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Clinical Decision System

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https://www.readbyqxmd.com/read/28546052/status-report-from-norway-implementation-of-patient-involvement-in-norwegian-health-care
#1
Jürgen Kasper, Anne Regine Lager, Markus Rumpsfeld, Simone Kienlin, Kristine Hoel Smestad, Tone Bråthen, Holly Ankell, Tore Knutsen, Rune Kløvtveit, Pål Gulbrandsen, Per Olav Vandvik, Anja Fog Heen, Signe Flottorp, Geir Tollåli, Øystein Eiring
Norway has traditionally high standards regarding civil rights particularly emphasizing equal access to societal resources including health care. This background and the health care system's centralized national organization make it perfectly suited for implementation of shared decision making (SDM). In recent years, great efforts have been made by policy- makers, regional health authorities and not least the patients to facilitate a process of change in health communication culture. SDM is currently even given highest priority in health care strategies on all system levels...
May 22, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28546050/shared-decision-making-in-argentina-in-2017
#2
Mariela Barani, Karin Kopitowski, Carolina Carrara, María Victoria Ruiz Yanzi
Argentina is a high-middle income country located in Southern South America with an estimated population of 44 million inhabitants. The epidemiological profile of the population is characterised by an increase of non-communicable diseases. The health system is heterogeneous, fragmented and loosely integrated. There are no unified research agenda or government initiatives encouraging the implementation of and research on Shared Decision-Making (SDM). Progress has been made lately to respect patient autonomy through the enactment of the 'Patients' Rights Act', which expressly enshrines the right of patients to get information as a key element of decision-making...
May 22, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28545598/indonesian-dengue-burden-estimates-review-of-evidence-by-an-expert-panel
#3
T Y M Wahyono, J Nealon, S Beucher, A Prayitno, A Moureau, S Nawawi, H Thabrany, M Nadjib
Routine, passive surveillance systems tend to underestimate the burden of communicable diseases such as dengue. When empirical methods are unavailable, complimentary opinion-based or extrapolative methods have been employed. Here, an expert Delphi panel estimated the proportion of dengue captured by the Indonesian surveillance system, and associated health system parameters. Following presentation of medical and epidemiological data and subsequent discussions, the panel made iterative estimates from which expansion factors (EF), the ratio of total:reported cases, were calculated...
May 26, 2017: Epidemiology and Infection
https://www.readbyqxmd.com/read/28544391/the-experience-sampling-method-as-an-mhealth-tool-to-support-self-monitoring-self-insight-and-personalized-health-care-in-clinical-practice
#4
Jim van Os, Simone Verhagen, Anne Marsman, Frenk Peeters, Maarten Bak, Machteld Marcelis, Marjan Drukker, Ulrich Reininghaus, Nele Jacobs, Tineke Lataster, Claudia Simons, Richel Lousberg, Sinan Gülöksüz, Carsten Leue, Peter C Groot, Wolfgang Viechtbauer, Philippe Delespaul
BACKGROUND: The experience sampling method (ESM) builds an intensive time series of experiences and contexts in the flow of daily life, typically consisting of around 70 reports, collected at 8-10 random time points per day over a period of up to 10 days. METHODS: With the advent of widespread smartphone use, ESM can be used in routine clinical practice. Multiple examples of ESM data collections across different patient groups and settings are shown and discussed, varying from an ESM evaluation of a 6-week randomized trial of mindfulness, to a twin study on emotion dynamics in daily life...
May 23, 2017: Depression and Anxiety
https://www.readbyqxmd.com/read/28543961/automated-low-contrast-pattern-recognition-algorithm-for-magnetic-resonance-image-quality-assessment
#5
Morgan Ehman, Zhonghao Bao, Scott A Stiving, Mallik Kasam, Dianna Lanners, Teresa Peterson, Renee Jonsgaard, Rickey Carter, Kiaran P McGee
PURPOSE: Low contrast (LC) detectability is a common test criterion for diagnostic radiologic quality control (QC) programs. Automation of this test is desirable in order to reduce human variability and to speed up analysis. However, automation is challenging due to the complexity of the human visual perception system and the ability to create algorithms that mimic this response. This paper describes the development and testing of an automated LC detection algorithm for use in the analysis of magnetic resonance (MR) images of the American College of Radiology (ACR) QC phantom...
