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https://www.readbyqxmd.com/read/28634503/monitoring-the-diagnostic-process-on-an-inpatient-neurology-service
#1
Amar Dhand, Robert Bucelli, Arun Varadhachary, Michael Tsiaklides, Gabriela de Bruin, Gurpreet Dhaliwal
The Institute of Medicine report Improving Diagnosis in Health Care called for tools to monitor physicians' diagnostic process. We addressed this need by developing a tool for clinicians to record and analyze their diagnostic process. The tool was a secure web application in which clinicians used a structured grading system to assess the relative impact of clinical, laboratory, and neuroimaging data for every new diagnosis. Four neurohospitalists used the tool for 6.5 months on a general neurology ward service at a single tertiary-level teaching hospital...
July 2017: Neurohospitalist
https://www.readbyqxmd.com/read/28623568/evaluation-of-venous-thromboembolism-prophylaxis-in-a-major-hospital-in-a-developing-country
#2
Lubna Gharaibeh, Hanan Sartawi, Diana Ayyad, Tareq Juma, Kamal Albassoumi, Enas Ismail
Background Venous thromboembolism is the most common preventable cause of hospital death. Despite that, there is still a large gap between what we know about venous thromboembolism prophylaxis and what is happening in current practice. Objective To evaluate VTE prophylaxis in Al-Basheer hospital and assess the extent of agreement of physicians' practice with the guidelines. Setting Al-Basheer governmental hospital in Jordan between January 2016 and June 2016. Method In this cross-sectional observational study, patients were randomly selected from medical and surgical wards...
June 16, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28606846/agreement-between-home-based-measurement-of-stool-calprotectin-and-elisa-results-for-monitoring-inflammatory-bowel-disease-activity
#3
Anke Heida, Mariska Knol, Anneke Muller Kobold, Josette Bootsman, Gerard Dijkstra, Patrick F van Rheenen
BACKGROUND AND AIMS: An increasing number of physicians use repeated measurements of stool calprotectin to monitor intestinal inflammation in patients with inflammatory bowel diseases (IBD). A lateral flow-based rapid test allows patients to measure their own stool calprotectin values at home. The test comes with a software application (IBDoc) that turns a smartphone camera into a results reader. We compared results from this method with those from the hospital-based reader (Quantum Blue) and ELISA analysis...
June 9, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28597467/development-of-indicators-for-evaluating-the-appropriate-use-of-triazoles-for-invasive-fungal-disease-a-delphi-panel-survey
#4
W H Dong, G Z Zhang, J X Li, Y Wang, T T Wang, Y L Dong
WHAT IS KNOWN AND OBJECTIVES: Triazoles including fluconazole, itraconazole, voriconazole and posaconazole are now widely used, whereas in some countries, they are reportedly used in inappropriate way frequently; thus, it is clearly a matter of urgency to regulate the use of triazole drugs. Several studies have made good attempts to evaluate antifungal use, but they did not cover the entire medication process. This study aimed to establish indicators for the appropriate use of triazoles for invasive fungal disease, so as to produce a reference for evaluating and standardizing the rational application of triazole antifungals...
June 8, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28562157/validity-of-a-chinese-version-of-the-mini-asthma-quality-of-life-questionnaire-miniaqlq-and-a-comparison-of-completion-by-patients-and-relatives
#5
Yulan Qu, Chen Zhang, Wei Gao, Yunye Ning, Ruohua Chen, Shu Zhang, Yahong Sun, Yan Shang, Chong Bai
OBJECTIVE: To test the psychometric properties of the Chinese version of the Mini Asthma Quality of Life Questionnaire (MiniAQLQ) and to investigate the differences between the MiniAQLQ completed by patients (p-MiniAQLQ) and by their relatives (r-MiniAQLQ). METHODS: One hundred and two asthmatic patients and 45 relatives were recruited. The reliability was evaluated using Cronbach's alpha and intraclass correlation coefficient (ICC). The validity of the MiniAQLQ was assessed by comparing it with the Sydney Asthma Quality of Life Questionnaire (AQLQ-S) and lung function measurements...
