No abstract available.
Multicenter Studies as Topic

Humans ; Multicenter Studies as Topic

Background: Antimicrobials are drugs that are often misused and inappropriate antimicrobial prescribing often results in poor clinical outcome and drug resistance. Monitoring and regulation of antimicrobial use is currently being done by the Department of Health through the Antimicrobial Stewardship (AMS) Program. There is a need to determine the factors that affect successful implementation of an AMS program in private hospitals in the Philippines. This study was conducted to identify the enablers and potential barriers in implementing an AMS program in nine (9) private hospitals. Methodology: A concurrent mixed methods design was used to assess various stakeholders’ (physicians, administrators, other AMS members) perceptions of existing or proposed AMS programs, and to identify barriers and enablers in their implementation. Quantitative data were collected using self-administered survey questionnaire to assess clinician’s acceptance of AMS programs. Qualitative data were collected through semi-structured one-on-one interviews of clinicians and other AMS personnel and focus group discussions (FGD) of selected clinician groups. Data were gathered from October 2018 to October 2019. Results: 409 clinicians were surveyed, 52 were interviewed and 46 sat for 13 sessions of FGDs. Overall, the survey established that physicians were well aware of antimicrobial resistance problem. Majority of the clinicians indicated general agreement with the currently practiced antimicrobial protocols in their hospitals and with the AMS program. However, there were disagreements in perceptions with how antimicrobial restrictions impair prescribing practices and overuse of the same. These responses were strong points of discussion during the Key Informant Interviews (KII) and FGDs. All respondents were amenable with the institutionalization of an AMS program in their hospitals. The hospital leadership’s commitment was determined to be the key enabler of a successful AMS program’s implementation. Barriers identified for hospitals with existing AMS programs were: lack of dedicated staff, resistance and/or non-cooperation of physicians, lack of support from non-medical departments, and inadequate cooperation between hospital personnel. Barriers identified, regardless of the status of the AMS programs were: deficiency in knowledge with developing and implementing an AMS program, inadequate information dissemination, unavailability of an IT-based monitoring for antibiotic use, and the influence of pharmaceutical companies on stakeholders with regards to antimicrobial use. Conclusion Similar enablers and barriers to a successful implementation of an AMS program were seen in the different hospitals. A hospital leadership’s commitment was determined to be the key enabler. The success or failure of any AMS program appears to depend on physician understanding, commitment and support for such a program. By involving the main players in an AMS program- the hospital administrators, clinicians and other key members, perceived barriers will be better identified and overcome, and enablers will help allow a successful implementation of an AMS program. This multi-center study was funded by Philippine Council on Health Research and Development ( PCHRD) and Pediatric Infectious Disease Society of the Philippines ( PIDSP) and was conducted by the PIDSP Research Committee.
Physicians ; Multicenter Studies as Topic

No abstract available.
Acne Vulgaris* ; Female* ; Humans ; Multicenter Studies as Topic*

Recently, multicenter clinical trials have been getting more popular inside and outside of the country. The disease pattern of our country is somewhat different from that of western countries in terms of its incidence, clinical feature. Therefore, the results of clinical studies in US or European countries cannot be properly applied without consideration of trial design features and intertrial comparisons. Therefore, the conduct of multicenter trial with our own population is necessary. Well organized multicenter trials having competitive power will make it possible to develop new treatment modalities, frame a reasonable policies for its clinical applications and ultimately contribute to improve national healthcare services.
Delivery of Health Care ; Incidence ; Multicenter Studies as Topic

Recently, multicenter clinical trials have been getting more popular inside and outside of the country. The disease pattern of our country is somewhat different from that of western countries in terms of its incidence, clinical feature. Therefore, the results of clinical studies in US or European countries cannot be properly applied without consideration of trial design features and intertrial comparisons. Therefore, the conduct of multicenter trial with our own population is necessary. Well organized multicenter trials having competitive power will make it possible to develop new treatment modalities, frame a reasonable policies for its clinical applications and ultimately contribute to improve national healthcare services.
Delivery of Health Care ; Incidence ; Multicenter Studies as Topic

Biomedical Research ; Humans ; Multicenter Studies as Topic ; Vestibular Diseases ; diagnosis ; therapy

Biomedical Research ; Child ; Humans ; Multicenter Studies as Topic ; Pediatrics

Carcinoma, Non-Small-Cell Lung ; therapy ; Humans ; Lung Neoplasms ; therapy ; Multicenter Studies as Topic ; Retrospective Studies

This review focuses on the use of contrast-enhanced ultrasonography (CEUS) with SonoVue (Bracco Imaging) for the diagnosis of focal liver lesions (FLLs), guidance during ablative treatment, and follow-up of liver tumors. Multicenter trials have shown that the performance of CEUS for the characterization of FLLs is similar to that of contrast-enhanced computed tomography or contrast-enhanced magnetic resonance imaging. CEUS with SonoVue has been effectively used for guiding the percutaneous treatment of malignant liver tumors that are invisible or poorly visualized in traditional gray-scale ultrasonography. Postprocedural CEUS may be used to detect and retreat residual viable tissue in the same ablative session. The use of CEUS for the assessment of diffuse liver disease is also discussed.
Carcinoma, Hepatocellular ; Diagnosis ; Follow-Up Studies ; Liver Diseases ; Liver* ; Magnetic Resonance Imaging ; Multicenter Studies as Topic ; Ultrasonography*