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CONTEXT Better health care quality is a universal goal, yet measuring quality has proven to be difficult and problematic. A central problem has been isolating physician practices from other effects of the health care system. OBJECTIVE To validate clinical vignettes as a method for measuring the competence of physicians and the quality of their actual(More)
BACKGROUND Worldwide efforts are under way to improve the quality of clinical practice. Most quality measurements, however, are poorly validated, expensive, and difficult to compare among sites. OBJECTIVE To validate whether vignettes accurately measure the quality of clinical practice by using a comparison with standardized patients (the gold standard(More)
PURPOSE Despite widespread reliance on chart abstraction for quality measurement, concerns persist about its reliability and validity. We prospectively evaluated the validity of chart abstraction by directly comparing it with the gold standard of reports by standardized patients. SUBJECTS AND METHODS Twenty randomly selected general internal medicine(More)
UNLABELLED Collaborative care models for depression in primary care are effective and cost-effective, but difficult to spread to new sites. Translating Initiatives for Depression into Effective Solutions (TIDES) is an initiative to promote evidence-based collaborative care in the U.S. Veterans Health Administration (VHA). Social marketing applies marketing(More)
BACKGROUND Administrative data play a central role in health care. Inaccuracies in such data are costly to health systems, they obscure health research, and they affect the quality of patient care. OBJECTIVES We sought to prospectively determine the accuracy of the primary and secondary diagnoses recorded in administrative data sets. RESEARCH DESIGN(More)
OBJECTIVE To assess the validity of standardised patients to measure the quality of physicians' practice. DESIGN Validation study of standardised patients' assessments. Physicians saw unannounced standardised patients presenting with common outpatient conditions. The standardised patients covertly tape recorded their visit and completed a checklist of(More)
BACKGROUND Use of standardized patients for evaluating the clinical skills of medical students and medical trainees is commonplace. This has encouraged the use of standardized patients to evaluate the quality of physician practice in outpatient settings. However, there may be substantive differences between observing student performance and evaluating(More)
Local health information can be a powerful vehicle for improving the health of a community. It can highlight both the existence of problems and opportunities for improvement. It can also guide local action in support of policy changes and improve programs' effectiveness. However, efforts to expand the availability and use of local health information face(More)
OBJECTIVE To provide a multidisciplinary and comprehensive analysis on the impact of tuberculosis (TB) in a high incidence country. METHODS Data from several large scale surveys, carried out between 1997 and 2001 in the Philippines, were used to: (1) perform a burden of disease (BoD) analysis, (2) model the economic costs to society due to lost wages, and(More)
BACKGROUND Some family physicians may be under pressure to relinquish the interpretation of outpatient electrocardiograms to cardiologists. The purpose of this study was to determine whether the quality of electrocardiogram (ECG) interpretations by family physicians justifies this pressure, and whether an immediately available computerized ECG(More)