
Marjukka MäkeläFinnish Institute for Health and Welfare | THL · Service System Department
Marjukka Mäkelä
Professor, MD, PhD M.Sc.
About
208
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Introduction
Additional affiliations
January 2005 - present
April 2003 - present
January 1992 - present
Education
June 1994
September 1990
Publications
Publications (208)
Linkki kokotekstiin: https://palveluvalikoima.fi/documents/1237350/71003213/Kirjallisuuskatsaus+%28Summaryx%29.pdf/9d044d76-cd37-5132-3819-2ac11a529997/Kirjallisuuskatsaus+%28Summaryx%29.pdf?t=1618576891300
Palveluvalikoimaneuvoston toimeksiannosta laadittu systemaattinen katsaus sekä siihen kuuluvat liitteet ja neuvoston suositus perustelumuistioineen ovat saatavissa osoitteesta https://palveluvalikoima.fi/psykoterapiat-ja-muut-psykososiaaliset-hoito-ja-kuntoutusmenetelmat-mielenterveys-ja-paihdehairioiden-hoidossa
Background
Acute rhinosinusitis is an acute infection of the nasal passages and paranasal sinuses that lasts less than four weeks. Diagnosis of acute rhinosinusitis is generally based on clinical signs and symptoms in ambulatory care settings. Technical investigations are not routinely performed, nor are they recommended in most countries. Some tr...
Background:
Inappropriate prescription of antibiotics is the leading driver of antimicrobial resistance (AMR). The majority of antibiotics are prescribed in primary care. Understanding how general practitioners (GPs) use diagnostic tests and the effect on treatment decision under daily practice conditions is important to reduce inappropriate presc...
Background:
Dental sealants were introduced in the 1960s to help prevent dental caries, mainly in the pits and fissures of occlusal tooth surfaces. Sealants act to prevent bacteria growth that can lead to dental decay. Evidence suggests that fissure sealants are effective in preventing caries in children and adolescents compared to no sealants. Ef...
TULES-kivun varhaisen moniammatillisen kuntoutuksen vaikutus työkykyyn Järjestelmällinen kirjallisuuskatsaus Finohtan arviointiseloste 2/2016
Urine culture samples comprise a large proportion of the workload in clinical microbiology laboratories, and most of the urine samples show no growth or insignificant growth. A flow cytometry-based analyzer (Sysmex Corporation, Japan) has been used to screen out negative urine samples prior to culture in the Päijät-Häme district. We applied decisio...
Objectives
To describe and compare antibiotic prescribing patterns for primary care patients with respiratory tract infections (RTIs) in four South American countries.
Methods
This was a prospective observational study. General practitioners (GPs) from Argentina, Bolivia, Paraguay and Uruguay registered data about all consultations of patients wit...
PALKOn tuki- ja liikuntaelinsairauksien jaoston selvityspyyntö 24.2.2016
This review aims to clarify which instruments measuring at-risk and problem gambling (ARPG) among youth are reliable and valid in light of reported estimates of internal consistency, classification accuracy, and psychometric properties. A systematic search was conducted in PubMed, Medline, and PsycInfo covering the years 2009–2015. In total, 50 ori...
STM:n mielenterveys- ja päihdehuoltolakien uudistamisen arviomuistiota valmisteleva työryhmän selvityspyyntö 2.6.2015
Background:
Ensuring patient involvement in health technology assessments (HTAs) and clinical practice guidelines (CPGs) is important. However, the goals and methods of such involvement are not always clear.
Objectives:
The aim of this study was to 1) discover ways to involve patients in HTA and CPG processes, 2) describe challenges, and 3) find...
Background:
Sinusitis is one of the most common diagnoses among adults in ambulatory care, accounting for 15% to 21% of all adult outpatient antibiotic prescriptions. However, the role of antibiotics for sinusitis is controversial.
Objectives:
To assess the effects of antibiotics in adults with acute maxillary sinusitis by comparing antibiotics...
Variation in prescription of antibiotics in primary care can indicate poor clinical practice that contributes to the increase of resistant strains. General Practitioners (GPs), as a professional group, are expected to have a fairly homogeneous prescribing style. In this paper, we describe variation in prescribing style within and across groups of G...
In Denmark the general practice research units operating in connection with universities provide a home base, training and methodology support for researchers in the field from medical students to general practitioners carrying out practical work. Research issues frequently require a multidisciplinary approach and use of different kinds of material...
Researchers within our largest specialty, general practice, are above all interested in the contents and quality of their own work, organizing the work and treatment practices. Clinical research is conducted to a limited extent only. Primary health care is being studied in the universities and research institutes in a multidisciplinary manner, but...
Computer-based decision support systems are a promising method for incorporating research evidence into clinical practice. However, evidence is still scant on how such information technology solutions work in primary healthcare when support is provided across many health problems. In Finland, we designed a trial where a set of evidence-based, patie...
