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patient centered decision making

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https://www.readbyqxmd.com/read/28648008/-circulating-tumor-cells-in-patients-with-breast-tumors-were-detected-by-a-novel-device-a-multicenter-clinical-trial-in-china
#1
J B Li, C Z Geng, M Yan, Y S Wang, Q C Ouyang, Y M Yin, L N Wu, J He, Z F Jiang
Objective: Circulating tumor cells (CTC) have become an important part of liquid biopsy, which have underwent a process from simple counting to molecular typing and genotyping. To this end, we used Cellcollector to verify the effectiveness and safety of CTC detection in patients with breast tumor, and to conduct the following analysis. Methods: One hundred and ninety patients who received treatment in six leading Chinese cancer centers were involved from April to August in 2016. Among which, 127 patients were diagnosed as metastatic breast cancer, and the other 63 patients as benign breast tumors...
June 27, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28645277/dignity-in-people-with-frontotemporal-dementia-and-similar-disorders-a-qualitative-study-of-the-perspective-of-family-caregivers
#2
Mette Sagbakken, Dagfinn Nåden, Ingun Ulstein, Kari Kvaal, Birgitta Langhammer, May-Karin Rognstad
BACKGROUND: Frontotemporal dementia (FTD) constitutes on average 10-15% of dementia in younger persons (≤65 years old), but can also affect older people. These patients demonstrate a decline in social conduct, and/or language aphasias, apathy, and loss of insight that is gradual and progressive. Preservation of dignity seems to be highly relevant both before and after admission to different types of institutionalized care, but the research is scant. From the perspective of close relatives, this study aims to develop knowledge related to dignified or undignified care of patients with FTD and similar conditions...
June 23, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28643147/the-perioperative-surgical-home-improving-the-value-and-quality-of-care-in-total-joint-replacement
#3
REVIEW
George F Chimento, Leslie C Thomas
PURPOSE OF REVIEW: The perioperative surgical home (PSH) is a patient-centered, physician-led, multidisciplinary care pathway developed to deliver value-based care based on shared decision-making. Physician and hospital reimbursement will be tied to providing quality care at lower cost, and the PSH model has been used in providing care to patients undergoing lower extremity arthroplasty. The purpose of this review is to discuss the rationale, definition, development, current state, and future direction of the PSH...
June 22, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28639869/economic-burden-of-inpatient-admission-of-ankle-fractures
#4
Justin D Stull, Suneel B Bhat, Justin M Kane, Steven M Raikin
BACKGROUND: Ankle fractures are among the most prevalent traumatic orthopaedic injuries. A large proportion of patients sustaining operative ankle fractures are admitted directly from the emergency department prior to operative management. In the authors' experience, however, many closed ankle injuries may be safely and effectively managed on an outpatient basis. The aim of this study was to characterize the economic impact of routine inpatient admission of ankle fractures. METHODS: A retrospective review of all outpatient ankle fracture surgery performed by a single foot and ankle fellowship-trained surgeon at a tertiary level academic center in 2012 was conducted to identify any patients requiring postoperative inpatient admission...
June 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28636558/prognostic-significance-of-clinicopathological-factors-in-early-breast-cancer-20-years-of-follow-up-in-a-single-center-analysis
#5
Valentina Cocciolone, Katia Cannita, Maria Letizia Calandrella, Enrico Ricevuto, Paola Lanfiuti Baldi, Tina Sidoni, Azzurra Irelli, Stefania Paradisi, Laura Pizzorno, Valter Resta, Alberto Bafile, Edoardo Alesse, Alessandra Tessitore, Corrado Ficorella
BACKGROUND: To quantify the effect of traditional prognostic factors [nodal status, estrogen-receptor (ER), progesterone-receptor (PR), human epidermal growth factor receptor 2 (HER2)] on long-term outcome of patients with early breast cancer (EBC), treated in clinical practice over a period of about twenty years. RESULTS: 1198 consecutive patients were identified. Median DFS (disease-free survival): ER+/PR±/HER2-, 165 months (mo) if node-negative (N0) and 114mo if node-positive (N+) (p < 0...
