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Choosing wisely

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https://www.readbyqxmd.com/read/29907644/helping-patients-choose-wisely
#1
EDITORIAL
Jack Ross, Ramai Santhirapala, Carrie MacEwen, Angela Coulter
No abstract text is available yet for this article.
June 15, 2018: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29868894/eliminating-inappropriate-telemetry-monitoring-an-evidence-based-implementation-guide
#2
Raymond Y Yeow, Garth W Strohbehn, Calvin M Kagan, Christopher M Petrilli, Jamuna K Krishnan, Karli Edholm, L Scott Sussman, Jaime F Blanck, Remus I Popa, Amit K Pahwa
In-hospital continuous electrocardiographic monitoring, commonly referred to as telemetry, has allowed for rapid recognition of life-threatening conditions, including complex arrhythmias and myocardial ischemia. However, inappropriate use can lead to unnecessary downstream testing from "false alarms," which in turn affects clinician efficiency and increases health care costs without benefiting patients. For these reasons, the Society of Hospital Medicine's Choosing Wisely campaign recommended use of a protocol-driven discontinuation of telemetry...
June 4, 2018: JAMA Internal Medicine
https://www.readbyqxmd.com/read/29861083/choosing-wisely-bloodwork-for-preeclampsia
#3
Venu Jain
No abstract text is available yet for this article.
June 2018: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/29861082/choosing-wisely-sogc-s-top-10-recommendations
#4
Courtney R Green, Jennifer M Blake, George D Carson, Leslie Po, Adrian R H Brown, Catherine L Friedman
No abstract text is available yet for this article.
June 2018: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/29851190/choosing-wisely-in-pediatric-anesthesia-an-interpretation-from-the-german-scientific-working-group-of-paediatric-anaesthesia-wakka
#5
Karin Becke, Christoph Eich, Claudia Höhne, Martin Jöhr, Andreas Machotta, Markus Schreiber, Robert Sümpelmann
Inspired by the Choosing Wisely initiative, a group of pediatric anesthesiologists representing the German Working Group on Paediatric Anaesthesia (WAKKA) coined and agreed upon 10 concise positive ("dos") or negative ("don'ts") evidence-based recommendations. (i) In infants and children with robust indications for surgical, interventional, or diagnostic procedures, anesthesia or sedation should not be avoided or delayed due to the potential neurotoxicity associated with the exposure to anesthetics...
May 30, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29805440/image-guided-rendering-with-an-evolutionary-algorithm-based-on-cloud-model
#6
Tao Wu
The process of creating nonphotorealistic rendering images and animations can be enjoyable if a useful method is involved. We use an evolutionary algorithm to generate painterly styles of images. Given an input image as the reference target, a cloud model-based evolutionary algorithm that will rerender the target image with nonphotorealistic effects is evolved. The resulting animations have an interesting characteristic in which the target slowly emerges from a set of strokes. A number of experiments are performed, as well as visual comparisons, quantitative comparisons, and user studies...
2018: Computational Intelligence and Neuroscience
https://www.readbyqxmd.com/read/29779675/utilization-of-head-ct-during-injury-visits-to-united-states-emergency-departments-2012-2015
#7
Brian J Yun, Pierre Borczuk, Kori S Zachrison, Joshua N Goldstein, Yosef Berlyand, Ali S Raja
INTRODUCTION: Studies have shown increasing utilization of head computed tomography (CT) imaging of emergency department (ED) patients presenting with an injury-related visit. Multiple initiatives, including the Choosing Wisely™ campaign and evidence-based clinical decision support based on validated decision rules, have targeted head CT use in patients with injuries. Therefore, we investigated national trends in the use of head CT during injury-related ED visits from 2012 to 2015. METHODS: This was a secondary analysis of data from the annual United States (U...
May 18, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29777402/a-national-study-of-the-use-of-asymptomatic-systemic-imaging-for-surveillance-following-breast-cancer-treatment-aft-01
#8
Jessica R Schumacher, Heather B Neuman, George J Chang, Benjamin D Kozower, Stephen B Edge, Menggang Yu, David J Vanness, Yajuan Si, Elizabeth A Jacobs, Amanda B Francescatti, Patricia A Spears, Jeffrey Havlena, Taiwo Adesoye, Daniel McKellar, David Winchester, Elizabeth S Burnside, Caprice C Greenberg
BACKGROUND: Although not guideline recommended, studies suggest 50% of locoregional breast cancer patients undergo systemic imaging during follow-up, prompting its inclusion as a Choosing Wisely measure of potential overuse. Most studies rely on administrative data that cannot delineate scan intent (prompted by signs/symptoms vs. asymptomatic surveillance). This is a critical gap as intent is the only way to distinguish overuse from appropriate care. OBJECTIVE: Our aim was to assess surveillance systemic imaging post-breast cancer treatment in a national sample accounting for scan intent...
