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Shared decision making

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https://www.readbyqxmd.com/read/29054848/national-commitment-to-shared-decision-making
#1
EDITORIAL
Gillian Leng, Celia Ingham Clark, Kate Brian, Gemma Partridge
No abstract text is available yet for this article.
October 20, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29054462/communication-with-patients-and-the-duration-of-family-medicine-consultations
#2
Francisco Javier Valverde Bolívar, Miguel Pedregal González, Herminia Moreno Martos, Inmaculada Cózar García, Jesús Torío Durántez
OBJECTIVE: To determine the distribution of consultation times, the factors that determine their length, and their relationship with a more participative, patient-centred consulting style. DESIGN: Cross-sectional multicentre study. LOCATION: Primary Healthcare Centres in Andalusia, Spain. PARTICIPANTS: A total of 119 tutors and family medicine physician residents. PRINCIPAL MEASUREMENTS: Consultation length and communication with the patient were analysed using the CICCAA scale (Connect, Identify, Understand, Consent, Help) during 436 interviews in Primary Care...
October 17, 2017: Atencion Primaria
https://www.readbyqxmd.com/read/29050054/indication-criteria-for-total-knee-arthroplasty-in-patients-with-osteoarthritis-a-multi-perspective-consensus-study
#3
Jochen Schmitt, Toni Lange, Klaus-Peter Günther, Christian Kopkow, Elisabeth Rataj, Christian Apfelbacher, Martin Aringer, Eckhardt Böhle, Hartmut Bork, Karsten Dreinhöfer, Niklaus Friederich, Karl-Heinz Frosch, Sascha Gravius, Erika Gromnica-Ihle, Karl-Dieter Heller, Stephan Kirschner, Bernd Kladny, Hendrik Kohlhof, Michael Kremer, Nicolai Leuchten, Maike Lippmann, Jürgen Malzahn, Heiko Meyer, Rainer Sabatowski, Hanns-Peter Scharf, Johannes Stoeve, Richard Wagner, Jörg Lützner
Background and Objectives Knee osteoarthritis (OA) is a significant public health burden. Rates of total knee arthroplasty (TKA) in OA vary substantially between geographical regions, most likely due to the lack of standardised indication criteria. We set out to define indication criteria for the German healthcare system for TKA in patients with knee OA, on the basis of best evidence and transparent multi-stakeholder consensus. Methods We undertook a complex mixed methods study, including an iterative process of systematic appraisal of existing evidence, Delphi consensus methods and stakeholder conferences...
October 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/29048264/counseling-parents-at-risk-of-delivery-of-an-extremely-premature-infant-differing-strategies
#4
Marlyse F Haward, Annie Janvier, John M Lorenz, Baruch Fischhoff
BACKGROUND: It is not known how neonatologists address the affective and cognitive loads on parents deciding whether to resuscitate infants born extremely preterm. This study explores expert neonatologists' views on these decision-making processes and their own roles in counseling parents. METHODS: Semi-structured interviews asked internationally recognized experts to share their perspectives on perinatal consultations. Their responses were subjected to thematic analysis...
October 19, 2017: AJOB Empirical Bioethics
https://www.readbyqxmd.com/read/29045672/dynamics-of-evidence-informed-health-policy-making-in-pakistan
#5
Zaeem Haq, Assad Hafeez, Shamsa Zafar, Abdul Ghaffar
Incorporating evidence is fundamental to maintaining the general acceptance and efficiency in public policies. In Pakistan, different actors-local and global-strive to facilitate the development of evidence-informed health policies. Effective involvement however, requires knowledge of the country-context, i.e. knowing the intricacies of how policies are formulated in Pakistan. Obtaining this knowledge is one of the key steps to making interventions impactful. We carried out a qualitative study to explore the environment of evidence-informed health policy in Pakistan...
