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https://www.readbyqxmd.com/read/29314508/how-the-dual-process-model-of-human-cognition-can-inform-efforts-to-de-implement-ineffective-and-harmful-clinical-practices-a-preliminary-model-of-unlearning-and-substitution
#1
Christian D Helfrich, Adam J Rose, Christine W Hartmann, Leti van Bodegom-Vos, Ian D Graham, Suzanne J Wood, Barbara R Majerczyk, Chester B Good, Leonard M Pogach, Sherry L Ball, David H Au, David C Aron
RATIONALE AND OBJECTIVES: One way to understand medical overuse at the clinician level is in terms of clinical decision-making processes that are normally adaptive but become maladaptive. In psychology, dual process models of cognition propose 2 decision-making processes. Reflective cognition is a conscious process of evaluating options based on some combination of utility, risk, capabilities, and/or social influences. Automatic cognition is a largely unconscious process occurring in response to environmental or emotive cues based on previously learned, ingrained heuristics...
January 5, 2018: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/29310966/improving-the-anesthetic-process-by-a-fuzzy-rule-based-medical-decision-system
#2
Juan Albino Mendez, Ana Leon, Ayoze Marrero, Jose M Gonzalez-Cava, Jose Antonio Reboso, Jose Ignacio Estevez, José F Gomez-Gonzalez
OBJECTIVE: The main objective of this research is the design and implementation of a new fuzzy logic tool for automatic drug delivery in patients undergoing general anesthesia. The aim is to adjust the drug dose to the real patient needs using heuristic knowledge provided by clinicians. A two-level computer decision system is proposed. The idea is to release the clinician from routine tasks so that he can focus on other variables of the patient. METHODS: The controller uses the Bispectral Index (BIS) to assess the hypnotic state of the patient...
January 5, 2018: Artificial Intelligence in Medicine
https://www.readbyqxmd.com/read/29308293/a-neural-candidate-selector-architecture-for-automatic-structured-clinical-text-annotation
#3
Gaurav Singh, Iain J Marshall, James Thomas, John Shawe-Taylor, Byron C Wallace
We consider the task of automatically annotating free texts describing clinical trials with concepts from a controlled, structured medical vocabulary. Specifically we aim to build a model to infer distinct sets of (ontological) concepts describing complementary clinically salient aspects of the underlying trials: the populations enrolled, the interventions administered and the outcomes measured, i.e., the PICO elements. This important practical problem poses a few key challenges. One issue is that the output space is vast, because the vocabulary comprises many unique concepts...
November 2017: Proceedings of the ... ACM International Conference on Information & Knowledge Management
https://www.readbyqxmd.com/read/29305681/dynamically-accepting-and-scheduling-patients-for-home-healthcare
#4
Mustafa Demirbilek, Juergen Branke, Arne Strauss
The importance of home healthcare is growing rapidly since populations of developed and even developing countries are getting older and the number of hospitals, retirement homes, and medical staff do not increase at the same rate. We consider the Home Healthcare Nurse Scheduling Problem where patients arrive dynamically over time and acceptance and appointment time decisions have to be made as soon as patients arrive. The objective is to maximise the average number of daily visits for a single nurse. For the sake of service continuity, patients have to be visited at the same day and time each week during their episode of care...
January 5, 2018: Health Care Management Science
https://www.readbyqxmd.com/read/29300386/modeling-the-acmg-amp-variant-classification-guidelines-as-a-bayesian-classification-framework
#5
Sean V Tavtigian, Marc S Greenblatt, Steven M Harrison, Robert L Nussbaum, Snehit A Prabhu, Kenneth M Boucher, Leslie G Biesecker
PurposeWe evaluated the American College of Medical Genetics and Genomics/Association for Molecular Pathology (ACMG/AMP) variant pathogenicity guidelines for internal consistency and compatibility with Bayesian statistical reasoning.MethodsThe ACMG/AMP criteria were translated into a naive Bayesian classifier, assuming four levels of evidence and exponentially scaled odds of pathogenicity. We tested this framework with a range of prior probabilities and odds of pathogenicity.ResultsWe modeled the ACMG/AMP guidelines using biologically plausible assumptions...
January 4, 2018: Genetics in Medicine: Official Journal of the American College of Medical Genetics
https://www.readbyqxmd.com/read/29278142/a-stratification-approach-using-logit-based-models-for-confounder-adjustment-in-the-study-of-continuous-outcomes
#6
Chuen Seng Tan, Nathalie C Støer, Ying Chen, Marielle Andersson, Yilin Ning, Hwee-Lin Wee, Eric Yin Hao Khoo, E-Shyong Tai, Shih Ling Kao, Marie Reilly
The control of confounding is an area of extensive epidemiological research, especially in the field of causal inference for observational studies. Matched cohort and case-control study designs are commonly implemented to control for confounding effects without specifying the functional form of the relationship between the outcome and confounders. This paper extends the commonly used regression models in matched designs for binary and survival outcomes (i.e. conditional logistic and stratified Cox proportional hazards) to studies of continuous outcomes through a novel interpretation and application of logit-based regression models from the econometrics and marketing research literature...
