Prioritization of patients access to outpatient augmentative and alternative communication services in Quebec: a decision tool
Notice bibliographique
Résumé
A large number of people living with a chronic disability wait a long time to access publicly funded rehabilitation services such as Augmentative and Alternative Communication (AAC) services, and there is no standardized tool to prioritize these patients. We aimed to develop a prioritization tool to improve the organization and access to the care for this population. In this sequential mixed methods study, we began with a qualitative phase in which we conducted semi-structured interviews with 14 stakeholders including patients, their caregivers, and AAC service providers in Quebec City, Canada to gather their ideas about prioritization criteria. Then, during a half-day consensus group meeting with stakeholders, using a consensus-seeking technique (i.e. Technique for Research of Information by Animation of a Group of Experts), we reached consensus on the most important prioritization criteria. These criteria informed the quantitative phase in which used an electronic questionnaire to collect stakeholders’ views regarding the relative weights for each of the selected criteria. We analyzed these data using a hybrid quantitative method called group based fuzzy analytical hierarchy process, to obtain the importance weights of the selected eight criteria. Analyses of the interviews revealed 48 criteria. Collectively, the stakeholders reached consensus on eight criteria, and through the electronic questionnaire they defined the selected criteria’s importance weights. The selected eight prioritization criteria and their importance weights are: person’s safety (weight: 0.274), risks development potential (weight: 0.144), psychological well-being (weight: 0.140), physical well-being (weight: 0.124), life prognosis (weight: 0.106), possible impact on social environment (weight: 0.085), interpersonal relationships (weight: 0.073), and responsibilities and social role (weight: 0.054). In this study, we co-developed a prioritization decision tool with the key stakeholders for prioritization of patients who are referred to AAC services in rehabilitation settings.IMPLICATIONS FOR REHABILIATIONStudies in Canada have shown that people in Canada with a need for rehabilitation services are not receiving publicly available services in a timely manner.There is no standardized tool for the prioritization of AAC patients.In this mixed methods study, we co-developed a prioritization tool with key stakeholders for prioritization of patients who are referred to AAC services in a rehabilitation center in Quebec, Canada. Studies in Canada have shown that people in Canada with a need for rehabilitation services are not receiving publicly available services in a timely manner. There is no standardized tool for the prioritization of AAC patients. In this mixed methods study, we co-developed a prioritization tool with key stakeholders for prioritization of patients who are referred to AAC services in a rehabilitation center in Quebec, Canada.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,014 | 0,026 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,005 | 0,004 |
| Études des sciences et des technologies | 0,004 | 0,001 |
| Communication savante | 0,004 | 0,001 |
| Science ouverte | 0,001 | 0,002 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,006 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».