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https://www.readbyqxmd.com/read/28068789/pragmatic-trial-of-video-education-in-nursing-homes-the-design-and-rationale-for-a-pragmatic-cluster-randomized-trial-in-the-nursing-home-setting
#1
Vincent Mor, Angelo E Volandes, Roee Gutman, Constantine Gatsonis, Susan L Mitchell
Background/Aims Nursing homes are complex healthcare systems serving an increasingly sick population. Nursing homes must engage patients in advance care planning, but do so inconsistently. Video decision support tools improved advance care planning in small randomized controlled trials. Pragmatic trials are increasingly employed in health services research, although not commonly in the nursing home setting to which they are well-suited. This report presents the design and rationale for a pragmatic cluster randomized controlled trial that evaluated the "real world" application of an Advance Care Planning Video Program in two large US nursing home healthcare systems...
January 1, 2017: Clinical Trials: Journal of the Society for Clinical Trials
https://www.readbyqxmd.com/read/28062801/wire-escalation-in-emergent-revascularization-procedures-of-internal-carotid-artery-occlusions-the-use-of-high-tip-stiffness-microguidewires
#2
José E Cohen, Ronen R Leker, John M Gomori, Eyal Itshayek
OBJECTIVE: We examined the usefulness and safety of high tip stiffness cardiac microguidewires in the endovascular revascularization of selected cases of internal carotid artery (ICA) occlusion. METHODS: Files of patients with acute ischemic symptoms due to ICA occlusions managed from August 2010 to August 2016 by urgent endovascular revascularization were retrospectively reviewed with a waiver of informed consent. Cases where there was escalation to stiff tipped cardiovascular microguidewires after at least two failed attempts to cross the carotid occlusion with standard neuro-microguidewires were included...
January 6, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27977329/reducing-artifacts-during-arterial-phase-of-gadoxetate-disodium-enhanced-mr-imaging-dilution-method-versus-reduced-injection-rate
#3
Young Kon Kim, Wei-Chan Lin, Kyunghyun Sung, Steven S Raman, Daniel Margolis, Yaeji Lim, Seonhye Gu, David Lu
Purpose To compare two contrast material-administration protocols (dilution vs slow injection) in terms of their effectiveness in arterial phase artifact reduction at gadoxetic acid-enhanced magnetic resonance (MR) imaging. Materials and Methods This HIPAA-compliant retrospective case-controlled cohort study was approved by the institutional review board, with a waiver of informed patient consent. A total of 318 consecutive patients undergoing gadoxetic acid-enhanced MR imaging were placed into one of two subcohorts of 159 consecutive patients each: the dilution subcohort (gadoxetic acid was diluted 1:1 with saline and injected at a rate of 2...
December 15, 2016: Radiology
https://www.readbyqxmd.com/read/27922974/training-and-validating-a-deep-convolutional-neural-network-for-computer-aided-detection-and-classification-of-abnormalities-on-frontal-chest-radiographs
#4
Mark Cicero, Alexander Bilbily, Errol Colak, Tim Dowdell, Bruce Gray, Kuhan Perampaladas, Joseph Barfett
OBJECTIVES: Convolutional neural networks (CNNs) are a subtype of artificial neural network that have shown strong performance in computer vision tasks including image classification. To date, there has been limited application of CNNs to chest radiographs, the most frequently performed medical imaging study. We hypothesize CNNs can learn to classify frontal chest radiographs according to common findings from a sufficiently large data set. MATERIALS AND METHODS: Our institution's research ethics board approved a single-center retrospective review of 35,038 adult posterior-anterior chest radiographs and final reports performed between 2005 and 2015 (56% men, average age of 56, patient type: 24% inpatient, 39% outpatient, 37% emergency department) with a waiver for informed consent...
December 5, 2016: Investigative Radiology
https://www.readbyqxmd.com/read/27893857/shear-wave-elastography-for-the-differential-diagnosis-of-breast-papillary-lesions
#5
Jin Chung, Won Kyung Lee, Eun-Suk Cha, Jee Eun Lee, Jeoung Hyun Kim, Young Hoon Ryu
OBJECTIVE: To evaluate the diagnostic performance of shear-wave elastography (SWE) for the differential diagnosis of breast papillary lesions. METHODS: This study was an institutional review board-approved retrospective study, with a waiver of informed consent. A total of 79 breast papillary lesions in 71 consecutive women underwent ultrasound and SWE prior to biopsy. Ultrasound features and quantitative SWE parameters were recorded for each lesion. All lesions were surgically excised or excised using an ultrasound-guided vacuum-assisted method...
