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Evidence Based Medicine

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https://www.readbyqxmd.com/read/28101728/implementation-of-an-evidence-based-biobehavioral-treatment-for-cancer-patients
#1
Marlena M Ryba, Brittany M Brothers, Barbara L Andersen
One aim of dissemination and implementation (DI) research is to study the translation of evidence-based treatments (EBTs) from the research environments of their development and testing to broader communities where they are needed. There are few behavioral medicine DI studies and none in cancer survivorship. A determinant model (Setting, Therapist, Education, imPlementation, and Sustainability (STEPS)) was used to conceptualize DI of mental health treatment and frame a longitudinal study of implementation of a behavioral medicine EBT-a biobehavioral intervention (BBI) for cancer patients...
January 18, 2017: Translational Behavioral Medicine
https://www.readbyqxmd.com/read/28099330/clarifying-the-debate-on-population-based-screening-for-breast-cancer-with-mammography-a-systematic-review-of-randomized-controlled-trials-on-mammography-with-bayesian-meta-analysis-and-causal-model
#2
Tony Hsiu-Hsi Chen, Amy Ming-Fang Yen, Jean Ching-Yuan Fann, Paula Gordon, Sam Li-Sheng Chen, Sherry Yueh-Hsia Chiu, Chen-Yang Hsu, King-Jen Chang, Won-Chul Lee, Khay Guan Yeoh, Hiroshi Saito, Supannee Promthet, Chisato Hamashima, Alimin Maidin, Fredie Robinson, Li-Zhong Zhao
BACKGROUND: The recent controversy about using mammography to screen for breast cancer based on randomized controlled trials over 3 decades in Western countries has not only eclipsed the paradigm of evidence-based medicine, but also puts health decision-makers in countries where breast cancer screening is still being considered in a dilemma to adopt or abandon such a well-established screening modality. METHODS: We reanalyzed the empirical data from the Health Insurance Plan trial in 1963 to the UK age trial in 1991 and their follow-up data published until 2015...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28099046/death-notification-someone-needs-to-call-the-family
#3
Rachel Ombres, Lauren Montemorano, Daniel Becker
BACKGROUND: The death notification process can affect family grief and bereavement. It can also affect the well-being of involved physicians. There is no standardized process for making death notification phone calls. We assumed that residents are likely to be unprepared before and troubled after. OBJECTIVE: We investigated current death notification practices to develop an evidence-based template for standardizing this process. DESIGN: We used results of a literature review and open-ended interviews with faculty, residents, and widows to develop a survey regarding resident training and experience in death notification by phone...
January 18, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28098628/the-abcdef-bundle-science-and-philosophy-of-how-icu-liberation-serves-patients-and-families
#4
E Wesley Ely
Over the past 20 years, critical care has matured in a myriad of ways resulting in dramatically higher survival rates for our sickest patients. For millions of new survivors comes de novo suffering and disability called "the postintensive care syndrome." Patients with postintensive care syndrome are robbed of their normal cognitive, emotional, and physical capacity and cannot resume their previous life. The ICU Liberation Collaborative is a real-world quality improvement initiative being implemented across 76 ICUs designed to engage strategically the ABCDEF bundle through team- and evidence-based care...
February 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28098436/bringing-3d-tumor-models-to-the-clinic-predictive-value-for-personalized-medicine
#5
REVIEW
Kathrin Halfter, Barbara Mayer
Current decision-guiding algorithms in cancer drug treatment are based on decades of research and numerous clinical trials. For the majority of patients, this data is successfully applied for a systemic disease management. For a number of patients however, treatment stratification according to clinically based risk criteria will not be sufficient. The most effective treatment options are ideally identified prior to the start of clinical drug therapy. This review will discuss the implementation of three-dimensional (3D) cell culture models as a preclinical testing paradigm for the efficacy of clinical cancer treatment...
