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https://www.readbyqxmd.com/read/28453916/digital-technology-and-clinical-decision-making-in-depression-treatment-current-findings-and-future-opportunities
#1
REVIEW
Kevin A Hallgren, Amy M Bauer, David C Atkins
Clinical decision making encompasses a broad set of processes that contribute to the effectiveness of depression treatments. There is emerging interest in using digital technologies to support effective and efficient clinical decision making. In this paper, we provide "snapshots" of research and current directions on ways that digital technologies can support clinical decision making in depression treatment. Practical facets of clinical decision making are reviewed, then research, design, and implementation opportunities where technology can potentially enhance clinical decision making are outlined...
April 28, 2017: Depression and Anxiety
https://www.readbyqxmd.com/read/28449247/informant-discrepancy-defines-discrete-clinically-useful-autism-spectrum-disorder-subgroups
#2
Matthew D Lerner, Andres De Los Reyes, Deborah A G Drabick, Alan H Gerber, Kenneth D Gadow
BACKGROUND: Discrepancy between informants (parents and teachers) in severity ratings of core symptoms commonly arise when assessing autism spectrum disorder (ASD). Whether such discrepancy yields unique information about the ASD phenotype and its clinical correlates has not been examined. We examined whether degree of discrepancy between parent and teacher ASD symptom ratings defines discrete, clinically meaningful subgroups of youth with ASD using an efficient, cost-effective procedure...
April 27, 2017: Journal of Child Psychology and Psychiatry, and Allied Disciplines
https://www.readbyqxmd.com/read/28449244/indications-and-extent-of-central-neck-dissection-for-papillary-thyroid-cancer-an-american-head-and-neck-society-consensus-statement
#3
Nishant Agrawal, Maria R Evasovich, Emad Kandil, Salem I Noureldine, Erin A Felger, Ralph P Tufano, Dennis H Kraus, Lisa A Orloff, Raymon Grogan, Peter Angelos, Brendan C Stack, Bryan McIver, Gregory W Randolph
BACKGROUND: The primary purposes of this interdisciplinary consensus statement were to review the relevant indications for central neck dissection (CND) in patients with papillary thyroid cancer (PTC) and to outline the appropriate extent and relevant techniques required to accomplish a safe and effective CND. METHODS: A writing group convened by the American Head and Neck Society (AHNS) Endocrine Committee was tasked with identifying the important clinical elements to consider when managing the central neck compartment in patients with PTC based on available evidence in the literature, and the group's collective experience...
April 27, 2017: Head & Neck
https://www.readbyqxmd.com/read/28449205/impact-of-pharmacist-involved-collaborative-care-on-the-clinical-humanistic-and-cost-outcomes-of-high-risk-patients-with-type-2-diabetes-impact-a-randomized-controlled-trial
#4
M Y L Siaw, Y Ko, D C Malone, K Y K Tsou, Y-J Lew, D Foo, E Tan, S C Chan, A Chia, S S Sinaram, K C Goh, J Y-C Lee
WHAT IS KNOWN AND OBJECTIVE: With the increasing prevalence of diabetes, the physician-centred model is challenged to deliver holistic care in Asia. Diabetes may be managed effectively within a multidisciplinary collaborative care model; however, evidence on its effectiveness in Asian patients is lacking. Therefore, the primary objective was to evaluate the clinical outcomes of multidisciplinary collaborative care vs physician-centred care in diabetes. The secondary objectives were to evaluate humanistic and economic outcomes among the two types of care...
April 27, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28449105/family-communication-styles-and-resilience-among-adolescents
#5
M Alejandra Acuña, Sheryl Kataoka
Some adolescents manage to be resilient, whereas others develop posttraumatic stress disorder (PTSD) symptoms after experiencing trauma, but the mechanisms underlying these differences are unclear. Public secondary school students (N = 98) referred for counseling completed questionnaires assessing exposure to stressful events, family communication, and PTSD. Seventy percent of the sample reported PTSD symptoms in the clinical range. Open family communication was negatively associated with female gender, problem family communication (PFC), and PTSD symptom severity...