October 17, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/29045647/mechanical-aortic-valve-replacement-in-non-elderly-adults-meta-analysis-and-microsimulation
#6
Nelleke M Korteland, Jonathan R G Etnel, Bardia Arabkhani, M Mostafa Mokhles, Arezo Mohamad, Jolien W Roos-Hesselink, Ad J J C Bogers, Johanna J M Takkenberg
Aims: To support decision-making regarding prosthetic valve selection in non-elderly adults, we aim to provide a detailed overview of outcome after contemporary mechanical aortic valve replacement (AVR). Methods and results: A systematic review was conducted for papers reporting clinical outcome after AVR with bileaflet mechanical valves with a mean patient age ≥18 and ≤55 years, published between 1 January 1995 and 31 December 2015. Through meta-analysis outcomes were pooled and entered into a microsimulation model to calculate (event-free) life expectancy and lifetime event risk...
May 10, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29045575/shared-and-disorder-specific-neurocomputational-mechanisms-of-decision-making-in-autism-spectrum-disorder-and-obsessive-compulsive-disorder
#7
Christina O Carlisi, Luke Norman, Clodagh M Murphy, Anastasia Christakou, Kaylita Chantiluke, Vincent Giampietro, Andrew Simmons, Michael Brammer, Declan G Murphy, David Mataix-Cols, Katya Rubia
Autism spectrum disorder (ASD) and obsessive-compulsive disorder (OCD) often share phenotypes of repetitive behaviors, possibly underpinned by abnormal decision-making. To compare neural correlates underlying decision-making between these disorders, brain activation of boys with ASD (N = 24), OCD (N = 20) and typically developing controls (N = 20) during gambling was compared, and computational modeling compared performance. Patients were unimpaired on number of risky decisions, but modeling showed that both patient groups had lower choice consistency and relied less on reinforcement learning compared to controls...
October 17, 2017: Cerebral Cortex
https://www.readbyqxmd.com/read/29045282/prediction-model-for-wait-times-in-cardiac-transplantation
#8
David L Joyce, Brian D Lahr, Lyle D Joyce, Sudhir S Kushwaha, Richard C Daly
Wait times have increased for patients approved for heart transplants. We reviewed United Network for Organ Sharing (UNOS) data for 14,242 patients listed for isolated heart transplant (2009-2013) to develop a risk score model for timing left ventricular assist device (LVAD) implantation in bridge-to-transplant patients. We used a multivariable Cox proportional hazards regression model with subsequent bootstrap resampling for internal validation to develop a scoring system that combined risk factors, weighted by the corresponding regression coefficients, to define an individual's risk score...
October 18, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29044367/one-health-economics-to-confront-disease-threats
#9
Catherine Machalaba, Kristine M Smith, Lina Awada, Kevin Berry, Franck Berthe, Timothy A Bouley, Mieghan Bruce, Jose Cortiñas Abrahantes, Anas El Turabi, Yasha Feferholtz, Louise Flynn, Giullaume Fournié, Amanda Andre, Delia Grace, Olga Jonas, Tabitha Kimani, François Le Gall, Juan Jose Miranda, Marisa Peyre, Julio Pinto, Noam Ross, Simon R Rüegg, Robert H Salerno, Richard Seifman, Carlos Zambrana-Torrelio, William B Karesh
Global economic impacts of epidemics suggest high return on investment in prevention and One Health capacity. However, such investments remain limited, contributing to persistent endemic diseases and vulnerability to emerging ones. An interdisciplinary workshop explored methods for country-level analysis of added value of One Health approaches to disease control. Key recommendations include: 1. systems thinking to identify risks and mitigation options for decision-making under uncertainty; 2. multisectoral economic impact assessment to identify wider relevance and possible resource-sharing, and 3...
June 1, 2017: Transactions of the Royal Society of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/29043918/-being-able-to-speak-what-individuals-in-jail-perceived-as-helpful-about-participating-in-alcohol-related-brief-interventions
#10
Mandy D Owens, Megan Kirouac, Kylee Hagler, Lauren N Rowell, Emily C Williams
BACKGROUND: A significant proportion of individuals within the criminal justice system meet criteria for a substance use disorder. Treatments for individuals who are incarcerated with substance use disorders show minimal to no benefit on post-release outcomes, suggesting a need to improve their effectiveness, particularly those that can be delivered in a brief format. The purpose of this study was to describe what individuals in jail with substance use disorders perceived as being helpful about two brief alcohol-focused interventions, which can be used to inform future treatments with this population...
