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https://www.readbyqxmd.com/read/29350509/measuring-overuse-with-electronic-health-records-data
#1
Thomas Isaac, Meredith B Rosenthal, Carrie H Colla, Nancy E Morden, Alexander J Mainor, Zhonghe Li, Kevin H Nguyen, Elizabeth A Kinsella, Thomas D Sequist
OBJECTIVES: To measure overuse of low-value care using electronic health record (EHR) data and manual chart review and to evaluate whether certain low-value services are better captured using EHR data. STUDY DESIGN: We implemented algorithms to extract performance on 13 Choosing Wisely-identified healthcare services using EHR data at a large physician practice group between 2011 and 2013. METHODS: We calculated rates of overuse using automated EHR extracts...
January 2018: American Journal of Managed Care
https://www.readbyqxmd.com/read/29331781/a-step-wise-self-assembly-approach-in-preparation-of-multi-responsive-poly-styrene-co-methyl-methacrylate-nanoparticles-containing-spiropyran
#2
Fahimeh Khakzad, Ali Reza Mahdavian, Hamid Salehi-Mobarakeh, Mohammad Hossain Sharifian
HYPOTHESIS: Surfactant-free emulsion polymerization has become favorable due to circumventing instability issues reasonably. Incorporation of an appropriate hydrophilic macroRAFT, could provide controlled in-situ self-assembly via copolymerization with hydrophobic monomers into polymer particles. So far, this approach has mostly been studied in dispersion systems and further studies are needed in emulsions. Beside the corresponding mechanistic studies, the prepared latex particles would potentially exhibit smart behaviors by choosing stimuli-responsive monomers...
January 4, 2018: Journal of Colloid and Interface Science
https://www.readbyqxmd.com/read/29327445/don-t-just-do-something-stand-there-the-value-and-art-of-deliberate-clinical-inertia
#3
Gerben Keijzers, Louise Cullen, Diana Egerton-Warburton, Daniel M Fatovich
It can be difficult to avoid unnecessary investigations and treatments, which are a form of low-value care. Yet every intervention in medicine has potential harms, which may outweigh the potential benefits. Deliberate clinical inertia is the art of doing nothing as a positive response. This paper provides suggestions on how to incorporate deliberate clinical inertia into our daily clinical practice, and gives an overview of current initiatives such as 'Choosing Wisely' and the 'Right Care Alliance'. The decision to 'do nothing' can be complex due to competing factors, and barriers to implementation are highlighted...
January 12, 2018: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29326348/choosing-ibrutinib-wisely
#4
Farrukh T Awan
No abstract text is available yet for this article.
January 11, 2018: Blood
https://www.readbyqxmd.com/read/29324617/quality-assurance-and-improvement-tools-how-to-choose-wisely
#5
Kavita Shah Arora, Jennifer L Bailit
No abstract text is available yet for this article.
January 9, 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29315969/effectiveness-of-interventions-to-decrease-image-ordering-for-low-back-pain-presentations-in-the-emergency-department-a-systematic-review
#6
Chaocheng Liu, Shashwat Desai, Lynette D Krebs, Scott W Kirkland, Diana Keto-Lambert, Brian H Rowe
BACKGROUND: Low back pain (LBP) is an extremely frequent reason for patients to present to an emergency department (ED). Despite evidence against the utility of imaging, simple and advanced imaging (i.e., computed tomography [CT], magnetic resonance imaging [MRI]) for patients with LBP has become increasingly frequent in the ED. The objective of this review was to identify and examine the effectiveness of interventions aimed at reducing image ordering in the ED for LBP patients. METHODS: A protocol was developed a priori, following the PRISMA guidelines, and registered with PROSPERO...
January 8, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29236409/cna-leads-development-of-first-nursing-list-for-choosing-wisely-canada
#7
Karey Shuhendler
No abstract text is available yet for this article.
