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Decision support tools

Lordkipanidze Maia, Lulofs Kris, Bressers Hans
The paper focuses on the governance of the Dutch national park Weerribben-Wieden and its ability to foster ecological resilience in the face of climate change and human disturbances. The study highlights the role of various characteristics of the institutional context of governance in which resilience-relevant decisions are prepared, taken and implemented as referenced by an assessment of the governance context. The relevance of such an assessment is found in the frequent institutional changes in nature policy...
August 10, 2018: Science of the Total Environment
Alexander Procaskey, Heather White, Tregony Simoneau, Nadav Traeger, Thomas Lahiri, Elie Abu Jawdeh, Ted Kremer, Catherine Sheils, Kathleen Meyer, Ted Rosenkrantz, Krishnan Sankaran, Tyler Hartman, Henry Feldman, Lawrence Rhein
Improved survival among preterm infants has led to an increase in diagnosis of chronic lung disease and infants discharged home from the NICU on supplemental oxygen. Despite this increased prevalence, no clearly defined guidelines for the management of home oxygen therapy (HOT) exist. This lack of consensus leads to significant variability in the duration of home oxygen therapy and a general paucity of evidence-based practice. Our team has identified recorded home oxygen therapy (RHO) as a potential new resource to guide clinical decision making in the outpatient pulmonology clinic...
August 11, 2018: Contemporary Clinical Trials
Robert E Freundlich, Jonathan P Wanderer, Jesse M Ehrenfeld
No abstract text is available yet for this article.
September 2018: Anesthesiology
Fabian Spill, Chris Bakal, Michael Mak
Mechanics and biochemical signaling are both often deregulated in cancer, leading toincreased cell invasiveness, proliferation, and survival. The dynamics and interactions of cytoskeletal components control basic mechanical properties, such as cell tension, stiffness, and engagement with the extracellular environment, which can lead to extracellular matrix remodeling. Intracellular mechanics can alter signaling and transcription factors, impacting cell decision making. Additionally, signaling from soluble and mechanical factors in the extracellular environment, such as substrate stiffness and ligand density, can modulate cytoskeletal dynamics...
2018: Computational and Structural Biotechnology Journal
Thomas B Silverman, Alejandro Vanegas, Awilda Marte, Jennie Mata, Margaret Sin, Juan Carlos Rodriguez Ramirez, Wei-Yann Tsai, Katherine D Crew, Rita Kukafka
BACKGROUND: BRCA1 and BRCA2 mutations confer a substantial breast risk of developing breast cancer to those who carry them. For this reason, the United States Preventative Services Task Force (USPSTF) has recommended that all women be screened in the primary care setting for a family history indicative of a mutation, and women with strong family histories of breast or ovarian cancer be referred to genetic counseling. However, few high-risk women are being routinely screened and fewer are referred to genetic counseling...
August 13, 2018: BMC Health Services Research
Sarah L Mullane, Dana R Epstein, Matthew P Buman
Within the behavioral field, a plethora of conceptual frameworks and tools have been developed to improve transition from efficacy to effectiveness trials; however, they are limited in their ability to support new, iterative intervention design decision-making methodologies beyond traditional randomized controlled trial design. Emerging theories suggest that researchers should employ engineering based user-centered design (UCD) methods to support more iterative intervention design decision-making in the behavioral field...
August 7, 2018: Translational Behavioral Medicine
Aditya V Karhade, Quirina Thio, Paul Ogink, Jason Kim, Santiago Lozano-Calderon, Kevin Raskin, Joseph Schwab
INTRODUCTION: Chordomas are locally invasive slow-growing tumors that are difficult to study because of the rarity of the tumors and the lack of significant volumes of patients with longitudinal follow-up. As such, there are currently no machine learning studies in the chordoma literature. The purpose of this study was to develop machine learning models for survival prediction and deploy them as open access web applications as a proof of concept for machine learning in rare nervous system lesions...