October 18, 2017: Substance Abuse
https://www.readbyqxmd.com/read/29042146/is-patient-behavior-during-consultation-associated-with-shared-decision-making-a-study-of-patients-questions-cues-and-concerns-in-relation-to-observed-shared-decision-making-in-a-cancer-outpatient-clinic
#11
Anita Amundsen, Tone Nordøy, Kristine Emilie Lingen, Tore Sørlie, Svein Bergvik
OBJECTIVES: To explore how cancer patients actively participate in consultations by asking questions and expressing emotional cues/concerns and to what extent this is associated with physician shared decision making (SDM) behavior. METHODS: This observational study included audio recordings of 31 primary consultation with patients at the Oncology Outpatient Clinic at the University Hospital of North Norway. The content (topics) and frequency of health related questions from patients/caregivers were registered along with emotional cues and concerns (VR-CoDES) and observed shared decision-making (OPTION)...
October 12, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/29042032/clinical-outcomes-and-predictors-of-patient-satisfaction-in-displaced-midshaft-clavicle-fractures-in-adults-results-from-a-retrospective-multicentre-study
#12
Eric D Tutuhatunewa, Martin Stevens, Ron L Diercks
BACKGROUND: The optimal treatment of displaced midshaft clavicle fractures (Robinson Type 2B1 & 2B2) in adults remains controversial. Little is known about patient satisfaction with treatment for this type of injury. The purpose of this study was to compare clinical outcomes and explore predictors of patient satisfaction after nonoperative and direct-operative treatment of displaced midshaft clavicle fractures in adults. METHODS: A retrospective multicentre study was conducted...
October 7, 2017: Injury
https://www.readbyqxmd.com/read/29039368/connecting-parents-to-a-pediatric-emergency-department-designing-a-mobile-app-based-on-patient-centred-care-principles
#13
Frederic Ehrler, Johan N Siebert, Jessica Rochat, Franck Schneider, Annick Galetto, Alain Gervaix, Christian Lovis
INTRODUCTION: Patient centred care fosters a holistic approach of care switching the focus from a disease perspective to a patient's experience perspective. Patient centred care is of particular importance in the context of paediatric emergency medicine. Indeed, parents entering a paediatric emergency department (PED) are usually under stress caused by their children's illness, the unfamiliar setting of the PED and delays of care. All these factors can deteriorate their experience as well as the relationships between healthcare providers, the patients and their parents...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/29039136/cancer-risk-management-in-tasmanian-women-with-brca1-and-brca2-mutations
#14
Stephanie Kearton, Karen Wills, Michael Bunting, Penny Blomfield, Paul A James, Jo Burke
Women carrying germline mutations in BRCA1 or BRCA2 have significantly increased lifetime risks of breast and tubo-ovarian cancer. To manage the breast cancer risk women may elect to have breast screening by MRI/mammogram from age 30, to take risk-reducing medication, or to have a prophylactic bilateral mastectomy. To manage the tubo-ovarian cancer risk, the only effective strategy is to have a bilateral salpingo-oophorectomy, recommended by age 40 (BRCA1) or 'around' age 40 (BRCA2). Early studies suggested that uptake of these cancer risk-reducing strategies was low...
October 16, 2017: Familial Cancer
https://www.readbyqxmd.com/read/29038481/the-social-and-cultural-roots-of-whale-and-dolphin-brains
#15
Kieran C R Fox, Michael Muthukrishna, Susanne Shultz
Encephalization, or brain expansion, underpins humans' sophisticated social cognition, including language, joint attention, shared goals, teaching, consensus decision-making and empathy. These abilities promote and stabilize cooperative social interactions, and have allowed us to create a 'cognitive' or 'cultural' niche and colonize almost every terrestrial ecosystem. Cetaceans (whales and dolphins) also have exceptionally large and anatomically sophisticated brains. Here, by evaluating a comprehensive database of brain size, social structures and cultural behaviours across cetacean species, we ask whether cetacean brains are similarly associated with a marine cultural niche...