January 2017: Canadian Nurse
https://www.readbyqxmd.com/read/29236093/trends-in-troponin-only-testing-for-ami-in-academic-teaching-hospitals-and-the-impact-of-choosing-wisely%C3%A2
#8
Micah T Prochaska, Samuel F Hohmann, Matthew Modes, Vineet M Arora
BACKGROUND: Identifying hospitals that are both early and consistent adopters of high-value care can help shed light on the culture and practices at those institutions that are necessary to promote high-value care nationwide. The use of troponin to diagnose acute myocardial infarction (AMI), and not to test for myoglobin or creatine kinase-MB (CK-MB), is a high-value recommendation of the Choosing Wisely® campaign. OBJECTIVE: To examine the variation in cardiac biomarker testing and the effect of the Choosing Wisely® troponin-only recommendation for the diagnosis of AMI...
December 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29232870/synthesis-and-characterization-of-nanofunctionalized-gelatin-methacrylate-hydrogels
#9
Kamel Rahali, Ghazi Ben Messaoud, Cyril J F Kahn, Laura Sanchez-Gonzalez, Mouna Kaci, Franck Cleymand, Solenne Fleutot, Michel Linder, Stéphane Desobry, Elmira Arab-Tehrany
Given the importance of the extracellular medium during tissue formation, it was wise to develop an artificial structure that mimics the extracellular matrix while having improved physico-chemical properties. That is why the choice was focused on gelatin methacryloyl (GelMA), an inexpensive biocompatible hydrogel. Physicochemical and mechanical properties were improved by the incorporation of nanoparticles developed from two innovative fabrication processes: High shear fluid and low frequencies/high frequencies ultrasounds...
December 10, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29228072/an-implementation-guide-to-reducing-overtreatment-of-asymptomatic-bacteriuria
#10
Michael Daniel, Sara Keller, Mohammad Mozafarihashjin, Amit Pahwa, Christine Soong
Treatment of asymptomatic bacteriuria (ASB) frequently lacks appropriate indication, yet remains prevalent across settings. Numerous guidelines, professional societies, and campaigns such as Choosing Wisely advocate against this low-value practice. Efforts aimed at reducing unnecessary treatment of ASB demonstrate improved costs, and avoidable harm without increased risk of adverse events. We propose an evidence-based implementation guide to aid practitioners in reducing inappropriate treatment of ASB.
December 11, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/29227516/pediatric-ingestions-and-choosing-wisely
#11
EDITORIAL
Joseph R Hageman
No abstract text is available yet for this article.
December 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/29226050/determinants-of-computed-tomography-head-scan-ordering-for-patients-with-low-risk-headache-in-the-emergency-department
#12
Meaghan J Mackenzie, Rashi Hiranandani, Dongmei Wang, Tak Fung, Eddy Lang
Background Many specialty societies have found that neuroimaging in headache is a low-value intervention for benign presentations. This study describes factors that influence Emergency Room (ER) physicians' adherence to Choosing Wisely (CW) recommendations for low-risk headache patients presenting to Calgary's Emergency Departments (EDs). Emergency medicine has yet to address imaging in headache as a CW topic; however, this study may inform that decision. Methods Data were retrospectively collected for all patients presenting to Calgary EDs with headaches from April 1, 2014 to March 31, 2016...
October 9, 2017: Curēus
https://www.readbyqxmd.com/read/29207420/-internal-medicine-from-guidelines-to-choosing-wisely
#13
Jürgen Floege
No abstract text is available yet for this article.
December 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29189825/-appropriateness-and-surroundings-doing-more-does-not-mean-doing-better-choosing-wisely-an-unfulfilled-commitment
#14
Fulvio Camerini, Enrico Fabris, Gianfranco Sinagra
The attention of the medical community to the appropriateness of diagnostic and therapeutic procedures has increased in recent years, recognizing the need for a careful use of resources and for avoiding unnecessary and sometimes harmful medical tests, procedures and therapies. Not only healthcare providers, but also public, patients and politicians, should know the consequences of inappropriate decisions and behaviors. Indeed, inappropriateness has clinical (risks), economic (waste of resources), but also ethical implications (i...
