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"clinical decision making"

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https://www.readbyqxmd.com/read/29352649/optimal-use-of-peri-operative-human-chorionic-gonadotrophin-concentrations-to-identify-persistent-ectopic-pregnancy-after-laparoscopic-salpingostomy-a-retrospective-cohort-study
#1
Abraham N Morse, Wenyue Si, Shuang Qin, Huiying Liang
The aim of this study was to improve clinical decision-making for the identification of persistent ectopic pregnancy after linear salpingostomy. The study identified 854 laparoscopic salpingostomies performed between 2011 and 2016; 794 had a human chorionic gonadotrophin (HCG) <10 mIU/ml documented in the electronic medical record within 1 month after surgery ('successes'). Sixty (7%) received either methotrexate or repeat surgery for persistent ectopic pregnancy ('failures'). Five hundred and seventeen, including 46 'failures', had two or more immediate post-operative HCG measurements available...
December 28, 2017: Reproductive Biomedicine Online
https://www.readbyqxmd.com/read/29351735/assessing-the-effect-of-a-partly-unobserved-exogenous-binary-time-dependent-covariate-on-survival-probabilities-using-generalised-pseudo-values
#2
Ulrike Pötschger, Harald Heinzl, Maria Grazia Valsecchi, Martina Mittlböck
BACKGROUND: Investigating the impact of a time-dependent intervention on the probability of long-term survival is statistically challenging. A typical example is stem-cell transplantation performed after successful donor identification from registered donors. Here, a suggested simple analysis based on the exogenous donor availability status according to registered donors would allow the estimation and comparison of survival probabilities. As donor search is usually ceased after a patient's event, donor availability status is incompletely observed, so that this simple comparison is not possible and the waiting time to donor identification needs to be addressed in the analysis to avoid bias...
January 19, 2018: BMC Medical Research Methodology
https://www.readbyqxmd.com/read/29351654/what-is-the-role-of-imaging-in-the-clinical-diagnosis-of-osteoarthritis-and-disease-management
#3
Xia Wang, Win Min Oo, James M Linklater
While OA is predominantly diagnosed on the basis of clinical criteria, imaging may aid with differential diagnosis in clinically suspected cases. While plain radiographs are traditionally the first choice of imaging modality, MRI and US also have a valuable role in assessing multiple pathologic features of OA, although each has particular advantages and disadvantages. Although modern imaging modalities provide the capability to detect a wide range of osseous and soft tissue (cartilage, menisci, ligaments, synovitis, effusion) OA-related structural damage, this extra information has not yet favourably influenced the clinical decision-making and management process...
January 16, 2018: Rheumatology
https://www.readbyqxmd.com/read/29350640/scapular-fractures-a-common-diagnostic-pitfall
#4
Daniela Berritto, Antonio Pinto, Anna Russo, Fabrizio Urraro, Antonella Laporta, Maria Paola Belfiore, Roberto Grassi
Scapular fractures are one of the most difficult fractures to diagnose on radiographs. Detection can be challenging because of the obscuration by the overlying structures or incomplete imaging due to difficult patient collaboration. Familiarity with imaging characteristics of these abnormalities will allow radiologists to better diagnose and characterize scapular fractures. Three-dimensional computed tomographic scans are considered the gold standard for scapular diagnoses. Treatment strategies differ depending on the type of scapular fractures, but the site and degree of displacement will determine whether surgical intervention should be considered...
January 19, 2018: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/29349902/association-between-pre-sarcopenia-sarcopenia-and-bone-mineral-density-in-patients-with-chronic-hepatitis-c
#5
Tatiana Bering, Kiara G D Diniz, Marta Paula P Coelho, Diego A Vieira, Maria Marta S Soares, Adriana M Kakehasi, Maria Isabel T D Correia, Rosângela Teixeira, Dulciene M M Queiroz, Gifone A Rocha, Luciana D Silva
BACKGROUND: Preserved skeletal muscle is essential for the maintenance of healthy bone. Loss of bone mineral density (BMD) and muscle strength, considered a predictor of BMD, have been demonstrated in patients with cirrhosis, but they are poorly studied in chronic hepatitis C (CHC) without cirrhosis. Thus, we aimed to evaluate the prevalence of low BMD and its association with body composition, muscle strength, and nutritional status in CHC. METHODS: One hundred and four subjects [mean age, 50...
