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"clinical decision making"

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https://www.readbyqxmd.com/read/28934822/stent-placement-for-benign-esophageal-leaks-perforations-and-fistulae-a-clinical-prediction-rule-for-successful-leakage-control
#1
Emo E van Halsema, Wouter F W Kappelle, Bas L A M Weusten, Robert Lindeboom, Mark I van Berge Henegouwen, Paul Fockens, Frank P Vleggaar, Manon C W Spaander, Jeanin E van Hooft
Background and study aims Sealing esophageal leaks by stent placement allows healing in 44 % - 94 % of patients. We aimed to develop a prediction rule to predict the chance of successful stent therapy. Patients and methods In this multicenter retrospective cohort study, patients with benign upper gastrointestinal leakage treated with stent placement were included. We used logistic regression analysis including four known clinical predictors of stent therapy outcome. The model performance to predict successful stent therapy was evaluated in an independent validation sample...
September 21, 2017: Endoscopy
https://www.readbyqxmd.com/read/28933247/a-bayesian-decision-support-tool-for-child-sexual-abuse-assessment-and-investigation
#2
Alessandro Tadei, Johan Pensar, Jukka Corander, Katarina Finnilä, Pekka Santtila, Jan Antfolk
In assessments of child sexual abuse (CSA) allegations, informative background information is often overlooked or not used properly. We therefore created and tested an instrument that uses accessible background information to calculate the probability of a child being a CSA victim that can be used as a starting point in the following investigation. Studying 903 demographic and socioeconomic variables from over 11,000 Finnish children, we identified 42 features related to CSA. Using Bayesian logic to calculate the probability of abuse, our instrument-the Finnish Investigative Instrument of Child Sexual Abuse (FICSA)-has two separate profiles for boys and girls...
September 1, 2017: Sexual Abuse: a Journal of Research and Treatment
https://www.readbyqxmd.com/read/28932903/a-survey-of-australian-dysphagia-practice-patterns
#3
Anna Rumbach, Caitlin Coombes, Sebastian Doeltgen
Dysphagia assessment and rehabilitation practice is complex, and significant variability in speech-language pathology approaches has been documented internationally. The aim of this study was to evaluate swallowing-related assessment and rehabilitation practices of SLPs currently working in Australia. One hundred and fifty-four SLPs completed an online questionnaire administered via QuickSurveys from May to July 2015. Results were analysed descriptively. The majority of clinicians had accessed post-graduate training in dysphagia management and assessment (66...
September 20, 2017: Dysphagia
https://www.readbyqxmd.com/read/28929528/a-quality-control-exercise-in-the-echo-laboratory-reduction-in-inter-observer-variability-in-the-interpretation-of-pulmonary-hypertension
#4
Daniel M Patton, Atoosa Enzevaie, Andrew Day, Anthony Sanfilippo, Amer M Johri
BACKGROUND: Right ventricular systolic pressure (RVSP) estimated by echocardiography is critical for the initial screening and follow-up of pulmonary hypertension (PH). Inter-observer variability (IOV) in RVSP can impact clinical decision making. This study assessed whether a simple guideline-based teaching intervention could reduce the IOV in RVSP interpretation. METHODS AND RESULTS: Eleven participants in a high-volume tertiary level echocardiography laboratory underwent an assessment of the baseline IOV in the assessment of RVSP for a series of transthoracic echocardiograms (TTE), depicting various degrees of PH among 8 cases each before and after a teaching intervention...
September 19, 2017: Echocardiography
https://www.readbyqxmd.com/read/28928262/the-use-of-speaking-valves-in-children-with-tracheostomy-tubes-what-is-the-scope-of-the-literature
#5
Weeda Zabih, Theresa Holler, Faiza Syed, Laurie Russell, Jennifer Allegro, Reshma Amin
One-way speaking valves have been successfully used to restore audible meaningful speech in adult patients after tracheostomy tube placement. One-way speaking valves have also been used in pediatric patients after tracheostomy tube placement with promising results. We conducted a scoping review to synthesize and summarize the current evidence on the use of one-way tracheostomy tube speaking valves in the pediatric population to identify knowledge gaps that could inform future research programs and facilitate evidence-based clinical decision making...
