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The following reports are currently under development. If you would like to provide comments about a particular topic, serve as a peer reviewer for the draft report, or know the timeline for completion, please contact the ESP Coordinating Center.
To review the most up-to-date protocols, please visit the PROSPERO website. Protocol registration numbers for an individual project can be found along with the brief abstract for the project, below.
PROSPERO registration number: RD42022347945
KQ1: What are the effects of automating the delivery of oral, enteral, or parenteral nutrition supplements to hospitalized patients on patient and process outcomes?
KQ2: How is automating the delivery of oral, enteral, or parenteral nutrition supplements to hospitalized patients experienced by the staff involved in implementing and delivering it?
Population(s): KQ1: Hospitalized patients - including long-term care, skilled nursing facility residents and end of life patients - at risk of malnutrition (ie, who have difficulty eating or absorbing nutrients through GI tract)
KQ2: Hospital staff involved in automating the delivery oral, enteral, or parenteral nutrition supplements to patients (eg, nurses and nursing assistants, pharmacists, food service, registered dietitians)
Interventions: Automated nutrition delivery of oral, enteral, or parenteral nutrition supplements (ie, medical food supplements) that includes automated notifications to the hospital care team (eg, nurses and nursing assistants, physicians pharmacists, food service, registered dietitians) that nutrition supplements have been ordered/ prescribed and requires responses that the care team has administered nutrition supplements and/or how much the patient actually received (eg, electronic health record alerts, barcode scanning)
Automation is defined as the "creation of a process or application of a technology to deliver hospital-based nutrition to patients minimizing human intervention” (ie, hospital staff provide the thinking on the ordering side (inputs) and the delivery side (outputs) is automated to minimize human touch points).
Automation should include one or both of the following aspects of implementation:
Comparator: KQ1: Any comparator (eg, usual care, active comparator, historical controls)
Outcome(s): KQ1:
Process outcomes:
Performance outcomes (eg, time required for supplement administration)
Patient outcomes:
Patient-level harms among patients exposed to automated delivery of nutrition (eg, all-cause mortality, pressure injury, falls, organ damage, aspiration, refeeding syndrome (ie, consuming calories too quickly after starvation), failure to thrive diagnosis, medication-nutrition interactions
KQ2:
Primary purpose of evaluation is to explore the experiences and attitudes of hospital staff (eg, nursing, pharmacy, food service, dietetics) who interact with some aspect of implementing and delivering the automated delivery of nutrition
We will conduct a primary search from inception to the current date of MEDLINE (via Ovid), Embase, and CINAHL from inception to January 16, 2022. We will use a combination of MeSH keywords and selected free-text terms to search titles and abstracts. To ensure completeness, search strategies will be developed in consultation with an expert medical librarian. We will hand-search previous systematic reviews conducted on this or a related topic for potential inclusion.
PROSPERO registration number: CRD42024547851
KQ1: What are the contextual factors for implementation of the Age-Friendly Health Systems (AFHS) model in outpatient settings?
KQ2:
2a. What is the effect of implementing support strategies on reach, effectiveness, adoption, implementation, and maintenance of AFHS in outpatient settings?
2b. Are there differences in reach, effectiveness, adoption, implementation, and maintenance based on patient or system factors (such as gender, race/ethnicity, rurality, etc)?
KQ1a: What is the effect of teach-back on patient and provider outcomes?
KQ1b: Does the effect of teach-back vary based on clinical context (eg, hospital discharge, perioperative visit), intervention characteristic (eg, mode, content, interventionist), or patient characteristics (eg, education level, age)?
KQ2: What is the effect of strategies to increase use of teach-back on key implementation outcomes (eg, adoption, penetration, sustainability)?
