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Article ; Online: Construction of reference criteria to admit patients to intermediate care units in France: a Delphi survey of intensivists, anaesthesiologists and emergency medicine practitioners (first part of the UNISURC project).

Misset, Benoît / Aegerter, Philippe / Boulkedid, Rym / Alberti, Corinne / Baillard, Christophe / Guidet, Bertrand / Beaussier, Marc

BMJ open

2023 Volume 13, Issue 7, Page(s) e072836

Abstract: Objectives: No consensus criteria describe the medical eligibility of the patients to intermediate care units (IMCUs). In this first part of the UNISURC project, we aimed to develop criteria based on a consensus of physicians from the main specialties ... ...

Abstract	Objectives: No consensus criteria describe the medical eligibility of the patients to intermediate care units (IMCUs). In this first part of the UNISURC project, we aimed to develop criteria based on a consensus of physicians from the main specialties involved in IMCU admission decisions. Design: We selected criteria from IMCU literature, scoring systems and intensive care unit nursing workload. We submitted these criteria to a panel of experts in a Delphi survey. We used a two-round Delphi survey procedure to assess the validity and feasibility of each criterion. Setting: Medical practitioners in either public or private French institutions and proposed by the national scientific societies of anaesthesiology, emergency medicine and intensive care. The Delphi rounds took place in 2015-2016. Outcome measures: Validity and feasibility of the proposed criteria; uniformity of the judgement across the primary specialty and the hospital category of the responders. Results: The criteria submitted to vote were classified as one of: chronic factor (CF); acute factor (AF); specific pathway (SP); nursing activity (NA) and hospital environment (HE). Of 189 experts invited, 81 (41%) responded to the first round and 62 of them (76%) responded to the second round. A definite selection of 63 items was made, distributed across 6 CF, 18 AF, 31 SP, 3 NA and 5 HE. Validity and feasibility were influenced by the specialty or the public/private status of the institution of the responders for a few items. Conclusion: We created a set of 63 consensus criteria with acceptable validity and feasibility to assess the medical eligibility of the patients to IMCUs. The second part of the UNISURC project will assess the distribution of each criterion in a prospective multicentre national cohort. Trial registration number: NCT02590172.
MeSH term(s)	Humans ; Prospective Studies ; Hospitalization ; Intensive Care Units ; Surveys and Questionnaires ; Emergency Medicine ; Delphi Technique
Language	English
Publishing date	2023-07-24
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2023-072836
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Article ; Online: Describing ICU data with tables.

Alberti, Corinne / Boulkedid, Rym

Intensive care medicine

2014 Volume 40, Issue 5, Page(s) 667–673

Abstract: Introduction: The purpose of a scientific paper is to communicate results and within the paper this applies especially to the presentation of data. It is the universal practice in medical journals to present statistical results using tables. Good tables ...

Abstract	Introduction: The purpose of a scientific paper is to communicate results and within the paper this applies especially to the presentation of data. It is the universal practice in medical journals to present statistical results using tables. Good tables are an integral part of the manuscript. To help researchers communicate their results, we present practical guidance for reporting statistical results using tables. Results: Five key points are presented for reporting statistical results using tables: (1) early reflection and choice about the results to present, (2) presentation of tables and definition of rows and columns, (3) filling the cells, (4) title, caption, footnotes, and quality, (5) final checklist. Conclusion: This guidance is a practical tool to improve the reporting of statistical results using tables when presenting ICU data in future research.
MeSH term(s)	Data Interpretation, Statistical ; Guidelines as Topic ; Humans ; Intensive Care Units/statistics & numerical data ; Journalism, Medical/standards ; Research Subjects/statistics & numerical data ; Sampling Studies ; Statistics as Topic/methods ; Statistics as Topic/standards
Language	English
Publishing date	2014-03-11
Publishing country	United States
Document type	Journal Article
ZDB-ID	80387-x
ISSN	1432-1238 ; 0340-0964 ; 0342-4642 ; 0935-1701
ISSN (online)	1432-1238
ISSN	0340-0964 ; 0342-4642 ; 0935-1701
DOI	10.1007/s00134-014-3248-1
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Article ; Online: Exploring how non-inferiority and equivalence are assessed in paediatrics: a systematic review.