May 17, 2018: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29768480/internal-medicine-trainees-knowledge-and-confidence-in-using-the-american-society-of-hematology-choosing-wisely-guidelines-in-hemostasis-thrombosis-and-non-malignant-hematology
#9
Ariela L Marshall, Sarah Jenkins, Amy S Oxentenko, Alfred I Lee, Mark D Siegel, Joel T Katz, Jatin M Vyas, John Del Valle, Joseph R Mikhael
BACKGROUND: Several specialty societies participate in the Choosing Wisely (CW) campaign in an attempt to reduce waste in health care spending. We surveyed internal medicine (IM) residents with an objective of classifying knowledge of and confidence in using the American Society of Hematology (ASH) CW principles in hemostasis, thrombosis, and non-malignant hematology. METHODS: Multi-institutional study of IM residents at 5 academic training programs in the United States...
2018: PloS One
https://www.readbyqxmd.com/read/29768294/a-pilot-study-to-reduce-computed-tomography-utilization-for-pediatric-mild-head-injury-in-the-emergency-department-using-a-clinical-decision-support-tool-and-a-structured-parent-discussion-tool
#10
Rakesh S Engineer, Seth R Podolsky, Baruch S Fertel, Purva Grover, Heather Jimenez, Erin L Simon, Courtney M Smalley
INTRODUCTION: The American College of Emergency Physicians embarked on the "Choosing Wisely" campaign to avoid computed tomographic (CT) scans in patients with minor head injury who are at low risk based on validated decision rules. We hypothesized that a Pediatric Mild Head Injury Care Path could be developed and implemented to reduce inappropriate CT utilization with support of a clinical decision support tool (CDST) and a structured parent discussion tool. METHODS: A quality improvement project was initiated for 9 weeks to reduce inappropriate CT utilization through 5 interventions: (1) engagement of leadership, (2) provider education, (3) incorporation of a parent discussion tool to guide discussion during the emergency department (ED) visit between the parent and the provider, (4) CDST embedded in the electronic medical record, and (5) importation of data into the note to drive compliance...
May 15, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29765244/an-echo-to-choosing-wisely-%C3%A2-in-switzerland
#11
Lionel Chok, Johann Debrunner, Sandra Jaeggli, Karmen Kusic, Esther B Bachli
Background: Inspired by the US Choosing Wisely® , in 2016 the Swiss Society of General Internal Medicine released a list of five treatments or diagnostic tests used in the hospital and considered unnecessary based on not improving patient care and adding to health care costs. These "Smarter Medicine" recommendations were implemented in the Department of Internal Medicine, Uster Hospital, in August 2016. They were supported by lectures and weekly email communications. We analyzed the number of blood draws before and after implementation of the recommendation aimed at reducing blood tests...
2018: International Journal of General Medicine
https://www.readbyqxmd.com/read/29760257/choosing-wisely-canada-recommendations
#12
Dr Meldon Kahan
No abstract text is available yet for this article.
May 2018: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/29760252/choosing-wisely-in-primary-care-moving-from-recommendations-to-implementation
#13
Kimberly Wintemute, Lynn Wilson, Wendy Levinson
No abstract text is available yet for this article.
May 2018: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/29750659/evidence-based-physiatry-learning-to-choose-wisely
#14
Sabrina Paganoni
No abstract text is available yet for this article.
May 10, 2018: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/29748677/effect-of-iron-doping-on-protein-molecular-conductance
#15
Nikolai Lebedev, Igor Griva, Anders Blom, Leonard M Tender
Protein molecular conductance has attracted attention from researchers for the possibility of constructing innovative flexible biocompatible nanoscale electronic devices and smart hybrid materials. Due to protein complexity, most evaluations of protein conductivity are based on the simple estimation of protein's molecular orbital energy levels and spatial distributions without analysing its protein interaction with electrodes and the calculation of the rates of electron transfer (ET). In the present work, we included in our density functional theory (DFT) analysis an approach based on the non-equilibrium Green's function (NEGF) allowing for calculation from the first principles the molecular interaction with electrodes and thus the role of electrode materials, Fermi level, the thermal distribution of electronic energy levels, and the coupling efficiency between the molecule and the electrodes...
