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Value-based medicine

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https://www.readbyqxmd.com/read/27919057/principles-of-precision-medicine-in-stroke
#1
REVIEW
Jason D Hinman, Natalia S Rost, Thomas W Leung, Joan Montaner, Keith W Muir, Scott Brown, Juan F Arenillas, Edward Feldmann, David S Liebeskind
The era of precision medicine has arrived and conveys tremendous potential, particularly for stroke neurology. The diagnosis of stroke, its underlying aetiology, theranostic strategies, recurrence risk and path to recovery are populated by a series of highly individualised questions. Moreover, the phenotypic complexity of a clinical diagnosis of stroke makes a simple genetic risk assessment only partially informative on an individual basis. The guiding principles of precision medicine in stroke underscore the need to identify, value, organise and analyse the multitude of variables obtained from each individual to generate a precise approach to optimise cerebrovascular health...
October 19, 2016: Journal of Neurology, Neurosurgery, and Psychiatry
https://www.readbyqxmd.com/read/27918573/benchmarking-the-cost-per-person-of-mass-treatment-for-selected-neglected-tropical-diseases-an-approach-based-on-literature-review-and-meta-regression-with-web-based-software-application
#2
Christopher Fitzpatrick, Fiona M Fleming, Matthew Madin-Warburton, Timm Schneider, Filip Meheus, Kingsley Asiedu, Anthony W Solomon, Antonio Montresor, Gautam Biswas
BACKGROUND: Advocacy around mass treatment for the elimination of selected Neglected Tropical Diseases (NTDs) has typically put the cost per person treated at less than US$ 0.50. Whilst useful for advocacy, the focus on a single number misrepresents the complexity of delivering "free" donated medicines to about a billion people across the world. We perform a literature review and meta-regression of the cost per person per round of mass treatment against NTDs. We develop a web-based software application (https://healthy...
December 2016: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/27916962/lightweight-sensor-authentication-scheme-for-energy-efficiency-in-ubiquitous-computing-environments
#3
Jaeseung Lee, Yunsick Sung, Jong Hyuk Park
The Internet of Things (IoT) is the intelligent technologies and services that mutually communicate information between humans and devices or between Internet-based devices. In IoT environments, various device information is collected from the user for intelligent technologies and services that control the devices. Recently, wireless sensor networks based on IoT environments are being used in sectors as diverse as medicine, the military, and commerce. Specifically, sensor techniques that collect relevant area data via mini-sensors after distributing smart dust in inaccessible areas like forests or military zones have been embraced as the future of information technology...
December 1, 2016: Sensors
https://www.readbyqxmd.com/read/27913069/otolaryngology-sleep-medicine-curriculum-objectives-as-determined-by-sleep-experts
#4
Nathan Cass, Alan Kominsky, Cristina Cabrera-Muffly
PURPOSE: (1) Ascertain the most important concepts and topics for otolaryngology resident education in sleep medicine and surgery, as determined by faculty who teach sleep medicine to otolaryngology residents. (2) Create learning objectives within the area of otolaryngologic sleep medicine in order to design a sleep medicine curriculum for otolaryngology residents. MATERIALS AND METHODS: Two web-based surveys were sent to 163 academic otolaryngologists who teach sleep medicine...
November 23, 2016: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/27912878/selecting-optimum-protein-nano-carriers-for-natural-polyphenols-using-chemoinformatics-tools
#5
AbdelKader A Metwally, Sherweit H El-Ahmady, Rania M Hathout
BACKGROUND: The normal fate of any natural product with a therapeutic potential is to be formulated into an effective medicine. However, the conventional methods of selecting the suitable formulations or carriers based on the formulator experiences, trials and errors as well as materials availability do not usually yield the optimal results. HYPOTHESIS: We hypothesize the possibility of the virtual optimum selection of a protein carrier for two polyphenolic compounds widely investigated for their chemopreventive effects; resveratrol and curcumin using a combination of some chemoinformatics tools...
