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https://www.readbyqxmd.com/read/28634770/medical-negligence-determinations-the-right-to-try-and-expanded-access-to-innovative-treatments
#1
Denise Meyerson
This article considers the issue of expanded access to innovative treatments in the context of recent legislative initiatives in the United Kingdom and the United States. In the United Kingdom, the supporters of legislative change argued that the common law principles governing medical negligence are a barrier to innovation. In an attempt to remove this perceived impediment, two bills proposed that innovating doctors sued for negligence should be able to rely in their defence on the fact that their decision to innovate was "responsible...
June 20, 2017: Journal of Bioethical Inquiry
https://www.readbyqxmd.com/read/28634503/monitoring-the-diagnostic-process-on-an-inpatient-neurology-service
#2
Amar Dhand, Robert Bucelli, Arun Varadhachary, Michael Tsiaklides, Gabriela de Bruin, Gurpreet Dhaliwal
The Institute of Medicine report Improving Diagnosis in Health Care called for tools to monitor physicians' diagnostic process. We addressed this need by developing a tool for clinicians to record and analyze their diagnostic process. The tool was a secure web application in which clinicians used a structured grading system to assess the relative impact of clinical, laboratory, and neuroimaging data for every new diagnosis. Four neurohospitalists used the tool for 6.5 months on a general neurology ward service at a single tertiary-level teaching hospital...
July 2017: Neurohospitalist
https://www.readbyqxmd.com/read/28632576/understanding-the-constipation-conundrum-predictors-of-obtaining-an-abdominal-radiograph-during-the-emergency-department-evaluation-of-pediatric-constipation
#3
Claire A MacGeorge, Daniel C Williams, Natalie Vajta, Kristen Morella, Paul G Thacker, Scott Russell, William T Basco, David G Bundy
OBJECTIVES: Many children with constipation who are evaluated in emergency departments (EDs) receive an abdominal radiograph (AR) despite evidence-based guidelines discouraging imaging. The objectives of this study were to identify predictors associated with obtaining an AR and to determine if ARs were associated with a longer length of stay (LOS) among children with constipation evaluated in the ED. METHODS: A review of billing and electronic health records was conducted in an academic pediatric ED for children ages 0 to 17 years who had a primary discharge diagnosis of constipation from July 2013 to June 2014...
June 20, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28630544/pregnancies-and-fetal-anomalies-incompatible-with-life-in-chile-arguments-and-experiences-in-advocating-for-legal-reform
#4
Lidia Casas, Lieta Vivaldi
Chile allows abortion under no circumstances. Whether it's fetal anomaly incompatible with life or congenital malformation resulting in little or no life expectancy, all Chilean women are expected to carry their pregnancies to term. In this context, in January 2015 the Chilean Congress began debating a bill to legalize abortion on three grounds, including fatal congenital malformation. The medical community, including midwives, has presented its views for and against, especially on how the law may affect clinical practices; in addition, women, many of whom have experienced a fatal congenital malformation diagnosis, have weighed in...
June 2017: Health and Human Rights
https://www.readbyqxmd.com/read/28629385/administrative-algorithms-to-identify-avascular-necrosis-of-bone-among-patients-undergoing-upper-or-lower-extremity-magnetic-resonance-imaging-a-validation-study
#5
Medha Barbhaiya, Yan Dong, Jeffrey A Sparks, Elena Losina, Karen H Costenbader, Jeffrey N Katz
BACKGROUND: Studies of the epidemiology and outcomes of avascular necrosis (AVN) require accurate case-finding methods. The aim of this study was to evaluate performance characteristics of a claims-based algorithm designed to identify AVN cases in administrative data. METHODS: Using a centralized patient registry from a US academic medical center, we identified all adults aged ≥18 years who underwent magnetic resonance imaging (MRI) of an upper/lower extremity joint during the 1...
June 19, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28629305/evaluation-of-cost-and-length-of-stay-linked-to-complications-associated-with-major-surgical-procedures
#6
M Pirson, F Dehanne, J Van den Bulcke, P Leclercq, D Martins, A De Wever
INTRODUCTION: A lot of studies have demonstrated the possibility of reducing the number of post-operative complications in the domain of major surgical procedures with the use of medical preventive techniques. However, complications following surgical procedures are unfortunately frequent and are a major problem, not only because of the impact for the patient, but also because of economic consequences that they provoke. The aim of the present study is to evaluate the extra length of stay and the extra cost, born by the hospital and the social security, linked to complications, incurring after major surgical procedures...
