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https://www.readbyqxmd.com/read/28551926/-the-failure-modes-and-effects-analysis-facilitates-a-safe-time-and-money-saving-open-access-colonoscopy-service
#1
Rachel Gingold-Belfer, Yaron Niv, Nehama Horev, Shuli Gross, Nadav Sahar, Ram Dickman
BACKGROUND: Failure modes and effects analysis (FMEA) is used for the identification of potential risks in health care processes. We used a specific FMEA - based form for direct referral for colonoscopy and assessed it for procedurerelated perforations. METHODS: Ten experts in endoscopy evaluated and computed the entire referral process, modes of preparation for the endoscopic procedure, the endoscopic procedure itself and the discharge process. We used FMEA assessing for likelihood of occurrence, detection and severity and calculated the risk profile number (RPN) for each of the above points...
April 2017: Harefuah
https://www.readbyqxmd.com/read/28551878/underreporting-of-congenital-rubella-in-italy-2010-2014
#2
Cristina Giambi, Antonino Bella, Antonietta Filia, Martina Del Manso, Gloria Nacca, Silvia Declich, Maria Cristina Rota
In accordance with the goals of the World Health Organization Regional Committee for Europe, the Italian national Measles and Rubella Elimination Plan 2010-2015 aimed to reduce the incidence of congenital rubella cases to <1 case/100,000 live births by 2015. In Italy, a passive national surveillance system for congenital rubella and rubella in pregnancy is active since 2005. We estimated the degree of underreporting of congenital rubella, performing a capture-recapture analysis of cases detected through two independent sources: the national surveillance system and the national hospital discharge database, in the years 2010-2014...
May 28, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28551481/clinical-applicability-and-cost-effectiveness-of-diabscore-in-screening-for-type-2-diabetes-in-primary-care
#3
María Cristo Rodríguez-Pérez, Domingo Orozco-Beltrán, Vicente Gil-Guillén, Santiago Domínguez-Coello, Delia Almeida-González, Buenaventura Brito-Díaz, Itahisa Marcelino-Rodríguez, María Concepción Carratalá-Munuera, Nieves Gómez-Moreno, Jorge Navarro-Perez, Francisco Brotons-Munto, Salvador Pertusa-Martinez, Antonio Cabrera de León
AIMS: To evaluate the applicability and cost-effectiveness of a clinical risk score (DIABSCORE) to screen for type 2 diabetes in primary care patients. METHODS: Multicenter cross-sectional study of 10,508 adult no previously diagnosed with diabetes, in 2 Spanish regions (Canary Islands and Valencian Community). The variables comprising DIABSCORE were age, waist to height ratio, family history of diabetes and gestational diabetes. ROC curves were obtained; the diabetes prevalences odds ratios (HbA1c ≥6...
May 12, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28551445/decreasing-post-operative-narcotics-in-reconstructive-pelvic-surgery-a-randomized-controlled-trial
#4
Krista Ml Reagan, David M O'Sullivan, Richard Gannon, Adam C Steinberg
BACKGROUND: Post-operative pain control is crucial to any successful recovery plan. Many currently used medication regimens are narcotic-focused. OBJECTIVE: The objective of our study was to evaluate the efficacy of a multi-modal pain regimen after pelvic reconstructive surgery. STUDY DESIGN: The primary outcome measure was narcotic use. Secondary outcomes included pain, nausea and constipation. Patients were randomized to either a "usual care" post-operative treatment regimen or a multimodal pain regimen...
May 24, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28551002/development-of-a-computer-interpretable-clinical-guideline-model-for-decision-support-in-the-differential-diagnosis-of-hyponatremia
#5
Arturo González-Ferrer, M Ángel Valcárcel, Martín Cuesta, Joan Cháfer, Isabelle Runkle
INTRODUCTION: Hyponatremia is the most common type of electrolyte imbalance, occurring when serum sodium is below threshold levels, typically 135mmol/L. Electrolyte balance has been identified as one of the most challenging subjects for medical students, but also as one of the most relevant areas to learn about according to physicians and researchers. We present a computer-interpretable guideline (CIG) model that will be used for medical training to learn how to improve the diagnosis of hyponatremia applying an expert consensus document (ECDs)...