May 31, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28551002/development-of-a-computer-interpretable-clinical-guideline-model-for-decision-support-in-the-differential-diagnosis-of-hyponatremia
#6
Arturo González-Ferrer, M Ángel Valcárcel, Martín Cuesta, Joan Cháfer, Isabelle Runkle
INTRODUCTION: Hyponatremia is the most common type of electrolyte imbalance, occurring when serum sodium is below threshold levels, typically 135mmol/L. Electrolyte balance has been identified as one of the most challenging subjects for medical students, but also as one of the most relevant areas to learn about according to physicians and researchers. We present a computer-interpretable guideline (CIG) model that will be used for medical training to learn how to improve the diagnosis of hyponatremia applying an expert consensus document (ECDs)...
July 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/28551000/physician-satisfaction-with-transition-from-cpoe-to-paper-based-prescription
#7
N Griffon, M Schuers, M Joulakian, M Bubenheim, J-P Leroy, S J Darmoni
INTRODUCTION: In January 2015, Rouen University Hospital's information system experienced serious issues. It was necessary to rapidly switch from the computerized provider order entry (CPOE) system towards a paper-based order entry (PBOE) system. This was an opportunity to evaluate prescriber opinion on the two provider order entry (POE) systems. METHODS: All residents were asked to fill an augmented version of the POE satisfaction and usage survey for both POE systems...
July 2017: International Journal of Medical Informatics
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
#8
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/28537754/development-of-a-standardized-kalamazoo-communication-skills-assessment-tool-for-radiologists-validation-multisource-reliability-and-lessons-learned
#9
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
#10
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/28522918/combination-of-corticosteroids-and-5-aminosalicylates-or-corticosteroids-alone-for-patients-with-moderate-severe-active-ulcerative-colitis-a-global-survey-of-physicians-practice
#11
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/28492523/evaluation-of-identifier-field-agreement-in-linked-neonatal-records
#12
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/28460696/caring-for-kids-bridging-gaps-in-pediatric-emergency-care-through-community-education-and-outreach
#13
REVIEW
Ann Luckstead-Gosdin, Lori Vinson, Cynthia Greenwell, Jefferson Tweed
The Pediatric Emergency Services Network (PESN) was developed to provide ongoing continuing education on pediatric guidelines and pediatric emergency care to rural and nonpediatric hospitals, physicians, nurses, and emergency personnel. A survey was developed and given to participants attending PESN educational events to determine the perceived benefit and application to practice of the PESN outreach program. Overall, 91% of participants surveyed reported agreement that PESN educational events were beneficial to their clinical practice, provided them with new knowledge, and made them more knowledgeable about pediatric emergency care...
June 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28455104/a-comparison-of-tuberculosis-diagnostic-systems-in-a-retrospective-cohort-of-hiv-infected-children-in-rio-de-janeiro-brazil
#14
Solange Gonçalves David, Kathryn L Lovero, Maria de Fátima B Pombo March, Thalita G Abreu, Antonio Ruffino Netto, Afranio L Kritski, Clemax C Sant'Anna
OBJECTIVES: The diagnosis of pediatric tuberculosis (TB) presents many challenges, and is further complicated in HIV-infected patients. While many diagnostic systems have been proposed, there is no pediatric TB diagnosis gold standard. The outcomes of four TB diagnostic systems in HIV-infected children were compared in this study. METHODS: A retrospective cohort study was conducted at a TB/HIV reference hospital in Rio de Janeiro. HIV-infected pediatric patients evaluated for TB from 1998 to 2010 were reassessed using four diagnostic systems: Kenneth Jones, 1969; Tidjani, 1986; Ben Marais, 2006; Brazilian Ministry of Health, 2010...
April 25, 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/28453186/emergency-physicians-are-able-to-detect-right-ventricular-dilation-with-good-agreement-compared-to-cardiology
#15
Matt A Rutz, Julie M Clary, Jeffrey A Kline, Frances M Russell
OBJECTIVE: Focused cardiac ultrasound (FOCUS) is a useful tool in evaluating patients presenting to the emergency department (ED) with acute dyspnea. Prior work has shown that right ventricular (RV) dilation is associated with repeat hospitalizations and shorter life expectancy. Traditionally, RV assessment has been evaluated by cardiologist-interpreted comprehensive echocardiography. The primary goal of this study was to determine the interrater reliability between emergency physicians (EPs) and a cardiologist for determining RV dilation on FOCUS performed on ED patients with acute dyspnea...