December 15, 2016: Phytomedicine: International Journal of Phytotherapy and Phytopharmacology
https://www.readbyqxmd.com/read/27910756/fatty-acid-composition-of-different-collections-of-coprinoid-mushrooms-agaricomycetes-and-their-nutritional-and-medicinal-values
#6
Susanna M Badalyan
Qualitative and quantitative analyses of the free fatty acid (FA) composition of ethanol extracts obtained from mycelia of 30 genetically identified strains of 18 species of coprinoid mushrooms (CMs) or coprini belonging to clades Coprinellus (C. bisporus, C. curtus, C. disseminatus, C. domesticus, C. ellisii, C.flocculosus, C. micaceus, C. aff radians I, C. aff radians II, C. aff radians III, C. xanthothrix, Coprinellus sp. 4), Coprinopsis (C. cinerea, C. cothurnata, C. gonophylla, C. lagopides, C. maysoidispora, C...
2016: International Journal of Medicinal Mushrooms
https://www.readbyqxmd.com/read/27910122/one-stage-individual-participant-data-meta-analysis-models-estimation-of-treatment-covariate-interactions-must-avoid-ecological-bias-by-separating-out-within-trial-and-across-trial-information
#7
Hairui Hua, Danielle L Burke, Michael J Crowther, Joie Ensor, Catrin Tudur Smith, Richard D Riley
Stratified medicine utilizes individual-level covariates that are associated with a differential treatment effect, also known as treatment-covariate interactions. When multiple trials are available, meta-analysis is used to help detect true treatment-covariate interactions by combining their data. Meta-regression of trial-level information is prone to low power and ecological bias, and therefore, individual participant data (IPD) meta-analyses are preferable to examine interactions utilizing individual-level information...
December 1, 2016: Statistics in Medicine
https://www.readbyqxmd.com/read/27908176/activity-cross-calibration-of-unsealed-radionuclides-utilizing-a-portable-ion-chamber
#8
Hans-Sonke Jans
PURPOSE: To present and evaluate an ion chamber-based method for the cross-calibration between sites of activity measurements of unsealed radionuclides. Notably, the method allows direct comparison of short lived (i.e., clinically used) radioisotopes and the cross-calibration of radionuclide activity meters (also known as "dose calibrators"). METHODS: A portable ion chamber has been designed which is easily shipped between sites, e.g., between a standards laboratory and a nuclear medicine department...
December 2016: Medical Physics
https://www.readbyqxmd.com/read/27905926/understanding-clinical-and-non-clinical-decisions-under-uncertainty-a-scenario-based-survey
#9
Vlad V Simianu, Margaret A Grounds, Susan L Joslyn, Jared E LeClerc, Anne P Ehlers, Nidhi Agrawal, Rafael Alfonso-Cristancho, Abraham D Flaxman, David R Flum
BACKGROUND: Prospect theory suggests that when faced with an uncertain outcome, people display loss aversion by preferring to risk a greater loss rather than incurring certain, lesser cost. Providing probability information improves decision making towards the economically optimal choice in these situations. Clinicians frequently make decisions when the outcome is uncertain, and loss aversion may influence choices. This study explores the extent to which prospect theory, loss aversion, and probability information in a non-clinical domain explains clinical decision making under uncertainty...
December 1, 2016: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/27905060/perioperative-risk-adjustment-for-total-shoulder-arthroplasty-are-simple-clinically-driven-models-sufficient
#10
David N Bernstein, Aakash Keswani, David Ring
BACKGROUND: There is growing interest in value-based health care in the United States. Statistical analysis of large databases can inform us of the factors associated with and the probability of adverse events and unplanned readmissions that diminish quality and add expense. For example, increased operating time and high blood urea nitrogen (BUN) are associated with adverse events, whereas patients on antihypertensive medications were more likely to have an unplanned readmission. Many surgeons rely on their knowledge and intuition when assessing the risk of a procedure...