2016: PloS One
https://www.readbyqxmd.com/read/27875106/neoadjuvant-systemic-therapy-in-breast-cancer-association-of-contrast-enhanced-mr-imaging-findings-diffusion-weighted-imaging-findings-and-tumor-subtype-with-tumor-response
#6
Gorane Santamaría, Xavier Bargalló, Pedro Luis Fernández, Blanca Farrús, Xavier Caparrós, Martin Velasco
Purpose To investigate the performance of tumor subtype and various magnetic resonance (MR) imaging parameters in the assessment of tumor response to neoadjuvant systemic therapy (NST) in patients with breast cancer and to outline a model of pathologic response, considering pathologic complete response (pCR) as the complete absence of any residual invasive cancer or ductal carcinoma in situ (DCIS). Materials and Methods This was an institutional review board-approved retrospective study, with waiver of the need to obtain informed consent...
November 22, 2016: Radiology
https://www.readbyqxmd.com/read/27875105/renal-cell-carcinoma-comparison-of-renal-nephrometry-and-padua-scores-with-maximum-tumor-diameter-for-prediction-of-local-recurrence-after-thermal-ablation
#7
Aaron W P Maxwell, Grayson L Baird, Jason D Iannuccilli, William W Mayo-Smith, Damian E Dupuy
Purpose To evaluate the performance of the radius, exophytic or endophytic, nearness to collecting system or sinus, anterior or posterior, and location relative to polar lines (RENAL) nephrometry and preoperative aspects and dimensions used for anatomic classification (PADUA) scoring systems and other tumor biometrics for prediction of local tumor recurrence in patients with renal cell carcinoma after thermal ablation. Materials and Methods This HIPAA-compliant study was performed with a waiver of informed consent after institutional review board approval was obtained...
November 22, 2016: Radiology
https://www.readbyqxmd.com/read/27875104/ct-guided-native-medical-renal-biopsy-cortical-tangential-versus-non-tangential-approaches-a-comparison-of-efficacy-and-safety
#8
Bo Liu, Matthew O'Dell, Miguel Flores, Joseph Limback, Melissa Kendall, Julie Pepe, Jeremy R Burt, Francisco Contreras, Andrew R Lewis, Thomas J Ward
Purpose To review a single-center experience with the cortical tangential approach during computed tomography (CT)-guided native medical renal biopsy and to evaluate its efficacy and safety compared with those of a non-cortical tangential approach. Materials and Methods This retrospective study received institutional review board approval, with a waiver of the HIPAA requirement for informed consent. The number of cores, glomeruli, and complications were reviewed in 431 CT-guided medical renal biopsies performed between July 2007 and September 2015...
November 22, 2016: Radiology
https://www.readbyqxmd.com/read/27875000/combined-hepatocellular-cholangiocarcinoma-gadoxetic-acid-enhanced-mri-findings-correlated-with-pathologic-features-and-prognosis
#9
So Hyun Park, Seung Soo Lee, Eunsil Yu, Hyo Jeong Kang, Yangsoon Park, So Yeon Kim, So Jung Lee, Yong Moon Shin, Moon Gyu Lee
PURPOSE: To evaluate gadoxetic acid-enhanced magnetic resonance imaging (MRI) findings of combined hepatocellular cholangiocarcinoma (cHCC-CC) with special emphasis on correlation of MRI findings with histopathologic tumor characteristics and survival outcomes after curative surgery. MATERIALS AND METHODS: Our Institutional Review Board approved this study, with a waiver of informed consent. For 82 patients (64 men, 18 women; mean age, 54.0 years; age range, 30-81) with surgically confirmed cHCC-CCs, we evaluated clinical features, histologic findings, and tumor morphologic and enhancement features on gadoxetic acid-enhanced liver MRI at 1...
November 22, 2016: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/27861230/structured-reporting-of-rectal-magnetic-resonance-imaging-in-suspected-primary-rectal-cancer-potential-benefits-for-surgical-planning-and-interdisciplinary-communication
#10
Dominik Nörenberg, Wieland H Sommer, Wolfgang Thasler, Jan DʼHaese, Markus Rentsch, Thomas Kolben, Andreas Schreyer, Carsten Rist, Maximilian Reiser, Marco Armbruster
OBJECTIVES: The aim of this study was to evaluate the effect of structured reports (SRs) in comparison to nonstructured, free-text (FT) rectal magnetic resonance imaging (MRI) reports in patients with histologically proven rectal cancer and potential effects of both types of reporting on referring surgeons' satisfaction, interdisciplinary communication, and further clinical decision making. MATERIALS AND METHODS: The institutional review board approved this retrospective study with waiver of informed consent...