July 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/28550994/prospective-validation-of-a-near-real-time-ehr-integrated-automated-sofa-score-calculator
#6
Christopher Aakre, Pablo Moreno Franco, Micaela Ferreyra, Jaben Kitson, Man Li, Vitaly Herasevich
OBJECTIVES: We created an algorithm for automated Sequential Organ Failure Assessment (SOFA) score calculation within the Electronic Health Record (EHR) to facilitate detection of sepsis based on the Third International Consensus Definitions for Sepsis and Septic Shock (SEPSIS-3) clinical definition. We evaluated the accuracy of near real-time and daily automated SOFA score calculation compared with manual score calculation. METHODS: Automated SOFA scoring computer programs were developed using available EHR data sources and integrated into a critical care focused patient care dashboard at Mayo Clinic in Rochester, Minnesota...
July 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/28550955/effect-of-hospital-and-surgeon-case-volume-on-perioperative-quality-of-care-and-short-term-outcomes-after-radical-cystectomy-for-muscle-invasive-bladder-cancer-results-from-a-european-tertiary-care-center-cohort
#7
Malte W Vetterlein, Christian P Meyer, Sami-Ramzi Leyh-Bannurah, Roman Mayr, Michael Gierth, Hans-Martin Fritsche, Maximilian Burger, Bastian Keck, Bernd Wullich, Thomas Martini, Christian Bolenz, Armin Pycha, Julian Hanske, Florian Roghmann, Joachim Noldus, Patrick J Bastian, Christian Gilfrich, Matthias May, Michael Rink, Felix K-H Chun, Roland Dahlem, Margit Fisch, Atiqullah Aziz
BACKGROUND: Case volume has been suggested to affect surgical outcomes in different arrays of procedures. We aimed to delineate the relationship between case volume and surgical outcomes and quality of care criteria of radical cystectomy (RC) in a prospectively collected multicenter cohort. PATIENTS AND METHODS: This was a retrospective analysis of a prospectively collected European cohort of patients with bladder cancer treated with RC in 2011. We relied on 479 and 459 eligible patients with available information on hospital case volume and surgeon case volume, respectively...
April 26, 2017: Clinical Genitourinary Cancer
https://www.readbyqxmd.com/read/28550930/real-time-mobile-device-assisted-chest-compression-during-cardiopulmonary-resuscitation
#8
Satyam Sarma, Hakiza Bucuti, Anurag Chitnis, Alex Klacman, Ram Dantu
Prompt administration of high-quality cardiopulmonary resuscitation (CPR) is a key determinant of survival from cardiac arrest. Strategies to improve CPR quality at point of care could improve resuscitation outcomes. We tested whether a low cost and scalable mobile phone- or smart watch-based solution could provide accurate measures of compression depth and rate during simulated CPR. Fifty health care providers (58% intensive care unit nurses) performed simulated CPR on a calibrated training manikin (Resusci Anne, Laerdal) while wearing both devices...
May 4, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28550916/assessment-of-three-point-of-care-platelet-function-assays-in-adult-trauma-patients
#9
Christopher Robert Connelly, John D Yonge, Sean P McCully, Kyle D Hart, Thomas C Hilliard, Diane E Lape, Justin J Watson, Beth Rick, Ben Houser, Thomas G Deloughery, Martin A Schreiber, Laszlo N Kiraly
BACKGROUND: Antiplatelet (AP) medication use is common among trauma patients and is associated with poor outcomes. Management options for platelet dysfunction in trauma patients are controversial, expensive, and potentially harmful. Although light transmission platelet aggregometry is considered the standard test to assess platelet function, it is cumbersome and not generally available. Currently, there are no widely accepted platelet function point-of-care tests for acute trauma. STUDY DESIGN: Prospective observational study from 2014 to 2015...
May 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28550610/association-between-patient-centered-medical-home-capabilities-and-outcomes-for-medicare-beneficiaries-seeking-care-from-federally-qualified-health-centers
#10
Justin W Timbie, Peter S Hussey, Claude M Setodji, Amii Kress, Rosalie Malsberger, Tara A Lavelle, Mark W Friedberg, Suzanne G Wensky, Katherine D Giuriceo, Katherine L Kahn
BACKGROUND: Patient-centered medical home (PCMH) models of primary care have the potential to expand access, improve population health, and lower costs. Federally qualified health centers (FQHCs) were early adopters of PCMH models. OBJECTIVE: We measured PCMH capabilities in a diverse nationwide sample of FQHCs and assessed the relationship between PCMH capabilities and Medicare beneficiary outcomes. DESIGN: Cross-sectional, propensity score-weighted, multivariable regression analysis...
