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15. Exploring guideline adaptation strategy for Turkey: Is 'ADAPTE' feasible or does it need adaptation as well?

Author

Ayhan Baser DAUID- ORCID: 0000-0002-5153-2184, Kahveci R, Baydar Artantas A, Yasar İ, Aksoy H, Koc EM, Kasim İ, Kunnamo I, and Özkara A

Subjects
Evidence-Based Medicine/methods/standards, Expert Testimony, Guideline Adherence/*organization & administration, Humans, Pilot Projects, Practice Guidelines as Topic/*standards, Practice Patterns, Physicians', Quality Improvement, Reproducibility of Results, Turkey
Abstract

RATIONALE, AIMS, OBJECTIVES: Clinical Practice Guidelines are mostly developed by 3 methods; namely, de novo, adoption, and adaptation. Nonpublished studies and authors experience shows that most guidelines in Turkey are either by adoption or by adaptation. There is no available local tool for adaptation, so the process is not standardized and most of the time not explicitly defined. The objective of this study is to search for international guideline adaptation tools and test their feasibility in Turkish context, to serve a final goal of developing a unique local strategic tool for guideline adaptation. METHODS: The methodological design of this study includes selection of an international tool for Clinical Practice Guideline adaptation, piloting this tool with selected Turkish guidelines, identifying the feasibility of this tool and exploring the needs for adaptation of the tool, drawing recommendations for adaptation of the strategies, and validation of the process by local experts. RESULTS: The study from planning phase to finalizing the guidance, including pilot studies and panel but excluding translation of ADAPTE, lasted 18 months. Nine researchers were involved in the adaptation process and 15 more experts were involved in the validation panel. Following the suggestions of the research team on modifications and validation through the expert panel; 2 steps of the ADAPTE toolkit were rejected, 2 steps were accepted by modification, 7 steps were accepted by additional recommendations. In addition, 2 tools were suggested to be added to the toolkit. CONCLUSION: This is the first study on adaptation of guidelines in Turkey. Pilot adaptation of 2 guidelines with ADAPTE revealed that ADAPTE is a useful and feasible tool in Turkish setting, but might require certain changes in recommendations and revision of tools.

Published
2018

20. Toward a Contingency Model for Hospital-Based Health Technology Assessment: Evidence from the AdHopHTA Project

Author

Cicchetti, A., Iacopino, V., Coretti, S., Fiore, A., Marchetti, M., Sampietro-Colom, L., Kidholm, K., Wasserfallen, J. B., Kahveci, R., Halmesmäki, E., Rosenmölle, r. M., Wil, d. C., Kive, t. R. A., Cicchetti A. (ORCID:0000-0002-4633-9195), Iacopino V. (ORCID:0000-0002-0366-7092), Coretti S., Fiore A., Marchetti M. (ORCID:0000-0002-8367-8268), Cicchetti, A., Iacopino, V., Coretti, S., Fiore, A., Marchetti, M., Sampietro-Colom, L., Kidholm, K., Wasserfallen, J. B., Kahveci, R., Halmesmäki, E., Rosenmölle, r. M., Wil, d. C., Kive, t. R. A., Cicchetti A. (ORCID:0000-0002-4633-9195), Iacopino V. (ORCID:0000-0002-0366-7092), Coretti S., Fiore A., and Marchetti M. (ORCID:0000-0002-8367-8268)

Abstract

Objectives: Hospital-based health technology assessment (HB-HTA) is becoming increasingly relevant because of its role in managing the introduction and withdrawal of health technologies. The organizational arrangement in which HB-HTA activities are conducted depends on several contextual factors, although the dominant models have several similarities. The aims of this study were to explore, describe, interpret, and explain seven cases of the application of HB-HTA logic and to propose a classification for HB-HTA organizational models which may be beneficial for policy makers and HTA professionals. Methods: The study was part of the AdHopHTA Project, granted under the European 7th Framework Research Programme. A case study methodology was applied to analyze seven HB-HTA initiatives in seven countries, with collection of qualitative and quantitative data. Cross-case analysis was performed within the framework of contingent organizational theory. Results: Evidence showed that some organizational or “structural” variables, namely the level of procedure formalization/structuration and the level of integration with other HTA bodies at the national, regional, and provincial levels, predominantly shape the HB-HTA approach, determining a contingency model of HB-HTA. Crossing the two variables, four options have emerged: integrated specialized HTA unit, stand-alone HTA unit, integrated-essential HTA, independent group unit. Conclusions: No one-best-way approach can be used for HTA at the hospital level. Rather, the characteristics of HTA models depend on many contextual factors. Such conceptualization may aid the diffusion of HB-HTA to inform managerial decision making and clinical practice.

