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Shared decision making

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https://www.readbyqxmd.com/read/28821939/analgesic-use-in-patients-with-knee-and-or-hip-osteoarthritis-referred-to-an-outpatient-center-a-cross-sectional-study-within-the-amsterdam-osteoarthritis-cohort
#1
Jesper Knoop, Joyce van Tunen, Martin van der Esch, Leo D Roorda, Joost Dekker, Marike van der Leeden, Willem F Lems
Although analgesics are widely recommended in current guidelines, underuse and inadequate prescription of analgesics seem to result in suboptimal treatment effects in patients with knee and/or hip osteoarthritis (OA). This study aimed (i) to describe the use of analgesics; and (ii) to determine factors that are related to analgesic use in patients with knee and/or hip OA referred to an outpatient center. A cross-sectional study with data from 656 patients with knee and/or hip OA referred to an outpatient center (Amsterdam Osteoarthritis (AMS-OA) cohort) was conducted...
August 18, 2017: Rheumatology International
https://www.readbyqxmd.com/read/28819046/tuberculous-tales-an-east-london-experience
#2
REVIEW
Apeksha M Shah, Dominika Raciborska, Matthew Stevens, Sharmilee Gnanapavan, Veronica L C White, Benjamin Turner
Tuberculous meningitis presents a diagnostic and therapeutic challenge, and considering its long history and increasing global incidence, the evidence base for its treatment is relatively scanty. Many UK neurologists will have little first-hand experience of this deadly condition, and if faced with a patient with possible tuberculous meningitis will find decision making less than straightforward. In parts of East London (UK) the rates of tuberculosis and tuberculous meningitis are among the highest in Western Europe, and so the neurologists and respiratory physicians at the Royal London Hospital have encountered many such patients over the years...
August 17, 2017: Practical Neurology
https://www.readbyqxmd.com/read/28818317/reconsidering-the-gatekeeper-paradigm-for-percutaneous-coronary-intervention-in-stable-coronary-disease-management
#3
EDITORIAL
Joshua Schulman-Marcus, William S Weintraub, William E Boden
Major randomized clinical trials over the last decade support the role of optimal medical therapy for the initial management approach for patients with stable coronary artery disease (CAD), whereas percutaneous coronary intervention (PCI) ought to be reserved for patients with persistent symptoms despite optimal medical therapy. Likewise, several studies have continued to demonstrate the superiority of coronary artery bypass grafting surgery over PCI in many patients with extensive multivessel CAD, especially those with diabetes...
July 24, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28817861/population-health-management-and-cancer-screening
#4
Bradley Kamstra, Mark K Huntington
Population health management (PHM) is a new health care model being implemented. It has been defined as "the health outcomes of a group of individuals, including the distribution of such outcomes within the group." This includes health outcomes and patterns of health determinants, and policies and interventions that link these two. Moving from a fee-for-service payment system to a quality- or value-based system, this model places on the clinician more responsibility for the costs of health care and its reimbursements...
2017: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://www.readbyqxmd.com/read/28816094/theories-of-health-care-decision-making-at-the-end-of-life-a-meta-ethnography
#5
Kyounghae Kim, Katherine Heinze, Jiayun Xu, Melissa Kurtz, Hyunjeong Park, Megan Foradori, Marie T Nolan
The aim of this meta-ethnography is to appraise the types and uses of theories relative to end-of-life decision making and to develop a conceptual framework to describe end-of-life decision making among patients with advanced cancers, heart failure, and amyotrophic lateral sclerosis (ALS) and their caregivers or providers. We used PubMed, Embase, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases to extract English-language articles published between January 2002 and April 2015...
August 1, 2017: Western Journal of Nursing Research
https://www.readbyqxmd.com/read/28815982/bridge-the-gap-the-need-for-harmonized-regulatory-and-ethical-standards-for-postmarketing-observational-studies
#6
REVIEW
Hisashi Urushihara, Louise Parmenter, Shimon Tashiro, Kenji Matsui, Nancy Dreyer
Drug safety issues do not respect national borders. Hence, addressing a safety question may necessitate globally coordinated efforts between regulatory authorities and market authorization holders (MAHs) to draw reliable conclusions. Regulatory authorities have shared responsibility with MAHs sponsoring postmarketing nonintervention studies in determining study goals and design. Their shared accountabilities include what will be investigated and how the data will be retrieved to ensure appropriate study quality required for regulatory decision making...
