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https://www.readbyqxmd.com/read/28725188/using-virtual-reality-to-assess-ethical-decisions-in-road-traffic-scenarios-applicability-of-value-of-life-based-models-and-influences-of-time-pressure
#1
Leon R Sütfeld, Richard Gast, Peter König, Gordon Pipa
Self-driving cars are posing a new challenge to our ethics. By using algorithms to make decisions in situations where harming humans is possible, probable, or even unavoidable, a self-driving car's ethical behavior comes pre-defined. Ad hoc decisions are made in milliseconds, but can be based on extensive research and debates. The same algorithms are also likely to be used in millions of cars at a time, increasing the impact of any inherent biases, and increasing the importance of getting it right. Previous research has shown that moral judgment and behavior are highly context-dependent, and comprehensive and nuanced models of the underlying cognitive processes are out of reach to date...
2017: Frontiers in Behavioral Neuroscience
https://www.readbyqxmd.com/read/28725165/cost-effectiveness-of-pre-referral-antimalarial-treatment-in-severe-malaria-among-children-in-sub-saharan-africa
#2
Vivian Rakuomi, Faith Okalebo, Stanley Ndwigah, Levi Mbugua
BACKGROUND: In 2013, 78% of malaria deaths occurred in children aged 5 years and below, in sub-Saharan Africa. Treatment of severe malaria requires a health facility with inpatient care. However, in most sub-Sahara African countries, access to health facilities is a major problem. Pre-referral antimalarial treatments aim to delay the progress of severe malaria as patients seek to access health facilities. Rectal artesunate can be administered in the community as a pre-referral treatment in rural hard-to-reach areas...
2017: Cost Effectiveness and Resource Allocation: C/E
https://www.readbyqxmd.com/read/28723311/visual-perceptual-learning-and-models
#3
Barbara Dosher, Zhong-Lin Lu
Visual perceptual learning through practice or training can significantly improve performance on visual tasks. Originally seen as a manifestation of plasticity in the primary visual cortex, perceptual learning is more readily understood as improvements in the function of brain networks that integrate processes, including sensory representations, decision, attention, and reward, and balance plasticity with system stability. This review considers the primary phenomena of perceptual learning, theories of perceptual learning, and perceptual learning's effect on signal and noise in visual processing and decision...
July 19, 2017: Annual Review of Vision Science
https://www.readbyqxmd.com/read/28715911/hepatitis-c-treatment-regimens-are-cost-effective-but-compared-with-what
#4
T Joseph Mattingly, Julia F Slejko, C Daniel Mullins
BACKGROUND: Numerous economic models have been published evaluating treatment of chronic hepatitis C virus (HCV) infection, but none provide a comprehensive comparison among new antiviral agents. OBJECTIVE: Evaluate the cost-effectiveness of all recommended therapies for treatment of genotypes 1 and 4 chronic HCV. METHODS: Using data from clinical trials, observational analyses, and drug pricing databases, Markov decision models were developed for HCV genotypes 1 and 4 to compare all recommended drugs from the perspective of the third-party payer over a 5-, 10-, and 50-year time horizon...
July 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28699130/cost-effectiveness-of-risk-reducing-mastectomy-versus-surveillance-in-brca-mutation-carriers-with-a-history-of-ovarian-cancer
#5
Charlotte Gamble, Laura J Havrilesky, Evan R Myers, Junzo P Chino, Scott Hollenbeck, Jennifer K Plichta, P Kelly Marcom, E Shelley Hwang, Noah D Kauff, Rachel A Greenup
BACKGROUND: The appropriate management of breast cancer risk in BRCA mutation carriers following ovarian cancer diagnosis remains unclear. We sought to determine the survival benefit and cost effectiveness of risk-reducing mastectomy (RRM) among women with BRCA1/2 mutations following stage II-IV ovarian cancer. DESIGN: We constructed a decision model from a third-party payer perspective to compare annual screening with magnetic resonance imaging (MRI) and mammography to annual screening followed by RRM with reconstruction following ovarian cancer diagnosis...
