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Clinical Decision Support

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https://www.readbyqxmd.com/read/28742762/kdigo-clinical-practice-guideline-on-the-evaluation-and-care-of-living-kidney-donors
#1
Krista L Lentine, Bertram L Kasiske, Andrew S Levey, Patricia L Adams, Josefina Alberú, Mohamed A Bakr, Lorenzo Gallon, Catherine A Garvey, Sandeep Guleria, Philip Kam-Tao Li, Dorry L Segev, Sandra J Taler, Kazunari Tanabe, Linda Wright, Martin G Zeier, Michael Cheung, Amit X Garg
The 2017 Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guideline on the Evaluation and Care of Living Kidney Donors is intended to assist medical professionals who evaluate living kidney donor candidates and provide care before, during and after donation. The guideline development process followed the Grades of Recommendation Assessment, Development, and Evaluation (GRADE) approach and guideline recommendations are based on systematic reviews of relevant studies that included critical appraisal of the quality of the evidence and the strength of recommendations...
August 2017: Transplantation
https://www.readbyqxmd.com/read/28742730/predictive-model-for-neoplastic-potential-of-gallbladder-polyp
#2
Ju-Il Yang, Jong Kyun Lee, Dae Geon Ahn, Joo Kyung Park, Kwang Hyuck Lee, Kyu Taek Lee, Sang Ah Chi, Sin-Ho Jung
GOAL: To provide the statistical predictive model for neoplastic potential of gallbladder polyp (GBP). BACKGROUND: Many studies have attempted to define the risk factors for neoplastic potential of GBP. It remains difficult to precisely adapt the reported risk factors for the decision of surgery. Estimating the probability for neoplastic potential of GBP using a combination of several risk factors before surgical resection would be useful in patient consultation...
July 24, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28742678/committee-opinion-no-713-antenatal-corticosteroid-therapy-for-fetal-maturation
#3
(no author information available yet)
Corticosteroid administration before anticipated preterm birth is one of the most important antenatal therapies available to improve newborn outcomes. A single course of corticosteroids is recommended for pregnant women between 24 0/7 weeks and 33 6/7 weeks of gestation who are at risk of preterm delivery within 7 days, including for those with ruptured membranes and multiple gestations. It also may be considered for pregnant women starting at 23 0/7 weeks of gestation who are at risk of preterm delivery within 7 days, based on a family's decision regarding resuscitation, irrespective of membrane rupture status and regardless of fetal number...
August 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28742672/committee-opinion-no-713-summary-antenatal-corticosteroid-therapy-for-fetal-maturation
#4
(no author information available yet)
Corticosteroid administration before anticipated preterm birth is one of the most important antenatal therapies available to improve newborn outcomes. A single course of corticosteroids is recommended for pregnant women between 24 0/7 weeks and 33 6/7 weeks of gestation who are at risk of preterm delivery within 7 days, including for those with ruptured membranes and multiple gestations. It also may be considered for pregnant women starting at 23 0/7 weeks of gestation who are at risk of preterm delivery within 7 days, based on a family's decision regarding resuscitation, irrespective of membrane rupture status and regardless of fetal number...
August 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28742539/translating-evidence-into-practice-in-acute-respiratory-distress-syndrome-teamwork-clinical-decision-support-and-behavioral-economic-interventions
#5
Michael W Sjoding
PURPOSE OF REVIEW: Although the treatment of the acute respiratory distress syndrome (ARDS) with low tidal volume (LTV) mechanical ventilation improves mortality, it is not consistently administered in clinical practice. This review examines strategies to improve LTV and other evidence-based therapies for patients with ARDS. RECENT FINDINGS: Despite the well established role of LTV in the treatment of ARDS, a recent multinational study suggests it is under-utilized in clinical practice...