May 26, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28550609/validation-of-the-taps-1-a-four-item-screening-tool-to-identify-unhealthy-substance-use-in-primary-care
#11
Jan Gryczynski, Jennifer McNeely, Li-Tzy Wu, Geetha A Subramaniam, Dace S Svikis, Lauretta A Cathers, Gaurav Sharma, Jacqueline King, Eve Jelstrom, Courtney D Nordeck, Anjalee Sharma, Shannon G Mitchell, Kevin E O'Grady, Robert P Schwartz
BACKGROUND: The Tobacco, Alcohol, Prescription Medication, and Other Substance use (TAPS) tool is a combined two-part screening and brief assessment developed for adult primary care patients. The tool's first-stage screening component (TAPS-1) consists of four items asking about past 12-month use for four substance categories, with response options of never, less than monthly, monthly, weekly, and daily or almost daily. OBJECTIVE: To validate the TAPS-1 in primary care patients...
May 26, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28550065/exceptional-durable-response-to-everolimus-in-a-patient-with-biphenotypic-breast-cancer-harboring-an-stk11-variant
#12
Christine A Parachoniak, Andrew Rankin, Bernadette Gaffney, Ryan Hartmaier, Dan Spritz, Rachel L Erlich, Vincent A Miller, Deborah Morosini, Phil Stephens, Jeffrey S Ross, John Keech, Juliann Chmielecki
Metastatic triple negative breast cancer comprises 12-17% of breast cancers and carries a poor prognosis relative to other breast cancer subtypes. Treatment options in this disease are largely limited to systemic chemotherapy. A majority of clinical studies assessing efficacy of targeted therapeutics (e.g. the mTOR inhibitor everolimus) in advanced breast cancer patients have not utilized predictive genomic biomarker-based selection and have reported only modest improvement in clinical outcome relative to standard of care...
May 26, 2017: Cold Spring Harbor Molecular Case Studies
https://www.readbyqxmd.com/read/28550027/exceptional-response-to-nivolumab-and-stereotactic-body-radiation-therapy-sbrt-in-neuroendocrine-cervical-carcinoma-with-high-tumor-mutational-burden-management-considerations-from-the-center-for-personalized-cancer-therapy-at-uc-san-diego-moores-cancer-center
#13
Andrew Sharabi, Sangwoo Shawn Kim, Shumei Kato, Philip D Sanders, Sandip Pravin Patel, Parag Sanghvi, Elizabeth Weihe, Razelle Kurzrock
Neuroendocrine carcinoma of the cervix is an ultra-rare malignancy with a poor prognosis and limited treatment options. Checkpoint blockade immunotherapy has rapidly developed into an emerging standard of care for several common disease types. Interestingly, in preclinical and retrospective clinical data, radiation therapy has been demonstrated to synergize with checkpoint inhibitors. Here we report a patient with metastatic, chemotherapy-refractory neuroendocrine carcinoma who presented with partial bowel obstruction due to a large tumor burden...
May 26, 2017: Oncologist
https://www.readbyqxmd.com/read/28550003/an-mhealth-framework-to-improve-birth-outcomes-in-benue-state-nigeria-a-study-protocol
#14
Echezona Edozie Ezeanolue, Semiu Olatunde Gbadamosi, John Olajide Olawepo, Juliet Iwelunmor, Daniel Sarpong, Chuka Eze, Amaka Ogidi, Dina Patel, Chima Onoka
BACKGROUND: The unprecedented coverage of mobile technology across the globe has led to an increase in the use of mobile health apps and related strategies to make health information available at the point of care. These strategies have the potential to improve birth outcomes, but are limited by the availability of Internet services, especially in resource-limited settings such as Nigeria. OBJECTIVE: Our primary objective is to determine the feasibility of developing an integrated mobile health platform that is able to collect data from community-based programs, embed collected data into a smart card, and read the smart card using a mobile phone-based app without the need for Internet access...
