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https://www.readbyqxmd.com/read/28440855/accuracy-of-current-diagnostic-criteria-for-acute-bacterial-infection-in-older-adults-in-the-emergency-department
#1
Jeffrey M Caterino, Robert Leininger, David M Kline, Lauren T Southerland, Salman Khaliqdina, Christopher W Baugh, Daniel J Pallin, Kurt B Stevenson
OBJECTIVES: To compare the accuracy of the Loeb criteria, emergency department (ED) physicians' diagnoses, and Centers for Disease Control and Prevention (CDC) guidelines for acute bacterial infection in older adults with a criterion standard expert review. DESIGN: Prospective, observational study. SETTING: Urban, tertiary-care ED. PARTICIPANTS: Individuals aged 65 and older in the ED, excluding those who were incarcerated, underwent a trauma, did not speak English, or were unable to consent...
April 25, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28427475/protocol-a-systematic-review-of-studies-developing-and-or-evaluating-search-strategies-to-identify-prognosis-studies
#2
Nadia Corp, Joanne L Jordan, Jill A Hayden, Emma Irvin, Robin Parker, Andrea Smith, Danielle A van der Windt
BACKGROUND: Prognosis research is on the rise, its importance recognised because chronic health conditions and diseases are increasingly common and costly. Prognosis systematic reviews are needed to collate and synthesise these research findings, especially to help inform effective clinical decision-making and healthcare policy. A detailed, comprehensive search strategy is central to any systematic review. However, within prognosis research, this is challenging due to poor reporting and inconsistent use of available indexing terms in electronic databases...
April 20, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28419267/a-national-survey-assessing-the-number-of-records-allowed-open-in-electronic-health-records-at-hospitals-and-ambulatory-sites
#3
Jason S Adelman, Matthew A Berger, Amisha Rai, William L Galanter, Bruce L Lambert, Gordon D Schiff, David K Vawdrey, Robert A Green, Hojjat Salmasian, Ross Koppel, Clyde B Schechter, Jo R Applebaum, William N Southern
To reduce the risk of wrong-patient errors, safety experts recommend limiting the number of patient records providers can open at once in electronic health records (EHRs). However, it is unknown whether health care organizations follow this recommendation or what rationales drive their decisions. To address this gap, we conducted an electronic survey via 2 national listservs. Among 167 inpatient and outpatient study facilities using EHR systems designed to open multiple records at once, 44.3% were configured to allow ≥3 records open at once (unrestricted), 38...
April 17, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28389856/identification-and-management-of-comorbidity-in-psoriatic-arthritis-evidence-and-expert-based-recommendations-from-a-multidisciplinary-panel-from-spain
#4
Juan Carlos Torre-Alonso, Loreto Carmona, Mireia Moreno, Eva Galíndez, Jesús Babío, Pedro Zarco, Luis Linares, Eduardo Collantes-Estevez, Manuel Fernández Barrial, Juan Carlos Hermosa, Pablo Coto, Carmen Suárez, Raquel Almodóvar, Jesús Luelmo, Santos Castañeda, Jordi Gratacós
The objective is to establish recommendations, based on evidence and expert opinion, for the identification and management of comorbidities in patients with psoriatic arthritis (PsA). The following techniques were applied: discussion group, systematic review, and Delphi survey for agreement. A panel of professionals from four specialties defined the users, the sections of the document, possible recommendations, and what systematic reviews should be performed. A second discussion was held with the results of the systematic reviews...
April 7, 2017: Rheumatology International
https://www.readbyqxmd.com/read/28388335/agreement-between-two-methods-for-retrospective-assessment-of-occupational-exposure-intensity-to-six-chlorinated-solvents-data-from-the-national-birth-defects-prevention-study
#5
Candice Y Johnson, Carissa M Rocheleau, Misty J Hein, Martha A Waters, Patricia A Stewart, Christina C Lawson, Jennita Reefhuis
The wide variety of jobs encountered in population-based studies makes retrospective exposure assessment challenging in occupational epidemiology. In this analysis, two methods for estimating exposure intensity to chlorinated solvents are compared: rated (assigned by an expert rater) and modeled (assigned using statistical models). Estimates of rated and modeled intensities were compared for jobs held by mothers participating in the National Birth Defects Prevention Study with possible exposure to six chlorinated solvents: carbon tetrachloride, chloroform, methylene chloride, perchloroethylene, 1,1,1-trichloroethane, and trichloroethylene...
