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Your search keyword '"Kobewka, Daniel"' showing total 210 results
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210 results on '"Kobewka, Daniel"'

15. Predicting death in home care users: derivation and validation of the Risk Evaluation for Support: Predictions for Elder-Life in the Community Tool (RESPECT)

Author

Hsu, Amy T., Manuel, Douglas G., Spruin, Sarah, Bennett, Carol, Taljaard, Monica, Beach, Sarah, Sequeira, Yulric, Talarico, Robert, Chalifoux, Mathieu, Kobewka, Daniel, Costa, Andrew P., Bronskill, Susan E., and Tanuseputro, Peter

Subjects
Home care -- Patient outcomes, Aged patients -- Models -- Care and treatment, Mortality -- Models -- Health aspects -- Canada, Medical care -- Needs assessment, Needs assessment -- Models -- Methods, Health risk assessment -- Models -- Methods, Health
Abstract

BACKGROUND: Prognostication tools that report personalized mortality risk and survival could improve discussions about end-of-life and advance care planning. We sought to develop and validate a mortality risk model for older adults with diverse care needs in home care using self-reportable information--the Risk Evaluation for Support: Predictions for Elder-Life in the Community Tool (RESPECT). METHODS: Using a derivation cohort that comprised adults living in Ontario, Canada, aged 50 years and older with at least 1 Resident Assessment Instrument for Home Care (RAI-HC) record between Jan. 1, 2007, and Dec. 31, 2012, we developed a mortality risk model. The primary outcome was mortality 6 months after a RAI-HC assessment. We used proportional hazards regression with robust standard errors to account for clustering by the individual. We validated this algorithm for a second cohort of users of home care who were assessed between Jan. 1 and Dec. 31, 2013. We used Kaplan-Meier survival curves to estimate the observed risk of death at 6 months for assessment of calibration and median survival. We constructed 61 risk groups based on incremental increases in the estimated median survival of about 3 weeks among adults at high risk and 3 months among adults at lower risk. RESULTS: The derivation and validation cohorts included 435 009 and 139 388 adults, respectively. We identified a total of 122 823 deaths within 6 months of a RAI-HC assessment in the derivation cohort. The mean predicted 6-month mortality risk was 10.8% (95% confidence interval [CI] 10.7%-10.8%) and ranged from 1.54% (95% CI 1.53%-1.54%) in the lowest to 98.1% (95% CI 98.1%-98.2%) in the highest risk group. Estimated median survival spanned from 28 days (11 to 84 d at the 25th and 75th percentiles) in the highest risk group to over 8 years (1925 to 3420 d) in the lowest risk group. The algorithm had a c-statistic of 0.753 (95% CI 0.750-0.756) in our validation cohort. INTERPRETATION: The RESPECT mortality risk prediction tool that makes use of readily available information can improve the identification of palliative and end-of-life care needs in a diverse older adult population receiving home care., Most people in high-income countries die of causes with progressive, predictable trajectories of decline. (1-4) Since 2000, the 3 leading causes of death in Canada--accounting for 55% of all deaths--have [...]

Published
2021
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20. Practice Patterns of Medical Oncologists: A Survey of Advance Care Planning in the Outpatient Setting.

Author

Gotfrit, Joanna, Leung, Macyn, Marginean, Horia, Kobewka, Daniel, Fergusson, Dean, and Goodwin, Rachel

Subjects
FISHER exact test, ADVANCE directives (Medical care), QUESTIONNAIRES, DESCRIPTIVE statistics, PHYSICIAN practice patterns, ONCOLOGISTS, OUTPATIENT services in hospitals
Abstract

Introduction. Advance care planning (ACP) is an important part of cancer care. We determined the ACP practice patterns of medical oncologists at our academic cancer centre in Canada. Methods. Medical oncologists were invited to participate in a questionnaire in August 2019. Questions were validated by a local survey expert. Twelve multiple-choice questions were included. Results. Seventeen of the 23 eligible oncologists responded. 64% were male, and 76% were in practice for <16 years. Common tumour sites treated by respondents included breast (53%), lung (24%), gastrointestinal (24%), and genitourinary (24%) cancers. Oncologists responded that components of ACP included designating a substitute decision-maker (100%), determining goals of care (100%), making decisions about cardiopulmonary resuscitation (94%), and disposition of property/finances (88%). They discuss ACP with curable vs. incurable patients 6% vs. 93% of the time. While 88% of oncologists reported it would be desirable to initiate ACP discussions in the first 3 visits, in the incurable setting, only 29% reported doing so. Patient characteristics that prompt oncologists to discuss ACP in the first 3 visits in the curative vs. incurable settings include elderly age (23% vs. 59%), poor performance status (47% vs. 88%), and short prognosis (47% vs. 88%). Oncologists thought the most appropriate time to discuss ACP in the curative setting was at the time the patient initiates it (35%), and during visits 2-3 in the incurable setting (41%). The most common barriers to discussing ACP include insufficient time (71%) and too much information for the patient (71%). Conclusions. While medical oncologists believe that discussing ACP with cancer patients in the first few outpatient visits is important, this seldom occurs due to the presence of several barriers. [ABSTRACT FROM AUTHOR]