Aupiais, Camille / Zohar, Sarah / Taverny, Garry / Le Roux, Enora / Boulkedid, Rym / Alberti, Corinne

Archives of disease in childhood

2018 Volume 103, Issue 11, Page(s) 1067–1075

Abstract: Objective: To review characteristics, methodology and reporting of non-inferiority and equivalence trials in the specific context of paediatrics.: Design: PubMed and Cochrane databases were searched (up to September 2016) for non-inferiority/ ... ...

Abstract	Objective: To review characteristics, methodology and reporting of non-inferiority and equivalence trials in the specific context of paediatrics. Design: PubMed and Cochrane databases were searched (up to September 2016) for non-inferiority/equivalence randomised controlled trials conducted in children published in high-impact-factor journals ( Results: We found that the statistical hypothesis was inconsistent with the objective in 12 (10%) of the 125 reports included. Non-inferiority (n=98) and equivalence trials (n=27) were mostly used to evaluate interventions with easier administration (45%, n=54/120) and/or better safety profile (34%, n=41/120). All the data needed for targeted sample size recalculation were available for 39 reports (31%). The margin-representing the largest difference between arms that would be clinically acceptable-was reported in 119 (95%), and 44/119 (37%) reported the method used for margin determination. The median sample size was 268 (IQR 125-531). Margins were wider in smaller trials (<125 randomised patients) than in larger trials (p=0.04/p<0.01 for binary/continuous outcomes, respectively). We did not agree with the authors' conclusions in 11% (11/103) of the reports that provided sufficient information. Conclusions: There is still a need to improve the quality of methodology, reporting and interpretation of non-inferiority/equivalence trials in paediatrics. In particular, the margins were often not justified and the conclusion was often not supported by the design and/or the results. As researchers have to cope with small sample size and with lack of evidence, methods for non-inferiority/equivalence trials need to be used and/or developed in this vulnerable population.
MeSH term(s)	Child ; Editorial Policies ; Equivalence Trials as Topic ; Guideline Adherence/statistics & numerical data ; Humans ; Pediatrics/methods ; Periodicals as Topic ; Randomized Controlled Trials as Topic ; Research Design
Language	English
Publishing date	2018-05-24
Publishing country	England
Document type	Journal Article ; Systematic Review
ZDB-ID	524-1
ISSN	1468-2044 ; 0003-9888 ; 1359-2998
ISSN (online)	1468-2044
ISSN	0003-9888 ; 1359-2998
DOI	10.1136/archdischild-2018-314874
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Article ; Online: Quality indicator development and implementation in maternity units.

Boulkedid, Rym / Alberti, Corinne / Sibony, Olivier

Best practice & research. Clinical obstetrics & gynaecology

2013 Volume 27, Issue 4, Page(s) 609–619

Abstract: Measuring the quality of inpatient obstetrical care has generated considerable interest in recent years. Numerous quality measures have been proposed by national and international programmes and by obstetrics societies; however, no agreement has been ... ...

Abstract	Measuring the quality of inpatient obstetrical care has generated considerable interest in recent years. Numerous quality measures have been proposed by national and international programmes and by obstetrics societies; however, no agreement has been reached on which measures should be used. Differences in opinions across healthcare professionals complicate the development of a standardised set of quality indicators. The use of structured methods, particularly consensus methods such as Delphi techniques, can help to choose indicators according to quality goals. Once relevant indicators are identified, maternity units should consider using a dashboard to plan and improve their services. Statistical process control is a statistical method designed to monitor and control processes. This method seems particularly promising for monitoring quality indicators in maternity units. Among statistical process control techniques, cumulative sum charts that monitor pre-selected quality indicators can be easily designed for obstetrics and gynaecology units. Cumulative sum charts provide clinicians with a picture of current practices, and rapidly detect unwanted changes in quality indicator rates.
MeSH term(s)	Data Collection ; Data Display ; Delphi Technique ; Female ; Humans ; Obstetrics and Gynecology Department, Hospital/standards ; Obstetrics and Gynecology Department, Hospital/statistics & numerical data ; Outcome and Process Assessment (Health Care)/methods ; Pregnancy ; Quality Indicators, Health Care
Language	English
Publishing date	2013-08
Publishing country	Netherlands
Document type	Journal Article ; Review
ZDB-ID	2050090-7
ISSN	1532-1932 ; 1521-6934
ISSN (online)	1532-1932
ISSN	1521-6934
DOI	10.1016/j.bpobgyn.2013.04.001
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Article ; Online: Practical generic guidelines for paediatric-to-adult transition for adolescents with chronic disease.