July 11, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28696420/a-cost-effectiveness-analysis-of-maternal-cyp2d6-genetic-testing-to-guide-treatment-for-postpartum-pain-and-avert-infant-adverse-events
#6
M E Moretti, D F Lato, H Berger, G Koren, S Ito, W J Ungar
Mothers with a CYP2D6 ultrarapid metabolizer phenotype may expose their infants to risk of adverse events when taking codeine while breastfeeding, by producing more of the active metabolite, morphine. Pharmacogenetic testing may be a valuable tool to identify such mothers, but testing can be costly. The objective of the study was to determine the incremental costs of genotyping to avert neonatal adverse events during maternal pharmacotherapy. A cost-effectiveness analysis, using a decision model, was performed with a hypothetical cohort of prenatal subjects...
July 11, 2017: Pharmacogenomics Journal
https://www.readbyqxmd.com/read/28679676/economic-evaluation-of-a-community-based-diagnostic-pathway-to-stratify-adults-for-non-alcoholic-fatty-liver-disease-a-markov-model-informed-by-a-feasibility-study
#7
Lukasz Tanajewski, Rebecca Harris, David J Harman, Guruprasad P Aithal, Timothy R Card, Georgios Gkountouras, Vladislav Berdunov, Indra N Guha, Rachel A Elliott
OBJECTIVES: To assess the long-term cost-effectiveness of a risk stratification pathway, compared with standard care, for detecting non-alcoholic fatty liver disease (NAFLD) in primary care. SETTING: Primary care general practices in England. PARTICIPANTS: Adults who have been identified in primary care to have a risk factor for developing NAFLD, that is, type 2 diabetes without a history of excessive alcohol use. INTERVENTION: A community-based pathway, which uses transient elastography and hepatologists to stratify patients at risk of NAFLD, has been implemented and demonstrated to be feasible (NCT02037867)...
July 5, 2017: BMJ Open
https://www.readbyqxmd.com/read/28672073/prediction-of-treatment-outcomes-to-exercise-in-patients-with-nonremitted-major-depressive-disorder
#8
Chad D Rethorst, Charles C South, A John Rush, Tracy L Greer, Madhukar H Trivedi
BACKGROUND: Only one-third of patients with major depressive disorder (MDD) achieve remission with initial treatment. Consequently, current clinical practice relies on a "trial-and-error" approach to identify an effective treatment for each patient. The purpose of this report was to determine whether we could identify a set of clinical and biological parameters with potential clinical utility for prescription of exercise for treatment of MDD in a secondary analysis of the Treatment with Exercise Augmentation in Depression (TREAD) trial...
July 3, 2017: Depression and Anxiety
https://www.readbyqxmd.com/read/28667086/suitable-support-for-anxious-hospice-patients-what-do-nurses-know-do-and-need-an-explanatory-mixed-method-study
#9
Danielle Zweers, Everlien de Graaf, Saskia Teunissen
OBJECTIVE: To provide insight into what nurses know, do and need to provide support to anxious patients in hospice care (HC). METHODS: A mixed method study consisted of an online survey and focus groups (FGs) about what nurses know, do, and need was conducted. 336 HC nurses were invited to participate. Descriptive statistics were computed using SPSS. The χ(2) and t-tests were conducted to compare. The FGs were transcribed verbatim and thematically analysed. RESULTS: The survey was completed by 265 nurses (79%), and five FGs (n=25) were conducted...
June 30, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28655413/the-impact-of-physician-burnout-on-clinical-and-academic-productivity-of-gynecologic-oncologists-a-decision-analysis
#10
Taylor B Turner, Sarah E Dilley, Haller J Smith, Warner K Huh, Susan C Modesitt, Stephen L Rose, Laurel W Rice, Jeffrey M Fowler, J Michael Straughn
OBJECTIVE: Physician burnout is associated with mental illness, alcohol abuse, and job dissatisfaction. Our objective was to estimate the impact of burnout on productivity of gynecologic oncologists during the first half of their career. METHODS: A decision model evaluated the impact of burnout on total relative value (RVU) production during the first 15years of practice for gynecologic oncologists entering the workforce from 2011 to 2015. The SGO practice survey provided physician demographics and mean annual RVUs...
