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McArthur A, Munn Z, Lizarondo L. Methods for developing quality indicators for evidence implementation: a scoping review protocol. JBI Evid Synth 2023; 21:601-608. [PMID: 35997328 DOI: 10.11124/jbies-22-00056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE The aim of this scoping review is to locate, identify, and understand the extent and type of evidence in relation to the development of quality indicators within evidence implementation health care programs. INTRODUCTION Health care organizations evaluate care using quality improvement initiatives, which are based on quality indicators that are clearly defined and measure what they are intended to, based on structures, processes, or outcomes of care. However, the development of quality indicators is an area plagued by inconsistency and issues in terms of their pragmatic use in the health care context. Inconsistency when using terminology related to quality improvement has highlighted issues with distinct definitions, and many terms appear to be used interchangeably. This leads to confusion and a lack of clarity in what these terms are actually describing with regard to measures of quality in health care. INCLUSION CRITERIA The proposed review will consider studies, guidelines, manuals, evidence syntheses, and other relevant literature that examine the key concepts, terms, or definitions used in the development of quality indicators and that identify the methods or frameworks used in the development approaches across the international health care setting. METHODS The search strategy will aim to locate both published and unpublished documents, using a 3-step search strategy. Results of the search, study inclusion, data extraction, and analysis and presentation of results will be conducted by 2 independent reviewers, in accordance with JBI's methodology for conducting scoping reviews.Findings will be presented in tables or visual charts, accompanied by a narrative summary. DETAILS OF THIS REVIEW PROJECT ARE AVAILABLE AT Open Science Framework https://osf.io/54q8j.
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Affiliation(s)
- Alexa McArthur
- JBI, School of Public Health, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia
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Hennessy M, Linehan L, Dennehy R, Devane D, Rice R, Meaney S, O'Donoghue K. Developing guideline-based key performance indicators for recurrent miscarriage care: lessons from a multi-stage consensus process with a diverse stakeholder group. RESEARCH INVOLVEMENT AND ENGAGEMENT 2022; 8:18. [PMID: 35568920 PMCID: PMC9107009 DOI: 10.1186/s40900-022-00355-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 04/29/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Standardised care pathways tailored to women/couples who experience recurrent miscarriage are needed; however, clinical practice is inconsistent and poorly organised. In this paper, we outline our processes and experiences of developing guideline-based key performance indicators (KPIs) for recurrent miscarriage care with a diverse stakeholder group which will be used to evaluate national services. To date, such exercises have generally only involved clinicians, with the need for greater stakeholder involvement highlighted. METHODS Our study involved six stages: (i) identification and synthesis of recommendations for recurrent miscarriage care through a systematic review of clinical practice guidelines; (ii) a two-round modified e-Delphi survey with stakeholders to develop consensus on recommendations and outcomes; (iii) four virtual meetings to develop this consensus further; (iv) development of a list of candidate KPIs; (v) survey to achieve consensus on the final suite of KPIs and a (vi) virtual meeting to agree on the final set of KPIs. Through participatory methods, participants provided feedback on the process of KPI development. RESULTS From an initial list of 373 recommendations and 14 outcomes, 110 indicators were prioritised for inclusion in the final suite of KPIs: (i) structure of care (n = 20); (ii) counselling and supportive care (n = 7); (iii) investigations (n = 30); treatment (n = 34); outcomes (n = 19). Participants' feedback on the process comprised three main themes: accessibility, richness in diversity, streamlining the development process. CONCLUSIONS It is important and feasible to develop guideline-based KPIs with a diverse stakeholder group. One hundred and ten KPIs were prioritised for inclusion in a suite of guideline-based KPIs for recurrent miscarriage care. Insights into our experiences may help others undertaking similar projects, particularly those undertaken in the absence of a clinical guideline and/or involving a range of stakeholders.
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Affiliation(s)
- Marita Hennessy
- Pregnancy Loss Research Group, Department of Obstetrics and Gynaecology, University College Cork, Cork, T12 DC4A, Ireland.
- INFANT Research Centre, University College Cork, Cork University Maternity Hospital, Cork, T12 DC4A, Ireland.
