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Process level: Feasibility and usability of the CDM tool reported in studies.
For example, if the CDM tool targets improving glycaemic control as part of diabetes care, we would consider glycosylated haemoglobin or haemoglobin A1c level as the primary outcome of interest or any reported composite outcome such as a CDM score.
Analysis will include descriptive summaries of study and appraisal characteristics, effectiveness of each CDM tool (meta-analysis if appropriate); and a realist programme theory will be developed and refined to explain the outcome patterns within the included studies.
Once reviewers attain at least 90% raw agreement, two reviewers will independently abstract data on study characteristics, population, setting, CDM tool and its components, outcomes, follow-up, analysis methods, findings and study quality.
For example, if one of the systematic review findings was the reduction in HbA1c levels in seniors who completed a 6-month diabetes self-management CDM tool, we will seek explanations of what has caused this outcome to occur (ie, the mechanism(s)) and the contexts in which this happened.
We will use content analysis to do this: two investigators will review the description of each CDM tool, and independently document its components, by whom and to which target it was delivered (eg, nurse delivers education to patients), at what frequency (eg, twice a week) and duration (eg, 6 months) this was done, and where or in what context (eg, primary care clinic).
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23 We developed our eligibility criteria from our research questions: (1) What is the effectiveness of chronic disease management (CDM) tools addressing one or more high-burden chronic diseases affecting people aged≥ 65 years?
Chronic disease management (CDM) tools have the potential to meet this challenge but they are primarily focused on a single disease, which fails to address the growing number of seniors with multiple chronic conditions.
12 13 Chronic disease management (CDM) tools (ie, tools that facilitate ongoing, proactive and preventative support for optimal disease management) are potential strategies to meet this challenge, but they are not usually developed for seniors with multiple chronic diseases or created for sustained use.
FP: Family physician; FFS: Fee-for-service; CHC: Community health centre; HSO Healthh services organization; FHN: Family health network; COMP-PC: Comparison of models project; FTE: Full time equivalent; PCAT: Primary care assessment tool; CDM: Chronic disease management.
The practically important problem of rotorcraft nose cowling is attempted using Continuum Damage Mechanics (CDM) model as a design tool for the prediction of damaged behavior under service conditions.
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