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https://www.readbyqxmd.com/read/28548896/implementation-of-asthma-clinical-practice-guidelines-in-primary-care-a-cross-sectional-study-based-on-the-knowledge-to-action-cycle
#1
Myriam E Gagné, Louis-Philippe Boulet
OBJECTIVE: Based on the Knowledge-to-Action Cycle, we assessed the self-reported implementation and perception of asthma clinical practice guideline (CPG) recommendations in primary care physicians (PCPs), along with the barriers and facilitators to CPG use in primary care. METHODS: We conducted a cross-sectional study. Using the extended Asthma Physicians' Practice Assessment Questionnaire(©), PCPs self-reported the following: their knowledge of 15 key asthma CPG recommendations, the perceived usefulness of each of these recommendations, their motivation to apply these recommendations, and their agreement with the content of these recommendations...
May 26, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28539104/development-of-collaborative-drug-therapy-management-and-clinical-pharmacy-services-in-an-outpatient-psychiatric-clinic
#2
Ashley Tewksbury, Kevin M Bozymski, Laura Ruekert, Cheen Lum, Elizabeth Cunningham, Frank Covington
Collaborative drug therapy management (CDTM) is a written agreement that allows a pharmacist to initiate, modify, or continue pharmacotherapies under a physician's scope of practice. While available literature pertaining to cardiometabolic and respiratory CDTM services is growing, publications are sparse in psychiatry, particularly outside Veterans Health Administration medical centers. A descriptive study was undertaken to demonstrate how a board-certified psychiatric pharmacist would begin organizing a protocol for clinical pharmacy services at an outpatient, community treatment center for mental health and substance abuse disorders...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28538984/accuracy-of-medical-claims-for-identifying-cardiovascular-and-bleeding-events-after-myocardial-infarction-a-secondary-analysis-of-the-translate-acs-study
#3
Patricia O Guimarães, Arun Krishnamoorthy, Lisa A Kaltenbach, Kevin J Anstrom, Mark B Effron, Daniel B Mark, Patrick L McCollam, Linda Davidson-Ray, Eric D Peterson, Tracy Y Wang
Importance: Pragmatic clinical trial designs have proposed the use of medical claims data to ascertain clinical events; however, the accuracy of billed diagnoses in identifying potential events is unclear. Objectives: To compare the 1-year cumulative incidences of events when events were identified by medical claims vs by physician adjudication and to assess the accuracy of bill-identified events using physician adjudication as the criterion standard. Design, Setting, and Participants: This post hoc analysis of a clinical trial assessed the medical claims forms and records for all rehospitalizations at 233 US hospitals within 1 year of the index acute myocardial infarction (MI) of 12 365 patients enrolled in the Treatment With Adenosine Diphosphate Receptor Inhibitors: Longitudinal Assessment of Treatment Patterns and Events After Acute Coronary Syndrome (TRANSLATE-ACS) study between April 1, 2010, and October 31, 2012...
May 24, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28538605/the-heads-ed-evaluating-the-clinical-use-of-a-brief-action-oriented-pediatric-mental-health-screening-tool
#4
Mario Cappelli, Roger Zemek, Christine Polihronis, Nathalie R Thibedeau, Allison Kennedy, Clare Gray, Mona Jabbour, Sarah Reid, Paula Cloutier
OBJECTIVES: This effectiveness study aimed to evaluate the clinical use of the HEADS-ED tool for patients presenting to a pediatric emergency department (PED) for mental health (MH) care. METHODS: In this pragmatic trial, PED physicians used the HEADS-ED to guide their assessment and identify areas of MH need in 639 patients (mean [SD], 15.16 [1.40] years; female, 72.6%) who presented to the emergency department with MH concerns between May 2013 and March 2014. RESULTS: The HEADS-ED guided consultation to psychiatry/crisis, with 86% receiving a recommended consult...