May 2017: Journal of Occupational and Environmental Hygiene
https://www.readbyqxmd.com/read/28369935/phase-2-of-catalise-a-multinational-and-multidisciplinary-delphi-consensus-study-of-problems-with-language-development-terminology
#6
Dorothy V M Bishop, Margaret J Snowling, Paul A Thompson, Trisha Greenhalgh
BACKGROUND: Lack of agreement about criteria and terminology for children's language problems affects access to services as well as hindering research and practice. We report the second phase of a study using an online Delphi method to address these issues. In the first phase, we focused on criteria for language disorder. Here we consider terminology. METHODS: The Delphi method is an iterative process in which an initial set of statements is rated by a panel of experts, who then have the opportunity to view anonymised ratings from other panel members...
March 30, 2017: Journal of Child Psychology and Psychiatry, and Allied Disciplines
https://www.readbyqxmd.com/read/28363925/methods-to-decrease-variability-in-histological-scoring-in-placentas-from-a-cohort-of-preterm-infants
#7
Jennifer K Straughen, Dawn P Misra, Linda M Ernst, Adrian K Charles, Samantha VanHorn, Samiran Ghosh, Irina Buhimschi, Catalin Buhimschi, George Divine, Carolyn M Salafia
OBJECTIVE: Reliable semiquantitative assessment of histological placental acute inflammation is problematic, even among experts. Tissue samples in histology slides often show variability in the extent and location of neutrophil infiltrates. We sought to determine whether the variability in pathologists' scoring of neutrophil infiltrates in the placenta could be reduced by the use of 'regions of interest' (ROIs) that break the sample into smaller components. DESIGN: ROIs were identified within stained H&E slides from a cohort of 56 women...
March 31, 2017: BMJ Open
https://www.readbyqxmd.com/read/28343772/report-of-the-who-technical-consultation-on-the-effect-of-maternal-influenza-and-influenza-vaccination-on-the-developing-fetus-montreal-canada-september-30-october-1-2015
#8
Deshayne B Fell, Zulfiqar A Bhutta, Jennifer A Hutcheon, Ruth A Karron, Marian Knight, Michael S Kramer, Arnold S Monto, Geeta K Swamy, Justin R Ortiz, David A Savitz
In 2012, the World Health Organization (WHO) released a position paper on influenza vaccination recommending that pregnant women have the highest priority for seasonal vaccination in countries where the initiation or expansion of influenza immunization programs is under consideration. Although the primary goal of the WHO recommendation is to prevent influenza illness in pregnant women, the potential benefits of maternal immunization in protecting young infants are also recognized. The extent to which maternal influenza vaccination may prevent adverse birth outcomes such as preterm birth or small-for-gestational-age birth, however, is unclear as available studies are in disagreement...
March 23, 2017: Vaccine
https://www.readbyqxmd.com/read/28336737/comparative-effectiveness-of-different-wound-dressings-for-patients-with-partial-thickness-burns-study-protocol-of-a-systematic-review-and-a-bayesian-framework-network-meta-analysis
#9
Qiong Jiang, Zhao-Hong Chen, Shun-Bin Wang, Xiao-Dong Chen
INTRODUCTION: Selecting a suitable wound dressing for patients with partial-thickness burns (PTBs) is important in wound care. However, the comparative effectiveness of different dressings has not been studied. We report the protocol of a network meta-analysis designed to combine direct and indirect evidence of wound dressings in the management of PTB. METHODS AND ANALYSIS: We will search for randomised controlled trials (RCTs) evaluating the wound-healing effect of a wound dressing in the management of PTB...
March 22, 2017: BMJ Open
https://www.readbyqxmd.com/read/28286523/interobserver-agreement-in-magnetic-resonance-of-the-sacroiliac-joints-in-patients-with-spondyloarthritis
#10
Juan C Rueda, Sofia Arias-Correal, Andres Y Vasquez, Enrique Calvo, Paola Peña, Marlon Porras, Jose-Ignacio Angarita, Eugenia-Lucia Saldarriaga, Ana M Santos, John Londono
Background. Clinical, laboratory, and radiologic parameters are used for diagnosis and classification of spondyloarthritis (SpA). Magnetic resonance imaging (MRI) of sacroiliac (SI) joints is being increasingly used to detect early sacroiliitis. We decided to evaluate the interobserver agreement in MRI findings of SI joints of SpA patients between a local radiologist, a rheumatologist, and an expert radiologist in musculoskeletal diseases. Methods. 66 MRI images of the SI joints of patients with established diagnosis of SpA were evaluated...
