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Accreditation in stroke units of 6 European regions / Ömer R. Saka in Cerebrovascular Diseases, 35(2013)Suppl.3 ([05/01/2013])  

[article] Accreditation in stroke units of 6 European regions : One name different realities [printed text] / Ömer R. Saka, Author ; Ying Sun, Author ; D Michiels, Author ; Vincent Thijs, Author ; Dimitri Hemelsoet, Author ; Marijke Eyssen , Author ; Dominique Paulus , Author . - 2013 . - 481. Languages : English (eng) in Cerebrovascular Diseases > 35(2013)Suppl.3 [05/01/2013] . - 481 Descriptors: Classification W 1 Serials. Periodicals Indexation 2011-20 ; Belgium ; Cardiac Resynchronization Therapy Devices ; Emergency Treatment ; Journal Article ; Peer Review ; R181 ; Stroke Abstract: Background: ESO guidelines aim to promote standardised care of high quality in Europe but the organisation of acute care in stroke units (SU) largely differs between countries. This study aimed to scrutinize the accreditation or certification procedures of SU in 6 countries/regions: Scotland, Sweden, The Netherlands, France, Germany and the “London Stroke Services” (LSS). Methods: the information was collected with standardised questionnaires (25 pages) sent by mail to 12 experts from the 6 countries/regions. The research team analyzed the answers and clarified further issues by interviews. Results: an official mandatory accreditation procedure (organized and paid by governmental agencies) exists in Scotland, in LSS and in France. In Germany this procedure exists (private organizations) but is not mandatory. The accreditation process always implies at least site-visits and patient data review. Accreditation is renewed on a 1-, 3-, or 5-year basis. Some countries differentiate between types of SU (e.g. primary, comprehensive SU). The study further listed the criteria that SU must fulfil and the indicators measured for their accreditation (structure, process and outcome). Few of them refer to outcomes e.g. mortality, complications and recurrence. Incentives to encourage better quality differ between countries: public reporting of the results of the accreditation procedure, support to poor performers, benchmarking between hospitals, financial consequences. Conclusion: this exhaustive analysis gives an overview of the accreditation procedures in selected European countries. Care of high quality relies on a common evidence base but the quality assurance procedures, the indicators used as well as the consequences of the measurement largely differ between the countries. The question is to know if these various accreditation procedures result in differences in patients' outcomes. Link for e-copy: http://dx.doi.org/10.1159/000353129 Format of e-copy: PDF [Requires Subscription] Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=3779 [article]

Cardiac rehabilitation / Ilse Van Vlaenderen / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2010)  