May 23, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28537754/development-of-a-standardized-kalamazoo-communication-skills-assessment-tool-for-radiologists-validation-multisource-reliability-and-lessons-learned
#5
Stephen D Brown, Elizabeth A Rider, Katherine Jamieson, Elaine C Meyer, Michael J Callahan, Carolynn M DeBenedectis, Sarah D Bixby, Michele Walters, Sara F Forman, Pamela H Varrin, Peter Forbes, Christopher J Roussin
OBJECTIVE: The purpose of this study was to develop and test a standardized communication skills assessment instrument for radiology. MATERIALS AND METHODS: The Delphi method was used to validate the Kalamazoo Communication Skills Assessment instrument for radiology by revising and achieving consensus on the 43 items of the preexisting instrument among an interdisciplinary team of experts consisting of five radiologists and four nonradiologists (two men, seven women)...
May 24, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28536719/insulin-bolus-calculator-in-a-pediatric-hospital-safety-and-user-perceptions
#6
Mohammad B Ateya, Ranjit Aiyagari, Colleen Moran, Kanakadurga Singer
BACKGROUND: Insulin dosing in hospitalized pediatric patients is challenging and requires dosing to be matched with the specific clinical and nutritional circumstances. We implemented a customized subcutaneous insulin bolus dose calculator tool integrated with the electronic health record to improve patient care. Here we describe this tool, its utilization and safety, and assess user satisfaction and perceptions of the tool. METHODS: Blood glucose results for all patients who received insulin with and without the calculator tool were compared to assess safety...
May 24, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28530088/-common-treatment-for-acute-tonsillitis-in-the-community
#7
Oded Mazor, Martine Granek-Catarivas, Shmuel Giveon
BACKGROUND: Streptococcal tonsillitis among adults is a common diagnosis. There is wide agreement regarding the recommended treatment, which is Phenoxymethyl Penicillin (Penicillin V) 1000 mg daily (usually 500 mg BID for 10 days). OBJECTIVES: Description of the variability of routine antibiotic treatment prescribed by family physicians in the community for the treatment of acute tonsillitis (which represents a common diagnosis in primary care), and observation of the prescribed antibiotics adherence to the guidelines...
September 2016: Harefuah
https://www.readbyqxmd.com/read/28522918/combination-of-corticosteroids-and-5-aminosalicylates-or-corticosteroids-alone-for-patients-with-moderate-severe-active-ulcerative-colitis-a-global-survey-of-physicians-practice
#8
Shomron Ben-Horin, Jane M Andrews, Konstantinos H Katsanos, Florian Rieder, Flavio Steinwurz, Konstantinos Karmiris, Jae Hee Cheon, Gordon William Moran, Monica Cesarini, Christian D Stone, Doron Schwartz, Marijana Protic, Xavier Roblin, Giulia Roda, Min-Hu Chen, Ofir Har-Noy, Charles N Bernstein
AIM: To examine treatment decisions of gastroenterologists regarding the choice of prescribing 5-aminosalycilates (5ASA) with corticosteroids (CS) versus corticosteroids alone for patients with active ulcerative colitis (UC). METHODS: A cross-sectional questionnaire exploring physicians' attitude toward 5ASA + CS combination therapy vs CS alone was developed and validated. The questionnaire was distributed to gastroenterology experts in twelve countries in five continents...
April 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28515025/priority-setting-and-feasibility-of-health-information-exchange-for-primary-care-patients-with-intellectual-disabilities-a-modified-delphi-study
#9
Mathilde Mastebroek, Jenneken Naaldenberg, Hilde Tobi, Henny M J van Schrojenstein Lantman-de Valk, Antoine L M Lagro-Janssen, Geraline L Leusink
OBJECTIVE: Accurate health information exchange (HIE) is fragile in healthcare for patients with intellectual disabilities (ID), threatening the health outcomes for this patient group. In conjunction with a group of experts, we aimed to identify the principal actions and organisational factors facilitating HIE for primary care patients with ID and to assess their perceived feasibility in daily practice. METHODS: We conducted a two-round modified Delphi study with Dutch GPs (n=22), support workers (n=18) and ID physicians (n=20)...
