keyword
MENU ▼
Read by QxMD icon Read
search

Clinical judgement

keyword
https://www.readbyqxmd.com/read/27925577/the-role-of-ultrasound-compared-to-biopsy-of-temporal-arteries-in-the-diagnosis-and-treatment-of-giant-cell-arteritis-tabul-a-diagnostic-accuracy-and-cost-effectiveness-study
#1
Raashid Luqmani, Ellen Lee, Surjeet Singh, Mike Gillett, Wolfgang A Schmidt, Mike Bradburn, Bhaskar Dasgupta, Andreas P Diamantopoulos, Wulf Forrester-Barker, William Hamilton, Shauna Masters, Brendan McDonald, Eugene McNally, Colin Pease, Jennifer Piper, John Salmon, Allan Wailoo, Konrad Wolfe, Andrew Hutchings
BACKGROUND: Giant cell arteritis (GCA) is a relatively common form of primary systemic vasculitis, which, if left untreated, can lead to permanent sight loss. We compared ultrasound as an alternative diagnostic test with temporal artery biopsy, which may be negative in 9-61% of true cases. OBJECTIVE: To compare the clinical effectiveness and cost-effectiveness of ultrasound with biopsy in diagnosing patients with suspected GCA. DESIGN: Prospective multicentre cohort study...
November 2016: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/27925274/supplementation-of-a-clinical-trial-by-historical-control-data-is-the-prospect-of-dynamic-borrowing-an-illusion
#2
N W Galwey
There are strong arguments, ethical, logistical and financial, for supplementing the evidence from a new clinical trial using data from previous trials with similar control treatments. There is a consensus that historical information should be down-weighted or discounted relative to information from the new trial, but the determination of the appropriate degree of discounting is a major difficulty. The degree of discounting can be represented by a bias parameter with specified variance, but a comparison between the historical and new data gives only a poor estimate of this variance...
December 7, 2016: Statistics in Medicine
https://www.readbyqxmd.com/read/27920243/between-the-flags-implementing-a-safety-net-system-at-scale-to-recognise-and-manage-deteriorating-patients-in-the-new-south-wales-public-health-system
#3
Charles Pain, Malcolm Green, Colette Duff, Deborah Hyland, Annette Pantle, Kimberley Fitzpatrick, Cliff Hughes
QUALITY PROBLEM: In 2005, the Clinical Excellence Commission (CEC) found that unrecognised patient deterioration remained an important problem in New South Wales (NSW) public hospitals. INITIAL ASSESSMENT: The challenge was to design and implement an effective and sustainable safety-net system in all 225 NSW public hospitals. DESIGNING A SOLUTION: The CEC's system was designed in collaboration with a broad coalition of partners, including clinicians, managers, system administrators and collaborating agencies...
December 4, 2016: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/27920229/octreotide-use-in-post-cardiac-surgery-chylothorax-a-12-year-perspective
#4
Abdulrazaq Sheikh Aljazairi, Tauhid Ahmed Bhuiyan, Abdullah Hasan Alwadai, Rayd Abdulaziz Almehizia
BACKGROUND: Chylothorax following cardiothoracic surgery is a rare condition in pediatric patients with significant morbidity and mortality. Pharmacological management with octreotide suggests possible efficacy; however, current evidence is inadequate. The objective of this study was to assess the safety and efficacy of octreotide as a therapeutic option in this clinical setting. METHODS: This was a 12-year single-center retrospective cohort study of all patients (birth to 18-years old) who received octreotide for management of post-cardiac surgery chylothorax between January 2003 to August 2015...
December 5, 2016: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/27916497/the-diabeates-project-perceptual-affective-and-psychophysiological-effects-of-music-and-music-video-in-a-clinical-exercise-setting
#5
Jasmin C Hutchinson, Costas I Karageorghis, Jessica D Black
OBJECTIVES: The purpose of this study was to examine the effects of music and music-video on perceptual (attentional focus, rated perceived exertion), affective (affective valence and enjoyment) and psychophysiological (blood glucose, heart rate) variables in outpatients attending a diabetes exercise clinic. METHODS: Participants were 24 females (age = 66.0 ± 8.5 years) enrolled in a supervised exercise program for people with diabetes. They engaged in mixed-modality exercise sessions that included a standardized combination of flexibility, aerobic and resistance activities under conditions of music, music-video and control...