Cardiac rehabilitation : clinical effectiveness and utilisation in Belgium [printed text] / Ilse Van Vlaenderen, Author ; Jodie Worrall, Author ; Syed Raza, Author ; An Colle, Author ; Cedric De Vos, Author ; Danielle Strens, Author ; Ömer R. Saka, Author ; Brigitte Moore, Author ; Marijke Eyssen , Author ; Dominique Paulus , Author . - Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre, 2010 . - IIIV, 100 p. : ill. ; 30 cm.. - (KCE Reports. Health Services Research (HSR); 140C) . ISSN : D/2010/10.273/67 : € 0,00 Study n. : 2009-22 Languages : English (eng) Descriptors: Indexation 2009-22 ; Cardiac rehabilitation ; Evidence-Based Practice ; Health Services Accessibility ; Health Services Needs and Demand ; R140 ; Rehabilitation centers Classification WG 166 Cardiovascular Diseases, Diagnosis and Therapeutics -- Therapeutics Contents note: GLOSSARY 3 -- 1 BACKGROUND AND RESEARCH QUESTIONS 4 -- 1.1 BACKGROUND 4 -- 1.1.1 Cardiac rehabilitation 4 -- 1.1.2 Different approaches to cardiac rehabilitation 4 -- 1.1.3 Heart disease and treatment goals 4 -- 1.1.4 Organisation of multidisciplinary cardiac rehabilitation in Belgium 5 -- 1.1.5 Treatment access 5 -- 1.2 RESEARCH QUESTIONS 6 -- 1.3 PARTS OF THE STUDY 6 -- 2 SYSTEMATIC LITERATURE REVIEW 7 -- 2.1 RESEARCH QUESTION 7 -- 2.2 METHODS 7 -- 2.2.1 Selection of studies 7 -- 2.2.2 Project Outline 8 -- 2.2.3 Literature search strategy 9 -- 2.2.4 Assessing methodological quality and risk of bias 9 -- 2.2.5 Data extraction 10 -- 2.3 RESULTS 10 -- 2.3.1 Phase I: systematic reviews and meta-analyses 10 -- 2.3.2 Phase II: original RCTs 17 -- 2.3.3 Multidisciplinary cardiac rehabilitation versus exercise 22 -- 2.4 HTA DOCUMENTS 22 -- 2.5 SUMMARY OF RESULTS AND DISCUSSION 24 -- 2.5.1 Summary of results 24 -- 2.5.2 Additional Cochrane reviews published in 2010 25 -- 2.5.3 Discussion of results 26 -- 2.5.4 Systematic review of the economic literature 27 -- 2.5.5 Comparison of the current results with guidance documents 28 -- 3 REHABILITATION AFTER DEFINED CARDIAC PROCEDURES IN BELGIUM: -- DATA ANALYSIS 32 -- 3.1 METHODOLOGY 32 -- 3.1.1 Data source 32 -- 3.1.2 Study period and observation period 32 -- 3.1.3 Target population and patient selection procedure 33 -- 3.1.4 Data collection 34 -- 3.1.5 Patient classification 35 -- 3.1.6 Data analysis 38 -- 3.2 RESULTS 39 -- 3.2.1 Patients selected for analysis. 39 -- 3.2.2 Patient Geographical Spread 40 -- 3.2.3 Type of Rehabilitation 41 -- 3.2.4 Rehabilitation related data 45 -- 3.2.5 Utilisation of rehabilitation types per socio-demographic patient characteristics 53 -- 3.2.6 Cardiac centre related data 60 -- 3.2.7 Multivariate analysis 61 -- 3.2.8 Cardiac disease related resource use: outpatient visits and diagnostic tests 65 -- 3.3 SUMMARY AND LIMITATIONS 69 -- 3.3.1 Summary of the descriptive statistics 69 -- 3.3.2 Summary of the multivariate analyses 70 -- 3.3.3 Strengths and limitations of the data analysis 70 -- 4 PATIENT SURVEY 71 -- 4.1 METHODOLOGY 71 -- 4.1.1 Study design 71 -- 4.1.2 Study population 71 -- 4.1.3 Time horizon 71 -- 4.1.4 Patient recruitment 72 -- 4.1.5 Data management & privacy 72 -- 4.1.6 Data collection 72 -- 4.1.7 Data analysis 73 -- 4.2 RESULTS 74 -- 4.2.1 Cardiologists 74 -- 4.2.2 Characteristics of the patients. 74 -- 4.2.3 Participation to the cardiac rehabilitation programme 75 -- 4.3 SUMMARY OF RESULTS AND LIMITATIONS OF THE SURVEY 86 -- 4.3.1 Main results 86 -- 4.3.2 Limitations of the survey 87 -- 5 GENERAL DISCUSSION AND CONCLUSIONS 88 -- 5.1 DEFINITIONS OF MULTIDISCIPLINARY REHABILITATION 88 -- 5.2 EVIDENCE ABOUT EXERCISE AND MULTIDISCIPLINARY CARDIAC REHABILITATION -- INCLUDING EXERCISE 88 -- 5.3 LACK OF PRECISION ABOUT TARGET POPULATIONS AND OTHER FEATURES OF -- CARDIAC REHABILITATION 89 -- 5.4 PARTICIPATION IN REHABILITATION PROGRAMMES IN BELGIUM 89 -- 5.4.1 Influence of patient characteristics 89 -- 5.4.2 Other factors that influence the participation in cardiac rehabilitation programmes 91 -- 5.4.3 Limits in the comparison between this study and the data from the literature 91 -- 6 REFERENCES 93 Link for e-copy: https://doi.org/10.57598/R140C Format of e-copy: PDF (2,43 Mb) Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=2217

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Cardiac rehabilitation / Ilse Van Vlaenderen / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2010)  

