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Clinical Decision Support

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https://www.readbyqxmd.com/read/29793213/end-stage-renal-disease-models-in-the-americas-optimizing-resources-to-achieve-better-health-outcomes
#1
Ramiro E Gilardino, Eduardo González-Pier, Claudia Brabata
End-stage renal disease, the last and most severe stage of chronic kidney disease, represents a major and rising concern for countries in Latin America, driven in large part by aging populations and the near-epidemic rises in diabetes, obesity, and hypertension. This places a great clinical, economic, and social burden on the region's health systems. During the ISPOR 6th Latin America Conference held in Sao Paulo, Brazil, in September 2017, an educational forum debated on value-based decision making in the treatment of end-stage renal disease in Latin America...
May 21, 2018: Value in Health Regional Issues
https://www.readbyqxmd.com/read/29792972/association-between-early-confirmatory-testing-and-the-adoption-of-active-surveillance-for-men-with-favorable-risk-prostate-cancer
#2
Deborah R Kaye, Ji Qi, Todd M Morgan, Susan Linsell, Brian R Lane, James E Montie, Michael L Cher, David C Miller
OBJECTIVE: To examine the relationship between the use and results of early confirmatory testing and persistence on active surveillance (AS). METHODS: We identified all men in the MUSIC registry diagnosed with favorable-risk prostate cancer from 01/2016-02/2017. We next examined trends in the use of early confirmatory test(s), defined as repeat biopsy, prostate MRI and/or molecular classifiers obtained within 6-months of the initial cancer diagnosis, in patients with favorable-risk prostate cancer...
May 21, 2018: Urology
https://www.readbyqxmd.com/read/29791286/metastatic-pancreatic-cancer-asco-clinical-practice-guideline-update
#3
Davendra P S Sohal, Erin B Kennedy, Alok Khorana, Mehmet S Copur, Christopher H Crane, Ignacio Garrido-Laguna, Smitha Krishnamurthi, Cassadie Moravek, Eileen M O'Reilly, Philip A Philip, Ramesh K Ramanathan, Joseph T Ruggiero, Manish A Shah, Susan Urba, Hope E Uronis, Michelle W Lau, Daniel Laheru
Purpose In 2016, ASCO published a guideline to assist in clinical decision making in metastatic pancreatic cancer for initial assessment after diagnosis, first- and second-line treatment options, palliative and supportive care, and follow-up. The purpose of this update is to incorporate new evidence related to second-line therapy for patients who have experienced disease progression or intolerable toxicity during first-line therapy. Methods ASCO convened an Expert Panel to conduct a systematic review of the literature on second-line therapy published between June 2015 and January 2018...
May 23, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/29791243/amcp-partnership-forum-managing-care-in-the-wave-of-precision-medicine
#4
(no author information available yet)
Precision medicine, the customization of health care to an individual's genetic profile while accounting for biomarkers and lifestyle, has increasingly been adopted by health care stakeholders to guide the development of treatment options, improve treatment decision making, provide more patient-centered care, and better inform coverage and reimbursement decisions. Despite these benefits, key challenges prevent its broader use and adoption. On December 7-8, 2017, the Academy of Managed Care Pharmacy convened a group of stakeholders to discuss these challenges and provide recommendations to facilitate broader adoption and use of precision medicine across health care settings...
May 23, 2018: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29790017/machine-learning-in-the-integration-of-simple-variables-for-identifying-patients-with-myocardial-ischemia
#5
Luis Eduardo Juarez-Orozco, Remco J J Knol, Carlos A Sanchez-Catasus, Octavio Martinez-Manzanera, Friso M van der Zant, Juhani Knuuti
BACKGROUND: A significant number of variables are obtained when characterizing patients suspected with myocardial ischemia or at risk of MACE. Guidelines typically use a handful of them to support further workup or therapeutic decisions. However, it is likely that the numerous available predictors maintain intrinsic complex interrelations. Machine learning (ML) offers the possibility to elucidate complex patterns within data to optimize individual patient classification. We evaluated the feasibility and performance of ML in utilizing simple accessible clinical and functional variables for the identification of patients with ischemia or an elevated risk of MACE as determined through quantitative PET myocardial perfusion reserve (MPR)...
