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The following reports are under development at one of the four ESP sites. If you would like to provide comments about the topic under development, 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.
KQ1: Among males, is there a clinical risk tool (eg, FRAX) that identify patients at highest risk of osteoporosis or major osteoporotic fracture?
KQ2: Among male Veterans, is there a combination of risk factors that identify patients at highest risk of osteoporosis or major osteoporotic fracture?
KQ3: What systems level interventions improve uptake of osteoporosis screening?
Populations:
KQ 1: Adult men, KQ 2: Adult male Veterans, KQ 3: Health care providers, adult patients, health system administrators and/or staff.
In studies that recruit populations with and without facture histories, 80% of recruited study population should have no prior identified low-trauma fracture.
For studies with mixed populations of men and women, we will include them if they conduct a subgroup analysis of men only.
Interventions:
KQ 1: Clinical risk assessment or fracture risk predations tools (eg, FRAX, GARVAN FRC, Q fracture, fracture risk calculator, Osteoporosis Screening tool [OST], male osteoporosis screening tool [MOST], Male Osteoporosis Risk Estimation Score [MORES]); combination of assessment tools and screening tests (eg, dual-energy x-ray absorptiometry-DXA)
KQ 2: Risk factor for osteoporosis (eg, medication use, smoking, body mass index) and clinical risk assessment or fracture risk predations tools.
KQ 3: System-level approaches targeting provider behaviors or systems operations to optimize uptake of osteoporosis screening (eg, clinical reminder systems; bone health clinics; provider education; tailored and/or bi-directional patient education such as IVR assessing individual risk scores; remote consultation; nurse/physician/pharmacist led interventions; clinician incentives, academic detailing; patient self-referral system)
Comparators:
KQ 1 & KQ 2: other risk assessment tools, bone mineral density testing via validated approach (eg, dual-energy x-ray absorptiometry-DXA)
KQ 3: usual care, other system-level approached, patient-focused interventions
Outcomes:
KQ 1 & KQ 2: fracture rates; bone mineral density
KQ 3: fracture rates, screening rates
Setting: Outpatient general medical settings (eg, geriatrics, family medicine, general internal medicine, integrative medicine, urgent care, emergency departments) or inpatient health care settings
We will conduct a primary search from inception to the current date of MEDLINE® (via PubMed®), Embase, and CINAHL. 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 librarian. We will also hand search key references for relevant citations that may not be captured by our database search.
KQ1: How is culture of innovation defined in the literature?
KQ2a: What are key characteristics of programs to improve or establish a culture of innovation?
KQ2b: In assessments of these programs, what metrics are used to capture culture of innovation?
KQ2c: In assessments of these programs, what other outcomes or impacts are described?
Interventions: Programs designed to improve or establish a culture of innovation
Outcome(s): Culture of innovation, organizational innovation, organizational or workforce outcomes
Setting: Large healthcare systems in high-income countries
We will procure literature from databases including Ovid Medline, Business Source Complete, and PsycInfo using terms related to culture of innovation (eg, culture, climate, innovation, creativity).
PROSPERO registration number: CRD42020188943
Key Question #1: What are the effects of population and community-based prevention interventions on suicide attempts and suicide deaths?
Key Question #1a. What are the key/common components of the most effective interventions?
Key Question #1b: What strategies have been used to deliver, sustain, and improve the quality of the most effective interventions?
Key Question #1c: How do the effects vary by differences in community/setting and characteristics of individuals targeted?
Key Question #2: What are the potential unintended consequences of population and community-based prevention interventions?
Population(s): Veteran and non-Veteran populations of high school age or older
Interventions: Population and community-based interventions to prevent suicide
Excluding: (a) pharmacotherapy, (b) psychotherapy and therapeutic interventions that can be delivered only by licensed health care professionals, (c) legislation enacted to reduce suicide risk factors (eg, firearms, affordable housing, employment opportunities), and also excluding multi-component interventions that include (a) or (b) or (c) unless we can determine specific results of an eligible intervention alone or the add-on effects.
Comparator: Pre-intervention or concurrent comparative intervention or other control group
Outcome(s): Suicide attempts, suicide deaths, stigma, caregiver burden, healthcare utilization/help-seeking, switching suicide means, cost associated with developing and delivering the intervention
Exclude: only reports suicidal ideation
Setting: Community-based settings such as schools, workplace, prisons, and suicide hotspots in countries with very high Human Development Index
We will search MEDLINE, Embase, PsycINFO, Sociological Abstracts, and the Cochrane Database of Systematic Reviews.
KQ1:
a.) Among adults, what are the effects of tele-urgent care for low acuity conditions on key clinical and health systems outcomes (ie, patient satisfaction, health care access, health care utilization, case resolution, cost, patient safety)?
b.) Does the impact of tele-urgent care for low acuity conditions differ by
1.) provider characteristics (ie, specialty, amount of telehealth experience, training) or
2.)mode of delivery (ie, telephone, video, web, short message service [SMS])?
