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Decision Support Systems, Clinical

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https://www.readbyqxmd.com/read/28433671/montreal-accord-on-patient-reported-outcomes-use-series-paper-3-patient-reported-outcomes-pro-can-facilitate-shared-decision-making-and-guide-self-management
#1
V K Noonan, A Lyddiatt, P Ware, S B Jaglal, R J Riopelle, C O Bingham, S Figueiredo, R Sawatzky, M Santana, S J Bartlett, S Ahmed
BACKGROUND: There is a shift towards making health care patient-centred whereby patients are part of medical decision-making and take responsibility for managing their health. Patient-reported outcomes (PROs) capture the patient voice and can be used to engage patients in medical decision-making. OBJECTIVE: The objective of this paper is to present important factors from patients', clinicians', researchers', and decision-makers' perspectives that influence successful adoption of PROs in clinical practice...
April 19, 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/28428165/a-framework-for-the-study-of-complex-mhealth-interventions-in-diverse-cultural-settings
#2
Marion A Maar, Karen Yeates, Nancy Perkins, Lisa Boesch, Diane Hua-Stewart, Peter Liu, Jessica Sleeth, Sheldon W Tobe
BACKGROUND: To facilitate decision-making capacity between options of care under real-life service conditions, clinical trials must be pragmatic to evaluate mobile health (mHealth) interventions under the variable conditions of health care settings with a wide range of participants. The mHealth interventions require changes in the behavior of patients and providers, creating considerable complexity and ambiguity related to causal chains. Process evaluations of the implementation are necessary to shed light on the range of unanticipated effects an intervention may have, what the active ingredients in everyday practice are, how they exert their effect, and how these may vary among recipients or between sites...
April 20, 2017: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/28428140/automated-annotation-and-classification-of-bi-rads-assessment-from-radiology-reports
#3
Sergio M Castro, Eugene Tseytlin, Olga Medvedeva, Kevin Mitchell, Shyam Visweswaran, Tanja Bekhuis, Rebecca S Jacobson
The Breast Imaging Reporting and Data System (BI-RADS) was developed to reduce variation in the descriptions of findings. Manual analysis of breast radiology report data is challenging but is necessary for clinical and healthcare quality assurance activities. The objective of this study is to develop a natural language processing (NLP) system for automated BI-RADS categories extraction from breast radiology reports. We evaluated an existing rule-based NLP algorithm, and then we developed and evaluated our own method using a supervised machine learning approach...
April 17, 2017: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/28427915/-multimorbidity-in-general-practice-and-the-ariadne-principles-a-person-centred-approach
#4
Alexandra Prados-Torres, Isabel Del Cura-González, Juan Daniel Prados-Torres, Francisca Leiva-Fernández, Juan Antonio López-Rodríguez, Amaia Calderón-Larrañaga, Christiane Muth
Multimorbidity, defined as the coexistence of two or more chronic conditions in one same individual, has negative consequences for people suffering from it and it poses a real challenge for health systems. In primary care, where most of these patients are attended, the clinical management of multimorbidity can be a complex task due, among others, to the high volume of clinical information that needs to be handled, the scarce scientific evidence available to approach multimorbidity, and the need for coordination among multiple health providers to guarantee continuity of care...
April 17, 2017: Atencion Primaria
https://www.readbyqxmd.com/read/28425920/development-of-a-fast-monte-carlo-dose-calculation-system-for-online-adaptive-radiation-therapy-quality-assurance
#5
Yuhe Wang, Thomas Mazur, Justin Park, Deshan Yang, Sasa Mutic, H Harold Li
Online adaptive radiation therapy (ART) based on real-time magnetic resonance imaging represents a paradigm-changing treatment scheme. However, conventional quality assurance (QA) methods based on phantom measurements are not feasible with the patient on the treatment couch. The purpose of this work is to develop a fast Monte Carlo system for validating online re-optimized tri-60Co IMRT adaptive plans with both high accuracy and speed. The Monte Carlo system is based on Dose Planning Method (DPM) code with further simplification of electron transport and consideration of external magnetic fields...
