Table 1 Description of articles

Ackermann, 2012 [46]

Commentary

To challenge the use of mere clinical practice guidelines to inform quality measurement and performance assessment in primary care

Australia

Primary

System, clinical

Not specified

GP patients

Anstey et al., 2015 [51]

Cross-sectional study using surveys

To determine the extent and characteristics of perceived inappropriate treatment among ICU doctors and nurses

USA

Inpatient

Clinical

ICU care

ICU patients

Barber et al., 2015 [52]

Mixed method, qualitative, review

To develop key performance indicators to evaluate centralized intake systems for patients with osteoarthritis and rheumatoid arthritis

Canada

Various

System

Various

Patients with osteoarthritis and rheumatoid arthritis

Bateson, 2013 [39]

Review

To evaluate the potential role of GPs to reduce unnecessary female genital surgery, while also providing culturally sensitive care

Australia

Primary

Clinical

Procedure counseling and referral

Women who have had or are requesting genital cutting

Bonvicini et al., 2014 [30]

Observational, population-based study

To compare Caesarian section (CS) and ultrasound scan utilization in a public vs. private model of care and the association of use with perinatal outcomes

Italy

Specialized, inpatient, integrated

Clinical

Use of ultrasound and frequency of CS during prenatal care and delivery

Women giving birth in Reggio Emilia Province

Bradford et al., 2015 [53]

Qualitative methods and consensus process

To customize the existing IT-enabled cardiac rehabilitation program delivered by mobile phone through a smartphone app to make it culturally relevant and suitable for Indigenous Australians living in urban and remote communities

Australia

Rehabilitation, Remote care

Patient

Remote cardiac rehabilitation

Indigenous Australians

Breivik et al., 2013 [40]

Review

To make a case for prioritizing chronic pain management in Europe, outline strategies to overcome barriers to effective pain care, and address the confusion of proper uses of opioid medications

Europe

Primary, specialized, inpatient, integrated, other

System

Chronic pain management therapies

European adults with chronic pain

Brien et al., 2014 [41]

Review

To conduct a scoping review to map Canadian research and related activity on system-level appropriateness of care

Canada

Not specified

System

Not specified

Patients in Quebec

Brindis et al., 2011 [42]

Review

To evaluate how Maryland hospitals dealt with issues of inappropriate use of cardiac procedures through new policy initiatives

USA

Inpatient

System

Percutaneous coronary intervention (PCI) and stenting

Patients that have received or may prospectively need PCI

Broekhuis et al., 2014 [54]

Cross-sectional study using surveys

To study the appropriateness of walk-in clinic visits in Quebec, Canada

Canada

Walk-in clinics

Clinical; patient

General

Not specified

Brooks et al., 2013 [73]

Qualitative, mixed methods

To provide a model for adapting remote monitoring to specific populations who are undergoing care for post-traumatic stress disorder (PTSD)

USA

Telehealth

Clinical; patient

Telehealth monitoring for PTSD

American Indian Veterans with PTSD

Chen, 2011 [43]

Review

To evaluate the medical, functional, and quality of life costs of Parkinson's Disease and to discuss treatments that help manage better outcomes

USA

Primary, specialized, integrated, other

System; clinical

Parkinson's disease management therapies

Adults with Parkinson's disease

D’Alleyrand & O’Toole, 2013 [44]

Review

To evaluate the treatment trends in the literature on appropriate timing of (femoral) fractures in polytrauma patients following an injury and discuss the new concept of Early Appropriate Care

USA

Inpatient

Clinical

Fixation surgery for femoral fractures

Polytrauma patients with femoral fractures

Fanari et al., 2015 [76]

Case studies

To highlight how quality measures that aim to decrease Door-to-Balloon-Time (the time from suspected myocardial infarction presentation to primary coronary intervention) may result in poor outcomes due to rushed triage decisions

USA

Inpatient

Clinical

Procedures in the coronary catheterization lab

Patients with suspected myocardial infarction

Fuchs, 2011 [47]

Commentary

To discuss how doctors can be incentivized to provide appropriate care utilization given the dilemma of fulfilling the commitment to the primacy of patient welfare and providing cost-effective care

USA

Not specified

System; clinical

Not specified

Not specified

Hosaka et al., 2011 [31]

