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surrogate decision making

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https://www.readbyqxmd.com/read/27913502/mrd-in-aml-does-it-already-guide-therapy-decision-making
#1
Gert Ossenkoppele, Gerrit Jan Schuurhuis
Prognostic factors determined at diagnosis are predictive for outcome whereas achievement of morphological complete remission (CR) is still an important end point during treatment. Residual disease after therapy may reflect the sum of all diagnosis and postdiagnosis resistance mechanisms/factors; its measurement could hypothetically be very instrumental for guiding treatment. The possibility of defining residual disease (minimal residual disease [MRD]) far below the level of 5% blast cells is changing the landscape of risk classification...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27910091/a-dyadic-perspective-on-engagement-in-advance-care-planning
#2
Terri Fried, Maria Zenoni, Lynne Iannone
OBJECTIVES: To understand the perspectives of both patients and the person who would make medical decisions for them if they were unable (surrogates) on their participation in advance care planning (ACP). DESIGN: Qualitative cross-sectional study. SETTING: Community. PARTICIPANTS: Thirty-one veterans age 55 years and older and their surrogates. MEASUREMENTS: In interviews conducted with both the veteran and surrogate, they were asked to discuss their participation in four ACP activities: communication about life-sustaining treatment, communication about views on quality of life, completion of a living will, and appointment of a healthcare proxy...
December 2, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27907968/palliative-care-practice-in-neurocritical-care
#3
Andrea K Knies, David Y Hwang
Many neurocritically ill patients and their families have high amounts of palliative care needs. Multiple professional societies relevant to neurocritical care have released consensus statements on meeting palliative care needs in neuroscience intensive care units. In this review, the authors discuss the ongoing debate regarding what model of palliative care delivery is optimal, focus on the process of shared decision making during goals-of-care discussions, and briefly comment on transitions from intensive care to comfort care...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27906720/decisions-regarding-forgoing-life-sustaining-treatments
#4
Gail A Van Norman
PURPOSE OF REVIEW: Decisions to forego life-sustaining treatments are complex, and disagreements between physicians and patients occur. This review discusses recent findings regarding what factors influence physicians and patients or their surrogates in these decisions and considers whether futility arguments regarding life-sustaining treatments should be abandoned. RECENT FINDINGS: Cardiopulmonary resuscitation is one paradigm in the literature for studying end-of-life decision-making...
November 30, 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27899188/familial-prostate-cancer
#5
Veda N Giri, Jennifer L Beebe-Dimmer
Prostate cancer is the most commonly diagnosed cancer among men in the United States as well as most Western countries. A significant proportion of men report having a positive family history of prostate cancer in a first-degree relative (father, brother, son), which is important in that family history is one of the only established risk factors for the disease and plays a role in decision-making for prostate cancer screening. Familial aggregation of prostate cancer is considered a surrogate marker of genetic susceptibility to developing the disease, but shared environment cannot be excluded as an explanation for clustering of cases among family members...
October 2016: Seminars in Oncology
https://www.readbyqxmd.com/read/27889873/information-technology-based-interventions-to-improve-drug-drug-interaction-outcomes-a-systematic-review-on-features-and-effects
#6
Ehsan Nabovati, Hasan Vakili-Arki, Zhila Taherzadeh, Mohammad Reza Saberi, Stephanie Medlock, Ameen Abu-Hanna, Saeid Eslami
The purpose of this systematic review was to identify features and effects of information technology (IT)-based interventions on outcomes related to drug-drug interactions (DDI outcomes). A literature search was conducted in Medline, EMBASE, and the Cochrane Library for published English-language studies. Studies were included if a main outcome was related to DDIs, the intervention involved an IT-based system, and the study design was experimental or observational with controls. Study characteristics, including features and effects of IT-based interventions, were extracted...
January 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/27874181/ags-position-statement-making-medical-treatment-decisions-for-unbefriended-older-adults
#7
Timothy W Farrell, Eric Widera, Lisa Rosenberg, Craig D Rubin, Aanand D Naik, Ursula Braun, Alexia Torke, Ina Li, Caroline Vitale, Joseph Shega
In this position statement, we define unbefriended older adults as patients who: (1) lack decisional capacity to provide informed consent to the medical treatment at hand; (2) have not executed an advance directive that addresses the medical treatment at hand and lack capacity to do so; and (3) lack family, friends or a legally authorized surrogate to assist in the medical decision-making process. Given the vulnerable nature of this population, clinicians, health care teams, ethics committees and other stakeholders working with unbefriended older adults must be diligent when formulating treatment decisions on their behalf...
November 22, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27872409/complexity-analysis-of-decision-making-in-the-critically-ill
#8
Barbara J Daly, Sara L Douglas, Elizabeth O'Toole, James Rowbottom, Alan Hoffer, Amy R Lipson, Christopher Burant
RATIONALE: Despite multiple trials of interventions to improve end-of-life care of the critically ill, there is a persistent lack of understanding of factors associated with barriers to decision-making at the end of life. OBJECTIVE: To apply the principles of complexity science in examining the extent to which transitions to end-of-life care can be predicted by physician, family, or patient characteristics; outcome expectations; and the evaluation of treatment effectiveness...