July 22, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28739478/an-overview-of-clinical-guidelines-for-the-management-of-vertebral-compression-fracture-a-systematic-review
#6
REVIEW
Patrícia Parreira, Chris G Maher, Rodrigo Z Megale, Lyn March, Manuela L Ferreira
BACKGROUND CONTEXT: Vertebral compression fractures are the most common type of osteoporotic fracture comprising approximately 1.4 million cases worldwide. Clinical practice guidelines can be powerful tools for promoting evidence-based practice, as they integrate research findings in order to support decision-making. However, currently available clinical guidelines and recommendations, established by different medical societies, are sometimes contradictory. PURPOSE: The aim of this study was to appraise the recommendations and methodological quality of international clinical guidelines for the management of VCFs...
July 21, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28739290/implementation-of-the-canadian-ct-head-rule-and-its-association-with-use-of-computed-tomography-among-patients-with-head-injury
#7
Adam L Sharp, Brian Z Huang, Tania Tang, Ernest Shen, Edward R Melnick, Arjun K Venkatesh, Michael H Kanter, Michael K Gould
STUDY OBJECTIVE: Approximately 1 in 3 computed tomography (CT) scans performed for head injury may be avoidable. We evaluate the association of implementation of the Canadian CT Head Rule on head CT imaging in community emergency departments (EDs). METHODS: We conducted an interrupted time-series analysis of encounters from January 2014 to December 2015 in 13 Southern California EDs. Adult health plan members with a trauma diagnosis and Glasgow Coma Scale score at ED triage were included...
July 21, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28739202/the-relationship-between-dietary-intake-growth-and-body-composition-in-phenylketonuria
#8
Maureen Evans, Helen Truby, Avihu Boneh
AIM: Phenylketonuria (PKU) is an inborn error of protein metabolism that results from perturbation in phenylalanine hydroxylase activity leading to elevated blood levels of phenylalanine (phe). We aimed to explore the relationships between dietary patterns (total-protein, natural-protein, amino-acid formula), and the ratio of protein to energy intake with growth and body composition. METHOD: Longitudinal prospective data (1-6 measurements) of growth, dietary intake and body composition in patients treated with phe-restricted diet only (D-PKU; n=32), and tetrahydrobiopterin (BH4)±phe-restricted diet (BH4-PKU; n=5) were collected over a two-year period...
July 20, 2017: Molecular Genetics and Metabolism
https://www.readbyqxmd.com/read/28739094/automatic-repositioning-of-jaw-segments-for-three-dimensional-virtual-treatment-planning-of-orthognathic-surgery
#9
Rodrigo Mologni Gonçalves Dos Santos, José Mario De Martino, Luis Augusto Passeri, Romis Ribeiro de Faissol Attux, Francisco Haiter Neto
PURPOSE: To develop a computer-based method for automating the repositioning of jaw segments in the skull during three-dimensional virtual treatment planning of orthognathic surgery. The method speeds up the planning phase of the orthognathic procedure, releasing surgeons from laborious and time-consuming tasks. MATERIALS AND METHODS: The method finds the optimal positions for the maxilla, mandibular body, and bony chin in the skull. Minimization of cephalometric differences between measured and standard values is considered...
July 4, 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28738986/pilot-testing-fall-tips-tailoring-interventions-for-patient-safety-a-patient-centered-fall-prevention-toolkit
#10
Patricia C Dykes, Megan Duckworth, Stephanie Cunningham, Sasha Dubois, Melissa Driscoll, Zinnia Feliciano, Michael Ferrazzi, Farah E Fevrin, Stephanie Lyons, Mary Ellen Lindros, Allison Monahan, Matthew M Paley, Saby Jean-Pierre, Maureen Scanlan
BACKGROUND: Patient falls during an acute hospitalization cause injury, reduced mobility, and increased costs. The laminated paper Fall TIPS Toolkit (Fall TIPS) provides clinical decision support at the bedside by linking each patient's fall risk assessment with evidence-based interventions. Strategies were needed to integrate this evidence into clinical practice. METHODS: The Institute for Healthcare Improvement's Framework for Spread is the conceptual model for pilot implementation of Fall TIPS at Brigham and Women's Hospital (BWH; Boston) and Montefiore Medical Center (MMC; Bronx, New York)...