Participants/population:
KQ1: Adult patients or their caregivers*; clinicians** delivering care to adult patients
KQ2: Health care organizations, clinics, teams, or clinicians; patients with or without their caregivers
*Caregiver includes any non-paid, informal individual providing supportive care
**Clinician is defined as health care provider (ie, MD, APP), pharmacist, psychologist, nurse, licensed clinical social worker, or other professionally trained clinical personnel
Intervention(s)/exposure(s):
KQ1: Single clinical synchronous, bi-directional encounter-based interaction using teach-back* by a clinician; must include demonstration of understanding of medical information or skills by repeating the information back to the clinician with or without demonstration of specific skill or behavior.
KQ2: Implementation strategies employed to improve the uptake or use of teach-back by a clinician.
*Include if labeled as “teach-back” but does not include specific intervention description as outlined above. “Teach-back” must be described as part of the intervention as opposed to a strategy used to evaluate an intervention. “Teach-back” must occur in the context of a real-time human interaction though initial education delivery may be delivered via recorded information.
Comparator(s):
KQ1: Usual care, other types of health education delivered by a clinician to a patient or their caregiver
KQ2: No implementation support, comparison between implementation strategies
Context:
Inpatient ward, outpatient clinics
Any country
Outcome(s):
KQ1: Proximal/intermediate outcomes:
KQ2: Implementation outcomes such as adoption, reach/penetration, adherence to teach-back/fidelity, sustained use, acceptability, feasibility
PROSPERO registration number: CRD42024603377
KQ1: What are the characteristics of studies that have evaluated antimicrobial stewardship programs or strategies focused on improving antimicrobial prescribing?
KQ2: For prioritized studies (based on settings and/or type of programs or strategies), what are the reported outcomes associated with implementation of antimicrobial stewardship programs or strategies?
PROSPERO registration number: CRD42024611898
KQ1a: What is the comparative effectiveness of high-intensity focused ultrasound therapy versus other surgical treatments (eg, deep brain stimulation, stereotactic radiosurgery and other ablative treatments) applied to specific anatomic targets for the treatment of:
KQ21b: Do benefits and harms vary by patient characteristics (including treatment history) and anatomic targets?
KQ2a: What are the benefits and harms of high-intensity focused ultrasound therapy applied to specific anatomic targets for the treatment of:
KQ2b: Do benefits and harms vary by patient characteristics (including treatment history) and anatomic targets?
KQ1: What measures and models have been evaluated to assess medical specialty physician productivity in ambulatory settings (including time and effort spent in indirect clinical activities such as population health management and care coordination)?
Participants/population: Physicians
Intervention(s)/exposure(s): Physician productivity measures or models implemented or tested with real-world data (ie, wRVUs)
Comparator(s): Any other measure or model of physician productivity (ie, team-based care measures, value-based care models, measures of other physician efforts including population health management, and/or care coordination)
Outcome(s): Health care quality outcomes, productivity outcomes (ie, workload, time spent in clinical activities), patient-reported outcomes, cost, care coordination outcomes, or unintended consequences
Setting: Ambulatory care, including care delivered via telehealth
The scope of this report is an update of Evidence Map of Tai Chi and will include the following: an evidence map that provides a visual overview of the distribution of evidence (both what is known and where there is little or no evidence base) for tai chi/qigong for certain conditions, and an accompanying narrative that helps stakeholders interpret the state of the evidence to inform policy and clinical decision-making. This update will include more conditions of interest to VA stakeholders.
The scope of this report is an update of a previous map conducted in 2016 that will include the following: an evidence map that provides a visual overview of the distribution of evidence for massage for non-pain conditions, and an accompanying narrative that helps stakeholders interpret the state of the evidence to inform policy and clinical decision-making. This update will include more conditions of interest to VA stakeholders.
Participants/population: Adults
Intervention(s)/exposure(s): Not self-delivered massage therapy, acupressure, and myofascial therapy, which could include but is not limited to sports massage, manual lymph drainage, etc. Reviews of osteopathic manipulative medicine and needling are excluded. Reviews of cupping and myofascial rolling as single approaches are excluded.
Comparator(s): Comparators include sham, placebo, usual care, other active therapies.
Context: Any health care setting
Outcome(s): Non-pain related health outcomes and adverse events. Additional outcomes might include use of medications, health care services utilization.
