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https://www.readbyqxmd.com/read/29451078/oncologists-perceptions-of-drug-affordability-using-nccn-evidence-blocks-results-from-a-national-survey
#1
Bijal Shah-Manek, William Wong, Arliene Ravelo, Marco DiBonaventura
BACKGROUND: The increasing prevalence of cancer coupled with approvals of new drugs and technologies used in therapy have brought increased scrutiny to the cost and value of treatments in oncology. To address the rising concern about oncology drug costs, several organizations have developed value frameworks to help assess the value of oncology regimens. The objective of this study was to assess oncologists' perceptions, awareness, and knowledge of all oncology value frameworks in the United States and to understand oncologists' perceptions of affordability in the context of National Comprehensive Cancer Network (NCCN) Evidence Blocks...
February 16, 2018: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29449049/extended-spectrum-%C3%AE-lactamase-producing-enterobacteriaceae-national-study-of-antimicrobial-treatment-for-pediatric-urinary-tract-infection
#2
M Lagree, S Bontemps, R Dessein, F Angoulvant, F Madhi, A Martinot, R Cohen, F Dubos
OBJECTIVE: To evaluate clinical practices for ESBL-producing urinary tract infection (UTI) in France. METHODS: We performed an observational, retrospective, cross-sectional, hospital-based study in 22 pediatric departments of university or secondary care hospitals. We collected data of the last five patients presenting with ESBL-producing UTI in 2012 and the physicians' therapeutic approach to two case vignettes of acute non-septic ESBL-producing pyelonephritis (7-month-old girl) and cystitis (30-month-old girl)...
February 12, 2018: Médecine et Maladies Infectieuses
https://www.readbyqxmd.com/read/29447274/health-literacy-of-hospital-patients-using-a-linguistically-validated-croatian-version-of-the-newest-vital-sign-screening-test-nvs-hr
#3
Sanja Brangan, Martina Ivanišić, Goranka Rafaj, Gill Rowlands
The Newest Vital Sign (NVS) is a simple, quick and accurate screening test for health literacy (HL). It has been validated for different languages but, to date, not for the Croatian language. The aim of this study was to develop a linguistically validated Croatian version of the NVS and to use it at a later stage in a pilot study of health literacy assessment of hospital patients in Croatia. A full linguistic validation procedure was applied, including forward and backward translation, expert panel review, cognitive interview with 10 respondents from general population, and full involvement in the procedure of one of the screening test developers, the lead author of the NVS-UK version...
2018: PloS One
https://www.readbyqxmd.com/read/29446469/clinical-trials-in-allergen-immunotherapy-current-concepts-and-future-needs
#4
REVIEW
O Pfaar, M Alvaro, V Cardona, E Hamelmann, R Mösges, J Kleine-Tebbe
Allergen immunotherapy (AIT) is a safe, effective treatment for allergic rhinoconjunctivitis and allergic asthma. However, AIT's clinical effect is still contested - primarily due to heterogeneity in clinical trial designs, study populations, therapeutic formulations and efficacy criteria. After discussing current concepts and unmet needs, an international panel of experts made several recommendations: (i) explore and validate definitions for [clinical] responders in AIT-trials; (ii) use of well-documented, standardized provocation tests prior to inclusion of subjects with relevant diseases in AIT trials; (iii) monitoring neo-sensitizations and occurrence of new allergy in extended AIT trials, and exclusion of polyallergic participants; (iv) validation of allergen exposure chambers with regard to natural exposure; (v) in studies of seasonal allergies, focus on peak exposure but also consider organising two parallel, geographically distinct but otherwise identical trials; (vi) discuss adaptive trial designs with the regulatory authorities; (vii) use e-health and m-health technologies to capture more information on individual exposure to allergens; (viii) initiate research on potential psychological, biochemical, immune, neural and even genomic markers of the placebo response; (ix) identify trial designs and primary endpoints that will give children with allergies easier, faster access to AIT formulations; and (x) promote and apply standardized methods for reporting systemic and local adverse events...
February 15, 2018: Allergy
https://www.readbyqxmd.com/read/29435727/gendered-expectations-do-they-contribute-to-high-burnout-among-female-physicians
#5
Mark Linzer, Eileen Harwood
Patients have differing expectations of female versus male physicians. Female patients tend to seek more empathic listening and longer visits, especially with female physicians; however, female doctors are not provided more time for this. Female doctors have more female patients than male doctors, and more patients with psychosocial complexity. We propose that gender differences in patient panels and gendered expectations of female physicians may contribute to the high rate of burnout among female clinicians, as well as to the many female physicians working part-time to reduce stress in their work lives...