2017: International Journal of Rheumatology
https://www.readbyqxmd.com/read/28277255/recommendations-for-the-use-of-ultrasound-and-magnetic-resonance-in-patients-with-spondyloarthritis-including-psoriatic-arthritis-and-patients-with-juvenile-idiopathic-arthritis
#11
Jacqueline Uson, Estibaliz Loza, Ingrid Möller, Carlos Acebes, Jose Luis Andreu, Enrique Batlle, Ángel Bueno, Paz Collado, Juan Manuel Fernández-Gallardo, Carlos González, Mercedes Jiménez Palop, María Pilar Lisbona, Pilar Macarrón, Joan Maymó, Jose Antonio Narváez, Victoria Navarro-Compán, Jesús Sanz, M Piedad Rosario, Esther Vicente, Esperanza Naredo
OBJECTIVE: To develop evidence-based recommendations on the use of ultrasound (US) and magnetic resonance imaging in patients with spondyloarthritis, including psoriatic arthritis, and juvenile idiopathic arthritis. METHODS: Recommendations were generated following a nominal group technique. A panel of experts (15 rheumatologists and 3 radiologists) was established in the first panel meeting to define the scope and purpose of the consensus document, as well as chapters, potential recommendations and systematic literature reviews (we used and updated those from previous EULAR documents)...
October 27, 2016: Reumatología Clinica
https://www.readbyqxmd.com/read/28275992/follow-up-intervals-in-patients-with-cushing-s-disease-recommendations-from-a-panel-of-experienced-pituitary-clinicians
#12
Eliza B Geer, Alejandro Ayala, Vivien Bonert, John D Carmichael, Murray B Gordon, Laurence Katznelson, Ekaterina Manuylova, Ismat Shafiq, Vijaya Surampudi, Ronald S Swerdloff, Michael S Broder, Dasha Cherepanov, Marianne Eagan, Jackie Lee, Qayyim Said, Maureen P Neary, Beverly M K Biller
PURPOSE: Follow-up guidelines are needed to assess quality of care and to ensure best long-term outcomes for patients with Cushing's disease (CD). The purpose of this study was to assess agreement by experts on recommended follow-up intervals for CD patients at different phases in their treatment course. METHODS: The RAND/UCLA modified Delphi process was used to assess expert consensus. Eleven clinicians who regularly manage CD patients rated 79 hypothetical patient scenarios before and after ("second round") an in-person panel discussion to clarify definitions...
March 9, 2017: Pituitary
https://www.readbyqxmd.com/read/28242031/is-the-french-criminal-psychiatric-assessment-in-crisis
#13
J Guivarch, M-D Piercecchi-Marti, D Glezer, V Murdymootoo, J-M Chabannes, F Poinso
The criminal psychiatric assessment in France seems to be facing growing criticism related to disagreements between experts and, on the other hand, a lack of interest of psychiatrists for the assessment. We start by explaining the current framework of the criminal psychiatric assessment in France, which differs from the assessment used in English-speaking countries, where Roman law applies. Then, we will describe the disagreements through a literature review and two clinical vignettes. Finally, we will try to understand the causes of discrepancies between experts and the reasons for a supposed lack of interest of the psychiatrists for the expertise...
February 24, 2017: International Journal of Law and Psychiatry
https://www.readbyqxmd.com/read/28188689/sentinel-node-biopsy-for-prostate-cancer-report-from-a-consensus-panel-meeting
#14
Henk G van der Poel, Esther M Wit, Cenk Acar, Nynke S van den Berg, Fijs W B van Leeuwen, Renato A Valdes Olmos, Alexander Winter, Friedhelm Wawroschek, Fredrik Liedberg, Steven Maclennan, Thomas Lam
OBJECTIVE: To explore the evidence and knowledge gaps in sentinel node biopsy (SNB) in prostate cancer by a consensus panel of experts. METHODS: A two-round Delphi survey among experts was followed by a consensus panel meeting of 16 experts in February 2016. Agreement voting was performed using the RAND/University of California, Los Angeles Appropriateness Methodology on 150 statements in 9 domains. The disagreement index based on the interpercentile range-adjusted for symmetry score was used to assess consensus and non-consensus among panel members RESULTS: Consensus was obtained on 91 of 150 (61%) statements...
February 10, 2017: BJU International
https://www.readbyqxmd.com/read/28145427/variability-in-assigning-pathogenicity-to-incidental-findings-insights-from-ldlr-sequence-linked-to-the-electronic-health-record-in-1013-individuals
#15
Maya S Safarova, Eric W Klee, Linnea M Baudhuin, Erin M Winkler, Michelle L Kluge, Suzette J Bielinski, Janet E Olson, Iftikhar J Kullo
Knowledge of variant pathogenicity is key to implementing genomic medicine. We describe variability between expert reviewers in assigning pathogenicity to sequence variants in LDLR, the causal gene in the majority of cases of familial hypercholesterolemia. LDLR was sequenced on the Illumina HiSeq platform (average read depth >200 × ) in 1013 Mayo Biobank participants recruited from 2012 to 2013. Variants with a minor allele frequency (MAF) <5% predicted to be functional or referenced in HGMD (Human Gene Mutation Database) or NCBI-ClinVar databases were reviewed...