Cardiac rehabilitation : clinical effectiveness and utilisation in Belgium- Supplement [printed text] / Ilse Van Vlaenderen, Author ; Jodie Worrall, Author ; Syed Raza, Author ; An Colle, Author ; Cedric De Vos, Author ; Danielle Strens, Author ; Ömer R. Saka, Author ; Brigitte Moore, Author ; Marijke Eyssen , Author ; Dominique Paulus , Author . - Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre, 2010 . - 132 p. : ill. ; 30 cm.. - (KCE Reports. Health Services Research (HSR); 140S) . ISSN : D/2010/10.273/68 : € 0,00 Study n. : 2009-22 Languages : English (eng) Descriptors: Indexation 2009-22 ; Cardiac rehabilitation ; Evidence-Based Practice ; Health Services Accessibility ; Health Services Needs and Demand ; R140 ; Rehabilitation centers Classification WG 166 Cardiovascular Diseases, Diagnosis and Therapeutics -- Therapeutics Contents note: GLOSSARY 2 -- 1 APPENDICES SYSTEMATIC LITERATURE REVIEW 3 -- Appendix 1: systematic review Search strategy 3 -- Appendix 2: RCT Search strategy 10 -- Appendix 3: INAHTA member websites searched 17 -- 2 APPENDICES: ANALYSIS OF IMA DATABASE 79 -- Appendix 1: Nomenclature codes used for patient classification 79 -- Appendix 2: Description of patient inclusion and exclusion 85 -- appendix 3: Rehabilitation sequences 86 -- Appendix 4 rehabilitation related data during the entire one-year observation period 87 -- Appendix 5: cost related to rehabilitation 91 -- Appendix 6 socio-demographic patient characteristics 98 -- Appendix 7 Geographical spread of patients in outpatient rehabilitation 99 -- Appendix 8 Cardiac disease related medical care consumption 103 -- Appendix 9: Multivariate analysis 107 -- 3 APPENDIX : SURVEY 109 -- Patient Survey questionnaires 109 -- List of participating hospitals/centres 117 -- Participating cardiologists 117 -- Details on patients’ characteristics 118 -- Details on the participation to the rehabilitation programme 121 Link for e-copy: https://doi.org/10.57598/R140S Format of e-copy: PDF (1,18 Mb) Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=2218

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Cardiale revalidatie / Ilse Van Vlaenderen / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2010)  