Le Roux, Enora / Mellerio, Hélène / Jacquin, Paul / Bourmaud, Aurélie / Guilmin-Crépon, Sophie / Faye, Albert / Matheron, Sophie / Boulkedid, Rym / Alberti, Corinne

European journal of public health

2018 Volume 29, Issue 3, Page(s) 442–448

Abstract: Background: The last 20 years have seen many attempts to improve transition to adult healthcare for adolescents with chronic disease, but there is currently no established consensus on generic practices. Our goal was to identify relevant and pragmatic ... ...

Abstract	Background: The last 20 years have seen many attempts to improve transition to adult healthcare for adolescents with chronic disease, but there is currently no established consensus on generic practices. Our goal was to identify relevant and pragmatic guidelines for transition practice for each step of this process (before, during and after transfer), applicable to a wide range of chronic illnesses and health services, via a participatory approach involving all the key stakeholders. Methods: We conducted interviews and a literature review to elaborate a questionnaire for use in an online 2-round Delphi survey. The survey panel included 36 French health and social professionals from different care settings, and young adults and parents with an experience of healthcare transition related to all types of chronic disease. Results: The survey consensus identified 19 items on feasibility and relevance criteria, which form the guidelines. It is composed of five practices to be adopted during preparation in paediatrics, seven practices in the active phase of transition and seven in adult care. Two guidelines achieved complete consensus: having a longer consultation for the first appointment with the adult doctor, and keeping the same adult doctor throughout follow-up. A further 36 items met the criterion of relevance, but were deemed unfeasible. Conclusions: Taking into account all stakeholder views and the real-world applicability of care practices enabled us to elaborate consensual guidelines whose implementation requires no additional health service resources.
MeSH term(s)	Adolescent ; Chronic Disease ; Delphi Technique ; Female ; France ; Guidelines as Topic ; Humans ; Male ; Surveys and Questionnaires ; Transition to Adult Care
Language	English
Publishing date	2018-12-06
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1129243-x
ISSN	1464-360X ; 1101-1262
ISSN (online)	1464-360X
ISSN	1101-1262
DOI	10.1093/eurpub/cky258
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Article ; Online: Identifying potential indicators to measure the outcome of translational cancer research: a mixed methods approach.

Thonon, Frédérique / Boulkedid, Rym / Teixeira, Maria / Gottot, Serge / Saghatchian, Mahasti / Alberti, Corinne

Health research policy and systems

2015 Volume 13, Page(s) 72

Abstract: Background: In a context where there is an increasing demand to evaluate the outcome of bio-medical research, our work aims to develop a set of indicators to measure the impact of translational cancer research. The objective of our study was to explore ... ...

