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https://www.readbyqxmd.com/read/28439818/can-experienced-surgeons-predict-the-additional-value-of-a-ct-scan-in-patients-with-displaced-intra-articular-distal-radius-fractures
#1
Y V Kleinlugtenbelt, K Madden, S R Groen, S J Ham, P Kloen, R Haverlag, M P Simons, M Bhandari, J C Goslings, V A B Scholtes, R W Poolman
There are no clear guidelines when an additional CT scan should be obtained for the treatment of displaced intra-articular distal radius fractures (DRF). This study aimed to investigate whether surgeons can predict the usefulness of CT scans to facilitate choice of treatment plan and/or pre-operative planning for DRF. Four surgeons evaluated 51 patients with displaced DRF. The choice of treatment (operative or nonoperative) was based on conventional radiographs. Subsequently, the surgeons were asked whether they would have requested an additional CT scan to determine this treatment choice, and also whether they required a CT scan for pre-operative planning...
April 24, 2017: Strategies in Trauma and Limb Reconstruction
https://www.readbyqxmd.com/read/28436113/using-predictions-from-a-joint-model-for-longitudinal-and-survival-data-to-inform-the-optimal-time-of-intervention-in-an-abdominal-aortic-aneurysm-screening-programme
#2
Michael J Sweeting
Joint models of longitudinal and survival data can be used to predict the risk of a future event occurring based on the evolution of an endogenous biomarker measured repeatedly over time. This has led naturally to the use of dynamic predictions that update each time a new longitudinal measurement is provided. In this paper, we show how such predictions can be utilised within a fuller decision modelling framework, in particular to allow planning of future interventions for patients under a 'watchful waiting' care pathway...
April 24, 2017: Biometrical Journal. Biometrische Zeitschrift
https://www.readbyqxmd.com/read/28414738/barriers-and-facilitators-for-men-to-attend-prenatal-care-and-obtain-hiv-voluntary-counseling-and-testing-in-brazil
#3
Nava Yeganeh, Mariana Simon, Deborah Mindry, Karin Nielsen-Saines, Maria Cristina Chaves, Breno Santos, Marineide Melo, Brenna Mendoza, Pamina Gorbach
BACKGROUND: Providing HIV voluntary counseling and testing (VCT) to men who attend their partner's prenatal care is an intervention with potential to reduce HIV transmission to women and infants during the vulnerable period of pregnancy. Little is known about the acceptability of this intervention in global settings outside of Africa. METHODS: We conducted in-depth qualitative interviews to evaluate potential barriers and facilitators to prenatal care attendance for HIV VCT with 20 men who did and 15 men who did not attend prenatal care with their partners at Hospital Conceiçao in Porto Alegre, Brazil...
2017: PloS One
https://www.readbyqxmd.com/read/28410983/toward-better-public-health-reporting-using-existing-off-the-shelf-approaches-the-value-of-medical-dictionaries-in-automated-cancer-detection-using-plaintext-medical-data
#4
Suranga N Kasthurirathne, Brian E Dixon, Judy Gichoya, Huiping Xu, Yuni Xia, Burke Mamlin, Shaun J Grannis
OBJECTIVES: Existing approaches to derive decision models from plaintext clinical data frequently depend on medical dictionaries as the sources of potential features. Prior research suggests that decision models developed using non-dictionary based feature sourcing approaches and "off the shelf" tools could predict cancer with performance metrics between 80%-90%. We sought to compare non-dictionary based models to models built using features derived from medical dictionaries. MATERIALS AND METHODS: We evaluated the detection of cancer cases from free text pathology reports using decision models built with combinations of dictionary or non-dictionary based feature sourcing approaches, 4 feature subset sizes, and 5 classification algorithms...
April 11, 2017: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/28390820/mortality-reduction-and-cost-effectiveness-of-performing-hysterectomy-at-the-time-of-risk-reducing-salpingo-oophorectomy-for-prophylaxis-against-serous-serous-like-uterine-cancers-in-brca1-mutation-carriers
#5
Laura J Havrilesky, Haley A Moss, Junzo Chino, Evan R Myers, Noah D Kauff
OBJECTIVE: To estimate the survival benefit and cost-effectiveness of performing hysterectomy during risk-reducing salpingo-oophorectomy (RRSO) for BRCA1 mutation carriers. METHODS: Based on a recent prospective cohort study indicating an elevated incidence of serous/serous-like uterine cancers among BRCA1 mutation carriers, we constructed a modified Markov decision model from a payer perspective to inform decisions about performance of hysterectomy during RRSO at age 40...