August 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28738984/transfusing-wisely-clinical-decision-support-improves-blood-transfusion-practices
#11
Ian Jenkins, Jay J Doucet, Brian Clay, Patricia Kopko, Donald Fipps, Eema Hemmen, Debra Paulson
BACKGROUND: The cost and risks of red blood cell (RBC) transfusions, along with evidence of overuse, suggest that improving transfusion practices is a key opportunity for health systems to improve both the quality and value of patient care. Previous work, which included a BestPractice Advisory (BPA), was adapted in a quality improvement project designed to reduce both exposure to unnecessary blood products and costs. METHODS: A prospective, pre-post study was conducted at an academic medical center with a diverse patient population...
August 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28738746/how-do-clinical-competency-committees-use-different-sources-of-data-to-assess-residents-performance-on-the-internal-medicine-milestones-a-mixed-methods-pilot-study
#12
Andem Ekpenyong, Elizabeth Baker, Ilene Harris, Ara Tekian, Richard Abrams, Shalini Reddy, Yoon Soo Park
PURPOSE: This study examines how Clinical Competency Committees (CCCs) synthesize assessment data to make judgments about residents' clinical performances. METHODS: Between 2014 and 2015, after four six-month reporting periods to the Accreditation Council for Graduate Medical Education (ACGME), 7 of 16 CCC faculty at Rush University Medical Center completed questionnaires focused on their perspectives about rating residents on their achievement of the milestones and participated in a focus group...
July 25, 2017: Medical Teacher
https://www.readbyqxmd.com/read/28737972/identifying-health-information-technology-needs-of-oncologists-to-facilitate-the-adoption-of-genomic-medicine-recommendations-from-the-2016-american-society-of-clinical-oncology-omics-and-precision-oncology-workshop
#13
Kevin S Hughes, Edward P Ambinder, Gregory P Hess, Peter Paul Yu, Elmer V Bernstam, Mark J Routbort, Jean Rene Clemenceau, John T Hamm, Phillip G Febbo, Susan M Domchek, James L Chen, Jeremy L Warner
At the ASCO Data Standards and Interoperability Summit held in May 2016, it was unanimously decided that four areas of current oncology clinical practice have serious, unmet health information technology needs. The following areas of need were identified: 1) omics and precision oncology, 2) advancing interoperability, 3) patient engagement, and 4) value-based oncology. To begin to address these issues, ASCO convened two complementary workshops: the Omics and Precision Oncology Workshop in October 2016 and the Advancing Interoperability Workshop in December 2016...
July 24, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28736390/-side-effects-are-central-effects-that-challenge-retention-in-hiv-treatment-programmes-in-six-sub-saharan-african-countries-a-multicountry-qualitative-study
#14
Jenny Renju, Mosa Moshabela, Estelle McLean, William Ddaaki, Morten Skovdal, Fred Odongo, Dominic Bukenya, Joyce Wamoyi, Oliver Bonnington, Janet Seeley, Basia Zaba, Alison Wringe
OBJECTIVES: To explore the bodily and relational experience of taking antiretroviral therapy (ART) and the subsequent effect on retention in HIV care in six sub-Saharan African countries. METHODS: In-depth interviews were conducted with 130 people living with HIV (PLHIV) who had initiated ART, 38 PLHIV who were lost to follow-up and 53 healthcare workers (HCWs) in Kenya, Uganda, Tanzania, Malawi, Zimbabwe and South Africa. PLHIV were purposely selected to include a range of HIV treatment histories...
July 2017: Sexually Transmitted Infections
https://www.readbyqxmd.com/read/28735766/risk-factor-analysis-for-predicting-vertebral-body-re-collapse-after-posterior-instrumented-fusion-in-thoracolumbar-burst-fracture
#15
Hae-Dong Jang, Jae Chul Lee, Jae-Wan Soh, Sung-Woo Choi, Hyeung-Kyu Cho, Byung-Joon Shin
BACKGROUND CONTEXT: In the posterior instrumented fusion surgery for thoracolumbar (T-L) burst fracture, early postoperative re-collapse of well-reduced vertebral body fracture could induces critical complications such as correction loss, post-traumatic kyphosis, metal failure, often lead to revision surgery. Furthermore, re-collapse is quite difficult to predict because of the variety of risk factors and no widely accepted accurate prediction systems existed. Although load sharing classification (LSC) has been known to help to decide the need for additional anterior column support, this radiographic scoring system has several critical limitations...