Published
2023
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23. Decisions and Decisional Needs of Canadians From all Provinces and Territories During the COVID-19 Pandemic: Population-Based Cross-sectional Surveys

Author

Stacey, Dawn, primary, Ludwig, Claire, additional, Archambault, Patrick, additional, Smith, Maureen, additional, Taljaard, Monica, additional, Carley, Meg, additional, Plourde, Karine, additional, Boland, Laura, additional, Gogovor, Amédé, additional, Graham, Ian, additional, Kobewka, Daniel, additional, McLean, Robert K D, additional, Nelson, Michelle L A, additional, Vanderspank-Wright, Brandi, additional, and Légaré, France, additional

Published
2023
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27. sj-pdf-1-mpp-10.1177_23814683231168589 – Supplemental material for 'To Be or Not to Be'—Cardiopulmonary Resuscitation for Hospitalized People Who Have a Low Probability of Benefit: Qualitative Analysis of Semi-structured Interviews

Author

Kobewka, Daniel, Lalani, Yasmin, Shaffer, Victoria, Adewole, Tolulope, Lypka, Kiefer, and Wegier, Pete

Subjects
111799 Public Health and Health Services not elsewhere classified, FOS: Health sciences
Abstract

Supplemental material, sj-pdf-1-mpp-10.1177_23814683231168589 for “To Be or Not to Be”—Cardiopulmonary Resuscitation for Hospitalized People Who Have a Low Probability of Benefit: Qualitative Analysis of Semi-structured Interviews by Daniel Kobewka, Yasmin Lalani, Victoria Shaffer, Tolulope Adewole, Kiefer Lypka and Pete Wegier in MDM Policy & Practice

Published
2023
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28. Functional and Quality of Life Outcomes After In Hospital CPR: A Systematic Review

Author

Adewole, Tolu, Kobewka, Daniel, Wegier, Pete, McIsaac, Daniel, Kyeremanteng, Kwado, Mulpuru, Sunita, Ferguson, Dean, and Fernando, Shannon

Subjects
Cardiopulmonary resuscitation, ADLs, education, Medicine and Health Sciences, CPR, in-hospital cardiac arrest, neurological outcome, health care economics and organizations, Education, discharge disposition, functional outcome
Abstract

We are performing a systematic review of all studies that report quality of life outcomes for patients who had in-hospital cardiac arrest and have received CPR in hospital.

Published
2022
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29. Decisions and decisional needs of Canadians from all provinces and territories during the COVID-19 pandemic: population-based cross-sectional surveys (Preprint)

Author

Stacey, Dawn, primary, Ludwig, Claire, additional, Archambault, Patrick, additional, Smith, Maureen, additional, Taljaard, Monica, additional, Carley, Meg, additional, Plourde, Karine, additional, Boland, Laura, additional, Gogovor, Amédé, additional, Graham, Ian, additional, Kobewka, Daniel, additional, McLean, Robert K.D., additional, Nelson, Michelle L.A., additional, Vanderspank-Wright, Brandi, additional, and Légaré, France, additional

Published
2022
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30. Using linked administrative data to evaluate and improve the quality of end-of-life care in nursing homes.

Author

Webber, Colleen, primary, Milani, Christina, additional, Clarke, Anna, additional, R Isenberg, Sarina, additional, Downar, James, additional, Kobewka, Daniel, additional, Hsu, Amy, additional, Lau, Jenny, additional, Sinnarajah, Aynharan, additional, Simon, Jessica, additional, Boese, Kaitlyn, additional, Arya, Amit, additional, Hannon, Breffni, additional, Roberts, Rhiannon, additional, Turcotte, Luke, additional, Howard, Michelle, additional, Maxwell, Colleen, additional, and Tanuseputro, Peter, additional

Published
2022
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31. The Impact of the COVID-19 Pandemic on End-of-Life Prescribing in Ontario Nursing Homes.

Author

Milani, Christina, primary, Webber, Colleen, additional, Clarke, Anna, additional, Isenberg, Sarina, additional, Downar, James, additional, Kobewka, Daniel, additional, Hsu, Amy, additional, Lau, Jenny, additional, Sinnarajah, Aynharan, additional, Simon, Jessica, additional, Boese, Kaitlyn, additional, Arya, Amit, additional, Roberts, Rhiannon, additional, Turcotte, Luke, additional, Howard, Michelle, additional, Maxwell, Colleen, additional, Robert, Benoit, additional, and Tanuseputro, Peter, additional

Published
2022
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36. Usability, acceptability and clinical utility of a mobile app to screen for hearing loss in older adults in a geriatric rehabilitation hospital.

