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Decision support system

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https://www.readbyqxmd.com/read/27914156/-intratechal-chemotherapy-treatment-through-an-ommaya-reservoir-catheter-for-meningeal-carcinomatosis-a-single-centre-experience
#1
José Pedro Lavrador, Nuno Simas, Edson Oliveira, Manuel Herculano Carvalho
INTRODUCTION: Meningeal carcinomatosis is defined as tumour cells infiltration of leptomeninges and subarachnoid space. It is normally related with poor survival (2 - 5 months). The best multidisciplinary treatment for this condition is a matter of discussion. Patient's condition and the natural history of the disease should be considered in the decision making process. MATERIAL AND METHODS: Retrospective cohort analysis of patients submitted to Ommaya Reservoir placement due to systemic solid tumour meningeal carcinomatosis between 2006 and 2014...
August 2016: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/27913742/frailty-assessment-in-hospitalized-older-adults-using-the-electronic-health-record
#2
Deborah A Lekan, Debra C Wallace, Thomas P McCoy, Jie Hu, Susan G Silva, Heather E Whitson
INTRODUCTION: Frailty, a clinical syndrome of decreased physiologic reserve and dysregulation in multiple physiologic systems, is associated with increased risk for adverse outcomes. PURPOSE: The aim of this retrospective, cross-sectional, correlational study was to characterize frailty in older adults admitted to a tertiary-care hospital using a biopsychosocial frailty assessment and to determine associations between frailty and time to in-hospital mortality and 30-day rehospitalization...
December 2, 2016: Biological Research for Nursing
https://www.readbyqxmd.com/read/27912776/improving-stroke-prevention-therapy-for-patients-with-atrial-fibrillation-in-primary-care-protocol-for-a-pragmatic-cluster-randomized-trial
#3
Theresa M Lee, Noah M Ivers, Sacha Bhatia, Debra A Butt, Paul Dorian, Liisa Jaakkimainen, Kori Leblanc, Dan Legge, Dante Morra, Alissia Valentinis, Laura Wing, Jacqueline Young, Karen Tu
BACKGROUND: The prevalence of atrial fibrillation (AF) is growing as the population ages, and at least 15% of ischemic strokes are attributed to AF. However, many high-risk AF patients are not offered guideline-recommended stroke prevention therapy due to a variety of system, provider, and patient-level barriers. METHODS: We will conduct a pragmatic, cluster-randomized controlled trial randomizing primary care clinics to test a "toolkit" of quality improvement interventions in primary care...
December 3, 2016: Implementation Science: IS
https://www.readbyqxmd.com/read/27909262/overcoming-the-limits-of-evidence-on-effective-multisectoral-nutrition-policy
#4
Madhu Kumar Marasini, Ssansa Mugenyi
The multisectoral approach has evolved as a popular instrument to attain nutrition goals and targets. But as policy makers, we need timely, relevant, and accurate information in order to effectively support these plans. This commentary comes from the members of the nutrition secretariats at the National Planning Commission in Nepal and the Office of the Prime Minister in Uganda on availability and use of evidence and the nutrition policy cycle. As has been highlighted in this supplement, some of the challenges we have faced include tracking nutrition spending and limited human resource capacity...
December 2016: Food and Nutrition Bulletin
https://www.readbyqxmd.com/read/27909256/optimizing-the-multisectoral-nutrition-policy-cycle-a-systems-perspective
#5
Sascha Lamstein, Amanda Pomeroy-Stevens, Patrick Webb, Eileen Kennedy
Based on the data collected in Uganda, Nepal, and Ethiopia, the papers included in this supplement fill a critical gap in evidence regarding multisectoral National Nutrition Action Plans. The studies offer new data and new thinking on how and why governance, effective financial decentralization, and improved accountability all matter for nutrition actions in low-income countries. This introductory paper offers an overview of the current state of evidence and thinking on the multisectoral nutrition policy cycle, including how governance and financing support that process...
December 2016: Food and Nutrition Bulletin
https://www.readbyqxmd.com/read/27908662/too-cool-symbolic-but-not-iconic-stimuli-impair-4-year-old-children-s-performance-on-the-delay-of-gratification-choice-paradigm
#6
Lisa G Labuschagne, Taylor-Jane Cox, Kaitlyn Brown, Damian Scarf
A common method of improving the performance of children and non-human primates on the delay-of-gratification maintenance paradigm and measures of executive function (e.g., the Less is More task) is to represent the rewards subjects can acquire symbolically. This method, known as symbolic distancing, is thought to lower activation of the "hot" impulsive system and allow the "cool" rational system to dominate processing. Surprisingly, in contrast to its impact on the measures noted above, recent developmental and comparative studies have reported that symbolic distancing has a null or negative impact on performance on the delay-of-gratification choice paradigm...