August 7, 2018: World Neurosurgery
Jessica M Goehringer, Michele A Bonhag, Laney K Jones, Tara Schmidlen, Marci Schwartz, Alanna Kulchak Rahm, Janet L Williams, Marc S Williams
Context: Communication of genetic laboratory results to patients and providers is impeded by the complexity of results and reports. This can lead to misinterpretation of results, causing inappropriate care. Patients often do not receive a copy of the report leading to possible miscommunication. To address these problems, we conducted patient-centered research to inform design of interpretive reports. Here we describe the development and deployment of a specific patient-centered clinical decision support (CDS) tool, a multi-use patient-centered genomic test report (PGR) that interfaces with an electronic health record (EHR)...
June 26, 2018: EGEMS
Aritta Suwarno, Meine van Noordwijk, Hans-Peter Weikard, Desi Suyamto
The Indonesian government recently confirmed its Intended Nationally Determined Contributions (INDCs) to mitigate global climate change. A forest moratorium policy that protects forest and peatland is a significant part of the INDCs; however, its effectiveness is unclear in the face of complex land-use and land-cover change. This study aims to assess the dynamics of land-use change and ecosystem service supply as a function of local decision-making. We developed an agent-based model, Land-Use Change and Ecosystem Services (LUCES), and used it to explore the possible effects of the forest moratorium policy on the land-use decisions of private companies and communities...
2018: Mitigation and adaptation strategies for global change
Linda A Klaassen, Carmen D Dirksen, Liesbeth J Boersma, Ciska Hoving
OBJECTIVE: A patient decision aid (PtDA), was developed to support breast cancer patients making choices about their aftercare. The aim of this pilot was to test the effects of the PtDA on Shared Decision Making (SDM), Decision Evaluation (DES) in patients, consultation time, choice of aftercare and hospital costs. METHODS: A prospective before-and-after study including a control (no PtDA-usage) and experimental group (PtDA-usage during consultation) was conducted in six hospitals...
July 18, 2018: Breast: Official Journal of the European Society of Mastology
Theresa Thoma-Lürken, Monique A S Lexis, Michel H C Bleijlevens, Jan P H Hamers
AIMS AND OBJECTIVES: The first aim is to gain insight into the perceived added value of a decision support App for district nurses and case managers intended to support a problem assessment and the provision of advices on possible solutions to facilitate aging in place of people with dementia. The second aim is to investigate how they would implement the App in daily practice. BACKGROUND: District nurses and case managers play an important role in facilitating aging in place of persons with dementia (PwD)...
August 9, 2018: Journal of Clinical Nursing
Eriko Shiraishi, Kouhei Sugimoto, Jason Solomon Shapiro, Yuki Ito, Keiko Kamoshita, Atsuko Kusuhara, Takayuki Haino, Tomoe Koizumi, Aikou Okamoto, Nao Suzuki
Purpose The oncofertility decision tree was developed by the oncofertility consortium as a tool to support healthcare professionals and patients through the complicated process of deciding the most appropriate fertility preservation strategy for patients with cancer. Various strategies include oocyte retrieval, oocyte donation, use of a gestational carrier and adoption. However, differences in the cultural and legal landscape present serious barriers to utilizing some of these strategies in Japan. Patients and Methods We surveyed Japanese oncofertility stakeholders including 60 cancer survivors, 27 oncology facilities, 78 reproductive medicine facilities and 15 adoption agencies by a questionnaire to characterize awareness among oncofertility stakeholders in Japan about parenting options including adoption to inform work to establish guidelines for decision-making by cancer survivors in an oncofertility...
July 2018: Journal of Global Oncology
Luke J Potgieter, Mirijam Gaertner, Ulrike M Irlich, Patrick J O'Farrell, Louise Stafford, Hannah Vogt, David M Richardson
Alien plant invasions in urban areas can have considerable impact on biodiversity and ecosystem services (ES). Managing urban plant invasions is particularly challenging given the complex interactions between ecological, economic and social elements that exist in the urban milieu. Strategic landscape-scale insights are crucial for guiding management, as are tactical site-scale perspectives to plan and coordinate control efforts on the ground. Integrating these requirements to enhance management efficiency is a major challenge...
August 6, 2018: Environmental Management
Megan A Clarke, Beverly J Long, Arena Del Mar Morillo, Marc Arbyn, Jamie N Bakkum-Gamez, Nicolas Wentzensen
Importance: As the worldwide burden of endometrial cancer continues to rise, interest is growing in the evaluation of early detection and prevention strategies among women at increased risk. Focusing efforts on women with postmenopausal bleeding (PMB), a common symptom of endometrial cancer, may be a useful strategy; however, PMB is not specific for endometrial cancer and is often caused by benign conditions. Objective: To provide a reference of the prevalence of PMB in endometrial cancers and the risk of endometrial cancer in women with PMB...
