The objective of this paper is to describe the development of an analytic process to organize and synthesize data from a realist review.
Methods: Clinical practice guidelines have had an inconsistent and modest impact on clinical practice, which may in part be due to limitations in their design. This study illustrates the development of a transparent method for organizing and analyzing a complex data set informed by a Realist Review on guideline
implementability to better understand the characteristics of guidelines that affect their uptake in practice (e.g., clarity, format). The data organization method consisted of 4 levels of refinement: 1) extraction and 2) organization of data; 3) creation of a conceptual map of guideline implementability; and 4) the development of a codebook of definitions.
Results: SCH772984 research buy This new method is comprised of four steps: data extraction, data organization, development of a conceptual map, and operationalization vis-a-vis a codebook. Applying this method, we extracted 1736
guideline attributes from 278 articles into a consensus-based set of categories, and collapsed them into 5 core conceptual domains for our selleckchem guideline implementability map: Language, Format, Rigor of development, Feasibility, Decision-making.
Conclusions: This study advances analysis methods by offering a systematic approach to analyzing complex data sets where the goals are to condense, organize and identify relationships.”
“Objective-To estimate the relative risk of paratuberculosis (Johne’s disease [JD]) in calves fed a plasma-derived colostrum-replacement (CR) product versus raw bovine maternal colostrum Mdivi1 (MC).
Study Design-Randomized controlled clinical trial.
Animals-497 heifer calves born in 12 JD-endemic commercial Holstein dairy farms located in Minnesota and Wisconsin.
Procedures-Every calf was separated from its dam
within 30 to 60 minutes after birth and systematically assigned to be fed raw bovine MC (control group, n = 261 calves) or CR (treatment group, 236 calves). The calves were monitored to adulthood and tested for Mycobacterium avium subsp paratuberculosis (MAP) infection by use of an ELISA to detect serum antibodies against MAP and bacterial culture for MAP in feces at approximately 30, 42, and 54 months of age. Weibull regression models were used to evaluate the effect of feeding CR (vs raw bovine MC) on the risk of developing JD infection.
Results-Calves fed CR at birth were less likely (hazard ratio = 0.559) to become infected with MAP (as determined by use of an ELISA, bacterial culture, or both diagnostic tests), compared with the likelihood for calves fed MC at birth.
Conclusions and Clinical Relevance-This study revealed that feeding CB reduced the risk of developing MAP infection in Holstein calves born in JD-endemic herds, which implied that feeding raw bovine MC may be a source of MAP for calves.