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https://www.readbyqxmd.com/read/29768480/internal-medicine-trainees-knowledge-and-confidence-in-using-the-american-society-of-hematology-choosing-wisely-guidelines-in-hemostasis-thrombosis-and-non-malignant-hematology
#1
Ariela L Marshall, Sarah Jenkins, Amy S Oxentenko, Alfred I Lee, Mark D Siegel, Joel T Katz, Jatin M Vyas, John Del Valle, Joseph R Mikhael
BACKGROUND: Several specialty societies participate in the Choosing Wisely (CW) campaign in an attempt to reduce waste in health care spending. We surveyed internal medicine (IM) residents with an objective of classifying knowledge of and confidence in using the American Society of Hematology (ASH) CW principles in hemostasis, thrombosis, and non-malignant hematology. METHODS: Multi-institutional study of IM residents at 5 academic training programs in the United States...
2018: PloS One
https://www.readbyqxmd.com/read/29768294/a-pilot-study-to-reduce-computed-tomography-utilization-for-pediatric-mild-head-injury-in-the-emergency-department-using-a-clinical-decision-support-tool-and-a-structured-parent-discussion-tool
#2
Rakesh S Engineer, Seth R Podolsky, Baruch S Fertel, Purva Grover, Heather Jimenez, Erin L Simon, Courtney M Smalley
INTRODUCTION: The American College of Emergency Physicians embarked on the "Choosing Wisely" campaign to avoid computed tomographic (CT) scans in patients with minor head injury who are at low risk based on validated decision rules. We hypothesized that a Pediatric Mild Head Injury Care Path could be developed and implemented to reduce inappropriate CT utilization with support of a clinical decision support tool (CDST) and a structured parent discussion tool. METHODS: A quality improvement project was initiated for 9 weeks to reduce inappropriate CT utilization through 5 interventions: (1) engagement of leadership, (2) provider education, (3) incorporation of a parent discussion tool to guide discussion during the emergency department (ED) visit between the parent and the provider, (4) CDST embedded in the electronic medical record, and (5) importation of data into the note to drive compliance...
May 15, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29765244/an-echo-to-choosing-wisely-%C3%A2-in-switzerland
#3
Lionel Chok, Johann Debrunner, Sandra Jaeggli, Karmen Kusic, Esther B Bachli
Background: Inspired by the US Choosing Wisely® , in 2016 the Swiss Society of General Internal Medicine released a list of five treatments or diagnostic tests used in the hospital and considered unnecessary based on not improving patient care and adding to health care costs. These "Smarter Medicine" recommendations were implemented in the Department of Internal Medicine, Uster Hospital, in August 2016. They were supported by lectures and weekly email communications. We analyzed the number of blood draws before and after implementation of the recommendation aimed at reducing blood tests...
2018: International Journal of General Medicine
https://www.readbyqxmd.com/read/29760257/choosing-wisely-canada-recommendations
#4
Dr Meldon Kahan
No abstract text is available yet for this article.
May 2018: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/29760252/choosing-wisely-in-primary-care-moving-from-recommendations-to-implementation
#5
Kimberly Wintemute, Lynn Wilson, Wendy Levinson
No abstract text is available yet for this article.
May 2018: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/29750659/evidence-based-physiatry-learning-to-choose-wisely
#6
Sabrina Paganoni
No abstract text is available yet for this article.
May 10, 2018: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/29748677/effect-of-iron-doping-on-protein-molecular-conductance
#7
Nikolai Lebedev, Igor Griva, Anders Blom, Leonard M Tender
Protein molecular conductance has attracted attention from researchers for the possibility of constructing innovative flexible biocompatible nanoscale electronic devices and smart hybrid materials. Due to protein complexity, most evaluations of protein conductivity are based on the simple estimation of protein's molecular orbital energy levels and spatial distributions without analysing its protein interaction with electrodes and the calculation of the rates of electron transfer (ET). In the present work, we included in our density functional theory (DFT) analysis an approach based on the non-equilibrium Green's function (NEGF) allowing for calculation from the first principles the molecular interaction with electrodes and thus the role of electrode materials, Fermi level, the thermal distribution of electronic energy levels, and the coupling efficiency between the molecule and the electrodes...