December 1, 2016: Canadian Journal of Diabetes
https://www.readbyqxmd.com/read/27909591/mobbing-exposure-of-anaesthesiology-residents-in-turkey
#6
Gülnihal Aykut, Esra Mercanoğlu Efe, Selcan Bayraktar, Sinem Şentürk, İrem Başeğmez, Özlem Özkumit, Elmas Kabak, Belgin Yavaşçaoğlu, Hülya Bilgin
OBJECTIVE: In recent years, psychological problems that are caused by working conditions, like burn out syndrome, are more commonly observed. In our study, we aimed to evaluate mobbing exposure, factors causing mobbing and precautions for mobbing in residency students who are educated in anaesthesiology and reanimation clinics in Turkey. METHODS: After obtaining consent from the ethics committee, we sent our questionnaires to the secretariats of the departments by postal mail...
August 2016: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/27902536/patients-on-psychotropic-medications-and-herbal-supplement-combinations-clinical-considerations
#7
Siu W Tang, Wayne Tang, Brian E Leonard
Populations using herbs and herbal preparations are widespread and growing. As many herbal ingredients exert actions on psychotropic drug targets, psychiatrists should be well informed and aware of potential drug-drug interactions in clinical practice. Reliable and clinically useful information in this area, however, is fragmented, if not deficient. This paper reviewed the clinical aspects of herb-drug interactions, focusing in particular on the monoamine oxidase enzyme and P450 cytochrome enzyme-inhibitory properties of herbs and their potential interference with psychotropic drug actions and clinical judgement...
November 29, 2016: International Clinical Psychopharmacology
https://www.readbyqxmd.com/read/27888294/total-hip-arthroplasty-with-dual-mobility-cup-in-osteonecrosis-of-the-femoral-head-in-young-patients-over-ten-years-of-follow-up
#8
Pierre Martz, Alexandre Maczynski, Sebastien Elsair, Ludovic Labattut, Brice Viard, Emmanuel Baulot
Osteonecrosis of the femoral head affects mainly young patients with high functional needs this increases the risk of dislocation. Dual mobility cups known for low rate of dislocation and high mobility range seems indicated. We evaluate functional efficiency, survival and dislocation rate of dual mobility cup for total hip arthroplasty for osteonecrosis in young patients. Monocentric retrospective clinical study, from 2000 to 2008. With a clinical analysis in pre-operative and over ten years of follow-up of one cohort of patients under 55 years old with an indication of THA for ONFH...
November 25, 2016: International Orthopaedics
https://www.readbyqxmd.com/read/27881586/iatrogenic-parafoveal-macular-hole-following-nd-yag-posterior-hyaloidotomy-for-premacular-haemorrhage
#9
Ravi Bypareddy, Rohan Chawla, Shorya Vardhan Azad, Brijesh Takkar
Premacular sub-internal limiting membrane (sub-ILM) haemorrhage is a known cause of sudden profound loss of vision. Neodymium-doped yttrium aluminium garnet (ND-YAG) posterior hyaloidotomy is an inexpensive, effective and safe treatment modality for rapid drainage of haemorrhage covering the macula. An 18-year-old male patient presented to us with a history of Nd-YAG posterior hyaloidotomy for Valsalva-related premacular bleed. At the posterior pole, a cavity formed by the detached ILM with a central defect in ILM-posterior hyaloid complex was evident...
November 23, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27878797/choosing-wisely-at-the-end-of-life-the-crucial-role-of-medical-indication
#10
Gian Domenico Borasio, Ralf J Jox
At the end of life, several treatments are administered routinely that lack medical indication and may cause significant harm to patients. Examples include artificial hydration and oxygen therapy in the dying phase, as well as enteral nutrition in advanced dementia. Medical indication is defined as the appropriateness of a therapeutic or diagnostic measure in the patient's concrete clinical situation, in light of the best available evidence. The decision about the absence or presence of a medical indication is a core competence of physicians...
2016: Swiss Medical Weekly
https://www.readbyqxmd.com/read/27855088/does-the-ukcat-predict-performance-on-exit-from-medical-school-a-national-cohort-study
#11
R K MacKenzie, J A Cleland, D Ayansina, S Nicholson
OBJECTIVES: Most UK medical programmes use aptitude tests during student selection, but large-scale studies of predictive validity are rare. This study assesses the UK Clinical Aptitude Test (UKCAT: http://www.ukcat.ac.uk), and 4 of its subscales, along with individual and contextual socioeconomic background factors, as predictors of performance during, and on exit from, medical school. METHODS: This was an observational study of 6294 medical students from 30 UK medical programmes who took the UKCAT from 2006 to 2008, for whom selection data from the UK Foundation Programme (UKFPO), the next stage of UK medical education training, were available in 2013...
