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https://www.readbyqxmd.com/read/28340046/validation-of-a-screening-risk-index-for-serious-prescription-opioid-induced-respiratory-depression-or-overdose-in-a-us-commercial-health-plan-claims-database
#1
Barbara K Zedler, William B Saunders, Andrew R Joyce, Catherine C Vick, E Lenn Murrelle
Objective.:  To validate a risk index that estimates the likelihood of overdose or serious opioid-induced respiratory depression (OIRD) among medical users of prescription opioids. Subjects and Methods.:  A case-control analysis of 18,365,497 patients with an opioid prescription from 2009 to 2013 in the IMS PharMetrics Plus commercially insured health plan claims database (CIP). An OIRD event occurred in 7,234 cases. Four controls were selected per case. Validity of the Risk Index for Overdose or Serious Opioid-induced Respiratory Depression (RIOSORD), developed previously using Veterans Health Administration (VHA) patient data, was assessed...
March 6, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28337731/arthroplasty-registries-around-the-world-valuable-sources-of-hip-implant-revision-risk-data
#2
REVIEW
Richard E Hughes, Aditi Batra, Brian R Hallstrom
PURPOSE OF REVIEW: National and regional arthroplasty registries have proliferated since the Swedish Knee Arthroplasty Register was started in 1975. Registry reports typically present implant-specific estimates of revision risk and patient- and technique-related factors that can inform clinical decision-making about implants and techniques. However, annual registry reports are long and it is difficult for clinicians to extract comparable revision risk data. Since implants may appear in multiple registry reports, it is even more difficult to gather relevant data for clinical decision-making about implant selection...
March 23, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28337167/research-recommendations-for-improving-measurement-of-treatment-effectiveness-in-depression
#3
Kaloyan Kamenov, María Cabello, Mónica Nieto, Renaldo Bernard, Elisabeth Kohls, Christine Rummel-Kluge, José L Ayuso-Mateos
Background: Despite the steadily escalating psychological and economic burden of depression, there is a lack of evidence for the effectiveness of available interventions on functioning areas beyond symptomatology. Therefore, the main objective of this study was to give an insight into the current measurement of treatment effectiveness in depression and to provide recommendations for its improvement. Materials and Methods: The study was based on a multi-informant approach, comparing data from a systematic literature review, an expert survey with representatives from clinical practice (130), and qualitative interviews with patients (11) experiencing depression...
2017: Frontiers in Psychology
https://www.readbyqxmd.com/read/28336740/towards-personalised-intra-arterial-treatment-of-patients-with-acute-ischaemic-stroke-a-study-protocol-for-development-and-validation-of-a-clinical-decision-aid
#4
Maxim J H L Mulder, Esmee Venema, Bob Roozenbeek, Joseph P Broderick, Sharon D Yeatts, Pooja Khatri, Olvert A Berkhemer, Yvo B W E M Roos, Charles B L M Majoie, Robert J van Oostenbrugge, Wim H van Zwam, Aad van der Lugt, Ewout W Steyerberg, Diederik W J Dippel, Hester F Lingsma
INTRODUCTION: Overall, intra-arterial treatment (IAT) proved to be beneficial in patients with acute ischaemic stroke due to a proximal occlusion in the anterior circulation. However, heterogeneity in treatment benefit may be relevant for personalised clinical decision-making. Our aim is to improve selection of patients for IAT by predicting individual treatment benefit or harm. METHODS AND ANALYSIS: We will use data collected in the Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands (MR CLEAN) trial to analyse the effect of baseline characteristics on outcome and treatment effect...
March 22, 2017: BMJ Open
https://www.readbyqxmd.com/read/28336504/mhealth-for-clinical-decision-making-in-sub-saharan-africa-a-scoping-review
#5
Ibukun-Oluwa Omolade Adepoju, Bregje Joanna Antonia Albersen, Vincent De Brouwere, Jos van Roosmalen, Marjolein Zweekhorst
BACKGROUND: In a bid to deliver quality health services in resource-poor settings, mobile health (mHealth) is increasingly being adopted. The role of mHealth in facilitating evidence-based clinical decision-making through data collection, decision algorithms, and evidence-based guidelines, for example, is established in resource-rich settings. However, the extent to which mobile clinical decision support systems (mCDSS) have been adopted specifically in resource-poor settings such as Africa and the lessons learned about their use in such settings are yet to be established...