April 26, 2017: Social Work
https://www.readbyqxmd.com/read/28448784/a-motivational-interviewing-intervention-by-pharmacy-students-to-improve-medication-adherence
#6
Susan Abughosh, Xin Wang, Omar Serna, Tara Esse, Amanda Mann, Santhi Masilamani, Marcia McDonnell Holstad, Ekere James Essien, Marc Fleming
BACKGROUND: Diabetes mellitus (DM) patients with comorbid hypertension (HTN) are at a higher risk of developing microvascular and macrovascular DM complications. Through guideline-driven recommendations, angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) are highly recommended for these patients. Unfortunately, medication adherence to these products, though crucial to achieving therapeutic benefit, is frequently suboptimal. Motivational interviewing (MI) is a patient-centered collaborative communication style that is used to strengthen internal motivation for change that may prove effective in enhancing adherence...
May 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28448781/assessment-of-clinical-pharmacy-interventions-to-reduce-outpatient-use-of-high-risk-medications-in-the-elderly
#7
Sarah C Weddle, A Shaun Rowe, Julie W Jeter, Rachel C Renwick, Shaunta' M Chamberlin, Andrea S Franks
BACKGROUND: Use of high-risk medications in the elderly (HRME) and drug-disease (Rx-DIS) interactions in the elderly, as defined by the Healthcare Effectiveness Data and Information Set (HEDIS) Measures, are significantly associated with mortality, hospital admission, and need for emergency care. No published studies to date evaluate interventions to reduce the use of HEDIS-defined HRME, although many studies have postulated a beneficial effect of such interventions. OBJECTIVE: To evaluate the effect of pharmacist interventions on use of HRME and Rx-DIS interactions in the outpatient elderly population...
May 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28448778/economic-impact-of-above-label-dosing-with-etanercept-adalimumab-or-ustekinumab-in-patients-with-psoriasis
#8
Steven R Feldman, Yang Zhao, Huanxue Zhou, Vivian Herrera, Haijun Tian, Yunfeng Li
BACKGROUND: Patients with moderate-to-severe psoriasis may be treated with above-label doses of biologics in an attempt to optimize outcomes. Dose escalation will have an effect on the cost of treatment. OBJECTIVE: To examine costs related to above-label use of etanercept, adalimumab, and ustekinumab among patients with moderate-to-severe psoriasis. METHODS: A retrospective study was performed using a large U.S. claims database. Patients were included in the study if they were aged ≥ 18 years with a diagnosis of psoriasis (excluding psoriatic arthritis) and had at least 1 medication fill for etanercept, adalimumab, or ustekinumab between January 1, 2011, and June 30, 2012...
May 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28448386/barriers-to-goal-concordant-care-for-older-patients-with-acute-surgical-illness-communication-patterns-extrinsic-to-decision-aids
#9
Lauren J Taylor, Sara K Johnson, Michael J Nabozny, Jennifer L Tucholka, Nicole M Steffens, Kristine L Kwekkeboom, Karen J Brasel, Toby C Campbell, Margaret L Schwarze
OBJECTIVE: We sought to characterize patterns of communication extrinsic to a decision aid that may impede goal-concordant care. BACKGROUND: Decision aids are designed to facilitate difficult clinical decisions by providing better treatment information. However, these interventions may not be sufficient to effectively reveal patient values and promote preference-aligned decisions for seriously ill, older adults. METHODS: We conducted a secondary analysis of 31 decision-making conversations between surgeons and frail, older inpatients with acute surgical problems at a single tertiary care hospital...
April 26, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28448200/better-together-the-making-and-maturation-of-the-palliative-care-research-cooperative-group
#10
Christine L Ritchie, Kathryn I Pollak, Karen A Kehl, Jeri L Miller, Jean S Kutner
OBJECTIVE: To describe the growth and outcomes of the Palliative Care Research Cooperative Group (PCRC). BACKGROUND: Despite advances, significant gaps remain in the evidence base to inform care for people with serious illness. To generate this needed evidence and bolster research capacity, the Palliative Care Research Cooperative (PCRC) group was formed. METHODS: The PCRC supports investigators in the conduct of multisite clinical studies...