January 1, 2017: Statistical Methods in Medical Research
https://www.readbyqxmd.com/read/29230698/mode-2-knowledge-production-in-the-context-of-medical-research-a-call-for-further-clarifications
#7
Hojjat Soofi
The traditional researcher-driven environment of medical knowledge production is losing its dominance with the expansion of, for instance, community-based participatory or participant-led medical research. Over the past few decades, sociologists of science have debated a shift in the production of knowledge from traditional discipline-based (Mode 1) to more socially embedded and transdisciplinary frameworks (Mode 2). Recently, scholars have tried to show the relevance of Mode 2 knowledge production to medical research...
December 11, 2017: Journal of Bioethical Inquiry
https://www.readbyqxmd.com/read/29209469/probability-or-reasoning-current-thinking-and-realistic-strategies-for-improved-medical-decisions
#8
REVIEW
Yogarabindranath Swarna Nantha
A prescriptive model approach in decision making could help achieve better diagnostic accuracy in clinical practice through methods that are less reliant on probabilistic assessments. Various prescriptive measures aimed at regulating factors that influence heuristics and clinical reasoning could support clinical decision-making process. Clinicians could avoid time-consuming decision-making methods that require probabilistic calculations. Intuitively, they could rely on heuristics to obtain an accurate diagnosis in a given clinical setting...
November 2017: Korean Journal of Family Medicine
https://www.readbyqxmd.com/read/29196280/search-and-graph-database-technologies-for-biomedical-semantic-indexing-experimental-analysis
#9
Isabel Segura Bedmar, Paloma Martínez, Adrián Carruana Martín
BACKGROUND: Biomedical semantic indexing is a very useful support tool for human curators in their efforts for indexing and cataloging the biomedical literature. OBJECTIVE: The aim of this study was to describe a system to automatically assign Medical Subject Headings (MeSH) to biomedical articles from MEDLINE. METHODS: Our approach relies on the assumption that similar documents should be classified by similar MeSH terms. Although previous work has already exploited the document similarity by using a k-nearest neighbors algorithm, we represent documents as document vectors by search engine indexing and then compute the similarity between documents using cosine similarity...
December 1, 2017: JMIR Medical Informatics
https://www.readbyqxmd.com/read/29171969/teaching-learning-based-optimization-functional-link-artificial-neural-network-filter-for-mixed-noise-reduction-from-magnetic-resonance-image
#10
M Kumar, S K Mishra
BACKGROUND: The clinical magnetic resonance imaging (MRI) images may get corrupted due to the presence of the mixture of different types of noises such as Rician, Gaussian, impulse, etc. Most of the available filtering algorithms are noise specific, linear, and non-adaptive. OBJECTIVE: There is a need to develop a nonlinear adaptive filter that adapts itself according to the requirement and effectively applied for suppression of mixed noise from different MRI images...
2017: Bio-medical Materials and Engineering
https://www.readbyqxmd.com/read/29158662/medication-management-apps-usable-by-older-adults
#11
Rachel E Stuck, Amy W Chong, Tracy L Mitzner, Wendy A Rogers
For older adults, managing medications can be a burden and could lead to medication non-adherence. To decrease risks associated with medication non-adherence, healthcare providers may recommend medication reminder apps as an assistive tool. However, these apps are often not designed with consideration of older adults' needs, capabilities, and limitations. To identify whether available apps are suitable for older adults, we conducted an in-depth cognitive walkthrough and a heuristic evaluation of the most commonly downloaded medication reminder app...
September 2017: Proceedings of the Human Factors and Ergonomics Society ... Annual Meeting
https://www.readbyqxmd.com/read/29143393/an-algorithm-to-detect-unexpected-increases-in-frequency-of-reports-of-adverse-events-in-eudravigilance
#12
Luis C Pinheiro, Gianmario Candore, Cosimo Zaccaria, Jim Slattery, Peter Arlett
PURPOSE: The European Medicines Agency developed an algorithm to detect unexpected increases in frequency of reports, to enhance the ability to detect adverse events that manifest as increases in frequency, in particular quality defects, medication errors, and cases of abuse or misuse. METHODS: An algorithm based on a negative binomial time-series regression model run on 6 sequential observations prior to the monitored period was developed to forecast monthly counts of reports...
November 16, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/29106378/two-argument-total-scatter-factor-for-small-fields-simultaneously-collimated-by-mlc-and-jaws-application-to-stereotactic-radiosurgery-and-radiotherapy
#13
Zhaohui Han, Scott Friesen, Fred L Hacker, Piotr Zygmanski
Direct use of the total scatter factor (S<sub>tot</sub>) for independent monitor unit (MU) calculations can be a good alternative approach to the traditional separate treatment of head/collimator scatter (S<sub>c</sub>) and phantom scatter (S<sub>p</sub>), especially for stereotactic small fields under the simultaneous collimation of secondary jaws and tertiary multileaf collimators (MLC). We have carried out the measurement of S<sub>tot</sub> in water for field sizes down to 0...