January 18, 2017: Biotechnology Journal
https://www.readbyqxmd.com/read/28097829/barriers-to-conducting-research-a-survey-of-trainees-in-emergency-medicine
#6
Alexander Olaussen, Paul A Jennings, Gerard O'Reilly, Biswadev Mitra, Peter A Cameron
OBJECTIVE: Research underpins evidence-based practice, but there are significant barriers to conducting research relevant to each clinical discipline. Understanding these barriers could allow strategies to reduce their impact. The present study was undertaken to understand specific barriers to research for emergency medicine (EM) trainees. METHODS: EM trainees attending research short courses were surveyed. Free-text responses were classified into themes and a list of pre-specified potential barriers was used for ranking purposes...
January 17, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28096006/immunizations-challenge-healthcare-personnel-and-affects-immunization-rates
#7
Pamela K Strohfus, Susan C Kim, Sara Palma, Russell A Duke, Richard Remington, Caleb Roberts
PURPOSE: This study measured 1. medical office immunization rates and 2. health care personnel competency in managing vaccine practices before and after evidence-based immunization education was provided. METHOD: This descriptive study compared 32 family medicine and pediatric offices and 178 medical assistants, licensed practical nurses, registered nurses, nurse practitioners, and physicians in knowledge-based testing pre-education, post-education, and 12-months post-education...
February 2017: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/28095824/community-based-health-care-is-an-essential-component-of-a-resilient-health-system-evidence-from-ebola-outbreak-in-liberia
#8
Kendra Siekmans, Salim Sohani, Tamba Boima, Florence Koffa, Luay Basil, Saïd Laaziz
BACKGROUND: Trained community health workers (CHW) enhance access to essential primary health care services in contexts where the health system lacks capacity to adequately deliver them. In Liberia, the Ebola outbreak further disrupted health system function. The objective of this study is to examine the value of a community-based health system in ensuring continued treatment of child illnesses during the outbreak and the role that CHWs had in Ebola prevention activities. METHODS: A descriptive observational study design used mixed methods to collect data from CHWs (structured survey, n = 60; focus group discussions, n = 16), government health facility workers and project staff...
January 17, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28095476/a-systematic-review-of-ebola-treatment-trials-to-assess-the-extent-to-which-they-adhere-to-ethical-guidelines
#9
Thomas Richardson, Andrew McDonald Johnston, Heather Draper
BACKGROUND: Objective: To determine to what extent each trial met criteria specified in three research frameworks for ethical trial conduct. Design: Systematic review and narrative analysis. METHODS AND FINDINGS: Data sources: MEDBASE and EMBASE databases were searched using a specific search strategy. The Cochrane database for systematic reviews, the PROSPERO database and trial registries were examined. A grey literature search and citation search were also carried out...
2017: PloS One
https://www.readbyqxmd.com/read/28093977/the-amyloid-cascade-hypothesis-in-alzheimer-s-disease-it-s-time-to-change-our-mind
#10
Roberta Ricciarelli, Ernesto Fedele
Since its discovery in 1984, the beta amyloid peptide has treaded the boards of neurosciences as the star molecule in Alzheimer's disease pathogenesis. In the last decade, however, this vision has been challenged by evidence-based medicine showing the almost complete failure of clinical trials that experimented anti-amyloid therapies with great hopes. Moreover, data have accumulated which clearly indicates that this small peptide plays a key role in the physiological processes of memory formation. In the present review, we will discuss the different aspects of the amyloid cascade hypothesis, highlighting its pros and cons, and we will analyse the results of the therapeutic approaches attempted to date that should change the direction of Alzheimer's disease research in the future...
January 16, 2017: Current Neuropharmacology
https://www.readbyqxmd.com/read/28093877/a-shovel-ready-solution-to-fill-the-nursing-data-gap-in-the-interdisciplinary-clinical-picture
#11
Gail M Keenan, Karen Dunn Lopez, Vanessa E C Sousa, Janet Stifter, Tamara G R Macieira, Andrew D Boyd, Yingwei Yao, T Heather Herdman, Sue Moorhead, Anna McDaniel, Diana J Wilkie
PURPOSE: To critically evaluate 2014 American Academy of Nursing (AAN) call-to-action plan for generating interoperable nursing data. DATA SOURCES: Healthcare literature. DATA SYNTHESIS: AAN's plan will not generate the nursing data needed to participate in big data science initiatives in the short term because Logical Observation Identifiers Names and Codes and Systematized Nomenclature of Medicine - Clinical Terms are not yet ripe for generating interoperable data...