January 19, 2018: Journal of Cachexia, Sarcopenia and Muscle
https://www.readbyqxmd.com/read/29349761/multi-gene-panel-testing-in-breast-cancer-management
#6
Christos Fountzilas, Virginia G Kaklamani
Hereditary predisposition accounts for approximately 10% of all breast cancers and is mostly associated with germline mutations in high-penetrance genes encoding for proteins participating in DNA repair through homologous recombination (BRCA1 and BRCA2). With the advent of massive parallel next-generation DNA sequencing, simultaneous analysis of multiple genes with a short turnaround time and at a low cost has become possible. The clinical validity and utility of multi-gene panel testing is getting better characterized as more data on the significance of moderate-penetrance genes are collected from large, cancer genetic testing studies...
2018: Cancer Treatment and Research
https://www.readbyqxmd.com/read/29346783/does-2-pro-prostate-specific-antigen-meet-the-criteria-to-justify-its-inclusion-in-the-clinical-decision-making-process
#7
Angeles Sanchis-Bonet, Marta Barrionuevo-González, Ana Bajo-Chueca, Nelson Morales-Palacios, Manuel Sanchez-Chapado
INTRODUCTION: To assess whether [-2]pro-prostate-specific antigen (p2PSA) meets the criteria to justify its inclusion in a predictive model of prostate cancer (PCa) diagnosis and in the clinical decision-making process. MATERIALS AND METHODS: A total 172 men with total prostate-specific antigen of 2-10 ng/mL underwent measurement of free PSA and p2PSA before prostate biopsy in an observational and prospective study. From these measurements, the Prostate Health Index (PHI) was calculated...
January 18, 2018: Urologia Internationalis
https://www.readbyqxmd.com/read/29346512/validation-of-the-pids-idsa-severity-criteria-in-children-with-community-acquired-pneumonia
#8
Todd A Florin, Cole Brokamp, Rachel Mantyla, Bradley DePaoli, Richard Ruddy, Samir S Shah, Lilliam Ambroggio
Background: The Pediatric Infectious Diseases Society (PIDS)/Infectious Diseases Society of America (IDSA) guideline for community-acquired pneumonia (CAP) recommends intensive care unit (ICU) admission or continuous monitoring for children meeting severity criteria. Our objective was to validate these criteria. Methods: This was a retrospective cohort study of children age 3 months-18 years diagnosed with CAP in a pediatric Emergency Department (ED) from 9/2014-8/2015...
January 13, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29345224/therapy-interventions-for-children-with-neurodisabilities-a-qualitative-scoping-study
#9
Bryony Beresford, Susan Clarke, Jane Maddison
BACKGROUND: Therapy interventions emerged four times in the top 10 research priorities in a James Lind Alliance research prioritisation exercise for children with neurodisabilities (Morris C, Simkiss D, Busk M, Morris M, Allard A, Denness J, et al. Setting research priorities to improve the health of children and young people with neurodisability: a British Academy of Childhood Disability-James Lind Alliance Research Priority Setting Partnership. BMJ Open 2015;5:e006233). The National Institute for Health Research (NIHR) commissioned this study as part of an information-gathering exercise in response to this...
January 2018: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29345107/introduction-to-methodology-of-dose-response-meta-analysis-for-binary-outcome-with-application-on-software
#10
Chao Zhang, Pengli Jia, Liu Yu, Chang Xu
OBJECTIVE: Dose-response meta-analysis (DRMA) is widely applied to investigate the dose-specific relationship between independent and dependent variables. Such methods have been in use for over 30 years and are increasingly employed in healthcare and clinical decision-making. In this article, we give an overview of the methodology used in DRMA. METHODS: We summarize the commonly used regression model and the pooled method in DRMA. We also use an example to illustrate how to employ a DRMA by these methods...
