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Clinical Decision Support

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https://www.readbyqxmd.com/read/27911088/african-american-women-s-perspectives-on-donating-healthy-breast-tissue-for-research-implications-for-recruitment
#1
Katherine E Ridley-Merriweather, Katharine J Head
African American women die of breast cancer at a higher rate than any other racial group. The Komen Tissue Bank (KTB) is an ongoing clinical trial that collects healthy breast tissue from women of all racial groups to use as controls in research and represents a critical tool in efforts to treat and prevent breast cancer; however, African Americans display reticence toward donating breast tissue to the KTB. Through the lens of the Integrated Behavioral Model, this study recruited African American women to share their perspectives on donating breast tissue for research purposes...
December 2, 2016: Health Communication
https://www.readbyqxmd.com/read/27910719/artifacts-in-multimodal-imaging-of-titanium-zirconium-and-binary-titanium-zirconium-alloy-dental-implants-an-in-vitro-study
#2
Ralf Smeets, Maximilian Schöllchen, Tobias Gauer, Gahzal Aarabi, Alexandre T Assaf, Carsten Rendenbach, Benedicta Beck-Broichsitter, Jan Semmusch, Jan Sedlacik, Max Heiland, Jens Fiehler, Susanne Siemonsen
OBJECTIVES: To analyze and evaluate imaging artifacts induced by zirconium, titanium and titanium-zirconium alloy dental implants. METHODS: Zirconium, titanium and titanium-zirconium alloy implants were embedded in gelatin and MRI, CT and CBCT were performed. Standard-protocols were used for each modality. For MRI, line-distance-profiles were plotted to quantify the accuracy of size-determination. For CT and CBCT, six shells surrounding the implant were defined every 0...
December 2, 2016: Dento Maxillo Facial Radiology
https://www.readbyqxmd.com/read/27910189/a-qualitative-investigation-into-the-hiv-disclosure-process-within-an-intimate-partnership-the-moment-i-realized-that-our-relationship-was-developing-into-something-serious-i-just-had-to-tell-him
#3
Charlotte Smith, Rachel Cook, Poul Rohleder
OBJECTIVES: This study sought to elucidate the process through which people living with HIV (PLWH) in the United Kingdom disclose their status to an intimate partner (IP). DESIGN: A qualitative cross-sectional survey design was used. METHOD: A total of 95 PLWH took part. They were presented with a series of open-ended questions enquiring into their last experience of disclosing to an IP. The data were analysed using thematic analysis. RESULTS: Disclosure became a salient issue when the discloser acknowledged their relationship as meaningful...
December 2, 2016: British Journal of Health Psychology
https://www.readbyqxmd.com/read/27909972/can-we-estimate-short-and-intermediate-term-survival-in-patients-undergoing-surgery-for-metastatic-bone-disease
#4
Jonathan A Forsberg, Rikard Wedin, Patrick J Boland, John H Healey
BACKGROUND: Objective means of estimating survival can be used to guide surgical decision-making and to risk-stratify patients for clinical trials. Although a free, online tool ( www.pathfx.org ) can estimate 3- and 12-month survival, recent work, including a survey of the Musculoskeletal Tumor Society, indicated that estimates at 1 and 6 months after surgery also would be helpful. Longer estimates help justify the need for more durable and expensive reconstructive options, and very short estimates could help identify those who will not survive 1 month and should not undergo surgery...
December 1, 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27908334/antimicrobial-stewardship-in-the-management-of-sepsis
#5
REVIEW
Michael S Pulia, Robert Redwood, Brian Sharp
Sepsis represents a unique clinical dilemma with regard to antimicrobial stewardship. The standard approach to suspected sepsis in the emergency department centers on fluid resuscitation and timely broad-spectrum antimicrobials. The lack of gold standard diagnostics and evolving definitions for sepsis introduce a significant degree of diagnostic uncertainty that may raise the potential for inappropriate antimicrobial prescribing. Intervention bundles that combine traditional quality improvement strategies with emerging electronic health record-based clinical decision support tools and rapid molecular diagnostics represent the most promising approach to enhancing antimicrobial stewardship in the management of suspected sepsis in the emergency department...