March 23, 2017: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/28333829/acute-traumatic-coagulopathy-the-elephant-in-a-room-of-blind-scientists
#6
Michael A Meledeo, Maryanne C Herzig, James A Bynum, Xiaowu Wu, Anand K Ramasubramanian, Daniel N Darlington, Kristin M Reddoch, Andrew P Cap
Acute traumatic coagulopathy (ATC) is the failure of coagulation homeostasis that can rapidly arise following traumatic injury, hemorrhage, and shock; it is associated with higher injury severity, coagulation abnormalities, and increased blood transfusions. ATC has historically been defined by a prolonged prothrombin time (PT), although newer, more informative measurements of hemostatic function have been employed to improve diagnosis and support clinical decision making. The underlying biochemical mechanisms of and best practice therapeutics for ATC remain under active investigation because of its significant correlation to poor outcomes...
March 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28331928/computed-tomographic-evaluation-of-femoral-and-tibial-conformation-in-english-staffordshire-bull-terriers-with-and-without-congenital-medial-patellar-luxation
#7
Mark Newman, Katja Voss
OBJECTIVE: To compare hindlimb conformation of English Staffordshire Bull Terriers with and without medial patellar luxation using computed tomography. METHODS: Hindlimb computed tomography (CT) was performed on six English Staffordshire Bull Terriers with grade II or III medial patellar luxation, and six without medial patellar luxation. Inclination angle, femoral condyle trochanteric angle, anteversion angle (AA), distal anteversion angle (DAA), proximal anteversion angle (PAA), femoral varus angle (FVA), tibial valgus angle (TVA), and tibial torsion angle (TTA) were measured...
March 23, 2017: Veterinary and Comparative Orthopaedics and Traumatology: V.C.O.T
https://www.readbyqxmd.com/read/28329250/sudden-cardiac-arrest-risk-assessment-population-science-and-the-individual-risk-mandate
#8
Robert J Myerburg, Jeffrey J Goldberger
Importance: High-resolution stratification of risk of sudden cardiac arrest (SCA) in individual patients is a tool that is necessary for achieving effective and efficient application of data generated by population-based research. This concept is at the core of initiatives for merging cost effectiveness with maximized clinical efficiency and individual patient treatment. Observations: For this review, we analyzed data on sudden cardiac death and SCA available from population studies that included large longitudinal and cross-sectional databases, observational cohort studies, and randomized clinical trials...
March 22, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28328388/bedside-critical-care-staff-use-of-intensive-care-unit-telemedicine-comparisons-by-intensive-care-unit-complexity
#9
Jonathan T Thomas, Jane Moeckli, Michelle A Mengeling, Cassie Cunningham Goedken, Jacinda Bunch, Peter Cram, Heather Schacht Reisinger
BACKGROUND: Effects of Intensive Care Unit (ICU) telemedicine on patient and staff outcomes are mixed. Variation in utilization is potentially driving these differences. INTRODUCTION: ICU telemedicine utilization is understudied, with existing research focusing on telemedicine staff. We assess ICU telemedicine utilization from the perspective of the end user-ICU staff-to better understand how telemedicine use is conceptualized and practiced at the bedside. MATERIALS AND METHODS: We conducted a thematic content analysis of semistructured interviews with bedside ICU staff...
February 16, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/28327985/the-need-to-approximate-the-use-case-in-clinical-machine-learning
#10
Sohrab Saeb, Luca Lonini, Arun Jayaraman, David C Mohr, Konrad P Kording
Background: The availability of smartphone and wearable sensor technology is leading to a rapid accumulation of human subject data, and machine learning is emerging as a technique to map that data into clinical predictions. As machine learning algorithms are increasingly used to support clinical decision making, it is vital to reliably quantify their prediction accuracy. Cross-validation is the standard approach where the accuracy of such algorithms is evaluated on data the algorithm has not seen during training...
March 15, 2017: GigaScience
https://www.readbyqxmd.com/read/28327577/metabolic-profiling-of-idh-mutation-and-malignant-progression-in-infiltrating-glioma
#11
Llewellyn E Jalbert, Adam Elkhaled, Joanna J Phillips, Evan Neill, Aurelia Williams, Jason C Crane, Marram P Olson, Annette M Molinaro, Mitchel S Berger, John Kurhanewicz, Sabrina M Ronen, Susan M Chang, Sarah J Nelson
Infiltrating low grade gliomas (LGGs) are heterogeneous in their behavior and the strategies used for clinical management are highly variable. A key factor in clinical decision-making is that patients with mutations in the isocitrate dehydrogenase 1 and 2 (IDH1/2) oncogenes are more likely to have a favorable outcome and be sensitive to treatment. Because of their relatively long overall median survival, more aggressive treatments are typically reserved for patients that have undergone malignant progression (MP) to an anaplastic glioma or secondary glioblastoma (GBM)...