May 22, 2018: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/29788362/similar-inhibition-of-dynamic-adhesion-of-lymphocytes-from-ibd-patients-to-madcam-1-by-vedolizumab-and-etrolizumab-s
#6
Marie-Theres Binder, Emily Becker, Maximilian Wiendl, Lena Schleier, Friederike Fuchs, Moritz Leppkes, Raja Atreya, Clemens Neufert, Imke Atreya, Markus F Neurath, Sebastian Zundler
Background: Although anti-adhesion therapies are a novel mainstay in the treatment of inflammatory bowel diseases (IBDs), the mechanisms controlling integrin-dependent gut homing are poorly elucidated, and the available techniques for translational functional investigations are limited. Methods: We used dynamic adhesion assays to study adhesion of CD4+ T cells, CD8+ T cells, CD19+ B cells, and granulocytes to the addressins MAdCAM-1, VCAM-1, and ICAM-1. The effects of vedolizumab, natalizumab, etrolizumab-s, anti-CD11a, and anti-CD18 antibodies were explored...
May 18, 2018: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/29788082/statistical-testing-against-baseline-in-orthodontic-research-a-meta-epidemiologic-study
#7
Sophia Gratsia, Despina Koletsi, Padhraig S Fleming, Nikolaos Pandis
Background/objectives: To assess the prevalence of within-group comparisons from baseline to follow-up in published orthodontic articles and to identify potential associations between this statistical problem and a number of study characteristics. Materials/method: The most recent 24 issues of four leading orthodontic journals with highest impact factor (American Journal of Orthodontics and Dentofacial Orthopedics; AJODO, European Journal of Orthodontics; EJO, Angle Orthodontist; ANGLE, Orthodontics and Craniofacial Research; OCR) were electronically searched until December 31st 2017...
May 18, 2018: European Journal of Orthodontics
https://www.readbyqxmd.com/read/29788041/do-older-and-younger-patients-derive-similar-survival-benefits-from-novel-oncology-drugs-a-systematic-review-and-meta-analysis
#8
Vanessa S Arciero, Sierra Cheng, Robert Mason, Erica McDonald, Ronak Saluja, Kelvin K W Chan
Background: older patients are commonly believed to derive less benefit from cancer drugs, even if they fulfil clinical trial eligibility [Talarico et al. (2004, J Clin Oncol, 22(22):4626-31)]. We aim to examine if novel oncology drugs provide differential age-based treatment outcomes for patients on clinical trials. Methods: a systematic review of randomised control trials (RCTs) cited for clinical efficacy evidence in novel oncology drug approvals by the Food and Drug Administration, European Medicines Agency and Health Canada between 2006 and 2017 was conducted...
May 19, 2018: Age and Ageing
https://www.readbyqxmd.com/read/29785685/network-meta-analysis-an-introduction-for-pharmacists
#9
Yina Xu, Mohamed Amine Amiche, Mina Tadrous
Network meta-analysis is a new tool used to summarize and compare studies for multiple interventions, irrespective of whether these interventions have been directly evaluated against each other. Network meta-analysis is quickly becoming the standard in conducting therapeutic reviews and clinical guideline development. However, little guidance is available to help pharmacists review network meta-analysis studies in their practice. Major institutions such as the Cochrane Collaboration, Agency for Healthcare Research and Quality, Canadian Agency for Drugs and Technologies in Health, and National Institute for Health and Care Excellence Decision Support Unit have endorsed utilizing network meta-analysis to establish therapeutic evidence and inform decision making...
May 21, 2018: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/29785684/impact-of-a-clinical-decision-support-system-for-drug-dosage-in-patients-with-renal-failure
#10
Sophie Desmedt, Anne Spinewine, Michel Jadoul, Séverine Henrard, Dominique Wouters, Olivia Dalleur
Background A clinical decision support system (CDSS) linked to the computerized physician order entry may help improve prescription appropriateness in inpatients with renal insufficiency. Objective To evaluate the impact on prescription appropriateness of a CDSS prescriber alert for 85 drugs in renal failure patients. Setting Before-after study in a 975-bed academic hospital. Method Prescriptions of patients with renal failure were reviewed during two comparable periods of 6 days each, before and after the implementation of the CDSS (September 2009 and 2010)...
