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https://www.readbyqxmd.com/read/28449017/a-multifaceted-intervention-to-improve-primary-care-radiology-referral-quality-and-value-in-canterbury
#1
Kieran Holland, Graham McGeoch, Carolyn Gullery
AIMS: This article describes a seven-year multifaceted intervention leading to sustained improvement in primary care radiology referral quality and value in Canterbury, New Zealand, and discusses the transferability to other health systems. METHODS: Access criteria were developed with input from general practitioners and hospital-based specialists, and embedded in locally developed clinical pathways. A referral management service was created to streamline referral processes...
April 28, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28448782/amcp-partnership-forum-driving-value-and-outcomes-in-oncology
#2
(no author information available yet)
Innovation in cancer treatment has provided a wealth of recently available therapeutic agents and a healthy drug pipeline that promises to change the way we approach this disease and the lives of those affected in the years to come. However, the majority of these new agents, many of which are targeted to specific genomic features of various tumors, may challenge the health care system's ability to afford cancer care. This innovation drives the need to focus on the value of the treatments provided to patients with cancer and on methods to optimize the efficiency of the dollars we spend, in addition to the clinical value itself...
May 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28448780/integration-strategies-of-pharmacists-in-primary-care-based-accountable-care-organizations-a-report-from-the-accountable-care-organization-research-network-services-and-education
#3
Tina Joseph, Genevieve M Hale, Sara M Eltaki, Yesenia Prados, Renee Jones, Matthew J Seamon, Cynthia Moreau, Stephanie A Gernant
BACKGROUND: The accountable care organization (ACO) is an innovative health care delivery model centered on value-based care. ACOs consisting of primary care providers are increasingly becoming commonplace in practice; however, medication management remains suboptimal. PROGRAM DESCRIPTION: As experts in medication management, pharmacists perform direct patient care and assist in the transition from one provider to another, which places them in an ideal position to manage multiple aspects of patient care...
May 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28448528/minimally-invasive-estimation-of-ventricular-dead-space-volume-through-use-of-frank-starling-curves
#4
Shaun Davidson, Chris Pretty, Antoine Pironet, Thomas Desaive, Nathalie Janssen, Bernard Lambermont, Philippe Morimont, J Geoffrey Chase
This paper develops a means of more easily and less invasively estimating ventricular dead space volume (Vd), an important, but difficult to measure physiological parameter. Vd represents a subject and condition dependent portion of measured ventricular volume that is not actively participating in ventricular function. It is employed in models based on the time varying elastance concept, which see widespread use in haemodynamic studies, and may have direct diagnostic use. The proposed method involves linear extrapolation of a Frank-Starling curve (stroke volume vs end-diastolic volume) and its end-systolic equivalent (stroke volume vs end-systolic volume), developed across normal clinical procedures such as recruitment manoeuvres, to their point of intersection with the y-axis (where stroke volume is 0) to determine Vd...
2017: PloS One
https://www.readbyqxmd.com/read/28448200/better-together-the-making-and-maturation-of-the-palliative-care-research-cooperative-group
#5
Christine L Ritchie, Kathryn I Pollak, Karen A Kehl, Jeri L Miller, Jean S Kutner
OBJECTIVE: To describe the growth and outcomes of the Palliative Care Research Cooperative Group (PCRC). BACKGROUND: Despite advances, significant gaps remain in the evidence base to inform care for people with serious illness. To generate this needed evidence and bolster research capacity, the Palliative Care Research Cooperative (PCRC) group was formed. METHODS: The PCRC supports investigators in the conduct of multisite clinical studies...
April 27, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28447858/risk-prediction-of-hepatotoxicity-in-paracetamol-poisoning
#6
Anselm Wong, Andis Graudins
CONTEXT: Paracetamol (acetaminophen) poisoning is the most common cause of acute liver failure in the developed world. A paracetamol treatment nomogram has been used for over four decades to help determine whether patients will develop hepatotoxicity without acetylcysteine treatment, and thus indicates those needing treatment. Despite this, a small proportion of patients still develop hepatotoxicity. More accurate risk predictors would be useful to increase the early detection of patients with the potential to develop hepatotoxicity despite acetylcysteine treatment...
April 27, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28447144/-standardized-collection-of-presenting-complaints-in-the-emergency-room-integration-of-coded-presenting-complaints-into-the-electronic-medical-record-system-of-an-emergency-department-and-their-value-for-health-care-research
#7
F Greiner, D Brammen, M Kulla, F Walcher, B Erdmann
BACKGROUND: The point of entry of a patient in emergency care is a symptom or a complaint. To evaluate subsequent processes in an emergency department until a diagnosis is made, this information has to be taken into account. OBJECTIVES: We report the introduction of coded presenting complaints into the electronic medical record system of an emergency department and describe the patients based on these data. METHODS: The CEDIS presenting complaint list was integrated into the emergency department information system of an emergency department (38,000 patients/year)...
