Guideline adherence in cystic fibrosis: a center-based analysis

Brendel, Paul (2014) Guideline adherence in cystic fibrosis: a center-based analysis. Master's Thesis, University of Pittsburgh.

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Abstract

Background: The Cystic Fibrosis Foundation (CFF) brings together committees of experts to write guidelines for various aspects of patient care. Despite these standardized guidelines, cystic fibrosis (CF) care centers and affiliates across the U.S. have been shown to have great variations in guideline adherence and patient outcomes. Methods: The 2012 center-level data for 114 centers and 49 affiliate programs was accessed online. This study described the variations in center-level patient outcomes and adherence to Clinical Care Practice Guidelines (Guidelines), defined as the proportion of patients with at least four outpatient visits, two pulmonary function tests, and one sputum culture annually. The outcome variables: forced expiratory volume in one second (FEV1) % predicted in adults, FEV1 % predicted in children, body mass index (BMI) in adults, and BMI percentile in children were case-mix adjusted for current age, race/ethnicity, age and presentation at diagnosis, pancreatic status, gender, and income based on the characteristics at the individual centers. Correlation coefficients were calculated to determine if center-level adherence to Guidelines is positively correlated with outcomes, and regression analysis was used to assess the ability of Guidelines adherence to predict outcomes. A model selection method evaluated if center-level covariates [proportion of patients screened for cystic fibrosis-related diabetes (CFRD), number of patients seen, and program type (center or affiliate)] improve the prediction of outcomes. Results: Guidelines adherence and FEV1 % predicted were significantly greater in children than adults (p

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Details

Item Type:	Other Thesis, Dissertation, or Long Paper (Master's Thesis)
Status:	Unpublished
Creators/Authors:	Creators Email Pitt Username ORCID Brendel, Paul
Contributors:	Contribution Contributors Name Email Pitt Username ORCID Committee Chair Brooks, Maria M. mbrooks@pitt.edu MBROOKS UNSPECIFIED Committee Member Weiner, Daniel daniel.weiner@chp.edu UNSPECIFIED UNSPECIFIED Committee Member Wassel, Christina cwassel@pitt.edu CWASSEL UNSPECIFIED
Date:	December 2014
Date Type:	Publication
Submission Date:	26 November 2014
Access Restriction:	No restriction; Release the ETD for access worldwide immediately.
Publisher:	University of Pittsburgh
Institution:	University of Pittsburgh
Schools and Programs:	School of Public Health > Epidemiology
Degree:	MPH - Master of Public Health
Thesis Type:	Master's Thesis
Refereed:	Yes
Uncontrolled Keywords:	cystic, fibrosis, adherence, center-based, analysis
Date Deposited:	17 Aug 2015 20:34
Last Modified:	14 Sep 2024 11:55
URI:	http://d-scholarship.pitt.edu/id/eprint/23679

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