February 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/27907957/surgical-strategies-for-spontaneous-intracerebral-hemorrhage
#6
Wendy Ziai, J Ricardo Carhuapoma, Paul Nyquist, Daniel F Hanley
In recent decades, the medical and surgical treatment of intracerebral hemorrhage (ICH) have become the focus of a number of scientific investigations. This effort has been led by an international group of neurologists and neurosurgeons with the goal of studying functional recovery and developing new medical and surgical treatments to facilitate improved clinical outcomes. Currently, two of the most pressing ICH investigational goals are (1) early blood pressure control, and (2) safe hematoma volume reduction...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27907952/neurology-of-critical-care
#7
Eelco F M Wijdicks
It is a truism that care of the patient with an acutely severe neurologic illness starts with a full neurologic examination. Neurologic examination is followed by tests (neuroimaging and laboratory) resulting in a diagnosis (presumptive or definitive) and treatment (definitive or preemptive) and followed by admission for supportive care and more treatment. The sequence of decisions depends on the diagnosis, but treatment may be needed to diagnose a neurologic disorder. To find out what underlies the acute presentation of certain neurologic conditions requires (1) interpretation of neurologic findings, (2) interpretation of neuroimaging, (3) linking laboratory abnormalities to certain clinical neurologic findings, and (4) evaluation of improvement or refractoriness after treatment...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27907898/obstetrical-and-perinatal-outcomes-following-blastocyst-transfer-compared-to-cleavage-transfer-a-systematic-review-and-meta-analysis
#8
W P Martins, C O Nastri, L Rienzi, S Z van der Poel, C R Gracia, C Racowsky
STUDY QUESTION: Is blastocyst transfer safe when compared to cleavage stage embryo transfer regarding obstetric and perinatal outcomes? SUMMARY ANSWER: The clinical equipoise between blastocyst and cleavage stage embryo transfer remains as the evidence associating blastocyst transfer with some adverse perinatal outcomes is of low/very low quality. WHAT IS KNOWN ALREADY: Extended embryo culture to the blastocyst stage provides some theoretical advantages and disadvantages...
November 2016: Human Reproduction
https://www.readbyqxmd.com/read/27906771/postoperative-rehabilitation-of-low-energy-hip-fractures-in-the-elderly
#9
Robert H Quinn, Pekka A Mooar, Jayson N Murray, Ryan Pezold, Kaitlyn S Sevarino
Evidence-based information, in conjunction with the clinical expertise of physicians, was used to develop the Appropriate Use Criteria (AUC) document Postoperative Rehabilitation of Low Energy Hip Fractures in the Elderly to improve patient care and obtain the best outcomes while considering the subtleties and distinctions necessary in making clinical decisions. The AUC clinical patient scenarios were derived from patient indications that typically accompany hip fractures, as well as from current evidence-based clinical practice guidelines and supporting literature...
November 30, 2016: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/27906054/is-radical-surgery-of-an-inverted-papilloma-of-the-maxillary-sinus-obsolete-a-case-report
#10
Vedat Yildirim, Niels Christian Pausch, Dirk Halama, Heinz-Theo Lübbers, Ayhan Yildirim
BACKGROUND: Sinonasal inverted papilloma is a locally aggressive tumor arising from the Schneiderian membrane which lines the nasal cavity and paranasal sinuses. Aggressive surgical approaches, such as lateral rhinotomy, were used until recently for complete removal of the inverted papilloma. Currently, endoscopic resection is the gold standard in the treatment of inverted papilloma. However, there are situations that justify an open approach. For example there are studies that report a higher postoperative recurrence rate after endonasal endoscopic resection, particularly in the treatment of recurrent diseases...
December 1, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27904234/allocation-of-rehabilitation-services-for-older-adults-in-the-ontario-home-care-system
#11
Joshua J Armstrong, Joanie Sims-Gould, Paul Stolee
Background: Physiotherapy and occupational therapy services can play a critical role in maintaining or improving the physical functioning, quality of life, and overall independence of older home care clients. Despite their importance, however, there is limited understanding of the factors that influence how rehabilitation services are allocated to older home care clients. The aim of this pilot study was to develop a preliminary understanding of the factors that influence decisions to allocate rehabilitation therapy services to older clients in the Ontario home care system, as perceived by three stakeholder groups...
2016: Physiotherapy Canada. Physiothérapie Canada
https://www.readbyqxmd.com/read/27904167/comparison-of-errors-of-35-weight-estimation-formulae-in-a-standard-collective
#12
M Hoopmann, K O Kagan, A Sauter, H Abele, P Wagner
Issue: The estimation of foetal weight is an integral part of prenatal care and obstetric routine. In spite of its known susceptibility to errors in cases of underweight or overweight babies, important obstetric decisions depend on it. In the present contribution we have examined the accuracy and error distribution of 35 weight estimation formulae within the normal weight range of 2500-4000 g. The aim of the study was to identify the weight estimation formulae with the best possible correspondence to the requirements of clinical routine...
November 2016: Geburtshilfe und Frauenheilkunde
https://www.readbyqxmd.com/read/27903488/information-and-communication-technologies-for-the-dissemination-of-clinical-practice-guidelines-to-health-professionals-a-systematic-review
#13
REVIEW
Gino De Angelis, Barbara Davies, Judy King, Jessica McEwan, Sabrina Cavallo, Laurianne Loew, George A Wells, Lucie Brosseau
BACKGROUND: The transfer of research knowledge into clinical practice can be a continuous challenge for researchers. Information and communication technologies, such as websites and email, have emerged as popular tools for the dissemination of evidence to health professionals. OBJECTIVE: The objective of this systematic review was to identify research on health professionals' perceived usability and practice behavior change of information and communication technologies for the dissemination of clinical practice guidelines...
