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patient centered decision making

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https://www.readbyqxmd.com/read/28922208/patient-centered-outcome-spectrum-an-evidence-based-framework-to-aid-in-shared-decision-making
#1
Angela M Ingraham, Suresh K Agarwal, Hee Soo Jung, Amy E Liepert, Ann P O'Rourke, John E Scarborough
OBJECTIVE: Our objective was to develop an alternate construct for reporting anticipated outcomes after emergency general surgery (EGS) that presents risk in terms of a composite measure. BACKGROUND: Currently available prediction tools generate risk outputs for discrete as opposed to composite measures of postoperative outcomes. A construct to synthesize multiple discrete estimates into a global understanding of a patient's likely postoperative health status is lacking and could augment shared decision-making conversations...
September 15, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28918408/effectiveness-cost-utility-and-implementation-of-a-decision-aid-for-patients-with-localised-prostate-cancer-and-their-partners-study-protocol-of-a-stepped-wedge-cluster-randomised-controlled-trial
#2
Hoda H M Al-Itejawi, Cornelia F van Uden-Kraan, Peter M van de Ven, Veerle M H Coupé, André N Vis, Jakko A Nieuwenhuijzen, Jeroen A van Moorselaar, Irma M Verdonck-de Leeuw
INTRODUCTION: Patient decision aids (PDAs) have been developed to help patients make an informed choice for a treatment option. Despite proven benefits, structural implementation falls short of expectations. The present study aims to assess the effectiveness and cost-utility of the PDA among newly diagnosed patients with localised prostate cancer and their partners, alongside implementation of the PDA in routine care. METHODS/ANALYSIS: A stepped-wedge cluster randomised trial will be conducted...
September 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/28916666/regional-evaluation-of-the-severity-based-stroke-triage-algorithm-for-emergency-medical-services-using-discrete-event-simulation
#3
Brittany M Bogle, Andrew W Asimos, Wayne D Rosamond
BACKGROUND AND PURPOSE: The Severity-Based Stroke Triage Algorithm for Emergency Medical Services endorses routing patients with suspected large vessel occlusion acute ischemic strokes directly to endovascular stroke centers (ESCs). We sought to evaluate different specifications of this algorithm within a region. METHODS: We developed a discrete event simulation environment to model patients with suspected stroke transported according to algorithm specifications, which varied by stroke severity screen and permissible additional transport time for routing patients to ESCs...
September 15, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28916602/validation-study-of-image-based-fractional-flow-reserve-during-coronary-angiography
#4
Mariano Pellicano, Ifat Lavi, Bernard De Bruyne, Hana Vaknin-Assa, Abid Assali, Orna Valtzer, Yonit Lotringer, Giora Weisz, Yaron Almagor, Panagiotis Xaplanteris, Ajay J Kirtane, Pablo Codner, Martin B Leon, Ran Kornowski
BACKGROUND: Fractional flow reserve (FFR), an index of the hemodynamic severity of coronary stenoses, is derived from invasive measurements and requires a pressure-monitoring guidewire and hyperemic stimulus. Angiography-derived FFR measurements (FFRangio) may have several advantages. The aim of this study is to assess the diagnostic performance and interobserver reproducibility of FFRangio in patients with stable coronary artery disease. METHODS AND RESULTS: FFRangio is a computational method based on rapid flow analysis for the assessment of FFR...
September 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28915414/evaluation-of-surgical-decision-making-and-resulting-outcome-in-patients-with-highly-eloquent-glioblastoma-results-of-a-multicenter-assessment
#5
Jan Coburger, Mirjam Renovanz, Oliver Ganslandt, Florian Ringel, Christian Rainer Wirtz, Javier Segovia von Riehm
INTRODUCTION: Treatment of glioblastoma(GB) patients amenable only for a subtotal resection(STR) is controversial. Since outcome of patients is affected by surgical management, our aim was to assess surgical decision making and resulting outcome in patients with highly eloquent GBs. PATIENTS AND METHODS: We retrospectively assessed GB patients with intended sub-total resection (STR) or stereotactic biopsy (STX) of 3 neurooncological centers operated between 2008 and 2013...