November 28, 2016: Behavioural Processes
https://www.readbyqxmd.com/read/27908577/the-use-of-predictive-models-to-optimize-risk-of-decisions
#7
József Baranyi, Nathália Buss da Silva
The purpose of this paper is to set up a mathematical framework that risk assessors and regulators could use to quantify the "riskiness" of a particular recommendation (choice/decision). The mathematical theory introduced here can be used for decision support systems. We point out that efficient use of predictive models in decision making for food microbiology needs to consider three major points: (1) the uncertainty and variability of the used information based on which the decision is to be made; (2) the validity of the predictive models aiding the assessor; and (3) the cost generated by the difference between the a-priory choice and the a-posteriori outcome...
October 15, 2016: International Journal of Food Microbiology
https://www.readbyqxmd.com/read/27907898/obstetrical-and-perinatal-outcomes-following-blastocyst-transfer-compared-to-cleavage-transfer-a-systematic-review-and-meta-analysis
#8
W P Martins, C O Nastri, L Rienzi, S Z van der Poel, C R Gracia, C Racowsky
STUDY QUESTION: Is blastocyst transfer safe when compared to cleavage stage embryo transfer regarding obstetric and perinatal outcomes? SUMMARY ANSWER: The clinical equipoise between blastocyst and cleavage stage embryo transfer remains as the evidence associating blastocyst transfer with some adverse perinatal outcomes is of low/very low quality. WHAT IS KNOWN ALREADY: Extended embryo culture to the blastocyst stage provides some theoretical advantages and disadvantages...
November 2016: Human Reproduction
https://www.readbyqxmd.com/read/27907231/use-of-autopsy-to-determine-live-or-stillbirth-new-approaches-in-decision-support-systems
#9
Riza Yilmaz, Okan Erkaymaz, Erdogan Kara, Kivanc Ergen
Fetal deaths are important cases for forensic medicine, as well as for criminal and civil law. From a legal perspective, the determination of whether a deceased infant was stillborn is a difficult process. Such a determination is generally made during autopsy; however, no standardized procedures for this determination exist. Therefore, new facilitative approaches are needed. In this study, three new support systems based on 10 autopsy parameters were tested for their ability to correctly determine whether deceased infants were alive or stillborn...
December 1, 2016: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/27904234/allocation-of-rehabilitation-services-for-older-adults-in-the-ontario-home-care-system
#10
Joshua J Armstrong, Joanie Sims-Gould, Paul Stolee
Background: Physiotherapy and occupational therapy services can play a critical role in maintaining or improving the physical functioning, quality of life, and overall independence of older home care clients. Despite their importance, however, there is limited understanding of the factors that influence how rehabilitation services are allocated to older home care clients. The aim of this pilot study was to develop a preliminary understanding of the factors that influence decisions to allocate rehabilitation therapy services to older clients in the Ontario home care system, as perceived by three stakeholder groups...
2016: Physiotherapy Canada. Physiothérapie Canada
https://www.readbyqxmd.com/read/27903488/information-and-communication-technologies-for-the-dissemination-of-clinical-practice-guidelines-to-health-professionals-a-systematic-review
#11
REVIEW
Gino De Angelis, Barbara Davies, Judy King, Jessica McEwan, Sabrina Cavallo, Laurianne Loew, George A Wells, Lucie Brosseau
BACKGROUND: The transfer of research knowledge into clinical practice can be a continuous challenge for researchers. Information and communication technologies, such as websites and email, have emerged as popular tools for the dissemination of evidence to health professionals. OBJECTIVE: The objective of this systematic review was to identify research on health professionals' perceived usability and practice behavior change of information and communication technologies for the dissemination of clinical practice guidelines...
November 30, 2016: JMIR Medical Education
https://www.readbyqxmd.com/read/27900739/-evidence-based-knowledge-translation-from-scientific-evidence-to-clinical-nursing-practice
#12
Kee-Hsin Chen, Ching-Chiu Kao, Chiehfeng Chen
In 1992, Gordon Guyatt coined the term "evidence-based medicine", which has since attracted worldwide attention. In 2007, the Institute of Medicine's Roundtable on Evidence-Based Medicine set the goal that 90% of clinical decisions would be supported by accurate, timely, and up-to-date clinical information and would reflect the best available evidence by 2020. However, the chasm between knowing and doing remains palpable. In 2000, the Canadian Institute of Health Research applied the term "knowledge translation" to describe the bridge that is necessary to cross the gap between research knowledge and clinical practice...
December 2016: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/27899905/effects-of-individual-differences-in-working-memory-on-plan-presentational-choices
#13
Nava Tintarev, Judith Masthoff
This paper addresses research questions that are central to the area of visualization interfaces for decision support: (RQ1) whether individual user differences in working memory should be considered when choosing how to present visualizations; (RQ2) how to present the visualization to support effective decision making and processing; and (RQ3) how to evaluate the effectiveness of presentational choices. These questions are addressed in the context of presenting plans, or sequences of actions, to users. The experiments are conducted in several domains, and the findings are relevant to applications such as semi-autonomous systems in logistics...
