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https://www.readbyqxmd.com/read/28938046/the-value-that-infectious-diseases-physicians-bring-to-the-healthcare-system
#1
Daniel P McQuillen, Ann T MacIntyre
While a career in infectious diseases (ID) has always been challenging and exciting, recognition of the value that ID physicians provide to the healthcare system as a whole, over and above the value they provide to individual patients, has been poor in this system. In response to this disparity, the Infectious Diseases Society of America Clinical Affairs Committee has long endeavored to quantify the value of ID physicians to the system, which is challenging in part because of the many avenues through which they influence healthcare...
September 15, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28937346/deep-brain-stimulation-authenticity-and-value
#2
Jonathan Pugh, Hannah Maslen, Julian Savulescu
Deep brain stimulation has been of considerable interest to bioethicists, in large part because of the effects that the intervention can occasionally have on central features of the recipient's personality. These effects raise questions regarding the philosophical concept of authenticity. In this article, we expand on our earlier work on the concept of authenticity in the context of deep brain stimulation by developing a diachronic, value-based account of authenticity. Our account draws on both existentialist and essentialist approaches to authenticity, and Laura Waddell Ekstrom's coherentist approach to personal autonomy...
October 2017: Cambridge Quarterly of Healthcare Ethics: CQ: the International Journal of Healthcare Ethics Committees
https://www.readbyqxmd.com/read/28935458/-value-based-health-care-vbhc-whence-and-wither
#3
Heiner Raspe
Since about 2005 VbHC has become a prominent movement on the border between population medicine and health economics. The "value" it is aiming at is defined as health care "outcomes per dollar spent". The text focuses on the work of two prominent proponents: M.E. Porter and J.A.M. Gray. It considers background and central elements of VbHC and discusses similarities and differences between the two authors. Especially the differences raise questions that will hopefully play a role in the German discussion that is still in its infancy...
September 18, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28933010/economic-evaluation-of-dupilumab-for-the-treatment-of-moderate-to-severe-atopic-dermatitis-in-adults
#4
Andreas Kuznik, Gaëlle Bégo-Le-Bagousse, Laurent Eckert, Abhijit Gadkari, Eric Simpson, Christopher N Graham, LaStella Miles, Vera Mastey, Puneet Mahajan, Sean D Sullivan
INTRODUCTION: Dupilumab significantly improves signs and symptoms of atopic dermatitis (AD), including pruritus, symptoms of anxiety and depression, and health-related quality of life versus placebo in adults with moderate-to-severe AD. Since the cost-effectiveness of dupilumab has not been evaluated, the objective of this analysis was to estimate a value-based price range in which dupilumab would be considered cost-effective compared with supportive care (SC) for treatment of moderate-to-severe AD in an adult population...
September 20, 2017: Dermatology and Therapy
https://www.readbyqxmd.com/read/28932389/challenges-facing-the-veterinary-profession-in-ireland-2-on-farm-use-of-veterinary-antimicrobials
#5
Manuel Magalhães-Sant'Ana, Simon J More, David B Morton, Alison J Hanlon
BACKGROUND: Antimicrobial resistance has emerged in recent years as a significant public health threat, which requires both an ethical and a scientific approach. In a recent Policy Delphi study, on-farm use of antimicrobials was a key concern identified by veterinary professionals in Ireland. In this case study (the second in a series of three resulting from a research workshop exploring the challenges facing the veterinary profession in Ireland; the other two case studies investigate clinical veterinary services and emergency/casualty slaughter certification) we aim to provide a value-based reflection on the constraints and possible opportunities for responsible use of veterinary antimicrobials in Ireland...
2017: Irish Veterinary Journal
https://www.readbyqxmd.com/read/28930760/medical-education-and-health-care-delivery-a-call-to-better-align-goals-and-purposes
#6
David P Sklar, Paul A Hemmer, Steven J Durning
The transformation of the U.S. health care system is under way, driven by the needs of an aging population, rising health care spending, and the availability of health information. However, the speed and effectiveness of the transformation of health care delivery will depend, in large part, upon engagement of the health professions community and changes in clinicians' practice behaviors. Current efforts to influence practice behaviors emphasize changes in the health payment system with incentives to move from fee-for-service to alternative payment models...
