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Value-based medicine

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https://www.readbyqxmd.com/read/28444218/current-dilemmas-in-defining-the-boundaries-of-disease
#1
Jenny Doust, Mary Jean Walker, Wendy A Rogers
Boorse's biostatistical theory states that diseases should be defined in ways that reflect disturbances of biological function and that are objective and value free. We use three examples from contemporary medicine that demonstrate the complex issues that arise when defining the boundaries of disease: polycystic ovary syndrome, chronic kidney disease, and myocardial infarction. We argue that the biostatistical theory fails to provide sufficient guidance on where the boundaries of disease should be drawn, contains ambiguities relating to choice of reference class, and is out of step with medical processes for identifying disease boundaries...
April 21, 2017: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/28441671/swimming-upstream-creating-a-culture-of-high-value-care
#2
Reshma Gupta, Christopher Moriates
As health system leaders strategize the best ways to encourage the transition toward value-based health care, the underlying culture-defined as a system of shared assumptions, values, beliefs, and norms existing within an environment-continues to shape clinician practice patterns. The current prevailing medical culture contributes to overtesting, overtreatment, and health care waste. Choosing Wisely lists, appropriateness criteria, and guidelines codify best practices, but academic medicine as a whole must recognize that faculty and trainees are all largely still operating within the same cultural climate...
May 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28441379/finally-a-practical-approach-to-value-based-medicine
#3
Lodovico Balducci
No abstract text is available yet for this article.
April 2017: Cancer Control: Journal of the Moffitt Cancer Center
https://www.readbyqxmd.com/read/28440719/a-case-based-medical-curriculum-for-the-21st-century-the-use-of-innovative-approaches-in-designing-and-developing-a-case-on-mental-health
#4
Athanasios Hassoulas, Elizabeth Forty, Mathew Hoskins, James Walters, Stephen Riley
The introduction of case-based learning (CBL) by the School of Medicine at Cardiff University has encouraged innovation in medical teaching and learning. During years one and two of the modernized MBBCh program, students complete 17 cases as part of the newly developed C21 curriculum that emphasizes a patient-oriented and student-centered approach to learning. The mental health case, which is presented in year 2, incorporates a number of novel teaching resources that aim to enhance the students' learning experience and to further reinforce the patient-oriented and community-based philosophy of C21...
May 2017: Medical Teacher
https://www.readbyqxmd.com/read/28439480/development-of-microsatellite-markers-based-on-expressed-sequence-tags-in-asparagus-cochinchinensis-asparagaceae
#5
Bo-Yun Kim, Han-Sol Park, Jung-Hoon Lee, Myounghai Kwak, Young-Dong Kim
PREMISE OF THE STUDY: Transcriptome-derived simple sequence repeat (SSR) markers were developed in Asparagus cochinchinensis (Asparagaceae). Due to its application in traditional medicine, its wild populations are threatened by over-collection even in protected areas, requiring immediate conservation efforts. METHODS AND RESULTS: Based on transcriptome data of A. cochinchinensis, 96 primer pairs with two to seven alleles per locus were selected for initial validation; of those, 27 primer pairs amplified across all samples, resulting in 15 polymorphic and 12 monomorphic microsatellite markers...
April 2017: Applications in Plant Sciences
https://www.readbyqxmd.com/read/28435813/medical-care-or-disciplinary-discourses-preventive-measures-against-the-black-death-in-late-medieval-paris-a-brief-review
#6
REVIEW
Yong Jin Hong, Sam Hun Park
BACKGROUND: This paper examined the political and social implications of the Compendium de epidemia prescription written by the Masters of the Faculty of Medicine of the University of Paris in the mid-14th century during the Black Death. This study aimed to examine how the effects of power as a discourse owned by medical knowledge are revealed. METHODS: This paper outlines the composition of the contents based on the 1888 edition edited and translated by Émile H...