February 12, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29425902/is-there-a-pig-cycle-in-the-labour-supply-of-doctors-how-training-and-immigration-policies-respond-to-physician-shortages
#6
Xavier Chojnicki, Yasser Moullan
Many OECD countries are faced with the considerable challenge of a physician shortage. This paper investigates the strategies that OECD governments adopt and determines whether these policies effectively address these medical shortages. Due to the amount of time medical training requires, it takes longer for an expansion in medical school capacity to have an effect than the recruitment of foreign-trained physicians. Using data obtained from the OECD (2014) and Bhargava et al. (2011), we constructed a unique country-level panel dataset that includes annual data for 17 OECD countries on physician shortages, the number of medical school graduates and immigration and emigration rates from 1991 to 2004...
January 31, 2018: Social Science & Medicine
https://www.readbyqxmd.com/read/29422373/international-commission-for-mountain-emergency-medicine-consensus-guidelines-for-on-site-management-and-transport-of-patients-in-canyoning-incidents
#7
REVIEW
Giacomo Strapazzon, Oliver Reisten, Fabien Argenone, Ken Zafren, Greg Zen-Ruffinen, Gordon L Larsen, Inigo Soteras
Canyoning is a recreational activity that has increased in popularity in the last decade in Europe and North America, resulting in up to 40% of the total search and rescue costs in some geographic locations. The International Commission for Mountain Emergency Medicine convened an expert panel to develop recommendations for on-site management and transport of patients in canyoning incidents. The goal of the current review is to provide guidance to healthcare providers and canyoning rescue professionals about best practices for rescue and medical treatment through the evaluation of the existing best evidence, focusing on the unique combination of remoteness, water exposure, limited on-site patient management options, and technically challenging terrain...
February 5, 2018: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/29420323/management-of-carpal-tunnel-syndrome
#8
Pekka A Mooar, William J Doherty, Jayson N Murray, Ryan Pezold, Kaitlyn S Sevarino
The American Academy of Orthopaedic Surgeons (AAOS) has developed Appropriate Use Criteria (AUC) for Management of Carpal Tunnel Syndrome. Evidence-based information, in conjunction with the clinical expertise of physicians, was used to develop the criteria to improve patient care and obtain best outcomes while considering the subtleties and distinctions necessary in making clinical decisions. To provide the evidence foundation for this AUC, the AAOS Evidence-Based Medicine Unit provided the writing panel and voting panel with the 2016 AAOS Clinical Practice Guideline titled Management of Carpal Tunnel Syndrome Evidence-Based Clinical Practice Guideline...
February 7, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29410171/how-fragile-are-clinical-trial-outcomes-that-support-the-chest-clinical-practice-guidelines-for-venous-thromboembolism
#9
Elizabeth Edwards, Cole Wayant, Jonathan Besas, Justin Chronister, Matt Vassar
BACKGROUND: Venous thromboembolism (VTE) remains a health concern for global populations. Clinical practice guidelines are necessary to guide physicians in the prophylaxis and treatment of VTE. METHODS: Our investigation assessed the robustness of the underlying evidence in 21 randomized controlled trials (RCTs) used to support treatment recommendations in the 2016 CHEST Guideline and Expert Panel Report on Antithrombotic Therapy for VTE Disease. We calculated the fragility index and fragility quotient for qualifying outcomes within RCTs...
February 1, 2018: Chest
https://www.readbyqxmd.com/read/29406129/a-decision-making-tool-to-prescribe-knee-orthoses-in-daily-practice-for-patients-with-osteoarthritis
#10
Emmanuel Coudeyre, Christelle Nguyen, Aurore Chabaud, Bruno Pereira, Johann Beaudreuil, Jean-Marie Coudreuse, Philippe Deat, Frédéric Sailhan, Alain Lorenzo, François Rannou
OBJECTIVE: To develop a decision-making tool (DMT) to facilitate the prescription of knee orthoses for patients with osteoarthritis (OA) in daily practice. METHODS: A steering committee gathered a multidisciplinary task force experienced in OA management/clinical research. Two members performed a literature review with qualitative analysis of the highest-quality randomized controlled trials and practice guidelines to confirm evidence concerning knee orthosis for OA...
February 2, 2018: Annals of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/29401740/primary-care-comprehensiveness-can-reduce-emergency-department-visits-and-hospitalization-in-people-with-hypertension-in-south-korea
#11
Nak-Jin Sung, Yong-Jun Choi, Jae-Ho Lee
Hypertension has been the leading risk factor contributing to cardiovascular morbidity and mortality, which needs comprehensive measures to manage and can be controlled effectively in primary care. In the health care context of South Korea, where specialists can see patients directly at their own community clinics and there has been no consensus on the definition of primary care, the authors used the nationally representative 2013 Korea Health Panel data, categorized adults (≥18 years) with hypertension by types of usual source of care (USC), and analyzed the association of having a comprehensive community clinic (i...