April 15, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/28508614/methods-for-rating-sexual-development-in-girls
#10
Vincenzo De Sanctis, Ihab Zaki Elhakim, Ashraf T Soliman, Heba Elsedfy, Rania Elalaily, Giuseppe Millimaggi
Sexual maturity rating (SMR) is important in population studies and in clinical care. Pubertal staging allows doctors to assess the maturation of adolescents to correlate several pubertal phenomena such as age at menarche, growth spurt and final height, to advise and manage patients appropriately and to have sensitive "sensors" of the effects of environmental exposure on human populations. The commonly used markers of the timing of female puberty are thelarche and menarche. Appearance of the breast bud is the first indicator of puberty onset in 90% of girls...
September 2016: Pediatric Endocrinology Reviews: PER
https://www.readbyqxmd.com/read/28506939/printed-mdct-3d-models-for-prediction-of-left-atrial-appendage-laa-occluder-device-size-a-feasibility-study
#11
Orly Goitein, Noam Fink, Victor Guetta, Roy Beinart, Yafim Brodov, Eli Konen, David Goitein, Elio Di Segni, Avishay Grupper, Michael Glikson
AIMS: Trans-esophageal echocardiography (TEE) and MDCT currently serve as imaging modalities for left atrial appendage (LAA) occlusion pre-procedural planning. We assessed the feasibility of multi-detector CT (MDCT) based models to predict the correct size of device for LAA occlusion procedures. METHODS AND RESULTS: Patients planned for LAA occlusion underwent MDCT before implantation, which was used for creating and printing 3D LAA models. Three cardiologists evaluated the 3D models and predicted the correct size of the device by manual manipulation, these predictions were compared with the actual device implanted during the procedure...
May 16, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28506398/integration-of-pharmacists-into-patient-centered-medical-homes-in-federally-qualified-health-centers-in-texas
#12
Shui Ling Wong, Jamie C Barner, Kristina Sucic, Michelle Nguyen, Karen L Rascati
OBJECTIVES: To describe the integration and implementation of pharmacy services in patient-centered medical homes (PCMHs) as adopted by federally qualified health centers (FQHCs) and compare them with usual care (UC). SETTING: Four FQHCs (3 PCMHs, 1 UC) in Austin, TX, that provide care to the underserved populations. PRACTICE DESCRIPTION: Pharmacists have worked under a collaborative practice agreement with internal medicine physicians since 2005...
May 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28505323/the-perception-of-spiritual-health-differences-between-citizens-and-physicians-in-the-czech-republic
#13
Ivo Jirásek, Emanuel Hurych
This paper focuses on a phenomenon known as spiritual health. Although the scientific literature defines the concept of this health component (in relation to other dimensions, i.e. physical, mental and social health), there is no agreement concerning its relation to religiousness. The aim of this research is to find out the views of citizens (n = 1810) and physicians (n = 1200) in the Czech Republic on the potential dimension of health in its spiritual mode, and on the understanding of its content by those who acknowledge its existence...
May 15, 2017: Health Promotion International
https://www.readbyqxmd.com/read/28495073/expert-statement-on-the-single-agent-use-of-inhaled-bronchodilator-in-the-treatment-of-stable-mild-moderate-chronic-obstructive-pulmonary-disease
#14
Juan Antonio Riesco Miranda, Bernardino Alcázar, Inmaculada Alfageme, Ciro Casanova, Bartolomé Celli, Juan P de-Torres, Carlos A Jiménez Ruiz
OBJECTIVE: To describe the evidence- and experience-based expert consensus on the use of single-agent bronchodilators in patients with stable mild-moderate chronic obstructive pulmonary disease (COPD). METHODS: Using Delphi methodology, a panel of 7 respiratory medicine experts was established, who, in the first nominal group meeting defined the scope, users, and document sections. The panel drew up 14 questions on the use of single-agent bronchodilators in patients with mild-moderate stable COPD to be answered with a systematic review of the literature...
May 8, 2017: Archivos de Bronconeumología
https://www.readbyqxmd.com/read/28493254/h%C3%A3-rger%C3%A3-teversorgung-f%C3%A3-r-erwachsene
#15
Thomas Berger, Sylvia Meuret, Andreas Dietz
The identification and treatment of hearing disorders belong to the fundamental tasks of an ENT-specialist. In this context the fitting of hearing aids has a special relevance. To verify a highly qualified medical care the knowledge of the audiological threshold values for the indication of the fitting of hearing aids and the detection of early signs for impaired communication are essential. The current quality assurance agreement defines technical and steric conditions pertaining to hearing aid fitting in the context of statutory health insurance...