May 24, 2017: Medical Physics
https://www.readbyqxmd.com/read/28542627/predictive-features-of-chronic-kidney-disease-in-atypical-haemolytic-uremic-syndrome
#6
Matthieu Jamme, Quentin Raimbourg, Dominique Chauveau, Amélie Seguin, Claire Presne, Pierre Perez, Pierre Gobert, Alain Wynckel, François Provôt, Yahsou Delmas, Christiane Mousson, Aude Servais, Laurence Vrigneaud, Agnès Veyradier, Eric Rondeau, Paul Coppo
Chronic kidney disease (CKD) is a frequent and serious complication of atypical haemolytic uremic syndrome (aHUS). We aimed to develop a simple accurate model to predict the risk of renal dysfunction in aHUS based on clinical and biological features available at hospital admission. Renal function at 1-year follow-up, based on an estimated glomerular filtration rate < 60mL/min/1.73m2 as assessed by the Modification of Diet in Renal Disease equation, was used as an indicator of significant CKD. Prospectively collected data from a cohort of 156 aHUS patients who did not receive eculizumab were used to identify predictors of CKD...
2017: PloS One
https://www.readbyqxmd.com/read/28542516/evaluation-of-the-systemic-micro-and-macrovasculature-in-stable-angina-a-case-control-study
#7
Ulf Neisius, Erin Olson, Sabrina H Rossi, Hagar A Ibrahim, Gemma Currie, Anna F Dominiczak, Christian Delles
AIMS: The diagnosis of stable angina involves the use of probability estimates based on clinical presentation, age, gender and cardiovascular risk factors. In view of the link between the cardiac and systemic vasculature we tested whether non-invasive measures of systemic micro- and macrovascular structure and function differentiate between individuals with flow-limiting coronary artery disease (CAD) and those with normal coronary arteries (NCA). METHODS AND RESULTS: We recruited 84 patients undergoing elective coronary angiography for investigation of symptoms of stable angina...
2017: PloS One
https://www.readbyqxmd.com/read/28541749/multilevel-barriers-to-the-successful-implementation-of-lung-cancer-screening-why-does-it-have-to-be-so-hard
#8
Lisa Carter-Harris, Michael K Gould
The U.S. Preventive Services Task Force recommends lung cancer screening with low-dose computed tomography for long-term current and former smokers. However, lung cancer screening and its implementation is a complex issue. Screening has associated risks and potential harms that complicate the decision to screen for the patient, add to the already time-constrained clinical encounter for the provider, and present logistical and sociopolitical challenges in creating and implementing lung cancer screening programs for the health care system...
May 25, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28541137/clinical-use-of-continuous-glucose-monitoring-in-adults-with-type-2-diabetes
#9
Anders L Carlson, Deborah M Mullen, Richard M Bergenstal
Hemoglobin A1c is an excellent population health measure for the risk of vascular complications in diabetes, while continuous glucose monitoring (CGM) is a tool to help personalize a diabetes treatment plan. The value of CGM in individuals with type 1 diabetes (T1D) has been well demonstrated when compared with utilizing self-monitoring of blood glucose (SMBG) to guide treatment decisions. CGM is a tool for patients and clinicians to visualize the important role that diet, exercise, stress management, and the appropriate selection of diabetes medications can have in managing type 2 diabetes (T2D)...
May 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28539192/shared-decision-making-and-the-promise-of-a-respectful-and-equitable-healthcare-system-in-peru
#10
Germán Málaga, Zoila O Romero, Ariana S Málaga, Sofia Cuba-Fuentes
Peru has achieved sustained development in the last two decades. However, despite this achievement, it has not been matched with improvements in the quality of education and health; investment in both sectors is among the lowest in the region. This situation perpetuates huge gaps in infrastructure and also conditions a poor literacy level of the population specifically in health. Currently, there is a fragmented model of patient care, in which the systems are exclusive of each other. They do not cooperate or communicate with each other; and if there is no vertical communication within the system, preventing referral of patients directly from the basic level to the complex level of care when needed...