Author

Kobewka, Daniel, Ruller, Sydney, Daly, Blake, Mark Fraser, Amy E., Bromwich, Matt, Sveistrup, Heidi, and Wilson, Kumanan

Subjects
*HEARING disorder diagnosis, *EVALUATION of medical care, *PILOT projects, *MOBILE apps, *AUDIOMETRY, *QUALITY assurance, *GERIATRIC rehabilitation, *OLD age
Abstract

Rationale: Hearing loss is a common problem for older adults entering rehabilitation hospitals. Aims and Objectives: To pilot a hearing loss screening device to determine feasibility, usability, and impact on patient outcomes. Methods: We screened all patients newly admitted to a geriatric day hospital for hearing loss using the SHOEBOX® QuickTest (SHOEBOX Ltd.) app as part of a quality improvement programme. We measured the time it took for each patient to complete screening and recorded any issues they had using the app. We recorded the number of patients who screened positive who did not have a previous diagnosis and changes in physician behaviours after they received their patients' results. Results: Seventy‐four patients with a mean age of 83.4 years used the hearing screener. All patients were able to complete the screening with a mean time to completion of 10 min and 48 s. Ninety‐nine percent of patients screened positive for hearing loss. Of these positives 56% were in participants not already known to have hearing loss. Physicians often changed their behaviour after receiving results by using assistive devices during visits and referring to audiology for formal testing. Conclusions: Screening for hearing loss is feasible in a geriatric day hospital. The SHOEBOX QuickTest app is acceptable, usable, resulting in the identification of undiagnosed hearing loss and in changes to physician behaviour. [ABSTRACT FROM AUTHOR]

Published
2023
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37. A Quality Improvement Initiative to Implement the Serious Illness Care Program on Hospital Medical Wards

Author

You, John, primary, Singh, Japteg, additional, Simon, Jessica, additional, Ma, Irene W.Y., additional, Paladino, Joanna, additional, Swinton, Marilyn, additional, Kobewka, Daniel, additional, Munene, Peter, additional, Jayaraman, Dev, additional, Dunne, Fiona, additional, Lagrotteria, Andrew, additional, and Bernacki, Rachelle, additional

Published
2022
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40. Implementation of the Serious Illness Care Program on Hospital Medical Wards

Author

Singh, Japteg, primary, Simon, Jessica, additional, Ma, Irene, additional, Dunne, Fiona, additional, Dugan, Alison, additional, Wooller, Krista, additional, Munene, Peter, additional, Kobewka, Daniel, additional, Jayaraman, Dev, additional, Swinton, Marilyn, additional, Lagrotteria, Andrew, additional, Bernacki, Rachelle, additional, and You, John, additional

Published
2021
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44. Additional file 1 of Predicting the need for supportive services after discharged from hospital: a systematic review

Author

Kobewka, Daniel, Mulpuru, Sunita, Chassé, Michaël, Kednapa Thavorn, Lavallée, Luke, English, Shane, Neilipovitz, Benjamin, Neilipovitz, Jonathan, Forster, Alan, and McIsaac, Daniel

Subjects
education
Abstract

Additional file 1. Predicting need for supportive services. Database: Ovid MEDLINE(R) Epub Ahead of Print, In-Process & Other Non-Indexed Citations, Ovid MEDLINE(R) Daily and Ovid MEDLINE(R) Search Strategy: Search strategy formatted for MEDLINE.

Published
2020
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48. An Evaluation of Rapidly Progressive Dementia Culminating in a Diagnosis of Creutzfeldt–Jakob Disease

Author

Parmar, Parmvir, Cooper, Curtis L., and Kobewka, Daniel

Subjects
Article Subject, mental disorders
Abstract

Rapidly progressive dementia is a curious and elusive clinical description of a pattern of cognitive deficits that progresses faster than typical dementia syndromes. The differential diagnosis and clinical workup for rapidly progressive dementia are quite extensive and involve searching for infectious, inflammatory, autoimmune, neoplastic, metabolic, and neurodegenerative causes. We present the case of a previously highly functional 76-year-old individual who presented with a 6-month history of rapidly progressive dementia. His most prominent symptoms were cognitive impairment, aphasia, visual hallucinations, and ataxia. Following an extensive battery of tests in hospital, the differential diagnosis remained probable CJD versus autoimmune encephalitis. He clinically deteriorated and progressed to akinetic mutism and myoclonus. He passed away 8 weeks after his initial presentation to hospital, and an autopsy confirmed a diagnosis of sporadic CJD. We use this illustrative case as a framework to discuss the clinical and diagnostic considerations in the workup for rapidly progressive dementia. We also discuss CJD and autoimmune encephalitis, the two main diagnostic possibilities in our patient, in more detail.

Published
2018
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50. Additional file 1: of Advance care planning after hospital discharge: qualitative analysis of facilitators and barriers from patient interviews

Author

Peck, Vanessa, Valiani, Sabira, Tanuseputro, Peter, Mulpuru, Sunita, Kwadwo Kyeremanteng, Fitzgibbon, Edward, Forster, Alan, and Kobewka, Daniel

Abstract

SRQR standards for Reporting Qualitative Research Checklist. Checklist for all elements that are suggested to be reported for qualitative research. (PDF 263 kb)

Published
2018
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