April 20, 2017: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/28425472/label-free-single-cell-separation-and-imaging-of-cancer-cells-using-an-integrated-microfluidic-system
#6
Maria Antfolk, Soo Hyeon Kim, Saori Koizumi, Teruo Fujii, Thomas Laurell
The incidence of cancer is increasing worldwide and metastatic disease, through the spread of circulating tumor cells (CTCs), is responsible for the majority of the cancer deaths. Accurate monitoring of CTC levels in blood provides clinical information supporting therapeutic decision making, and improved methods for CTC enumeration are asked for. Microfluidics has been extensively used for this purpose but most methods require several post-separation processing steps including concentration of the sample before analysis...
April 20, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28424830/-when-is-a-nonsurgical-approach-possible-for-metastatic-primary-tumors-and-lymph-node-metastases-of-the-urinary-bladder-and-prostate
#7
R Fietkau
For metastatic carcinomas of the urinary bladder and prostate, systemic therapy is of primary importance. Due to technological advances in radiation oncology such as stereotactic radiotherapy, intensity-modulated radiotherapy, interstitial radiotherapy, and the combination of radiotherapy and chemotherapy, pelvic irradiation can nowadays be carried out effectively and without the risk of major side effects. New data from other tumor entities and retrospective analyses suggest that the use of these technologies can lead to a clinical benefit in terms of improvement in quality of life, local control, and overall survival...
April 19, 2017: Der Urologe. Ausg. A
https://www.readbyqxmd.com/read/28423808/security-policy-and-infrastructure-in-the-context-of-a-multi-centeric-information-system-dedicated-to-autism-spectrum-disorder
#8
Mohamed Ben Said, Laurence Robel, Bernard Golse, Jean Philippe Jais
Autism spectrum disorders (ASD) are complex neuro-developmental disorders affecting children in their early age. The diagnosis of ASD relies on multidisciplinary investigations, in psychiatry, neurology, genetics, electrophysiology, neuro-imagery, audiology and ophthalmology. In order to support clinicians, researchers and public health decision makers, we designed an information system dedicated to ASD, called TEDIS. TEDIS was designed to manage systematic, exhaustive and continuous multi-centric patient data collection via secured Internet connections...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28423763/learning-healthcare-system-for-the-prescription-of-genetic-testing-in-the-gynecological-cancer-risk
#9
Cristina Suárez-Mejías, Alicia Martínez-García, María Ángeles Martínez-Maestre, José Manuel Silvan-Alfaro, Jesús Moreno Conde, Carlos Luis Parra-Calderón
Clinical evidence demonstrates that BRCA 1 and BRCA2 mutations can develop a gynecological cancer but genetic testing has a high cost to the healthcare system. Besides, several studies in the literature indicate that performing these genetic tests to the population is not cost-efficient. Currently, our physicians do not have a system to provide them the support for prescribing genetic tests. A Decision Support System for prescribing these genetic tests in BRCA1 and BRCA2 and preventing gynecological cancer risks has been designed, developed and deployed in the Virgen del Rocío University Hospital (VRUH)...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28423745/reasoning-and-data-representation-in-a-health-and-lifestyle-support-system
#10
Sten Hanke, Karl Kreiner, Johannes Kropf, Marc Scase, Christian Gossy
Case-based reasoning and data interpretation is an artificial intelligence approach that capitalizes on past experience to solve current problems and this can be used as a method for practical intelligent systems. Case-based data reasoning is able to provide decision support for experts and clinicians in health systems as well as lifestyle systems. In this project we were focusing on developing a solution for healthy ageing considering daily activities, nutrition as well as cognitive activities. The data analysis of the reasoner followed state of the art guidelines from clinical practice...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28422968/the-impact-of-a-point-of-care-testing-device-on-cvd-risk-assessment-completion-in-new-zealand-primary-care-practice-a-cluster-randomised-controlled-trial-and-qualitative-investigation
#11
Sue Wells, Natasha Rafter, Timothy Kenealy, Geoff Herd, Kyle Eggleton, Rose Lightfoot, Kim Arcus, Angela Wadham, Yannan Jiang, Chris Bullen
OBJECTIVES: To assess the effect of a point of care (POC) device for testing lipids and HbA1c in addition to testing by community laboratory facilities (usual practice) on the completion of cardiovascular disease (CVD) risk assessments in general practice. METHODS: We conducted a pragmatic, cluster randomised controlled trial in 20 New Zealand general practices stratified by size and rurality and randomised to POC device plus usual practice or usual practice alone (controls)...