May 20, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28539115/quad-phased-data-mining-modeling-for-dementia-diagnosis
#11
Sunjoo Bang, Sangjoon Son, Hyunwoong Roh, Jihye Lee, Sungyun Bae, Kyungwon Lee, Changhyung Hong, Hyunjung Shin
BACKGROUND: The number of people with dementia is increasing along with people's ageing trend worldwide. Therefore, there are various researches to improve a dementia diagnosis process in the field of computer-aided diagnosis (CAD) technology. The most significant issue is that the evaluation processes by physician which is based on medical information for patients and questionnaire from their guardians are time consuming, subjective and prone to error. This problem can be solved by an overall data mining modeling, which subsidizes an intuitive decision of clinicians...
May 18, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28538287/cost-utility-analysis-of-reconstruction-compared-with-primary-amputation-for-patients-with-severe-lower-limb-trauma-in-colombia
#12
Mateo Ceballos, Carlos Oliver Valderrama, Luis Esteban Orozco, Laura Sánchez, Juan Pablo Valderrama, Luz Helena Lugo
BACKGROUND: To establish, from the health system perspective, the cost-utility relationship of limb reconstruction compared with primary amputation for patients over 32 years with grade IIIB and IIIC severe lower limb trauma in Colombia, S.A. METHODS: A Markov model was built including different short-term and long-term states that represent the main events that a patient could experience after a lower limb amputation or a reconstruction. A 42-year time horizon was considered for the base case...
May 17, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28538138/factors-leading-to-overutilisation-of-hospital-pathology-testing-the-junior-doctor
#13
William Ericksson, Janine Bothe, Heidi Cheung, Kate Zhang, Simone Kelly
Objective Pathology overutilisation is a significant issue affecting the quality and cost of health care. Because junior medical officers (JMOs) order most pathology tests in the hospital setting, the aim of the present study was to identify the main reasons for hospital pathology overutilisation from the perspective of the JMO.Methods A qualitative method, using focus group methodology, was undertaken. Sixteen JMOs from two hospitals participated in three focus groups. Data were analysed using thematic analysis...
May 25, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28537945/making-sense-of-effective-partnerships-among-senior-leaders-in-the-national-health-service
#14
Mahima Mitra, Timothy Hoff, Paul Brankin, Sue Dopson
BACKGROUND: Changing health care systems depend on strong organizational leadership that realizes the collaborative potential of both physician and nonphysician leaders. PURPOSE: The aim of this study was to seek insight into the everyday health care leader experience by examining 24 physician and nonphysician leaders working in the U.K. National Health Service. We explored (a) how they make sense of and act with respect to specific collaborative tensions in their interactions and (b) which aspects of their everyday leadership contexts heighten the probability for producing and resolving such tensions...
May 22, 2017: Health Care Management Review
https://www.readbyqxmd.com/read/28537422/mindfulness-based-stress-reduction-program-on-chronic-low-back-pain-a-study-investigating-the-impact-on-endocrine-physical-and-psychologic-functioning
#15
Rita B Ardito, Piero Stanley Pirro, Tania S Re, Isabella Bonapace, Valentino Menardo, Emanuela Bruno, Laura Gianotti
OBJECTIVE: To explore the impact of the Mindfulness-Based Stress Reduction (MBSR) program on pain severity and endocrine, physical, and psychologic functioning in patients with chronic low-back pain (CLBP). METHODS: A total of 28 participants were enrolled in the study between January and June 2014; 17 participants were sequentially sampled for an 8-week MBSR program, and 11 were placed on a waitlist control group. Pain severity, quality of life (QOL), global psychologic functioning, and depression were assessed at baseline, at the end of treatment, and 4-5 months post-treatment for both groups...