September 8, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28914111/analyzing-how-discursive-practices-affect-physicians-decision-making-processes-a-phenomenological-based-qualitative-study-in-critical-care-contexts
#6
Luigina Mortari, Roberta Silva
An intensive care unit (ICU) is a demanding environment, defined by significant complexity, in which physicians must make decisions in situations characterized by high levels of uncertainty. This study used a phenomenological approach to investigate the decision-making (DM) processes among ICU physicians' team with the aim of understanding what happens when ICU physicians must reach a decision about the infectious status of a patient. The focus was put on the identification of how the discursive practices influence physicians' DM processes and on how different ICU environments make different discursive profiles emerge, particularly when a key issue is at the center of the physicians' discussion...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28913817/return-to-play-in-2017-and-the-role-of-shared-decision-making-in-patients-with-inherited-and-acquired-channelopathies-and-cardiomyopathies
#7
REVIEW
Kia Afshar, T Jared Bunch
Shared decision-making is based upon a physician-patient encounter in which there is adequate education using aids if needed, a mutual discussion of how to assist the patient in weighing risks and benefits, and a supportive environment that allows the patient to deliberate on the clinical decision and make their own choice. This decision-making paradigm centers on the principles of autonomy and self-determination. Physical activity is a critical part of healthy lifestyle choices that helps lower risk of cardiovascular disease or the progression of it...
September 14, 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28911896/patient-selection-and-outcomes-of-transfemoral-transcatheter-aortic-valve-replacement-performed-with-monitored-anesthesia-care-versus-general-anesthesia
#8
Saroj Pani, John Cagino, Paul Feustel, Sridhar Reddy Musuku, Asim Raja, Natalie Bruno, Christopher Ursillo, Nathapong Arunakul, Constantine M Poulos, Michael Welljams-Dorof, Kevin Roberts, Mikhail Torosoff, Augustine Delago
OBJECTIVE: The aim of this study was to compare outcomes of monitored anesthesia care (MAC) versus general anesthesia (GA) for transfemoral transcatheter aortic valve replacement (TF-TAVR) and to describe a selection process for the administration of MAC. DESIGN: Retrospective analysis of patients who underwent TF-TAVR under MAC or GA. SETTING: Department of Cardiac Anesthesia, Albany Medical Center, a tertiary university hospital. PARTICIPANTS: Patients selected for TF-TAVR...
April 5, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28911072/oncologist-use-and-perception-of-large-panel-next-generation-tumor-sequencing
#9
A M Schram, D Reales, J Galle, R Cambria, R Durany, D Feldman, E Sherman, J Rosenberg, G D'Andrea, S Baxi, Y Janjigian, W Tap, M Dickler, J Baselga, B S Taylor, D Chakravarty, J Gao, N Schultz, D B Solit, M F Berger, D M Hyman
Background: Genomic profiling is increasingly incorporated into oncology research and the clinical care of cancer patients. We sought to determine physician perception and use of enterprise-scale clinical sequencing at our center, including whether testing changed management and the reasoning behind this decision-making. Patients and methods: All physicians who consented patients to MSK-IMPACT, a next-generation hybridization capture assay, in tumor types where molecular profiling is not routinely performed were asked to complete a questionnaire for each patient...
September 1, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/28906367/predicting-the-mortality-in-geriatric-patients-with-dengue-fever
#10
Hung-Sheng Huang, Chien-Chin Hsu, Je-Chiuan Ye, Shih-Bin Su, Chien-Cheng Huang, Hung-Jung Lin
Geriatric patients have high mortality for dengue fever (DF); however, there is no adequate method to predict mortality in geriatric patients. Therefore, we conducted this study to develop a tool in an attempt to address this issue.We conducted a retrospective case-control study in a tertiary medical center during the DF outbreak in Taiwan in 2015. All the geriatric patients (aged ≥65 years) who visited the study hospital between September 1, 2015, and December 31, 2015, were recruited into this study. Variables included demographic data, vital signs, symptoms and signs, comorbidities, living status, laboratory data, and 30-day mortality...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28903664/preferences-and-actual-chemotherapy-decision-making-in-the-greater-plains-collaborative-breast-cancer-study
#11
Ann M Berger, Russell J Buzalko, Kevin A Kupzyk, Bret J Gardner, Dilorom M Djalilova, Julie L Otte
INTRODUCTION: There is renewed interest in identifying breast cancer patients' participation in decision-making about adjuvant chemotherapy. There is a gap in the literature regarding the impact of these decisions on quality of life (QOL) and quality of care (QOC). Our aims were to determine similarities and differences in how patients diagnosed with breast cancer preferred to make decisions with providers about cancer treatment, to examine the patient's recall of her role when the decision was made about chemotherapy and to determine how preferred and actual roles, as well as congruence between them, relate to QOL and perceived QOC...