November 17, 2016: Investigative Radiology
https://www.readbyqxmd.com/read/27823694/design-and-rationale-for-the-acute-congestive-heart-failure-urgent-care-evaluation-the-acute-study
#11
Douglas S Lee, Jacques S Lee, Michael J Schull, Jeremy M Grimshaw, Peter C Austin, Jack V Tu
BACKGROUND: Heart failure (HF) is one of the leading reasons for emergency department (ED) visits and hospitalization. However, externally validated risk algorithms for acute prognostication of heart failure patients are not available. Thus, many low-risk patients are hospitalized and some high-risk patients are discharged home, which, in some cases, may lead to death. OBJECTIVES: The first objective of the ACUTE study is to perform a prospective validation of the Emergency Heart failure Mortality Risk Grade (EHMRG), which is a risk score derived to predict 7-day mortality in the ED setting...
November 2016: American Heart Journal
https://www.readbyqxmd.com/read/27820871/consent-refusal-and-waivers-in-patient-centered-dysphagia-care-using-law-ethics-and-evidence-to-guide-clinical-practice
#12
Jennifer Horner, Maria Modayil, Laura Roche Chapman, An Dinh
Purpose: When patients refuse medical or rehabilitation procedures, waivers of liability have been used to bar future lawsuits. The purpose of this tutorial is to review the myriad issues surrounding consent, refusal, and waivers. The larger goal is to invigorate clinical practice by providing clinicians with knowledge of ethics and law. This tutorial is for educational purposes only and does not constitute legal advice. Method: The authors use a hypothetical case of a "noncompliant" individual under the care of an interdisciplinary neurorehabilitation team to illuminate the ethical and legal features of the patient-practitioner relationship; the elements of clinical decision-making capacity; the duty of disclosure and the right of informed consent or informed refusal; and the relationship among noncompliance, defensive practices, and iatrogenic harm...
November 1, 2016: American Journal of Speech-language Pathology
https://www.readbyqxmd.com/read/27768540/sex-differences-in-academic-rank-of-radiologists-in-u-s-medical-schools
#13
Neena Kapoor, Daniel M Blumenthal, Stacy E Smith, Ivan K Ip, Ramin Khorasani
Purpose To determine whether there were sex differences in full professorship after accounting for factors known to influence academic advancement. Materials and Methods Institutional review board approval was obtained for this HIPAA-compliant study, with waiver of informed consent. In this cross-sectional study, the authors used a comprehensive 2014 physician database (5089 academic radiologists, inclusive of all U.S. academic radiologists in 2014; 11.3% of all U.S. radiologists) containing information on physician age, years since residency, National Institutes of Health funding, scientific publications (first or last author and total), clinical trial investigation, and clinical volume measured according to 2013 Medicare reimbursement...
October 21, 2016: Radiology
https://www.readbyqxmd.com/read/27765694/postoperative-outcome-of-cystic-renal-cell-carcinoma-defined-on-preoperative-imaging-a-retrospective-study
#14
Jung Jae Park, Byong Chang Jeong, Chan Kyo Kim, Seong Il Seo, Keumhee C Carriere, Minji Kim, Byung Kwan Park, Seong Soo Jeon, Hyun Moo Lee, Han Yong Choi
PURPOSE: To evaluate postoperative outcome of cystic renal cell carcinoma (RCC) defined on preoperative computed tomography (CT), and to find the optimal cut-off of cystic cystic proportion in association with patients' prognosis. MATERIAL AND METHODS: In this institutional review board-approved study with waiver of informed consent, a total of 1315 patients who received surgery for single RCC with pre-operative CT were enrolled. The cystic proportion of RCC was determined on CT...
October 17, 2016: Journal of Urology
https://www.readbyqxmd.com/read/27740906/the-vancouver-lung-cancer-risk-prediction-model-assessment-by-using-a-subset-of-the-national-lung-screening-trial-cohort
#15
Charles S White, Ekta Dharaiya, Erin Campbell, Lilla Boroczky
Purpose To assess the likelihood of malignancy among a subset of nodules in the National Lung Screening Trial (NLST) by using a risk calculator based on nodule and patient characteristics. Materials and Methods All authors received approval for use of NLST data. An institutional review board exemption and a waiver for informed consent were granted to the author with an academic appointment. Nodule characteristics and patient attributes with regard to benign and malignant nodules in the NLST were applied to a nodule risk calculator from a group in Vancouver, Canada...
