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Choosing wisely

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https://www.readbyqxmd.com/read/28336719/colon-cancer-screening-among-patients-receiving-dialysis-in-the-united-states-are-we-choosing-wisely
#1
Christopher A Carlos, Charles E McCulloch, Chi-Yuan Hsu, Barbara Grimes, Meda E Pavkov, Nilka R Burrows, Vahakn B Shahinian, Rajiv Saran, Neil R Powe, Kirsten L Johansen
The American Society of Nephrology recommends against routine cancer screening among asymptomatic patients receiving maintenance dialysis on the basis of limited survival benefit. To determine the frequency of colorectal cancer screening among patients on dialysis and the extent to which screening tests were targeted toward patients at lower risk of death and higher likelihood of receiving a kidney transplant, we performed a cohort study of 469,574 Medicare beneficiaries ages ≥50 years old who received dialysis between January 1, 2007 and September 30, 2012...
March 23, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28327977/the-ethics-of-choosing-wisely-the-use-of-neuroimaging-for-uncomplicated-headache
#2
David J Cote, Edward R Laws
The use of magnetic resonance imaging (MRI) for evaluation of headache remains excessive among physicians across many specialties according to both the American Headache Society and the American College of Radiology, despite recent attempts at limiting overuse of imaging and procedures. As part of the Choosing Wisely campaign, both of these organizations have explicitly recommended against imaging in patients with uncomplicated or typical migraine headaches. Yet, the practice nevertheless remains prevalent, with estimates ranging from 12...
February 20, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28321324/choosing-wisely-the-canadian-society-of-nephrology-s-list-of-5-items-physicians-and-patients-should-question
#3
Emilie Chan, Brenda Hemmelgarn, Scott Klarenbach, Braden Manns, Reem Mustafa, Gihad Nesrallah, Rory McQuillan
PURPOSE OF REVIEW: The purpose of this review is to contribute to the Choosing Wisely Canada campaign and develop a list of 5 items for nephrology health care professionals and patients to re-evaluate based on evidence that they are overused or misused. SOURCES OF INFORMATION: A working group was formed from the Canadian Society of Nephrology (CSN) Clinical Practice Guidelines Committee. This working group sequentially used a multistage Delphi method, a survey of CSN members, a modified Delphi process, and a comprehensive literature review to determine 10 candidate items representing potentially ineffective care in nephrology...
2017: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/28314175/choosing-wisely-preclinical-test-models-in-the-era-of-precision-medicine
#4
REVIEW
Konrad Klinghammer, Wolfgang Walther, Jens Hoffmann
Through the introduction of a steadily growing variety of preclinical test models drug development and biomarker research has advanced. Next to classical used 2D cell line cultures, tissue-slice cultures, 3D organoid cell cultures, genetically engineered mouse models, cell line derived mouse models and patient derived xenografts may be selected for a specific question. All models harbor advantages and disadvantages. This review focuses on the available preclinical test models, novel developments such as humanized mice and discusses for which question a particular model should be employed...
March 6, 2017: Cancer Treatment Reviews
https://www.readbyqxmd.com/read/28306523/evaluation-of-thyroid-test-utilization-through-analysis-of-population-level-data
#5
Jasmine Gill, Vilte E Barakauskas, Dylan Thomas, Karina Rodriguez-Capote, Trefor Higgins, Don Zhang, Amanda VanSpronsen, Oksana Babenko, Roberta Martindale, Mathew P Estey
BACKGROUND: Inappropriate laboratory test utilization can result in unnecessary patient testing and increased healthcare costs. While several thyroid function tests are available, thyroid-stimulating hormone (TSH) is recommended as the first-line test for investigating and monitoring thyroid dysfunction. We evaluate thyroid test utilization in Northern Alberta in terms of testing patterns, frequencies, and reflex cutpoints. METHODS: This retrospective study analyzed thyroid test requests from January to December 2014...
March 15, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28301680/variation-in-the-use-of-advanced-imaging-at-the-time-of-breast-cancer-diagnosis-in-a-statewide-registry
#6
N Lynn Henry, Thomas M Braun, Tara M Breslin, David H Gorski, Samuel M Silver, Jennifer J Griggs
BACKGROUND: Although national guidelines do not recommend extent of disease imaging for patients with newly diagnosed early stage breast cancer given that the harm outweighs the benefits, high rates of testing have been documented. The 2012 Choosing Wisely guidelines specifically addressed this issue. We examined the change over time in imaging use across a statewide collaborative, as well as the reasons for performing imaging and the impact on cost of care. METHODS: Clinicopathologic data and use of advanced imaging tests (positron emission tomography, computed tomography, and bone scan) were abstracted from the medical records of patients treated at 25 participating sites in the Michigan Breast Oncology Quality Initiative (MiBOQI)...
