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Clinical decision support system

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https://www.readbyqxmd.com/read/28535102/why-value-framework-assessments-arrive-at-different-conclusions-a-multiple-myeloma-case-study
#1
Kimberly Westrich, Lisabeth Buelt, Robert W Dubois
As the United States transitions from a volume-based health care system to one that rewards value, new frameworks are emerging to help patients, providers, and payers assess the value of medical services and biopharmaceutical products. These value assessment frameworks are intended to support various types of health care decision making. They have the potential to substantially affect patients, whether as tools for shared decision making with their doctors, as an input to care pathways used by providers, or through payer use of the frameworks to make coverage or reimbursement decisions...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28532470/health-care-professionals-attitudes-towards-evidence-based-medicine-in-the-workers-compensation-setting-a-cohort-study
#2
Nieke A Elbers, Robin Chase, Ashley Craig, Lyn Guy, Ian A Harris, James W Middleton, Michael K Nicholas, Trudy Rebbeck, John Walsh, Simon Willcock, Keri Lockwood, Ian D Cameron
BACKGROUND: Problems may arise during the approval process of treatment after a compensable work injury, which include excess paperwork, delays in approving services, disputes, and allegations of over-servicing. This is perceived as undesirable for injured people, health care professionals and claims managers, and costly to the health care system, compensation system, workplaces and society. Introducing an Evidence Based Medicine (EBM) decision tool in the workers' compensation system could provide a partial solution, by reducing uncertainty about effective treatment...
May 22, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28532308/contributions-of-national-and-global-health-estimates-to-monitoring-health-related-sustainable-development-goals-in-thailand
#3
Kanitta Bundhamcharoen, Supon Limwattananon, Khanitta Kusreesakul, Viroj Tangcharoensathien
The Millennium Development Goals (MDGs) triggered increased demand for data on child and maternal mortality for monitoring progress. With the advent of the Sustainable Development Goals (SDGs) and growing evidence of an epidemiological transition towards non-communicable diseases, policy makers need data on mortality and disease trends and distribution to inform effective policies and support monitoring progress. Where there are limited capacities to produce national health estimates (NHEs), global health estimates (GHEs) can fill gaps for global monitoring and comparisons...
January 2017: Global Health Action
https://www.readbyqxmd.com/read/28530527/health-care-costs-associated-with-addition-titration-and-switching-antihypertensive-medications-after-first-line-treatment-results-from-a-commercially-insured-sample
#4
Kalyani B Sonawane Deshmukh, Jingjing Qian, Kimberly B Garza, Bradley M Wright, Peng Zeng, Cecilia M Ganduglia Cazaban, Richard A Hansen
BACKGROUND: Treatment modifications are necessary for addressing issues related to efficacy and tolerance of first-line monotherapy, but they increase the economic burden on patients and their health plans. Understanding the differences in costs between alternative treatment modification strategies, if any, can serve as a guideline for clinical decision making and for designing cost-containment strategies. OBJECTIVE: To compare the health care utilization costs between (a) addition (i...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28530523/cost-effectiveness-of-peginterferon-beta-1a-and-alemtuzumab-in-relapsing-remitting-multiple-sclerosis
#5
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/28529124/shared-decision-making-in-spain-supportive-policies-and-research-initiatives-trends-and-directions-for-future
#6
Lilisbeth Perestelo-Perez, Amado Rivero-Santana, Yolanda Alvarez-Perez, Pablo Alonso-Coello, Carola Orrego, Pedro Serrano-Aguilar
Patients' rights to autonomy, information and participation in their own health care are recognized in the Spanish legal system from the early 2000's. Public institutions have progressively launched several initiatives to promote and improve patients' empowerment and self-care. However, the concept of Shared Decision Making (SDM), although embedded in the more general concept of "active/empowered patient", usually has not been specifically advocated as an essential requisite for improving the quality of health services, either in the legal normative or the existing educational proposals...
May 18, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28529123/implementing-shared-decision-making-in-denmark-first-steps-and-future-focus-areas
#7
Karina Dahl Steffensen, Vibe Hjelholt Baker, Mette Marianne Vinter
What about the political climate? Although there is no explicit description of patient involvement in Danish legislation, patient-centred care is on the political agenda in Denmark. It is integrated as one of eight new national indicators of quality in health care, as well as in the most recent national plan for cancer treatment. What about tools for patient decision support? Development of evidence-based patient decision aids (PDAs) are still at an early stage in Denmark, but recent national and private funding has helped push the field forward...
May 18, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28529122/shared-decision-making-a-buzz-word-in-the-netherlands-the-pace-quickens-towards-nationwide-implementation%C3%A2
#8
Trudy van der Weijden, Heleen Post, Paul L P Brand, Haske van Veenendaal, Ton Drenthen, Linda Aj van Mierlo, Peep Stalmeier, Olga C Damman, Anne Stiggelbout
Currently, shared decision making (SDM) is on the agenda among target patient representative groups, policy makers and professional bodies. Although the International Conference for Shared Decision Making (ISDM) 2011 generated a positive boost, hesitation was also felt among Dutch clinicians, who are challenged by many new tasks. No hesitation is seen among the majority of patients, opting mostly for the SDM model. We haven't reached these patients' needs fully yet, given disappointing research data on patients' experiences and professional behaviour...