- College of Medicine and Health, University College Cork, Cork, T12 EKDO, Ireland.
| | - Laura Linehan
- Pregnancy Loss Research Group, Department of Obstetrics and Gynaecology, University College Cork, Cork, T12 DC4A, Ireland
- INFANT Research Centre, University College Cork, Cork University Maternity Hospital, Cork, T12 DC4A, Ireland
- College of Medicine and Health, University College Cork, Cork, T12 EKDO, Ireland
| | - Rebecca Dennehy
- Pregnancy Loss Research Group, Department of Obstetrics and Gynaecology, University College Cork, Cork, T12 DC4A, Ireland
- INFANT Research Centre, University College Cork, Cork University Maternity Hospital, Cork, T12 DC4A, Ireland
- College of Medicine and Health, University College Cork, Cork, T12 EKDO, Ireland
| | - Declan Devane
- INFANT Research Centre, University College Cork, Cork University Maternity Hospital, Cork, T12 DC4A, Ireland
- School of Nursing and Midwifery, National University of Ireland, Galway, Galway, H91 E3YV, Ireland
- Evidence Synthesis Ireland, National University of Ireland, Galway, Galway, H91 E3YV, Ireland
| | - Rachel Rice
- Pregnancy Loss Research Group, Department of Obstetrics and Gynaecology, University College Cork, Cork, T12 DC4A, Ireland
- School of Applied Social Studies, University College Cork, Cork, T12 D726, Ireland
| | - Sarah Meaney
- National Perinatal Epidemiology Centre, University College Cork, Cork University Maternity Hospital, Cork, T12 DC4A, Ireland
| | - Keelin O'Donoghue
- Pregnancy Loss Research Group, Department of Obstetrics and Gynaecology, University College Cork, Cork, T12 DC4A, Ireland
- INFANT Research Centre, University College Cork, Cork University Maternity Hospital, Cork, T12 DC4A, Ireland
- College of Medicine and Health, University College Cork, Cork, T12 EKDO, Ireland
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García EI, Martin-Delgado J, Queiro R, Pérez Venegas JJ, Gratacos J, Sanz J, Torrés A, Mira JJ. Quality certification standard proposal "SpACE" for axial spondyloarthritis treatment units. ACTA ACUST UNITED AC 2021; 18:299-303. [PMID: 34736873 DOI: 10.1016/j.reumae.2021.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 04/05/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND OBJECTIVE Axial spondyloarthritis is an immune-mediated disease with a high cost, diagnostic delay and associated complications that makes it a particularly important condition. This work aims to establish a certification standard (SpACE Project) for monographic consultations in its diagnosis and treatment. MATERIALS AND METHODS Qualitative study of consensus, through the technique of the nominal group. First, a pragmatic review of the literature was carried out. Second, professionals involved throughout the care process (rheumatology, ophthalmology, gastroenterology, traumatology, family medicine, physical therapy, and nursing) were included. RESULTS Thirty-seven possible standards were extracted from the pragmatic review of the literature. During the consensus phase only those standards with high feasibility and importance in the care process were prioritized. Finally, the group of 26 experts agreed on the inclusion of 14 standards. DISCUSSION AND CONCLUSIONS SpACE is a consensus-based certification standard that seeks to improve health outcomes and more integrated care.
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Affiliation(s)
| | - Jimmy Martin-Delgado
- Grupo de Investigación Atenea, Fundación para el Fomento de la Investigación Sanitaria y Biomédica (FISABIO), Sant Joan d'Alacant, Alicante, Spain.