August 16, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28815145/evolving-research-data-sharing-networks-to-clinical-app-sharing-networks
#7
Kavishwar B Wagholikar, Rahul Jain, Eliel Oliveira, Joshua Mandel, Jeffery Klann, Ricardo Colas, Prasad Patil, Kuladip Yadav, Kenneth D Mandl, Thomas Carton, Shawn N Murphy
Research networks for data sharing are growing into a large platform for pragmatic clinical trials to generate quality evidence for shared medical decision-making. Institutions partnering in the networks have made large investments in developing the infrastructure for sharing data. We investigate whether institutions partnering on Patient-Centered Outcomes Research Institute's (PCORI) network can share clinical apps. At two different sites, we imported patient data in PCORI's clinical data model (CDM) format into i2b2 repositories, and adapted the SMART-on-FHIR cell to perform CDM-to-FHIR translation, serving demographics, laboratory results and diagnoses...
2017: AMIA Summits on Translational Science Proceedings
https://www.readbyqxmd.com/read/28815107/introducing-a-comprehensive-informatics-framework-to-promote-breast-cancer-risk-assessment-and-chemoprevention-in-the-primary-care-setting
#8
Joseph Finkelstein, Jeffrey Wood, Katherine D Crew, Rita Kukafka
Breast cancer is the most commonly diagnosed cancer among women in the United States, and current routine screening prevention methods are costly and expose patients to unnecessary risks of overtreatment. The utilization of a risk-based stratification model, genetic testing, and chemoprevention could decrease the incidence of invasive breast cancer but uptake has been low among high-risk women. The goal of this project was to implement a comprehensive informatics framework to promote breast cancer risk assessment and chemoprevention in the primary care setting that was informed by potential user feedback...
2017: AMIA Summits on Translational Science Proceedings
https://www.readbyqxmd.com/read/28814138/finnish-nurses-attitudes-towards-their-role-in-the-euthanasia-process
#9
Anja Terkamo-Moisio, Chris Gastmans, Olli-Pekka Ryynänen, Anna-Maija Pietilä
BACKGROUND: Nurses' voices remain unheard in most debates about euthanasia, although their crucial role in the euthanasia process is widely acknowledged. Moreover, in Canadian euthanasia law, nurses have a more active role, which further highlights the need for knowledge about nurses' attitudes towards their role in the euthanasia process. RESEARCH QUESTIONS: What are Finnish nurses' attitudes towards their potential role in the euthanasia process? Which characteristics are associated with those attitudes? RESEARCH DESIGN: Cross-sectional web-based survey...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28811918/shared-decision-making-in-medication-management-development-of-a-training-intervention
#10
Ute Stead, Nicola Morant, Shulamit Ramon
Shared decision-making is a collaborative process in which clinicians and patients make treatment decisions together. Although it is considered essential to patient-centred care, the adoption of shared decision-making into routine clinical practice has been slow, and there is a need to increase implementation. This paper describes the development and delivery of a training intervention to promote shared decision-making in medication management in mental health as part of the Shared Involvement in Medication Management Education (ShIMME) project...
August 2017: BJPsych Bulletin
https://www.readbyqxmd.com/read/28811044/learning-how-to-teach-one-a-needs-assessment-of-the-state-of-faculty-development-within-the-consortium-of-the-american-college-of-surgeons-accredited-education-institutes
#11
John T Paige, Nehal N Khamis, Jeffrey B Cooper
BACKGROUND: Developing faculty competencies in curriculum development, teaching, and assessment using simulation is critical for the success of the Consortium of the American College of Surgeons Accredited Education Institutes program. The state of and needs for faculty development in the Accredited Education Institute community are unknown currently. The Faculty Development Committee of the Consortium of the Accredited Education Institutes conducted a survey of Accredited Education Institutes to ascertain what types of practices are used currently, with what frequency, and what needs are perceived for further programs and courses to guide the plan of action for the Faculty Development Committee...
August 12, 2017: Surgery
https://www.readbyqxmd.com/read/28810897/cost-of-hospitalization-for-childbirth-in-india-how-equitable-it-is-in-the-post-nrhm-era
#12
Jaya Prasad Tripathy, Hemant D Shewade, Sanskruti Mishra, A M V Kumar, A D Harries
BACKGROUND AND OBJECTIVE: Information on out-of-pocket (OOP) expenditure during childbirth in public and private health facilities in India is needed to make rational decisions for improving affordability to maternal care services. We undertook this study to evaluate the OOP expenditure due to hospitalization from childbirth and its impact on households. METHODS: This is a secondary data analysis of a nationwide household survey by the National Sample Survey Organization in 2014...
August 15, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28810390/shared-decision-making-rhetoric-and-reality-women-s-experiences-and-perceptions-of-adjuvant-treatment-decision-making-for-breast-cancer
#13
Neda Mahmoodi, Sally Sargeant
This interview-based study uses phenomenology as a theoretical framework and thematic analysis to challenge existing explanatory frameworks of shared decision-making, in an exploration of women's experiences and perceptions of shared decision-making for adjuvant treatment in breast cancer. Three themes emerged are as follows: (1) women's desire to participate in shared decision-making, (2) the degree to which shared decision-making is perceived to be shared and (3) to what extent are women empowered within shared decision-making...