May 18, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28527638/shared-decision-making-in-australia-in-2017
#9
Lyndal Trevena, Heather L Shepherd, Carissa Bonner, Jesse Jansen, Anne E Cust, Julie Leask, Narelle Shadbolt, Chris Del Mar, Kirsten McCaffery, Tammy Hoffmann
Shared Decision Making (SDM) is now firmly established within national clinical standards for accrediting hospitals, day procedure services, public dental services and medical education in Australia, with plans to align general practice, aged care and disability service. Implementation of these standards and training of health professionals is a key challenge for the Australian health sector at this time. Consumer involvement in health research, policy and clinical service governance has also increased, with a major focus on encouraging patients to ask questions during their clinical care...
May 17, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28526944/ventilator-data-extraction-with-a-video-display-image-capture-and-processing-system
#10
David B Wax, Bryan Hill, Matthew A Levin
Medical hardware and software device interoperability standards are not uniform. The result of this lack of standardization is that information available on clinical devices may not be readily or freely available for import into other systems for research, decision support, or other purposes. We developed a novel system to import discrete data from an anesthesia machine ventilator by capturing images of the graphical display screen and using image processing to extract the data with off-the-shelf hardware and open-source software...
June 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/28526675/iterative-user-interface-design-for-automated-sequential-organ-failure-assessment-score-calculator-in-sepsis-detection
#11
Christopher Ansel Aakre, Jaben E Kitson, Man Li, Vitaly Herasevich
BACKGROUND: The new sepsis definition has increased the need for frequent sequential organ failure assessment (SOFA) score recalculation and the clerical burden of information retrieval makes this score ideal for automated calculation. OBJECTIVE: The aim of this study was to (1) estimate the clerical workload of manual SOFA score calculation through a time-motion analysis and (2) describe a user-centered design process for an electronic medical record (EMR) integrated, automated SOFA score calculator with subsequent usability evaluation study...
May 18, 2017: JMIR Human Factors
https://www.readbyqxmd.com/read/28521785/expect-with-me-development-and-evaluation-design-for-an-innovative-model-of-group-prenatal-care-to-improve-perinatal-outcomes
#12
Shayna D Cunningham, Jessica B Lewis, Jordan L Thomas, Stephanie A Grilo, Jeannette R Ickovics
BACKGROUND: Despite biomedical advances and intervention efforts, rates of preterm birth and other adverse outcomes in the United States have remained relatively intransigent. Evidence suggests that group prenatal care can reduce these risks, with implications for maternal and child health as well as substantial cost savings. However, widespread dissemination presents challenges, in part because training and health systems have not been designed to deliver care in a group setting. This manuscript describes the design and evaluation of Expect With Me, an innovative model of group prenatal care with a strong integrated information technology (IT) platform designed to be scalable nationally...
May 18, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28521782/combining-alcohol-interventions-with-tobacco-addictions-treatment-in-primary-care-the-combat-study-a-pragmatic-cluster-randomized-trial
#13
Nadia Minian, Dolly Baliunas, Laurie Zawertailo, Aliya Noormohamed, Norman Giesbrecht, Christian S Hendershot, Bernard Le Foll, Jürgen Rehm, Andriy Samokhvalov, Peter L Selby
BACKGROUND: Tobacco and alcohol use present multiplicative risk for aerodigestive cancers. Reducing alcohol consumption improves smoking cessation outcomes and reduces cancer risk. Risky alcohol consumption and smoking are often treated separately despite concurrent treatment potentially leading to better outcomes for each. However, no rapidly scalable program exists for combined interventions in primary care clinics spread across wide geographic areas. This cluster randomized trial aims to report on the effects of a novel clinical decision support system (CDSS) on intervention rates by primary care practitioners addressing risky alcohol use in a smoking cessation program...
May 18, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28520904/sources-of-unsafe-primary-care-for-older-adults-a-mixed-methods-analysis-of-patient-safety-incident-reports
#14
Alison Cooper, Adrian Edwards, Huw Williams, Huw P Evans, Anthony Avery, Peter Hibbert, Meredith Makeham, Aziz Sheikh, Liam J Donaldson, Andrew Carson-Stevens
Background: older adults are frequent users of primary healthcare services, but are at increased risk of healthcare-related harm in this setting. Objectives: to describe the factors associated with actual or potential harm to patients aged 65 years and older, treated in primary care, to identify action to produce safer care. Design and Setting: a cross-sectional mixed-methods analysis of a national (England and Wales) database of patient safety incident reports from 2005 to 2013...