November 6, 2017: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/29072893/an-interpretable-classification-framework-for-information-extraction-from-online-healthcare-forums
#14
Jun Gao, Ninghao Liu, Mark Lawley, Xia Hu
Online healthcare forums (OHFs) have become increasingly popular for patients to share their health-related experiences. The healthcare-related texts posted in OHFs could help doctors and patients better understand specific diseases and the situations of other patients. To extract the meaning of a post, a commonly used way is to classify the sentences into several predefined categories of different semantics. However, the unstructured form of online posts brings challenges to existing classification algorithms...
2017: Journal of Healthcare Engineering
https://www.readbyqxmd.com/read/29065580/an-interpretable-classification-framework-for-information-extraction-from-online-healthcare-forums
#15
Jun Gao, Ninghao Liu, Mark Lawley, Xia Hu
Online healthcare forums (OHFs) have become increasingly popular for patients to share their health-related experiences. The healthcare-related texts posted in OHFs could help doctors and patients better understand specific diseases and the situations of other patients. To extract the meaning of a post, a commonly used way is to classify the sentences into several predefined categories of different semantics. However, the unstructured form of online posts brings challenges to existing classification algorithms...
2017: Journal of Healthcare Engineering
https://www.readbyqxmd.com/read/29055608/qualitative-study-to-understand-ordering-of-ct-angiography-to-diagnose-pulmonary-embolism-in-the-emergency-room-setting
#16
Soterios Gyftopoulos, Silas W Smith, Emma Simon, Masha Kuznetsova, Leora I Horwitz, Danil V Makarov
PURPOSE: To better understand the decision making behind the ordering of CT pulmonary angiography (CTPA) for the diagnosis of pulmonary embolism (PE) in the emergency department. METHODS: We conducted semistructured interviews with our institution's emergency medicine (EM) providers and radiologists who read CTPAs performed in the emergency department. We employed the Theoretical Domains Framework-a formal, structured approach used to better understand the motivations and beliefs of physicians surrounding a complex medical decision making-to categorize the themes that arose from our interviews...
October 19, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29016972/biases-introduced-by-filtering-electronic-health-records-for-patients-with-complete-data
#17
Griffin M Weber, William G Adams, Elmer V Bernstam, Jonathan P Bickel, Kathe P Fox, Keith Marsolo, Vijay A Raghavan, Alexander Turchin, Xiaobo Zhou, Shawn N Murphy, Kenneth D Mandl
Objective: One promise of nationwide adoption of electronic health records (EHRs) is the availability of data for large-scale clinical research studies. However, because the same patient could be treated at multiple health care institutions, data from only a single site might not contain the complete medical history for that patient, meaning that critical events could be missing. In this study, we evaluate how simple heuristic checks for data "completeness" affect the number of patients in the resulting cohort and introduce potential biases...
November 1, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28980097/decision-making-in-paediatric-cardiology-are-we-prone-to-heuristics-biases-and-traps
#18
Aedin Ryan, Sophie Duignan, Damien Kenny, Colin J McMahon
Hidden traps in decision making have been long recognised in the behavioural economics community. Yet we spend very limited, if any time, analysing our decision-making processes in medicine and paediatric cardiology. Systems 1 and 2 thought processes differentiate between rapid emotional thoughts and slow deliberate rational thoughts. For fairly clear cut medical decisions, in-depth analysis may not be needed, but in our field of paediatric cardiology it is not uncommon for challenging cases and occasionally 'simple' cases to generate significant debate and uncertainty as to the best decision...
October 4, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28935225/heart-rate-variability-biofeedback-and-other-psychophysiological-procedures-as-important-elements-in-psychotherapy
#19
REVIEW
Paul M Lehrer
Lang's distinction of psychophysiological, behavioral, and cognitive domains in psychological problems and therapies provides a useful heuristic for guiding psychotherapy. Much psychotherapy practice emphasizes the cognitive domain, but behavioral and psychophysiological interventions show at least equivalent effectiveness for some kinds of problems. Most descriptions of cognitive behavior therapy emphasize cognitive procedures, although most CBT approaches also incorporate behavioral interventions such as social skills training, exposure, and behavior activation...
September 19, 2017: International Journal of Psychophysiology
https://www.readbyqxmd.com/read/28922133/aligning-event-logs-to-task-time-matrix-clinical-pathways-in-bpmn-for-variance-analysis
#20
Hui Yan, Pieter Van Gorp, Uzay Kaymak, Xudong Lu, Lei Ji, Choo Chiap Chiau, Hendriks H M Korsten, Huilong Duan
Clinical pathways (CPs) are popular healthcare management tools to standardise care and ensure quality. Analysing CP compliance levels and variances is known to be useful for training and CP redesign purposes. Flexible semantics of the Business Process Model and Notation (BPMN) language has been shown to be useful for the modeling and analysis of complex protocols. However, in practical cases one may want to exploit that CPs often have the form of Task-Time matrices. This paper presents a new method parsing complex BPMN models and aligning traces to the models heuristically...
September 18, 2017: IEEE Journal of Biomedical and Health Informatics
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