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https://www.readbyqxmd.com/read/28742260/incorporating-patient-preferences-into-estimation-of-optimal-individualized-treatment-rules
#1
Emily L Butler, Eric B Laber, Sonia M Davis, Michael R Kosorok
Precision medicine seeks to provide treatment only if, when, to whom, and at the dose it is needed. Thus, precision medicine is a vehicle by which healthcare can be made both more effective and efficient. Individualized treatment rules operationalize precision medicine as a map from current patient information to a recommended treatment. An optimal individualized treatment rule is defined as maximizing the mean of a pre-specified scalar outcome. However, in settings with multiple outcomes, choosing a scalar composite outcome by which to define optimality is difficult...
July 25, 2017: Biometrics
https://www.readbyqxmd.com/read/28739656/guiding-principles-for-team-based-pediatric-care
#2
Julie P Katkin, Susan J Kressly, Anne R Edwards, James M Perrin, Colleen A Kraft, Julia E Richerson, Joel S Tieder, Liz Wall
The American Academy of Pediatrics (AAP) recognizes that children's unique and ever-changing needs depend on a variety of support systems. Key components of effective support systems address the needs of the child and family in the context of their home and community and are dynamic so that they reflect, monitor, and respond to changes as the needs of the child and family change. The AAP believes that team-based care involving medical providers and community partners (eg, teachers and state agencies) is a crucial and necessary component of providing high-quality care to children and their families...
July 24, 2017: Pediatrics
https://www.readbyqxmd.com/read/28739577/common-pitfalls-and-mistakes-in-the-set-up-analysis-and-interpretation-of-results-in-network-meta-analysis-what-clinicians-should-look-for-in-a-published-article
#3
Anna Chaimani, Georgia Salanti, Stefan Leucht, John R Geddes, Andrea Cipriani
OBJECTIVE: Several tools have been developed to evaluate the extent to which the findings from a network meta-analysis would be valid; however, applying these tools is a time-consuming task and often requires specific expertise. Clinicians have little time for critical appraisal, and they need to understand the key elements that help them select network meta-analyses that deserve further attention, optimising time and resources. This paper is aimed at providing a practical framework to assess the methodological robustness and reliability of results from network meta-analysis...
July 24, 2017: Evidence-based Mental Health
https://www.readbyqxmd.com/read/28738098/somatization-disorder-and-somatoform-symptoms-in-systematically-studied-survivors-of-10-disasters
#4
Gus Zhang, Carol S North
BACKGROUND: There is little agreement about the association of somatization with exposure to disaster trauma in the existing literature. METHODS: Pre-disaster and post-disaster psychiatric disorders, somatization disorder, and individual somatoform (medically unexplained) symptoms were assessed with structured diagnostic interviews in 811 directly exposed survivors of 10 disasters. RESULTS: Only 1 individual met criteria for post-disaster somatization disorder; there were no incident cases...
August 1, 2017: Annals of Clinical Psychiatry: Official Journal of the American Academy of Clinical Psychiatrists
https://www.readbyqxmd.com/read/28738052/collaborative-care-in-melanoma-the-essential-role-of-the-nurse%C3%A2
#5
John M Kirkwood, Antoni Ribas
This article provides perspective from medical oncologists on the importance of this supplement from the Melanoma Nursing Initiative. The authors (a) delineate the challenges inherent in addressing adverse event (AE) management with newer melanoma therapies, particularly in the community setting; (b) illustrate how advanced practice providers with extensive clinical trial experience in melanoma are in a key position to set the agenda and educate colleagues on best practices in AE management; and
August 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28736474/phenotype-analysis-of-early-risk-factors-from-electronic-medical-records-improves-image-derived-diagnostic-classifiers-for-optic-nerve-pathology
#6
Shikha Chaganti, Kunal P Nabar, Katrina M Nelson, Louise A Mawn, Bennett A Landman
We examine imaging and electronic medical records (EMR) of 588 subjects over five major disease groups that affect optic nerve function. An objective evaluation of the role of imaging and EMR data in diagnosis of these conditions would improve understanding of these diseases and help in early intervention. We developed an automated image-processing pipeline that identifies the orbital structures within the human eyes from computed tomography (CT) scans, calculates structural size, and performs volume measurements...
February 11, 2017: Proceedings of SPIE
https://www.readbyqxmd.com/read/28733142/deprescribing-for-frail-older-people-learning-from-the-case-of-mrs-hansen
#7
Anne Gerd Granas, Marit Stendal Bakken, Sabine Ruths, Katja Taxis
Drug treatment is often an essential part in treatment and prevention of diseases in older people, but there is much concern about inappropriate medication use. This paper aims to describe the complexity of medication safety issues and clinical judgments when optimizing prescribing in older individuals. It uses the case of Mrs. Hansen, an aged nursing home resident, to illustrate the facilitators and barriers of this process. With decreasing life expectancy, medication use should shift from cure to care, focusing on symptomatic treatment to increase the patient's well-being...