November 20, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27865371/assessing-head-and-neck-cancer-patient-preferences-and-expectations-a-systematic-review
#9
REVIEW
Pierre Blanchard, Robert J Volk, Jolie Ringash, Susan K Peterson, Katherine A Hutcheson, Steven J Frank
INTRODUCTION: To enhance the value of care, interventions should aim at improving endpoints that matter to patients. The preferences of head and neck cancer patients regarding treatment outcomes are therefore a major topic for patient-centered research. METHODS: A systematic review (PROSPERO number CRD42016035692) was conducted by searching electronic databases (Medline, Embase, Cochrane, CINAHL) for articles evaluating patient or surrogate preferences in head and neck cancer...
November 2016: Oral Oncology
https://www.readbyqxmd.com/read/27856490/prevalence-and-contents-of-advance-directives-of-patients-with-esrd-receiving-dialysis
#10
Molly A Feely, Daniel Hildebrandt, Jithinraj Edakkanambeth Varayil, Paul S Mueller
BACKGROUND AND OBJECTIVES: ESRD requiring dialysis is associated with increased morbidity and mortality rates, including increased rates of cognitive impairment, compared with the general population. About one quarter of patients receiving dialysis choose to discontinue dialysis at the end of life. Advance directives are intended to give providers and surrogates instruction on managing medical decision making, including end of life situations. The prevalence of advance directives is low among patients receiving dialysis...
November 17, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27849142/a-multicenter-study-of-surrogate-decision-makers-experiences-in-being-approached-for-consent-for-patient-participation-in-research
#11
Karen E A Burns, Clara Juando Prats, Maria Maione, Mary Lanceta, Celia Zubrinich, Lianne Jeffs, Orla M Smith
RATIONALE: Recruitment in critical care research differs from other contexts in important ways: patients lack decision-making capacity, uncertainty exits regarding patient's prognosis, and critical illnesses are often associated with appreciable morbidity and mortality. OBJECTIVES: We aimed to describe surrogate decision makers (SDMs) experiences in being approached for consent for critically ill patients to participate in research. METHODS: A multicenter qualitative study involving 26 SDMs at 5 Canadian centers nested within a multicenter observational study of research recruitment practices...
November 16, 2016: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/27835704/preliminary-identification-of-coping-profiles-relevant-to-surrogate-decision-making-in-the-icu
#12
Jorie M Butler, Eliotte L Hirshberg, Ramona O Hopkins, Emily L Wilson, James F Orme, Sarah J Beesley, Kathryn Kuttler, Samuel M Brown
OBJECTIVE: The Intensive Care Unit (ICU) is a stressful environment for families of critically ill patients and these individuals are at risk to develop persistent psychological morbidity. Our study objective was to identify individual differences in coping with stress and information presentation preferences of respondents exposed to a simulated ICU experience. METHODS: Participants were recruited from a university and two community populations. Participants completed questionnaires that measured demographic information and characteristics that may be relevant to an individual's ICU experience...
2016: PloS One
https://www.readbyqxmd.com/read/27833208/is-tube-feeding-futile-in-advanced-dementia
#13
Matthew C Lynch
It is controversial whether tube feeding in people with dementia improves nutritional status or prolongs survival. Guidelines published by several professional societies cite observational studies that have shown no benefit and conclude that tube feeding in patients with advanced dementia should be avoided. However, all studies on tube feeding in dementia have major methodological flaws that invalidate their findings. The present evidence is not sufficient to justify general guidelines. Patients with advanced dementia represent a very heterogeneous group, and evidence demonstrates that some patients with dementia benefit from tube feeding...
August 2016: Linacre Quarterly
https://www.readbyqxmd.com/read/27802950/the-family-navigator-a-pilot-intervention-to-support-intensive-care-unit-family-surrogates
#14
Alexia M Torke, Lucia D Wocial, Shelley A Johns, Greg A Sachs, Christopher M Callahan, Gabriel T Bosslet, James E Slaven, Susan M Perkins, Susan E Hickman, Kianna Montz, Emily S Burke
BACKGROUND: Communication problems between family surrogates and intensive care unit (ICU) clinicians have been documented, but few interventions are effective. Nurses have the potential to play an expanded role in ICU communication and decision making. OBJECTIVES: To conduct a pilot randomized controlled trial of the family navigator (FN), a distinct nursing role to address family members' unmet communication needs early in an ICU stay. METHODS: An interprofessional team developed the FN protocol...