September 19, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28927952/determining-the-glomerular-filtration-rate-an-overview
#6
REVIEW
Elke Schaeffner
Correct determination of glomerular filtration rate (GFR) as an indicator of kidney function bears great importance because clinical decision-making depends on it at many occasions. During the last years, a huge body of literature has been published on estimation and measurement of GFR. The increasing pace with which novel estimation formulae, current and newer biomarkers, assay standardization procedures as well as invasive measurement methods of GFR were published, has been overwhelming for many clinicians...
September 16, 2017: Journal of Renal Nutrition
https://www.readbyqxmd.com/read/28927507/providing-physical-care-to-persons-with-serious-mental-illness-attitudes-confidence-barriers-and-psychological-empowerment
#7
Margaret Knight, Paula Bolton, Lynne Kopeski
The prevalence of metabolic syndrome (MetS) in people with serious mental illness (SMI) has been well documented in the mental health literature. Despite the adoption of various guidelines for monitoring risk factors for diabetes and cardiovascular risk in this population, limited translation has occurred in actual practice (Hermes, Sernyak, & Rosenheck, 2013). The Institute of Medicine (IoM) (2009) has noted a lag time in the application of knowledge within clinical settings. Evidence-based practice was deemed as a means of improving healthcare outcomes through the use of science supported standards of care...
October 2017: Archives of Psychiatric Nursing
https://www.readbyqxmd.com/read/28927305/discovery-and-application-of-immune-biomarkers-for-hematological-malignancies
#8
Dimitrios Zafeiris, Jayakumar Vadakekolathu, Sarah Wagner, Alan Graham Pockley, Graham Roy Ball, Sergio Rutella
Hematological malignancies originate and progress in primary and secondary lymphoid organs, where they establish a uniquely immune-suppressive tumour microenvironment. Although high-throughput transcriptomic and proteomic approaches are being employed to interrogate immune surveillance and escape mechanisms in patients with solid tumours, and to identify actionable targets for immunotherapy, our knowledge of the immunological landscape of hematological malignancies, as well as our understanding of the molecular circuits that underpin the establishment of immune tolerance, is not comprehensive...
September 19, 2017: Expert Review of Molecular Diagnostics
https://www.readbyqxmd.com/read/28926449/combining-angiotensin-converting-enzyme-inhibitors-and-angiotensin-receptor-blocker-for-clinical-decision-making-lacks-vision
#9
Michael W Manning, Chandrika R Garner, Emily G Teeter
No abstract text is available yet for this article.
October 2017: Anesthesiology
https://www.readbyqxmd.com/read/28920818/biochemistry-panel-reference-intervals-for-juvenile-goldfish-carassius-auratus
#10
Laura A Adamovicz, Macy R Trosclair, Gregory A Lewbart
Reference intervals for diagnostic tests are vitally important for clinical decision making. Despite the popularity of pet goldfish (Carassius auratus), reference intervals have not been generated for routine biochemistry panel analytes in this species. This study establishes de novo reference intervals for packed cell volume and total solids, using 47 apparently healthy immature goldfish, and for 11 common chemistry panel analytes (albumin, aspartate aminotransferase, calcium, creatine kinase, globulin, blood glucose, sodium, potassium, phosphorous, total protein, and uric acid) using 39 immature goldfish...
September 2017: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
https://www.readbyqxmd.com/read/28919290/utility-and-limitations-of-long-term-monitoring-of-atrial-fibrillation-using-an-implantable-loop-recorder
#11
Randall Lee, Suneet Mittal
Atrial fibrillation (AF) is the most common cardiac arrhythmia diagnosed and treated in the world. The treatment of patients' symptoms as well as the prevention of stroke and heart failure is dependent on accurate detection and characterization of AF. A variety of electrocardiographic (ECG) monitoring techniques are being used for these purposes. However, these intermittent ECG monitoring techniques have been shown to under diagnose AF events, while having limited ability to characterize AF burden and density...