March 16, 2017: Cancer
https://www.readbyqxmd.com/read/28292534/synonymous-codons-choose-wisely-for-expression
#7
REVIEW
Christina E Brule, Elizabeth J Grayhack
The genetic code, which defines the amino acid sequence of a protein, also contains information that influences the rate and efficiency of translation. Neither the mechanisms nor functions of codon-mediated regulation were well understood. The prevailing model was that the slow translation of codons decoded by rare tRNAs reduces efficiency. Recent genome-wide analyses have clarified several issues. Specific codons and codon combinations modulate ribosome speed and facilitate protein folding. However, tRNA availability is not the sole determinant of rate; rather, interactions between adjacent codons and wobble base pairing are key...
March 11, 2017: Trends in Genetics: TIG
https://www.readbyqxmd.com/read/28290130/the-choosing-wisely-initiative-in-infectious-diseases
#8
REVIEW
Clara Lehmann, Reinhard Berner, Johannes R Bogner, Oliver A Cornely, Katja de With, Susanne Herold, Winfried V Kern, Sebastian Lemmen, Mathias W Pletz, Bernhard Ruf, Bernd Salzberger, Hans Jürgen Stellbrink, Norbert Suttorp, Andrew J Ullmann, Gerd Fätkenheuer, Norma Jung
OBJECTIVE: "Choosing Wisely" is a growing international campaign aiming at practice changes to improve patient health and safety by both, conduct of essential and avoidance of unnecessary diagnostic, preventive and therapeutic procedures. The goal is to create an easily recognizable and distributable list ("Choosing Wisely items") that addresses common over- and underuse in the management of infectious diseases. METHODS: The German Society of Infectious Diseases (DGI) participates in the campaign "Klug Entscheiden" by the German Society of Internal Medicine...
March 13, 2017: Infection
https://www.readbyqxmd.com/read/28266327/choosing-wisely-the-antidote-to-overmedicalisation
#9
Luke Worley
No abstract text is available yet for this article.
March 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/28251880/choosing-wisely-canada%C3%A2-five-tests-procedures-and-treatments-to-question-in-emergency-medicine
#10
Amy H Y Cheng, Sam Campbell, Lucas B Chartier, Tom Goddard, Kirk Magee, Jill McEwen, Atul K Kapur, Brian R Holroyd, Suneel Upadhye, Stephanie Couperthwaite, Brian H Rowe
OBJECTIVES: Choosing Wisely Canada (CWC) is an initiative to encourage patient-physician discussions about the appropriate, evidence based use of medical tests, procedures and treatments. We present the Canadian Association of Emergency Physicians' (CAEP) top five list of recommendations, and the process undertaken to generate them. METHODS: The CAEP Expert Working Group (EWG) generated a candidate list of 52 tests, procedures, and treatments in emergency medicine whose value to care was questioned...
March 2, 2017: CJEM
https://www.readbyqxmd.com/read/28236307/stabilization-of-activated-fragments-by-shell-wise-construction-of-an-embedding-environment
#11
Florian Krausbeck, Jan-Grimo Sobez, Markus Reiher
An activated fragment which is structurally unstable when considered isolated can be stabilized through binding to a suitable molecular environment; for instance, to a transition-metal fragment. The metal fragment may be designed in a shell-wise build-up of a surrounding molecular environment. However, adding more and more atoms in a consecutive fashion soon leads to a combinatorial explosion of structures, which is unfeasible to handle without automation. Here, we present a fully automated and parallelized framework that constructs such an embedding environment atom-wise...
February 25, 2017: Journal of Computational Chemistry
https://www.readbyqxmd.com/read/28220485/epidemiology-of-basal-cell-carcinoma-scholarly-review
#12
REVIEW
J A C Verkouteren, K H R Ramdas, M Wakkee, T Nijsten
Basal cell carcinoma (BCC) is the most common cancer in white-skinned individuals with increasing incidence rates worldwide. Patients with BCC place a large burden on healthcare systems, because of the high incidence and the increased risk of synchronous and metachronous BCCs and other ultraviolet radiation (UVR) related skin cancers (i.e. field cancerization). As a result, the disability-adjusted life years and healthcare costs have risen significantly in recent decades. BCC is a complex disease, in which the interplay between UVR, phenotype (UVR-sensitive) and genotype (somatic mutations and germline mutations/polymorphisms) fulfils a key role in the aetiopathogenesis...