April 2017: European Journal of Human Genetics: EJHG
https://www.readbyqxmd.com/read/28135804/the-interaction-between-equipoise-and-logistics-in-clinical-trials-a-case-study
#16
Meredith G Warshaw, Vincent J Carey, Elizabeth J McFarland, Liza Dawson, Elaine Abrams, Ann Melvin, Lee Fairlie, Hans Spiegel, Jonathan Jay, Allison L Agwu
INTRODUCTION: Equipoise is usually discussed as an ethical issue in clinical trials. However, it also has practical implications. BACKGROUND: Clinical equipoise is usually construed to mean uncertainty or disagreement among the expert clinician community. However, an individual physician's sense of equipoise may vary by location, based on the local standard of care or availability of specific treatment options, and these differences can affect providers' willingness to enroll participants into clinical trials...
January 1, 2017: Clinical Trials: Journal of the Society for Clinical Trials
https://www.readbyqxmd.com/read/28113887/aggnet-deep-learning-from-crowds-for-mitosis-detection-in-breast-cancer-histology-images
#17
Shadi Albarqouni, Christoph Baur, Felix Achilles, Vasileios Belagiannis, Stefanie Demirci, Nassir Navab
The lack of publicly available ground-truth data has been identified as the major challenge for transferring recent developments in deep learning to the biomedical imaging domain. Though crowdsourcing has enabled annotation of large scale databases for real world images, its application for biomedical purposes requires a deeper understanding and hence, more precise definition of the actual annotation task. The fact that expert tasks are being outsourced to non-expert users may lead to noisy annotations introducing disagreement between users...
February 11, 2016: IEEE Transactions on Medical Imaging
https://www.readbyqxmd.com/read/28101941/key-messages-for-communicating-information-about-brca1-and-brca2-to-women-with-breast-or-ovarian-cancer-consensus-across-health-professionals-and-service-users
#18
Chris Jacobs, Gabriella Pichert, Jackie Harris, Kathy Tucker, Susan Michie
BACKGROUND: Genetic testing of cancer predisposing genes will increasingly be needed in oncology clinics to target cancer treatment. This Delphi study aimed to identify areas of agreement and disagreement between genetics and oncology health professionals and service users about the key messages required by women with breast/ovarian cancer who undergo BRCA1/BRCA2 genetic testing and the optimal timing of communicating key messages. METHODS: Participants were 16 expert health professionals specialising in oncology/genetics and 16 service users with breast/ovarian cancer and a pathogenic BRCA1/BRCA2 variant...
January 18, 2017: Psycho-oncology
https://www.readbyqxmd.com/read/28087236/determination-of-the-feasibility-of-a-multicomponent-intervention-program-to-prevent-delirium-in-the-intensive-care-unit-a-modified-rand-delphi-study
#19
Annelies Wassenaar, Mark van den Boogaard, Underpin-Icu Study Group, Lisette Schoonhoven, Peter Pickkers
BACKGROUND: Delirium is common in Intensive Care Unit (ICU) patients and associated with poor outcome. In non-ICU patients a multicomponent intervention program with non-pharmacological interventions has shown to reduce delirium. Currently, there is insufficient evidence regarding the effects of such a program in ICU patients. We developed a draft program based on a review. As most studies were conducted in non-ICU patients, the feasibility of the program in ICU patients needs to be assessed before investigating its effectiveness...
January 10, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/28076488/use-of-tranexamic-acid-in-trauma-patients-an-analysis-of-cost-effectiveness-for-use-in-brazil
#20
REVIEW
Marcelo A Pinto, Jair G da Silva, Aljamir D Chedid, Marcio F Chedid
Introduction: Use of tranexamic acid (TXA) in trauma has been the subject of growing interest by researchers and health professionals. However, there are still several open questions regarding its use. In some aspects medical literature is controversial. The points of disagreement among experts include questions such as: Which patients should receive TXA in trauma? Should treatment be performed in the pre-hospital environment? Is there any need for laboratory parameters before starting TXA treatment? What is the drug safety profile? The main issue on which there is still no basis in literature is: What is the indication for treatment within massive transfusion protocols? Objective: Answer the questions proposed based on critical evaluation of the evidence gathered so far and carry out a study of cost-effectiveness of TXA use in trauma adapted to the Brazilian reality...
November 2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
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