June 19, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28625302/pharmacogenetics-in-obstetric-anesthesia
#7
REVIEW
Ruth Landau, Richard Smiley
The 21st century has been billed as the era of "precision/personalized medicine." Genetic investigation of clinical syndromes may guide therapy as well as reveal previously unknown biological or pharmacological pathways that may result in novel drug therapies. Several clinical issues in obstetrics and obstetric anesthesiology have been targets for genetic investigations. These include evaluation of the genetic effects on preterm labor and the progression of labor, spinal anesthesia-induced hypotension and the response to medications used to treat hypotension, and the effect of gene variants on pain and analgesic responses...
March 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/28624066/complexity-of-medical-decision-making-in-care-provided-by-surgeons-through-patient-portals
#8
Jamie R Robinson, Alissa Valentine, Cathy Carney, Daniel Fabbri, Gretchen P Jackson
BACKGROUND: Patient portals are online applications that allow patients to interact with healthcare organizations and view information. Portal messages exchanged between patients and providers contain diverse types of communications, including delivery of medical care. The types of communications and complexity of medical decision-making in portal messages sent to surgeons have not been studied. MATERIALS AND METHODS: We obtained all message threads initiated by patients and exchanged with surgical providers through the Vanderbilt University Medical Center patient portal from June 1 to December 31, 2014...
June 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28622808/characterizing-and-predicting-rates-of-delirium-across-general-hospital-settings
#9
Thomas H McCoy, Kamber L Hart, Roy H Perlis
OBJECTIVE: To better understand variation in reported rates of delirium, this study characterized delirium occurrence rate by department of service and primary admitting diagnosis. METHOD: Nine consecutive years (2005-2013) of general hospital admissions (N=831,348) were identified across two academic medical centers using electronic health records. The primary admitting diagnosis and the treating clinical department were used to calculate occurrence rates of a previously published delirium definition composed of billing codes and natural language processing of discharge summaries...
May 2017: General Hospital Psychiatry
https://www.readbyqxmd.com/read/28621753/media-coverage-of-alcohol-issues-a-critical-political-economy-framework-a-case-study-from-ireland
#10
Julien Mercille
There is a growing literature on news media representations of alcohol-related issues. However, current scholarship has neglected critical political economic frameworks to interpret media coverage of alcohol. This paper presents such a framework that conceives of news organisations as corporations that share the values and interests of political and economic elites. The media are thus expected to present viewpoints that are more aligned with the alcohol industry than the scientific consensus on public health policy would warrant...
June 16, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28613066/balance-billing-by-health-care-providers-assessing-consumer-protections-across-states
#11
Kevin Lucia, Jack Hoadley, Ashley Williams
ISSUE: Privately insured consumers expect that if they pay premiums and use in-network providers, their insurer will cover the cost of medically necessary care beyond their cost-sharing. However, when obtaining care at emergency departments and in-network hospitals, patients treated by an out-of-network provider may receive an unexpected "balance bill" for an amount beyond what the insurer paid. With no explicit federal protections against balance billing, some states have stepped in to protect consumers from this costly and confusing practice...
June 2017: Issue Brief of the Commonwealth Fund
https://www.readbyqxmd.com/read/28606904/transition-structures-and-timing-of-transfer-from-paediatric-to-adult-based-care-after-kidney-transplantation-in-germany-a-qualitative-study
#12
Jenny Prüfe, Marie-Luise Dierks, Dirk Bethe, Martina Oldhafer, Silvia Müther, Julia Thumfart, Markus Feldkötter, Anja Büscher, Katja Sauerstein, Matthias Hansen, Martin Pohl, Jens Drube, Florian Thiel, Susanne Rieger, Ulrike John, Christina Taylan, Katalin Dittrich, Sabine Hollenbach, Günter Klaus, Henry Fehrenbach, Birgitta Kranz, Carmen Montoya, Bärbel Lange-Sperandio, Bettina Ruckenbrod, Heiko Billing, Hagen Staude, Reinhard Brunkhorst, Krisztina Rusai, Lars Pape, Martin Kreuzer
OBJECTIVES: It is known that transition, as a shift of care, marks a vulnerable phase in the adolescents' lives with an increased risk for non-adherence and allograft failure. Still, the transition process of adolescents and young adults living with a kidney transplant in Germany is not well defined. The present research aims to assess transition-relevant structures for this group of young people. Special attention is paid to the timing of the process. SETTING: In an observational study, we visited 21 departments of paediatric nephrology in Germany...
