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share making decisions

Cornelia Lützner, Anne Postler, Franziska Beyer, Stephan Kirschner, Jörg Lützner
PURPOSE: Constant efforts have been made to improve prosthesis design in total knee arthroplasty (TKA), but a significant number of patients remain dissatisfied postoperatively. Besides poor improvement in pain or function, poor fulfillment of patients expectations were identified as contributing factors. Purpose of the study was to assess fulfillment of patients' expectations and satisfaction with TKA 5 years after surgery. METHODS: A total of 103 patients from a prospective randomised study of a high-flexion or standard TKA implant were investigated 5 years after surgery and patient-reported outcomes (PRO), fulfillment of expectations and satisfaction with the result of the surgery were obtained...
December 13, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Saroj Niraula, Zoann Nugent
Background: FDA approvals do not consider cost, but they set the tone for regulatory approvals worldwide, including in countries with universal healthcare where cost-effectiveness, utility, and adoption feasibility are considered rigorously. Methods: Data from the pan-Canadian Oncology Drug Review (pCODR), a national drug review system that makes evidence-based funding recommendations to Canada's provinces and territories, were collected. Our objectives were to assess (1) temporal trends in cost and efficacy of drugs reviewed, (2) correlations among magnitude of benefits, cost, and pCODR decisions, and (3) predictors of approvals...
December 2018: Journal of the National Comprehensive Cancer Network: JNCCN
Michael D McGoon, Pisana Ferrari, Iain Armstrong, Migdalia Denis, Luke S Howard, Gabi Lowe, Sanjay Mehta, Noriko Murakami, Brad A Wong
The assessment of objective measurement of cardiopulmonary status has helped us achieve better clinical outcomes for patients and develop new therapies through to the point of market access; however, patient surveys indicate that more can be done to improve holistic care and patient engagement. In this multidisciplinary review, we examine how clinical teams can acknowledge and embrace the individual patient's perspective, and thus improve the care for individual patients suffering from pulmonary hypertension by cultivating the importance and relevance of health-related quality of life in direct clinical care...
December 13, 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
Tanner J Caverly, Rodney A Hayward, James F Burke
OBJECTIVE: To investigate the credibility of claims that general practitioners lack time for shared decision making and preventive care. DESIGN: Monte Carlo microsimulation study. SETTING: Primary care, United States. PARTICIPANTS: Sample of general practitioners (n=1000) representative of annual work hours and patient panel size (n=2000 patients) in the US, derived from the National Health and Nutrition Examination Survey...
December 13, 2018: BMJ: British Medical Journal
Tara Nicole Downs
Alzheimer's disease is becoming more predominant in our aging population. Statin medications have been reported to contribute to cognitive impairment. Updated cholesterol treatment guidelines significantly increase the proportion of people eligible for treatment with statins. Therefore, uncommon adverse effects related to this medication class have the potential to impact health care by increasing cognitive impairment and/or contributing to statin treatment avoidance. CASE : An 83-year-old Caucasian male was seen in a cognitive evaluation clinic for noticeable memory decline...
December 1, 2018: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
Mircea Zloteanu, Nigel Harvey, David Tuckett, Giacomo Livan
The Sharing Economy (SE) is a growing ecosystem focusing on peer-to-peer enterprise. In the SE the information available to assist individuals (users) in making decisions focuses predominantly on community-generated trust and reputation information. However, how such information impacts user judgement is still being understood. To explore such effects, we constructed an artificial SE accommodation platform where we varied the elements related to hosts' digital identity, measuring users' perceptions and decisions to interact...
2018: PloS One
Allen S Ho, Timothy J Daskivich, Wendy L Sacks, Zachary S Zumsteg
Importance: Across many countries, a rapid escalation of the incidence of thyroid cancer has been observed, a surge that nonetheless underestimates the true extent of the disease. Most thyroid cancers now diagnosed comprise small, low-risk cancers that are incidentally found and are unlikely to cause harm. In many ways, prostate cancer similarly harbors a well-behaved subclinical reservoir, a long natural history, and superlative outcomes that have made active surveillance the de facto guideline recommendation for low-risk disease...