July 13, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/28725937/aspirin-use-and-head-and-neck-cancer-survival-an-observational-study-of-11-623-person-years-follow-up
#8
Shin-Ae Kim, Jong-Lyel Roh, Sung-Bae Kim, Seung-Ho Choi, Soon Yuhl Nam, Sang Yoon Kim
BACKGROUND: Acetylsalicylic acid (aspirin) and non-steroidal anti-inflammatory drugs (NSAIDs) have been associated with reduced risks for certain human cancers. However, the effects of aspirin and NSAIDs on head and neck squamous cell carcinoma (HNSCC) remain controversial, and the prognostic effects of these drugs in patients with HNSCC are largely unknown. This study examined the clinical impact of aspirin and NSAIDs on disease recurrence and survival in patients with HNSCC. METHODS: This study analysed a cohort of 1392 consecutive patients who received definitive treatment for previously untreated HNSCC at our tertiary referral center...
July 19, 2017: International Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28723702/reducing-falls-in-the-inpatient-hospital-setting
#9
Catherine M Melin
AIM: This quality improvement project's objective was to introduce and assess a process change to potentially reduce fall rates on an inpatient medical-surgical unit. METHODS: The Iowa Model of Evidence-Based Practice was used to guide the implementation of this project. This project was piloted over a 3-month period from October to December 2016 on a 38-bed medical-surgical unit at a community-based hospital in the southeastern United States. Prior to the implementation of this quality improvement project, staff received falls education using a modified pre-existing falls prevention protocol, with a focus on increasing the consistency of bed/chair alarm use for patients identified as being at risk for falling...
July 18, 2017: International Journal of Evidence-based Healthcare
https://www.readbyqxmd.com/read/28723416/unravelling-the-pharmacologic-opportunities-and-future-directions-for-targeted-therapies-in-gastro-intestinal-cancers-part-2-neuroendocrine-tumours-hepatocellular-carcinoma-and-gastro-intestinal-stromal-tumours
#10
REVIEW
Cindy Neuzillet, Louis de Mestier, Benoît Rousseau, Olivier Mir, Mohamed Hebbar, Hemant M Kocher, Philippe Ruszniewski, Christophe Tournigand
Until the 1990s, cytotoxic chemotherapy has been the cornerstone of medical therapy for gastrointestinal (GI) cancers. Better understanding of the cancer cell molecular biology has led to the therapeutic revolution of targeted therapies, i.e. monoclonal antibodies or small molecule inhibitors directed against proteins that are specifically overexpressed or mutated in cancer cells. These agents, being more specific to cancer cells, were expected to be less toxic than conventional cytotoxic agents. However, their effects have sometimes been disappointing, due to intrinsic or acquired resistance mechanisms, or to an activity restricted to some tumour settings, illustrating the importance of patient selection and early identification of predictive biomarkers of response to these therapies...
July 16, 2017: Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28722494/cost-efficiency-analyses-for-the-us-of-biosimilar-filgrastim-sndz-reference-filgrastim-pegfilgrastim-and-pegfilgrastim-with-on-body-injector-in-the-prophylaxis-of-chemotherapy-induced-febrile-neutropenia
#11
Ali McBride, Kim Campbell, Mohan Bikkina, Karen MacDonald, Ivo Abraham, Sanjeev Balu
AIMS: Guidelines recommend prophylaxis with granulocyte colony-stimulating factor for chemotherapy-induced (febrile) neutropenia (CIN/FN) based on regimen myelotoxicity and patient-related risk factors. Our aim was to conduct a cost-efficiency analysis for the US of the direct acquisition and administration costs of the recently approved biosimilar filgrastim-sndz (Zarxio® EP2006) with reference filgrastim (Neupogen(®)), pegfilgrastim (Neulasta(®)), and pegfilgrastim injection device (Neulasta Onpro(®); hereafter pegfilgrastim-injector) for CIN/FN prophylaxis...
July 19, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28722088/-evaluation-of-new-minimally-invasive-techniques-in-gastrointestinal-surgery-and-contemplation-on-health-economics
#12
Xishan Wang
With the widespread introduction of minimally invasive surgery (MIS) in late 1987 by laparoscopic cholecystectomy, the practice and expectation of general surgery were changed forever. As the development of scientific technology, new techniques of MIS have sprung up all around the world. 3D laparoscopy surgery, natural orifice transluminal endoscopic surgery, da Vinci surgical system and other new technologies also need time to be verified, and this is the only way all new things should get though. They are very unique in their own right, and all have advantages and disadvantages...
July 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28721738/counting-bodies-on-future-engagements-with-science-studies-in-medical-anthropology
#13
Emily Yates-Doerr
Thirty years ago, Nancy Scheper-Hughes and Margaret Lock outlined a strategy for 'future work in medical anthropology' that focused on three bodies. Their article - a zeitgeist for the field - sought to intervene into the Cartesian dualisms characterizing ethnomedical anthropology at the time. Taking a descriptive and diagnostic approach, they defined 'the mindful body' as a domain of future anthropological inquiry and mapped three analytic concepts that could be used to study it: the individual/phenomenological body, the social body, and the body politic...