KQ2:
a.) Among adults, what are the adverse effects (ie, inappropriate treatment, misdiagnosis, or delayed diagnosis; provider burnout) of tele-urgent care for low acuity conditions?
b.) Do the adverse effects of low acuity conditions differ by
1.) provider characteristics (ie, specialty, amount of telehealth experience, training) or
2.) mode of delivery (ie, telephone, video, web, short message service [SMS])?
Population(s): KQ1 & KQ2: Adults with low acuity but urgent conditions (≥18 years of age) and their families and caregivers.
KQ2 ONLY: Tele-urgent care providers (if included in harms)
Interventions: Tele-urgent care for low acuity conditions is defined as remotely delivered (eg, telephone, video conferencing) medical services indented to provide on-demand, initial treatment of illnesses or injuries of a less serious nature than those constituting emergencies (ie, urgent care, not routine primary care) and is initiated by a patient with a provider
Comparator: KQ1: Usual care/standard of care, waitlist control, other active comparator (eg, in-person care
KQ 2: No comparator required
Outcome(s): KQ1: Patient, provider, system outcomes (eg, patient satisfaction, health care access, health care utilization, case resolution, cost, and patient safety)
KQ 2: Key adverse effects associated with telehealth (eg, inappropriate treatment, misdiagnosis, delayed diagnosis, increase in resource costs; provider burnout)
We will conduct a primary search from inception to the current date of MEDLINE® (via Ovid®), EMBASE (via Elsevier), CINAHL Complete (via EBSCO). 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 librarian. We will hand search previous systematic reviews conducted on this or a related topic for potential inclusion.
KQ1: What intervention strategies have been studied among adults who are homeless or at high risk of becoming homeless and who have serious mental illness (SMI) to promote engagement in primary care?
KQ2: What measures have been used to evaluate interventions among adults who are homeless or at high risk of becoming homeless and who have SMI to promote engagement in primary care?
Population(s): Ambulatory adults (18 years and older) who are currently homeless or at high risk of becoming homeless:
AND who have serious mental illness (SMI) as determined by meeting one of the following criteria:
Interventions: Interventions designed to promote structured interaction with a prescribing primary care clinician or with a clinical team member(s) that have a direct linkage to a prescribing primary care clinician AND:
OR,
OR,
Comparator: Any comparator (eg, usual care, active comparator) or no comparator
Outcome(s): Any
Setting: Any setting (eg, clinical, housing services, criminal justice system), OECD countries only
We will conduct a primary search from inception to the current date of MEDLINE® (via Ovid®), EMBASE (via Elsevier), and PsycINFO (via Ovid). 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 librarian. We will hand-search previous systematic reviews conducted on this or a related topic for potential inclusion.
KQ1: Within longitudinal studies with primary data collection, what are the risk and protective factors for suicidal behaviors (attempts or death by suicide) across socioecological levels of risk?
KQ2: Within the intervention studies identified for KQ1, how do risk and protective factors for suicidal behaviors (attempts or death by suicide) mediate effects of non-pharmacologic suicide prevention interventions across socioecological levels of risk?
Population(s): Veteran or military service members preferred (may potentially expand to general population of adults aged ≥18)
Interventions: For KQ2: Non-pharmacologic interventions to prevent suicide Excluding: pharmacotherapy interventions
Comparator: For KQ2: Pre-intervention or concurrent comparative intervention or other control group
Outcome(s): Suicide attempts, suicide deaths
We will search MEDLINE, Embase, PsycINFO, and Sociological Abstracts. We will include longitudinal prospective studies, cohort studies, and randomized controlled trials (RCTs) published 2011 – 2020 with primary data collection. We will exclude studies using data that were originally collected/generated for purposes other than to examine suicide risk (eg, administrative medical record data, general social surveys), systematic reviews, narrative reviews, case reports, editorials, commentary, conference abstracts, and non-English language publications.
PROSPERO registration number: CRD42020215229
KQ1: Among adults hospitalized with COVID-19 and discharged with physical functional impairment, what is the prevalence of short (eg, < 3 months) and long-term (eg, 4+ months) healthcare use?
Population(s): Adults hospitalized with diagnosis COVID-19 (ie, SARs-CoV-2)
Interventions: Diagnosis of COVID-19 (ie, SARs-CoV-2) as defined as laboratory-confirmed cases
Comparator: None
Outcome(s): Prevalence of short term and long term health care services (eg, skilled nursing facility, in-patient rehabilitation, occupational therapy, physical therapy, primary care, ER/urgent care, home health) and durable medical equipment use (eg, walkers) post-acute hospitalization
We conducted the search of our living review in MEDLINE (via Ovid) and Embase (via Elsevier) databases on September 2, 2020. We also reviewed posted evidence syntheses on the multiple online databases for recent and ongoing rapid reviews related to COVID-19. To identify emerging literature, we adapted our search strategy for preprint server collections from medRxiv.org. Searches were not limited by date or language.
