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001-es BibID:	BIBFORM105073
035-os BibID:	(WOS)000382876700016 (Scopus)84991063666 (cikkazonosító)e0161367
Első szerző:	Cnossen, Maryse C.
Cím:	Variation in Structure and Process of Care in Traumatic Brain Injury : provider Profiles of European Neurotrauma Centers Participating in the CENTER-TBI Study / Maryse C. Cnossen, Suzanne Polinder, Hester F. Lingsma, Andrew I. R. Maas, David Menon, Ewout W. Steyerberg, CENTER-TBI Investigators and Participants
Dátum:	2016
ISSN:	1932-6203
Megjegyzések:	Abstract Introduction The strength of evidence underpinning care and treatment recommendations in traumatic brain injury (TBI) is low. Comparative effectiveness research (CER) has been proposed as a framework to provide evidence for optimal care for TBI patients. The first step in CER is to map the existing variation. The aim of current study is to quantify variation in general struc tural and process characteristics among centers participating in the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. Methods We designed a set of 11 provider profiling questionnaires with 321 questions about various aspects of TBI care, chosen based on literature and expert opinion. After pilot testing, ques tionnaires were disseminated to 71 centers from 20 countries participating in the CENTER TBI study. Reliability of questionnaires was estimated by calculating a concordance rate among 5% duplicate questions. Results All 71 centers completed the questionnaires. Median concordance rate among duplicate questions was 0.85. The majority of centers were academic hospitals (n = 65, 92%), desig nated as a level I trauma center (n = 48, 68%) and situated in an urban location (n = 70, 99%). The availability of facilities for neuro-trauma care varied across centers; e.g. 40 (57%) had a dedicated neuro-intensive care unit (ICU), 36 (51%) had an in-hospital rehabili tation unit and the organization of the ICU was closed in 64% (n = 45) of the centers. In addi tion, we found wide variation in processes of care, such as the ICU admission policy and intracranial pressure monitoring policy among centers.Conclusion Even among high-volume, specialized neurotrauma centers there is substantial variation in structures and processes of TBI care. This variation provides an opportunity to study effec tiveness of specific aspects of TBI care and to identify best practices with CER approaches.
Tárgyszavak:	Orvostudományok Elméleti orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk
Megjelenés:	Plos One. - 11 : 8 (2016), p. 1-21. -
További szerzők:	Polinder, Suzanne Lingsma, Hester Maas, Andrew I. R. Menon, David Krishna Steyerberg, Ewout W. Sándor János (1966-) (orvos-epidemiológus) CENTER-TBI Participants and Investigators
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