Retrospective data analysis

To evaluate the association between the number of blood cultures collected and the appropriateness of care for suspected bacteremic community-acquired urinary tract infection (UTI) in the elderly

Japan

Inpatient

Clinical

Blood cultures collection and UTI treatment

Elderly patients with suspected UTI

Hubbard & Jatoi, 2012

Commentary

To discuss why adjunctive chemotherapy is less used in the elderly than in younger populations

USA

Specialized

Clinical

Adjunctive chemotherapy for colon cancer

Older (vs. younger) colon cancer patients

Kazandijian & Lipitz-Snyderman, 2011 [55]

Review

To discuss the usefulness of health care information technology in assisting care providers to minimize uncertainty while simultaneously increasing efficiency of the care provided

USA

Inpatient

System; clinical

Not specified/ general

Inpatient

King et al., 2013 [32]

Pre-post test

To institute and assess the impact of a process improvement project for blood utilization to ensure appropriateness in transfusion practice

USA

Inpatient

Clinical

Blood transfusions and red blood cell unit usage

Anemic patients, patients that may need transfusions

Korst et al., 2015 [56]

Cross-sectional survey

To examine the extent to which hospitals could be classified by increasingly sophisticated maternal levels of care

USA

Inpatient

Clinical

Perinatal care

Women giving birth in California hospitals

Korst et al., 2015 [57]

Conceptual framework and quantitative survey

To describe the resources and activities associated with childbirth services

USA

Inpatient

Clinical

Perinatal care

Women giving birth in California hospitals

Liang et al., 2012 [33]

Longitudinal study

To examine the racial/ ethnic differences in prostate-specific antigen (PSA) testing and follow-up in primary care practices serving an indigent population

USA

Primary

System; clinical

PSA testing and follow-up

Indigent men in South Texas

Lin & Harris, 2015 [58]

Commentary

To address the issues of variation in interpretation when applying appropriate use criteria in cardiology diagnostic imaging

USA

Not specified

System; clinical

Cardiology diagnostic imaging

Cardiology patients

Lippi & Favaloro, 2011 [49]

Commentary

To identify problems associated with diagnosing bleeding disorders and suggest possible solutions

Italy, Australia

Primary, specialized, integrated, other

Clinical

Diagnosis of bleeding disorders

Patients with hemophilia

Martin, 2012 [59]

Qualitative study using in-depth interviews

To explore older Iranian immigrants' perceptions/ experiences of discrimination in their encounter with the American health care system

USA

Not specified

Patient

Not specified/ general

Iranian immigrant patients that immigrated after age 50, All had health insurance

Mancuso et al., 2016 [71]

Quantitative

To investigate the relationship between care appropriateness and productivity evolution in public hospital services in 20 Italian region systems for the period 2008-2012

Italy

Inpatient

System

Not specified

Not specified

Mataoui & Sheldon, 2016 [60]

Commentary

To call attention to the importance of oncology nurses to develop a deeper understanding of the cultural practices and health beliefs of Muslim patients when providing cancer care

USA

Not specified

Patient

Oncology/ cancer care

Muslim cancer patients

Matthie, 2015 [78]

Literature review and case studies

To highlight prominent issues of pain treatment for sickle cell disease (SCD) and make recommendations to hospital nursing staff on how to improve care for adults with SCD

USA

Inpatient

Clinical; patient

Sickle cell disease pain treatment

Patients with presenting with sickle cell disease related pain episodes

McCormick, 2014 [61]

Commentary

To call attention to the importance of culturally sensitive care and identify tips for cultural sensitivity

USA

Not specified

Patient

Not specified/ general

Culturally diverse, older patients

McFadden et al. 2013 [62]

Qualitative study using interviews

To explore the extent to which cultural context makes a difference to experiences of breast-feeding support for women of Bangladeshi origin and to consider the implications for the provision of culturally appropriate care

England

Inpatient, community/ home-based care

Patient

Maternity care and breast feeding support

Breast feeding women of Bangladeshi origin

Mitchell et al., 2016 [79]

Quantitative

To evaluate the diagnostic outcomes and therapeutic decisions made after a repeat pancreatic cancer testing using endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) for patients that have undergone a prior testing with inconclusive results

