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https://www.readbyqxmd.com/read/28322487/methodology-for-senior-proof-guidelines-a-practice-example-from-the-netherlands
#1
Barbara C van Munster, Johanna E A Portielje, Andrea B Maier, Arend J Arends, Johannes J A de Beer
RATIONALE, AIMS AND OBJECTIVES: Evidence-based guidelines constitute a foundation for medical decision making. It is often unclear whether recommendations in general guidelines also apply to older people. This study aimed to develop a methodology to increase the focus on older people in the development of guidelines. METHODS: The methodology distinguishes 4 groups of older people: (1) relatively healthy older people; (2) older people with 1 additional specific (interfering) comorbid condition; (3) older people with multimorbidity; and (4) vulnerable older people...
March 21, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28298567/omeract-quality-adjusted-life-years-qaly-working-group-do-current-qaly-measures-capture-what-matters-to-patients
#2
Logan Trenaman, Annelies Boonen, Francis Guillemin, Mickael Hiligsmann, Alison Hoens, Carlo Marra, Will Taylor, Jennifer Barton, Peter Tugwell, George Wells, Nick Bansback
OBJECTIVE: To understand the limitations with current patient-reported outcome measures (PROM) used to generate quality-adjusted life-years (QALY) in rheumatology, and set a research agenda. METHODS: Two activities were undertaken. The first was a scoping review of published studies that have used PROM to generate QALY in rheumatology between 2011 and 2016. The second was an interactive "eyeball test" exercise at Outcome Measures in Rheumatology 13 that compared subdomains of widely used generic PROM, as identified through the scoping review, to subdomains of the Assessment of SpondyloArthritis Health Index (ASAS-HI) condition-specific PROM for ankylosing spondylitis...
March 15, 2017: Journal of Rheumatology
https://www.readbyqxmd.com/read/28289548/the-comparative-effectiveness-and-cost-effectiveness-of-ranibizumab-for-neovascular-macular-degeneration-revisited
#3
Gary C Brown, Melissa M Brown, Heidi B Lieske, Adam Turpcu, Yamina Rajput
BACKGROUND: To compare a near decade of follow-up, newer control cohort data, use of both the societal and third party insurer cost perspectives, and integration of unilateral/bilateral therapy on the comparative effectiveness and cost-effectiveness of intravitreal ranibizumab therapy for neovascular, age-related macular degeneration (AMD). METHODS: Value-Based Medicine(®), 12-year, combined-eye model, cost-utility analysis employing MARINA and HORIZON clinical trial data...
2017: International Journal of Retina and Vitreous
https://www.readbyqxmd.com/read/28288314/attributing-a-monetary-value-to-patients-time-a-contingent-valuation-approach
#4
Bernard van den Berg, Amiram Gafni, France Portrait
It is hard to ignore the importance of patient time investment in the production of health since the influential paper by Grossman (1972). Patients' time includes time to admission, travel time, waiting time, and treatment time and can be substantial. Patients' time is, however, often ignored in economic analyses. This may lead to biased results and inappropriate policy recommendations, which may eventually influence patients' health, wellbeing and welfare. How to value patient time is not straightforward. Although there is some emerging literature on the monetary valuation of patient time, an important challenge remains to develop an approach that can be used to monetarily value time of patients not participating in the labour market...
February 20, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28282227/an-integrated-framework-for-effective-and-efficient-communication-with-families-in-the-adult-intensive-care-unit
#5
Jennifer B Seaman, Robert M Arnold, Leslie P Scheunemann, Douglas B White
The increased focus on patient and family-centered care in adult intensive care units (ICUs) has generated multiple platforms for clinician-family communication beyond traditional interdisciplinary family meetings (family meetings)-including family-centered rounds, bedside or telephone updates, and electronic family portals. Some clinicians and administrators are now using these platforms instead of conducting family meetings. For example, some institutions are moving toward using family-centered rounds as the main platform for clinician-family communication, and some physicians rely on brief daily updates to the family at the bedside or by phone, in lieu of family meetings...
March 10, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28279216/understanding-optimal-approaches-to-patient-and-caregiver-engagement-in-the-development-of-cancer-practice-guidelines-a-mixed-methods-study
#6
Melissa C Brouwers, Marija Vukmirovic, Karen Spithoff, Julie Makarski
BACKGROUND: Practice guidelines (PGs) can assist health care practitioners and patients to make decisions about health care options. A key component of high quality PGs is the consideration of patient values and preferences. A mixed methods study was conducted to understand optimal approaches to patient engagement in the development of cancer PGs. METHODS: Cancer patients, survivors, family members and caregivers were recruited from cancer clinics, follow-up clinics, community support programs, a provincial patient and family advisory committee, and a provincial cancer PG development program...
