Titre :
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Comparison of vignettes, standardized patients, and chart abstraction : A Prospective validation study of 3 methods for measuring quality. (2000)
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Auteurs :
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J.W. PEABODY ;
T.R. DRESSELHAUS ;
P. GLASSMAN ;
M. LEE ;
J. LUCK ;
University of California. Los Angeles. Schools of Medicine and Public Health. Los Angeles. USA ;
Veterans Affairs Center for the Study of Health Care Provider Behavior. USA ;
Veterans Affairs. Greater Los Angeles Healthcare System. West Los Angeles. USA
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Type de document :
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Article
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Dans :
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JAMA - Journal of the american medical association (vol. 283, n° 13, 2000)
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Pagination :
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1715-1722
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Langues:
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Anglais
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Mots-clés :
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Cardiopathie coronaire
;
Soins
;
Etat santé
;
Médecin
;
Thérapeutique
;
Gestion
;
Homme
;
Appareil circulatoire [pathologie]
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Résumé :
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[BDSP. Notice produite par INIST yHR0xP3z. Diffusion soumise à autorisation]. Context Better health care quality is a universal goal, yet measuring quality has proven to be difficult and problematic. A central problem has been isolating physician practices from other effects of the health care system. Objective To validate clinical vignettes as a method for measuring the competence of physicians and the quality of their actual practice. Design Prospective trial conducted in 1997 comparing 3 methods for measuring the quality of care for 4 common outpatient conditions : (1) structured reports by standardized patients (SPs), trained actors who presented unannounced to physicians'clinics (the gold standard) ; (2) abstraction of medical records for those same visits ; and (3) physicians'responses to clinical vignettes that exactly corresponded to the SPs'presentations. Setting Outpatient primary care clinics at 2 Veterans Affairs medical centers. Participants Ninety-eight (97%) of 101 general internal medicine staff physicians, faculty, and second-and third-year residents consented to be randomized for the study. From this group, 10 physicians at each site were randomly selected for inclusion. Main Outcome Measures A total of 160 quality scores (8 cases x 20 physicians) were generated for each method using identical explicit criteria based on national guidelines and local expert panels. Scores were defined as the percentage of process criteria correctly met and were compared among the 3 methods. (...)
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