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Choosing wisely

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
Jennifer L Middleton
No abstract text is available yet for this article.
April 1, 2018: American Family Physician
M Diane Lougheed
No abstract text is available yet for this article.
April 2018: Annals of Allergy, Asthma & Immunology
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
John C Probasco, Annette Lavezza, Andre Cassell, Tenise Shakes, Angie Feurer, Holly Russell, Hilary Sporney, Margie Burnett, Chepkorir Maritim, Victor Urrutia, H Adrian Puttgen, Michael Friedman, Erik H Hoyer
Background: Although many hospitalized neuroscience patients have physical and occupational therapy (rehabilitation) needs, patients with none or minimal physical impairments frequently receive rehabilitation consultation, diverting from patients with greatest need. Methods: A multidisciplinary team on the general and cerebrovascular neurology acute inpatient services mapped the rehabilitation consultation process, resulting in multiple implemented interventions including physician education on appropriate acute rehabilitation consultations, modification of multidisciplinary rounds, and discussion of patient rehabilitation needs throughout hospitalization...
April 2018: Neurohospitalist
Allen S Lichter
No abstract text is available yet for this article.
March 28, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Michael Lavelle-Jones
No abstract text is available yet for this article.
February 2018: Indian Journal of Surgery
Andrea Grosso, Piero Ceruti, Giuseppe Scarpa, Franco Giardini, Giorgio Marchini, Emanuela Aragona, Fabrizio Bert, Francesco Bandello, Roberta Siliquini
BACKGROUND: One of the directions of modern ophthalmology is toward an odontoiatric model, and new settings of eye care are becoming the standard of care: one day surgery and also office-based therapies. METHODS: Retrospective analysis of three tertiary-care centers in Italy and analysis of the literature. RESULTS: We provide readers with state-of-the-art measures of prophylaxis in ophthalmic surgery. DISCUSSION AND CONCLUSION: Role of antibiotics is criticized in the light of stewardship antimicrobial paradigm...
February 1, 2018: European Journal of Ophthalmology
Blayne Welk, Jennifer Winick-Ng, J Andrew McClure, Armando J Lorenzo, Girish Kulkarni, Michael Ordon
OBJECTIVE: To determine if three of the Canadian Urological Association's Choosing Wisely recommendations (released in 2013-2014) related to urologic care altered physician and patient behavior. METHODS: Administrative data from Ontario, Canada between 2008-2017 was used. We identified three cohorts: First, we determined how men >66 years of age who had a serum testosterone level prior to starting testosterone therapy. Second, we determined how many boys undergoing an orchiopexy underwent abdominal imaging prior to their surgery...
March 20, 2018: Urology
Meredith B Rosenthal, Carrie H Colla, Nancy E Morden, Thomas D Sequist, Alexander J Mainor, Zhonghe Li, Kevin H Nguyen
OBJECTIVES: A substantial portion of healthcare spending is wasted on services that do not directly improve patient health and that cause harm in some cases. Features of health insurance coverage, including enrollment in high-deductible health plans (HDHPs) or health maintenance organizations (HMOs), may provide financial and nonfinancial mechanisms to potentially reduce overuse of low-value healthcare services. STUDY DESIGN: Using 2009 to 2013 administrative data from 3 large commercial insurers, we examined patient characteristics and health insurance plan types associated with overuse of 6 healthcare services identified by the Choosing Wisely campaign...
March 2018: American Journal of Managed Care
Adam Fleischer
No abstract text is available yet for this article.
January 2018: Journal of the American Podiatric Medical Association
Marc-Etienne Parent, François Vézina, Nathalie Carrier, Ariel Masetto
OBJECTIVE: To analyze the indications for and clinical procedures resulting from knee magnetic resonance imaging (MRI) in older patients. DESIGN: We retrospectively analyzed 215 medical records of patients 50 years of age and older who had undergone a unilateral knee MRI in 2009. SETTING: Centre hospitalier universitaire de Sherbrooke in Quebec. PARTICIPANTS: Patients 50 years of age and older who underwent a knee MRI in 2009...
March 2018: Canadian Family Physician Médecin de Famille Canadien
Dr Rebecca Powell
No abstract text is available yet for this article.