This paper (1) presents the protocol of an on-going systematic literature review on the methods of structuring electronic health record (EHR) data and studying the impacts of implemented structures, thus laying basis for the analysis of the empirical articles (2) describes previous reviews published on the subject and retrieved during the search of...
Guidelines for reporting economic evaluations in health care are very welcome. A task force of the International Society for Pharmacoeconomics and Outcomes Research has organized a two-round, modified Delphi Panel process to compile a set of recommendations for reporting Consolidated Health Economic Evaluation Reporting Standards. The result is a 2...
Background:
Dental sealants were introduced in the 1960s to help prevent dental caries in the pits and fissures of mainly the occlusal tooth surfaces. Sealants act to prevent the growth of bacteria that can lead to dental decay. There is evidence to suggest that fissure sealants are effective in preventing caries in children and adolescents when c...
Background
Health information technology, particularly electronic decision support systems, can reduce the existing gap between evidence-based knowledge and health care practice but professionals have to accept and use this information. Evidence is scant on which features influence the use of computer-based clinical decision support (eCDS) in prima...
Virtual health check results within the physician’s appointment schedule.
Patient specific drug interaction alert function on the electronic patient record screen.
Computer-based Clinical Decision Support: An overview of the Evidence-Based Medicine electronic Decision Support (EBMeDS) architecture and decision support rules (= scripts).
We describe the process of putting into practice a computer-based clinical decision support (eCDS) service integrated in the electronic patient record, and the actual use of eCDS after one year in a primary care organization with 48 health care professionals. Multiple methods were used to support the implementation. The actual use was measured by m...
This issue of the International Journal of Technology Assessment in Health Care (IJTAHC) brings to the readers a lively discussion on the possibility of benchmarking health technology assessment (HTA) organizations. Michael Drummond and colleagues present a paper discussing “the conceptual and methodological challenges associated with benchmarking”...
The 27th year of the International Journal of Technology Assessment in Health Care (IJTAHC) introduced major changes in editorial work. Submission processes were modernized by introducing Web-based submission at http://mc.manuscriptcentral.com/thc in September 2010. The change has been a learning process to staff, authors, and reviewers alike. Duri...
Vuonna 2009 julkaistussa HALO-katsauksessa ei voitu luotettavasti arvioida, parantaako synnytyksenaikainen sikiövalvonta STAN-laitteella synnytysturvallisuutta. Tässä HALO-katsauksen päivityksessä arvioidaan STAN-seurannan vaikuttavuus ja turvallisuus merkittävien uusien tutkimustietojen perusteella. Meta-analyysien perusteella STAN-laitteella seur...
The aim of this study was to describe the process and challenges of developing a decision aid for the national public breast cancer screening program in Finland.
An expert team with stakeholder representation used European guidelines and other literature as basis for selecting relevant content and format for the decision aid for breast cancer scree...
Scientific reports should be orderly, clear, and unambiguous. Clarity is even more important for health technology assessments (HTAs), which aim at supplying reliable and up-to-date evidence on the effectiveness, safety, and cost of healthcare interventions. Increasingly assessments also provide information about the effects of technologies on orga...
During the 26th year of the International Journal of Technology Assessment in Health Care (IJTAHC), 154 original manuscripts were evaluated. Of these, 70 percent were from Europe and 14 percent from North America, as judged by the address of the first author. At the end of September 2010, sixty-four papers (42 percent of submissions) had been accep...
7st Annual Meeting of the Health Technology Assessment International (HTAi). Dublin 6.–9.6.2010. Book of abstracts 2010: 97.
Scientific journals bring researchers' findings to their colleagues and other audiences, mediate advances in methodology, and facilitate understanding by dialogue. Differences of opinion can be talked through and mistakes clarified. In some fields, these debates take place rapidly, on the net or in weekly publications. Quarterly journals, such as t...
Background:
Most of the detected increment in dental caries among children and adolescents is confined to occlusal surfaces of posterior permanent molars. Dental sealants and fluoride varnishes are much used preventive options for caries. Although the effectiveness of sealants and fluoride varnishes for controlling caries as compared with no inter...
Welcome to the 26th volume of the International Journal of Technology Assessment in Health Care ( IJTAHC ). The editorial office has moved from the Institute of Health Economics in Alberta, Canada, to the National Institute for Health and Welfare (THL) in Finland and its Finnish Office for Health Technology Assessment (FINOHTA). It is exciting and...
Bacterial skin infections are common, and range from mild to serious, even life-threatening infections. This guideline presents treatment options for erysipelas, cellulitis, impetigo, ecthyma, folliculitis, abscess, paronychia (nail infection) and early borreliosis as well as for erysipeloid, mycobacterial skin infections and tularemia. Recommended...