April 5, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28383957/accumulating-evidence-about-what-prospective-memory-costs-actually-reveal
#6
Luke Strickland, Andrew Heathcote, Roger W Remington, Shayne Loft
Event-based prospective memory (PM) tasks require participants to substitute an atypical PM response for an ongoing task response when presented with PM targets. Responses to ongoing tasks are often slower with the addition of PM demands ("PM costs"). Prominent PM theories attribute costs to capacity-sharing between the ongoing and PM tasks, which reduces the rate of processing of the ongoing task. We modeled PM costs using the Linear Ballistic Accumulator and the Diffusion Decision Model in a lexical-decision task with nonfocal PM targets defined by semantic categories...
April 6, 2017: Journal of Experimental Psychology. Learning, Memory, and Cognition
https://www.readbyqxmd.com/read/28380129/factors-associated-with-user-satisfaction-regarding-treatment-offered-in-brazilian-primary-health-care
#7
Ane Polline Lacerda Protasio, Luciano Bezerra Gomes, Liliane Dos Santos Machado, Ana Maria Gondim Valença
The Program for Access and Quality Improvement in Primary Care (PMAQ-AB) aimed to improve healthcare public service quality. The purpose of this study was to identify the main factors that influence user satisfaction in Brazilian primary health care services. This research was carried out using secondary data from the first cycle of the PMAQ-AB. A cluster analysis was carried out to find the dependent variable of user satisfaction; and logistic regression was applied in order to obtain the decision model. From the resulting regression model, two factors can be highlighted as regards influencing user satisfaction in Brazil: the user's perception that the team did not attempt to address their needs/problems within the health unit; and the user not feeling respected by the professionals in relation to cultural habits, customs, and religion or only sometimes feeling so...
March 30, 2017: Cadernos de Saúde Pública
https://www.readbyqxmd.com/read/28379779/a-procedure-for-deriving-formulas-to-convert-transition-rates-to-probabilities-for-multi-state-markov-models
#8
Edmund Jones, David Epstein, Leticia García-Mochón
For health-economic analyses that use multi-state Markov models, it is often necessary to convert from transition rates to transition probabilities, and for probabilistic sensitivity analysis and other purposes it is useful to have explicit algebraic formulas for these conversions, to avoid having to resort to numerical methods. However, if there are four or more states then the formulas can be extremely complicated. These calculations can be made using packages such as R, but many analysts and other stakeholders still prefer to use spreadsheets for these decision models...
March 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28377444/development-of-a-risk-prediction-model-among-professional-hockey-players-with-visible-signs-of-concussion
#9
Jared M Bruce, Ruben J Echemendia, Willem Meeuwisse, Michael G Hutchison, Mark Aubry, Paul Comper
BACKGROUND: Little research examines how to best identify concussed athletes. The purpose of the present study was to develop a preliminary risk decision model that uses visible signs (VS) and mechanisms of injury (MOI) to predict the likelihood of subsequent concussion diagnosis. METHODS: Coders viewed and documented VS and associated MOI for all NHL games over the course of the 2013-2014 and 2014-2015 regular seasons. After coding was completed, player concussions were identified from the NHL injury surveillance system and it was determined whether players exhibiting VS were subsequently diagnosed with concussions by club medical staff as a result of the coded event...
April 4, 2017: British Journal of Sports Medicine
https://www.readbyqxmd.com/read/28371250/a-decision-model-to-estimate-a-risk-threshold-for-venous-thromboembolism-prophylaxis-in-hospitalized-medical-patients
#10
P Le, K A Martinez, M A Pappas, M B Rothberg
BACKGROUND: Venous thromboembolism (VTE) is a common preventable condition in medical inpatients. Thromboprophylaxis is recommended for inpatients who are not at low risk of VTE, but no specific risk threshold for prophylaxis has been defined. OBJECTIVE: To determine a threshold for prophylaxis based on risk of VTE. PATIENTS/METHODS: We constructed a decision model with a decision-tree following patients for 3 months after hospitalization, and a lifetime Markov model with 3-month cycles...