March 22, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28327114/study-protocol-for-a-randomized-controlled-trial-comparing-clinical-and-radiological-results-after-three-different-posterior-decompression-techniques-for-lumbar-spinal-stenosis-the-spinal-stenosis-trial-sst-part-of-the-nordsten-study
#12
Erland Hermansen, Ivar Magne Austevoll, Ulla Kristina Romild, Frode Rekeland, Tore Solberg, Kjersti Storheim, Oliver Grundnes, Jørn Aaen, Jens Ivar Brox, Christian Hellum, Kari Indrekvam
BACKGROUND: There are several posterior decompression techniques for lumbar spinal stenosis (LSS). There is a trend towards performing less invasive surgical procedures, but no multicentre randomized controlled trials have evaluated the relative efficacy of these techniques at short and long-term. METHOD/DESIGN: A multicentre randomized controlled trial [the Spinal Stenosis Trial (SST) (part of the NORDSTEN study)] including 465 patients aged 18-80 years with neurogenic claudication or radiating pain and MRI findings indicating lumbar spinal stenosis without spondylolisthesis is performed to compare three posterior decompression techniques: unilateral laminotomy with crossover, bilateral laminotomy and spinous process osteotomy...
March 21, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28325471/can-we-identify-who-gets-benefit-or-harm-from-mycophenolate-mofetil-in-systemic-lupus-erythematosus-a-systematic-review
#13
Claudia Mendoza-Pinto, Carmelo Pirone, Daniëlle A van der Windt, Ben Parker, Ian N Bruce
OBJECTIVES: We aimed to summarize the evidence examining factors that predict differential response to mycophenolate mofetil (MMF) in systemic lupus erythematosus (SLE). METHODS: Systematic searches of randomized clinical trials (RCT) to identify predictors of the effects of MMF (moderators), and cohort studies to explore prognostic factors associated with MMF outcomes (response, relapse, or adverse events) were performed. Two reviewers independently assessed the methodological quality of RCTs using the Cochrane Collaboration risk of bias tool and cohort studies using the QUality In Prognosis Studies tool...
February 9, 2017: Seminars in Arthritis and Rheumatism
https://www.readbyqxmd.com/read/28324898/breathing-and-swallowing-the-next-frontier
#14
Roxann Diez Gross, Marybeth Trapani-Hanasewych
The anatomical overlap of the pathways for air passage and nutrition necessitate precise coordination between the two vital functions. Neuroanatomic structures in the brainstem for sucking, breathing, and swallowing are also in close proximity and must swiftly coordinate the processes. In a healthy neonate, the oropharyngeal experience and stimulation of early feeding enables respiratory control during suckling to develop. Despite wide variability among the methods used to investigate breathing and swallowing coordination in infancy, a consistent finding of postswallow exhalation has been reported...
April 2017: Seminars in Speech and Language
https://www.readbyqxmd.com/read/28321120/decision-analysis-of-allogeneic-hematopoietic-stem-cell-transplantation-for-patients-with-myelodysplastic-syndrome-stratified-according-to-the-revised-international-prognostic-scoring-system-ipss-r
#15
M G Della Porta, C H Jackson, E P Alessandrino, M Rossi, A Bacigalupo, M T van Lint, M Bernardi, B Allione, A Bosi, S Guidi, V Santini, L Malcovati, M Ubezio, C Milanesi, E Todisco, M T Voso, P Musto, F Onida, A P Iori, R Cerretti, G Grillo, A Molteni, P Pioltelli, L Borin, E Angelucci, E Oldani, S Sica, C Pascutto, V Ferretti, A Santoro, F Bonifazi, M Cazzola, A Rambaldi
Allogeneic hematopoietic stem cell transplantation (allo-SCT) represents the only curative treatment for patients with myelodysplastic syndrome (MDS), but involves non-negligible morbidity and mortality. Crucial questions in clinical decision making include the definition of optimal timing of the procedure and the benefit of cytoreduction before transplant in high risk patients. We carried out a decision analysis on 1728 MDS who received supportive care, transplantation or hypomethylating agents (HMAs). Risk assessment was based on the revised International Prognostic Scoring System (IPSS-R)...
