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https://www.readbyqxmd.com/read/29145584/critical-lessons-from-high-value-oncology-practices
#1
Douglas W Blayney, Melora K Simon, Beatrice Podtschaske, Scott Ramsey, Margaret Shyu, Craig Lindquist, Arnold Milstein
Importance: Cancer care is expensive. Cancer care provided by practice organizations varies in total spending incurred by patients and payers during treatment episodes and in quality of care, and this unnecessary variation contributes to the high cost. Objective: To use the variation in total spending and quality of care to assess oncology practice attributes distinguishing "high value" that may be tested and adopted by others to produce similar results. Design, Setting, and Participants: "Positive deviance" was used in this exploratory mixed-methods (quantitative and qualitative) analysis of interview results...
November 16, 2017: JAMA Oncology
https://www.readbyqxmd.com/read/29144718/the-emerging-role-of-gammacore%C3%A2-in-the-management-of-cluster-headache-expert-panel-recommendations
#2
Stephen D Silberstein, Anne H Calhoun, Christina Treppendahl, David W Dodick, Alan M Rapoport, Avinash Mamidi, Peter Vargas, Thomas H Ebert, Stewart J Tepper
A panel of 9 experts, including neurologists, other headache specialists, and medical and pharmacy directors, from 4 health plans (1 integrated delivery network and 3 plans with commercial, Medicare, and Medicaid lines of business), convened to discuss cluster headache (CH). Topics covered included the current treatment landscape, treatment challenges, economic impact of disease, and gaps in care for patients with CH. One major challenge in the management of CH is that it is underrecognized and frequently misdiagnosed, leading to delays in and suboptimal treatment for patients who suffer from this painful and disabling condition...
November 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/29144599/assessing-social-values-for-california-s-efforts-to-reduce-the-overuse-of-unnecessary-medical-care
#3
Susan L Perez, Desiree Backman, Marge Ginsburg
BACKGROUND: A partnership of large health-care purchasers created a workgroup to reduce the overuse of harmful and wasteful medical care in California. OBJECTIVE: Employ a civic engagement process to identify the social values important to the public in considering different strategies to reduce overuse. INTERVENTION: Use of deliberation techniques for 3 case examples that explore possible strategies: physician oversight, physician compensation, increased patient cost-sharing or taking no definitive action...
November 16, 2017: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://www.readbyqxmd.com/read/29144250/case-not-closed-prescription-errors-12-years-after-computerized-physician-order-entry-implementation
#4
Gili Kadmon, Michal Pinchover, Avichai Weissbach, Shirley Kogan Hazan, Elhanan Nahum
OBJECTIVE: To assess the prolonged impact of computerized physician order entry (CPOE) on medication prescription errors in pediatric intensive care patients. STUDY DESIGN: This observational study was conducted at a pediatric intensive care unit in which a CPOE (Metavision, iMDsoft, Israel) with a limited clinical decision support system was implemented between 2004 and 2007. Since then, no changes were made to the systems. We analyzed 2500 electronic prescriptions (1250 prescriptions from 2015 and 1250 prescriptions from 2016)...
November 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29144047/evaluation-of-patient-satisfaction-in-pediatric-dermatology
#5
Sarah Ahmed, Jonathan Miller, James F Burrows, Ben Khallouq Bertha, Paul Rosen
BACKGROUND/OBJECTIVES: There remains a lack of investigation into which factors patients and families value the most in their experience at pediatric dermatology clinics. Most of the current literature on quality improvement in dermatology does not encompass the pediatric population. To determine the drivers that are most predictive of a positive patient experience, we observed the indirect relationship between several factors of the patient experience and their role in patient satisfaction...
