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The effect of professional-led guideline workshops on clinical practice for the management of patent ductus arteriosus in preterm neonates in Japan: a controlled before-and-after study

Overview of attention for article published in Implementation Science, May 2015
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Title
The effect of professional-led guideline workshops on clinical practice for the management of patent ductus arteriosus in preterm neonates in Japan: a controlled before-and-after study
Published in
Implementation Science, May 2015
DOI 10.1186/s13012-015-0258-5
Pubmed ID
Authors

Tetsuya Isayama, Xiang Y Ye, Hironobu Tokumasu, Hiroo Chiba, Hideko Mitsuhashi, Sadequa Shahrook, Satoshi Kusuda, Masanori Fujimura, Katsuaki Toyoshima, Rintaro Mori

Abstract

Clinical guidelines assist physicians to make decisions about suitable healthcare. We conducted a controlled before-and-after study to investigate the impact of professional-led guideline workshops for patent ductus arteriosus (PDA) management on physicians' clinical practices, discharge mortality, and associated morbid conditions among preterm neonates. We recruited physicians practicing at two neonatal intensive care units (NICUs) in Japan and used the data of all neonates weighing less than or equal to 1,500 g admitted to 90 NICUs (2 intervention NICUs and 88 control NICUs) in the Neonatal Research Network of Japan from April 2008 to March 2010. We held 1-day workshops for physicians on PDA clinical practice guidelines at the two intervention NICUs. Physicians' skills assessed by confidence rating (CR) scores and the Sheffield Peer Review Assessment Tool (SPRAT) were compared between pre- and post-workshop month at the intervention NICUs using Wilcoxon signed-rank tests. Neonatal discharge mortality and morbidity were compared between pre- and post-workshop year at both the intervention and control NICUs using multivariable regression analyses adjusting for potential confounders. Fifteen physicians were included in the study. Physicians' CR scores (2.14 vs. 2.47, p = 0.02) and SPRAT (4.14 vs. 4.50, p = 0.05) in PDA management improved the following workshops. The analyses of neonatal outcomes included 294 and 6,234 neonates in the intervention and control NICUs, respectively. Neonates' discharge mortality declined sharply at the intervention NICUs (from 15/146 to 5/148, relative risk reduction -0.67; adjusted odds ratio 0.30, 95% confidence interval 0.10 to 0.89) during the post-workshop period. The mortality reduction was much greater than that in the control NICUs (from 207/3,322 to 147/2,912, relative risk reduction -0.19; adjusted odds ratio 0.75, 95% confidence interval 0.59 to 0.95), although the difference between the intervention and control NICUs were not statistically significant. Overall, physicians' confidence in PDA management improved after attending guideline workshops. Face-to-face workshops by guideline developers can be a useful strategy to improve physicians' PDA management skills and, thereby, might reduce PDA-associated mortality in preterm neonates.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 56 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Australia 1 2%
Unknown 55 98%

Demographic breakdown

Readers by professional status Count As %
Student > Master 10 18%
Researcher 8 14%
Student > Bachelor 7 13%
Other 5 9%
Student > Doctoral Student 3 5%
Other 11 20%
Unknown 12 21%
Readers by discipline Count As %
Medicine and Dentistry 21 38%
Psychology 5 9%
Nursing and Health Professions 4 7%
Arts and Humanities 2 4%
Agricultural and Biological Sciences 2 4%
Other 8 14%
Unknown 14 25%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 08 May 2015.
All research outputs
#17,756,606
of 22,803,211 outputs
Outputs from Implementation Science
#1,627
of 1,721 outputs
Outputs of similar age
#179,872
of 264,548 outputs
Outputs of similar age from Implementation Science
#51
of 54 outputs
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