October 7, 2016: BMJ Open
https://www.readbyqxmd.com/read/27832830/-it-depends-on-the-consultation-revisiting-use-of-family-members-as-interpreters-for-general-practice-consultations-when-and-why
#12
Jo Hilder, Ben Gray, Anthony Dowell, Lindsay Macdonald, Rachel Tester, Maria Stubbe
Family members continue to be used as interpreters in medical consultations despite the well-known risks. This paper examines participant perceptions of this practice in three New Zealand clinics chosen for their frequent use of interpreters and their skill in using them. It is based on a detailed study of 17 video-recorded interpreted consultations and 48 post-consultation interviews with participants (5 doctors, 16 patients and 12 interpreters, including 6 family members). All participants expressed satisfaction with the communication...
November 11, 2016: Australian Journal of Primary Health
https://www.readbyqxmd.com/read/27825156/psychopathological-course-typology-in-schizophrenia-spectrum-disorders-a-heuristic-approach-in-a-sample-of-100-patients
#13
Moritz E Wigand, Fabian U Lang, Thomas Becker, Thomas G Schulze, Werner Strik, Markus Jäger
BACKGROUND: Despite several previous attempts at subtyping schizophrenia, a typology that reflects neurobiological knowledge and reliably predicts course and outcome is lacking. We applied the system-specific concept of the Bern Psychopathology Scale (BPS) to generate a course typology based on three domains: language, affectivity, and motor behaviour. SAMPLING AND METHODS: A cohort of 100 patients with schizophrenia or schizoaffective disorders according to DSM-IV criteria underwent psychopathological assessment, and all their available medical records were retrospectively analysed on the basis of the BPS...
November 9, 2016: Psychopathology
https://www.readbyqxmd.com/read/27819401/-clinical-usefulness-and-psychometric-properties-of-the-cambridge-behavioural-inventory
#14
R Fernandez-Martinez, E Kokoulina, E Carballido-Araujo, I Garcia-Fuertes, O Gutierrez-Martinez, F Santiago-Lopez, P Vazquez-Batan
INTRODUCTION: An important area in neuropsychological assessment is that of psychological and behavioural symptoms. The Cambridge Behavioural Inventory (CBI) is a self-report measure aimed at relatives which takes account of a wide range of behavioural symptoms that may occur during the course of neurological diseases. The main objective of the study is to test the clinical usefulness of its Spanish adaptation. SUBJECTS AND METHODS: The CBI was completed by 215 members of kin of patients referred from neurology and psychiatry services...
November 16, 2016: Revista de Neurologia
https://www.readbyqxmd.com/read/27817806/factors-which-influence-treatment-initiation-for-pulmonary-non-tuberculous-mycobacterium-infection-in-hiv-negative-patients-a-multicentre-observational-study
#15
Timothy M Rawson, Aula Abbara, Katharina Kranzer, Andrew Ritchie, James Milburn, Tim Brown, David Adeboyeku, Jim Buckley, Robert N Davidson, Matthew Berry, Onn Min Kon, Laurence John
BACKGROUND: Clinical, radiological and microbiological criteria inform diagnosis of pulmonary Non-Tuberculous Mycobacteria (NTM) disease and treatment decisions. This multicentre, review aims to characterise NTM disease meeting ATS/IDSA criteria and define factors associated with initiation of treatment. METHODS: Sputum samples growing NTM from 5 London hospitals between 2010 and 2014 were identified. Data for HIV-negative individuals meeting ATS/IDSA guidelines for pulmonary NTM disease were extracted...
November 2016: Respiratory Medicine
https://www.readbyqxmd.com/read/27816998/what-does-being-on-a-community-treatment-orders-entail-a-3-year-follow-up-of-the-octet-cto-cohort
#16
Jorun Rugkåsa, Ksenija Yeeles, Constantinos Koshiaris, Tom Burns
PURPOSE: Community Treatment Orders lack evidence of effectiveness. Very little is known about how they are used in practice and over time in terms of what it obliges patients to do and the judicial threshold for remaining on an order. AIMS: To investigate CTO implementation in England in terms of the use of specified conditions, and judicial hearings; whether these change over time, and; the level of continued coercion. METHOD: 36-month observational prospective study of patients on CTO in the OCTET follow-up study...