May 11, 2018: Physical Chemistry Chemical Physics: PCCP
https://www.readbyqxmd.com/read/29746537/kinetic-and-kinematic-variables-affecting-trunk-flexion-during-level-walking-in-patients-with-lumbar-spinal-stenosis
#16
Tatsuya Igawa, Junji Katsuhira, Akira Hosaka, Kenta Uchikoshi, Shinichi Ishihara, Ko Matsudaira
Lumbar spinal stenosis causes cauda equina and nerve root compression, resulting in neurological symptoms. Although trunk flexion during level walking may alleviate these symptoms by enabling spinal canal decompression, some patients do not use this strategy. We aimed to identify the kinetic and kinematic variables that affect trunk flexion in patients during level walking. Gait was recorded in 111 patients using a three-dimensional motion capture system and six force plates. From the data recorded, walking velocity, bilateral step length, cycle time, maximum trunk flexion angle, forward pelvic tilt angle, pelvic rotation angle, maximum and minimum joint angles, and moment and power of the lower limb were calculated...
2018: PloS One
https://www.readbyqxmd.com/read/29740638/mediterranean-diet-based-intervention-in-pregnancy-to-improve-maternal-and-fetal-outcomes-methodological-challenges-and-lessons-learned-from-the-multicentre-esteem-study
#17
Bassel H Al Wattar, Julie Dodds, Anna Placzek, Eleni Spyreli, Sally Higgins, Amanda Moore, Richard Hooper, Lee Beresford, Tessa J Roseboom, Maira Bes-Rastrollo, Graham Hitman, Khalid S Khan, Shakila Thangaratinam
Introduction: Evaluating complex dietary interventions such as Mediterranean diet in pregnancy presents unique methodological challenges. We present the challenges and the lessons learned from a multicentre randomised trial (ESTEEM) on Mediterranean-based dietary intervention in pregnancy. Methods: We recruited pregnant women who met our predefined inclusion criteria and randomised those with metabolic risk factors to the Mediterranean-based dietary intervention or routine antenatal care...
June 2017: Contemporary Clinical Trials Communications
https://www.readbyqxmd.com/read/29725412/locally-advanced-laryngeal-cancer-total-laryngectomy-or-primary-non-surgical-treatment
#18
Aleš Čoček, Miloslav Ambruš, Alena Dohnalová, Martin Chovanec, Martina Kubecová, Kateřina Licková
Between January 1997 and December 2013, the Charles University 3rd Medical School and Royal Vinohrady Teaching Hospital Ear, Nose and Throat oncology team treated 185 patients with advanced laryngeal cancer, which, from a surgical perspective, required a total laryngectomy. Overall, ~70% of these patients (n=129) underwent conventional treatment (i.e., total laryngectomy with post-operative radiotherapy), and ~30% (n=56) were treated with larynx preservation protocols (including primary radiotherapy, neoadjuvant chemotherapy followed by radiotherapy or chemoradiotherapy, or primary chemoradiotherapy)...
May 2018: Oncology Letters
https://www.readbyqxmd.com/read/29719428/factors-associated-with-imaging-in-patients-with-early-breast-cancer-after-initial-treatment
#19
K Enright, T Desai, R Sutradhar, A Gonzalez, M Powis, N Taback, C M Booth, M E Trudeau, M K Krzyzanowska
Background: Overuse of surveillance imaging in patients after curative treatment for early breast cancer (ebc) was recently identified as one of the Choosing Wisely Canada initiatives to improve the quality of cancer care. We undertook a population-level examination of imaging practices in Ontario as they existed before the launch of that initiative. Methods: Patients diagnosed with ebc between 2006 and 2010 in Ontario were identified from the Ontario Cancer Registry...
April 2018: Current Oncology
https://www.readbyqxmd.com/read/29710232/choosing-wisely-campaigns-a-work-in-progress
#20
Wendy Levinson, Karen Born, Daniel Wolfson
No abstract text is available yet for this article.
May 15, 2018: JAMA: the Journal of the American Medical Association
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