September 12, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28918905/raising-suspicion-of-mistreatment-from-burns-derivation-and-validation-of-the-burn-tool
#12
Alison M Kemp, Linda Hollén, Alan M Emond, Diane Nuttall, David Rea, Sabine Maguire
BACKGROUND: 10-25% of childhood burns arise from mistreatment. AIM: To derive and validate a clinical prediction tool to assist the recognition of suspected maltreatment. METHODS: Prospectively collected data from 1327 children with burns were analyzed using logistic regression. Regression coefficients for variables associated with 'referral for child maltreatment investigation' (112 cases) in multivariable analyses were converted to integers to derive the BuRN-Tool, scoring each child on a continuous scale...
September 14, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28918422/the-modern-art-of-reading-computed-tomography-images-of-the-lungs-quantitative-ct
#13
Felix J F Herth, Miranda Kirby, Jered Sieren, Jonas Herth, Joshua Schirm, Susan Wood, Maren Schuhmann
Lung diseases are increasing in prevalence and overall burden worldwide. To stem the tide, more and more national and international guidelines are recommending the use of various diagnostic algorithms that are disease specific. There is growing consensus among the respiratory community that although patient histories and lung function testing are the minimum required for clinical examinations, these tests alone are not sufficient for disease characterization. Therefore, the use of computed tomography (CT) imaging is increasing used in clinical decision making for lung diseases...
September 16, 2017: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/28917594/key-steps-in-conducting-systematic-reviews-for-underpinning-clinical-practice-guidelines-methodology-of-the-european-association-of-urology
#14
Thomas Knoll, Muhammad Imran Omar, Steven Maclennan, Virginia Hernández, Steven Canfield, Yuhong Yuan, Max Bruins, Lorenzo Marconi, Hein Van Poppel, James N'Dow, Richard Sylvester
CONTEXT: The findings of systematic reviews (SRs) and meta-analyses (MAs) are used for clinical decision making. The European Association of Urology has committed increasing resources into the development of high quality clinical guidelines based on such SRs and MAs. OBJECTIVE: In this paper, we have summarised the process of conducting SRs for underpinning clinical practice guidelines under the auspices of the European Association of Urology Guidelines Office. EVIDENCE ACQUISITION: The process involves explicit methods and the findings should be reproducible...
September 13, 2017: European Urology
https://www.readbyqxmd.com/read/28917372/transcendental-meditation-for-lowering-blood-pressure-an-overview-of-systematic-reviews-and-meta-analyses
#15
REVIEW
Soo Liang Ooi, Melisa Giovino, Sok Cheon Pak
BACKGROUND: Transcendental meditation (TM) is a stress reduction technique that can potentially lower blood pressure (BP) safely. The American Heart Association recommends that TM may be considered in clinical practice. OBJECTIVE: To provide an overview of all systematic reviews and meta-analyses of TM on BP for evidence-informed clinical decision making. METHOD: Systematic searches of PubMed, EBSCOhost, Cochrane Library, Web of Science, Embase, and PsycINFO for all systematic reviews and/or meta-analyses of randomized controlled trials (RCTs) with TM as an intervention, and outcome measures include systolic BP (SBP) and diastolic BP (DBP)...