July 20, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28734786/clinical-usefulness-of-tools-to-support-decision-making-for-palliative-treatment-of%C3%A2-metastatic-colorectal-cancer-a-systematic-review
#16
Ellen G Engelhardt, Dóra Révész, Hans J Tamminga, Cornelis J A Punt, Mirjam Koopman, Bregje D Onwuteaka-Philipsen, Ewout W Steyerberg, Ilse P Jansma, Henrica C W De Vet, Veerle M H Coupé
BACKGROUND: Decision-making regarding palliative treatment for patients with metastatic colorectal cancer (mCRC) is complex and comprises numerous decisions. Decision-making should be guided by the premise of maintaining and/or improving patients' quality of life, by patient preference, and by the trade-off between treatment benefits and harm. Decision support systems (DSSs) for clinicians (eg, nomograms) can assist in this process. The present systematic review aimed to provide a comprehensive overview of the available DSSs for incurable mCRC and to assess their clinical usefulness...
June 24, 2017: Clinical Colorectal Cancer
https://www.readbyqxmd.com/read/28734721/factors-influencing-survival-of-patients-with-pancreatic-adenocarcinoma-and-synchronous-liver-metastases-receiving-palliative-care
#17
Huaqiang Ouyang, Weidong Ma, Fang Liu, Zhensong Yue, Minghui Fang, Manman Quan, Zhanyu Pan
BACKGROUND AND AIMS: Patients with pancreatic ductal adenocarcinoma and synchronous liver metastases (PACLM) have an extremely limited life expectancy. We performed a single-center analysis to explore the clinical results and prognostic factors of patients with PACLM receiving palliative care. METHODS: We retrospectively reviewed 189 patients undergoing palliative care at Tianjin Medical University Cancer Hospital over a 15-year period. Clinical characteristics, survival condition, and factors associated with survival were analyzed...
July 8, 2017: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
https://www.readbyqxmd.com/read/28734532/the-novel-use-of-an-extreme-learning-machines-for-clinical-decision-support-systems
#18
EDITORIAL
Shabbir Syed-Abdul, Usman Iqbal, Yu-Chuan Jack Li
No abstract text is available yet for this article.
August 2017: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/28734488/clinical-fellowship-for-an-innovative-integrated-bsn-phd-program-an-academic-and-practice-partnership
#19
Madelyne Z Greene, Mary Kate FitzPatrick, Jean Romano, Linda H Aiken, Therese S Richmond
Opportunities for research-focused doctoral education must be available to nurses early in their careers in order to ensure the further development of nursing science. Early entry into the research doctorate through an integrated BSN-PhD program is one innovative approach. This approach highlights the value of integrating post-licensure clinical training into the doctoral curriculum. To better prepare innovative nurse scientists early in their careers we developed a clinical nurse fellowship within an integrated BSN-PhD program in partnership with an affiliated health system...
July 2017: Journal of Professional Nursing: Official Journal of the American Association of Colleges of Nursing
https://www.readbyqxmd.com/read/28733718/antimicrobial-resistance-in-the-next-30%C3%A2-years-humankind-bugs-and-drugs-a-visionary-approach
#20
REVIEW
Matteo Bassetti, Garyphallia Poulakou, Etienne Ruppe, Emilio Bouza, Sebastian J Van Hal, Adrian Brink
PURPOSE: To describe the current standards of care and major recent advances with regard to antimicrobial resistance (AMR) and to give a prospective overview for the next 30 years in this field. METHODS: Review of medical literature and expert opinion were used in the development of this review. RESULTS: There is undoubtedly a large clinical and public health burden associated with AMR in ICU, but it is challenging to quantify the associated excess morbidity and mortality...
July 21, 2017: Intensive Care Medicine
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