December 13, 2018: JAMA Oncology
Robert Harper, Eric Klineberg
PURPOSE: The purpose of this article is to review the evidence-based approach for surgical complications following disc herniation. METHODS: A search of the primary English literature was conducted for research examining the outcomes and complications of surgical discectomy. Special regard was given to high-quality prospective randomized studies. RESULTS: The most commonly reported complications of surgical treatment of disc herniation are included in this review...
December 12, 2018: International Orthopaedics
Bengt Jönsson
Healthcare expenditures for cancer account for a low share of total healthcare expenditures, compared to the relative burden of the disease. The share has also not changed very much over the last decades. Cost for cancer drugs has increased as a share of total expenditures, but this has been offset by a reduction of inpatient hospital care for cancer. Accounting for the cost of cancer should not be limited to healthcare expenditures. Resources are also used for public and private care of cancer patients outside the healthcare sector, for example for palliative care...
2019: Recent Results in Cancer Research
Brendan P Cassidy, Leah E Getchell, Lori Harwood, Juliya Hemmett, Louise M Moist
Purpose of review: Provision of education to inform decision making for renal replacement therapy (RRT) is a key component in the management of chronic kidney disease (CKD), yet patients report suboptimal satisfaction with the process of selecting a dialysis modality. Our purpose is to review the influencers of RRT decision making in the CKD population, which will better inform the process of shared decision making between clinicians and patients. Sources of information: PubMed and Google Scholar...
2018: Canadian Journal of Kidney Health and Disease
Vinaya Manchaiah, Monica L Bellon-Harn, Ashley L Dockens, Jamie H Azios, William E Harn
BACKGROUND: Communication during clinical consultations is an important factor that facilitates decision-making by patients and family members. For clinicians, these interactions are opportunities to build rapport and to facilitate appropriate decision-making. PURPOSE: This article presents the literature review of studies focusing on communication between audiologist, patients, and their family members during initial audiology consultations and rehabilitation planning sessions...
November 29, 2018: Journal of the American Academy of Audiology
Gildasio S De Oliveira, Martin Errea, Jane Bialek, Mark C Kendall, Robert J McCarthy
BACKGROUND: Poor health literacy affects over 90 million Americans. The primary aim of the study was to evaluate a possible association between health literacy and decision conflict in surgical patients. METHODS: Patients undergoing a diverse number of elective surgeries were enrolled in the study. Health literacy was measured using the Newest Vital Sign instrument and decision conflict using the low literacy version of the Decision Conflict Scale. RESULTS: 200 patients undergoing elective surgeries were included in the study...
December 12, 2018: BMC Health Services Research
Evehouenou Lionel Adisso, Valérie Borde, Marie-Ève Saint-Hilaire, Hubert Robitaille, Patrick Archambault, Johanne Blais, Cynthia Cameron, Michel Cauchon, Richard Fleet, Jean-Simon Létourneau, Michel Labrecque, Julien Quinty, Isabelle Samson, Alexandrine Boucher, Hervé Tchala Vignon Zomahoun, France Légaré
INTRODUCTION: Shared decision making (SDM) is a process whereby decisions are made together by patients and/or families and clinicians. Nevertheless, few patients are aware of its proven benefits. This study investigated the feasibility, acceptability and impact of an intervention to raise public awareness of SDM in public libraries. MATERIALS AND METHODS: A 1.5 hour interactive workshop to be presented in public libraries was co-designed with Quebec City public library network officials, a science communication specialist and physicians...
2018: PloS One
Ngaio J Beausoleil, David J Mellor, Liv Baker, Sandra E Baker, Mariagrazia Bellio, Alison S Clarke, Arnja Dale, Steve Garlick, Bidda Jones, Andrea Harvey, Benjamin J Pitcher, Sally Sherwen, Karen A Stockin, Sarah Zito
Increasingly, human activities, including those aimed at conserving species and ecosystems (conservation activities) influence not only the survival and fitness but also the welfare of wild animals. Animal welfare relates to how an animal is experiencing its life and encompasses both its physical and mental states. While conservation biology and animal welfare science are both multi-disciplinary fields that use scientific methods to address concerns about animals, their focus and objectives sometimes appear to conflict...