July 19, 2017: Anthropology & Medicine
https://www.readbyqxmd.com/read/28721120/effective-learning-environments-the-process-of-creating-and-maintaining-an-online-continuing-education-tool
#14
Sharon Davies, Gianni Roberto Lorello, Kristi Downey, Zeev Friedman
Continuing medical education (CME) is an indispensable part of maintaining physicians' competency. Since attending conferences requires clinical absenteeism and is not universally available, online learning has become popular. The purpose of this study is to conduct a retrospective analysis examining the creation process of an anesthesia website for adherence to the published guidelines and, in turn, provide an illustration of developing accredited online CME. Using Kern's guide to curriculum development, our website analysis confirmed each of the six steps was met...
2017: Advances in Medical Education and Practice
https://www.readbyqxmd.com/read/28721020/access-to-credible-information-on-schizophrenia-patients-medication-adherence-by-prescribers-can-change-their-treatment-strategies-evidence-from-an-online-survey-of-providers
#15
Jason Shafrin, Suepattra G May, Anshu Shrestha, Charles Ruetsch, Nicole Gerlanc, Felicia Forma, Ainslie Hatch, Darius N Lakdawalla, Jean-Pierre Lindenmayer
OBJECTIVE: Overestimating patients' medication adherence diminishes the ability of psychiatric care providers to prescribe the most effective treatment and to identify the root causes of treatment resistance in schizophrenia. This study was conducted to determine how credible patient drug adherence information (PDAI) might change prescribers' treatment decisions. METHODS: In an online survey containing 8 clinical case vignettes describing patients with schizophrenia, health care practitioners who prescribe antipsychotics to patients with schizophrenia were instructed to choose a preferred treatment recommendation from a set of predefined pharmacologic and non-pharmacologic options...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/28720203/the-personal-and-professional-face-of-the-basque-urologist-jos%C3%A3-juli%C3%A3-n-guim%C3%A3-n-rezola-1898-1980
#16
J C Angulo
OBJECTIVE: To understand certain outstanding aspects of the life of the Basque surgeon and urologist Julián Guimón Rezola. His personal and bibliographic documentary legacy helps reconstruct his works and personal character. MATERIAL AND METHODS: We analysed the written works of Julián Guimón Rezola and a collection of documents, letters, photographs, illustrations and objects from his personal and professional life, accessed through his family. We analysed the content of the author's main publications and related the documents to historic facts...
July 15, 2017: Actas Urologicas Españolas
https://www.readbyqxmd.com/read/28720188/the-importance-of-the-study-of-cognitive-performance-enhancement-for-u-s-national-security
#17
Richard G Malish
The American military is embarking on the 'Third Offset'-a strategy designed to produce seismic shifts in the future of warfare. Central to the approach is the conjoining of humans, technology, and machines to deliver a decisive advantage on the battlefield. Because technology will spread rapidly and globally, tactical overmatch will occur when American operators possess a competitive edge in cognition. Investigation of cognitive enhancing therapeutics is not widely articulated as an adjunct to the Third Offset, yet failure to study promising agents could represent a strategic vulnerability...
August 1, 2017: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/28719449/68ga-dotatate-uptake-in-solitary-pancreatic-metastasis-from-clear-cell-renal-cancer
#18
Shankar Vamadevan, Ken Le, Lily Shen, Han Loh, Robert Mansberg
A 64-year-old man with a lesion of the pancreatic tail was referred for Ga-DOTATATE PET/CT imaging. His medical history included previous metastatic clear cell renal cell cancer. Ga-DOTATATE PET/CT demonstrated increased DOTATATE uptake (SUVmax 10.5) in a pancreatic tail lesion. Histopathology of the resected lesion confirmed clear renal cell cancer metastasis. This case illustrates that clear cell renal cancer metastasis can demonstrate Ga-DOTATATE accumulation.
July 17, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/28718392/efficient-body-fat-estimation-using-multistage-pair-ranked-set-sampling
#19
M Mahdizadeh, Ehsan Zamanzade
Rank-based sampling methods are applicable in settings where precise measurements are expensive, but small sets of units can be accurately ranked at negligible cost. This article introduces one such a design, called multistage pair ranked set sampling. It mitigates ranking burden associated with a competitor scheme, namely multistage ranked set sampling. The mean estimator in multistage pair ranked set sampling is unbiased, and under perfect rankings has variance no larger than its simple random sampling counterpart...
January 1, 2017: Statistical Methods in Medical Research
https://www.readbyqxmd.com/read/28717823/-interdisciplinary-pain-assessment-in-the-hospital-setting-merely-a%C3%A2-door-opener-to-multimodal-pain-therapy
#20
E Sens, M Mothes-Lasch, J F Lutz
BACKGROUND: Chronic pain is characterized by a complex interaction of somatic, mental and social factors. Assessing these factors in patients with chronic pain is vital during the diagnostic work-up and when making a structured treatment plan. Interdisciplinary pain assessment (ISA) is the most promising method to deal with these challenges. This article presents our experience in performing pain assessments in the hospital setting and also illustrates the characteristic features of chronic pain patients undergoing such assessments...
July 17, 2017: Der Schmerz
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