November 5, 2016: Social Psychiatry and Psychiatric Epidemiology
https://www.readbyqxmd.com/read/27813208/an-interactive-training-programme-to-treat-body-image-disturbance
#17
Lucinda J Gledhill, Katri K Cornelissen, Piers L Cornelissen, Ian S Penton-Voak, Marcus R Munafò, Martin J Tovée
OBJECTIVES: Anorexia nervosa (AN) is a life-threatening mental health condition. A core feature is a disturbance of body image, such that sufferers see themselves as fatter than they actually are. DESIGN: We tested the effectiveness of a novel training programme to recalibrate our participants' perception of body size. METHODS: In a novel adaptation of a cognitive bias training programme, participants judged the body size of a series of female bodies and were given feedback to improve their accuracy over four daily training sessions...
November 3, 2016: British Journal of Health Psychology
https://www.readbyqxmd.com/read/27812262/membranoproliferative-glomerulonephritis-secondary-to-a-low-grade-lymphoproliferative-disorder-a-rare-cause-of-renal-dysfunction
#18
Tushar Sehgal, Nidhi Jain, Gaurav Prakash, Ritambhra Duseja, Neelam Varma
Chronic lymphocytic leukemia is a B-cell neoplasm with an indolent clinical course. Most patients are asymptomatic and are diagnosed incidentally on a routine blood count. The malignant cells of this low-grade neoplasm infiltrate various organs and tissues. However, the resultant end organ damage is a rare phenomenon. Here we describe a case of chronic lymphocytic leukemia that presented with an unusual cause of acute renal dysfunction. The patient had deranged renal parameters with a nephrotic range proteinuria...
December 2016: Indian Journal of Hematology & Blood Transfusion
https://www.readbyqxmd.com/read/27809956/the-effectiveness-cost-effectiveness-and-acceptability-of-community-versus-hospital-eye-service-follow-up-for-patients-with-neovascular-age-related-macular-degeneration-with-quiescent-disease-echoes-a-virtual-randomised-balanced-incomplete-block-trial
#19
Barnaby C Reeves, Lauren J Scott, Jodi Taylor, Ruth Hogg, Chris A Rogers, Sarah Wordsworth, Daisy Townsend, Alyson Muldrew, Tunde Peto, Mara Violato, Helen Dakin, Heike Cappel-Porter, Nicola Mills, Dermot O'Reilly, Simon P Harding, Usha Chakravarthy
BACKGROUND: Patients with neovascular age-related macular degeneration (nAMD) usually attend regular reviews, even when the disease is quiescent. Reviews are burdensome to health services, patients and carers. OBJECTIVES: To compare the proportion of correct lesion classifications made by community-based optometrists and ophthalmologists from vignettes of patients; to estimate the cost-effectiveness of community follow-up by optometrists compared with follow-up by ophthalmologists in the Hospital Eye Service (HES); to ascertain views of patients, their representatives, optometrists, ophthalmologists and clinical commissioners on the proposed shared care model...
October 2016: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/27789466/2016-american-college-of-rheumatology-european-league-against-rheumatism-classification-criteria-for-primary-sj%C3%A3-gren-s-syndrome-a-consensus-and-data-driven-methodology-involving-three-international-patient-cohorts
#20
REVIEW
Caroline H Shiboski, Stephen C Shiboski, Raphaèle Seror, Lindsey A Criswell, Marc Labetoulle, Thomas M Lietman, Astrid Rasmussen, Hal Scofield, Claudio Vitali, Simon J Bowman, Xavier Mariette
OBJECTIVES: To develop and validate an international set of classification criteria for primary Sjögren's syndrome (SS) using guidelines from the American College of Rheumatology (ACR) and the European League Against Rheumatism (EULAR). These criteria were developed for use in individuals with signs and/or symptoms suggestive of SS. METHODS: We assigned preliminary importance weights to a consensus list of candidate criteria items, using multi-criteria decision analysis...
October 26, 2016: Annals of the Rheumatic Diseases
keyword
keyword
27988
1
2
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read
×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"