2016: Frontiers in Psychology
https://www.readbyqxmd.com/read/27898778/drainage-and-nitrate-leaching-from-artificially-drained-maize-fields-simulated-by-the-precision-nitrogen-management-model
#14
Rebecca D Marjerison, Jeff Melkonian, John L Hutson, Harold M van Es, Shai Sela, Larry D Geohring, Jeffrey Vetsch
Environmental nitrogen (N) losses (e.g., nitrate leaching, denitrification, and ammonia volatilization) frequently occur in maize ( L.) agroecosystems. Decision support systems, designed to optimize the application of N fertilizer in these systems, have been developed using physically based models such as the Precision Nitrogen Management (PNM) model of soil and crop processes, which is an integral component of Adapt-N, a decision support tool providing N fertilizer recommendations for maize production. Such models can also be used to estimate N losses associated with particular management practices and over a range of current climates and future climate projections...
November 2016: Journal of Environmental Quality
https://www.readbyqxmd.com/read/27898691/a-personalized-electronic-movie-recommendation-system-based-on-support-vector-machine-and-improved-particle-swarm-optimization
#15
Xibin Wang, Fengji Luo, Ying Qian, Gianluca Ranzi
With the rapid development of ICT and Web technologies, a large an amount of information is becoming available and this is producing, in some instances, a condition of information overload. Under these conditions, it is difficult for a person to locate and access useful information for making decisions. To address this problem, there are information filtering systems, such as the personalized recommendation system (PRS) considered in this paper, that assist a person in identifying possible products or services of interest based on his/her preferences...
2016: PloS One
https://www.readbyqxmd.com/read/27897445/journal-club-predictors-of-provider-response-to-clinical-decision-support-lessons-learned-from-the-medicare-imaging-demonstration
#16
Ivan K Ip, Ronilda Lacson, Keith Hentel, Sameer Malhotra, Jonathan Darer, Curtis Langlotz, Jonathan Weiss, Ali S Raja, Ramin Khorasani
OBJECTIVE: The efficacy of imaging clinical decision support (CDS) varies. Our objective was to identify CDS factors contributing to imaging order cancellation or modification. SUBJECTS AND METHODS: This pre-post study was performed across four institutions participating in the Medicare Imaging Demonstration. The intervention was CDS at order entry for selected outpatient imaging procedures. On the basis of the information entered, computerized alerts indicated to providers whether orders were not covered by guidelines, appropriate, of uncertain appropriateness, or inappropriate according to professional society guidelines...
November 29, 2016: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/27896144/clinical-decision-support-for-drug-related-events-moving-towards-better-prevention
#17
REVIEW
Sandra L Kane-Gill, Archita Achanta, John A Kellum, Steven M Handler
Clinical decision support (CDS) systems with automated alerts integrated into electronic medical records demonstrate efficacy for detecting medication errors (ME) and adverse drug events (ADEs). Critically ill patients are at increased risk for ME, ADEs and serious negative outcomes related to these events. Capitalizing on CDS to detect ME and prevent adverse drug related events has the potential to improve patient outcomes. The key to an effective medication safety surveillance system incorporating CDS is advancing the signals for alerts by using trajectory analyses to predict clinical events, instead of waiting for these events to occur...
November 4, 2016: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/27894307/regional-health-workforce-monitoring-as-governance-innovation-a-german-model-to-coordinate-sectoral-demand-skill-mix-and-mobility
#18
E Kuhlmann, O Lauxen, C Larsen
BACKGROUND: As health workforce policy is gaining momentum, data sources and monitoring systems have significantly improved in the European Union and internationally. Yet data remain poorly connected to policy-making and implementation and often do not adequately support integrated approaches. This brings the importance of governance and the need for innovation into play. CASE: The present case study introduces a regional health workforce monitor in the German Federal State of Rhineland-Palatinate and seeks to explore the capacity of monitoring to innovate health workforce governance...
November 28, 2016: Human Resources for Health
https://www.readbyqxmd.com/read/27894220/the-role-of-the-pharmacist-in-the-design-development-and-implementation-of-medication-prescription-support-systems
#19
Nuria Sola Bonada, Ana María Álvarez Díaz, Carlos Codina Jané
Clinical Decision Support Systems (CDSS) are computerized tools designed to help healthcare professionals to make clinical and therapeutic decisions, with the objective of improving patient care. Prescription-targeted CDSS have the highest impact in improving patient safety. Although there are different designs and functionalities, all these systems will combine clinical knowledge and patient information in a smart manner, in order to improve the prescription process. With the emergence of new technologies and advances in smart decision systems, the implementation of said systems can achieve an important improvement in terms of the prescription process and patient safety...
November 1, 2016: Farmacia Hospitalaria
https://www.readbyqxmd.com/read/27893947/challenges-in-the-uptake-of-telemedicine-in-dentistry
#20
Mohamed Estai, Estie Kruger, Marc Tennant, Stuart Bunt, Yogesan Kanagasingam
With the availability of oral care services very unevenly distributed in rural or remote areas, underserved people seek oral care from non-dental care providers. Against this backdrop, and coupled with the decreasing cost of and innovations in technology, there is a growing interest in the adoption of telemedicine services. Regardless of the lack of good-quality evidence supporting the cost-effectiveness of telemedicine, evidence already indicates that telemedicine, even with extra costs, helps in reducing the inequalities in the provision of primary health care...
October 2016: Rural and Remote Health
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