February 5, 2018: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29399791/proposed-consensus-definitions-for-new-onset-refractory-status-epilepticus-norse-febrile-infection-related-epilepsy-syndrome-fires-and-related-conditions
#12
Lawrence J Hirsch, Nicolas Gaspard, Andreas van Baalen, Rima Nabbout, Sophie Demeret, Tobias Loddenkemper, Vincent Navarro, Nicola Specchio, Lieven Lagae, Andrea O Rossetti, Sara Hocker, Teneille E Gofton, Nicholas S Abend, Emily J Gilmore, Cecil Hahn, Houman Khosravani, Felix Rosenow, Eugen Trinka
We convened an international group of experts to standardize definitions of New-Onset Refractory Status Epilepticus (NORSE), Febrile Infection-Related Epilepsy Syndrome (FIRES), and related conditions. This was done to enable improved communication for investigators, physicians, families, patients, and other caregivers. Consensus definitions were achieved via email messages, phone calls, an in-person consensus conference, and collaborative manuscript preparation. Panel members were from 8 countries and included adult and pediatric experts in epilepsy, electroencephalography (EEG), and neurocritical care...
February 5, 2018: Epilepsia
https://www.readbyqxmd.com/read/29395026/association-of-shared-decision-making-on-patient-reported-health-outcomes-and-healthcare-utilization
#13
Tasha M Hughes, Katiuscha Merath, Qinyu Chen, Steven Sun, Elizabeth Palmer, Jay J Idrees, Victor Okunrintemi, Malcolm Squires, Eliza W Beal, Timothy M Pawlik
BACKGROUND: Shared decision-making (SDM) is a process that respects the rights of patients to be fully involved in decisions about their care. By evaluating all available healthcare options and weighing patients' personal values and preferences against available unbiased evidence, patients and healthcare professionals can make health-related decisions together, as partners. We sought to evaluate the impact of perceived SDM on patient-reported outcomes, healthcare quality, and healthcare utilization...
January 31, 2018: American Journal of Surgery
https://www.readbyqxmd.com/read/29386214/antenatal-chemotherapy-in-a-case-of-diffuse-large-b-cell-lymphoma
#14
Akhil Rajendra, Anup J Devasia, Nirmal Raj Francis, Vijay Prakash Turaka
A 28-year-old pregnant woman in the sixth month of gestation presented with complaints of altered bowel habit for a month, on examination found to have generalised lymphadenopathy, pedal oedema and locally infiltrating ano-rectal growth. Rectal growth biopsy was reported as high-grade B-cell lymphoma. After a discussion in a multidisciplinary panel consisting of haemato-oncologists, obstetricians and physicians, she was planned to receive antenatal chemotherapy. She delivered a live baby of 1.86 kg at 36 weeks of gestational age by normal vaginal delivery...
January 31, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29385837/verification-of-a-proteomic-biomarker-panel-to-diagnose-minor-stroke-and-transient-ischaemic-attack-phase-1-of-spectra-a-large-scale-translational-study
#15
Andrew M Penn, Maximilian B Bibok, Viera K Saly, Shelagh B Coutts, Mary L Lesperance, Robert F Balshaw, Kristine Votova, Nicole S Croteau, Anurag Trivedi, Angela M Jackson, Janka Hegedus, Evgenia Klourfeld, Amy Y X Yu, Charlotte Zerna, Christoph H Borchers
OBJECTIVE: To derive a plasma biomarker protein panel from a list of 141 candidate proteins which can differentiate transient ischaemic attack (TIA)/minor stroke from non-cerebrovascular ('mimic') conditions in emergency department (ED) settings. DESIGN: Prospective clinical study (#NCT03050099) with up to three timed blood draws no more than 36 hours following symptom onset. Plasma samples analysed by multiple reaction monitoring-mass spectrometry (MRM-MS). PARTICIPANTS: 545 participants suspected of TIA enrolled in the EDs of two urban medical centres...
February 1, 2018: Biomarkers: Biochemical Indicators of Exposure, Response, and Susceptibility to Chemicals
https://www.readbyqxmd.com/read/29385437/international-definition-of-a-point-of-care-test-in-family-practice-a-modified-e-delphi-procedure
#16
Angel M R Schols, Geert-Jan Dinant, Rogier Hopstaken, Christopher P Price, Ron Kusters, Jochen W L Cals
Background: The use of point-of-care tests (POCTs) in family practice is increasing, and the term POCT is often used in medical literature and clinical practice. Yet, no widely supported definition by several professional fields exists. Objective: To reach consensus on an international definition of a POCT in family practice. Methods: We performed a modified international e-Delphi procedure of four rounds among expert panel members from different professional backgrounds-family practitioners, laboratory specialists, policymakers, researchers and manufacturers...