Abstract	Background: In a context where there is an increasing demand to evaluate the outcome of bio-medical research, our work aims to develop a set of indicators to measure the impact of translational cancer research. The objective of our study was to explore the scope and issues of translational research relevant to evaluation, explore the views of researchers on the evaluation of oncological translational research, and select indicators measuring the outcomes and outputs of translational research in oncology by consensus. Methods: Semi-structured interviews amongst 23 researchers involved in translational cancer research were conducted and analysed using thematic analysis. A two-round modified Delphi survey of 35 participants with similar characteristics was then performed followed by a physical meeting. Participants rated the feasibility and validity of 60 indicators. The physical meeting was held to discuss the methodology of the new indicators. Results: The main themes emerging from the interviews included a common definition for translational research but disagreements about the exact scope and limits of this research, the importance of multidisciplinarity and collaboration for the success of translational research, the disadvantages that translational research faces in current evaluation systems, the relative lack of pertinence of existing indicators, and propositions to measure translational cancer research in terms of clinical applications and patient outcomes. A total of 35 participants took part in the first round survey and 12 in the second round. The two-round survey helped us select a set of 18 indicators, including four that seemed to be particularly adapted to measure translational cancer research impact on health service research (number of biomarkers identified, generation of clinical guidelines, citation of research in clinical guidelines, and citation of research in public health guidelines). The feedback from participants helped refine the methodology and definition of indicators not commonly used. Conclusion: Indicators need to be accepted by stakeholders under evaluation. This study helped the selection and refinement of indicators considered as the most relevant by researchers in translational cancer research. The feasibility and validity of those indicators will be tested in a scientometric study.
MeSH term(s)	Adult ; Attitude of Health Personnel ; Biomedical Research ; Clinical Protocols ; Consensus ; Female ; Health Services Research ; Humans ; Male ; Neoplasms ; Process Assessment (Health Care) ; Quality Indicators, Health Care ; Research Personnel ; Surveys and Questionnaires ; Translational Medical Research
Language	English
Publishing date	2015-12-03
Publishing country	England
Document type	Journal Article
ISSN	1478-4505
ISSN (online)	1478-4505
DOI	10.1186/s12961-015-0060-5
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Article ; Online: Interrater reliability of a tool to assess omission of prescription and inappropriate prescriptions in paediatrics.

Berthe-Aucejo, Aurore / Nguyen, N P K Khan / Angoulvant, François / Boulkedid, Rym / Bellettre, Xavier / Weil, Thomas / Alberti, Corinne / Bourdon, Olivier / Prot-Labarthe, Sonia

International journal of clinical pharmacy

2019 Volume 41, Issue 3, Page(s) 734–740

Abstract: Background Potentially inappropriate medication (PIM) and potential prescription omission (PPO) are common issues in pharmacotherapy in vulnerable populations. A first tool to assess PIM's and PPO's targeting pediatric populations: POPI «Pediatrics ... ...

Abstract	Background Potentially inappropriate medication (PIM) and potential prescription omission (PPO) are common issues in pharmacotherapy in vulnerable populations. A first tool to assess PIM's and PPO's targeting pediatric populations: POPI «Pediatrics Omission of Prescriptions and Inappropriate Prescriptions» was created in 2014. Objective This study aimed to evaluate inter-rater reliability between healthcare professionals who apply POPI. Setting: Mother and child emergency ward of a university hospital. Method Twenty cases with or without PIM or PPO were identified in a previous retrospective PIM-PPO prevalence study on 15,973 patients. One doctor and one pharmacist, who participated in the creation of POPI tool, identified PIM and PPO ("gold standard response"). These cases were reviewed independently by eleven clinicians (generalists, pediatricians, pharmacists, residents), with no previous experience of this tool. Interrater agreement was calculated by using the Kappa agreement test. Main outcome measure: Inter-clinician agreement. Results A high level of agreement of PIM and PPO detection was recorded (PIM: median = 0.80; PPO: median = 0.71). Conclusion POPI demonstrated a good interrater reliability. This validation by many clinicians proves that POPI is a reliable tool. Other multicenter and prospective studies should be conducted to evaluate economical and clinical impacts of POPI.
MeSH term(s)	Child ; Child, Preschool ; Cohort Studies ; Drug Prescriptions/standards ; Female ; Humans ; Inappropriate Prescribing/prevention & control ; Infant ; Male ; Medical Errors/prevention & control ; Potentially Inappropriate Medication List/standards ; Reproducibility of Results ; Retrospective Studies
Language	English
Publishing date	2019-04-11
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2601204-2
ISSN	2210-7711 ; 2210-7703 ; 0928-1231
ISSN (online)	2210-7711
ISSN	2210-7703 ; 0928-1231
DOI	10.1007/s11096-019-00819-1
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Article ; Online: Retrospective study of irrational prescribing in French paediatric hospital: prevalence of inappropriate prescription detected by Pediatrics: Omission of Prescription and Inappropriate prescription (POPI) in the emergency unit and in the ambulatory setting.