2017: PloS One
https://www.readbyqxmd.com/read/28422672/aiimds-an-integrated-framework-of-automatic-idiopathic-inflammatory-myopathy-diagnosis-for-muscle
#12
Manish Sapkota, Fujun Liu, Yuanpu Xie, Hai Su, Fuyong Xing, Lin Yang
Idiopathic Inflammatory Myopathy (IIM) is a common skeletal muscle disease that relates to weakness and inflammation of muscle. Early diagnosis and prognosis of different types of IIMs will guide the effective treatment. Interpretation of digitized images of the cross section muscle biopsy, which is currently done manually, provides the most reliable diagnostic information. With the increasing volume of images, the management and manual interpretation of the digitized muscle images suffer from low efficiency and high interobserver variabilities...
April 13, 2017: IEEE Journal of Biomedical and Health Informatics
https://www.readbyqxmd.com/read/28420257/gestational-diabetes-management-using-smart-mobile-telemedicine
#13
Mercedes Rigla, Iñaki Martínez-Sarriegui, Gema García-Sáez, Belén Pons, Maria Elena Hernando
Gestational diabetes (GDM) burden has been increasing progressively over the past years. Knowing that intrauterine exposure to maternal diabetes confers high risk for macrosomia as well as for future type 2 diabetes and obesity of the offspring, health care organizations try to provide effective control in spite of the limited resources. Artificial-intelligence-augmented telemedicine has been proposed as a helpful tool to facilitate an efficient widespread medical assistance to GDM. The aim of the study we present was to test the feasibility and acceptance of a mobile decision-support system for GDM, developed in the seventh framework program MobiGuide Project, which includes computer-interpretable clinical practice guidelines, access to data from the electronic health record as well as from glucose, blood pressure, and activity sensors...
April 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28420250/the-european-association-of-preventive-cardiology-exercise-prescription-in-everyday-practice-and-rehabilitative-training-expert-tool-a-digital-training-and-decision-support-system-for-optimized-exercise-prescription-in-cardiovascular-disease-concept-definitions
#14
Dominique Hansen, Paul Dendale, Karin Coninx, Luc Vanhees, Massimo F Piepoli, Josef Niebauer, Veronique Cornelissen, Roberto Pedretti, Eva Geurts, Gustavo R Ruiz, Ugo Corrà, Jean-Paul Schmid, Eugenio Greco, Constantinos H Davos, Frank Edelmann, Ana Abreu, Bernhard Rauch, Marco Ambrosetti, Simona S Braga, Olga Barna, Paul Beckers, Maurizio Bussotti, Robert Fagard, Pompilio Faggiano, Esteban Garcia-Porrero, Evangelia Kouidi, Michel Lamotte, Daniel Neunhäuserer, Rona Reibis, Martijn A Spruit, Christoph Stettler, Tim Takken, Cajsa Tonoli, Carlo Vigorito, Heinz Völler, Patrick Doherty
Background Exercise rehabilitation is highly recommended by current guidelines on prevention of cardiovascular disease, but its implementation is still poor. Many clinicians experience difficulties in prescribing exercise in the presence of different concomitant cardiovascular diseases and risk factors within the same patient. It was aimed to develop a digital training and decision support system for exercise prescription in cardiovascular disease patients in clinical practice: the European Association of Preventive Cardiology Exercise Prescription in Everyday Practice and Rehabilitative Training (EXPERT) tool...
January 1, 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/28419195/plasma-ctdna-ras-mutation-analysis-for-the-diagnosis-and-treatment-monitoring-of-metastatic-colorectal-cancer-patients
#15
J Vidal, L Muinelo, A Dalmases, F Jones, D Edelstein, M Iglesias, M Orrillo, A Abalo, C Rodríguez, E Brozos, Y Vidal, S Candamio, F Vázquez, J Ruiz, M Guix, L Visa, V Sikri, J Albanell, B Bellosillo, R López, C Montagut
Background: RAS assessement is mandatory for therapy decision in metastatic colorectal cancer (mCRC) patients. This determination is based on tumor tissue, however genotyping of circulating tumor (ct)DNA offers clear advantages as a minimally invasive method that represents tumor heterogeneity. Our study aims to evaluate the use of ctDNA as an alternative determining baseline RAS status and subsequent monitoring of RAS mutations during therapy as a component of routine clinical practice...