May 21, 2018: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/29784229/burnout-evaluation-and-potential-predictors-in-a-greek-cohort-of-mental-health-nurses
#11
Adamos-Konstantinos Konstantinou, Konstantinos Bonotis, Maria Sokratous, Vasileios Siokas, Efthimios Dardiotis
BACKGROUND: Job burnout is one of the most serious occupational health hazards, especially, among mental health nurses. It has been attributed among others to staff shortages, health service changes, poor morale and insufficient employee participation in decision-making. AIM: The aim of this study was to measure burnout among mental health nurses, investigate relations between burnout and organizational factors and examine potential predictors of nurses' burnout...
June 2018: Archives of Psychiatric Nursing
https://www.readbyqxmd.com/read/29782441/how-do-hearing-aid-owners-respond-to-hearing-aid-problems
#12
Rebecca J Bennett, Ariane Laplante-Lévesque, Robert H Eikelboom
BACKGROUND: Although hearing aids can improve hearing and communication, problems that arise following the acquisition of hearing aids can result in their disuse. This study aimed to gather perspectives of hearing aid owners and hearing health care clinicians about how hearing aid owners respond to problems that arise following hearing aid fitting, and then use these perspectives to generate a conceptual framework to better understand these responses. METHODS: Seventeen hearing aid owners and 21 hearing health care clinicians generated, sorted, and rated statements regarding how hearing aid owners respond to problems associated with hearing aid use...
May 18, 2018: Ear and Hearing
https://www.readbyqxmd.com/read/29782314/a-retrospective-belgian-multi-center-mri-biomarker-study-in-alzheimer-s-disease-remember
#13
Ellis Niemantsverdriet, Annemie Ribbens, Christine Bastin, Florence Benoit, Bruno Bergmans, Jean-Christophe Bier, Roxanne Bladt, Lene Claes, Peter Paul De Deyn, Olivier Deryck, Bernard Hanseeuw, Adrian Ivanoiu, Jean-Claude Lemper, Eric Mormont, Gaëtane Picard, Eric Salmon, Kurt Segers, Anne Sieben, Dirk Smeets, Hanne Struyfs, Evert Thiery, Jos Tournoy, Eric Triau, Anne-Marie Vanbinst, Jan Versijpt, Maria Bjerke, Sebastiaan Engelborghs
BACKGROUND: Magnetic resonance imaging (MRI) acquisition/processing techniques assess brain volumes to explore neurodegeneration in Alzheimer's disease (AD). OBJECTIVE: We examined the clinical utility of MSmetrix and investigated if automated MRI volumes could discriminate between groups covering the AD continuum and could be used as a predictor for clinical progression. METHODS: The Belgian Dementia Council initiated a retrospective, multi-center study and analyzed whole brain (WB), grey matter (GM), white matter (WM), cerebrospinal fluid (CSF), cortical GM (CGM) volumes, and WM hyperintensities (WMH) using MSmetrix in the AD continuum...
May 16, 2018: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/29782209/practical-assessment-and-management-of-vulnerabilities-in-older-patients-receiving-chemotherapy-asco-guideline-for-geriatric-oncology
#14
Supriya G Mohile, William Dale, Mark R Somerfield, Mara A Schonberg, Cynthia M Boyd, Peggy S Burhenn, Beverly Canin, Harvey Jay Cohen, Holly M Holmes, Judith O Hopkins, Michelle C Janelsins, Alok A Khorana, Heidi D Klepin, Stuart M Lichtman, Karen M Mustian, William P Tew, Arti Hurria
Purpose To provide guidance regarding the practical assessment and management of vulnerabilities in older patients undergoing chemotherapy. Methods An Expert Panel was convened to develop clinical practice guideline recommendations based on a systematic review of the medical literature. Results A total of 68 studies met eligibility criteria and form the evidentiary basis for the recommendations. Recommendations In patients ≥ 65 years receiving chemotherapy, geriatric assessment (GA) should be used to identify vulnerabilities that are not routinely captured in oncology assessments...
May 21, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/29782074/supporting-women-at-the-time-of-abortion-a-mixed-methods-study-of-male-partner-experiences-and-perspectives
#15
Brian T Nguyen, Luciana E Hebert, Sara L Newton, Melissa L Gilliam
CONTEXT: Although men are commonly viewed as unaware, uninvolved and even obstructive regarding their partner's abortion access, those who accompany women to an abortion appointment may be more supportive. A better understanding of men's motivations could inform clinic policies regarding their involvement. METHODS: In 2015-2016, data were collected from male partners of women seeking an abortion at two clinics in a large Midwestern city. Twenty-nine interviews were conducted to explore how men wanted to be involved in the abortion and why they accompanied their partners...