September 13, 2017: Acta Oncologica
https://www.readbyqxmd.com/read/28902106/fine-tuning-the-predictive-model-for-proximal-junctional-failure-in-surgically-treated-patients-with-adult-spinal-deformity
#12
Mitsuru Yagi, Nobuyuki Fujita, Eijiro Okada, Osahiko Tsuji, Narihito Nagoshi, Takashi Asazuma, Ken Ishii, Masaya Nakamura, Morio Matsumoto, Kota Watanabe
STUDY DESIGN: Multi-center retrospective study. OBJECTIVE: To validate and improve the predictive model for proximal junctional failure (PJF) with or without the bone mineral density (BMD) score. SUMMARY OF BACKGROUND DATA: PJF is a serious complication of surgery for adult spinal deformity (ADS). A predictive model for PJF was recently reported that has good accuracy, but does not include BMD, a known PJF risk factor, as a variable. METHODS: We included 145 surgically treated ASD patients who were older than 50 at the time of surgery and had been followed up for at least 2 years...
September 8, 2017: Spine
https://www.readbyqxmd.com/read/28901967/intervention-mapping-approach-in-the-design-of-an-interactive-mobile-health-application-to-improve-self-care-in-heart-failure
#13
Ponrathi Athilingam, John M Clochesy, Miguel A Labrador
Heart failure is a complex syndrome among older adults who may experience and interpret symptoms differently. These differences in symptom interpretation may influence decision-making in symptom management. A well-informed and motivated person may develop the knowledge and skills needed to successfully manage symptoms. Therefore, the patient-centered mobile health application HeartMapp was designed to engage patients with heart failure in self-care management by offering tailored alerts and feedback using mobile phones...
September 8, 2017: Computers, Informatics, Nursing: CIN
https://www.readbyqxmd.com/read/28900995/-association-between-genetic-polymorphisms-and-variation-of-imatinib-pharmacokinetics-in-gastrointestinal-stromal-tumors
#14
Haibo Qiu, Wei Zhuang, Xueding Wang, Min Huang, Zhiwei Zhou
OBJECTIVE: To investigate the influence of metabolic enzymes polymorphisms on variations of imatinib (IM) pharmacokinetics in gastrointestinal stromal tumors (GIST) patients. METHODS: Clinical data of 118 Chinese GIST patients receiving 400 mg/d IM at Sun Yat-sen University Cancer Center between 2014 and 2016 were retrospectively analyzed. The plasma concentration of imatinib mesylate(IM) and its main metabolic N-demethyl imatinib (NDI) were determined by LC-MS/MS...
September 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28896001/-barriers-impeding-access-to-epilepsy-surgery-a-review-of-the-literature
#15
REVIEW
L D Ladino, V Benjumea-Cuartas, J Vargas-Osorio, L V Villamil-Osorio, L Hernandez-Vanegas, I E Martinez-Juarez, J F Tellez-Zenteno
Drug-resistant epilepsy, a chronic condition with long-term consequences can be treated with surgery. The efficacy and safety of surgery for temporal lobe epilepsy have been established through a large number of retrospective and prospective cohort studies and two randomized controlled clinical trials. Despite the excellent outcomes reported after surgery, the literature suggests that this procedure is an underutilized treatment. While evidence is lacking as to why epilepsy surgery is underused, cited reasons include: failure of primary care physicians and neurologists to provide information and identify patients who could be referred for surgery; different levels of technology at various centers, resulting in different candidate selection strategies; the belief that epilepsy surgery is a risky procedure and that it should be only viewed as the last option; patient preference to avoid surgery; parents wanting to wait until their child is old enough to participate in the decision-making process regarding surgery; unwillingness of insurers to cover the expenses associated with presurgical evaluations or lack of insurance; racial and social disparities, among others...