| | - Ruben Queiro
- Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | | | - Jordi Gratacos
- Consorci Corporació Sanitària Parc Taulí, Sabadell, Barcelona, Spain
| | - Jesús Sanz
- Hospital Puerta de Hierro, Majadahonda, Madrid, Spain
| | | | - José Joaquín Mira
- Departamento de Salud Alicante-Sant Joan d'Alacant, Sant Joan d'Alacant, Alicante, Spain; Universidad Miguel Hernández, Elche, Alicante, Spain; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Alicante, Spain
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García EI, Martin-Delgado J, Queiro R, Pérez Venegas JJ, Gratacos J, Sanz J, Torrés A, Mira JJ. Quality Certification Standard Proposal "SpACE" for Axial Spondyloarthritis Treatment Units. REUMATOLOGIA CLINICA 2021; 18:S1699-258X(21)00126-1. [PMID: 34148827 DOI: 10.1016/j.reuma.2021.04.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 03/15/2021] [Accepted: 04/05/2021] [Indexed: 01/15/2023]
Abstract
BACKGROUND AND OBJECTIVE Axial spondyloarthritis is an immune-mediated disease with a high cost, diagnostic delay and associated complications that makes it a particularly important condition. This work aims to establish a certification standard (SpACE Project) for monographic consultations in its diagnosis and treatment. MATERIALS AND METHODS Qualitative study of consensus, through the technique of the nominal group. First, a pragmatic review of the literature was carried out. Second, professionals involved throughout the care process (rheumatology, ophthalmology, gastroenterology, traumatology, family medicine, physical therapy, and nursing) were included. RESULTS Thirty-seven possible standards were extracted from the pragmatic review of the literature. During the consensus phase only those standards with high feasibility and importance in the care process were prioritized. Finally, the group of 26 experts agreed on the inclusion of 14 standards. DISCUSSION AND CONCLUSIONS SpaCE is a consensus-based certification standard that seeks to improve health outcomes and more integrated care.
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Affiliation(s)
| | - Jimmy Martin-Delgado
- Grupo de Investigación Atenea, Fundación para el Fomento de la Investigación Sanitaria y Biomédica (FISABIO), Sant Joan d'Alacant, Alicante, España.
| | - Ruben Queiro
- Hospital Universitario Central de Asturias, Oviedo, Asturias, España
| | | | - Jordi Gratacos
- Consorci Corporació Sanitària Parc Taulí, Sabadell, Barcelona, España
| | - Jesús Sanz
- Hospital Puerta de Hierro, Majadahonda, Madrid, España
| | - Antonio Torrés
- Sociedad Española de Calidad Asistencial, Oviedo, España
| | - José Joaquín Mira
- Departamento de Salud Alicante-Sant Joan d'Alacant, Sant Joan d'Alacant, Alicante, España; Universidad Miguel Hernández, Elche, Alicante, España; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Alicante, España
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Glarcher M, Kundt FS, Meissner W, Osterbrink J. Quality Indicators (QI) of Acute Pain after Surgery in European Countries. Pain Manag Nurs 2021; 22:730-739. [PMID: 33642197 DOI: 10.1016/j.pmn.2021.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 01/04/2021] [Accepted: 01/24/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVES It is common practice to use pain quality indicators (QI) to accurately assess the medical care situation of patients. This literature review identifies the status quo of acute pain QI among adult inpatients. DATA SOURCES Studies published in English or German were identified using a systematic search on CINAHL, Cochrane Library, PubMed, Web of Science, and Google Scholar from 01/2007 to 02/2018. Additional pain management journals, conference proceedings, and websites of health organizations and pain societies were manually screened. Studies about postoperative pain in adults (≥18 years) during inpatient stay after all types of surgery in Europe were included in this review. REVIEW/ANALYSIS METHODS The identified study results were categorized into structural, process, and outcome indicators based on Donabedian's framework of evaluating care quality. RESULTS The search identified 319 citations, of which 20 studies used structure, process, and outcome data including 180,988 patients and 1,970 health care professionals to gain insight into the quality of acute pain management. Overall, 80% used patient surveys to collect data. National data on pain management are reported in five European studies (France [2], the Netherlands, Spain, and Austria). CONCLUSIONS European studies comprehensively comparing acute pain management results are currently missing. Thus, this report highlights the need to develop consensus-based quality indicators in management of acute pain, which take into account both the methodologic quality and the relevance to clinical practice.