November 2017: Pediatric Dermatology
https://www.readbyqxmd.com/read/29143208/a-new-measure-for-end-of-life-planning-preparation-and-preferences-in-huntington-disease-hdqlife-end-of-life-planning
#6
Noelle E Carlozzi, E A Hahn, S A Frank, J S Perlmutter, N D Downing, M K McCormack, S Barton, M A Nance, S G Schilling
BACKGROUND: Huntington disease is a fatal inherited neurodegenerative disease. Because the end result of Huntington disease is death due to Huntington disease-related causes, there is a need for better understanding and caring for individuals at their end of life. AIM: The purpose of this study was to develop a new measure to evaluate end of life planning. DESIGN: We conducted qualitative focus groups, solicited expert input, and completed a literature review to develop a 16-item measure to evaluate important aspects of end of life planning for Huntington disease...
November 15, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/29142837/preoperative-management-in-patients-with-graves-disease
#7
REVIEW
Eliana Piantanida
Graves' disease is the most frequent cause of hyperthyroidism in iodine-sufficient geographical areas and is characterized by the presence in patients' serum of autoantibodies directed against the thyrotropin receptor (TRAb) that cause overproduction and release of thyroid hormones. Clinical presentation results from both hyperthyroidism and underlying autoimmunity. The diagnosis is based on characteristic clinical features and biochemical abnormalities. If serum thyrotropin (TSH) is low, serum free thyroxine (FT4) and free triiodothyronine (FT3) concentrations should be measured to distinguish between subclinical (with normal circulating thyroid hormones) and overt hyperthyroidism (with increased circulating thyroid hormones)...
October 2017: Gland Surgery
https://www.readbyqxmd.com/read/29142579/pakistan-s-recommendations-for-optimal-management-of-diabetes-from-primary-to-tertiary-care-level-prompt
#8
A Samad Shera, Abdul Basit, Prompt Team
Pakistan is a developing country with limited resources and diverse socio-economic standards. Pakistan has high prevalence of diabetes and its complications, which is a great challenge to the existing health care system. National action plans for control of diabetes have been developed and initiatives have been taken but not at an ideal pace. First National Practice Guidelines for Pakistan were published in 1999. It was very helpful in standardizing the management of Type-2 diabetes. In view of important developments in the field of diabetes during the recent years, it was felt that 1999 National Clinical Practice Guidelines edited, should be revised...
September 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/29141769/turning-attention-to-clinician-engagement-in-victoria
#9
Christine Jorm, Robyn Hudson, Euan Wallace
The engagement of clinicians with employing organisations and with the broader health system results in better safer care for patients. Concerns about the adequacy of clinician engagement in the state of Victoria led the Victorian Department of Health and Human Services to commission a scoping study. During this investigation more than 100 clinicians were spoken with and 1800 responded to surveys. The result was creation of a clear picture of what engagement and disengagement looked like at all levels - from the clinical microsystem to state health policy making...
November 16, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/29141040/medical-therapy-versus-radiofrequency-endometrial-ablation-in-the-initial-treatment-of-heavy-menstrual-bleeding-itom-trial-a-clinical-and-economic-analysis
#10
Abimbola O Famuyide, Shannon K Laughlin-Tommaso, Sherif A Shazly, Kirsten Hall Long, Daniel M Breitkopf, Amy L Weaver, Michaela E McGree, Sherif A El-Nashar, Maureen A Lemens, Matthew R Hopkins
BACKGROUND: Radiofrequency endometrial ablation (REA) is currently a second line treatment in women with heavy menstrual bleeding (MHB) if medical therapy (MTP) is contraindicated or unsatisfactory. Our objective is to compare the effectiveness and cost burden of MTP and REA in the initial treatment of HMB. METHODS: We performed a randomized trial at Mayo Clinic Rochester, Minnesota. The planned sample size was 60 patients per arm. A total of 67 women with HMB were randomly allocated to receive oral contraceptive pills (Nordette ®) or Naproxen (Naprosyn®) (n = 33) or REA (n = 34)...