May 11, 2018: Physical Chemistry Chemical Physics: PCCP
https://www.readbyqxmd.com/read/29746537/kinetic-and-kinematic-variables-affecting-trunk-flexion-during-level-walking-in-patients-with-lumbar-spinal-stenosis
#8
Tatsuya Igawa, Junji Katsuhira, Akira Hosaka, Kenta Uchikoshi, Shinichi Ishihara, Ko Matsudaira
Lumbar spinal stenosis causes cauda equina and nerve root compression, resulting in neurological symptoms. Although trunk flexion during level walking may alleviate these symptoms by enabling spinal canal decompression, some patients do not use this strategy. We aimed to identify the kinetic and kinematic variables that affect trunk flexion in patients during level walking. Gait was recorded in 111 patients using a three-dimensional motion capture system and six force plates. From the data recorded, walking velocity, bilateral step length, cycle time, maximum trunk flexion angle, forward pelvic tilt angle, pelvic rotation angle, maximum and minimum joint angles, and moment and power of the lower limb were calculated...
2018: PloS One
https://www.readbyqxmd.com/read/29740638/mediterranean-diet-based-intervention-in-pregnancy-to-improve-maternal-and-fetal-outcomes-methodological-challenges-and-lessons-learned-from-the-multicentre-esteem-study
#9
Bassel H Al Wattar, Julie Dodds, Anna Placzek, Eleni Spyreli, Sally Higgins, Amanda Moore, Richard Hooper, Lee Beresford, Tessa J Roseboom, Maira Bes-Rastrollo, Graham Hitman, Khalid S Khan, Shakila Thangaratinam
Introduction: Evaluating complex dietary interventions such as Mediterranean diet in pregnancy presents unique methodological challenges. We present the challenges and the lessons learned from a multicentre randomised trial (ESTEEM) on Mediterranean-based dietary intervention in pregnancy. Methods: We recruited pregnant women who met our predefined inclusion criteria and randomised those with metabolic risk factors to the Mediterranean-based dietary intervention or routine antenatal care...
June 2017: Contemporary Clinical Trials Communications
https://www.readbyqxmd.com/read/29725412/locally-advanced-laryngeal-cancer-total-laryngectomy-or-primary-non-surgical-treatment
#10
Aleš Čoček, Miloslav Ambruš, Alena Dohnalová, Martin Chovanec, Martina Kubecová, Kateřina Licková
Between January 1997 and December 2013, the Charles University 3rd Medical School and Royal Vinohrady Teaching Hospital Ear, Nose and Throat oncology team treated 185 patients with advanced laryngeal cancer, which, from a surgical perspective, required a total laryngectomy. Overall, ~70% of these patients (n=129) underwent conventional treatment (i.e., total laryngectomy with post-operative radiotherapy), and ~30% (n=56) were treated with larynx preservation protocols (including primary radiotherapy, neoadjuvant chemotherapy followed by radiotherapy or chemoradiotherapy, or primary chemoradiotherapy)...
May 2018: Oncology Letters
https://www.readbyqxmd.com/read/29719428/factors-associated-with-imaging-in-patients-with-early-breast-cancer-after-initial-treatment
#11
K Enright, T Desai, R Sutradhar, A Gonzalez, M Powis, N Taback, C M Booth, M E Trudeau, M K Krzyzanowska
Background: Overuse of surveillance imaging in patients after curative treatment for early breast cancer (ebc) was recently identified as one of the Choosing Wisely Canada initiatives to improve the quality of cancer care. We undertook a population-level examination of imaging practices in Ontario as they existed before the launch of that initiative. Methods: Patients diagnosed with ebc between 2006 and 2010 in Ontario were identified from the Ontario Cancer Registry...
April 2018: Current Oncology
https://www.readbyqxmd.com/read/29710232/choosing-wisely-campaigns-a-work-in-progress
#12
Wendy Levinson, Karen Born, Daniel Wolfson
No abstract text is available yet for this article.
April 19, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29694449/appraising-the-evidence-supporting-choosing-wisely%C3%A2-recommendations
#13
Andrew J Admon, Ashwin Gupta, Margaret Williams, Thomas S Valley, Michael W Sjoding, Renda Soylemez Wiener, Colin R Cooke
Despite the growing enthusiasm surrounding the Choosing Wisely® campaign, little is known regarding the evidence underlying these recommendations. We extracted references for all 320 recommendations published through August, 2014, including the 10 adult and pediatric recommendations published by the Society for Hospital Medicine. We then categorized each item by evidence strength, and then assessed a sample of referenced clinical practice guidelines (CPGs) using the validated Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument...