June 16, 2017: Oncotarget
https://www.readbyqxmd.com/read/28634056/a-new-and-accurate-predictive-model-for-the-efficacy-of-extracorporeal-shock-wave-therapy-in-managing-patients-with-chronic-plantar-fasciitis
#6
Mengchen Yin, Ni Chen, Quan Huang, Anastasia Sulindro Marla, Junming Ma, Jie Ye, Wen Mo
OBJECTIVES: To identify factors for the outcome of a minimum clinically successful therapy and to establish a predictive model of extracorporeal shock wave therapy (ESWT) in managing patients with chronic plantar fasciitis. DESIGN: Randomized controlled, prospective study. SETTING: Outpatient of local medical center settings. PARTICIPANTS: Patients treated for symptomatic chronic plantar fasciitis between 2014 and 2016 (N=278)...
June 17, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28633915/patient-centered-care-in-obstructive-sleep-apnea-a%C3%A2-vision%C3%A2-for%C3%A2-the%C3%A2-future
#7
REVIEW
Janet Hilbert, Henry K Yaggi
Obstructive sleep apnea is a common condition, with multiple potential neurocognitive, cardiovascular, and metabolic consequences. Efficacious treatment is available, but patient engagement is typically required for treatment to be effective. Patients with sleep apnea are phenotypically diverse and have individual needs, preferences, and values that impact treatment decisions. There has been a shift in obstructive sleep apnea management from diagnosis to chronic care management. Making treatment decisions that incorporate an individual patient's values and preferences and are personalized for that patient's biology has the potential to improve patient outcomes...
February 24, 2017: Sleep Medicine Reviews
https://www.readbyqxmd.com/read/28633678/variation-in-empiric-coverage-versus-detection-of-methicillin-resistant-staphylococcus-aureus-and-pseudomonas-aeruginosa-in-hospitalizations-for-community-onset-pneumonia-across-128-us-veterans-affairs-medical-centers
#8
Barbara E Jones, Kevin Antoine Brown, Makoto M Jones, Benedikt D Huttner, Tom Greene, Brian C Sauer, Karl Madaras-Kelly, Michael A Rubin, Matthew Bidwell Goetz, Matthew H Samore
OBJECTIVE To examine variation in antibiotic coverage and detection of resistant pathogens in community-onset pneumonia. DESIGN Cross-sectional study. SETTING A total of 128 hospitals in the Veterans Affairs health system. PARTICIPANTS Hospitalizations with a principal diagnosis of pneumonia from 2009 through 2010. METHODS We examined proportions of hospitalizations with empiric antibiotic coverage for methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa (PAER) and with initial detection in blood or respiratory cultures...
June 21, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28631146/motivations-for-interest-disinterest-and-uncertainty-in-intrauterine-device-use-among-young-women
#9
Anu Manchikanti Gomez, Bridget Freihart
Objective To elucidate salient contraceptive preferences and priorities as they relate to young women's interest or lack thereof in intrauterine device (IUD) use. Methods Qualitative data were drawn from a 2012 survey on contraceptive preferences and IUD interest. Among 413 young (ages 18-29) women, open-ended responses describing reasons for interest, disinterest or uncertainty in future IUD use were examined using a thematic analysis approach. Results Most participants were unsure about (49.2%) or not interested in (30...