December 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/29178303/aanem-choosing-wisely-second-list
#15
(no author information available yet)
Choosing Wisely is an initiative of the ABIM Foundation in partnership with Consumer Reports that seeks to advance a national dialogue on avoiding wasteful or unnecessary medical tests, treatments and procedures. The American Association for Neuromuscular & Electrodiagnostic Medicine's (AANEM) Professional Practice Committee (PPC) identified areas in neuromuscular and electrodiagnostic medicine that have the greatest potential for overuse/misuse and provided five recommendations for both patients and physicians to consider before proceeding with the specified test or treatment...
November 27, 2017: Muscle & Nerve
https://www.readbyqxmd.com/read/29172972/choosing-doctors-wisely-can-assisted-choice-enhance-patients-selection-of-clinicians
#16
Steven C Martino, Rachel Grob, Sarah Davis, Andrew M Parker, Melissa L Finucane, Jennifer L Cerully, Lise Rybowski, Dale Shaller, Mark Schlesinger
We conducted a simulated clinician-choice experiment, comparing choices and decision-making processes of participants ( N = 688) randomized among four experimental arms: a conventional website reporting only quantitative performance information, a website reporting both qualitative (patient comments) and quantitative information, the second website augmented by a decision aid (labeling of patient comments), and the decision-aided website further augmented by the presence of a trained navigator. Introducing patient comments enhanced engagement with the quality information but led to a decline in decision quality, particularly the consistency of choices with consumers' stated preferences...
November 1, 2017: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29159367/promoting-high-value-practice-by-reducing-unnecessary-transfusions-with-a-patient-blood-management-program
#17
Divyajot Sadana, Ariella Pratzer, Lauren J Scher, Harry S Saag, Nicole Adler, Frank M Volpicelli, Moises Auron, Steven M Frank
Although blood transfusion is a lifesaving therapy for some patients, transfusion has been named 1 of the top 5 overused procedures in US hospitals. As unnecessary transfusions only increase risk and cost without providing benefit, improving transfusion practice is an effective way of promoting high-value care. Most high-quality clinical trials supporting a restrictive transfusion strategy have been published in the past 5 to 10 years, so the value of a successful patient blood management program has only recently been recognized...
November 20, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/29157561/-choosing-wisely-rationale-implementation-and-evaluation
#18
Gerd Hasenfuß, Ulrich R Fölsch
"Klug entscheiden" (Choosing Wisely) is an initiative launched by the German Society for Internal Medicine (DGIM) to boost the quality of medical indication by identifying both medical/therapeutic over- and underuse. Twelve specialist societies for internal medicine and DGIM associated societies develop corresponding recommendations which are subsequently evaluated and rejected or approved in a structured procedure by a multidisciplinary commission. Since 2016, 115 positive and negative recommendations have been developed and released for print media, radio and television...
November 17, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/29157559/-deciding-wisely-together-an-initiative-of-the-association-of-the-scientific-medical-societies-in-germany-mission-methodology-and-application
#19
Monika Nothacker, Rolf Kreienberg, Ina Kopp
The question of how to improve healthcare quality and the need for patient empowerment and shared decision-making has been subject of political and scientific debate for years. In addition to various quality initiatives, "top lists" summarizing selected recommendations to increase awareness of overuse, spread by means of public campaigns, has become popular on the international level-known as the "Choosing Wisely" initiative. However, the trustworthiness of "top lists", their impact on patient-relevant outcomes, their role in and integration into the context of the various pre-existing approaches to improve healthcare quality and the effects of neglecting under- and misuse are not clear...
November 17, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/29153357/choosing-wisely-%C3%A2-klug-entscheiden-begriffliche-und-ethische-%C3%A3-berlegungen
#20
Bettina Schöne-Seifert
Choosing Wisely and Klug Entscheiden are recent physician-triggered campaigns that aim at identifying and reducing blatant over-treatment as well as - a specialty of KE - occurring under-treatment. This paper provides some conceptual and normative analyses of these campaigns' goals and justifications.
November 15, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
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