Berthe-Aucejo, Aurore / Nguyen, Phuong Khanh Hoang / Angoulvant, François / Bellettre, Xavier / Albaret, Patrick / Weil, Thomas / Boulkedid, Rym / Bourdon, Olivier / Prot-Labarthe, Sonia

BMJ open

2019 Volume 9, Issue 3, Page(s) e019186

Abstract: Background and objective: Pediatrics: Omission of Prescription and Inappropriate prescription (POPI) is the first detection tool for potentially inappropriate medicines (PIMs) and potentially prescribing omissions (PPOs) in paediatrics. The aim of this ... ...

Abstract	Background and objective: Pediatrics: Omission of Prescription and Inappropriate prescription (POPI) is the first detection tool for potentially inappropriate medicines (PIMs) and potentially prescribing omissions (PPOs) in paediatrics. The aim of this study was to evaluate the prevalence of PIM and PPO detected by POPI regarding prescriptions in hospital and for outpatients. The second objective is to determine the risk factors related to PIM and PPO. Design: A retrospective, descriptive study was conducted in the emergency department (ED) and community pharmacy (CP) during 6 months. POPI was used to identify PIM and PPO. Setting: Robert-Debré Hospital (France) and Albaret community pharmacy (Seine and Marne). Participants: Patients who were under 18 years old and who had one or more drugs prescribed were included. Exclusion criteria consisted of inaccessible medical records for patients consulted in ED and prescription without drugs for outpatients. Primary and secondary outcome measures: PIM and PPO rate and risk factors. Results: At the ED, 18 562 prescriptions of 15 973 patients and 4780 prescriptions of 2225 patients at the CP were analysed. The PIM rate and PPO rate were, respectively, 2.9% and 2.3% at the ED and 12.3% and 6.1% at the CP. Respiratory and digestive diseases had the highest rate of PIM. Conclusion: This is the first study to assess the prevalence of PIM and PPO detected by POPI in a paediatric population. This study assessed PIMs or PPOs within a hospital and a community pharmacy. POPI could be used to improve drug use and patient care and to limit hospitalisation and adverse drug reaction. A prospective multicentric study should be conducted to evaluate the impact and benefit of implementing POPI in clinical practice.
MeSH term(s)	Child ; Child, Preschool ; Emergency Service, Hospital/standards ; Emergency Service, Hospital/statistics & numerical data ; Female ; France/epidemiology ; Humans ; Inappropriate Prescribing/prevention & control ; Inappropriate Prescribing/statistics & numerical data ; Male ; Medical Errors/prevention & control ; Medical Errors/statistics & numerical data ; Medication Therapy Management/standards ; Patient Safety/standards ; Pediatrics/methods ; Pediatrics/standards ; Pharmacies/standards ; Pharmacies/statistics & numerical data ; Potentially Inappropriate Medication List ; Practice Patterns, Physicians'/standards ; Practice Patterns, Physicians'/statistics & numerical data ; Prevalence ; Quality Improvement/organization & administration ; Retrospective Studies ; Risk Factors
Language	English
Publishing date	2019-03-20
Publishing country	England
Document type	Journal Article
ZDB-ID	2747269-3
ISSN	2044-6055 ; 2044-6055 ; 2053-3624
ISSN (online)	2044-6055
ISSN	2044-6055 ; 2053-3624
DOI	10.1136/bmjopen-2017-019186
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Article ; Online: POPI (Pediatrics: Omission of Prescriptions and Inappropriate prescriptions): development of a tool to identify inappropriate prescribing.

Prot-Labarthe, Sonia / Weil, Thomas / Angoulvant, François / Boulkedid, Rym / Alberti, Corinne / Bourdon, Olivier

PloS one

2014 Volume 9, Issue 6, Page(s) e101171

Abstract: Introduction: Rational prescribing for children is an issue for all countries and has been inadequately studied. Inappropriate prescriptions, including drug omissions, are one of the main causes of medication errors in this population. Our aim is to ... ...