May 16, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28512865/efficacy-and-safety-of-ruxolitinib-in-intermediate-1-ipss-risk-myelofibrosis-patients-results-from-an-independent-study
#15
Francesca Palandri, Mario Tiribelli, Giulia Benevolo, Alessia Tieghi, Francesco Cavazzini, Massimo Breccia, Micaela Bergamaschi, Nicola Sgherza, Nicola Polverelli, Monica Crugnola, Alessandro Isidori, Gianni Binotto, Florian H Heidel, Francesco Buccisano, Bruno Martino, Roberto Latagliata, Marco Spinsanti, Lydia Kallenberg, Giuseppe Alberto Palumbo, Elisabetta Abruzzese, Luigi Scaffidi, Antonio Cuneo, Michele Cavo, Nicola Vianelli, Massimiliano Bonifacio
Patients with myelofibrosis at intermediate-1 risk according to the International Prognostic Score System are projected to a relatively long survival; nonetheless, they may carry significant splenomegaly and/or systemic constitutional symptoms that hamper quality of life and require treatment. Since registrative COMFORT studies included only patients at intermediate-2/high International Prognostic Score System risk, safety and efficacy data in intermediate-1 patients are limited. We report on 70 intermediate-1 patients treated with ruxolitinib according to standard clinical practice that were evaluated for response using the 2013 IWG-MRT criteria...
May 17, 2017: Hematological Oncology
https://www.readbyqxmd.com/read/28508802/knowledge-engineering-as-a-component-of-the-curriculum-for-medical-cybernetists
#16
Sergey Karas, Arthur Konev
According to a new state educational standard, students who have chosen medical cybernetics as their major must develop a knowledge engineering competency. Previously, in the course "Clinical cybernetics" while practicing project-based learning students were designing automated workstations for medical personnel using client-server technology. The purpose of the article is to give insight into the project of a new educational module "Knowledge engineering". Students will acquire expert knowledge by holding interviews and conducting surveys, and then they will formalize it...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28508725/evaluating-change-in-virtual-reality-adoption-for-brain-injury-rehabilitation-following-knowledge-translation
#17
Stephanie M N Glegg, Liisa Holsti, Sue Stanton, Steven Hanna, Diana Velikonja, Barbara Ansley, Denise Sartor, Christine Brum
PURPOSE: To evaluate the impact of knowledge translation (KT) on factors influencing virtual reality (VR) adoption and to identify support needs of therapists. HYPOTHESES: Intervention will be associated with improvements in therapists' perceived ease of use and self-efficacy, and an associated increase in intentions to use VR. METHOD: Single group mixed-methods pre-test-post-test evaluation of convenience sample of physical, occupational and rehabilitation therapists (n=37) from two brain injury rehabilitation centres...
April 2017: Disability and Rehabilitation. Assistive Technology
https://www.readbyqxmd.com/read/28506868/drug-disease-modeling-in-the-pharmaceutical-industry-where-mechanistic-systems-pharmacology-and-statistical-pharmacometrics-meet
#18
Gabriel Helmlinger, Nidal Al-Huniti, Sergey Aksenov, Kirill Peskov, Melissa Hallow, Lulu Chu, David Boulton, Ulf Eriksson, Bengt Hamrén, Craig Lambert, Eric Masson, Helen Tomkinson, Donald Stanski
Modeling & simulation (M&S) methodologies are established quantitative tools, which have proven to be useful in supporting the research, development (R&D), regulatory approval, and marketing of novel therapeutics. Applications of M&S help design efficient studies and interpret their results in context of all available data and knowledge to enable effective decision-making during the R&D process. In this mini-review, we focus on two sets of modeling approaches: population-based models, which are well-established within the pharmaceutical industry today, and fall under the discipline of clinical pharmacometrics (PMX); and systems dynamics models, which encompass a range of models of (patho-)physiology amenable to pharmacological intervention, of signaling pathways in biology, and of substance distribution in the body (today known as physiologically-based pharmacokinetic models) - which today may be collectively referred to as quantitative systems pharmacology models (QSP)...
May 12, 2017: European Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28501815/can-the-prehospital-national-early-warning-score-identify-patients-most-at-risk-from-subsequent-deterioration
#19
Joanna Shaw, Rachael T Fothergill, Sophie Clark, Fionna Moore
INTRODUCTION: The National Early Warning Score (NEWS) aids the early recognition of those at risk of becoming critically ill. NEWS has been recommended for use by ambulance services, but very little work has been undertaken to date to determine its suitability. This paper examines whether a prehospital NEWS derived from ambulance service clinical observations is associated with the hospital ED disposition. METHODS: Prehospital NEWS was retrospectively calculated from the ambulance service clinical records of 287 patients who were treated by the ambulance service and transported to hospital...
May 13, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28498575/implementing-shared-decision-making-in-routine-mental-health-care
#20
Mike Slade
Shared decision making (SDM) in mental health care involves clinicians and patients working together to make decisions. The key elements of SDM have been identified, decision support tools have been developed, and SDM has been recommended in mental health at policy level. Yet implementation remains limited. Two justifications are typically advanced in support of SDM. The clinical justification is that SDM leads to improved outcome, yet the available empirical evidence base is inconclusive. The ethical justification is that SDM is a right, but clinicians need to balance the biomedical ethical principles of autonomy and justice with beneficence and non-maleficence...
June 2017: World Psychiatry: Official Journal of the World Psychiatric Association (WPA)
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