April 13, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/28418738/real-time-surveillance-of-infectious-diseases-taiwan-s-experience
#16
Shu-Wan Jian, Chiu-Mei Chen, Cheng-Yi Lee, Ding-Ping Liu
Integration of multiple surveillance systems advances early warning and supports better decision making during infectious disease events. Taiwan has a comprehensive network of laboratory, epidemiologic, and early warning surveillance systems with nationwide representation. Hospitals and clinical laboratories have deployed automatic reporting mechanisms since 2014 and have effectively improved timeliness of infectious disease and laboratory data reporting. In June 2016, the capacity of real-time surveillance in Taiwan was externally assessed and was found to have a demonstrated and sustainable capability...
March 2017: Health Security
https://www.readbyqxmd.com/read/28416374/comparing-originator-biologics-and-biosimilars-a-review-of-the-relevant-issues
#17
REVIEW
Corrado Blandizzi, Pier Luigi Meroni, Giovanni Lapadula
PURPOSE: We provide a review of current knowledge on comparability between biosimilars and originator biologics in view of the continuous evolution occurring in this highly dynamic area. METHODS: English-language literature indexed in MEDLINE was explored, without time limits, to July 31, 2016, using the terms biosimilar, biotechnologic drug, biologic drug, monoclonal antibody, fusion protein, and anti-tumor necrosis factor. The reference lists of identified articles were examined carefully for additional pertinent publications...
April 14, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28414786/the-model-for-end-stage-liver-disease-meld-as-a-predictor-of-short-term-mortality-in-staphylococcus-aureus-bloodstream-infection-a-single-centre-observational-study
#18
Jan A Roth, Andreas F Widmer, Sarah Tschudin-Sutter, Marc Dangel, Reno Frei, Manuel Battegay, Balthasar L Hug
BACKGROUND: Automated laboratory-based prediction models may support clinical decisions in Staphylococcus aureus bloodstream infections (BSIs), which carry a particularly high mortality. Small studies indicated that the laboratory-based Model for End-stage Liver Disease (MELD) score is a risk factor for mortality in critically ill patients with infections. For S. aureus BSIs, we therefore aimed to assess a potential association of the MELD score with mortality. METHODS: In this single-centre observational study, all consecutive patients with a first episode of methicillin-susceptible S...
2017: PloS One
https://www.readbyqxmd.com/read/28410649/incident-dialysis-access-in-patients-with-end-stage-kidney-disease-what-needs-to-be-improved
#19
REVIEW
Louise M Moist, Charmaine E Lok
The initiation of dialysis is a challenging time of transition for patients, families, and their supporters. Patients with exposure to a comprehensive chronic kidney disease clinic may have had education and subsequent decision making regarding dialysis modality and access; however, many patients with or without prior education will require an urgent start to dialysis, requiring quick decisions regarding dialysis modality and access. In many countries, hemodialysis (HD) using a central venous catheter (CVC) is the most common initial renal replacement modality and dialysis access...
March 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28410332/sepsis-3-on-the-block-what-does-it-mean-for-preclinical-sepsis-modeling
#20
Marcin F Osuchowski, Christoph Thiemermann, Daniel G Remick
To effectively improve outcomes of septic patients, we first need to elucidate the multifaceted pathogenesis of sepsis syndromes and related inflammatory conditions. In fulfillment of such needs, in February 2016, new definitions for sepsis and septic shock were published under the acronym Sepsis-3. Although aimed at the clinical area, Sepsis-3 will have an inevitable influence upon the field of translational research as well. Sepsis-3 brings a considerable shift regarding the experimental focal point: from inflammatory states (SIRS/CARS) to organ failure (single and multiple) as the decisive factor...
May 2017: Shock
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