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Affiliation(s)
- Manela Glarcher
- Paracelsus Medical University, Institute of Nursing Science and Practice, Austria.
| | - Firuzan Sari Kundt
- Paracelsus Medical University, Institute of Nursing Science and Practice, Austria
| | - Winfried Meissner
- Anesthesiology and Intensive Care, Head of Pain Unit, Head of Palliative Care Unit, Jena University Hospital, Germany
| | - Jürgen Osterbrink
- Head of Institute of Nursing Science and Practice & Director WHO Collaborating Centre for Nursing, Austria
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Pérez C, Martin-Delgado J, Vinuesa M, Ibor PJ, Guilabert M, Gomez J, Beato C, Sánchez-Jiménez J, Velázquez I, Calvo-Espinos C, Cánovas ML, Yáñez JA, Rodríguez M, Baquero JL, Gallach E, Folch E, Tuca A, Santiña M, Mira JJ. Pain Standards for Accredited Healthcare Organizations (ACDON Project): A Mixed Methods Study. J Pers Med 2021; 11:jpm11020102. [PMID: 33562456 PMCID: PMC7914789 DOI: 10.3390/jpm11020102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 01/26/2021] [Accepted: 02/03/2021] [Indexed: 12/24/2022] Open
Abstract
Up to 50% of cancer patients and up to 90% of those in terminal stages experience pain associated with disease progression, poor quality of life, and social impact on caregivers. This study aimed to establish standards for the accreditation of oncological pain management in healthcare organizations. A mixed methods approach was used. First, a pragmatic literature review was conducted. Second, consensus between professionals and patients was reached using the Nominal Group and Delphi technique in a step that involved anesthesiologists, oncologists, family physicians, nurses, psychologists, patient representatives, and caregivers. Third, eight hospitals participated in a pilot assessment of the level of fulfillment of each standard. A total of 37 standards were extracted. The Nominal Group produced additional standards, of which 60 were included in Questionnaire 0 that was used in the Delphi Technique. Two Delphi voting rounds were performed to reach a high level of consensus, and involved 64 and 62 participants with response rates of 90% and 87%, respectively. Finally, 39 standards for the management of cancer pain were agreed upon. In the self-evaluation, the average range of compliance was between 56.4% and 100%. The consensus standards of the ACDON Project might improve the monitoring of cancer pain management. These standards satisfied the demands of professionals and patients and could be used for the accreditation of approaches in cancer pain management.
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Affiliation(s)
- Concepción Pérez
- Pain Unit, Quality Department, La Princesa University Hospital, 28006 Madrid, Spain; (C.P.); (M.V.)
| | - Jimmy Martin-Delgado
- Atenea Research Group, Foundation for the Promotion of Health and Biomedical Research, 03550 Sant Joan d’Alacant, Spain; (J.M.-D.); (J.J.M.)
| | - Mercedes Vinuesa
- Pain Unit, Quality Department, La Princesa University Hospital, 28006 Madrid, Spain; (C.P.); (M.V.)
| | - Pedro J. Ibor
- Pain Research Group, Spanish Society of Primary Care Physicians, 28009 Valencia, Spain;
| | - Mercedes Guilabert
- Health Psychology Department, Miguel Hernandez University, 03202 Elche, Spain
- Correspondence: ; Tel.: +34-96-665-83-17
| | - José Gomez
- Oncology Department, La Fe Hospital, 46026 Valencia, Spain;
| | - Carmen Beato
- Oncology Department, Virgen del Rocio University Hospital, 41013 Sevilla, Spain;
| | | | | | | | - María L. Cánovas
- Anesthesiology Department, Ourense Hospital Complex, 32005 Ourense, Spain;
| | - José A. Yáñez
- Nursery Department, Carlos Haya Hospital, 29010 Malaga, Spain;
| | - Mireia Rodríguez
- Nursery Department, Terrassa Health Consortium, 08227 Terrasa, Spain;
| | - José L. Baquero
- Scientific Coordination, Spanish Forum of Patients, 28018 Madrid, Spain;
| | - Elisa Gallach
- Psychology Department, La Fe Hospital, 46026 Valencia, Spain;
| | - Emma Folch
- Nursery Department, Francolí Sociosanitary Hospital, 43005 Tarragona, Spain;
| | - Albert Tuca
- Oncology Department, Barcelona Clinic Hospital, 08036 Barcelona, Spain;
| | - Manel Santiña
- Spanish Society for Quality of Care, 33003 Oviedo, Spain;
| | - José J. Mira
- Atenea Research Group, Foundation for the Promotion of Health and Biomedical Research, 03550 Sant Joan d’Alacant, Spain; (J.M.-D.); (J.J.M.)