March 2017: Iranian Journal of Public Health
https://www.readbyqxmd.com/read/28432747/whole-body-adipose-tissue-and-lean-muscle-volumes-and-their-distribution-across-gender-and-age-mr-derived-normative-values-in-a-normal-weight-swiss-population
#7
Erika J Ulbrich, Daniel Nanz, Olof Dahlqvist Leinhard, Magda Marcon, Michael A Fischer
PURPOSE: To determine age- and gender-dependent whole-body adipose tissue and muscle volumes in healthy Swiss volunteers in Dixon MRI in comparison with anthropometric and bioelectrical impedance (BIA) measurements. METHODS: Fat-water-separated whole-body 3 Tesla MRI of 80 healthy volunteers (ages 20 to 62 years) with a body mass index (BMI) of 17.5 to 26.2 kg/m(2) (10 men, 10 women per decade). Age and gender-dependent volumes of total adipose tissue (TAT), visceral adipose tissue (VAT), total abdominal subcutaneous adipose tissue (ASAT) and total abdominal adipose tissue (TAAT), and the total lean muscle tissue (TLMT) normalized for body height were determined by semi-automatic segmentation, and correlated with anthropometric and BIA measurements as well as lifestyle parameters...
April 22, 2017: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
https://www.readbyqxmd.com/read/28432417/exploring-the-possibility-of-a-retrograde-embolism-pathway-from-the-facial-artery-to-the-ophthalmic-artery-system-in-vivo
#8
Hui Zheng, Lihong Qiu, Zonghui Liu, Yingjun Su, Xinyuan Pan, Sha Liu, Chenggang Yi
BACKGROUND: Blindness caused by soft tissue fillers is an extremely low-probability event, but it results in great concern because of its devastating consequences. Currently, the mechanism of an embolism is usually considered to be an accidental injection of fillers into the blood vessels of the face, such as a facial artery, and then retrograding into the ophthalmic artery system, which causes retinal ischemic necrosis. In addition, previous studies have shown that there are anastomoses between facial arteries and branches of the ophthalmic artery in cadavers...
April 21, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28432351/early-measurement-of-il-10-predicts-the-outcomes-of-patients-with-acute-respiratory-distress-syndrome-receiving-extracorporeal-membrane-oxygenation
#9
Chia-Hsiung Liu, Shuenn-Wen Kuo, Wen-Je Ko, Pi-Ru Tsai, Shu-Wei Wu, Chien-Heng Lai, Chih-Hsien Wang, Yih-Sharng Chen, Pei-Lung Chen, Tze-Tze Liu, Shu-Chien Huang, Tzuu-Shuh Jou
Patients diagnosed with acute respiratory distress syndrome are generally severely distressed and associated with high morbidity and mortality despite aggressive treatments such as extracorporeal membrane oxygenation (ECMO) support. To identify potential biomarker of predicting value for appropriate use of this intensive care resource, plasma interleukin-10 along with relevant inflammatory cytokines and immune cell populations were examined during the early and subsequent disease courses of 51 critically ill patients who received ECMO support...
April 21, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28431171/heritability-of-heart-rate-response-to-arousals-in-twins
#10
Xiaoling Gao, Ali Azarbarzin, Brendan T Keenan, Michele Ostrowski, Frances M Pack, Bethany Staley, Greg Maislin, Allan I Pack, Magdy Younes, Samuel T Kuna
Objectives: To determine if the large and highly reproducible inter-individual differences in arousal intensity and heart rate response to arousal (ΔHR) during non-REM sleep are heritable. Methods: Polysomnograms of 55 monozygotic (14 male and 41 female pairs) and 36 dizygotic (15 male and 21 female pairs) same-sex twin pairs were analyzed. Arousals were scored using the 2012 American Academy of Sleep Medicine criteria. Arousal intensity was scaled (between 0 and 9) using an automatic algorithm based on the change in EEG time and frequency characteristics...
