,Utvärdering och hälsoekonomi,Hälsouniversitetet(Swepub:liu)davan75 (author)
- Carlsson, PerLinköpings universitet,Utvärdering och hälsoekonomi,Hälsouniversitetet(Swepub:liu)perca23 (author)
- Linköpings universitetUtvärdering och hälsoekonomi (creator_code:org_t)
Related titles
- In:Scandinavian Journal of Public Health: Sage39:4, s. 345-3531403-49481651-1905
Internet link
Find in a library
- Scandinavian Journal of Public Health (Search for host publication in LIBRIS)
To the university's database
- 1 of 1
- Previous record
- Next record
- To hitlist
Find more in SwePub
- By the author/editor
- Ekerstad, Niklas ...
- Löfmark, Rurik
- Andersson, David
- Carlsson, Per
- Articles in the publication
- Scandinavian Jou ...
- By the university
- Linköping University
- Karolinska Institutet
Search outside SwePub
- Extend your search to:
- Google Book Search
- Google Scholar
Kungliga biblioteket hanterar dina personuppgifter i enlighet med EU:s dataskyddsförordning (2018), GDPR. Läs mer om hur det funkar här.
Så här hanterar KB dina uppgifter vid användning av denna tjänst.
- Copyright © LIBRIS - National Library Systems
- LIBRIS.kb.se