March 31, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28347513/cost-effectiveness-of-maintaining-daily-intake-of-oat-%C3%AE-glucan-for-coronary-heart-disease-primary-prevention
#11
Stephanie R Earnshaw, Cheryl L McDade, YiFang Chu, Lisa E Fleige, John L Sievenpiper
PURPOSE: Oat β-glucan reduces cholesterol levels and thus reduces the risk for coronary heart disease (CHD). However, its economic impact has not been well studied. We examined the economic impact of daily intake of ≥3 g of oat β-glucan in primary prevention of CHD in patients receiving statins or no pharmacologic treatment. METHODS: A decision model was developed to compare costs and outcomes associated with lowering cholesterol levels with no pharmacologic treatment and normal diet, no pharmacologic treatment plus ≥3 g/d of oat β-glucan, and statin therapy plus ≥3 g/d of oat β-glucan...
March 25, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28345481/cost-effectiveness-analysis-of-implementing-an-antimicrobial-stewardship-programme-in-critical-care-units
#12
Jesus Ruiz-Ramos, Juan Frasquet, Eva Romá, Jose Luis Poveda-Andres, Miguel Salavert-Leti, Alvaro Catellanos, Paula Ramirez
AIMS: To evaluate the cost-effectiveness of antimicrobial stewardship (AS) programme implementation focused on critical care units based on assumptions for the Spanish setting. MATERIAL AND METHODS: A decision model comparing costs and outcomes of sepsis, community-acquired pneumonia, and nosocomial infections (including catheter-related bacteremia, urinary tract infection, and ventilator-associated pneumonia) in critical care units with or without an AS was designed...
March 26, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28332417/cost-effectiveness-of-angiotensin-converting-enzyme-inhibitors-versus-angiotensin-ii-receptor-blockers-as-first-line-treatment-in-autosomal-dominant-polycystic-kidney-disease
#13
L A Clark, S Whitmire, S Patton, C Clark, C M Blanchette, R Howden
INTRODUCTION: Autosomal dominant polycystic kidney disease (ADPKD) is a rare kidney disorder impacting approximately 1:2500 individuals among the general US population. Hypertension is a significant predictor of ADPKD progression and risk factor for development of cardiovascular disease (CVD), the most common cause for mortality among ADPKD patients. Angiotensin-converting enzymes inhibitors (ACE-I) are widely used as first-line treatment in ADPKD for the management of hypertension. However, their cost-effectiveness relative to other hypertensive medications, such as angiotensin II receptor blockers (ARB) has never been assessed...
March 23, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28330940/impact-of-subsidies-on-cancer-genetic-testing-uptake-in-singapore
#14
Shao-Tzu Li, Jeanette Yuen, Ke Zhou, Nur Diana Binte Ishak, Yanni Chen, Marie Met-Domestici, Sock Hoai Chan, Yee Pin Tan, John Carson Allen, Soon Thye Lim, Khee Chee Soo, Joanne Ngeow
PURPOSE: Previous reports cite high costs of clinical cancer genetic testing as main barriers to patient's willingness to test. We report findings of a pilot study that evaluates how different subsidy schemes impact genetic testing uptake and total cost of cancer management. METHODS: We included all patients who attended the Cancer Genetics Service at the National Cancer Centre Singapore (January 2014-May 2016). Two subsidy schemes, the blanket scheme (100% subsidy to all eligible patients), and the varied scheme (patients received 50%-100% subsidy dependent on financial status) were compared...
April 2017: Journal of Medical Genetics
https://www.readbyqxmd.com/read/28316861/complexity-analysis-of-electroencephalogram-dynamics-in-patients-with-parkinson-s-disease
#15
Guotao Liu, Yanping Zhang, Zhenghui Hu, Xiuquan Du, Wanqing Wu, Chenchu Xu, Xiangyang Wang, Shuo Li
In this study, a new combination scheme has been proposed for detecting Parkinson's disease (PD) from electroencephalogram (EEG) signal recorded from normal subjects and PD patients. The scheme is based on discrete wavelet transform (DWT), sample entropy (SampEn), and the three-way decision model in analysis of EEG signal. The EEG signal is noisy and nonstationary, and, as a consequence, it becomes difficult to distinguish it visually. However, the scheme is a well-established methodology in analysis of EEG signal in three stages...