November 30, 2016: JMIR Medical Education
https://www.readbyqxmd.com/read/27900742/-precision-nursing-individual-based-knowledge-translation
#14
Li-Chi Chiang, Mei-Ling Yeh, Sui-Lung Su
U.S. President Obama announced a new era of precision medicine in the Precision Medicine Initiative (PMI). This initiative aims to accelerate the progress of personalized medicine in light of individual requirements for prevention and treatment in order to improve the state of individual and public health. The recent and dramatic development of large-scale biologic databases (such as the human genome sequence), powerful methods for characterizing patients (such as genomics, microbiome, diverse biomarkers, and even pharmacogenomics), and computational tools for analyzing big data are maximizing the potential benefits of precision medicine...
December 2016: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/27900739/-evidence-based-knowledge-translation-from-scientific-evidence-to-clinical-nursing-practice
#15
Kee-Hsin Chen, Ching-Chiu Kao, Chiehfeng Chen
In 1992, Gordon Guyatt coined the term "evidence-based medicine", which has since attracted worldwide attention. In 2007, the Institute of Medicine's Roundtable on Evidence-Based Medicine set the goal that 90% of clinical decisions would be supported by accurate, timely, and up-to-date clinical information and would reflect the best available evidence by 2020. However, the chasm between knowing and doing remains palpable. In 2000, the Canadian Institute of Health Research applied the term "knowledge translation" to describe the bridge that is necessary to cross the gap between research knowledge and clinical practice...
December 2016: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/27900669/disruptive-behaviour-in-the-perioperative-setting-a-contemporary-review
#16
Alexander Villafranca, Colin Hamlin, Stephanie Enns, Eric Jacobsohn
PURPOSE: Disruptive behaviour, which we define as behaviour that does not show others an adequate level of respect and causes victims or witnesses to feel threatened, is a concern in the operating room. This review summarizes the current literature on disruptive behaviour as it applies to the perioperative domain. SOURCE: Searches of MEDLINE(®), Scopus™, and Google books identified articles and monographs of interest, with backreferencing used as a supplemental strategy...
November 29, 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/27899132/cardiac-t1-mapping-and-extracellular-volume-ecv-in-clinical-practice-a-comprehensive-review
#17
REVIEW
Philip Haaf, Pankaj Garg, Daniel R Messroghli, David A Broadbent, John P Greenwood, Sven Plein
Cardiovascular Magnetic Resonance is increasingly used to differentiate the aetiology of cardiomyopathies. Late Gadolinium Enhancement (LGE) is the reference standard for non-invasive imaging of myocardial scar and focal fibrosis and is valuable in the differential diagnosis of ischaemic versus non-ischaemic cardiomyopathy. Diffuse fibrosis may go undetected on LGE imaging. Tissue characterisation with parametric mapping methods has the potential to detect and quantify both focal and diffuse alterations in myocardial structure not assessable by LGE...
November 30, 2016: Journal of Cardiovascular Magnetic Resonance
https://www.readbyqxmd.com/read/27899103/time-to-event-versus-ten-year-absolute-risk-in-cardiovascular-risk-prevention-does-it-make-a-difference-results-from-the-optimizing-risk-communication-optrisk-randomized-controlled-trial
#18
Charles Christian Adarkwah, Nikita Jegan, Monika Heinzel-Gutenbrunner, Felicitas Kühne, Uwe Siebert, Uwe Popert, Norbert Donner-Banzhoff, Sarah Kürwitz
BACKGROUND: The concept of shared-decision-making is a well-established approach to increase the participation of patients in medical decisions. Using lifetime risk or time-to-event (TTE) formats has been increasingly suggested as they might have advantages, e.g. in younger patients, to better show consequences of unhealthy behaviour. In this study, the most-popular ten-year risk illustration in the decision-aid-software arriba(TM) (emoticons), is compared within a randomised trial to a new-developed TTE illustration, which is based on a Markov model...
November 29, 2016: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/27898175/interventions-for-promoting-participation-in-shared-decision-making-for-children-with-cancer
#19
REVIEW
Imelda Coyne, Dónal P O'Mathúna, Faith Gibson, Linda Shields, Edith Leclercq, Greg Sheaf
BACKGROUND: This is an update of the Cochrane systematic review of shared decision-making (SMD) making published in 2013. Children's rights to have their views heard in matters that affect their lives are now well established since the publication of the UN Convention treaty (1989). Children with cancer generally prefer to be involved in decision-making and consider it important that they have the opportunity to take part in decision-making concerning their health care, even in end-of-life decisions...
November 29, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27897445/journal-club-predictors-of-provider-response-to-clinical-decision-support-lessons-learned-from-the-medicare-imaging-demonstration
#20
Ivan K Ip, Ronilda Lacson, Keith Hentel, Sameer Malhotra, Jonathan Darer, Curtis Langlotz, Jonathan Weiss, Ali S Raja, Ramin Khorasani
OBJECTIVE: The efficacy of imaging clinical decision support (CDS) varies. Our objective was to identify CDS factors contributing to imaging order cancellation or modification. SUBJECTS AND METHODS: This pre-post study was performed across four institutions participating in the Medicare Imaging Demonstration. The intervention was CDS at order entry for selected outpatient imaging procedures. On the basis of the information entered, computerized alerts indicated to providers whether orders were not covered by guidelines, appropriate, of uncertain appropriateness, or inappropriate according to professional society guidelines...
November 29, 2016: AJR. American Journal of Roentgenology
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