April 2017: Laryngo- Rhino- Otologie
https://www.readbyqxmd.com/read/28492523/evaluation-of-identifier-field-agreement-in-linked-neonatal-records
#16
E S Hall, K Marsolo, J M Greenberg
OBJECTIVE: To better address barriers arising from missing and unreliable identifiers in neonatal medical records, we evaluated agreement and discordance among traditional and non-traditional linkage fields within a linked neonatal data set. STUDY DESIGN: The retrospective, descriptive analysis represents infants born from 2013 to 2015. We linked children's hospital neonatal physician billing records to newborn medical records originating from an academic delivery hospital and evaluated rates of agreement, discordance and missingness for a set of 12 identifier field pairs used in the linkage algorithm...
May 11, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28488552/-should-every-doctor-be-allowed-to-use-ultrasound-dilemmas-surrounding-broad-application-of-ultrasound-in-clinical-practice
#17
P W G Elbers, O Kamp, J P van der Sluijs, R Lely, P R Tuinman
Ultrasound is rapidly gaining ground in clinical medicine. This offers distinct advantages for diagnosis and treatment. This is notably the case when moving images are created by the treating physician, who can integrate them immediately with all other clinical information. The downside of a broad application of ultrasound is an increase in the number of incidental findings and missed diagnoses. This is amplified by the frequent lack of formal requirements for training and skills. Storage of ultrasound images may furthermore lead to verifiable misinterpretations...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28484294/interobserver-variability-in-interpretation-of-planar-and-spect-tc-99m-dmsa-renal-scintigraphy-in-children
#18
Nermina Beslic, Renata Milardovic, Amera Sadija, Lejla Dzananovic, Semra Cavaljuga
OBJECTIVE: This study objective was to evaluate interobserver agreement between individual pairs of three nuclear medicine physicians in interpretation of renal cortical scintigraphy in children with respect to the mode of acquisition (planar vs. SPECT), diagnoses and kidney site (left vs. right). MATERIALS AND METHODS: Thirty children were imaged in planar and SPECT mode per protocol upon the injection of Tc-99m DMSA dose adjusted to their body weight. Patients were classified according to diagnoses into four groups...
March 2017: Acta Informatica Medica: AIM
https://www.readbyqxmd.com/read/28473597/diagnostic-performance-of-the-visual-reading-of-123-i-ioflupane-spect-images-when-assessed-with-or-without-quantification-in-patients-with-movement-disorders-or-dementia
#19
Jan Booij, Jacob Dubroff, Daniel Pryma, Jian Qin Yu, Rajan Agarwal, Paras Lakhani, Phillip H Kuo
Visual interpretation of (123)I-ioflupane single photon emission computed tomography (SPECT) images has high diagnostic accuracy to differentiate parkinsonian syndromes (PS) from essential tremor (ET) and probable dementia with Lewy bodies (DLB) from Alzheimer's disease. This study investigated the impact on accuracy and reader confidence offered by the addition of image quantification compared to visual interpretation alone. Methods: We collected 304 (123)I-ioflupane images from three trials, enrolling subjects with a clinical diagnosis of PS, non-PS (mainly ET), probable DLB and non-DLB (mainly Alzheimer's disease)...
May 4, 2017: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
https://www.readbyqxmd.com/read/28473462/reliability-of-a-scoring-system-used-for-qualitative-evaluation-of-lymphoscintigraphic-imaging-of-lower-extremities
#20
Mojgan Ebrahim, Irina Savitcheva, Rimma Axelsson
Introduction: Lymphoscintigraphy is an imaging technique to diagnose and characterize the severity of edema in upper and lower extremities. In lymphoscintigraphy a scoring system can increase ability of diagnostic differentiation but the use of any scoring system requires sufficient reliability. AIM: To determine inter- and intraobserver reliability of a proposed scoring system used for visual interpretation of lymphoscintigraphic imaging of lower extremities. Materials and Methods: Lymphoscintigrams in 81 persons were randomly selected from our database for retrospective evaluation...
May 4, 2017: Journal of Nuclear Medicine Technology
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