March 21, 2017: Leukemia: Official Journal of the Leukemia Society of America, Leukemia Research Fund, U.K
https://www.readbyqxmd.com/read/28320367/the-development-and-validation-of-the-clinicians-awareness-towards-cognitive-errors-catches-in-clinical-decision-making-questionnaire-tool
#16
Keng Sheng Chew, Yee Cheng Kueh, Adlihafizi Abdul Aziz
BACKGROUND: Despite their importance on diagnostic accuracy, there is a paucity of literature on questionnaire tools to assess clinicians' awareness toward cognitive errors. A validation study was conducted to develop a questionnaire tool to evaluate the Clinician's Awareness Towards Cognitive Errors (CATChES) in clinical decision making. METHODS: This questionnaire is divided into two parts. Part A is to evaluate the clinicians' awareness towards cognitive errors in clinical decision making while Part B is to evaluate their perception towards specific cognitive errors...
March 21, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28318605/achilles-tendon-moment-arm-length-is-smaller-in-children-with-cerebral-palsy-than-in-typically-developing-children
#17
Barbara M Kalkman, Lynn Bar-On, Francesco Cenni, Constantinos N Maganaris, Alfie Bass, Gill Holmes, Kaat Desloovere, Gabor J Barton, Thomas D O'Brien
When studying muscle and whole-body function in children with cerebral palsy (CP), knowledge about both internal and external moment arms is essential since they determine the mechanical advantage of a muscle over an external force. Here we asked if Achilles tendon moment arm (MAAT) length is different in children with CP and age-matched typically developing (TD) children, and if MAAT can be predicted from anthropometric measurements. Sixteen children with CP (age: 10y 7m±3y, 7 hemiplegia, 12 diplegia, GMFCS level: I (11) and II (8)) and twenty TD children (age: 10y 6m±3y) participated in this case-control study...
March 3, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/28315947/impact-of-18-f-fdg-pet-ct-on-surgical-management-in-patients-with-advanced-melanoma-an-outcome-based-analysis
#18
Andrea Forschner, Susann-Cathrin Olthof, Brigitte Gückel, Peter Martus, Werner Vach, Christian la Fougère, Konstantin Nikolaou, Ulrike Keim, Thomas Kurt Eigentler, Claus Garbe, Christina Pfannenberg
PURPOSE: To evaluate the influence of (18)F-FDG-PET/CT on clinical decision making and outcome in advanced melanoma patients planned for radical metastasectomy. METHODS AND MATERIALS: A cohort of 333 patients with mainly stage III/IV melanoma having a PET/CT for clinical reasons was prospectively enrolled in our oncologic PET/CT registry between 2013 and 2015. Referring physicians completed questionnaires regarding their intended management for each patient before and after PET/CT...
March 18, 2017: European Journal of Nuclear Medicine and Molecular Imaging
https://www.readbyqxmd.com/read/28315120/prognostic-biomarkers-in-acute-coronary-syndromes-risk-stratification-beyond-cardiac-troponins
#19
REVIEW
K M Eggers, B Lindahl
PURPOSE OF REVIEW: Cardiac troponin (cTn) plays an essential role for assessment of outcome in acute coronary syndrome (ACS). However, the prognostic value of cTn is not absolute. In this mini-review, we summarize the evidence on the utility of established biomarkers of left-ventricular dysfunction, hemodynamic stress, inflammation, and renal dysfunction for risk prediction beyond cTn in ACS. RECENT FINDINGS: Only few biomarkers consistently demonstrate additive prognostic value to cTn levels...
April 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28315113/-i-d-been-like-freaking-out-the-whole-night-exploring-emotion-regulation-based-on-junior-doctors-narratives
#20
Robert M Lundin, Kiran Bashir, Alison Bullock, Camille E Kostov, Karen L Mattick, Charlotte E Rees, Lynn V Monrouxe
The importance of emotions within medical practice is well documented. Research suggests that how clinicians deal with negative emotions can affect clinical decision-making, health service delivery, clinician well-being, attentiveness to patient care and patient satisfaction. Previous research has identified the transition from student to junior doctor (intern) as a particularly challenging time. While many studies have highlighted the presence of emotions during this transition, how junior doctors manage emotions has rarely been considered...
March 17, 2017: Advances in Health Sciences Education: Theory and Practice
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