September 14, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28930362/rapid-development-of-specialty-population-registries-and-quality-measures-from-electronic-health-record-data-an-agile-framework
#7
Vaishnavi Kannan, Jason S Fish, Jacqueline M Mutz, Angela R Carrington, Ki Lai, Lisa S Davis, Josh E Youngblood, Mark R Rauschuber, Kathryn A Flores, Evan J Sara, Deepa G Bhat, DuWayne L Willett
BACKGROUND: Creation of a new electronic health record (EHR)-based registry often can be a "one-off" complex endeavor: first developing new EHR data collection and clinical decision support tools, followed by developing registry-specific data extractions from the EHR for analysis. Each development phase typically has its own long development and testing time, leading to a prolonged overall cycle time for delivering one functioning registry with companion reporting into production. The next registry request then starts from scratch...
June 14, 2017: Methods of Information in Medicine
https://www.readbyqxmd.com/read/28927764/how-to-value-patient-values-cesarean-sections-for-the-periviable-fetus-and-home-births
#8
REVIEW
Howard Minkoff, Fouad Atallah
Respect for patient autonomy involves providing sufficient information to patients to allow them to make informed decisions, and then honoring their requests unless they are unethical or futile. At times, the factors that patients consider may not be purely biologic ones but rather will include "spiritual" factors (a sense of control in a home birth). When patients balance biologic risks against spiritual gain, physicians may not be comfortable giving deference to patients' choice. In order to explicate this issue we explore two clinical scenarios: home birth, and cesarean section for a periviable fetus; and we consider futility and limits on affirmative autonomy...
September 15, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28925623/finding-the-bright-spots-in-value-based-care
#9
Farzad Mostashari, Jen Brull, Julio Navarro, Jonathan Lilly
No abstract text is available yet for this article.
September 2017: Family Practice Management
https://www.readbyqxmd.com/read/28923844/red-flag-screening-for-low-back-pain-nothing-to-see-here-move-along-a-narrative-review
#10
REVIEW
Chad E Cook, Steven Z George, Michael P Reiman
Screening for red flags in individuals with low back pain (LBP) has been a historical hallmark of musculoskeletal management. Red flag screening is endorsed by most LBP clinical practice guidelines, despite a lack of support for their diagnostic capacity. We share four major reasons why red flag screening is not consistent with best practice in LBP management: (1) clinicians do not actually screen for red flags, they manage the findings; (2) red flag symptomology negates the utility of clinical findings; (3) the tests lack the negative likelihood ratio to serve as a screen; and (4) clinical practice guidelines do not include specific processes that aid decision-making...
September 18, 2017: British Journal of Sports Medicine
https://www.readbyqxmd.com/read/28920658/value-based-health-care-how-to-succeed-in-a-bundled-care-apm
#11
Daniel T Engelman
No abstract text is available yet for this article.
March 2017: Bulletin of the American College of Surgeons
https://www.readbyqxmd.com/read/28917833/values-based-shared-decision-making-in-the-antenatal-period
#12
REVIEW
Stephanie K Kukora, Renee D Boss
Despite advances in life-saving technology for critically ill neonates, challenges continue to arise for infants delivered with extreme prematurity, congenital anomalies, and genetic conditions that exceed the limits of currently available interventions. In these situations, parents are forced to make cognitively and emotionally difficult decisions, in discussion with a neonatologist, regarding how aggressively to provide supportive measures at the time of delivery and at what point burdens of therapy outweigh benefits...
September 13, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28903078/derivation-of-reliable-empirical-models-describing-lead-transfer-from-metal-polluted-soils-to-radish-raphanus-sativa-l-determining-factors-and-soil-criteria
#13
Sha Zhang, Jing Song, Yinwen Cheng, Peter Christie, Jian Long, Lingfei Liu
Reliable models describing Pb transfer from soils to food crops are useful in the improvement of soil protection guidelines. This study provides mechanistic insights from in-situ soil solution measurement on the Pb uptake in the root tissues (RF) of radish, grown in 25 representative Pb-contaminated agricultural soils. Lead speciation and regression analysis indicate that >88.6% of the variation in RF Pb is attributable to free Pb(2+) activity (aPb(2+)) in the soil solution, which is predominantly controlled by pH and DOC...
September 10, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/28901983/enhanced-recovery-after-surgery-evidence-for-delivering-value-based-care
#14
Anair Beverly, Dionisios Vrochides, Richard D Urman
No abstract text is available yet for this article.