June 19, 2017: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/28630829/are-we-justified-doing-salvage-or-amputation-procedure-based-on-mangled-extremity-severity-score-in-mangled-upper-extremity-injury
#10
R Siva Kumar, Prahalad Kumar Singhi, M Chidambaram
INTRODUCTION: Mangled upper limb injuries are at surge because of industrialization, modernization, and severe motor vehicle accidents. The utility of various scoring systems are meant for decision making in mangled lower limb injuries, and the same have been extrapolated for mangled upper limb injuries to make a decision of salvage or amputation for the lack of separate scoring system. MATERIALS AND METHODS: We applied mangled extremity severity score (MESS) and mangled extremity syndrome index (MESI) scoring systems to 10 cases of mangled upper limb injuries during the period of November 2010 to September 2012 presented at our tertiary trauma care center...
January 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28624066/complexity-of-medical-decision-making-in-care-provided-by-surgeons-through-patient-portals
#11
Jamie R Robinson, Alissa Valentine, Cathy Carney, Daniel Fabbri, Gretchen P Jackson
BACKGROUND: Patient portals are online applications that allow patients to interact with healthcare organizations and view information. Portal messages exchanged between patients and providers contain diverse types of communications, including delivery of medical care. The types of communications and complexity of medical decision-making in portal messages sent to surgeons have not been studied. MATERIALS AND METHODS: We obtained all message threads initiated by patients and exchanged with surgical providers through the Vanderbilt University Medical Center patient portal from June 1 to December 31, 2014...
June 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28623628/does-patient-preference-measurement-in-decision-aids-improve-decisional-conflict-a-randomized-trial-in-men-with-prostate-cancer
#12
Joseph D Shirk, Catherine M Crespi, Josemanuel D Saucedo, Sylvia Lambrechts, Ely Dahan, Robert Kaplan, Christopher Saigal
BACKGROUND: Shared decision making (SDM) has been advocated as an approach to medical decision making that can improve decisional quality. Decision aids are tools that facilitate SDM in the context of limited physician time; however, many decision aids do not incorporate preference measurement. OBJECTIVES: We aim to understand whether adding preference measurement to a standard patient educational intervention improves decisional quality and is feasible in a busy clinical setting...
June 16, 2017: Patient
https://www.readbyqxmd.com/read/28622200/service-line-structure-and-decision-maker-attention-in-three-health-systems-implications-for-patient-centered-care
#13
Christopher J Louis, Jonathan R Clark, Barbara Gray, Diane Brannon, Victoria Parker
BACKGROUND: Scholars have noted a disconnect between the level at which structure is typically examined (the organization) and the level at which the relevant coordination takes place (service delivery). Accordingly, our understanding of the role structure plays in care coordination is limited. PURPOSE: In this article, we explore service line structure, with an aim of advancing our understanding of the role service line structure plays in producing coordinated, patient-centered care...
June 15, 2017: Health Care Management Review
https://www.readbyqxmd.com/read/28619273/the-many-disguises-of-patient-centered-communication-problems-of-conceptualization-and-measurement
#14
Richard L Street
OBJECTIVE: To critically examine different approaches to the measurement of patient-centered communication. METHODS: Provides a critique of 7 different measures of patient-centered communication with respect to differences in their assumptions about what constitutes patient-centeredness and in their approaches to measurement. RESULTS: The measures differed significantly with regard to whether the measure captured behavior (what the interactants did) or judgment (how well the behavior was performed), focused on the individual clinician or on the interaction as a whole, and on who makes the assessment (participant or observer)...
May 5, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/28617166/challenges-in-providing-timely-physiotherapy-and-opportunities-to-influence-outcomes-for-potential-lung-donors
#15
Cassandra Raios, Jenny L Keating, Nicola Stitt, Helen I Opdam, Elizabeth H Skinner
CONTEXT: There is a critical shortage of donor lungs however, considerable ethical considerations are associated with the conduct of research to optimize care of the potential organ donor. OBJECTIVE: To investigate pathways of consent, respiratory care by physiotherapists and donation rates to contextualize future research on physiotherapy effects on donor lung suitability for procurement. DESIGN: Retrospective audit. SETTING: Australian tertiary hospital...
