Since the last update, several new studies of the passive dissemination of PEMs have been published, but no other review on the effectiveness of this strategy to improve any professional behaviour has, to our knowledge, been done. Several reviews have studied the passive dissemination of PEMs alongside other types of quality improvement strategies to improve specific behaviours, such as antibiotic prescribing (Arnold 2005), use of imaging (French 2010), management of diabetes (de Belvis 2009; Seitz 2011), or psychiatric care (Weinmann 2007). However, these reviews included few studies that compared the passive dissemination of PEMs to no intervention, limiting conclusions on their effectiveness.
Because we cannot ascribe CIs to the observed effect sizes, we cannot rule out the possibility that these effects might have occurred by chance alone. Clinical significance of the observed effect sizes is unknown, but they fall below the range of effects of other quality improvement systematic reviews that reported median effect sizes ranging from 0.04 to 0.09 for categorical professional outcomes and from 10% to 16% for continuous outcomes (Flodgren 2011; Forsetlund 2009; Jamtvedt 2006; O'Brien 2007; Shojania 2010). Clinical significance of the observed 13% improvement in continuous outcomes may be easier to judge if, for instance, we consider the results of Denig 1990: an 11% improvement corresponded in this case to a change from 27 defined daily doses (DDDs) of undesirable antispasmodic per 1000 prescriptions before the PEM delivery to 26 DDDs/1000 prescriptions after the PEM delivery.
office professional hybrid 2007 isosorbide
Thiol- ene free-radical and vinyl ether cationic hybrid photopolymerization, Macromolecules - 2007Collaborators: Huanyu Wei, Author; Qin Li, Author; Moriam Ojelade, Author; Joshua Otaigbe, Author; Charles Hoyle, Author
Unusual accelerated molecular relaxations of a tin fluorophosphate glass/polyamide 6 hybrid studied by broadband dielectric spectroscopy, Polymer - 2007Collaborators: Kevin Urman, Author; Joshua Otaigbe, Author 2ff7e9595c
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