May 24, 2017: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
https://www.readbyqxmd.com/read/28536089/smart-devices-for-older-adults-managing-chronic-disease-a-scoping-review
#16
REVIEW
Ben Yb Kim, Joon Lee
BACKGROUND: The emergence of smartphones and tablets featuring vastly advancing functionalities (eg, sensors, computing power, interactivity) has transformed the way mHealth interventions support chronic disease management for older adults. Baby boomers have begun to widely adopt smart devices and have expressed their desire to incorporate technologies into their chronic care. Although smart devices are actively used in research, little is known about the extent, characteristics, and range of smart device-based interventions...
May 23, 2017: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/28535102/why-value-framework-assessments-arrive-at-different-conclusions-a-multiple-myeloma-case-study
#17
Kimberly Westrich, Lisabeth Buelt, Robert W Dubois
As the United States transitions from a volume-based health care system to one that rewards value, new frameworks are emerging to help patients, providers, and payers assess the value of medical services and biopharmaceutical products. These value assessment frameworks are intended to support various types of health care decision making. They have the potential to substantially affect patients, whether as tools for shared decision making with their doctors, as an input to care pathways used by providers, or through payer use of the frameworks to make coverage or reimbursement decisions...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28533059/graft-versus-host-disease-of-the-gut-a-histologic-activity-grading-system-and-validation
#18
David Myerson, Gideon Steinbach, Ted A Gooley, Howard M Shulman
The pathologic interpretation of gut biopsies in hematopoietic cell transplant recipients to assess graft-versus-disease (GVHD) is well accepted and supplements clinical and endoscopic findings. However, the histologic activity grading of GVHD is controversial, with attempts to predict prognosis or response to treatment largely unsuccessful. GVHD is being diagnosed earlier in its course, raising the possibility that the pathologic grading system can be profitably modified. We have developed a histologic activity grading system designed to replace the commonly used modified-Lerner grading systems...
May 19, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28532698/validation-of-the-mayo-clinic-staging-system-in-determining-prognoses-of-patients-with-perihilar-cholangiocarcinoma
#19
Robert J S Coelen, Marcia P Gaspersz, Tim A Labeur, Jeroen L A van Vugt, Susan van Dieren, François E J A Willemssen, Chung Y Nio, Jan N M IJzermans, Heinz-Josef Klümpen, Bas Groot Koerkamp, Thomas M van Gulik
BACKGROUND AND AIMS: Most systems for staging perihilar cholangiocarcinoma (PHC) have been developed for the minority of patients with resectable disease. The recently developed Mayo Clinic system for staging PHC requires only clinical and radiological variables, but has not yet been validated. We performed a retrospective study to validate the Mayo Clinic staging system. METHODS: We identified consecutive patients with suspected PHC evaluated and treated at 2 tertiary centers in The Netherlands, from January 2002 through December 2014...
May 19, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28532511/challenges-and-strategies-for-implementing-genomic-services-in-diverse-settings-experiences-from-the-implementing-genomics-in-practice-ignite-network
#20
Nina R Sperber, Janet S Carpenter, Larisa H Cavallari, Laura J Damschroder, Rhonda M Cooper-DeHoff, Joshua C Denny, Geoffrey S Ginsburg, Yue Guan, Carol R Horowitz, Kenneth D Levy, Mia A Levy, Ebony B Madden, Michael E Matheny, Toni I Pollin, Victoria M Pratt, Marc Rosenman, Corrine I Voils, Kristen W Weitzel, Russell A Wilke, R Ryanne Wu, Lori A Orlando
BACKGROUND: To realize potential public health benefits from genetic and genomic innovations, understanding how best to implement the innovations into clinical care is important. The objective of this study was to synthesize data on challenges identified by six diverse projects that are part of a National Human Genome Research Institute (NHGRI)-funded network focused on implementing genomics into practice and strategies to overcome these challenges. METHODS: We used a multiple-case study approach with each project considered as a case and qualitative methods to elicit and describe themes related to implementation challenges and strategies...
May 22, 2017: BMC Medical Genomics
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