April 18, 2017: Sleep
https://www.readbyqxmd.com/read/28430862/how-health-related-quality-of-life-assessment-should-be-used-in-advanced-colorectal-cancer-clinical-trials
#11
F Bonnetain, C Borg, R R Adams, J A Ajani, A Benson, H Bleiberg, B Chibaudel, E Diaz-Rubio, J Y Douillard, C S Fuchs, B J Giantonio, R Goldberg, V Heinemann, M Koopman, R Labianca, A K Larsen, T Maughan, E Mitchell, M Peeters, C J A Punt, H J Schmoll, C Tournigand, A de Gramont
Traditionally, the efficacy of cancer treatment in patients with advance or metastatic disease in clinical studies has been studied using overall survival (OS) and more recently tumor-based endpoints such as progression-free survival, measurements of response to treatment. However, these seem not to be the relevant clinical endpoints in current situation if such endpoints were no validated as surrogate of OS to demonstrate the clinical efficacy. Appropriate, meaningful, primary patient-oriented and patient-reported endpoints that adequately measure the effects of new therapeutic interventions are then crucial for the advancement of clinical research in metastatic colorectal cancer to complement the results of tumor-based endpoints...
April 18, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/28430703/evidence-based-recommendations-for-pediatric-orthopaedic-practice
#12
Kishore Mulpuri, Emily K Schaeffer, H Kerr Graham, Mininder S Kocher, James Sanders, Ira Zaltz
BACKGROUND: Evidence-based medicine has become the cornerstone to guide clinical practice decision-making. Evidence-based medicine integrates the strongest available evidence with clinical expertise to make decisions about clinical care. The quality of the evidence depends upon the soundness of the study methodology to allow for meaningful interpretation of the clinical results. The purpose of this review is to analyze the methodological design and clinical findings of published pediatric orthopaedic studies to determine their ability to change or influence clinical practice...
April 20, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28430339/characterization-of-a-rare-nonpathogenic-sequence-variant-c-1905c-t-of-the-dihydropyrimidine-dehydrogenase-gene-dpyd
#13
Raffaele Palmirotta, Domenica Lovero, Erica Silvestris, Claudia Carella, Claudia Felici, Davide Quaresmini, Paola Cafforio, Franco Silvestris
BACKGROUND: In the era of precision medicine, the suitability of fluoropyrimidine therapies in clinical oncology can be checked by pharmacogenetic investigations of single patients, thus optimizing resources and indicating the appropriate drugs to personalize their chemotherapy. For example, the presence of dihydropyrimidine dehydrogenase gene (DPYD) polymorphisms in cancer patients may lead to adverse effects when adopting fluoropyrimidine-based therapies. METHODS: We detected in a cancer patient a rare germline synonymous heterozygous variant of DPYD (c...
April 11, 2017: International Journal of Biological Markers
https://www.readbyqxmd.com/read/28426520/nursing-practice-research-and-education-in-the-west-the-best-is-yet-to-come
#14
Heather M Young, Susan Bakewell-Sachs, Linda Sarna
PURPOSE: This paper celebrates the 60th anniversary of the Western Institute of Nursing, the nursing organization representing 13 states in the Western United States, and envisions a preferred future for nursing practice, research, and education. BACKGROUND: Three landmark calls to action contribute to transforming nursing and healthcare: the Patient Protection and Affordable Care Act of 2010; the Institute of Medicine report Future of Nursing: Leading Change, Advancing Health; and the report Advancing Healthcare Transformation: A New Era for Academic Nursing...
April 20, 2017: Nursing Research
https://www.readbyqxmd.com/read/28424057/personalized-medicine-in-europe-not-yet-personal-enough
#15
Antonello Di Paolo, François Sarkozy, Bettina Ryll, Uwe Siebert
BACKGROUND: Personalized medicine has the potential to allow patients to receive drugs specific to their individual disease, and to increase the efficiency of the healthcare system. There is currently no comprehensive overview of personalized medicine, and this research aims to provide an overview of the concept and definition of personalized medicine in nine European countries. METHODS: A targeted literature review of selected health databases and grey literature was conducted to collate information regarding the definition, process, use, funding, impact and challenges associated with personalized medicine...