June 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/28606088/developing-a-standardized-healthcare-cost-data-warehouse
#13
Sue L Visscher, James M Naessens, Barbara P Yawn, Megan S Reinalda, Stephanie S Anderson, Bijan J Borah
BACKGROUND: Research addressing value in healthcare requires a measure of cost. While there are many sources and types of cost data, each has strengths and weaknesses. Many researchers appear to create study-specific cost datasets, but the explanations of their costing methodologies are not always clear, causing their results to be difficult to interpret. Our solution, described in this paper, was to use widely accepted costing methodologies to create a service-level, standardized healthcare cost data warehouse from an institutional perspective that includes all professional and hospital-billed services for our patients...
June 12, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28601421/impact-of-the-introduction-of-pneumococcal-conjugate-vaccination-on-pneumonia-in-the-gambia-population-based-surveillance-and-case-control-studies
#14
Grant A Mackenzie, Philip C Hill, Shah M Sahito, David J Jeffries, Ilias Hossain, Christian Bottomley, Uchendu Uchendu, David Ameh, Malick Ndiaye, Chidebereh D Osuorah, Oyedeji Adeyemi, Jayani Pathirana, Yekini Olatunji, Bade Abatan, Ebirim Ahameefula, Bilquees S Muhammad, Augustin E Fombah, Debasish Saha, Roslyn Mackenzie, Ian Plumb, Aliu Akano, Bernard Ebruke, Readon C Ideh, Bankole Kuti, Peter Githua, Emmanuel Olutunde, Ogochukwu Ofordile, Edward Green, Effua Usuf, Henry Badji, Usman N A Ikumapayi, Ahmad Manjang, Rasheed Salaudeen, E David Nsekpong, Sheikh Jarju, Martin Antonio, Sana Sambou, Lamin Ceesay, Yamundow Lowe-Jallow, Dawda Sowe, Momodou Jasseh, Kim Mulholland, Maria Knoll, Orin S Levine, Stephen R Howie, Richard A Adegbola, Brian M Greenwood, Tumani Corrah
BACKGROUND: Pneumococcal conjugate vaccines (PCVs) are used in many low-income countries but their impact on the incidence of pneumonia is unclear. The Gambia introduced PCV7 in August, 2009, and PCV13 in May, 2011. We aimed to measure the impact of the introduction of these vaccines on pneumonia incidence. METHODS: We did population-based surveillance and case-control studies. The primary endpoint was WHO-defined radiological pneumonia with pulmonary consolidation...
June 7, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/28598801/improving-adolescent-access-and-services-in-a-large-primary-care-network-report-of-a-10-year-project
#15
Elizabeth M Alderman, Kim L Freeman, Katherine S Lobach
This report describes a decade long initiative to bring a unified approach and improved quality to the process and content of adolescent health care in a large and complex urban primary care network within an academic health system. The moving force was a voluntary multidisciplinary group who comprised the Montefiore Adolescent Primary Care Initiative, known as MAPCI, led by a physician subspecialist in Adolescent Medicine. A series of needs assessments formed the basis for a multipronged effort to create policies and procedures, educational activities and materials, changes in record-keeping and billing practices, and modification of staff attitudes and behavior that would enhance access and ensure confidentiality of services for the adolescent age group...