January 16, 2017: International Journal of Nursing Knowledge
https://www.readbyqxmd.com/read/28093833/cracking-the-code-residents-interpretations-of-written-assessment-comments
#12
Shiphra Ginsburg, Cees Pm van der Vleuten, Kevin W Eva, Lorelei Lingard
CONTEXT: Interest is growing in the use of qualitative data for assessment. Written comments on residents' in-training evaluation reports (ITERs) can be reliably rank-ordered by faculty attendings, who are adept at interpreting these narratives. However, if residents do not interpret assessment comments in the same way, a valuable educational opportunity may be lost. OBJECTIVES: Our purpose was to explore residents' interpretations of written assessment comments using mixed methods...
January 16, 2017: Medical Education
https://www.readbyqxmd.com/read/28093057/if-it-works-for-pills-can-it-work-for-skills-direct-to-consumer-social-marketing-of-evidence-based-psychological-treatments
#13
Robert D Friedberg, Hasan Bayar
The emergence of evidence-based psychological treatments (EVPTs) is a scientific success story, but unfortunately the application of these empirically supported procedures has been slow to gain ground in treatment-as-usual settings. This Open Forum commentary argues that direct-to-consumer (DTC) marketing, which has worked well in communicating the advantages of various medicines, should perhaps be considered for use in social marketing of EVPTs. DTC marketing of pharmaceuticals is a long-standing advertising strategy in the United States...
January 17, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28092685/precision-oncology-for-acute-myeloid-leukemia-using-a-knowledge-bank-approach
#14
Moritz Gerstung, Elli Papaemmanuil, Inigo Martincorena, Lars Bullinger, Verena I Gaidzik, Peter Paschka, Michael Heuser, Felicitas Thol, Niccolo Bolli, Peter Ganly, Arnold Ganser, Ultan McDermott, Konstanze Döhner, Richard F Schlenk, Hartmut Döhner, Peter J Campbell
Underpinning the vision of precision medicine is the concept that causative mutations in a patient's cancer drive its biology and, by extension, its clinical features and treatment response. However, considerable between-patient heterogeneity in driver mutations complicates evidence-based personalization of cancer care. Here, by reanalyzing data from 1,540 patients with acute myeloid leukemia (AML), we explore how large knowledge banks of matched genomic-clinical data can support clinical decision-making. Inclusive, multistage statistical models accurately predicted likelihoods of remission, relapse and mortality, which were validated using data from independent patients in The Cancer Genome Atlas...
January 16, 2017: Nature Genetics
https://www.readbyqxmd.com/read/28091756/-recommendation-on-temperature-management-after-cardiopulmonary-arrest-and-severe-traumatic-brain-injury-in-childhood-beyond-the-neonatal-period-statement-of-the-german-society-for-neonatology-and-pediatric-intensive-care-medicine%C3%A2-gnpi-and-the-scientific-working
#15
S Brenner, C Eich, G Rellensmann, M U Schuhmann, T Nicolai, F Hoffmann
The available data on the effectiveness of therapeutic hypothermia in different patient groups are heterogeneous. Although the benefits have been proven for some collectives, recommendations for the use of hypothermia treatment in other groups are based on less robust data and conclusions by analogy. This article gives a review of the current evidence of temperature management in all age groups and based on this state of knowledge, recommends active temperature management with the primary aim of strict normothermia (36-36...