February 20, 2017: British Journal of Dermatology
https://www.readbyqxmd.com/read/28217968/payer-type-and-low-value-care-comparing-choosing-wisely-services-across-commercial-and-medicare-populations
#13
Carrie H Colla, Nancy E Morden, Thomas D Sequist, Alexander J Mainor, Zhonghe Li, Meredith B Rosenthal
OBJECTIVE: To compare low-value health service use among commercially insured and Medicare populations and explore the influence of payer type on the provision of low-value care. DATA SOURCES: 2009-2011 national Medicare and commercial insurance administrative data. DESIGN: We created claims-based algorithms to measure seven Choosing Wisely-identified low-value services and examined the correlation between commercial and Medicare overuse overall and at the regional level...
February 19, 2017: Health Services Research
https://www.readbyqxmd.com/read/28187763/the-method-of-attachment-influences-accelerometer-based-activity-data-in-dogs
#14
Kyle W Martin, Anastasia M Olsen, Colleen G Duncan, Felix M Duerr
BACKGROUND: Accelerometer-based activity monitoring is a promising new tool in veterinary medicine used to objectively assess activity levels in dogs. To date, it is unknown how device orientation, attachment method, and attachment of a leash to the collar holding an accelerometer affect canine activity data. It was our goal to evaluate whether attachment methods of accelerometers affect activity counts. Eight healthy, client-owned dogs were fitted with two identical neck collars to which two identical activity monitors were attached using six different methods of attachment...
February 10, 2017: BMC Veterinary Research
https://www.readbyqxmd.com/read/28185714/choosing-wisely-the-top-5-recommendations-from-the-italian-panel-of-the-national-guidelines-for-the-management-of-acute-pharyngitis-in-children
#15
Elena Chiappini, Barbara Bortone, Giuseppe Di Mauro, Susanna Esposito, Luisa Galli, Massimo Landi, Andrea Novelli, Paola Marchisio, Gian Luigi Marseglia, Nicola Principi, Maurizio de Martino
PURPOSE: With the aim to reduce waste in the health care system and avoid risks associated with unnecessary treatment, the Italian Panel of the National Guidelines for the Management of Acute Pharyngitis in Children joined the Choosing Wisely initiative. METHODS: An ad hoc Choosing Wisely task force was selected to develop a candidate list of items for the top-5 list on pharyngitis medicine. Through a process of literature review and consensus, the final list of 5 items was chosen...
February 6, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28166352/applying-academic-detailing-and-process-change-to-promote-choosing-wisely-reply
#16
Anna L Parks, Patrick G O'Malley
No abstract text is available yet for this article.
February 1, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28166341/applying-academic-detailing-and-process-change-to-promote-choosing-wisely
#17
Dennis H Novack, Pamela Duke, Daniel B Wolfson
No abstract text is available yet for this article.
February 1, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28166340/applying-academic-detailing-and-process-change-to-promote-choosing-wisely
#18
Michael Fralick, Aaron Kesselheim, Jerry Avorn
No abstract text is available yet for this article.
February 1, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28164409/emergency-physician-knowledge-attitudes-and-behavior-regarding-acep-s-choosing-wisely-recommendations-a-survey-study
#19
Michelle P Lin, Thomas Nguyen, Marc A Probst, Lynne D Richardson, Jeremiah D Schuur
OBJECTIVE: In 2013, the American College of Emergency Physicians joined the Choosing Wisely campaign; however, its impact on emergency physician behavior is unknown. We assessed knowledge, attitudes and self-reported behaviors regarding the Choosing Wisely recommendations. METHODS: We performed a cross-sectional survey of emergency physicians at a national meeting. We approached 819 physicians; 765 (93.4%) completed the survey. RESULTS: As a result of the Choosing Wisely campaign, most respondents (64...
February 6, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28152945/choosing-wisely-opportunities-for-improving-value-of-cancer-care-in-the-deep-south
#20
Gabrielle Betty Rocque, Kelly Kenzik, Bradford E Jackson, Yufeng Li, Aras Acemgil, Richard A Taylor, Terri Salter, Edward E Partridge
13 Background: Under the Choosing Wisely (CW) Campaign, the American Society of Clinical Oncology (ASCO) and the American Society of Therapeutic Radiology and Oncology (ASTRO) recommend against non-evidence-based costly medications, tests, and procedures. CW recommendation adherence in the Deep South is largely unknown, and opportunities to reduce overuse and costs may exist. METHODS: Analysis of administrative claims and tumor registry data from 12 cancer centers of the University of Alabama Health System Cancer Community Network, for Medicare beneficiaries ≥65 years old with cancer...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
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