June 2017: Progress in Transplantation
https://www.readbyqxmd.com/read/28609563/bayesian-forecasting-tool-to-predict-the-need-for-antidote-in-acute-acetaminophen-overdose
#16
Julie Desrochers, Jessica Wojciechowski, Wendy Klein-Schwartz, Jogarao V S Gobburu, Mathangi Gopalakrishnan
STUDY OBJECTIVE: Acetaminophen (APAP) overdose is the leading cause of acute liver injury in the United States. Patients with elevated plasma acetaminophen concentrations (PAC) require hepatoprotective treatment with N-acetylcysteine (NAC). These patients have been primarily risk-stratified using the Rumack-Matthew nomogram. Previous studies of acute APAP overdoses found that the nomogram failed to accurately predict the need for the antidote. The objectives of this study were to develop a population pharmacokinetic (PK) model for APAP following acute overdose and evaluate the utility of population PK model-based Bayesian forecasting in NAC administration decisions...
June 13, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28609264/supporting-muslim-patients-during-advanced-illness
#17
REVIEW
Nathan A Boucher, Ejaz A Siddiqui, Harold G Koenig
Religion is an important part of many patients' cultural perspectives and value systems that influence them during advanced illness and toward the end of life when they directly face mortality. Worldwide violence perpetrated by people identifying as Muslim has been a growing fear for people living in the US and elsewhere. This fear has further increased by the tense rhetoric heard from the recent US presidential campaign and the new presidential administration. For many, this includes fear of all Muslims, the second-largest religious group in the world with 1...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28608450/analysis-of-giant-thoracic-neoplasms-correlations-between-imaging-pathology-and-surgical-management
#18
Zhen Feng, Meng Li, Fang Liu, Yue Peng, Wangang Ren, Hounai Xie, Zhongmin Peng
BACKGROUND: A giant thoracic neoplasm is extremely rare and poorly understood. Our systemic study introduced computed tomography angiography (CTA) with three-dimensional (3D) reconstruction imaging and evaluated correlations between imaging, pathology, and surgical management. METHODS: Data from 45 patients undergoing surgery for giant thoracic neoplasm in our institution between May 2007 and November 2015 were collected. The clinical characteristics, imaging manifestations, preoperative biopsy, surgical management, postoperative pathology, and prognosis and their correlation were analyzed...
June 13, 2017: Thoracic Cancer
https://www.readbyqxmd.com/read/28605312/examination-of-response-shift-after-rehabilitation-for-orthopedic-conditions-a-systematic-review
#19
Cameron J Powden, Matthew C Hoch, Johanna M Hoch
CONTEXT: There is an increased emphasis on the need to capture and incorporate self-reported function to make clinical decisions when providing patient-centered care. Response shift, or a change in an individual's self-evaluation of a construct, may affect the accurate assessment of change in self-reported function throughout the course of rehabilitation. A systematic review of this phenomenon may provide valuable information regarding the accuracy of self-reported function. OBJECTIVES: To systematically locate and synthesize the existing evidence regarding response shift during care for various orthopedic conditions...
June 12, 2017: Journal of Sport Rehabilitation
https://www.readbyqxmd.com/read/28605124/developing-abilities-to-navigate-through-the-grey-zones-in-complex-environments-nurses-reasons-for-applying-to-a-clinical-ethics-residency-for-nurses
#20
Martha Jurchak, Pamela J Grace, Susan M Lee, Danny G Willis, Angelika A Zollfrank, Ellen M Robinson
BACKGROUND AND PURPOSE: Nurses face complex ethical issues in practice and have to determine appropriate actions. An inability to conceptualize or follow a preferred course of action can give rise to moral uncertainty or moral distress. Both moral uncertainty and moral distress are problematic for nurses and their patients. A program designed to increase nurse confidence in moral decision making, the clinical ethics residency for nurses (CERN), was offered selectively to nurses affiliated with two academic medical centers...
June 12, 2017: Journal of Nursing Scholarship
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