November 30, 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27904837/positron-emission-tomography-computerized-tomography-for-tumor-response-assessment-a-review-of-clinical-practices-and-radiomics-studies
#11
Wei Lu, Wengen Chen
Even with recent advances in cancer diagnosis and therapy, treatment outcomes for many cancers remain dismal. Patients often show different response to the same therapy regimen, supporting the development of personalized medicine. 18F-FDG PET/CT has been used routinely in the assessment of tumor response, in prediction of outcomes, and in guiding personalized treatment. These assessments are mainly based on physician's subjective or semi-quantitative evaluation. Recent development in Radiomics provides a promising objective way for tumor response assessment, which uses computerized tools to extract a large number of image features that capture additional information not currently used in clinic that has prognostic value...
August 2016: Translational Cancer Research
https://www.readbyqxmd.com/read/27904452/virtual-modelling-of-novel-applicator-prototypes-for-cervical-cancer-brachytherapy
#12
Primoz Petric, Robert Hudej, Noora Al-Hammadi, Barbara Segedin
BACKGROUND: Standard applicators for cervical cancer Brachytherapy (BT) do not always achieve acceptable balance between target volume and normal tissue irradiation. We aimed to develop an innovative method of Target-volume Density Mapping (TDM) for modelling of novel applicator prototypes with optimal coverage characteristics. Patients and methods. Development of Contour-Analysis Tool 2 (CAT-2) software for TDM generation was the core priority of our task group. Main requests regarding software functionalities were formulated and guided the coding process...
December 1, 2016: Radiology and Oncology
https://www.readbyqxmd.com/read/27903462/radiomic-based-pathological-response-prediction-from-primary-tumors-and-lymph-nodes-in-nsclc
#13
Thibaud P Coroller, Vishesh Agrawal, Elizabeth Huynh, Vivek Narayan, Stephanie W Lee, Raymond H Mak, Hugo J W L Aerts
INTRODUCTION: Non-invasive biomarkers that capture the total tumor burden could provide important complementary information for precision medicine to aid clinical decision-making. We investigated the value of radiomic data, extracted from pre-treatment computed tomography (CT) images of the primary tumor and lymph nodes, in predicting pathological response following neoadjuvant chemoradiation prior to surgery. METHODS: Eighty-five patients with resectable locally-advanced (stage II-III) non-small cell lung cancer (NSCLC) (median age: 60...
November 26, 2016: Journal of Thoracic Oncology
https://www.readbyqxmd.com/read/27900641/cardiovascular-pet-mr-we-need-evidence-not-hype
#14
EDITORIAL
Afshin Farzaneh-Far, Raymond Y Kwong
Recent introduction of hybrid positron emission tomography/magnetic resonance (PET/MR) scanners has created excitement regarding potential applications in cardiovascular medicine. This has led to a number of optimistic assessments of its potential value in the nuclear cardiology literature, although most published data are still at the feasibility or pre-clinical level. Such excitement is understandable and provides "fuel" for generation of the necessary clinical validation studies, which will be required. Given the current scrutiny from payers and government agencies to reduce the costs of cardiac imaging, the responsibility for showing additive benefit lies on the shoulders of those advocating for new, more expensive technologies...
November 29, 2016: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/27897064/diagnosis-of-dementia-with-lewy-bodies-can-123-i-imp-and-123-i-mibg-scintigraphy-yield-new-core-features
#15
Fumi Sakamoto, Shinya Shiraishi, Noriko Tsuda, Mamoru Hashimoto, Seiji Tomiguchi, Manabu Ikeda, Yasuyuki Yamashita
OBJECTIVE: Since the clinical symptoms of different types of dementia frequently overlap, especially in the earlier stages at onset, it is difficult to distinguish dementias with Lewy bodies (DLB) from other neurodegenerative dementias based on their clinical manifestations alone. Nuclear medicine imaging has been reported as a high-value index for the objective evaluation and diagnosis of DLB. The aim of this study was to evaluate whether nuclear medicine imaging findings may yield core features to be added to the diagnosis of DLB...