May 26, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28550002/public-response-to-obamacare-on-twitter
#15
Matthew A Davis, Kai Zheng, Yang Liu, Helen Levy
BACKGROUND: The Affordable Care Act (ACA), often called "Obamacare," is a controversial law that has been implemented gradually since its enactment in 2010. Polls have consistently shown that public opinion of the ACA is quite negative. OBJECTIVE: The aim of our study was to examine the extent to which Twitter data can be used to measure public opinion of the ACA over time. METHODS: We prospectively collected a 10% random sample of daily tweets (approximately 52 million since July 2011) using Twitter's streaming application programming interface (API) from July 10, 2011 to July 31, 2015...
May 26, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28549669/the-iscreen-electronic-diabetes-dashboard-a-tool-to-improve-knowledge-and-implementation-of-clinical-practice-guidelines
#16
Stacy Zahanova, Alexandra Tsouka, Mark R Palmert, Farid H Mahmud
OBJECTIVES: Clinical practice guidelines (CPG) provide evidence-based recommendations for patient care but may not be optimally applied in clinical settings. As a pilot study, we evaluated the impact of a computerized, point-of-care decision support system (CDSS) on guideline knowledge and adherence in our diabetes clinic. METHODS: iSCREEN, a CDSS, integrated with a province-wide electronic health record, was designed based on the Canadian Diabetes Association 2013 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada...
May 23, 2017: Canadian Journal of Diabetes
https://www.readbyqxmd.com/read/28549593/-improving-the-quality-of-cancer-pain-management-in-palliative-care-unit-targeted-clinical-audit
#17
Colombe Tricou, Murielle Ruer, Mathilde Ledoux, Élise Perceau-Chambard, Dorothée Decrept, Claire Chabloz, Marilène Filbet
Goal This study aims to assess the quality of the cancer pain management in Palliative care unit. METHOD: The method used was the targeted clinical audit. The audit grid was built according to the recommendations of the pilot Committee, and tested until the final version with 19 items was obtained. In this retrospective study, 60 consecutive patients were studied on 2 periods of time. The first one (T1) shows the gap between the patient's chart and the expected standard, and proposes corrective measures...
May 23, 2017: Bulletin du Cancer
https://www.readbyqxmd.com/read/28549479/engaging-the-canadian-public-on-reimbursement-decision-making-for-drugs-for-rare-diseases-a-national-online-survey
#18
Julie Polisena, Michael Burgess, Craig Mitton, Larry D Lynd
BACKGROUND: Funding of drugs for rare diseases (DRDs) requires decisions that balance fairness for all individuals within the healthcare system with compassion for affected individuals. Our study objective was to conduct a national online survey to determine the Canadian public's perspective, including regional variations, associated with DRD decision-making. METHODS: The survey collected responses from 1631 Canadians. Respondents were asked to rank at least three and up to five DRD decision-making priorities, out of a total of eight priorities presented...
May 26, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28549120/dementia-capable-care-coordination-in-duals-demonstration-programs-workforce-needs-promising-practices-and-policy
#19
Brooke Hollister, Jason D Flatt, Susan A Chapman
Background and Objectives: This study describes the program requirements, workforce competencies, and barriers for dementia capable care coordination within health plans from seven states participating in the Center for Medicare and Medicaid Services demonstration programs for dually-eligible Medicare and Medicaid beneficiaries. Research Design and Methods: Data came from contracts, policy documents, and 24 semistructured key informant interviews with national experts and leaders from community-based organizations, advocacy organizations, researchers, federal and state government, and health plans in the seven states...
May 25, 2017: Gerontologist
https://www.readbyqxmd.com/read/28549047/health-related-quality-of-life-and-sleep-disorders-in-patients-with-a-urostomy-is-there-a-relationship
#20
Chie Furukawa, Ikuharu Morioka
PURPOSE: The purpose of this study was to evaluate the relationship between health-related quality of life (HRQOL) and sleep disorders in persons living with a urostomy. DESIGN: A cross-sectional descriptive study. SUBJECTS AND SETTINGS: Eighty-six adults with a urostomy who were cared for in a stoma outpatient clinic of a hospital in Osaka, Japan, for at least 1 month before data collection, and who were attending support group meetings comprised the sample...
May 25, 2017: Journal of Wound, Ostomy, and Continence Nursing
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