October 16, 2017: Nature ecology & evolution
https://www.readbyqxmd.com/read/29038166/why-and-how-to-step-down-chronic-asthma-drugs
#16
REVIEW
Michael R Gionfriddo, John B Hagan, Matthew A Rank
Asthma is a common chronic airways disease. The goal of asthma management is to control symptoms while minimizing the side effects of treatment. Following a period of stable asthma, clinicians should consider stepping down treatment. This approach is recommended by current guidelines. Step-down has been studied for several types of asthma drug regimens, and certain approaches may have lower risk than others. Systematic reviews of multiple trials support the following specific step-down approaches: optimizing inhaled corticosteroid dosing when stepping down oral corticosteroid, reducing inhaled corticosteroid from a higher dose, lowering inhaled corticosteroid-long acting bronchodilator (ICS-LABA) dose while adding ICS-LABA on-demand, adding leukotriene receptor antagonist (LTRA) while lowering inhaled corticosteroid dose, and using allergen immunotherapy when reducing inhaled corticosteroid from a higher dose...
October 16, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29036464/the-mimic-code-repository-enabling-reproducibility-in-critical-care-research
#17
Alistair E W Johnson, David J Stone, Leo A Celi, Tom J Pollard
Objective: Lack of reproducibility in medical studies is a barrier to the generation of a robust knowledge base to support clinical decision-making. In this paper we outline the Medical Information Mart for Intensive Care (MIMIC) Code Repository, a centralized code base for generating reproducible studies on an openly available critical care dataset. Materials and Methods: Code is provided to load the data into a relational structure, create extractions of the data, and reproduce entire analysis plans including research studies...
September 27, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/29036444/the-elephant-in-the-room-toward-a-more-ethical-approach-with-accountability-toward-intended-beneficiaries-in-humanitarian-aid
#18
Ramin Asgary, Ronald J Waldman
There is considerable tension between the concept of accountability to beneficiaries and its practice in humanitarian aid. The beneficiaries live in a relationship that is asymmetric; upward or horizontal accountability within the aid system alone-even with the best of intentions-might be short-sighted. Could beneficiaries be effectively involved in programing, priority setting or allocation of resources? Is there space for a rights-based approach in aid delivery and operations? The mind-set, governance and structure of operations in aid agencies may need significant institutional reform to share the process of decision-making, and to transform the current dynamic from connecting resources to brokering better governance, true collaboration and co-operation among all stakeholders...
September 28, 2017: International Health
https://www.readbyqxmd.com/read/29036406/effects-of-computerized-decision-support-system-implementations-on-patient-outcomes-in-inpatient-care-a-systematic-review
#19
Julian Varghese, Maren Kleine, Sophia Isabella Gessner, Sarah Sandmann, Martin Dugas
Objectives: To systematically classify the clinical impact of computerized clinical decision support systems (CDSSs) in inpatient care. Materials and Methods: Medline, Cochrane Trials, and Cochrane Reviews were searched for CDSS studies that assessed patient outcomes in inpatient settings. For each study, 2 physicians independently mapped patient outcome effects to a predefined medical effect score to assess the clinical impact of reported outcome effects. Disagreements were measured by using weighted kappa and solved by consensus...
September 23, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/29036378/the-effect-of-costs-on-kenyan-households-demand-for-medical-care-why-time-and-distance-matter
#20
Matt Kukla, Niccie McKay, Richard Rheingans, Jeff Harman, Jessica Schumacher, Karen L Kotloff, Myrone M Levine, Robert Breiman, Tamer Farag, Damian Walker, Dilruba Nasrin, Richard Omore, Ciara O'Reilly, Eric Mintz
In an environment of constrained resources, policymakers must identify solutions for financing and delivering health services that are efficient and sustainable. However, such solutions require that policymakers understand the complex interaction between household utilization patterns, factors influencing household medical decisions, and provider performance. This study examined whether and under what conditions out-of-pocket, transportation, and time costs influenced Kenyan households' choice of medical provider for childhood diarrhoeal illnesses...
October 5, 2017: Health Policy and Planning
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