April 25, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29692419/influenza-virus-choose-your-enemies-wisely
#14
Yvonne Bordon
No abstract text is available yet for this article.
April 25, 2018: Nature Reviews. Immunology
https://www.readbyqxmd.com/read/29691687/-characteristics-of-pharmacotherapy-in-older-patients-with-rheumatism
#15
REVIEW
H-J Lakomek, Christian Schulz
Due to medical advances and the availability of efficient immunosuppressive therapies, the life-expectancy of people suffering from inflammatory rheumatic diseases is continuously increasing. In Germany, geriatric patients (definition: age older than 70 years combined with geriatric multimorbidity) affected, e. g. by rheumatoid arthritis (RA) frequently receive corticosteroids and less often biologic disease-modifying antirheumatic drugs (bDMARDs) and conventional DMARDs (cDMARDs), which is justified by additionally existing comorbidities and polypharmacy...
April 24, 2018: Zeitschrift Für Rheumatologie
https://www.readbyqxmd.com/read/29686450/using-shared-decision-making-to-address-possible-overtreatment-in-patients-at-high-risk-for-hypoglycemia-the-veterans-health-administration-s-choosing-wisely-hypoglycemia-safety-initiative
#16
Samantha M Wright, Sandra C Hedin, Mark McConnell, Brian V Burke, Sharon A Watts, Donna M Leslie, David C Aron, Leonard M Pogach
IN BRIEF Successful management of patients with diabetes requires individualizing A1C and treatment goals in conjunction with identifying and managing hypoglycemia risk. This article describes the Veterans Health Administration's Choosing Wisely Hypoglycemia Safety Initiative (CW-HSI), a voluntary program that aims to reduce the occurrence of hypoglycemia through shared decision-making about deintensifying diabetes treatment in a dynamic cohort of patients identified as being at high risk for hypoglycemia and potentially overtreated...
April 2018: Clinical Diabetes: a Publication of the American Diabetes Association
https://www.readbyqxmd.com/read/29683430/reconnection-of-interrupted-curvilinear-structures-via-cortically-inspired-completion-for-ophthalmologic-images
#17
Jiong Zhang, Erik Bekkers, Da Chen, Tos T J M Berendschot, Jan Schouten, Josien P W Pluim, Yonggang Shi, Behdad Dashtbozorg, Bart M Ter Haar Romeny
OBJECTIVE: In this paper, we propose a robust, efficient, and automatic reconnection algorithm for bridging interrupted curvilinear skeletons in ophthalmologic images. METHODS: This method employs the contour completion process, i.e., mathematical modeling of the direction process in the roto-translation group to achieve line propagation/completion. The completion process can be used to reconstruct interrupted curves by considering their local consistency. An explicit scheme with finite-difference approximation is used to construct the three-dimensional (3-D) completion kernel, where we choose the Gamma distribution for time integration...
May 2018: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/29671554/putting-choosing-wisely-into-practice
#18
Jennifer L Middleton
No abstract text is available yet for this article.
April 1, 2018: American Family Physician
https://www.readbyqxmd.com/read/29625662/choosing-wisely-in-the-era-of-biologics-for-asthma
#19
EDITORIAL
M Diane Lougheed
No abstract text is available yet for this article.
April 2018: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/29623670/epidemiology-in-wonderland-big-data-and-precision-medicine
#20
Rodolfo Saracci
Big Data and precision medicine, two major contemporary challenges for epidemiology, are critically examined from two different angles. In Part 1 Big Data collected for research purposes (Big research Data) and Big Data used for research although collected for other primary purposes (Big secondary Data) are discussed in the light of the fundamental common requirement of data validity, prevailing over "bigness". Precision medicine is treated developing the key point that high relative risks are as a rule required to make a variable or combination of variables suitable for prediction of disease occurrence, outcome or response to treatment; the commercial proliferation of allegedly predictive tests of unknown or poor validity is commented...
April 5, 2018: European Journal of Epidemiology
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