April 19, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28420136/discovery-of-an-octahedral-silicon-complex-as-a-potent-antifungal-agent
#16
Chen Fu, Bin Fu, Xixi Peng, Guojian Liao
Octahedral transition metal complexes have been shown to have tremendous applications in chemical biology and medicinal chemistry. Meanwhile, structural transition metals can be replaced by inert octahedral silicon in a proof-of-principle study. We here introduce the first example of octahedral silicon complexes, which can very well serve as an efficient antimicrobial agent. The typical silicon arenediolate complex 1 {[(phen)₂Si(OO)](PF₆)₂, with phen = 1,10-phenanthroline, OO = 9,10-phenanthrenediolate} exhibited significant inhibition towards the growth of Cryptococcus neoformans with MIC and MFC values of 4...
April 15, 2017: Molecules: a Journal of Synthetic Chemistry and Natural Product Chemistry
https://www.readbyqxmd.com/read/28419893/carbon-monoxide-related-fatalities-a-60-year-single-institution-experience
#17
Martin Janík, Michaela Ublová, Štepánka Kučerová, Petr Hejna
OBJECTIVE: Though carbon monoxide (CO) poisonings account currently for a relatively small percentage of total non-natural deaths in Europe, they represent a serious public health burden and significant component of avoidable mortality in many countries. Our aim was to investigate long-term trends and to determine epidemiologic characteristics of the CO-related deaths in the Czech Republic, recorded at the Department of Forensic Medicine in Hradec Králové. METHODS: This was an autopsy-based single-centre retrospective cohort study of all fatalities caused by CO poisoning over six decades (1947-2006)...
April 13, 2017: Journal of Forensic and Legal Medicine
https://www.readbyqxmd.com/read/28418719/the-incremental-validity-of-self-report-and-performance-based-methods-for-assessing-hostility-to-predict-cardiovascular-disease-in-physicians
#18
Gregory J Meyer, Nicholas J Katko, Joni L Mihura, Michael J Klag, Lucy A Meoni
We evaluated the utility of an integrative, multimethod approach for assessing hostility-related constructs to predict premature cardiovascular disease (CVD) and premature coronary heart disease (CHD) using participants from the Johns Hopkins Precursors Study, which was designed to identify risk factors for heart disease. Participants were assessed at baseline while in medical school from 1946 to 1962 (M age = 24.6) and have been followed annually since then. Baseline assessment included individually administered Rorschach protocols (N = 416) scored for aggressive imagery (i...
April 18, 2017: Journal of Personality Assessment
https://www.readbyqxmd.com/read/28418717/diversity-of-endophytic-bacteria-in-a-fern-species-dryopteris-uniformis-makino-makino-and-evaluation-of-their-antibacterial-potential-against-five-foodborne-pathogenic-bacteria
#19
Gitishree Das, Seonjoo Park, Kwang-Hyun Baek
The fern plant Dryopteris uniformis has traditionally been used in herbal medicine and possesses many biological activities. This study was conducted to explore the endophytic bacterial diversity associated with D. uniformis and evaluate their antibacterial potential against foodborne pathogenic bacteria (FPB). Among 51 isolated endophytic bacteria (EB), 26 EB were selected based on their morphological characteristics and identified by 16S rRNA gene analysis. The distribution of EB was diverse in the leaf and the stem/root tissues...
April 18, 2017: Foodborne Pathogens and Disease
https://www.readbyqxmd.com/read/28418091/newsworthiness-versus-scientific-impact-are-the-most-highly-cited-urology-papers-the-most-widely-disseminated-in-the-media
#20
E M O'Connor, G J Nason, F O'Kelly, R P Manecksha, S Loeb
BACKGROUND: Discordance exists between scientific impact and media attention. Altmetrics are non-traditional measures of impact which are composite scores that include social media and traditional media sharing of an article. OBJECTIVE: To assess whether a correlation exists between newsworthiness (Altmetric score) and the scientific impact markers such as citation analysis, impact factors and levels of evidence. MATERIALS AND METHODS: The top 5 most cited articles for the year 2014 and 2015 from the top 10 ranking urology journals (scientific impact group) were identified...
April 18, 2017: BJU International
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