June 9, 2017: International Journal of Adolescent Medicine and Health
https://www.readbyqxmd.com/read/28595057/hospitalization-cost-at-childbirth-health-parameters-and-colonization-with-antimicrobial-resistant-bacteria-and-methicillin-susceptible-staphylococcus-aureus
#16
Alexandra C Adler, Mihai Zamfir, Lana Hendrowarsito, Antchen Dammeyer, Lasse Schomacher, Barbara Karlin, Manuela Franitza, Lilia Nasri, Stefan Hörmansdorfer, Christian Tuschak, Giuseppe Valenza, Thomas Ewert, Wolfgang Hierl, Uta Ochmann, Caroline Herr, Stefanie Heinze
OBJECTIVE: Antimicrobial resistant bacteria (AMR) are of public health and economic relevance. However, there is a lack of data regarding AMR colonization in pregnant women and in newborns. Furthermore, there are few studies analyzing hospital's net income (revenues and costs). STUDY DESIGN: The cross-sectional study took place in two Bavarian clinics. Available data regarding women and newborns were collected using a standardized questionnaire, personal IDs and medical records in addition to AMR/MSSA screening...
May 30, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28590797/using-the-electronic-medical-record-to-study-the-association-of-child-and-environmental-characteristics-on-the-type-of-physical-therapy-services-delivered-to-individuals-with-cerebral-palsy
#17
Amy F Bailes, Mary Gannotti, Matthew Fenchel
OBJECTIVE: The purpose of this study was to characterize the intervention type delivered to individuals with cerebral palsy (CP) in a pediatric outpatient medical setting and to identify factors associated with the total amount of service within each type. SUBJECTS: Four hundred and twenty-five individuals with CP (1-33 years) Gross Motor Function Classification System (GMFCS): Level I (n = 152); II (n = 63); III (n = 55); IV (n = 80); and V (n = 75). METHODS: Billing code data was extracted retrospectively from 2008 medical records and categorized to reflect four types: body structures and function (BSF), activity (ACT), environment (ENV), and examination (EXAM)...
June 7, 2017: Physiotherapy Theory and Practice
https://www.readbyqxmd.com/read/28589161/arthroscopic-mechanical-chondroplasty-of-the-knee-is-beneficial-for-treatment-of-focal-cartilage-lesions-in-the-absence-of-concurrent-pathology
#18
Devon E Anderson, Michael B Rose, Aaron J Wille, Jack Wiedrick, Dennis C Crawford
BACKGROUND: Articular cartilage lacks the ability for intrinsic repair after acute injury, and focal articular cartilage lesions cause significant morbidity worldwide. Arthroscopic debridement (chondroplasty) represents the majority of cartilage procedures of the knee; however, limited data exist regarding outcomes after chondroplasty performed in isolation of concurrent procedures or not as a primary treatment for osteoarthritis (OA). HYPOTHESIS: Arthroscopic mechanical chondroplasty is beneficial for patients with a focal cartilage lesion of the knee in the absence of meniscal pathology or OA...
May 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28584832/the-proportion-of-unmet-costs-considering-inpatients-billing-of-selected-hospitals-after-2014-health-system-reform-implementation-in-isfahan-province
#19
Parnaz Naghdi, Mahan Mohammadi, Mohammad Ali Jahangard, Alireza Yousefe, Noora Rafiee
INTRODUCTION: Since 2013, in Iran's health care, the contribution of direct payments for health-care services was estimated more than 50 % of all expenditures. In May 2014, Iran's health-care reform was established to improve health services quality and reduce patients' out-of-pocket payments <10% in urban and 5% in rural areas. Therefore, the purpose of this study is to investigate unmet costs (those which are not covered either by the insurance companies nor the recent reform coverage mentioned in Sections 1...
2017: Journal of Education and Health Promotion
https://www.readbyqxmd.com/read/28579627/carriage-of-sub-microscopic-sexual-and-asexual-plasmodium-falciparum-stages-in-the-dry-season-at-navrongo-ghana
#20
Geoffrey R Atelu, Nancy O Duah, Michael D Wilson
BACKGROUND: We investigated the prevalence of sub-microscopic Plasmodium falciparum infections and gametocyte carriage in asymptomatic individuals in Navrongo in northern Ghana, an area of seasonal malaria transmission. DESIGN: A cross sectional study of 209 randomly selected participants of all age-groups was conducted in February and March, 2015. METHODS: Capillary blood samples collected from these individuals were used for the detection of both asexual and gametocyte stage parasites by microscopy, reverse transcriptase polymerase chain reaction (RT-PCR) and conventional nested PCR methods...
December 2016: Ghana Medical Journal
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