2018: Frontiers in Veterinary Science
Anne L Ersig, Allison Werner-Lin, Lindsey Hoskins, Jennifer Young, Jennifer T Loud, June Peters, Mark H Greene
In families with hereditary breast/ovarian cancer, complex disease histories challenge established patterns of family communication and influence decision-making for clinical surveillance, genetic testing, and risk management. An interdisciplinary team examined longitudinal interview data from women with identified BRCA1/2 mutations to assess interactions within family and social networks about risk information communication and management. We used interpretive description to identify motivation, content, and derived benefit of these interactions...
December 12, 2018: Journal of Family Nursing
Genevra F Murray, Thomas D'Aunno, Valerie A Lewis
Policy Points Accountable care organizations (ACOs) form alliances with management partners to access financial, technical, and managerial support. Alliances between ACOs and management partners are subject to destabilizing tension around decision-making authority, distribution of shared savings, and conflicting goals and values. Management partners may serve either as trainers, ultimately breaking off from the ACO, or as central drivers of the ACO. Management partner participation in ACOs is currently unregulated, and management partners may receive a significant portion (in some cases, majority) of shared savings...
December 2018: Milbank Quarterly
Syed M Nazim, Mohamed Fawzy, Christian Bach, M Hammad Ather
Decision-making in the management of organ-confined prostate cancer is complex as it is based on multi-factorial considerations. It is complicated by a multitude of issues, which are related to the patient, treatment, disease, availability of equipment(s), expertise, and physicians. Combination of all these factors play a major role in the decision-making process and provide for an interactive decision-making preferably in the multi-disciplinary team (MDT) meeting. MDT decisions are comprehensive and are often based on all factors including patients' biological status, disease and its aggressiveness, and physician and centres' expertise...
December 2018: Arab Journal of Urology
Geoffrey Fairchild, Byron Tasseff, Hari Khalsa, Nicholas Generous, Ashlynn R Daughton, Nileena Velappan, Reid Priedhorsky, Alina Deshpande
Accessible epidemiological data are of great value for emergency preparedness and response, understanding disease progression through a population, and building statistical and mechanistic disease models that enable forecasting. The status quo, however, renders acquiring and using such data difficult in practice. In many cases, a primary way of obtaining epidemiological data is through the internet, but the methods by which the data are presented to the public often differ drastically among institutions. As a result, there is a strong need for better data sharing practices...
2018: Frontiers in Public Health
Zahra Kavosi, Mohsen Bayati, Masoud Arefnezhad, Enayatollah Homaie Rad, Abdosaleh Jaafari
Introduction: High-cost sharing in physician care may result in worse health outcomes and financial burdens for individuals, and it reduces needed health-care utilization. Hence, this study examines the impact of cost sharing on utilization of Physician care. Methods: In the present study, multistage sampling ( n = 1610) was done to collect general physician utilization and quality of life. Count data model was used to analyze the effect of cost sharing and other factor on the ratio of referring to the general physician...
2018: International Journal of Preventive Medicine
Indrani S Bhattacharya, Joanne S Haviland, Anna M Kirby, Cliona C Kirwan, Penelope Hopwood, John R Yarnold, Judith M Bliss, Charlotte E Coles
PURPOSE: IMPORT LOW demonstrated noninferiority of partial-breast and reduced-dose radiotherapy versus whole-breast radiotherapy for local relapse and similar or reduced toxicity at 5 years. Comprehensive patient-reported outcome measures collected at serial time points are now reported. PATIENTS AND METHODS: IMPORT LOW recruited women with low-risk breast cancer after breast-conserving surgery. Patients were randomly assigned to 40 Gy whole-breast radiotherapy (control), 36 Gy whole-breast and 40 Gy partial-breast radiotherapy (reduced-dose), or 40 Gy partial-breast radiotherapy only (partial-breast) in 15 fractions...
December 11, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
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