May 21, 2018: Perspectives on Sexual and Reproductive Health
https://www.readbyqxmd.com/read/29781145/core-outcome-set-for-gene-therapy-in-haemophilia-results-of-the-corehem-multistakeholder-project
#16
A Iorio, M W Skinner, E Clearfield, D Messner, G F Pierce, M Witkop, S Tunis
BACKGROUND: Gene therapy trial results show potential to cure haemophilia A and haemophilia B. Securing broad access to a cure for a lifelong chronic disease is anticipated to face barriers at the individual and healthcare system levels, which can be partly mitigated by harmonized planning of clinical research studies. The aim of the coreHEM project was to determine the set of outcome measures required to evaluate efficacy, safety, comparative effectiveness and value of gene therapy for haemophilia...
May 20, 2018: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/29780633/deep-learning-aided-decision-support-for-pulmonary-nodules-diagnosing-a-review
#17
REVIEW
Yixin Yang, Xiaoyi Feng, Wenhao Chi, Zhengyang Li, Wenzhe Duan, Haiping Liu, Wenhua Liang, Wei Wang, Ping Chen, Jianxing He, Bo Liu
Deep learning techniques have recently emerged as promising decision supporting approaches to automatically analyze medical images for different clinical diagnosing purposes. Diagnosing of pulmonary nodules by using computer-assisted diagnosing has received considerable theoretical, computational, and empirical research work, and considerable methods have been developed for detection and classification of pulmonary nodules on different formats of images including chest radiographs, computed tomography (CT), and positron emission tomography in the past five decades...
April 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29780224/correlative-study-between-c-reactive-protein-clinical-severity-and-nerve-conduction-studies-in-guillain-barr%C3%A3-syndrome
#18
Yosria A Altaweel, Sawsan Abdelaziz, Hala A Fathy, Shimaa AbdelBadea
Background: Guillain-Barre' syndrome (GBS) is a serious autoimmune disorder in which the immune system attacks healthy nerve cells of the peripheral nervous system causing polyradiculoneuropathy which leads to weakness, numbness, and tingling, and can eventually cause paralysis. Autoimmune conditions like GBS can induce a high level of inflammation resulting in an increase in the C-reactive protein( CRP) production. The aim of this study is to assess the relationship between CRP level and the clinical severity as well as the electrophysiological findings of nerve conduction studies in patients with GBS...
2018: The Egyptian journal of neurology, psychiatry and neurosurgery
https://www.readbyqxmd.com/read/29779924/management-of-nocturnal-enuresis-in-taiwan-consensus-statements-of-the-taiwan-enuresis-expert-committee
#19
REVIEW
Ta-Min Wang, Stephen Shei-Dei Yang, Jeng-Daw Tsai, Mei-Ching Yu, Yee-Hsuan Chiou, Kuo-Liang Chen, Hong-Lin Cheng, Jesun Lin, Hsiao-Wen Chen, Hann-Chorng Kuo, Shyh-Chyan Chen
Nocturnal enuresis causes significant psychological distress to affected children and their family and requires appropriate management. A 12-member expert committee of pediatric urologists and pediatric nephrologists in Taiwan with extensive experience in treating enuresis was established to develop consensus statements and a recommended treatment algorithm for the management of patients with nocturnal enuresis in Taiwan after careful consideration of current evidence, existing guidelines, and expert opinion as well as local practice and culture...
May 17, 2018: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/29779717/the-design-and-evaluation-of-an-antimicrobial-resistance-surveillance-system-for-neonatal-intensive-care-units-in-iran
#20
Peyman Rezaei-Hachesu, Taha Samad-Soltani, Sajad Yaghoubi, Marjan GhaziSaeedi, Kayvan Mirnia, Hossein Masoumi-Asl, Reza Safdari
INTRODUCTION: Neonatal intensive care units (NICUs) have complex patients in terms of their diagnoses and required treatments. Antimicrobial treatment is a common therapy for patients in NICUs. To solve problems pertaining to empirical therapy, antimicrobial stewardship programs have recently been introduced. Despite the success of these programs in terms of data collection, there is still inefficiency in terms of analyzing and reporting the data. Thus, to successfully implement these stewardship programs, the design of antimicrobial resistance (AMR) surveillance systems is recommended as a first step...
July 2018: International Journal of Medical Informatics
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