October 2017: Complementary Therapies in Medicine
https://www.readbyqxmd.com/read/28916933/interactions-between-genetics-lifestyle-and-environmental-factors-for-healthcare
#16
Yuxin Lin, Jiajia Chen, Bairong Shen
The occurrence and progression of diseases are strongly associated with a combination of genetic, lifestyle, and environmental factors. Understanding the interplay between genetic and nongenetic components provides deep insights into disease pathogenesis and promotes personalized strategies for people healthcare. Recently, the paradigm of systems medicine, which integrates biomedical data and knowledge at multidimensional levels, is considered to be an optimal way for disease management and clinical decision-making in the era of precision medicine...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28916890/coronary-calcium-score-influences-referral-for-invasive-coronary-angiography-after-normal-myocardial-perfusion-spect
#17
Shu Yokota, Mohamed Mouden, Jan Paul Ottervanger, Elsemiek Engbers, Pieter L Jager, Jorik R Timmer, Siert Knollema
BACKGROUND: In patients with normal SPECT but persistent complaints, invasive angiography may exclude obstructive coronary disease. We assessed whether high coronary artery calcium (CAC) scores are associated with increased referral for invasive angiography following normal SPECT. METHODS AND RESULTS: 2286 consecutive patients (mean age 60 ± 12, 39% male) with normal SPECT were assessed. All patients underwent simultaneous CAC scoring. Patients were categorized into four groups based on their CAC score: CAC = 0 (n = 694), CAC 1 to 100 (n = 891), CAC 101 to 400 (n = 368), and CAC >400 (n = 333)...
September 15, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/28912153/comprehensive-genomic-profiling-of-282-pediatric-low-and-high-grade-gliomas-reveals-genomic-drivers-tumor-mutational-burden-and-hypermutation-signatures
#18
Adrienne Johnson, Eric Severson, Laurie Gay, Jo-Anne Vergilio, Julia Elvin, James Suh, Sugganth Daniel, Mandy Covert, Garrett M Frampton, Sigmund Hsu, Glenn J Lesser, Kimberly Stogner-Underwood, Ryan T Mott, Sarah Z Rush, Jennifer J Stanke, Sonika Dahiya, James Sun, Prasanth Reddy, Zachary R Chalmers, Rachel Erlich, Yakov Chudnovsky, David Fabrizio, Alexa B Schrock, Siraj Ali, Vincent Miller, Philip J Stephens, Jeffrey Ross, John R Crawford, Shakti H Ramkissoon
BACKGROUND: Pediatric brain tumors are the leading cause of death for children with cancer in the U.S. Incorporating next-generation sequencing data for both pediatric low-grade (pLGGs) and high-grade gliomas (pHGGs) can inform diagnostic, prognostic, and therapeutic decision-making. MATERIALS AND METHODS: We performed comprehensive genomic profiling on 282 pediatric gliomas (157 pHGGs, 125 pLGGs), sequencing 315 cancer-related genes and calculating the tumor mutational burden (TMB; mutations per megabase [Mb])...
September 14, 2017: Oncologist
https://www.readbyqxmd.com/read/28911896/patient-selection-and-outcomes-of-transfemoral-transcatheter-aortic-valve-replacement-performed-with-monitored-anesthesia-care-versus-general-anesthesia
#19
Saroj Pani, John Cagino, Paul Feustel, Sridhar Reddy Musuku, Asim Raja, Natalie Bruno, Christopher Ursillo, Nathapong Arunakul, Constantine M Poulos, Michael Welljams-Dorof, Kevin Roberts, Mikhail Torosoff, Augustine Delago
OBJECTIVE: The aim of this study was to compare outcomes of monitored anesthesia care (MAC) versus general anesthesia (GA) for transfemoral transcatheter aortic valve replacement (TF-TAVR) and to describe a selection process for the administration of MAC. DESIGN: Retrospective analysis of patients who underwent TF-TAVR under MAC or GA. SETTING: Department of Cardiac Anesthesia, Albany Medical Center, a tertiary university hospital. PARTICIPANTS: Patients selected for TF-TAVR...
April 5, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28910812/what-can-be-expected-from-prostate-cancer-biomarkers-a-clinical-perspective
#20
Piotr Zapała, Bartosz Dybowski, Sławomir Poletajew, Piotr Radziszewski
Along with significant advances in prostate cancer biology research, we also observe the rapid development of modern diagnostic tests. New biomarkers are derived to detect disease while it is organ-confined to stratify the risk and to aid clinical decision-making. Majority of these tools have already been validated clinically, but only a few have received premarket clearance and administration approval. Superiority of novel tests is visible not only in improved detection accuracy but predominantly in the assessment of tumour aggressiveness and selection of patients eligible for conservative management...
September 15, 2017: Urologia Internationalis
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