Published
2018

21. The ideas about advanced life support and affecting factors at the end-stage of life in a hospital in Turkey

Author

Albayrak T, Şencan İ, Akça Ö, Koç EMAUID- ORCID: 0000-0003-3620-1261, Aksoy H, Ünsal S, Bülbül İ, Bahadır A, Kasım İ, Kahveci R, and Özkara A

Subjects
Adolescent, Adult, Advance Directives/*psychology, Aged, Attitude to Death, Cross-Sectional Studies, Culture, Decision Making, Family, Female, Hospitals, Teaching, Humans, Life Support Care/*psychology, Male, Middle Aged, Patient Preference, Psychiatric Status Rating Scales, Socioeconomic Factors, Surveys and Questionnaires, Terminal Care/*psychology, Turkey, Young Adult
Abstract

BACKGROUND: The participation of the people in health decisions may be structured in various levels. One of these is participation in decisions for the treatment. "Advanced directives" is one of the examples for the participation in decisions for the treatment. AIM: We wanted to determine the decisions on advanced life support at the end-stage of life in case of a life-threatening illness for the people themselves and their first degree relatives and the factors effecting these decisions. DESIGN AND SETTING: The cross-sectional study was conducted with volunteers among patients and patient relatives who applied to all polyclinics of the Ankara Numune Training and Research Hospital except the emergency, oncology and psychiatry polyclinics between 15.12.2012 and 15.03.2013. METHOD: A questionnaire, the Hospital Anxiety Depression (HAD) scale, and Templer's Death Anxiety Scale (TDA) were applied to all individuals. SPSS for Win. Ver. 17.0 and MS-Excel 2010 Starter software bundles were used for all statistical analysis and calculations. RESULTS: The participants want both themselves and their first degree relatives included in end-stage decision-making process. Therefore, the patients and their families should be informed adequately during decision making process and quality communication must be provided. CONCLUSION: Participants who have given their end-stage decisions previously want to be treated according to these decisions. This desire can just be possible by advanced directives.When moral and material loads of end-stage process are taken into consideration, countries, in which advanced directives are practiced, should be examined well and participants' desire should be evaluated in terms of practicability.

Published
2017

29. Gebelikte beslenme alışkanlıklarının değerlendirilmesi

Author

Aksoy H, Şencan I, Samur G, Şenol Eren N, Koç Em, Kahveci R, Kasım I, Adem Özkara, Hitit Üniversitesi, and Hitit Üniversitesi, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü

Subjects
Pregnancy, business.industry, White meat, lcsh:R, Breastfeeding, lcsh:Medicine, Obstetrics and Gynecology, Awareness, medicine.disease, lcsh:Gynecology and obstetrics, Obstetrics and gynaecology, Statistical significance, Environmental health, Red meat, medicine, Outpatient clinic, Clinical Investigation, business, Body mass index, lcsh:RG1-991, Nutrition, Cerrahi
Abstract

Objective: Pregnancy is a special period of increased nutritional needs during which conscious nutritional support is required. Insufficient and imbalancednutrition in this period of life causes serious conditions that affect both child and mother. This study aimed to evaluate the relationship between pregnancyand nutrition/nutritional habits during pregnancy.Materials and Methods: In this descriptive study, a questionnaire was conducted on a voluntary basis to pregnant women who were admitted to thePregnancy Outpatient Clinic of Obstetrics and Gynecology Department at Ankara Numune Training and Research Hospital. Questions about generalinformation, pregnancy-related information, thoughts and knowledge about breastfeeding, nutritional habits, and meal frequency were asked to pregnantwomen. Three hundred fourteen questionnaires were assessed in the study. SPSS for Windows Version 16.0 and MS-Excel 2007 were used for statisticalevaluations. P