November 2016: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/27780889/decision-making-on-behalf-of-people-living-with-dementia-how-do-surrogates-decision-makers-decide
#15
Deirdre Fetherstonhaugh, Linda McAuliffe, Michael Bauer, Chris Shanley
BACKGROUND: For people living with dementia, the capacity to make important decisions about themselves diminishes as their condition advances. As a result, important decisions (affecting lifestyle, medical treatment and end of life) become the responsibility of someone else, as the surrogate decision-maker. This study investigated how surrogate decision-makers make important decisions on behalf of a person living with dementia. METHODS: Semi-structured interviews were conducted with 34 family members who had formally or informally taken on the role of surrogate decision-maker...
October 25, 2016: Journal of Medical Ethics
https://www.readbyqxmd.com/read/27776894/end-of-life-euthanasia-and-assisted-suicide-an-update-on-the-situation-in-france
#16
REVIEW
R Aubry
On February 2, 2016, the French parliament adopted legislation creating new rights for the terminally ill. The text modifies and reinforces the rights of patients to end-of-life care and strengthens the status of surrogate decision makers. Under the new regulations, advance directives become legally binding though not unenforceable. Two types of advance directives are distinguished depending on whether the person is suffering or not from a serious illness when drafting them. The attending physician must abide by the patient's advance directives except in three situations: there is a life-threatening emergency; the directives are manifestly inappropriate; the directives are not compatible with the patient's medical condition...
December 2016: Revue Neurologique
https://www.readbyqxmd.com/read/27765378/a-systematic-review-of-effectiveness-of-decision-aids-to-assist-older-patients-at-the-end-of-life
#17
Magnolia Cardona-Morrell, Gustavo Benfatti-Olivato, Jesse Jansen, Robin M Turner, Diana Fajardo-Pulido, Ken Hillman
OBJECTIVE: To describe the range of decision aids (DAs) available to enable informed choice for older patients at the end of life and assess their effectiveness or acceptability. METHODS: Search strategy covered PubMed, Scopus, Ovid MEDLINE, EMBASE, EBM Reviews, CINAHL and PsycInfo between 1995 and 2015. The quality criteria framework endorsed by the International Patient Decision Aids Standards (IPDAS) was used to assess usefulness. RESULTS: Seventeen DA interventions for patients, their surrogates or health professionals were included...
October 11, 2016: Patient Education and Counseling
https://www.readbyqxmd.com/read/27746210/perspective-and-priorities-for-improvement-of-parathyroid-hormone-pth-measurement-a-view-from-the-ifcc-working-group-for-pth
#18
Catharine M Sturgeon, Stuart Sprague, Alison Almond, Etienne Cavalier, William D Fraser, Alicia Schimnich-Algeciras, Ravinder Singh, Jean-Claude Souberbielle, Hubert W Vesper
Parathyroid hormone (PTH) measurement in serum or plasma is a necessary tool for the exploration of calcium/phosphorus disorders, and is widely used as a surrogate marker to assess skeletal and mineral disorders associated with chronic kidney disease (CKD), referred to as CKD-bone mineral disorders (CKD-BMD). CKD currently affects >10% of the adult population in the United States and represents a major health issue worldwide. Disturbances in mineral metabolism and fractures in CKD patients are associated with increased morbidity and mortality...
October 13, 2016: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/27741304/simplified-acute-physiology-score-ii-as-predictor-of-mortality-in-intensive-care-units-a-decision-curve-analysis
#19
Jérôme Allyn, Cyril Ferdynus, Michel Bohrer, Cécile Dalban, Dorothée Valance, Nicolas Allou
BACKGROUND: End-of-life decision-making in Intensive care Units (ICUs) is difficult. The main problems encountered are the lack of a reliable prediction score for death and the fact that the opinion of patients is rarely taken into consideration. The Decision Curve Analysis (DCA) is a recent method developed to evaluate the prediction models and which takes into account the wishes of patients (or surrogates) to expose themselves to the risk of obtaining a false result. Our objective was to evaluate the clinical usefulness, with DCA, of the Simplified Acute Physiology Score II (SAPS II) to predict ICU mortality...
2016: PloS One
https://www.readbyqxmd.com/read/27720790/validation-of-the-family-inpatient-communication-survey
#20
Alexia M Torke, Patrick Monahan, Christopher M Callahan, Paul R Helft, Greg A Sachs, Lucia D Wocial, James E Slaven, Kianna Montz, Lev Inger, Emily S Burke
CONTEXT: Although many family members who make surrogate decisions report problems with communication, there is no validated instrument to accurately measure surrogate/clinician communication for older adults in the acute hospital setting. OBJECTIVES: The objective of this study was to validate a survey of surrogate-rated communication quality in the hospital that would be useful to clinicians, researchers, and health systems. METHODS: After expert review and cognitive interviewing (n = 10 surrogates), we enrolled 350 surrogates (250 development sample and 100 validation sample) of hospitalized adults aged 65 years and older from three hospitals in one metropolitan area...
October 5, 2016: Journal of Pain and Symptom Management
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