January 1, 2017: Journal of Health Psychology
https://www.readbyqxmd.com/read/28810270/the-personal-antipsychotic-choice-index
#14
Floor van Dijk, Iris de Wit, Matthijs Blankers, Iris Sommer, Lieuwe de Haan
Introduction We present an online decision aid to involve patients with a psychotic disorder in shared decision-making concerning the selection of antipsychotic medication. Method Patients selected effectiveness and adverse effects criteria from the Subject's Response to Antipsychotics-34 questionnaire. Numerical data from meta-analyses, clinical trial data, receptor affinities and expert opinions were used to rank antipsychotics on each criterion. When using the the tool, patients indicate on a 5-point Likert scale how they value each (adverse) effect...
August 15, 2017: Pharmacopsychiatry
https://www.readbyqxmd.com/read/28810207/intermediate-care-to-intensive-care-triage-a-quality-improvement-project-to-reduce-mortality
#15
David N Hager, Pranav Chandrashekar, Robert W Bradsher, Ali M Abdel-Halim, Souvik Chatterjee, Melinda Sawyer, Roy G Brower, Dale M Needham
PURPOSE: Medical patients whose care needs exceed what is feasible on a general ward, but who do not clearly require critical care, may be admitted to an intermediate care unit (IMCU). Some IMCU patients deteriorate and require medical intensive care unit (MICU) admission. In 2012, staff in the Johns Hopkins IMCU expressed concern that patient acuity and the threshold for MICU admission were too high. Further, shared triage decision-making between residents and supervising physicians did not consistently occur...
August 3, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28810005/shared-decision-making-and-improving-health-care-the-answer-is-not-in
#16
Victor M Montori, Marleen Kunneman, Juan P Brito
No abstract text is available yet for this article.
August 15, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28808671/survey-data-of-intra-household-decision-making-and-smallholder-agricultural-production-in-northern-uganda-and-southern-tanzania
#17
Chris M Mwungu, Caroline Mwongera, Kelvin M Shikuku, Fridah N Nyakundi, Jennifer Twyman, Leigh Ann Winowiecki, Edidah L Ampaire, Mariola Acosta, Peter Läderach
This article provides a description of intra-household survey data that were collected in Uganda and Tanzania in 2014 and 2015, respectively. The surveys were implemented using a structured questionnaire administered among 585 households in Uganda and 608 in Tanzania. Information on decision making processes in agricultural production was collected from the principal adult male and female decision-makers in each household. The survey consisted of two parts. Firstly, the decision-makers, both male and female of each household were jointly interviewed...
October 2017: Data in Brief
https://www.readbyqxmd.com/read/28807699/communication-challenges-of-oncologists-and-intensivists-caring-for-pediatric-oncology-patients-a-qualitative-study
#18
Folasade Odeniyi, Pamela G Nathanson, Theodore E Schall, Jennifer K Walter
CONTEXT: The families of oncology patients requiring intensive care often face increasing complexity in communication with their providers, particularly when patients are cared for by providers from different disciplines. OBJECTIVE: To describe experiences and challenges faced by pediatric oncologists and intensivists and how the oncologist-intensivist relationship impacts communication and initiation of goals of care discussions (GCDs). METHODS: We conducted semi-structured interviews with a convenience sample of ten physicians, including pediatric oncology and intensive care attendings and fellows...
August 11, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28804870/effect-of-the-tool-to-reduce-inappropriate-medications-on-medication-communication-and-deprescribing
#19
Terri R Fried, Kristina M Niehoff, Richard L Street, Peter A Charpentier, Nallakkandi Rajeevan, Perry L Miller, Mary K Goldstein, John R O'Leary, Brenda T Fenton
OBJECTIVES: To examine the effect of the Tool to Reduce Inappropriate Medications (TRIM), a web tool linking an electronic health record (EHR) to a clinical decision support system, on medication communication and prescribing. DESIGN: Randomized clinical trial. SETTING: Primary care clinics at a Veterans Affairs Medical Center. PARTICIPANTS: Veterans aged 65 and older prescribed seven or more medications randomized to receipt of TRIM or usual care (N = 128)...
August 14, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28803334/surgical-approaches-to-adenocarcinoma-of-the-gastroesophageal-junction-the-siewert-ii-conundrum
#20
REVIEW
Andrew M Brown, Danica N Giugliano, Adam C Berger, Michael J Pucci, Francesco Palazzo
BACKGROUND: The Siewert classification system for gastroesophageal junction adenocarcinoma has provided morphological and topographical information to help guide surgical decision-making. Evidence has shown that Siewert I and III tumors are distinct entities with differing epidemiologic and histologic characteristics and distinct patterns of disease progression, requiring different treatment. Siewert II tumors share some of the characteristics of type I and III lesions, and the surgical approach is not universally agreed upon...
August 12, 2017: Langenbeck's Archives of Surgery
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