Published
2015

30. Hospital managers' need for information in decision-making--An interview study in nine European countries.

Author

Kidholm, K., Ølholm, A. M., Birk Olsen, M, Cicchetti, Americo, Fure, B., Halmesmäki, E., Kahveci, R., Kiivet, Ra, Wasserfallen, J. B., Wild, C., Sampietro Colom, L., Cicchetti, Americo (ORCID:0000-0002-4633-9195), Kidholm, K., Ølholm, A. M., Birk Olsen, M, Cicchetti, Americo, Fure, B., Halmesmäki, E., Kahveci, R., Kiivet, Ra, Wasserfallen, J. B., Wild, C., Sampietro Colom, L., and Cicchetti, Americo (ORCID:0000-0002-4633-9195)

Abstract

Assessments of new health technologies in Europe are often made at the hospital level. However, the guidelines for health technology assessment (HTA), e.g. the EUnetHTA Core Model, are produced by national HTA organizations and focus on decision-making at the national level. This paper describes the results of an interview study with European hospital managers about their need for information when deciding about investments in new treatments. The study is part of the AdHopHTA project. Face-to-face, structured interviews were conducted with 53 hospital managers from nine European countries. The hospital managers identified the clinical, economic, safety and organizational aspects of new treatments as being the most relevant for decision-making. With regard to economic aspects, the hospital managers typically had a narrower focus on budget impact and reimbursement. In addition to the information included in traditional HTAs, hospital managers sometimes needed information on the political and strategic aspects of new treatments, in particular the relationship between the treatment and the strategic goals of the hospital. If further studies are able to verify our results, guidelines for hospital-based HTA should be altered to reflect the information needs of hospital managers when deciding about investments in new treatments.

Published
2015

32. Pharmacogenomics in Primary Care: A Crucial Entry Point for Global Personalized Medicine?

Author

Bartlett, G., Zgheib, N., Manamperi, A., wei wang, Hizel, C., Kahveci, R., Yazan, Y., Anadolu Üniversitesi, Edebiyat Fakültesi, and Yazan, Yasemin

Subjects
Essential Medicines, Pharmacogenomics And Primary Care, Developing World Genomics, Global Personalized Medicine, Primary Care Genomics, Genomics And International Development, Developing Countries, Public Health Pharmacogenomics, Article
Abstract

[No abstract available]

Published
2012

34. A Handbook and a Toolkit for Hospital-Based Health Technology Assessment

Author

Samprietro-Colom, L, primary, Lach, K, additional, Escolar, I, additional, Sroka, S, additional, Soto, M, additional, Cicchetti, A, additional, Fure, B, additional, Kahveci, R, additional, Kidholm, K, additional, Kiivet, R, additional, Pasternack, I, additional, Rossenmoller, M, additional, Wesserfallen, J, additional, and Wild, C, additional

Published
2015
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37. The Effects of Reforms, Price Cuts and Global Budget Implementation on Biotechnological Medicine Sales Which Have Annual Average Highest Amount Of Sales Between 2008-2013 In Turkey

Author

Vural, E.H., primary, Vural, I.M., additional, Yigit, O., additional, Uman, N., additional, Tolun, C., additional, Babacan, S., additional, Dogan, E., additional, Akbulat, A., additional, Kahveci, R., additional, Malhan, S., additional, Artiran, G., additional, and Kerman, S., additional

Published
2014
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38. The Effects of Reforms, Price Cuts And Global Budget Implementation on Original/Generic Medicine Sales Which Have Annual Average Highest Amount Of Sales Between 2008-2013 In Turkey

Author

Vural, I.M., primary, Vural, E.H., additional, Yigit, O., additional, Dogan, E., additional, Babacan, S., additional, Tolun, C., additional, Uman, N., additional, Akbulat, A., additional, Malhan, S., additional, Kahveci, R., additional, Artiran, G., additional, and Kerman, S., additional

Published
2014
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39. Effects of Reference Price System on Medicines Which Have Annual Average Highest Amount Of Sales Of Between Years 2008-2013

Author

Uman, N., primary, Tolun, C., additional, Babacan, S., additional, Dogan, E., additional, Vural, I.M., additional, Vural, E.H., additional, Dasdag, M.M., additional, Safak, Yilmaz E., additional, Malhan, S., additional, Kahveci, R., additional, Akbulat, A., additional, Artiran, G., additional, and Kerman, S., additional

Published
2014
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