Canada

Inpatient

Clinical

Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA)

Patients undergoing EUS-FNA after initial testing for pancreatic cancer was inconclusive

Mochizuki, 2012 [63]

Review

To describe current cultural issues in Japanese health care services that have resulted from increased immigration

Japan

Not specified

System; patient

Not specified

Foreigners, ethnically, culturally diverse patients

Morgan et al., 2015 [64]

Retrospective database cross-sectional analysis

To establish the prevalence and nature of pathology test-ordering of GP trainees, and to describe the associations of this test-ordering (in the context of increasing over-testing and implications for patient safety)

Australia

Primary (urban and rural settings)

Clinical

Not specified/ general

Not specified

Nahm et al., 2011 [34]

Retrospective database cross-sectional analysis

To examine the effects of timing of fixation and investigate risk factors for complications

USA

Inpatient

Clinical

Femur fracture stabilization in patients with multiple injuries

Patients with femoral fractures

Newbrander et al., 2014 [65]

Qualitative study

To explore traditional practices of women, families, and communities related to maternal and newborn care, and sociocultural and health system issues that create access barriers

Afghanistan

Home versus health care facilities

System; patient

Perinatal, antenatal, and newborn care

Women giving birth or have recently given birth, newborns

Panella et al., 2012 [35]

Multi-center cluster-randomized trial

To evaluate whether Clinical Pathways improve the outcomes and the quality of care provided to patients after acute ischemic stroke

Italy

Inpatient

Clinical

Post-acute ischemic stroke care

Patients that have just had an acute ischemic stroke

Pape et al., 2016 [80]

Commentary

To critique the parameters of the Early Appropriate Care protocol for determining whether patients are cleared for stabilization surgery

Germany

Inpatient

Clinical

Surgical stabilization of fractures

Trauma patients with fractures

Paprica et al., 2015 [66]

Literature review, consensus process

To explore whether the direct involvement of policy stakeholders could advance appropriateness and disinvestment

Canada

Not specified

System

Not specified

Patients in Canada

Piers et al., 2011 [5]

Cross-sectional survey

To determine the prevalence of perceived inappropriateness of care among intensive care unit (ICU) clinicians

Europe, Israel

Inpatient

Clinical

ICU services

ICU patients

Pittet et al., 2015 [87]

Quantitative questionnaire of a simulated case and qualitative methods using focus groups

To explore how treatment decisions of practicing gastroenterologists differ from those of experts, using a vignette case study and a focus group

Switzerland

Specialized

Clinical

Gastroenterology; treatment of Crohn's disease and ulcerative colitis

Hypothetical Crohn's disease and ulcerative colitis patients

Poulos et al., 2011 [36]

Cohort study

To report utilization review data on inpatients in acute care with stroke, hip fracture or elective joint replacement, and other inpatients referred for rehabilitation

Australia

Inpatient, integrated, other

Clinical

Readiness of transfer to rehabilitation

Inpatients in acute care with stroke, hip fracture or elective joint replacement

Reich et al., 2016 [81]

Cohort study

To evaluate whether Early Appropriate Care protocol for stabilizing fractures in patients with advanced age require unique parameters to mitigate complications

USA

Inpatient

Clinical

Surgical stabilization of fractures

Skeletally mature trauma patients with unstable fractures

Russo et al., 2016

Quantitative survey

To investigate the interplay between perceptions of individual employees regarding HR practices and the variability of such perceptions within the department and their effects on appropriateness of care

Italy

Inpatient

Clinical

Not specified

Not specified

Sandela et al., 2012

Cross-sectional analysis of simulated case

To investigate the appropriateness and cost of care and quantify their relationship to performance based on a simulated case

USA

Primary

Clinical

Simulated case of a 45-year-old man complaining of right-sided localized chest pain

Simulated case

Schneider, 2014 [83]

Case studies

To illustrate the importance of early digestive tract assessment impact on the outcomes of liver transplantation after acetaminophen poisoning

UK

Inpatient

Clinical

Emergency liver transplantation after acetaminophen poisoning

Patients needing liver transplants who suffer acetaminophen poisoning

Schoormans et al., 2013 [50]