2017: International Anesthesiology Clinics
https://www.readbyqxmd.com/read/28901346/-procurement-of-medical-devices-based-on-cost-effectiveness-data
#15
Sabrina Trippoli
The field of medical devices is characterized by a paucity of cost-effectiveness data that support their use. In this context, we have proposed a project based on the calculation of net monetary benefit (NMB) for each product subjected to procurement through tenders. This project consists of two steps: 1) calculation of NMB; 2) calculation of a value-based score to be used in the process of procurement and tendering. The NMB is defined as follows: NMB per patient= (monetary threshold of WTP) x (QALYs per patient) - (treatment cost per patient); WTP= willingness to pay]...
September 2017: Recenti Progressi in Medicina
https://www.readbyqxmd.com/read/28901308/utility-of-fluorescence-in-situ-hybridization-analysis-for-detecting-upper-urinary-tract-urothelial-carcinoma
#16
Jiang Yu, Hui Xiong, Chunxiao Wei, Zilian Cui, Xunbo Jin, Jianjun Zhang
OBJECTIVES: The objective of this study was to evaluate the clinical utility of fluorescence in situ hybridization (FISH) in the detection of upper urinary tract-urothelial carcinoma (UUT-UC). METHODS: Between November 2011 and November 2015, voided urine specimens from 52 consecutive patients with UUT-UC and 26 controls were collected for both FISH test and cytology. Sensitivity and specificity of FISH test and cytology were determined and compared. The frequency of chromosomal aberrations was also analyzed...
2017: Journal of Cancer Research and Therapeutics
https://www.readbyqxmd.com/read/28899704/2017-acr-annual-meeting-open-microphone-session-navigating-the-landscape-of-changing-practice-models-private-practice-corporate-radiology-and-enterprise-systems
#17
Eric J Stern, Catherine Everett, Eric B Friedberg, Amy L Kotsenas, McKinley Glover, Johnson B Lightfoote, Neil Lall, Timothy L Swan
Many practice groups are considering adopting new practice models, primarily to secure their practices by adapting to new payment models, government compliance and regulation, and increasing IT and infrastructure costs. As we move toward value-based care and capitation, the value equation (value = quality/cost) will lead us to also compete on cost to improve value. No matter what payment models ultimately dominate, we need to be prepared to lead in a value-based care environment. Measures of value will either be defined by radiologists or imposed by outside entities...
September 9, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28899233/differences-in-utility-elicitation-methods-in-cardiovascular-disease-a-systematic-review
#18
Marissa Blieden, Shravanthi R Gandra, Lung-I Cheng, Anna Szatkowski, Peter P Toth
AIMS: Utility values inform estimates of the cost-effectiveness of treatment for cardiovascular disease (CVD), but values can vary depending on the method used. The aim of this systematic literature review (SLR) was to explore how methods of elicitation impact utility values for CVD. MATERIALS AND METHODS: We identified English-language articles in Embase, MEDLINE, and the grey literature published between September 1992 and August 2015 using keywords for 'utilities' and 'stroke,' 'heart failure,' 'myocardial infarction,' or 'angina...
September 12, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28898574/integrating-kidney-transplantation-into-value-based-care-for-people-with-renal-failure
#19
Benjamin E Hippen, Franklin W Maddux
Healthcare reimbursement is increasingly tied to value instead of volume, with special attention paid to resource-intensive populations such as patients with renal disease. To this end, Medicare has sponsored pilot projects to encourage providers to develop care coordination and population health management strategies to provide quality care while reducing resource utilization. In this Personal Viewpoint essay, we argue in favor of expanding one such pilot project-the Comprehensive ESRD Care (CEC) initiative-to include patients with advanced chronic kidney disease and kidney transplant recipients...
September 12, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28898195/user-centered-design-for-developing-interventions-to-improve-clinician-recommendation-of-human-papillomavirus-vaccination
#20
Michelle L Henninger, Carmit K Mcmullen, Alison J Firemark, Allison L Naleway, Nora B Henrikson, Joseph A Turcotte
INTRODUCTION: Human papillomavirus (HPV) is the most common sexually transmitted infection in the US and is associated with multiple types of cancer. Although effective HPV vaccines have been available since 2006, coverage rates in the US remain much lower than with other adolescent vaccinations. Prior research has shown that a strong recommendation from a clinician is a critical determinant in HPV vaccine uptake and coverage. However, few published studies to date have specifically addressed the issue of helping clinicians communicate more effectively with their patients about the HPV vaccine...
2017: Permanente Journal
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