March 9, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28276567/patient-values-and-preferences-for-antithrombotic-therapy-in-atrial-fibrillation-a-narrative-systematic-review
#7
Peter S Loewen, Angela Tianshu Ji, Anita Kapanen, Alison McClean
Guidelines recommend that patients' values and preferences should be considered when selecting stroke prevention therapy for atrial fibrillation (SPAF). However, doing so is difficult, and tools to assist clinicians are sparse. We performed a narrative systematic review to provide clinicians with insights into the values and preferences of AF patients for SPAF antithrombotic therapy. Narrative systematic review of published literature from database inception. RESEARCH QUESTIONS: 1) What are patients' AF and SPAF therapy values and preferences? 2) How are SPAF therapy values and preferences affected by patient factors? 3) How does conveying risk information affect SPAF therapy preferences? and 4) What is known about patient values and preferences regarding novel oral anticoagulants (NOACs) for SPAF? Twenty-five studies were included...
March 9, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28271085/the-zeitgeist-of-challenging-the-evidence-a-perspective-on-the-international-consensus-meeting-on-periprosthetic-joint-infection
#8
Hangama C Fayaz, Jesse B Jupiter
BACKGROUND: The economic burden of the treatment of periprosthetic joint infection (PJI) is high and the treatment of PJI has a high degree of international controversy. Several papers have declared the International Consensus Meeting on Periprosthetic Joint Infection (ICMPJI) to be the "flawless pledge of international academics" to overcome the challenges of musculoskeletal infections. The purpose of this paper is to highlight for the first time some essential insights into the key dilemmas that are associated with this international consensus process...
January 2017: Archives of Bone and Joint Surgery
https://www.readbyqxmd.com/read/28270454/perforin-and-cd107a-testing-are-superior-to-nk-cell-function-testing-for-screening-patients-for-genetic-hlh
#9
Tamar S Rubin, Kejian Zhang, Carrie Gifford, Adam Lane, Jack J Bleesing, Rebecca A Marsh
Primary HLH (hemophagocytic lymphohistiocytosis) can be caused by bi-allelic mutations in PRF1, encoding perforin, or UNC13D, STXBP2, STX11, RAB27A, LYST and AP3B1, encoding proteins involved in cytotoxic lymphocyte degranulation. Natural killer (NK) cell cytotoxicity assays can quickly screen for all these genetic diseases, facilitating treatment, but combining NK cell perforin expression and CD107a upregulation tests can as well. To determine the relative diagnostic accuracies for each approach, we retrospectively reviewed screening test performance in 1614 patients referred for HLH evaluation...
March 7, 2017: Blood
https://www.readbyqxmd.com/read/28268161/minimally-invasive-pancreatic-resections-cost-and-value-perspectives
#10
Kevin C Conlon, Thijs de Rooij, Jony van Hilst, Mohammad Abu Hidal, Julie Fleshman, Mark Talamonti, Tsafrir Vanounou, Richard Garfinkle, Vic Velanovich, David Kooby, Charles M Vollmer
BACKGROUND: The number of minimally invasive pancreatic resections (MIPR) performed for benign or malignant disease, have increased in recent years. However, there is limited information regarding cost/value implications. METHODS: An international conference evaluating MIPR was held during the 12th Bi-Annual International Hepato-Pancreato-Biliary Association (IHPBA) World Congress in Sao Paulo, Brazil, on April 20th, 2016. This manuscript summarizes the presentations that reviewed current topics in cost and value as they pertain to MIPR...
March 4, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28259229/clinical-practice-guidelines-a-primer-on-development-and-dissemination
#11
REVIEW
M Hassan Murad
Trustworthy clinical practice guidelines should be based on a systematic review of the literature, provide ratings of the quality of evidence and the strength of recommendations, consider patient values, and be developed by a multidisciplinary panel of experts. The quality of evidence reflects our certainty that the evidence warrants a particular action. Transforming evidence into a decision requires consideration of the quality of evidence, balance of benefits and harms, patients' values, available resources, feasibility of the intervention, acceptability by stakeholders, and effect on health equity...
March 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/28255070/patient-values-informing-medical-treatment-a-pilot-community-and-advance-care-planning-survey
#12
S Milnes, C Corke, N R Orford, M Bailey, J Savulescu, D Wilkinson
Medicine regards the prevention of death as an important priority. Yet patients may have a range of priorities of equal or greater importance. These other priorities are often not discussed or appreciated by treating doctors. OBJECTIVES: We sought to identify priorities of care for patients attending an advance care planning (ACP) clinic and among the general population, and to identify factors associated with priorities other than prolonging life. METHODS: We used a locally developed survey tool 'What Matters Most' to identify values...
March 2, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28253532/using-cost-effectiveness-analysis-to-measure-value-in-musculoskeletal-imaging
#13
Jacob J Visser, Edwin H G Oei, M G Myriam Hunink
In the era of value-based health care, adding value is a key element in providing care. The choice of appropriate imaging modality and protocol should be based on consideration of patients' values, health care outcomes, and cost-effectiveness, taking into account the perspective of the decision maker, the health care system, and society at large. This article provides an overview of the available tools to measure value, outcomes, and cost-effectiveness in musculoskeletal radiology, illustrated with relevant examples...
