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https://www.readbyqxmd.com/read/29907157/why-do-some-physicians-choose-to-tackle-inequities-in-healthcare
#1
Victoria Nkunu, Kevin J McLaughlin
BACKGROUND: Despite the reputation of Canada's healthcare system as being accessible to all Canadians, certain populations continue to face inequities within our healthcare system. In addition to promoting fairness, addressing healthcare inequities has the potential to reduce healthcare costs, which is increasingly important as healthcare costs continue to rise. Intentionally or otherwise, physicians are often leaders in healthcare teams, but there is a paucity of literature on physicians' perceptions of the problem of healthcare inequities and their potential role in addressing inequities...
June 15, 2018: International Journal for Equity in Health
https://www.readbyqxmd.com/read/29906727/a-crowdsourced-valuation-of-recreational-ecosystem-services-using-social-media-data-an-application-to-a-tropical-wetland-in-india
#2
Michael Sinclair, Andrea Ghermandi, Albert M Sheela
Online social media represent an extensive, opportunistic source of behavioral data and revealed preferences for ecosystem services (ES) analysis. Such data may allow to advance the approach, scale and timespan to which ES are assessed, mapping and valued. This is especially relevant in the context of developing regions whose decision support tools are often limited by a lack of resources and funding. This research presents an economic valuation tool for recreational ES, suitable at wide spatial scales, relying on crowdsourced metadata from social media with a proof of concept tested on an Indian tropical Ramsar wetland...
June 12, 2018: Science of the Total Environment
https://www.readbyqxmd.com/read/29905511/isolated-subdural-hematomas-in-mild-traumatic-brain-injury-part-2-a-preliminary-clinical-decision-support-tool-for-neurosurgical-intervention
#3
Alessandro Orlando, A Stewart Levy, Benjamin A Rubin, Allen Tanner, Matthew M Carrick, Mark Lieser, David Hamilton, Charles W Mains, David Bar-Or
OBJECTIVE A paucity of studies have examined neurosurgical interventions in the mild traumatic brain injury (mTBI) population with intracranial hemorrhage (ICH). Furthermore, it is not understood how the dimensions of an ICH relate to the risk of a neurosurgical intervention. These limitations contribute to a lack of treatment guidelines. Isolated subdural hematomas (iSDHs) are the most prevalent ICH in mTBI, carry the highest neurosurgical intervention rate, and account for an overwhelming majority of all neurosurgical interventions...
June 15, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29905094/development-of-a-digital-clinical-pathway-for-emergency-medicine-lessons-from-usability-testing-and-implementation-failure
#4
Marc Gutenstein, John W Pickering, Martin Than
Clinical pathways are used to support the management of patients in emergency departments. An existing document-based clinical pathway was used as the foundation on which to design and build a digital clinical pathway for acute chest pain, with the aim of improving clinical calculations, clinician decision-making, documentation, and data collection. Established principles of decision support system design were used to build an application within the existing electronic health record, before testing with a multidisciplinary team of doctors using a think-aloud protocol...
June 1, 2018: Health Informatics Journal
https://www.readbyqxmd.com/read/29904596/scepticaemia-the-impact-on-the-health-system-and-patients-of-delaying-new-treatments-with-uncertain-evidence-a-case-study-of-the-sepsis-bundle
#5
Robin Blythe, David Cook, Nicholas Graves
BACKGROUND: A sepsis care bundle of intravenous vitamin C, thiamine, and hydrocortisone was reported to improve treatment outcomes. The data to support it are uncertain and decision makers are likely to be cautious about adopting it. The objective of this study was to model the opportunity costs in dollars and lives of waiting for better information before adopting the bundle. METHODS: A decision tree was built using information from the literature. We modelled the impact of bundle adoption under three scenarios using a simulation in which the bundle was effective as reported in the primary trial, less effective based on other information, and ineffective...