Cardiale revalidatie : klinische doeltreffendheid en gebruik in België [printed text] / Ilse Van Vlaenderen, Author ; Jodie Worrall, Author ; Syed Raza, Author ; An Colle, Author ; Cedric De Vos, Author ; Danielle Strens, Author ; Ömer R. Saka, Author ; Brigitte Moore, Author ; Marijke Eyssen , Author ; Dominique Paulus , Author . - Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre, 2010 . - IX, 100 p. : ill. ; 30 cm.. - (KCE Reports A. Health Services Research (HSR); 140A) . ISSN : D/2010/10.273/65 : € 0,00 Studie nr : 2009-22 Languages : English (eng) Dutch (nla) Descriptors: Indexation 2009-22 ; Cardiac rehabilitation ; Evidence-Based Practice ; Health Services Accessibility ; Health Services Needs and Demand ; R140 ; Rehabilitation centers Classification WG 166 Cardiovascular Diseases, Diagnosis and Therapeutics -- Therapeutics Abstract: Hartrevalidatie met lichamelijke oefeningen heeft een gunstig effect op de levenskwaliteit van hartpatiënten en vermindert het aantal hospitalisaties en overlijdens. Dit is een belangrijke conclusie van een studie van het Federaal Kenniscentrum voor de Gezondheidszorg (KCE) en Deloitte®. Toch volgt minder dan een op 2 hartpatiënten revalidatie na hospitalisatie. Vooral ouderen en vrouwen dreigen uit de boot te vallen. Als belangrijkste redenen vermelden ze tijdsgebrek, het idee dat ze ook wel zonder deze behandeling zullen genezen, de afstand tot een erkend revalidatiecentrum en het gebrek aan transportmiddelen. Het KCE pleit voor de ontwikkeling van individueel aangepaste oefen- en begeleidingsprogramma’s bij het ontslag uit het ziekenhuis, gespreid over verschillende maanden en dichtbij de woonplaats van de patiënt. Contents note: GLOSSARY 3 -- 1 BACKGROUND AND RESEARCH QUESTIONS 4 -- 1.1 BACKGROUND 4 -- 1.1.1 Cardiac rehabilitation 4 -- 1.1.2 Different approaches to cardiac rehabilitation 4 -- 1.1.3 Heart disease and treatment goals 4 -- 1.1.4 Organisation of multidisciplinary cardiac rehabilitation in Belgium 5 -- 1.1.5 Treatment access 5 -- 1.2 RESEARCH QUESTIONS 6 -- 1.3 PARTS OF THE STUDY 6 -- 2 SYSTEMATIC LITERATURE REVIEW 7 -- 2.1 RESEARCH QUESTION 7 -- 2.2 METHODS 7 -- 2.2.1 Selection of studies 7 -- 2.2.2 Project Outline 8 -- 2.2.3 Literature search strategy 9 -- 2.2.4 Assessing methodological quality and risk of bias 9 -- 2.2.5 Data extraction 10 -- 2.3 RESULTS 10 -- 2.3.1 Phase I: systematic reviews and meta-analyses 10 -- 2.3.2 Phase II: original RCTs 17 -- 2.3.3 Multidisciplinary cardiac rehabilitation versus exercise 22 -- 2.4 HTA DOCUMENTS 22 -- 2.5 SUMMARY OF RESULTS AND DISCUSSION 24 -- 2.5.1 Summary of results 24 -- 2.5.2 Additional Cochrane reviews published in 2010 25 -- 2.5.3 Discussion of results 26 -- 2.5.4 Systematic review of the economic literature 27 -- 2.5.5 Comparison of the current results with guidance documents 28 -- 3 REHABILITATION AFTER DEFINED CARDIAC PROCEDURES IN BELGIUM: -- DATA ANALYSIS 32 -- 3.1 METHODOLOGY 32 -- 3.1.1 Data source 32 -- 3.1.2 Study period and observation period 32 -- 3.1.3 Target population and patient selection procedure 33 -- 3.1.4 Data collection 34 -- 3.1.5 Patient classification 35 -- 3.1.6 Data analysis 38 -- 3.2 RESULTS 39 -- 3.2.1 Patients selected for analysis. 39 -- 3.2.2 Patient Geographical Spread 40 -- 3.2.3 Type of Rehabilitation 41 -- 3.2.4 Rehabilitation related data 45 -- 3.2.5 Utilisation of rehabilitation types per socio-demographic patient characteristics 53 -- 3.2.6 Cardiac centre related data 60 -- 3.2.7 Multivariate analysis 61 -- 3.2.8 Cardiac disease related resource use: outpatient visits and diagnostic tests 65 -- 3.3 SUMMARY AND LIMITATIONS 69 -- 3.3.1 Summary of the descriptive statistics 69 -- 3.3.2 Summary of the multivariate analyses 70 -- 3.3.3 Strengths and limitations of the data analysis 70 -- 4 PATIENT SURVEY 71 -- 4.1 METHODOLOGY 71 -- 4.1.1 Study design 71 -- 4.1.2 Study population 71 -- 4.1.3 Time horizon 71 -- 4.1.4 Patient recruitment 72 -- 4.1.5 Data management & privacy 72 -- 4.1.6 Data collection 72 -- 4.1.7 Data analysis 73 -- 4.2 RESULTS 74 -- 4.2.1 Cardiologists 74 -- 4.2.2 Characteristics of the patients. 74 -- 4.2.3 Participation to the cardiac rehabilitation programme 75 -- 4.3 SUMMARY OF RESULTS AND LIMITATIONS OF THE SURVEY 86 -- 4.3.1 Main results 86 -- 4.3.2 Limitations of the survey 87 -- 5 GENERAL DISCUSSION AND CONCLUSIONS 88 -- 5.1 DEFINITIONS OF MULTIDISCIPLINARY REHABILITATION 88 -- 5.2 EVIDENCE ABOUT EXERCISE AND MULTIDISCIPLINARY CARDIAC REHABILITATION -- INCLUDING EXERCISE 88 -- 5.3 LACK OF PRECISION ABOUT TARGET POPULATIONS AND OTHER FEATURES OF -- CARDIAC REHABILITATION 89 -- 5.4 PARTICIPATION IN REHABILITATION PROGRAMMES IN BELGIUM 89 -- 5.4.1 Influence of patient characteristics 89 -- 5.4.2 Other factors that influence the participation in cardiac rehabilitation programmes 91 -- 5.4.3 Limits in the comparison between this study and the data from the literature 91 -- 6 REFERENCES 93 Link for e-copy: https://doi.org/10.57598/R140A Format of e-copy: PDF (2,33 Mb) Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=2216