January 18, 2018: Journal of Evidence-based Medicine
https://www.readbyqxmd.com/read/29344894/systems-biology-approaches-in-cancer-pathology
#11
Aaron DeWard, Rebecca J Critchley-Thorne
The complex network of the tissue system, in both pre-neoplastic tissues and tumors, demonstrates the need for a systems biology approach to cancer pathology, in which quantification of key tissue system processes is combined with informatics tools to produce actionable scores to aid clinical decision-making. A systems biology approach to cancer pathology enables integration of key system features that are relevant to diagnoses, patient outcomes, and responses to therapies. Key tissue system features relevant to cancer pathology include molecular and morphologic abnormalities in epithelia, cellular changes in the stroma such as immune infiltrates, and relationships between components of the system, such as interactions and spatial relationships between epithelial and stromal components, and also between specific immune cell subsets...
2018: Methods in Molecular Biology
https://www.readbyqxmd.com/read/29343506/how-to-use%C3%A2-procalcitonin
#12
Philip Robinson, Surjo Kiran De
Diagnosing bacterial infection in the unwell or febrile child is a common challenge faced by all paediatricians. Despite the advent of novel molecular techniques, there is ongoing need for diagnostic assays with adequate performance and turnaround time to facilitate safe clinical decision-making when bacterial sepsis is suspected, such as whether to commence empirical treatment with antibiotics. Procalcitonin is an established marker of infection that has a potential role in the diagnosis and exclusion of serious or invasive bacterial infection in neonates and children...
January 17, 2018: Archives of Disease in Childhood. Education and Practice Edition
https://www.readbyqxmd.com/read/29342044/elevated-level-of-myeloperoxidase-deoxyribonucleic-acid-complex-in-the-middle-ear-fluid-obtained-from-patients-with-otitis-media-associated-with-antineutrophil-cytoplasmic-antibody-associated-vasculitis
#13
Shinya Morita, Yuji Nakamaru, Daigo Nakazawa, Fumihiko Hattanda, Haruki Shida, Yoshihiro Kusunoki, Kanako Watanabe, Sakiko Masuda, Dai Takagi, Masanobu Suzuki, Kimiko Hoshino, Atsushi Fukuda, Utano Tomaru, Akihiro Homma, Akihiro Ishizu
OBJECTIVE: The purpose was to explore the presence of myeloperoxidase (MPO)-deoxyribonucleic acid (DNA) complex as a surrogate marker of neutrophil extracellular traps (NETs) in the middle ear fluid, and to clarify the correlation between its quantifiable level and hearing outcome in patients with otitis media associated with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). STUDY DESIGN: Prospective study. SETTING: Tertiary referral center...
January 16, 2018: Otology & Neurotology
https://www.readbyqxmd.com/read/29341153/circulating-tumour-cells-and-dna-as-liquid-biopsies-in-gastrointestinal-cancer
#14
REVIEW
O Nordgård, K Tjensvoll, B Gilje, K Søreide
BACKGROUND: Blood is the most extensively studied body fluid and, because it contains circulating tumour cells (CTCs) and circulating tumour-derived cell-free DNA (ctDNA), it may represent a liquid biopsy for cancer. Methods for enrichment and detection of CTCs and ctDNA, their clinical applications and future opportunities in gastrointestinal cancers were the focus of this review. METHODS: The PubMed database was searched for literature up to 24 June 2017, with a focus on the past 10 years...
January 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/29340940/characterizing-potentially-preventable-admissions-a-mixed-methods-study-of-rates-associated-factors-outcomes-and-physician-decision-making
#15
Lisa M Daniels, Atsushi Sorita, Deanne T Kashiwagi, Masashi Okubo, Evan Small, Eric C Polley, Adam P Sawatsky
BACKGROUND: Potentially preventable admissions are a target for healthcare cost containment. OBJECTIVE: To identify rates of, characterize associations with, and explore physician decision-making around potentially preventable admissions. DESIGN: A comparative cohort study was used to determine rates of potentially preventable admissions and to identify associated factors and patient outcomes. A qualitative case study was used to explore physicians' clinical decision-making...