February 2017: Seminars in Musculoskeletal Radiology
https://www.readbyqxmd.com/read/28242771/improving-outcomes-from-high-risk-surgery-a-multimethod-evaluation-of-a-patient-centred-advanced-care-planning-intervention
#14
Amanda Selwood, Siva Senthuran, Brette Blakely, Paul Lane, John North, Robyn Clay-Williams
INTRODUCTION: Patients who are frail, have multiple comorbidities or have a terminal illness often have poor outcomes from surgery. However, sole specialists may recommend surgery in these patients without consultation with other treating clinicians or allowing for patient goals. The Patient-Centred Advanced Care Planning (PC-ACP) model of care provides a framework in which a multidisciplinary advanced care plan is devised to incorporate high-risk patients' values and goals. Decision-making is performed collaboratively by patients, their family, surgeons, anaesthetists, intensivists and surgical case managers...
February 27, 2017: BMJ Open
https://www.readbyqxmd.com/read/28237212/value-assessment-at-the-point-of-care-incorporating-patient-values-throughout-care-delivery-and-a-draft-taxonomy-of-patient-values
#15
Melissa J Armstrong, C Daniel Mullins
Incorporation of patient values is a key element of patient-centered care, but consistent incorporation of patient values at the point of care is lacking. Shared decision making encourages incorporation of patient values in decision making, but associated tools often lack guidance on value assessment. In addition, focusing on patient values relating only to specific decisions misses an opportunity for a more holistic approach to value assessment that could impact other aspects of clinical encounters, including health care planning, communication, and stakeholder involvement...
February 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28237198/patient-versus-physician-valuation-of-durable-survival-gains-implications-for-value-framework-assessments
#16
Jason Shafrin, Taylor T Schwartz, Tony Okoro, John A Romley
BACKGROUND: Previous research indicates that patients value therapies that provide durable or tail-of-the-curve survival gains, but it is unclear whether physicians share these preferences. OBJECTIVE: To compare patient and physician preferences for treatments with a positive probability of durable survival gains relative to those with fixed survival gains. METHODS: Patients with advanced stage melanoma or lung cancer and the oncologists who treated these patients were surveyed...
February 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28225799/sf-6d-utility-values-for-the-better-and-worse-seeing-eye-for-health-states-based-on-the-snellen-equivalent-in-patients-with-age-related-macular-degeneration
#17
Martijn S Visser, Sankha Amarakoon, Tom Missotten, Reinier Timman, Jan J Busschbach
OBJECTIVE: Economic evaluations in wet age-related macular degeneration (ARMD) is hampered as often utility values for solely one eye are used, mostly the better-seeing eye (BSE). Moreover, frequently chosen methods rely on patient values and/or disease specific measures, while economic evaluations prefer generic quality of life (QoL) measures based on societal preferences. The generic QoL utility instrument EQ-5D has shown to be insensitive for differences in visual acuity. The aim of this study was therefore to provide societal utility values, using the generic SF-6D, for health states acknowledging both BSE and worse-seeing eye (WSE)...
2017: PloS One
https://www.readbyqxmd.com/read/28215933/gender-determination-from-diagnostic-factors-on-anteroposterior-pelvic-radiographs
#18
Azadeh Memarian, Kamran Aghakhani, Shahrokh Mehrpisheh, Foroozan Fares
BACKGROUND: Gender determination from skeletal remains is one of the primary factors in forensic medicine. This study aimed to identify the gender of patients referred to the radiology ward of the Rasoul Akram Hospital of Tehran using anteroposterior pelvic radiography. METHODS: A total of 200 patients (100 male and 100 female) referred to the radiology ward of the Rasoul Akram Hospital for anteroposterior pelvic radiography during 2013-2014 were included in this study...
March 2017: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/28215660/progress-in-evidence-based-medicine-a-quarter-century-on
#19
REVIEW
Benjamin Djulbegovic, Gordon H Guyatt
In response to limitations in the understanding and use of published evidence, evidence-based medicine (EBM) began as a movement in the early 1990s. EBM's initial focus was on educating clinicians in the understanding and use of published literature to optimise clinical care, including the science of systematic reviews. EBM progressed to recognise limitations of evidence alone, and has increasingly stressed the need to combine critical appraisal of the evidence with patient's values and preferences through shared decision making...
February 16, 2017: Lancet
https://www.readbyqxmd.com/read/28193104/multidisciplinary-training-on-spiritual-care-for-patients-in-palliative-care-trajectories-improves-the-attitudes-and-competencies-of-hospital-medical-staff
#20
Joep van de Geer, Nic Veeger, Marieke Groot, Hetty Zock, Carlo Leget, Jelle Prins, Kris Vissers
OBJECTIVES: Patients value health-care professionals' attention to their spiritual needs. However, this is undervalued in health-care professionals' education. Additional training is essential for implementation of a national multidisciplinary guideline on spiritual care (SC) in palliative care (PC). Aim of this study is to measure effects of a training program on SC in PC based on the guideline. METHODS: A pragmatic multicenter trial using a quasi-experimental pretest-posttest design as part of an action research study...
January 1, 2017: American Journal of Hospice & Palliative Care
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