- Health Psychology Department, Miguel Hernandez University, 03202 Elche, Spain
- Alicante-Sant Joan Health District, 03013 Alicante, Spain
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Langendam MW, Piggott T, Nothacker M, Agarwal A, Armstrong D, Baldeh T, Braithwaite J, Castro Martins C, Darzi A, Etxeandia I, Florez I, Hoving J, Karam SG, Kötter T, Meerpohl JJ, Mustafa RA, Muti-Schünemann GEU, van der Wees PJ, Follmann M, Schünemann HJ. Approaches of integrating the development of guidelines and quality indicators: a systematic review. BMC Health Serv Res 2020; 20:875. [PMID: 32938461 PMCID: PMC7493171 DOI: 10.1186/s12913-020-05665-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 08/17/2020] [Indexed: 02/03/2023] Open
Abstract
Background Guidelines and quality indicators (for example as part of a quality assurance scheme) aim to improve health care delivery and health outcomes. Ideally, the development of quality indicators should be grounded in evidence-based, trustworthy guideline recommendations. However, anecdotally, guidelines and quality assurance schemes are developed independently, by different groups of experts who employ different methodologies. We conducted an extension and update of a previous systematic review to identify, describe and evaluate approaches to the integrated development of guidelines and related quality indicators. Methods On May 24th, 2019 we searched in Medline, Embase and CINAHL and included studies if they reported a methodological approach to guideline-based quality indicator development and were published in English, French, or German. Results: Out of 16,034 identified records, we included 17 articles that described a method to integrate guideline recommendations development and quality indicator development. Added to the 13 method articles from original systematic review we included a total 30 method articles. We did not find any evaluation studies. In most approaches, guidelines were a source of evidence to inform the quality indicator development. The criteria to select recommendations (e.g. level of evidence or strength of the recommendation) and to generate, select and assess quality indicators varied widely. We found methodological approaches that linked guidelines and quality indicator development explicitly, however none of the articles reported a conceptual framework that fully integrated quality indicator development into the guideline process or where quality indicator development was part of the question formulation for developing the guideline recommendations. Conclusions In our systematic review we found approaches which explicitly linked guidelines with quality indicator development, nevertheless none of the articles reported a comprehensive and well-defined conceptual framework which integrated quality indicator development fully into the guideline development process.
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Affiliation(s)
- Miranda W Langendam
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health institute, Amsterdam, Netherlands
| | - Thomas Piggott
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
| | - Monika Nothacker
- Institute of Medical Knowledge Management, Association of the Scientific Medical Societies, Berlin, Germany
| | - Arnav Agarwal
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - David Armstrong
- Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, Canada
| | - Tejan Baldeh
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health institute, Amsterdam, Netherlands
| | - Jeffrey Braithwaite
- Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Rd, Sydney, Australia
| | - Carolina Castro Martins
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada.,Department of Pediatric Dentistry, Dental School, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Andrea Darzi
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
| | - Itziar Etxeandia
- IKOetxe - Ikerkuntza Osaungintza, Health Research, Gipuzkoa, Irun, Basque Country, Spain
| | - Ivan Florez
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health institute, Amsterdam, Netherlands.,Department of Pediatrics, University of Antioquia, Medellin, Colombia
| | - Jan Hoving
- Coronel Institute of Occupational Health and Research Center for Insurance Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Samer G Karam
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
| | - Thomas Kötter
- Institute of Family Medicine, University Medical Center Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Joerg J Meerpohl
- Institute for Evidence in Medicine, Medical Center and Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Reem A Mustafa
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada.,Department of Internal Medicine, University of Kansas Medical Center, Kansas, USA
| | | | - Philip J van der Wees
- Department of Rehabilitation and IQ healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
| | | | - Holger J Schünemann
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada. .,Department of Medicine, Hamilton, McMaster University, Hamilton, Canada. .,Department of Health Research Methods, Evidence and Impact, McMaster University Health Sciences Centre, Room 2C16, 1280 Main Street West, Hamilton, ON, L8N 4K1, Canada.
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