September 16, 2017: Revista de Neurologia
https://www.readbyqxmd.com/read/28895960/atopic-dermatitis-therapeutic-care-delivery-therapeutic-education-shared-decision-making-and-access-to-care
#16
Jennifer LeBovidge, Jenna Borok, Jeremy Udkoff, Gil Yosipovitch, Lawrence F Eichenfield
Atopic dermatitis (AD) is a chronic skin condition affecting children and adults, with a significant negative impact on patient and caregiver quality of life (QOL). Although effective treatments for AD are available, outcomes are often limited by poor adherence to treatment plans. Effective patient and caregiver education about the disease and its management is a necessary and important component of AD care. Therapeutic patient education (TPE) is a patient-centered process that aims to transfer information and skills necessary to manage and cope with a disease from health care professionals to patients and caregivers...
September 2017: Seminars in Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28894983/earlier-day-of-blastocyst-development-is-predictive-of-embryonic-euploidy-across-all-ages-essential-data-for-physician-decision-making-and-counseling-patients
#17
Amy Kaing, Lindsay L Kroener, Robyn Tassin, Man Li, Lian Liu, Richard Buyalos, Gary Hubert, Mousa Shamonki
PURPOSE: The purpose of this study is to evaluate whether day of blastocyst development is associated with embryo chromosomal status as determined by high-density oligonucleotide microarray comparative genomic hybridization (aCGH). METHODS: This is a retrospective cohort analysis, including women who underwent in vitro fertilization (IVF) with trophectoderm biopsy at a single private fertility center from January 2014 to December 2014. Repeat cycles were excluded...
September 11, 2017: Journal of Assisted Reproduction and Genetics
https://www.readbyqxmd.com/read/28894545/comparing-performances-of-intelligent-classifier-algorithms-for-predicting-type-of-pain-in-patients-with-spinal-cord-injury
#18
Nasrolah Nasr HeidarAbadi, Laleh Hakemi, Pirhossein Kolivand, Reza Safdari, Marjan Ghazi Saeidi
BACKGROUND AND AIM: In this study, performances of classification techniques were compared in order to predict type of pain in patients with spinal cord injury. Pain is one of the main problems in people with spinal cord injury. Identifying the optimal classification technique will help improve decision support systems in clinical settings. METHODS: A descriptive retrospective analysis was performed in 253 patients. We compared performances of "Bayesian Networks", "Decision Tree", neural networks: "Multi-Layer Perceptron" (MLP), and "Support Vector Machines" (SVM)...
July 2017: Electronic Physician
https://www.readbyqxmd.com/read/28890891/collaborative-approaches-and-policy-opportunities-for-accelerated-progress-toward-effective-disease-prevention-care-and-control-using-the-case-of-poverty-diseases-to-explore-universal-access-to-affordable-health-care
#19
Samia Laokri
BACKGROUND: There is a massive global momentum to progress toward the sustainable development and universal health coverage goals. However, effective policies to health-care coverage can only emerge through high-quality services delivered to empowered care users by means of strong local health systems and a translational standpoint. Health policies aimed at removing user fees for a defined health-care package may fail at reaching desired results if not applied with system thinking. METHOD: Secondary data analysis of two country-based cost-of-illness studies was performed to gain knowledge in informed decision-making toward enhanced access to care in the context of resource-constraint settings...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28887782/development-of-acrodat-%C3%A2-a-new-software-medical-device-to-assess-disease-activity-in-patients-with-acromegaly
#20
Aart J van der Lely, Roy Gomez, Andreas Pleil, Xavier Badia, Thierry Brue, Michael Buchfelder, Pia Burman, David Clemmons, Ezio Ghigo, Jens Otto Lunde Jørgensen, Anton Luger, Joli van der Lans-Bussemaker, Susan M Webb, Christian J Strasburger
PURPOSE: Despite availability of multimodal treatment options for acromegaly, achievement of long-term disease control is suboptimal in a significant number of patients. Furthermore, disease control as defined by biochemical normalization may not always show concordance with disease-related symptoms or patient's perceived quality of life. We developed and validated a tool to measure disease activity in acromegaly to support decision-making in clinical practice. METHODS: An international expert panel (n = 10) convened to define the most critical indicators of disease activity...
September 8, 2017: Pituitary
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