April 26, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28446960/primary-care-screening-questionnaire-for-depression-reliability-and-validity-of-a-new-four-item-tool
#8
Pillaveetil Sathyadas Indu, Thekkethayyil Viswanathan Anilkumar, Ramdas Pisharody, Paul Swamidhas Sudhakar Russell, Damodaran Raju, P Sankara Sarma, Saradamma Remadevi, K R Leela Itty Amma, A Sheelamoni, Chittaranjan Andrade
BACKGROUND: Unidentified depression in primary care is a public health concern, globally. There is a need for brief, valid and easily administered tools in primary care. AIMS: To estimate reliability and validity of the newly developed Primary care Screening Questionnaire for Depression (PSQ4D), a four-item tool, with 'yes' or 'no' options. METHOD: PSQ4D was administered verbally (time required, <1 min) by primary care physicians to adult outpatients (n=827) in six primary care settings in Kerala, India...
March 2017: BJPsych Open
https://www.readbyqxmd.com/read/28446237/oral-impacts-on-quality-of-life-and-problem-oriented-attendance-among-south-east-london-adults
#9
Piyada Gaewkhiew, Eduardo Bernabé, Jennifer E Gallagher, Charlotte Klass, Elsa K Delgado-Angulo
BACKGROUND: Dental care seeking behaviour is often driven by symptoms. The value of oral health related quality of life (OHRQoL) measures to predict utilisation of dental services is unknown. This study aims to explore the association between OHRQoL and problem-oriented dental attendance among adults. METHODS: We analysed cross-sectional data for 705 adults, aged 16 years and above, living in three boroughs of Inner South East London. Data were collected during structured interviews at home...
April 26, 2017: Health and Quality of Life Outcomes
https://www.readbyqxmd.com/read/28445578/utility-of-a-noninvasive-2-gene-molecular-assay-for-cutaneous-melanoma-and-effect-on-the-decision-to-biopsy
#10
Laura K Ferris, Burkhard Jansen, Jonhan Ho, Klaus J Busam, Kenneth Gross, Doyle D Hansen, John P Alsobrook, Zuxu Yao, Gary L Peck, Pedram Gerami
Importance: Expression of long intergenic non-protein coding RNA 518 (LINC00518) and preferentially expressed antigen in melanoma (PRAME) genes, obtained via noninvasive adhesive patch biopsy, is a sensitive and specific method for detection of cutaneous melanoma. However, the utility of this test in biopsy decisions made by dermatologists has not been evaluated. Objective: To determine the utility of the pigmented lesion assay (PLA) for LINC00518/PRAME expression in decisions to biopsy a series of pigmented skin lesions...
April 26, 2017: JAMA Dermatology
https://www.readbyqxmd.com/read/28445100/remap-a-framework-for-goals-of-care-conversations
#11
Julie W Childers, Anthony L Back, James A Tulsky, Robert M Arnold
Conversations regarding goals of care with patients who have advanced cancer still occur too late, and oncologists say they lack the training to have these conversations effectively. Experts recommend a number of strategies when having these discussions, including discussing prognosis, responding to patient emotion, exploring values, and often making a recommendation for medical treatments that fit those values. To help learners, from residents to attending oncologists, learn these complex conversational skills, we have developed a framework with a mnemonic, REMAP: Reframe, Expect emotion, Map out patient goals, Align with goals, and Propose a plan...
April 26, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28444285/preeclampsia-screening-evidence-report-and-systematic-review-for-the-us-preventive-services-task-force
#12
Jillian T Henderson, Jamie H Thompson, Brittany U Burda, Amy Cantor
Importance: Preeclampsia is a complex disease of pregnancy with sometimes serious effects on maternal and infant morbidity and mortality. It is defined by hypertension after 20 weeks' gestation and proteinuria or other evidence of multisystem involvement. Objective: To systematically review the benefits and harms of preeclampsia screening and risk assessment for the US Preventive Services Task Force. Data Sources: MEDLINE, PubMed, and Cochrane Central Register of Controlled Trials databases from 1990 through September 1, 2015...
April 25, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28444135/prevalence-and-correlates-of-olfactory-dysfunction-in-old-age-a-population-based-study
#13
Janina Seubert, Erika J Laukka, Debora Rizzuto, Thomas Hummel, Laura Fratiglioni, Lars Bäckman, Maria Larsson
Background: Olfactory dysfunction (OD) in old age is associated with poor health outcomes. Interrelationships among different correlates of OD can offer insights into the underlying mechanisms, but to date remain understudied. Methods: Odor identification performance and self-reported olfactory functioning were studied in 2,234 people aged 60-90 years, who were free of neurodegenerative disease and enrolled in the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K) study, Stockholm, Sweden...