August 6, 2018: JAMA Internal Medicine
Jichi Chen, Hong Wang, Chengcheng Hua
This paper proposes a comprehensive approach to explore whether functional brain network (FBN) changes from the alert state to the drowsy state and to find out ideal neurophysiology indicators able to detect driver drowsiness in terms of FBN. A driving simulation experiment consisting of two driving tasks is designed and conducted using fifteen participant drivers. Collected EEG signals are then decomposed into multiple frequency bands by wavelet packet transform (WPT). Based on this, two novel FBN approaches, synchronization likelihood (SL) and minimum spanning tree (MST) are combined and applied to feature recognition and classification system...
August 3, 2018: International Journal of Psychophysiology
Brian E McGarry, Nicole Maestas, David C Grabowski
Helping older adults make good plan choices is a persistent challenge of the Medicare prescription drug (Part D) program. The Centers for Medicare and Medicaid Services (CMS) provides an internet-based decision support tool (Plan Finder), but this appears to have had limited effect in part because the tool is complex and difficult to interpret. This study used a randomized experiment with hypothetical Part D plan choices to test the effect of simplifying the default amount of financial information provided on Plan Finder on people's ability to select low-cost plans...
August 2018: Health Affairs
Edwin D Boudreaux, Celine Larkin, Nisha Kini, Lisa Capoccia, Michael H Allen, Julie Goldstein Grumet, Morton M Silverman, Richard McKeon, Bruce Barton, Ivan Miller, Scott W Formica, Carlos A Camargo
Emergency department (ED) clinicians routinely decide the disposition of patients with suicidal ideation, with potential consequences for patient safety, liability, and system costs and resources. An expert consensus panel recently created a 6-item decision support tool for patients with passive or active suicidal ideation. Individuals scoring a 0 (exhibiting none of the tool's 6 items) are considered "lower risk" and suitable for discharge, while those with non-0 scores are considered "elevated risk" and should receive further evaluation...
August 2018: Psychological Services
Mark T Mackay, Maja Steinlin
This review will discuss important developments in childhood arterial ischemic stroke over the past decade, focusing on improved understanding of the causes, consequences, and targets for intervention. Risk factors for childhood arterial ischemic stroke are different to adults. Infections, particularly herpes group viruses, are important precipitants for stroke. Non-atherosclerotic arteriopathies are the most common cause of childhood arterial ischemic stroke and an important predictor of recurrent events. Recent advances include the identification of serum biomarkers for inflammation and endothelial injury, and imaging biomarkers to monitor for vascular progression...
August 6, 2018: International Journal of Stroke: Official Journal of the International Stroke Society
Michelle Carbonneau, Tracy Davyduke, Jude Spiers, Amanda Brisebois, Kathleen Ismond, Puneeta Tandon
Aim: To investigate patient experiences and perceptions of advance care planning (ACP) process in cirrhosis. Methods: Purposive sampling was used to identify and recruit participants (N = 17) from discrete patient groups: compensated with no prior decompensation, decompensated and not yet listed for transplant, transplant wait listed, medical contraindications for transplant, and low socioeconomic status. Review and discussion of local ACP videos, documents, and experiences with ACP occurred in two individual interviews and four focus groups...
2018: Canadian Journal of Gastroenterology & Hepatology
Fatima Schera, Michael Schäfer, Anca Bucur, Jasper van Leeuwen, Eric Herve Ngantchjon, Norbert Graf, Haridimos Kondylakis, Lefteris Koumakis, Kostas Marias, Stephan Kiefer
Clinical decision support systems can play a crucial role in healthcare delivery as they promise to improve health outcomes and patient safety, reduce medical errors and costs and contribute to patient satisfaction. Used in an optimal way, they increase the quality of healthcare by proposing the right information and intervention to the right person at the right time in the healthcare delivery process. This paper reports on a specific approach to integrated clinical decision support and patient guidance in the cancer domain as proposed by the H2020 iManageCancer project...
2018: Ecancermedicalscience
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