2017: PloS One
https://www.readbyqxmd.com/read/29140945/a-retrospective-cohort-study-of-the-incidence-health-care-resource-utilization-and-costs-of-international-classification-of-diseases-clinical-modification-9th-revision-diagnosed-influenza-and-related-complications-in-us-children
#11
Philip O Buck, David M Smith, Rahul Shenolikar, Debra E Irwin
BACKGROUND: There is a paucity of data on the clinical and economic impact of seasonal influenza in children. This study estimated the incidence of diagnosed influenza and related complications and associated health care resource utilization and costs in US children. METHODS: Children ≥6 months and <18 years old diagnosed with influenza using International Classification of Diseases, Clinical Modification, 9th revision codes and enrolled in a health plan during at least one influenza season between 2010 and 2014 were matched to similar patients without diagnosed influenza (GSK study identifier: HO-15-15728)...
December 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29140859/patient-and-caregiver-assessment-of-the-benefits-from-the-clinical-use-of-amyloid-pet-imaging
#12
Rafid Mustafa, Jared R Brosch, Gil D Rabinovici, Bradford C Dickerson, Maria C Carrillo, Bradley S Glazier, Sujuan Gao, Martha Tierney, Keith N Fargo, Mary G Austrom, Susan De Santi, David G Clark, Liana G Apostolova
INTRODUCTION: Few studies to date have explored patient and caregiver views on the clinical use of amyloid positron emission tomography (PET). METHODS: A 7-item questionnaire assessing patient and caregiver views (510 total respondents) toward amyloid PET imaging was advertised broadly through alz.org/trialmatch. RESULTS: We received 510 unique responses from 48 US states, 2 Canadian provinces, the Dominican Republic, and Greece. Both patients and caregivers indicated that they would want to receive amyloid imaging if offered the opportunity...
November 14, 2017: Alzheimer Disease and Associated Disorders
https://www.readbyqxmd.com/read/29140732/a-rare-form-of-ankyloblepharon-filiforme-adnatum-associated-with-the-hay-wells-syndrome-and-a-c-1709t-c-mutation-on-the-tp63-gene
#13
Michal Koubek, Kristýna Strakošová, Juraj Timkovič, Dagmar Grečmalová, Aneta Orlíková, Hana Burčková, Hana Wiedermannová, Petr Mašek
INTRODUCTION: Ankyloblepharon filiforme adnatum associated with Hay-Wells syndrome is a rare congenital disease caused by mutations in TP63 gene on the 3q27 chromosome. Here, we report a case of a new-born suffering from this syndrome in whom we detected a mutation c.1709T>C not previously included in the Ensemble database. CASE DESCRIPTION: A girl delivered in the 34th week of gestation from a physiological pregnancy was born with extensive burn-like skin defects, ankyloblepharon filiforme adnatum, palate cleft, onychodystrophy of all limbs and syndactyly of toes...
November 15, 2017: Ophthalmic Genetics
https://www.readbyqxmd.com/read/29140508/interactions-with-the-healthcare-system-influence-advance-care-planning-activities-results-from-a-representative-survey-in-11-developed-countries
#14
Alex Sable-Smith, Kelly R Arnett, Molly A Nowels, Kathryn Colborn, Hillary D Lum, David Nowels
Aim: To identify factors associated with completion of Advance Care Planning (ACP) by patients seen in primary care in developed countries. We hypothesized that the quality of primary care is associated. Method: We analysed respondent reported individual and healthcare utilization factors associated with the completion of ACP activities from the 2014 Commonwealth Fund International Health Policy Survey of Older Adults in 11 Countries. The primary outcome is the combined number of ACP activities completed...
November 13, 2017: Family Practice
https://www.readbyqxmd.com/read/29139336/home-health-aides-perceptions-of-quality-care-goals-challenges-and-implications-for-a-rapidly-changing-industry
#15
Emily Franzosa, Emma K Tsui, Sherry Baron
Home care payment models, quality measures, and care plans are based on physical tasks workers perform, ignoring relational care that supports clients' cognitive, emotional, and social well-being. As states seek to rein in costs and improve the efficiency and quality of care, they will need to consider how to measure and support relational care. In four focus groups ( n = 27) of unionized, agency-based New York City home health aides, workers reported aide-client relationships were a cornerstone of high-quality care, and building them required communication, respect, and going the extra mile...