The aim of this study was to develop and test a generic framework to enable international collaboration for producing and sharing results of health technology assessments (HTAs).
Ten international teams constructed the HTA Core Model, dividing information contained in a comprehensive HTA into standardized pieces, the assessment elements. Each eleme...
The aim of this study was to analyze and describe process and outcomes of two pilot assessments based on the HTA Core Model, discuss the applicability of the model, and explore areas of development.
Data were gathered from HTA Core Model and pilot Core HTA documents, their validation feedback, questionnaires to investigators, meeting minutes, email...
The European network on Health Technology Assessment (EUnetHTA) aimed to produce tangible and practical results to be used in the various phases of health technology assessment and to establish a framework and processes to support this. This article presents the background, objectives, and organization of EUnetHTA, which involved a total of sixty-f...
To describe the adoption of the national Hypertension Guideline in primary care and to evaluate the consistency of the views of the health centre senior executives on the guideline's impact on clinical practices in the treatment of hypertension in their health centres.
A cross-sectional telephone survey.
All municipal health centres in Finland.
Hea...
Implementation of clinical practice guidelines has been proposed to improve quality in health care. Multifaceted implementation did not increase guideline acceptance. GPs' self-reports may overestimate performance. Objective - To assess the impact of a multifaceted implementation strategy aiming to improve GP adherence to a clinical guideline on de...
Since the 1990s, health policy makers in Finland have been supportive of evidence-based medicine and approaches to implement its results. The Finnish Office for Health Technology Assessment (Finohta) has grown from a small start in 1995 to a medium-sized health technology assessment (HTA) agency, with special responsibility in providing assessments...
Women who are invited for breast cancer screening should get enough information about the benefits and harms of screening to make an informed decision on participation. Personal invitations are an important source of information, because all invited women receive them. The objective of this study was to evaluate the information breast cancer screen...
To update the evidence of the efficacy and safety of the Essure system. Female sterilization has undergone changes in the last decade. Besides laparoscopic tubal occlusion, the Essure system is now a viable option, with about 200,000 women sterilized using this method.
The review is based on the report of the Alberta Heritage Foundation for Medical...
BMC Pediatrics 2008; 8 (14). http://www.biomedcentral.com/1471-2431/8/14.
Health technology assessment (HTA) is the multidisciplinary study of the implications of the development, diffusion and use of health technologies. It supports health-policy decisions by providing a joint knowledge base for decision-makers. To increase its policy relevance, HTA tries to extend beyond effectiveness and costs to also considering the...
Health technology assessment (HTA) is the multidisciplinary study of the implications of the development, diffusion and use of health technologies. It supports health-policy decisions by providing a joint knowledge base for decision-makers. To increase its policy relevance, HTA tries to extend beyond effectiveness and costs to also considering the...
We conducted a criteria-based appraisal of systematic reviews on the effectiveness of physiotherapy and conductive education interventions in children with cerebral palsy (CP). Computerized bibliographic databases were searched without language restriction up to August 2007. Reviews on trials and descriptive studies were included. Two reviewers ind...
Evidence-based guidelines on hypertension have been developed in many western countries. Yet, there is little evidence of their impact on the clinical practices of primary care nurses.
We assessed the style of implementation and adoption of the national Hypertension Guideline (HT Guideline) in 32 Finnish health centres classified in a previous stud...
Search strategy for Ovid Medline.
Methodological quality of the trials. The four items in italics were considered to constitute "high quality".
Patient and intervention characteristics.
Detailed intervention descriptions.
Data extraction form.
Articles excluded after reviewing full text and reasons for exclusion.
Effectiveness of physical therapy interventions by the ICF components. Outcomes with moderate evidence are in bold.
Quality assessment criteria list and decision rules (adapted and modified from van Tulder et al[33])
Full details of the baseline values and changes on all measured outcomes of each trial.
Background:
Although pit and fissure sealants are effective in preventing caries, their efficacy may be related to the caries prevalence in the population.
Objectives:
The primary objective of this review was to evaluate the caries prevention of pit and fissure sealants in children and adolescents.
Search strategy:
We searched the Cochrane Ora...
To assess the effectiveness of physical therapy (PT) interventions on functioning in children with cerebral palsy (CP).
A search was made in Medline, Cinahl, PEDro and the Cochrane library for the period 1990 to February 2007. Only randomized controlled trials (RCTs) on PT interventions in children with diagnosed CP were included. Two reviewers ind...
Expert opinions vary on the appropriate role of antibiotics for sinusitis, one of the most commonly diagnosed conditions among adults in ambulatory care.
We examined whether antibiotics are effective in treating acute sinusitis, and if so, which antibiotic classes are the most effective.
We searched the Cochrane Central Register of Controlled Trial...