June 24, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28650086/systemic-thrombolysis-catheter-directed-thrombolysis-and-anticoagulation-for-intermediate-risk-pulmonary-embolism-a-simulation-modeling-analysis
#11
Christopher Kabrhel, Ayman Ali, Jin Choi, Chin Hur
OBJECTIVES: Decision-making around the use of thrombolysis for patients with intermediate-risk (submassive) PE remains challenging. Studies indicate favorable clinical outcomes with systemic thrombolytics (IV tPA), but the risk of major bleeding and hemorrhagic stroke is a deterrent. Catheter-directed thrombolysis (CDT) may be a preferable strategy, as it has been shown to have a lower risk of bleeding than systemic thrombolysis. However, a three-arm randomized control study comparing IV tPA, CDT, and anticoagulation alone, with long-term follow up, would be costly and is unlikely to be performed...
June 26, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28648321/cost-utility-analysis-of-single-fraction-versus-multiple-fraction-radiotherapy-in-patients-with-painful-bone-metastases-an-iranian-patient-s-perspective-study
#12
Yahya Bayazidi, Ali Keshtkaran, Enayatollah Homaie Rad, Mansour Ansari, Mehdi Javanbakht, Amir Hashemi Meshkini, Shokoufeh Nikfar, Pardis Zaboli
OBJECTIVES: To evaluate two of the various treatment strategies of bone metastasis- single-fraction radiotherapy and multiple-fraction radiotherapy. METHODS: A multistage Markov decision model was applied to assess the incremental costs per quality-adjusted life-year (QALY) gained of single fraction against multiple fractions. The model had a monthly cycle length over a lifetime horizon with 1000 hypothetical cohort samples. The EuroQol five-dimensional questionnaire was used to estimate the health-related quality of life in patients...
May 2017: Value in Health Regional Issues
https://www.readbyqxmd.com/read/28643629/faecal-immunochemical-tests-to-triage-patients-with-lower-abdominal-symptoms-for-suspected-colorectal-cancer-referrals-in-primary-care-a-systematic-review-and-cost-effectiveness-analysis
#13
Marie Westwood, Isaac Corro Ramos, Shona Lang, Marianne Luyendijk, Remziye Zaim, Lisa Stirk, Maiwenn Al, Nigel Armstrong, Jos Kleijnen
BACKGROUND: Colorectal cancer (CRC) is the third most common cancer in the UK. Presenting symptoms that can be associated with CRC usually have another explanation. Faecal immunochemical tests (FITs) detect blood that is not visible to the naked eye and may help to select patients who are likely to benefit from further investigation. OBJECTIVES: To assess the effectiveness of FITs [OC-Sensor (Eiken Chemical Co./MAST Diagnostics, Tokyo, Japan), HM-JACKarc (Kyowa Medex/Alpha Laboratories Ltd, Tokyo, Japan), FOB Gold (Sentinel/Sysmex, Sentinel Diagnostics, Milan, Italy), RIDASCREEN Hb or RIDASCREEN Hb/Hp complex (R-Biopharm, Darmstadt, Germany)] for primary care triage of people with low-risk symptoms...
May 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28628931/-the-probabilistic-efficiency-frontier-a-value-assessment-of-treatment-options-in-hepatitis-c
#14
Axel C Mühlbacher, Andrew Sadler
Background The German Institute for Quality and Efficiency in Health Care (IQWiG) recommends the concept of the efficiency frontier to assess health care interventions. The efficiency frontier supports regulatory decisions on reimbursement prices for the appropriate allocation of health care resources. Until today this cost-benefit assessment framework has only been applied on the basis of individual patient-relevant endpoints. This contradicts the reality of a multi-dimensional patient benefit. Objective The objective of this study was to illustrate the operationalization of multi-dimensional benefit considering the uncertainty in clinical effects and preference data in order to calculate the efficiency of different treatment options for hepatitis C (HCV)...
June 19, 2017: Das Gesundheitswesen
https://www.readbyqxmd.com/read/28616889/risk-communication-emergency-response-preparedness-contextual-assessment-of-the-protective-action-decision-model
#15
Robert L Heath, Jaesub Lee, Michael J Palenchar, Laura L Lemon
Studies are continuously performed to improve risk communication campaign designs to better prepare residents to act in the safest manner during an emergency. To that end, this article investigates the predictive ability of the protective action decision model (PADM), which links environmental and social cues, predecision processes (attention, exposure, and comprehension), and risk decision perceptions (threat, alternative protective actions, and stakeholder norms) with protective action decision making. This current quasi-longitudinal study of residents (N = 400 for each year) in a high-risk (chemical release) petrochemical manufacturing community investigated whether PADM core risk perceptions predict protective action decision making...