2018: F1000Research
https://www.readbyqxmd.com/read/29904351/heart-rate-monitoring-in-team-sports-a-conceptual-framework-for-contextualizing-heart-rate-measures-for-training-and-recovery-prescription
#6
Christoph Schneider, Florian Hanakam, Thimo Wiewelhove, Alexander Döweling, Michael Kellmann, Tim Meyer, Mark Pfeiffer, Alexander Ferrauti
A comprehensive monitoring of fitness, fatigue, and performance is crucial for understanding an athlete's individual responses to training to optimize the scheduling of training and recovery strategies. Resting and exercise-related heart rate measures have received growing interest in recent decades and are considered potentially useful within multivariate response monitoring, as they provide non-invasive and time-efficient insights into the status of the autonomic nervous system (ANS) and aerobic fitness. In team sports, the practical implementation of athlete monitoring systems poses a particular challenge due to the complex and multidimensional structure of game demands and player and team performance, as well as logistic reasons, such as the typically large number of players and busy training and competition schedules...
2018: Frontiers in Physiology
https://www.readbyqxmd.com/read/29903798/eu-funded-initiatives-for-real-world-evidence-descriptive-analysis-of-their-characteristics-and-relevance-for-regulatory-decision-making
#7
Kelly Plueschke, Patricia McGettigan, Alexandra Pacurariu, Xavier Kurz, Alison Cave
INTRODUCTION: A review of European Union (EU)-funded initiatives linked to 'Real World Evidence' (RWE) was performed to determine whether their outputs could be used for the generation of real-world data able to support the European Medicines Agency (EMA)'s regulatory decision-making on medicines. METHOD: The initiatives were identified from publicly available websites. Their topics were categorised into five areas: 'Data source', 'Methodology', 'Governance model', 'Analytical model' and 'Infrastructure'...
June 14, 2018: BMJ Open
https://www.readbyqxmd.com/read/29903687/adolescents-experiences-of-obesity-surgery-a-qualitative-study
#8
Karin Nordin, Anna-Lena Brorsson, Kerstin Ekbom
BACKGROUND: The positive effects of behavioural treatment and weight management in adolescents with severe obesity are modest. Obesity surgery can be an option for adolescents, but is not the first-hand choice of treatment. The knowledge about adolescents' own experiences of having undergone surgery and their thoughts and feelings of the follow-up period are limited. OBJECTIVES: To describe adolescents' decision to go through obesity surgery as teenager and their experiences of the follow-up period...
April 26, 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29903493/a-decision-support-system-for-type-1-diabetes-mellitus-diagnostics-based-on-dual-channel-analysis-of-red-blood-cell-membrane-fluidity
#9
Ermanno Cordelli, Giuseppe Maulucci, Marco De Spirito, Alessandro Rizzi, Dario Pitocco, Paolo Soda
BACKGROUND AND OBJECTIVE: Investigation of membrane fluidity by metabolic functional imaging opens up a new and important area of translational research in type 1 diabetes mellitus, being a useful and sensitive biomarker for disease monitoring and treatment. We investigate here how data on membrane fluidity can be used for diabetes monitoring. METHODS: We present a decision support system that distinguishes between healthy subjects, type 1 diabetes mellitus patients, and type 1 diabetes mellitus patients with complications...
August 2018: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/29903475/computerized-decision-support-for-beneficial-home-based-exercise-rehabilitation-in-patients-with-cardiovascular-disease
#10
Andreas Triantafyllidis, Dimitris Filos, Roselien Buys, Jomme Claes, Véronique Cornelissen, Evangelia Kouidi, Anargyros Chatzitofis, Dimitris Zarpalas, Petros Daras, Deirdre Walsh, Catherine Woods, Kieran Moran, Nicos Maglaveras, Ioanna Chouvarda
BACKGROUND: Exercise-based rehabilitation plays a key role in improving the health and quality of life of patients with Cardiovascular Disease (CVD). Home-based computer-assisted rehabilitation programs have the potential to facilitate and support physical activity interventions and improve health outcomes. OBJECTIVES: We present the development and evaluation of a computerized Decision Support System (DSS) for unsupervised exercise rehabilitation at home, aiming to show the feasibility and potential of such systems toward maximizing the benefits of rehabilitation programs...