October 13, 2016: Radiology
https://www.readbyqxmd.com/read/27724954/single-source-chest-abdomen-pelvis-cancer-staging-on-a-third-generation-dual-source-ct-system-comparison-of-automated-tube-potential-selection-to-second-generation-dual-source-ct
#16
COMPARATIVE STUDY
Clara Park, Tatjana Gruber-Rouh, Doris Leithner, Amelie Zierden, Mortiz H Albrecht, Julian L Wichmann, Boris Bodelle, Mohamed Elsabaie, Jan-Erik Scholtz, Moritz Kaup, Thomas J Vogl, Martin Beeres
BACKGROUND: Evaluation of latest generation automated attenuation-based tube potential selection (ATPS) impact on image quality and radiation dose in contrast-enhanced chest-abdomen-pelvis computed tomography examinations for gynaecologic cancer staging. METHODS: This IRB approved single-centre, observer-blinded retrospective study with a waiver for informed consent included a total of 100 patients with contrast-enhanced chest-abdomen-pelvis CT for gynaecologic cancer staging...
October 10, 2016: Cancer Imaging: the Official Publication of the International Cancer Imaging Society
https://www.readbyqxmd.com/read/27697007/quantitative-liver-function-analysis-volumetric-t1-mapping-with-fast-multisection-b1-inhomogeneity-correction-in-hepatocyte-specific-contrast-enhanced-liver-mr-imaging
#17
Jeong Hee Yoon, Jeong Min Lee, Eunju Kim, Tomoyuki Okuaki, Joon Koo Han
Purpose To determine whether B1 inhomogeneity-corrected volumetric T1 maps of gadoxetic acid-enhanced liver magnetic resonance (MR) imaging are able to demonstrate global liver function and functional heterogeneity in patients with cirrhosis and to investigate their relationship with the development of hepatic insufficiency and decompensation. Materials and Methods This institutional review board-approved retrospective study with waiver of informed consent included 234 consecutive patients who underwent gadoxetic acid-enhanced liver MR imaging, including B1 inhomogeneity-corrected volumetric T1 mapping...
February 2017: Radiology
https://www.readbyqxmd.com/read/27660280/diffusion-mri-of-uterine-and-ovarian-masses-identifying-the-benign-lesions
#18
Amir H Davarpanah, Avinash Kambadakone, Nagaraj S Holalkere, Alexander R Guimaraes, Peter F Hahn, Susanna I Lee
PURPOSE: The purpose of the study was to assess the diagnostic performance of qualitative and quantitative diffusion-weighted imaging (DWI) in differentiating benign from malignant ovarian and uterine masses. MATERIALS AND METHODS: Institutional review board approval was obtained for this HIPAA-compliant retrospective study, with waiver of informed consent. DWI MRIs of 222 women acquired over 1.5 years were evaluated. Reference standard was pathology or follow-up imaging...
December 2016: Abdominal Radiology
https://www.readbyqxmd.com/read/27602584/increased-hepatic-fdg-uptake-on-pet-ct-in-hepatic-sinusoidal-obstructive-syndrome
#19
Honsoul Kim, Song-Ee Baek, Jieun Moon, Yun Ho Roh, Narae Lee, Arthur Cho
PURPOSE: Imaging features of sinusoidal obstruction syndrome (SOS), an increasingly common drawback of chemotherapy, were evaluated via 18F-fluorodeoxyglucose (FDG) positron emission tomography computed tomography (PET/CT). EXPERIMENTAL DESIGN: This retrospective study was approved by our Institutional Review Board, with a waiver of informed consent. FDG PET/CT studies of 35 patients (male, 24; female, 11; median age, 53.2 years) obtained between January, 2005 and December, 2012 were analyzed before and after systemic chemotherapy...
October 18, 2016: Oncotarget
https://www.readbyqxmd.com/read/27598538/ct-measures-of-bone-mineral-density-and-muscle-mass-can-be-used-to-predict-noncancer-death-in-men-with-prostate-cancer
#20
Andrew M McDonald, Thomas A Swain, David L Mayhew, Rex A Cardan, Christopher B Baker, David M Harris, Eddy S Yang, John B Fiveash
Purpose To determine if computed tomographic (CT) metrics of bone mineral density and muscle mass can improve the prediction of noncancer death in men with localized prostate cancer. Materials and Methods Institutional review board approval was obtained, with waiver of informed consent. All patients who underwent radiation therapy for localized prostate cancer between 2001 and 2012 with height, weight, and past medical history documented and who underwent CT that included the L4-5 vertebral interspace were included...
February 2017: Radiology
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