June 14, 2017: Risk Analysis: An Official Publication of the Society for Risk Analysis
https://www.readbyqxmd.com/read/28597236/bayesian-analysis-of-the-piecewise-diffusion-decision-model
#16
William R Holmes, Jennifer S Trueblood
Most past research on sequential sampling models of decision-making have assumed a time homogeneous process (i.e., parameters such as drift rates and boundaries are constant and do not change during the deliberation process). This has largely been due to the theoretical difficulty in testing and fitting more complex models. In recent years, the development of simulation-based modeling approaches matched with Bayesian fitting methodologies has opened the possibility of developing more complex models such as those with time-varying properties...
June 8, 2017: Behavior Research Methods
https://www.readbyqxmd.com/read/28576711/safety-and-efficacy-of-antibacterial-prophylaxis-after-craniotomy-a-decision-model-analysis
#17
Amal F Alotaibi, Rania A Mekary, Hasan A Zaidi, Timothy R Smith, Ankur Pandya
BACKGROUND: Antibiotic prophylaxis has revolutionized the safety of neurosurgical procedures in the last century. Today, the clinician's drug of choice prior surgery is often based on the antibiotic's resistance profile and drug-induced complications. METHODS: A decision tree model was developed to compare cefazolin (cephalosporin), vancomycin, or their combination on 90-day mortality post-craniotomy. We modeled the infection type (methicillin-sensitive, methicillin-resistant, or other organisms), antibiotic-related complications that could affect mortality (e...
May 30, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28550999/process-mining-routinely-collected-electronic-health-records-to-define-real-life-clinical-pathways-during-chemotherapy
#18
Karl Baker, Elaine Dunwoodie, Richard G Jones, Alex Newsham, Owen Johnson, Christopher P Price, Jane Wolstenholme, Jose Leal, Patrick McGinley, Chris Twelves, Geoff Hall
BACKGROUND: There is growing interest in the use of routinely collected electronic health records to enhance service delivery and facilitate clinical research. It should be possible to detect and measure patterns of care and use the data to monitor improvements but there are methodological and data quality challenges. Driven by the desire to model the impact of a patient self-test blood count monitoring service in patients on chemotherapy, we aimed to (i) establish reproducible methods of process-mining electronic health records, (ii) use the outputs derived to define and quantify patient pathways during chemotherapy, and (iii) to gather robust data which is structured to be able to inform a cost-effectiveness decision model of home monitoring of neutropenic status during chemotherapy...
July 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/28530523/cost-effectiveness-of-peginterferon-beta-1a-and-alemtuzumab-in-relapsing-remitting-multiple-sclerosis
#19
Ankur A Dashputre, Khalid M Kamal, Gauri Pawar
BACKGROUND: Multiple sclerosis (MS) is a chronic inflammatory disorder of the central nervous system, affecting 2.5 million people globally and 400,000 people in the United States. While no cure exists for MS, the goal is to manage the disease using disease-modifying therapies (DMTs), which have been shown to slow disease progression and prevent relapses. Relapsing-remitting MS (RRMS) is the most common form of MS at the time of diagnosis. Peginterferon beta-1a (PEG) and alemtuzumab (ALT) were recently approved and have demonstrated good clinical outcomes, including reduced relapse rates in clinical trials...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28529152/coevolution-of-patch-type-dependent-emigration-and-patch-type-dependent-immigration
#20
Helene C Weigang
The three phases of dispersal - emigration, transfer and immigration - are affecting each other and the former and latter decisions may depend on patch types. Despite the inevitable fact of the complexity of the dispersal process, patch-type dependencies of dispersal decisions modelled as emigration and immigration are usually missing in theoretical dispersal models. Here, I investigate the coevolution of patch-type dependent emigration and patch-type dependent immigration in an extended Hamilton-May model...
May 18, 2017: Journal of Theoretical Biology
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