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Efficacy of acute stroke units / Ömer R. Saka in Cerebrovascular Diseases, 35(2013)Suppl.3 ([05/01/2013])  

[article] Efficacy of acute stroke units : Updated meta-analysis [printed text] / Ömer R. Saka, Author ; Ying Sun, Author ; D Michiels, Author ; Vincent Thijs, Author ; Dimitri Hemelsoet, Author ; Marijke Eyssen , Author ; Dominique Paulus , Author ; Johan Maervoet, Author . - 2013 . - 824. Languages : English (eng) in Cerebrovascular Diseases > 35(2013)Suppl.3 [05/01/2013] . - 824 Descriptors: Classification W 1 Serials. Periodicals Indexation 2011-20 ; Belgium ; Journal Article ; Peer Review ; R181 ; Randomized Controlled Trials ; Stroke Abstract: Background A Cochrane review (2009) has concluded that the provision of care in stroke units (SU) improves stroke outcomes significantly. This study aimed to update the Cochrane review on acute SU care. We performed a meta-analysis on the benefit of acute SUs against alternatives. Methods Clinical trials published before 2006 were identified via the Cochrane review. Trials after 2006 were identified through a thorough electronic database search. For meta-analysis dichotomous outcomes were estimated by odds ratio (OR) and continuous outcomes were estimated by standardized mean difference. Weight of a study was calculated based on inverse variance. Results After two screenings 20 trials were included in the study: 12 compared SUs with alternative, 5 compared SUs with a specific protocol versus conventional SU care, 3 compared SUs followed by specific interventions versus SUs followed by conventional follow-up. Acute SU care significantly improved patient outcomes in terms of institutional care (OR=0.61, 95% confidence interval (CI) 0.47 to 0.79, P=0.0002); death or institutional care (OR=0.70, 95% CI 0.60 to 0.83, P<0.0001), death or dependency (OR=0.81, 95% CI 0.69 to 0.96, P=0.01; (4) length of hospital stay, standardized mean difference=-0.27 day, 95% CI -0.36 to -0.19, P<0.0001). The effect of SUs on mortality was around bottom-line statistical significance (OR=0.84, 95% CI 0.71 to 1.00, P=0.05). The benefit of SUs on mortality can be easily altered by changing the inclusion criteria (e.g. randomized controlled trials only, use of unpublished data). Effect of SUs on dependency was not significant (OR=0.92, 95% CI 0.74 to 1.13, P= 0.42). Conclusion This update confirmed the findings of the previous Cochrane review in general. Yet it showed that the benefit of SUs was more significant on composite outcomes (e.g. death or dependency, death or institutional care) than on individual outcomes (e.g. death, dependency). Link for e-copy: http://dx.doi.org/10.1159/000353129 Format of e-copy: PDF [Requires Subscription] Record link: https://kce.docressources.info/index.php?lvl=notice_display&id=3780 [article]

Participating or not in a cardiac rehabilitation programme / Cedric De Vos in European Journal of Preventive Cardiology, 20(2013)02 ([04/01/2013])  

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Quality indicators for stroke units / Ömer R. Saka in Cerebrovascular Diseases, 35(2013)Suppl.3 ([05/01/2013])  

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Rééducation cardiaque / Ilse Van Vlaenderen / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2010)  

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Stroke units / Dominik Michiels / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2012)  

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Stroke units / Dominik Michiels / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2012)  

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Stroke units / Dominik Michiels / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2012)  

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Stroke units / Dominik Michiels / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2012)  

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A systematic review and meta-analysis of acute stroke unit care / Ying Sun in BMC medical research methodology, 13(2013)132 ([10/01/2013])    

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Turkey / B. Serdar Savas / Brussels [Belgium] : European Observatory on Health Systems and Policies (2002)  

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Les unités neurovasculaires / Dominik Michiels / Brussels [Belgium] : KCE = Federaal Kenniscentrum voor de Gezondheidszorg = Centre Fédéral d'Expertise des Soins de Santé = Belgian Health Care Knowledge Centre (2012)  

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