Abstracts by keywords: Parkinson's disease
Health services research has gained in importance over the last decade because it is becoming increasingly clear that the majority of scientifically based decisions in health care are based on data that have been carried out under the ideal conditions of an experimental study. These ideal conditions make it possible to demonstrate 'efficacy', which means that an expected effect was very likely brought about by the intervention suspected of causing this effect. Under these ideal conditions, however, it is not possible to test whether the effect proven as efficacy can also be induced under everyday conditions (effectiveness) if the naturally occurring confounding factors (confounders) such as comorbidity or therapies for concomitant diseases cannot be ruled out. The differences in the methods for proving efficacy and effectiveness have been described (Porzsolt et al. 2015). In order to be able to make reliable care decisions, however, information on effects that occur under everyday conditions is required. The Lancet addressed the significant problem of overuse that will be with us in the next decade (Berwick 2017; Brownlee et al. 2017). This problem can neither be quantified nor solved without depicting the reality of care (under everyday conditions).