April 27, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28447914/diagnosis-of-life-threatening-alpha-gal-food-allergy-appears-to-be-patient-driven
#11
Mary Grace Flaherty, Samantha Jan Kaplan, Maya R Jerath
OBJECTIVE: Patients exhibiting life-threatening symptoms associated with the alpha-gal food allergy (delayed urticaria or anaphylaxis due to mammalian meat) are frequently undiagnosed, causing unnecessary emergency department (ED) and health care visits, and extensive pain and suffering. This study aimed to determine the path to diagnosis experienced by alpha-gal patients. METHODS: Semistructured interviews were conducted from March to June 2016 with a chronological systematic sample of approximately 10% of patients diagnosed with alpha-gal and treated by the University of North Carolina Allergy and Immunology Clinic (n = 28)...
April 1, 2017: Journal of Primary Care & Community Health
https://www.readbyqxmd.com/read/28447569/a-new-treatment-strategy-for-parkinson-s-disease-through-the-gut-brain-axis-the-glucagon-like-peptide-1-receptor-pathway
#12
Dong Seok Kim, Ho-Il Choi, Yun Wang, Yu Luo, Barry J Hoffer, Nigel H Greig
Molecular communications in the gut-brain axis, between the central nervous system and the gastrointestinal tract, arecritical for maintaining healthy brain function particularly in aging. Epidemiological analyses indicate type 2 diabetes mellitus (T2DM) is a risk factor for neurodegenerative disorders, including Alzheimer's disease (AD) and Parkinson's diseases (PD) for which aging shows a major correlative association. Common pathophysiological features exist between T2DM, AD and PD, including oxidative stress, inflammation, insulin resistance, abnormal protein processing and cognitive decline, and suggest that effective drugs for T2DM that positively impact the gut-brain axis could provide an effective treatment option for neurodegenerative diseases...
April 26, 2017: Cell Transplantation
https://www.readbyqxmd.com/read/28447421/clinical-decision-support-for-hematology-laboratory-test-utilization
#13
REVIEW
R Jackups, J J Szymanski, S P Persaud
Clinical decision support (CDS) is the use of information and communication technologies to improve clinical decision making and patient care. CDS applications have been used in many aspects of health care, including medication ordering and diagnostic prediction algorithms. As economic and regulatory pressures place a strain on laboratory resources, the potential of CDS to improve utilization of laboratory testing has also begun to be realized. Hematology and coagulation laboratories stand to gain tremendously from the implementation of CDS interventions, given their mixture of high-volume, low-cost tests (eg CBC, PT, aPTT) and tests that carry a high potential of being misused or misinterpreted (eg lupus anticoagulant, erythrocyte sedimentation rate, heparin-induced thrombocytopenia testing)...
May 2017: International Journal of Laboratory Hematology
https://www.readbyqxmd.com/read/28447213/discordance-between-physician-and-patient-reported-disease-severity-in-adults-with-atopic-dermatitis-a-us-cross-sectional-survey
#14
Wenhui Wei, Peter Anderson, Abhijit Gadkari, Stuart Blackburn, Rachel Moon, James Piercy, Shashank Shinde, Jorge Gomez, Eric Ghorayeb
BACKGROUND: There is limited understanding of severity rating of atopic dermatitis in clinical practice. OBJECTIVES: To evaluate the agreement between physician- and patient-rated severity of atopic dermatitis. METHODS: Data were collected from the 2014 Adelphi US Atopic Dermatitis Disease Specific Programme, a cross-sectional survey of physicians and their patients with a history of moderate-to-severe atopic dermatitis; patients voluntarily completed a questionnaire...
April 26, 2017: American Journal of Clinical Dermatology
https://www.readbyqxmd.com/read/28447017/in-sickness-and-in-health-clinical-research-and-social-media
#15
REVIEW
Saswata Ray
In this "digital age," the model of healthcare is changing rapidly, primarily in the area of communication that is happening among the major stakeholders each minute. Patients, being the central point of the importance of all the work and development, are more empowered than ever with information from various sources, among which social media is leading from the front. This article reviews how social media engages healthcare service providers, service seekers, and regulatory authorities. If the gaps in the current regulations are filled, better healthcare outputs can be triggered...