November 29, 2016: British Journal of Radiology
https://www.readbyqxmd.com/read/27894972/transcriptome-inference-and-systems-approaches-to-polypharmacology-and-drug-discovery-in-herbal-medicine
#16
Peng Li, Jianxin Chen, Wuxia Zhang, Bangze Fu, Wei Wang
ETHNOPHARMACOLOGICAL RELEVANCE: Herbal medicine is a concoction of numerous chemical ingredients, and it exhibits polypharmacological effects to act on multiple pharmacological targets, regulating different biological mechanisms and treating a variety of diseases. Thus, this complexity is impossible to deconvolute by the reductionist method of extracting one active ingredient acting on one biological target. AIM OF THE STUDY: To dissect the polypharmacological effects of herbal medicines and their underling pharmacological targets as well as their corresponding active ingredients...
November 25, 2016: Journal of Ethnopharmacology
https://www.readbyqxmd.com/read/27891830/a-randomized-trial-examining-the-impact-of-communicating-genetic-and-lifestyle-risks-for-obesity
#17
Catharine Wang, Erynn S Gordon, Tricia Norkunas, Lisa Wawak, Ching-Ti Liu, Michael Winter, Rachel S Kasper, Michael F Christman, Robert C Green, Deborah J Bowen
OBJECTIVE: Genetic testing for obesity is available directly to consumers, yet little is understood about its behavioral impact and its added value to nongenetic risk communication efforts based on lifestyle factors. METHODS: A randomized trial examined the short-term impact of providing personalized obesity risk information, using a 2 × 2 factorial design. Participants were recruited from the Coriell Personalized Medicine Collaborative (CPMC) and randomized to receive (1) no risk information (control), (2) genetic risk, (3) lifestyle risk, or (4) combined genetic/lifestyle risks...
December 2016: Obesity
https://www.readbyqxmd.com/read/27891361/serum-frap-levels-and-pre-eclampsia-among-pregnant-women-in-a-rural-community-of-northern-india
#18
Anant Gupta, Shashi Kant, Sanjeev Kumar Gupta, Shyam Prakash, Mani Kalaivani, Chandrakant S Pandav, Sanjay Kumar Rai, Puneet Misra
INTRODUCTION: There is a balance between the oxidative and the anti-oxidative forces in human body. Some studies document decreased level of anti-oxidant in pre-eclampsia while other studies showed normal level of anti-oxidant in pre-eclampsia and the evidence is equivocal. AIM: The aim of the present study was to assess enzymatic anti-oxidant activities in pre-eclamptic women and compare it with normotensive pregnant women with period of gestation between 28 to 36 weeks...
October 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27891310/assessment-of-oral-health-attitudes-and-behavior-among-students-of-kuwait-university-health-sciences-center
#19
Dena A Ali
AIM: The aims of this study were to assess attitudes and behavior of oral health maintenance among students in four faculties (Medicine, Dentistry, Pharmacy, and Allied Health) and to compare oral health attitudes and behavior of all students at Kuwait University Health Sciences Center (KUHSC) based on their academic level. MATERIALS AND METHODS: Students enrolled in the Faculties of Dentistry, Medicine, Pharmacy, and Allied Health at KUHSC were evaluated regarding their oral health attitudes and behavior by an e-mail invitation with a link to the Hiroshima University Dental Behavior Inventory survey that was sent to all 1802 students with Kuwait University Health Sciences Center e-mail addresses...
September 2016: Journal of International Society of Preventive & Community Dentistry
https://www.readbyqxmd.com/read/27889288/quiet-dissent-the-attitudes-beliefs-and-behaviours-of-uk-osteopaths-who-reject-low-back-pain-guidance-a-qualitative-study
#20
Joanna Figg-Latham, Dévan Rajendran
INTRODUCTION: Clinical guidelines are derived from best research evidence and aim to: improve quality of non-specific low back pain (nsLBP) management and identify patients at risk of suffering chronic pain. However, guideline discordant attitudes and beliefs have been identified in healthcare students and practitioners, including osteopaths. DESIGN: A qualitative approach with elements of grounded theory was used to explore underlying attitudes and beliefs of practitioners/students working in a British osteopathic education institution...
October 18, 2016: Manual Therapy
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