Abstract	Introduction: Rational prescribing for children is an issue for all countries and has been inadequately studied. Inappropriate prescriptions, including drug omissions, are one of the main causes of medication errors in this population. Our aim is to develop a screening tool to identify omissions and inappropriate prescriptions in pediatrics based on French and international guidelines. Methods: A selection of diseases was included in the tool using data from social security and hospital statistics. A literature review was done to obtain criteria which could be included in the tool called POPI. A 2-round-Delphi consensus technique was used to establish the content validity of POPI; panelists were asked to rate their level of agreement with each proposition on a 9-point Likert scale and add suggestions if necessary. Results: 108 explicit criteria (80 inappropriate prescriptions and 28 omissions) were obtained and submitted to a 16-member expert panel (8 pharmacists, 8 pediatricians hospital-based -50%- or working in community -50%-). Criteria were categorized according to the main physiological systems (gastroenterology, respiratory infections, pain, neurology, dermatology and miscellaneous). Each criterion was accompanied by a concise explanation as to why the practice is potentially inappropriate in pediatrics (including references). Two round of Delphi process were completed via an online questionnaire. 104 out of the 108 criteria submitted to experts were selected after 2 Delphi rounds (79 inappropriate prescriptions and 25 omissions). Discussion conclusion: POPI is the first screening-tool develop to detect inappropriate prescriptions and omissions in pediatrics based on explicit criteria. Inter-user reliability study is necessary before using the tool, and prospective study to assess the effectiveness of POPI is also necessary.
MeSH term(s)	Adult ; Aged ; Child ; Drug Prescriptions/statistics & numerical data ; Humans ; Inappropriate Prescribing/statistics & numerical data ; Middle Aged ; Practice Patterns, Physicians'/statistics & numerical data ; Reproducibility of Results
Language	English
Publishing date	2014-06-30
Publishing country	United States
Document type	Journal Article
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0101171
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Article ; Online: Using and reporting the Delphi method for selecting healthcare quality indicators: a systematic review.

Boulkedid, Rym / Abdoul, Hendy / Loustau, Marine / Sibony, Olivier / Alberti, Corinne

PloS one

2011 Volume 6, Issue 6, Page(s) e20476

Abstract: Objective: Delphi technique is a structured process commonly used to developed healthcare quality indicators, but there is a little recommendation for researchers who wish to use it. This study aimed 1) to describe reporting of the Delphi method to ... ...

Abstract	Objective: Delphi technique is a structured process commonly used to developed healthcare quality indicators, but there is a little recommendation for researchers who wish to use it. This study aimed 1) to describe reporting of the Delphi method to develop quality indicators, 2) to discuss specific methodological skills for quality indicators selection 3) to give guidance about this practice. Methodology and main finding: Three electronic data bases were searched over a 30 years period (1978-2009). All articles that used the Delphi method to select quality indicators were identified. A standardized data extraction form was developed. Four domains (questionnaire preparation, expert panel, progress of the survey and Delphi results) were assessed. Of 80 included studies, quality of reporting varied significantly between items (9% for year's number of experience of the experts to 98% for the type of Delphi used). Reporting of methodological aspects needed to evaluate the reliability of the survey was insufficient: only 39% (31/80) of studies reported response rates for all rounds, 60% (48/80) that feedback was given between rounds, 77% (62/80) the method used to achieve consensus and 57% (48/80) listed quality indicators selected at the end of the survey. A modified Delphi procedure was used in 49/78 (63%) with a physical meeting of the panel members, usually between Delphi rounds. Median number of panel members was 17(Q1:11; Q3:31). In 40/70 (57%) studies, the panel included multiple stakeholders, who were healthcare professionals in 95% (38/40) of cases. Among 75 studies describing criteria to select quality indicators, 28 (37%) used validity and 17(23%) feasibility. Conclusion: The use and reporting of the Delphi method for quality indicators selection need to be improved. We provide some guidance to the investigators to improve the using and reporting of the method in future surveys.
MeSH term(s)	Delphi Technique ; Guidelines as Topic ; Humans ; Quality Indicators, Health Care ; Research Design
Language	English
Publishing date	2011-06-09
Publishing country	United States
Document type	Journal Article ; Meta-Analysis ; Research Support, Non-U.S. Gov't ; Review ; Systematic Review
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0020476
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