January 29, 2018: Family Practice
https://www.readbyqxmd.com/read/29383957/physician-perceptions-of-pharmacologic-treatment-options-for-chorea-associated-with-huntington-disease-in-the-united-states
#17
Victor W Sung, Ravi G Iyer, Sanjay K Gandhi, Bijal Shah-Manek, Marco DiBonaventura, Victor Abler, Daniel O Claassen
OBJECTIVE: To survey neurologists and obtain clinical perceptions of tetrabenazine for the treatment of chorea in patients with Huntington disease (HD). METHODS: Board-certified/board-eligible neurologists, in practice for ≥5 years, who treat ≥3 HD patients in the past 2 years, were recruited from an online physician panel to participate in a cross-sectional, web-based survey. Respondents provided information about themselves, their practice, approaches to HD chorea management, and perceptions of available treatments...
January 31, 2018: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/29376134/engineering-of-a-miniaturized-robotic-clinical-laboratory
#18
Marilyn B Nourse, Kate Engel, Samartha G Anekal, Jocelyn A Bailey, Pradeep Bhatta, Devayani P Bhave, Shekar Chandrasekaran, Yutao Chen, Steven Chow, Ushati Das, Erez Galil, Xinwei Gong, Steven F Gessert, Kevin D Ha, Ran Hu, Laura Hyland, Arvind Jammalamadaka, Karthik Jayasurya, Timothy M Kemp, Andrew N Kim, Lucie S Lee, Yang Lily Liu, Alphonso Nguyen, Jared O'Leary, Chinmay H Pangarkar, Paul J Patel, Ken Quon, Pradeep L Ramachandran, Amy R Rappaport, Joy Roy, Jerald F Sapida, Nikolay V Sergeev, Chandan Shee, Renuka Shenoy, Sharada Sivaraman, Bernardo Sosa-Padilla, Lorraine Tran, Amanda Trent, Thomas C Waggoner, Dariusz Wodziak, Amy Yuan, Peter Zhao, Daniel L Young, Channing R Robertson, Elizabeth A Holmes
The ability to perform laboratory testing near the patient and with smaller blood volumes would benefit patients and physicians alike. We describe our design of a miniaturized clinical laboratory system with three components: a hardware platform (ie, the miniLab) that performs preanalytical and analytical processing steps using miniaturized sample manipulation and detection modules, an assay-configurable cartridge that provides consumable materials and assay reagents, and a server that communicates bidirectionally with the miniLab to manage assay-specific protocols and analyze, store, and report results (i...
January 2018: Bioengineering & Translational Medicine
https://www.readbyqxmd.com/read/29374481/use-of-health-services-according-to-income-before-and-after-elimination-of-copayment-in-germany-and-restriction-of-universal-health-coverage-in-spain
#19
Lourdes Lostao, Siegfried Geyer, Romana Albaladejo, Almudena Moreno-Lostao, Elena Ronda, Enrique Regidor
BACKGROUND: In Germany copayment for medical consultation was eliminated in 2013, and in Spain universal health coverage was partly restricted in 2012. This study shows the relationship between income and the use of health services before and after these measures in each country. METHODS: Data were taken from the 2009 and 2014 Socio-Economic Panel conducted in Germany, and from the 2009 and 2014 European Health Surveys in Spain. The health services investigated were physician consultations and hospital admissions, and the measure of socioeconomic position used was household income...
January 27, 2018: International Journal for Equity in Health
https://www.readbyqxmd.com/read/29370425/meaningful-use-s-benefits-and-burdens-for-us-family-physicians
#20
G Talley Holman, Steven E Waldren, John W Beasley, Deborah J Cohen, Lawrence D Dardick, Chester H Fox, Jenna Marquard, Ryan Mullins, Charles Q North, Matt Rafalski, A Joy Rivera, Tosha B Wetterneck
Objective: The federal meaningful use (MU) program was aimed at improving adoption and use of electronic health records, but practicing physicians have criticized it. This study was aimed at quantifying the benefits (ie, usefulness) and burdens (ie, workload) of the MU program for practicing family physicians. Materials and Methods: An interdisciplinary national panel of experts (physicians and engineers) identified the work associated with MU criteria during patient encounters...
January 23, 2018: Journal of the American Medical Informatics Association: JAMIA
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