Commentary

To discuss care provision problems of congenital heart disease (CHD) patients lost to follow-up, those receiving too little care, and those receiving too much care, and offers appropriate and cost-effective health care delivery targets

Netherlands

Primary, specialized, inpatient, integrated, other

System; patient

CHD long-term treatment and management

Adults with CHD

Sharpe & Uchendu, 2014 [45]

Review

To address the issues of discrimination and inadequate health care provision for LGBT veterans through new policies that align with the Veteran’s Health Administration's Strategic Plan 2013-2018

USA

Not specified

System; patient

Not specified

LGBT Veterans

Tasker et al., 2014 [67]

Review

To review evidence of performing damage control orthopedics versus definitive stabilization and the use of Early Appropriate Care protocols

UK

Inpatient

Clinical

Stabilization of fractures

Polytrauma patients with fractures

Tolson et al., 2011 [68]

Policy paper

To report the outcomes of a workshop by the International Association of Gerontology and Geriatrics about recommendations for improving quality of care experiences for older people in nursing homes around the world

International

Nursing homes

System; patient

Geriatric care, pain management, end of life care

Residents of nursing homes

Trinh et al., 2014 [74]

Quantitative survey and qualitative interviews

To describe the challenges implementing the Culturally Focused Psychiatric Consultation Program for depressed Latino and Asian Americans in four urban primary care practices

USA

Primary

Patient

Psychiatric consultation for depression

Latino and Asian Americans

Trinh et al., 2015 [75]

Qualitative interviews

To evaluate participant acceptability of a Culturally Focused Psychiatric Consultation Program for depressed Latino Americans

USA

Primary

Clinical; patient

Psychiatric consultation for depression

Latino Americans

Tucker et al., 2013 [69]

Review

To report the literature review findings of examples of the balance of care approach framework during a 40-year time span

Mostly UK, Ireland, Canada

Various

System

Various

Various (health, social, and mental care)

Vallier et al., 2013 [38]

Statistical modeling based on retrospective database cross-sectional analysis

To define which clinical conditions warrant delay of definitive fixation for pelvis, femur, acetabulum, and spine fractures and develop a model to predict complications

USA

Inpatient

Clinical

Definitive fixation for pelvis, femur, acetabulum, and spine fractures

Adults with pelvis, acetabulum, spine, and/or proximal or diaphyseal femur fractures

Vallier et al., 2015 [70]

Prospective study

To review initial experiences with a protocol (to determine the timing of definitive fracture care based on the adequacy of resuscitation) with adherence to the protocol and assess barriers to implementation

USA

Inpatient

Clinical

Definitive fixation of pelvis, acetabulum, spine and femur fractures within 36 hours of injury

Polytrauma, adult patients with fractures

Vallier et al., 2016 [84]

Prospective study

To evaluate whether a standardized protocol for fracture care would enhance revenue by reducing complications and length of stay

USA

Inpatient

Clinical

Surgical stabilization of fractures

Trauma patients with femur, pelvis or spine fractures

Vaucher et al., 2016 [71]

Qualitative study using focus groups

To explore and compare gastroenterologists’ and patients' perceptions of risks and benefits of treatments and prioritizations of expected outcomes

Switzerland

Specialized

Clinical; patient

Treatment of inflammatory bowel disease including ulcerative colitis and Crohn's disease

Patients with ulcerative colitis and Crohn's disease

Weideman et al., 2015

Mixed methods

To design, implement, and evaluate a virtual simulation experience facilitating student access to diverse cultures and strengthening their ability to provide culturally congruent care.

USA

Specialized; Virtual simulation of pre- and post-natal care

Clinical; patient

Pre- and post-natal care

Simulated Amish and African American patients

Weinberg et al., 2015 [72]

Case control study

To better characterize the relationship between post-operative complications and the time required for resuscitation of metabolic acidosis using the Early Appropriate Care protocol

USA

Inpatient

Clinical

Treatment of orthopedic fractures

Trauma patients with orthopedic fractures

Wynell-Mayow, et al., 2016 [85]

Pre-post test

To assess the impact of the Cambridge Polytrauma Pathway on quality process indicators

UK

Inpatient

Clinical

Treatment of orthopedic polytrauma

Trauma patients with orthopedic fractures