August 2018: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/29902284/environmental-impact-of-switching-from-the-synthetic-glucocorticoid-prednisolone-to-the-natural-alkaloid-berberine
#11
Iris E Allijn, Rik Oldenkamp, Gert Storm, Ad M J Ragas, Raymond M Schiffelers
Low amounts of human pharmaceuticals in the aquatic environment can affect bacteria, animals and ultimately humans. Here, the environmental consequences of a shift in prescription behavior from prednisolone to berberine was modeled using an environmental decision support system based on four consecutive steps: emission, fate, exposure and effect. This model estimates the relative aquatic and human health impacts of alternative pharmaceutical prescriptions throughout Europe. Since a Defined Daily Dose (DDD) of berberine has yet to be formulated, the environmental impacts of berberine and prednisolone were compared under the assumption of equal DDDs...
2018: PloS One
https://www.readbyqxmd.com/read/29900849/-health-data
#12
Dominique Polton
Healthcare is considered as one of the most promising areas where big data can be applied to foster innovation for the benefit of patients and of the whole system. Healthcare analytics have the potential to accelerate R&D, increase knowledge on diseases and risk factors, improve treatments, develop personalised medicine, help physicians with decision support systems… The access to data is also a driving force for patients' empowerment and for the democratic debate. However, there are also concerns about the societal, economic and ethic impacts of this wave of digitization and of the growing use of data, algorithms and artificial intelligence...
May 2018: Médecine Sciences: M/S
https://www.readbyqxmd.com/read/29898816/supporting-general-practice-to-make-timely-decisions-for-better-health-care-a-population-health-approach
#13
Deborah Davies
Primary Health Networks (PHNs) are tasked to enhance the efficiency and effectiveness of general practice. Gold Coast Primary Health Network (GCPHN) has been collecting de-identified aggregated clinical data from general practices and reporting back on areas for improvement on data coding and some clinical metrics, such as blood pressure not being recorded. However, aggregated data cannot be used to intervene at the individual patient level, and because of the collection-to-reporting time-lag, the data cannot help facilitate immediate action in the general practice...
June 14, 2018: Australian Journal of Primary Health
https://www.readbyqxmd.com/read/29898716/multidisciplinary-teams-and-ict-a-qualitative-study-exploring-the-use-of-technology-and-its-impact-on-multidisciplinary-team-meetings
#14
Anna Janssen, Tracy Robinson, Melissa Brunner, Paul Harnett, Kylie E Museth, Tim Shaw
BACKGROUND: Multidisciplinary teams (MDTs) are an integral component in the delivery of health care. This is particularly evident in the delivery of cancer care, where multidisciplinary teams are internationally recognized as the preferred method for service delivery. The use of health information systems and technology are key enabling factors for building the capacity of MDTs to engage in improvement and implementation projects but there is scant research on how MDTs make use of technology and information systems or the kinds of systems needed for them to undertake improvement and implementation research...
June 13, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29898469/artificial-intelligence-bayesian-versus-heuristic-method-for-diagnostic-decision-support
#15
Peter L Elkin, Daniel R Schlegel, Michael Anderson, Jordan Komm, Gregoire Ficheur, Leslie Bisson
Evoking strength is one of the important contributions of the field of Biomedical Informatics to the discipline of Artificial Intelligence. The University at Buffalo's Orthopedics Department wanted to create an expert system to assist patients with self-diagnosis of knee problems and to thereby facilitate referral to the right orthopedic subspecialist. They had two independent sports medicine physicians review 469 cases. A board-certified orthopedic sports medicine practitioner, L.B., reviewed any disagreements until a gold standard diagnosis was reached...