April 2017: Perspectives in Clinical Research
https://www.readbyqxmd.com/read/28446527/the-value-of-different-aspects-of-person-centred-care-a-series-of-discrete-choice-experiments-in-people-with-long-term-conditions
#16
Christopher D Burton, Vikki A Entwistle, Alison M Elliott, Nicolas Krucien, Terry Porteous, Mandy Ryan
OBJECTIVE: To measure the value the patients place on different aspects of person-centred care. DESIGN: We systematically identified four attributes of person-centred care. We then measured their value to 923 people with either chronic pain or chronic lung disease over three discrete choice experiments (DCEs) about services to support self-management. We calculated the value of each attribute for all respondents and identified groups of people with similar preferences using latent class modelling...
April 26, 2017: BMJ Open
https://www.readbyqxmd.com/read/28446515/role-of-biomarkers-for-the-prevention-assessment-and-management-of-heart-failure-a-scientific-statement-from-the-american-heart-association
#17
REVIEW
Sheryl L Chow, Alan S Maisel, Inder Anand, Biykem Bozkurt, Rudolf A de Boer, G Michael Felker, Gregg C Fonarow, Barry Greenberg, James L Januzzi, Michael S Kiernan, Peter P Liu, Thomas J Wang, Clyde W Yancy, Michael R Zile
BACKGROUND AND PURPOSE: Natriuretic peptides have led the way as a diagnostic and prognostic tool for the diagnosis and management of heart failure (HF). More recent evidence suggests that natriuretic peptides along with the next generation of biomarkers may provide added value to medical management, which could potentially lower risk of mortality and readmissions. The purpose of this scientific statement is to summarize the existing literature and to provide guidance for the utility of currently available biomarkers...
April 26, 2017: Circulation
https://www.readbyqxmd.com/read/28446164/core-information-sets-for-informed-consent-to-surgical-interventions-baseline-information-of-importance-to-patients-and-clinicians
#18
Barry G Main, Angus G K McNair, Richard Huxtable, Jenny L Donovan, Steven J Thomas, Paul Kinnersley, Jane M Blazeby
BACKGROUND: Consent remains a crucial, yet challenging, cornerstone of clinical practice. The ethical, legal and professional understandings of this construct have evolved away from a doctor-centred act to a patient-centred process that encompasses the patient's values, beliefs and goals. This alignment of consent with the philosophy of shared decision-making was affirmed in a recent high-profile Supreme Court ruling in England. The communication of information is central to this model of health care delivery but it can be difficult for doctors to gauge the information needs of the individual patient...
April 26, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/28446056/high-technology-augmentative-communication-for-adults-with-post-stroke-aphasia-a-systematic-review
#19
Maria Julieta Russo, Valeria Prodan, Natalia Meda, Lucila Carcavallo, Anibal Muracioli, Liliana Sabe, Lucas Bonamico, Ricardo Allegri, Lisandro Olmos
Augmentative and alternative communication (AAC) systems were introduced into clinical practice by therapists to help compensate for persistent language deficits in people with aphasia. Although, there is currently a push towards an increased focus on compensatory approaches in an attempt to maximize communication function for social interaction, available studies including AAC systems, especially technologically advanced communication tools and systems, known as "high-technology AAC", show key issues and obstacles for these tools to become utilized in mainstream clinical practice...
April 26, 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28445474/cost-effectiveness-of-a-transitional-pharmaceutical-care-program-for-patients-discharged-from-the-hospital
#20
Fatma Karapinar-Çarkıt, Ronald van der Knaap, Fatiha Bouhannouch, Sander D Borgsteede, Marjo J A Janssen, Carl E H Siegert, Toine C G Egberts, Patricia M L A van den Bemt, Marieke F van Wier, Judith E Bosmans
BACKGROUND: To improve continuity of care at hospital admission and discharge and to decrease medication errors pharmaceutical care programs are developed. This study aims to determine the cost-effectiveness of the COACH program in comparison with usual care from a societal perspective. METHODS: A controlled clinical trial was performed at the Internal Medicine department of a general teaching hospital. All admitted patients using at least one prescription drug were included...
2017: PloS One
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