January 13, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28090515/a-systematic-review-of-combinatorial-treatment-with-warming-and-invigorating-drugs-and-levothyroxine-for-hypothyroidism-caused-by-hashimoto-disease
#16
Xiangwen Cheng, Zixiao Wei, Guangde Zhang, Xin Shao, Bo Li, Rui Gao
BACKGROUND: We used the systematic review method to evaluate the clinical efficacy and safety of combinatorial treatment with warming and invigorating drugs and levothyroxine on hypothyroidism caused by Hashimoto thyroiditis (HT). METHODS: We set inclusion and exclusion criteria, searched for studies using electronic databases and manual retrieval, selected studies according to the inclusion and exclusion criteria, and assessed the qualities of the included studies according to the Jadad scale...
December 2016: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28088378/antimicrobial-coated-implants-in-trauma-and-orthopaedics-a-clinical-review-and-risk-benefit-analysis
#17
REVIEW
Volker Alt
Implant-associated infections remain a major issue in orthopaedics and antimicrobial functionalization of the implant surface by antibiotics or other anti-infective agents have gained interest. The goal of this article is to identify antimicrobial coatings, for which clinical data are available and to review their clinical need, safety profile, and their efficacy to reduce infection rates. PubMed database of the National Library of Medicine was searched for clinical studies on antimicrobial coated implants for internal fracture fixation devices and endoprostheses for bone surgery, for which study design, level of evidence, biocompatibility, development of resistance, and effectiveness to reduce infection rates were analyzed...
December 21, 2016: Injury
https://www.readbyqxmd.com/read/28088259/integration-for-coexistence-implementation-of-intercultural-health-care-policy-in-ghana-from-the-perspective-of-service-users-and-providers
#18
Razak Mohammed Gyasi, Adjoa Afriyie Poku, Simon Boateng, Padmore Adusei Amoah, Alhassan Abdul Mumin, Jacob Obodai, Williams Agyemang-Duah
OBJECTIVE: In spite of the World Health Organization's recommendations over the past decades, Ghana features pluralistic rather than truly integrated medical system. Policies about the integration of complementary medicine into the national health care delivery system need to account for individual-level involvement and cultural acceptability of care rendered by health care providers. Studies in Ghana, however, have glossed over the standpoint of the persons of the illness episode about the intercultural health care policy framework...
January 2017: Journal of Integrative Medicine
https://www.readbyqxmd.com/read/28086871/the-integrated-care-pathway-for-post-stroke-patients-icapps-a-shared-care-approach-between-stakeholders-in-areas-with-limited-access-to-specialist-stroke-care-services
#19
Aznida Firzah Abdul Aziz, Nor Azlin Mohd Nordin, Mohd Fairuz Ali, Noor Azah Abd Aziz, Saperi Sulong, Syed Mohamed Aljunid
BACKGROUND: Lack of intersectoral collaboration within public health sectors compound efforts to promote effective multidisciplinary post stroke care after discharge following acute phase. A coordinated, primary care-led care pathway to manage post stroke patients residing at home in the community was designed by an expert panel of specialist stroke care providers to help overcome fragmented post stroke care in areas where access is limited or lacking. METHODS: Expert panel discussions comprising Family Medicine Specialists, Neurologists, Rehabilitation Physicians and Therapists, and Nurse Managers from Ministry of Health and acadaemia were conducted...
January 13, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28086761/is-treatment-resistant-schizophrenia-categorically-distinct-from-treatment-responsive-schizophrenia-a-systematic-review
#20
Amy L Gillespie, Ruta Samanaite, Jonathan Mill, Alice Egerton, James H MacCabe
BACKGROUND: Schizophrenia is a highly heterogeneous disorder, and around a third of patients are treatment-resistant. The only evidence-based treatment for these patients is clozapine, an atypical antipsychotic with relatively weak dopamine antagonism. It is plausible that varying degrees of response to antipsychotics reflect categorically distinct illness subtypes, which would have significant implications for research and clinical practice. If these subtypes could be distinguished at illness onset, this could represent a first step towards personalised medicine in psychiatry...
January 13, 2017: BMC Psychiatry
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