April 2018: Applied Clinical Informatics
https://www.readbyqxmd.com/read/29897988/a-modelling-framework-based-on-mdp-to-coordinate-farmers-disease-control-decisions-at-a-regional-scale
#16
Anne-France Viet, Stéphane Krebs, Olivier Rat-Aspert, Laurent Jeanpierre, Catherine Belloc, Pauline Ezanno
The effectiveness of infectious disease control depends on the ability of health managers to act in a coordinated way. However, with regards to non-notifiable animal diseases, farmers individually decide whether or not to implement control measures, leading to positive and negative externalities for connected farms and possibly impairing disease control at a regional scale. Our objective was to facilitate the identification of optimal incentive schemes at a collective level, adaptive to the epidemiological situation, and minimizing the economic costs due to a disease and its control...
2018: PloS One
https://www.readbyqxmd.com/read/29897921/economic-evaluations-of-ehealth-technologies-a-systematic-review
#17
Chiranjeev Sanyal, Paul Stolee, Don Juzwishin, Don Husereau
BACKGROUND: Innovations in eHealth technologies have the potential to help older adults live independently, maintain their quality of life, and to reduce their health system dependency and health care expenditure. The objective of this study was to systematically review and appraise the quality of cost-effectiveness or utility studies assessing eHealth technologies in study populations involving older adults. METHODS: We systematically searched multiple databases (MEDLINE, EMBASE, CINAHL, NHS EED, and PsycINFO) for peer-reviewed studies published in English from 2000 to 2016 that examined cost-effectiveness (or utility) of eHealth technologies...
2018: PloS One
https://www.readbyqxmd.com/read/29897403/development-of-and-selected-performance-characteristics-of-canjem-a-general-population-job-exposure-matrix-based-on-past-expert-assessments-of-exposure
#18
Jean-François Sauvé, Jack Siemiatycki, France Labrèche, Lesley Richardson, Javier Pintos, Marie-Pierre Sylvestre, Michel Gérin, Denis Bégin, Aude Lacourt, Tracy L Kirkham, Thomas Rémen, Romain Pasquet, Mark S Goldberg, Marie-Claude Rousseau, Marie-Élise Parent, Jérôme Lavoué
Objectives: We developed a job-exposure matrix called CANJEM using data generated in population-based case-control studies of cancer. This article describes some of the decisions in developing CANJEM, and some of its performance characteristics. Methods: CANJEM is built from exposure information from 31673 jobs held by study subjects included in our past case-control studies. For each job, experts had evaluated the intensity, frequency, and likelihood of exposure to a predefined list of agents based on jobs histories and descriptions of tasks and workplaces...
June 12, 2018: Annals of Work Exposures and Health
https://www.readbyqxmd.com/read/29896312/preventive-predictive-and-personalized-medicine-for-effective-and-affordable-cancer-care
#19
REVIEW
Jaak Ph Janssens, Klaus Schuster, Andreas Voss
Preventive, predictive, and personalized medicine (PPPM) has created a wealth of new opportunities but added also new complexities and challenges. The European Cancer Prevention Organization already embraced unanimously molecular biology for primary and secondary prevention. The rapidly exploding genomic language and complexity of methods face oncologists with exponentially growing knowledge they need to assess and apply. Tissue specimen quality becomes one major concern. Some new innovative medicines cost beyond any reasonable threshold of financial support from patients, health care providers, and governments and risk sustainability for the health care system...
June 2018: EPMA Journal
https://www.readbyqxmd.com/read/29895340/reducing-indwelling-urinary-catheter-use-through-staged-introduction-of-electronic-clinical-decision-support-in-a-multicenter-hospital-system
#20
Brett E Youngerman, Hojjat Salmasian, Eileen J Carter, Michael L Loftus, Rimma Perotte, Barbara G Ross, E Yoko Furuya, Robert A Green, David K Vawdrey
OBJECTIVE: To integrate electronic clinical decision support tools into clinical practice and to evaluate the impact on indwelling urinary catheter (IUC) use and catheter-associated urinary tract infections (CAUTIs).Design, Setting, and ParticipantsThis 4-phase observational study included all inpatients at a multicampus, academic medical center between 2011 and 2015.InterventionsPhase 1 comprised best practices training and standardization of electronic documentation. Phase 2 comprised real-time electronic tracking of IUC duration...
June 13, 2018: Infection Control and Hospital Epidemiology
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