2017: Parkinson's Disease
https://www.readbyqxmd.com/read/28296280/prevention-of-renal-failure-in-chinese-patients-with-newly-diagnosed-type-2-diabetes-a-cost-effectiveness-analysis
#16
REVIEW
Bin Wu, Suhua Zhang, Houwen Lin, Shan Mou
AIMS: Diabetic kidney disease (DKD) is the second leading cause (16.4%) of end-stage renal disease (ESRD) in China. The current study is to assess the cost effectiveness of preventing DKD in patients with newly diagnosed type 2 diabetes (T2DM) from the Chinese health care perspective. METHODS: A lifetime Markov decision model was developed according to the disease course of DKD. Patients with newly diagnosed T2DM might receive treatment according to one of the following three strategies: "do nothing" strategy (control strategy), treatment with angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) (universal strategy), or screening for microalbuminuria followed by ACEI/ARB treatment (screening strategy)...
March 10, 2017: Journal of Diabetes Investigation
https://www.readbyqxmd.com/read/28292484/external-validation-of-health-economic-decision-models-for-chronic-obstructive-pulmonary-disease-copd-report-of-the-third-copd-modeling-meeting
#17
Martine Hoogendoorn, Talitha L Feenstra, Yumi Asukai, Andrew H Briggs, Ryan N Hansen, Reiner Leidl, Nancy Risebrough, Yevgeniy Samyshkin, Margarethe Wacker, Maureen P M H Rutten-van Mölken
OBJECTIVES: To validate outcomes of presently available chronic obstructive pulmonary disease (COPD) cost-effectiveness models against results of two large COPD trials-the 3-year TOwards a Revolution in COPD Health (TORCH) trial and the 4-year Understanding Potential Long-term Impacts on Function with Tiotropium (UPLIFT) trial. METHODS: Participating COPD modeling groups simulated the outcomes for the placebo-treated groups of the TORCH and UPLIFT trials using baseline characteristics of the trial populations as input...
March 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28265866/unpacking-buyer-seller-differences-in-valuation-from-experience-a-cognitive-modeling-approach
#18
Thorsten Pachur, Benjamin Scheibehenne
People often indicate a higher price for an object when they own it (i.e., as sellers) than when they do not (i.e., as buyers)-a phenomenon known as the endowment effect. We develop a cognitive modeling approach to formalize, disentangle, and compare alternative psychological accounts (e.g., loss aversion, loss attention, strategic misrepresentation) of such buyer-seller differences in pricing decisions of monetary lotteries. To also be able to test possible buyer-seller differences in memory and learning, we study pricing decisions from experience, obtained with the sampling paradigm, where people learn about a lottery's payoff distribution from sequential sampling...
March 6, 2017: Psychonomic Bulletin & Review
https://www.readbyqxmd.com/read/28265864/a-diffusion-decision-model-analysis-of-evidence-variability-in-the-lexical-decision-task
#19
Gabriel Tillman, Adam F Osth, Don van Ravenzwaaij, Andrew Heathcote
The lexical-decision task is among the most commonly used paradigms in psycholinguistics. In both the signal-detection theory and Diffusion Decision Model (DDM; Ratcliff, Gomez, & McKoon, Psychological Review, 111, 159-182, 2004) frameworks, lexical-decisions are based on a continuous source of word-likeness evidence for both words and non-words. The Retrieving Effectively from Memory model of Lexical-Decision (REM-LD; Wagenmakers et al., Cognitive Psychology, 48(3), 332-367, 2004) provides a comprehensive explanation of lexical-decision data and makes the prediction that word-likeness evidence is more variable for words than non-words and that higher frequency words are more variable than lower frequency words...
March 6, 2017: Psychonomic Bulletin & Review
https://www.readbyqxmd.com/read/28256925/markov-chain-decision-model-for-urinary-incontinence-procedures
#20
Sameer Kumar, Nidhi Ghildayal, Neha Ghildayal
Purpose Urinary incontinence (UI) is a common chronic health condition, a problem specifically among elderly women that impacts quality of life negatively. However, UI is usually viewed as likely result of old age, and as such is generally not evaluated or even managed appropriately. Many treatments are available to manage incontinence, such as bladder training and numerous surgical procedures such as Burch colposuspension and Sling for UI which have high success rates. The purpose of this paper is to analyze which of these popular surgical procedures for UI is effective...
March 13, 2017: International Journal of Health Care Quality Assurance
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