April 28, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28437573/using-internal-and-external-reviewers-can-help-to-optimise-neonatal-mortality-and-morbidity-conferences
#16
Michael-Andrew Assaad, Annie Janvier, Anie Lapointe
AIM: This study determined whether there was a difference in the conclusions reached by neonatologists in morbidity and mortality conferences based on their level of involvement in a case. METHODS: All neonatal deaths occurring between August 2014 and September 2015 at the neonatal intensive care unit of Sainte-Justine Hospital, Montreal, Quebec, Canada, were reviewed by internal physicians involved in the case and external physicians who were not. The reviewers were asked to identify positive and negative clinical practice items and provide written recommendations...
April 24, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28403889/muscle-mri-at-the-time-of-questionable-disease-flares-in-juvenile-dermatomyositis-jdm
#17
Rabheh Abdul-Aziz, Chack-Yung Yu, Brent Adler, Sharon Bout-Tabaku, Katherine E Lintner, Melissa Moore-Clingenpeel, Charles H Spencer
BACKGROUND: The course of JDM has improved substantially over the last 70 years with early and aggressive treatments. Yet it remains difficult to detect disease flares as symptoms may be mild; signs of rash and muscle weakness vary widely and are often equivocal; laboratory tests of muscle enzyme levels are often normal; electromyography and muscle biopsy are invasive. Alternative tools are needed to help decide if more aggressive treatment is needed. Our objective is to determine the effectiveness of muscle Magnetic Resonance Imaging (MRI) in detecting JDM flares, and how an MRI affects physician's decision-making regarding treatment...
April 12, 2017: Pediatric Rheumatology Online Journal
https://www.readbyqxmd.com/read/28375496/a-review-and-survey-of-neurosurgeon-hospital-relationships-evolution-and-options
#18
Dong H Kim, Bernard Duco, Daniel Wolterman, Charles Stokes, Rod Brace, Robert A Solomon, Nicholas Barbaro, Richard Westmark, David MacDougall, James Bean, Joanna O'Leary, Nicole Moayeri, Ralph G Dacey, Mitchel S Berger, Robert Harbaugh
As healthcare delivery shifts from fee-for-service, episodic care to pay for performance and population health, both hospitals and physicians are looking for new forms of integration. A number of regulations and restrictions govern physician relationships with hospitals. In this paper, we review the legal basis for such relationships and the options available. We also survey neurosurgeons and hospital executives to gain their perspective on the current situation and likely future. Two series of structured interviews were conducted with 10 neurosurgeons who work in a range of situations in diverse markets, and with Memorial Hermann Healthcare System senior executive leadership...
April 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28351762/does-ulipristal-acetate-affect-surgical-experience-at-laparoscopic-myomectomy
#19
Lea Luketic, Lindsay Shirreff, Sari Kives, Grace Liu, Ramadan El Sugy, Nicholas Leyland, Meir Jonathon Solnik, Ally Murji
STUDY OBJECTIVE: To compare surgical experience of laparoscopic/robotic myomectomy in premenopausal patients pretreated with ulipristal acetate (UPA) with women not hormonally pretreated. DESIGN: A retrospective, multicenter cohort study of laparoscopic/robotic myomectomy procedure videos (Canadian Task Force Classification III). SETTING: Multiple university-affiliated tertiary care hospitals. PATIENTS: Fifty-five premenopausal women who underwent laparoscopic/robotic myomectomy for intramural myomas and were either pretreated with 3 months of UPA or had no hormonal pretreatment...
March 25, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28336681/accuracy-and-reliability-of-stroke-diagnosis-in-the-pediatric-emergency-department
#20
Mark T Mackay, Adriana Yock-Corrales, Leonid Churilov, Paul Monagle, Geoffrey A Donnan, Franz E Babl
BACKGROUND AND PURPOSE: Access to acute stroke interventions in the emergency department (ED) relies on correct clinical diagnosis. Our aims were to determine the accuracy and reliability of pediatric ED physician diagnosis of childhood stroke and other conditions presenting with brain attack symptoms. METHODS: Prospective study of consecutive children aged 1 month to 18 years presenting to the ED from June 2009 to December 2010 with focal neurological deficits...
March 23, 2017: Stroke; a Journal of Cerebral Circulation
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