January 16, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29340873/fontan-surgical-planning-previous-accomplishments-current-challenges-and-future-directions
#16
Phillip M Trusty, Timothy C Slesnick, Zhenglun Alan Wei, Jarek Rossignac, Kirk R Kanter, Mark A Fogel, Ajit P Yoganathan
The ultimate goal of Fontan surgical planning is to provide additional insights into the clinical decision-making process. In its current state, surgical planning offers an accurate hemodynamic assessment of the pre-operative condition, provides anatomical constraints for potential surgical options, and produces decent post-operative predictions if boundary conditions are similar enough between the pre-operative and post-operative states. Moving forward, validation with post-operative data is a necessary step in order to assess the accuracy of surgical planning and determine which methodological improvements are needed...
January 16, 2018: Journal of Cardiovascular Translational Research
https://www.readbyqxmd.com/read/29337920/acute-traumatic-endotheliopathy-in-isolated-severe-brain-injury-and-its-impact-on-clinical-outcome
#17
Venencia Albert, Arulselvi Subramanian, Deepak Agrawal, Hara Prasad Pati, Siddhartha Datta Gupta, Asok Kumar Mukhopadhyay
STUDY DESIGN: Prospective observational cohort. OBJECTIVE: To investigate the difference in plasma levels of syndecan-1 (due to glycocalyx degradation) and soluble thrombomodulin (due to endothelial damage) in isolated severe traumatic brain injury (TBI) patients with/without early coagulopathy. A secondary objective was to compare the effects of the degree of TBI endotheliopathy on hospital mortality among patients with TBI-associated coagulopathy (TBI-AC). METHODS: Data was prospectively collected on isolated severe TBI (sTBI) patients with Glasgow Coma Scale (GCS) ≤8 less than 12 h after injury admitted to a level I trauma centre...
January 16, 2018: Medical Sciences: Open Access Journal
https://www.readbyqxmd.com/read/29337776/l%C3%A3-mann-index-at-diagnosis-predicts-the-risk-of-early-surgery-in-crohn-s-disease
#18
Wei Liu, Wei Zhou, Jianjian Xiang, Qian Cao, Jinzhou Zhu, Weilin Qi, Pengpeng Chen, Qingwen Xie
BACKGROUND: Identifying patients with Crohn's disease with rapid disease progress or high risk of early surgery is crucial to clinical decision making. OBJECTIVE: The aim was to evaluate the correlation between the Lémann index at diagnosis and abdominal surgery in the first year after Crohn's disease diagnosis and to find the risk factors for early surgery. DESIGN: This was a retrospective cohort study. SETTINGS: The study was conducted at a single tertiary hospital...
February 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29336276/streamlining-the-medication-review-process-by-use-of-a-new-review-tool-chart
#19
Quincy Ostrem, Stephen Carlson, Brady Hamilton
OBJECTIVE: The Carlson-Hamilton Adult Medication Review Tool (CHART) represents an effort to improve the approach to geriatric care by streamlining the medication review process and identifying potential medication issues that may be relevant to patient's cognitive presentation and impact clinical decision making. SETTING: CHART was created at a behavioral health facility. The most common primary diagnoses on this unit include new onset psychosis and recent mental status changes...
January 1, 2018: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/29334910/treatment-selection-of-early-stage-non-small-cell-lung-cancer-the-role-of-the-patient-in-clinical-decision-making
#20
S Mokhles, J J M E Nuyttens, M de Mol, J G J V Aerts, A P W M Maat, Ö Birim, A J J C Bogers, J J M Takkenberg
BACKGROUND: The objective of this study is to investigate the role and experience of early stage non-small cell lung cancer (NSCLC) patient in decision making process concerning treatment selection in the current clinical practice. METHODS: Stage I-II NSCLC patients (surgery 55 patients, SBRT 29 patients, median age 68) were included in this prospective study and completed a questionnaire that explored: (1) perceived patient knowledge of the advantages and disadvantages of the treatment options, (2) experience with current clinical decision making, and (3) the information that the patient reported to have received from their treating physician...
January 15, 2018: BMC Cancer
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