April 21, 2017: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/28443491/days-of-sick-leave-and-inpatient-care-at-the-time-of-pregnancy-and-childbirth-in-relation-to-maternal-age
#14
Lovisa Brehmer, Kristina Alexanderson, Erica Schytt
AIMS: To explore whether older women differ from younger women with respect to sick leave and inpatient care at the time around their first pregnancy and delivery. METHODS: This was a descriptive population-based cohort study. The study population included all 236,176 nulliparous women registered as living in Sweden who gave birth to their first singleton infant in 2006-2010. Data from nationwide Swedish registers were used. Maternal age was categorized in five-year intervals...
May 2017: Scandinavian Journal of Public Health
https://www.readbyqxmd.com/read/28442940/prevalence-of-anemia-and-its-associated-factors-among-pregnant-women-receiving-antenatal-care-at-aymiba-health-center-northwest-ethiopia
#15
Fikir Asrie
INTRODUCTION: Anemia is a global public health problem in both developing and developed countries; ~1.62 billion people suffer from anemia, and pregnant women are the most susceptible to it. The main aim of the present study was to assess the prevalence of anemia and associated risk factors among pregnant women receiving antenatal care at Aymiba Health Center, northwest Ethiopia. METHODS AND MATERIALS: An institution-based cross-sectional study was conducted at Aymiba Health Center from January to March 2015...
2017: Journal of Blood Medicine
https://www.readbyqxmd.com/read/28441950/development-of-a-web-based-patient-decision-aid-for-initiating-disease-modifying-anti-rheumatic-drugs-using-user-centred-design-methods
#16
Ingrid Nota, Constance H C Drossaert, Heleen C Melissant, Erik Taal, Harald E Vonkeman, Cees J Haagsma, Mart A F J van de Laar
BACKGROUND: A main element of patient-centred care, Patient Decision Aids (PtDAs) facilitate shared decision-making (SDM). A recent update of the International Patient Decision Aids Standards (IPDAS) emphasised patient involvement during PtDA development, but omitted a methodology for doing so. This article reports on the value of user-centred design (UCD) methods for the development of a PtDA that aims to support inflammatory arthritis patients in their choice between disease modifying anti-rheumatic drugs (DMARDs)...
April 26, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28441939/estimation-of-the-severity-of-breathlessness-in-the-emergency-department-a-dyspnea-score
#17
Tibor Gondos, Viktor Szabó, Ágnes Sárkány, Adrienn Sárkány, Gábor Halász
BACKGROUND: Dyspnea is a frequent complaint in emergency departments (ED). It has a significant amount of subjective and affective components, therefore the dyspnea scores, based on the patients' rating, can be ambiguous. Our purpose was to develop and validate a simple scoring system to evaluate the severity of dyspnea in emergency care, based on objectively measured parameters. METHODS: We performed a double center, prospective, observational study including 350 patients who were admitted in EDs with dyspnea...
April 26, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28441676/transitioning-from-volume-to-value-one-academic-medical-center-s-approach-to-improving-population-health
#18
Stephanie A C Halvorson, Mary E Tanski, Thomas R Yackel
PROBLEM: The U.S. health care system is undergoing a major transformation. Clinical delivery systems are now being paid according to the value of the care they provide, in accordance with the Triple Aim, which incorporates improving the quality and cost of care and the patient experience. Increasingly, financial risk is being transferred from insurers to clinical delivery systems that become responsible for both episode-based clinical care and the longitudinal care of patients. Thus, these delivery systems need to develop strategies to manage the health of populations...
May 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28441671/swimming-upstream-creating-a-culture-of-high-value-care
#19
Reshma Gupta, Christopher Moriates
As health system leaders strategize the best ways to encourage the transition toward value-based health care, the underlying culture-defined as a system of shared assumptions, values, beliefs, and norms existing within an environment-continues to shape clinician practice patterns. The current prevailing medical culture contributes to overtesting, overtreatment, and health care waste. Choosing Wisely lists, appropriateness criteria, and guidelines codify best practices, but academic medicine as a whole must recognize that faculty and trainees are all largely still operating within the same cultural climate...
May 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28441373/cost-effectiveness-analysis-of-interventions-to-reduce-risk-of-aspiration-in-elderly-cancer-survivors-residing-in-skilled-nursing-facilities
#20
S Mantravadi
BACKGROUND: Aspiration can occur in patients of any age group, but it can be prevented. The primary population at risk is made up of survivors of cancer because of their increased risk of mucositis, mucosal atrophy, and dysphagia associated with chemotherapy, radiotherapy, and the disease process itself. The rate of incidence of aspiration cannot be quantified, because minor cases of aspiration often go unreported. Sequelae ensuing from aspirations can include pneumonia, end-stage kidney disease, dialysis, and death...
April 2017: Cancer Control: Journal of the Moffitt Cancer Center
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