March 2018: Canadian Family Physician Médecin de Famille Canadien
Paul Atkinson, Eddy Lang, Meaghan Mackenzie, Rashi Hirandani, Rebecca Lys, Megan Laupacis, Heather Murray
No abstract text is available yet for this article.
March 2018: CJEM
Kelsey Chalmers, Tim Badgery-Parker, Sallie-Anne Pearson, Jonathan Brett, Ian A Scott, Adam G Elshaug
OBJECTIVE: Low-value health care refers to interventions where the risk of harm or costs exceeds the likely benefit for a patient. We aimed to develop indicators of low-value care, based on selected Choosing Wisely (CW) recommendations, applicable to routinely collected, hospital claims data. RESULTS: We assessed 824 recommendations from the United States, Canada, Australia and the United Kingdom CW lists regarding their capacity to be measured in administrative hospital admissions datasets...
March 5, 2018: BMC Research Notes
Luis C L Correia, Guilherme B Barcellos, Vitor Calixto, André Volschan, José A S Barreto-Filho, Renato D Lopes, Anis Rassi, Wendy Levinson, Angelo A V de Paola
Objective: (i) To describe how aligned the 'Choosing Wisely' concept is with the medical culture among Brazilian cardiologists and (ii) to identify predictors for physicians' preference for avoiding wasteful care. Design: Cross-sectional study. Setting: Brazilian Society of Cardiology. Participants: Cardiologists who agree to fill a web questionary. Intervention: A task force of 12 Brazilian cardiologists prepared a list of 13 'do not do' recommendations, which were made available on the Brazilian Society of Cardiology website for affiliates to assign a supported score of 1 to 10 to each recommendation...
March 1, 2018: International Journal for Quality in Health Care
Ana D Mandić, Michael Blaut
In a recent article in Cell Reports, Dalby and colleagues convincingly demonstrate that choosing an inadequate control diet in animal experiments that investigate the interaction of nutrition, gut microbiota, and obesity development may lead to the wrong conclusions. The authors systematically compared the effects of refined high- and low-fat diets (rHFD and rLFD) with those of a standard chow diet on mouse physiology, microbiota composition, cecal fermentation, and intestinal morphology. The results obtained in this study question the conclusions drawn from animal studies that compared the effects of HFDs with those of chow diets...
March 1, 2018: Trends in Endocrinology and Metabolism: TEM
Jason Chui, Rasha Saeed, Luke Jakobowski, Wanyu Wang, Basem Eldeyasty, Angel Zhu, LeeAnne Fochesato, Ronit Lavi, Daniel Bainbridge
BACKGROUND: A routine chest X-ray (CXR) is recommended as a screening test after central venous catheter (CVC) insertion. We sought to assess the value of a routine post-procedural CXR in the era of ultrasound-guided CVC insertion. METHODS: We performed a population-based retrospective cohort study to review the records of all adult patients who had a CVC inserted in the operating room in a tertiary institution between July 1, 2008 and December 31, 2015. We determined the incidence of pneumothorax and catheter misplacement after ultrasound-guided CVC insertion...
February 28, 2018: Chest
Deborah Kim, Kyung Min Lee, Marc R Freiman, W Ryan Powell, Elizabeth S Klings, Seppo Rinne, Donald Miller, Adam J Rose, Renda Soylemez Wiener
RATIONALE: Care of patients with pulmonary hypertension (PH) is complex. While pulmonary vasodilators are effective for Group 1 PH, clinical guidelines and the Choosing Wisely Campaign recommend against routine use for Groups 2 and 3 PH (the most common types of PH) due to a lack of benefit, potential for harm, and high cost ($10,000-$13,000 per patient per year treated). Little is known about how these medications are used in practice. OBJECTIVE(S): To determine national patterns of phosphodiesterase-5-inhibitor (PDE5i) prescribing for PH in the Veterans Health Administration (VA)...
February 27, 2018: Annals of the American Thoracic Society
Jeremy N Friedman, Sanjay Mahant
The Choosing Wisely campaign has stimulated many clinicians to think about the appropriateness of various tests and treatments. Most of the recommendations published thus far are adult-focused. In this commentary, we discuss the development and early implementation of a Choosing Wisely 'top 5' list specifically aimed at children being cared for at our tertiary care children's hospital. We hope that this will encourage others involved in the health care of infants and children to engage in further thought and discussion about the appropriateness of current tests and therapies...
May 2017: Paediatrics & Child Health
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