January 1, 2017: New Solutions: a Journal of Environmental and Occupational Health Policy: NS
https://www.readbyqxmd.com/read/29139220/creating-and-facilitating-change-for-person-centred-coordinated-care-p3c-the-development-of-the-organisational-change-tool-p3c-oct
#16
Jane Horrell, Helen Lloyd, Thavapriya Sugavanam, James Close, Richard Byng
BACKGROUND: Person Centred Coordinated Care (P3C) is a UK priority for patients, carers, professionals, commissioners and policy makers. Services are developing a range of approaches to deliver this care with a lack of tools to guide implementation. METHODOLOGY: A scoping review and critical examination of current policy, key literature and NHS guidelines, together with stakeholder involvement led to the identification of domains, subdomains and component activities (processes and behaviours) required to deliver P3C...
November 15, 2017: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://www.readbyqxmd.com/read/29139007/adding-high-intensity-interval-training-to-conventional-training-modalities-optimizing-health-related-outcomes-during-chemotherapy-for-breast-cancer-the-optitrain-randomized-controlled-trial
#17
Sara Mijwel, Malin Backman, Kate A Bolam, Anna Jervaeus, Carl Johan Sundberg, Sara Margolin, Maria Browall, Helene Rundqvist, Yvonne Wengström
PURPOSE: Exercise training is an effective and safe way to counteract cancer-related fatigue (CRF) and to improve health-related quality of life (HRQoL). High-intensity interval training has proven beneficial for the health of clinical populations. The aim of this randomized controlled trial was to compare the effects of resistance and high-intensity interval training (RT-HIIT), and moderate-intensity aerobic and high-intensity interval training (AT-HIIT) to usual care (UC) in women with breast cancer undergoing chemotherapy...
November 14, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/29138568/epidemiology-and-costs-of-multiple-sclerosis-in-switzerland-an-analysis-of-health-care-claims-data-2011-2015
#18
Eva Blozik, Roland Rapold, Klaus Eichler, Oliver Reich
Background: Medical therapy for multiple sclerosis (MS) is expensive. Quantifying the burden of MS is fundamental for health-care planning and the allocation of resources for the management of MS. This study provides current national estimates of prevalence, incidence, mortality, and costs of MS in Switzerland using claims data between 2011 and 2015. Methods: We analyzed health insurance claims of adult persons enrolled with a large health insurance group covering about 13% of the Swiss population between 2011 and 2015...
2017: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/29138528/the-predictive-value-of-pitx2-dna-methylation-for-high-risk-breast-cancer-therapy-current-guidelines-medical-needs-and-challenges
#19
REVIEW
Michaela Aubele, Manfred Schmitt, Rudolf Napieralski, Stefan Paepke, Johannes Ettl, Magdalena Absmaier, Viktor Magdolen, John Martens, John A Foekens, Olaf G Wilhelm, Marion Kiechle
High-risk breast cancer comprises distinct tumor entities such as triple-negative breast cancer (TNBC) which is characterized by lack of estrogen (ER) and progesterone (PR) and the HER2 receptor and breast malignancies which have spread to more than three lymph nodes. For such patients, current (inter)national guidelines recommend anthracycline-based chemotherapy as the standard of care, but not all patients do equally benefit from such a chemotherapy. To further improve therapy decision-making, predictive biomarkers are of high, so far unmet, medical need...
2017: Disease Markers
https://www.readbyqxmd.com/read/29138217/effectiveness-of-interprofessional-education-in-renal-physiology-curricula-for-health-sciences-graduate-students
#20
Lisa M Harrison-Bernard, Mihran V Naljayan, Jane M Eason, Donald E Mercante, Tina P Gunaldo
The primary purpose of conducting an interprofessional education (IPE) experience during the renal physiology block of a graduate-level course was to provide basic science, physical therapy, and physician assistant graduate students with an opportunity to work as a team in the diagnosis, treatment, and collaborative care of a patient with acute kidney injury. The secondary purpose was to enhance the understanding of basic renal physiology principles with a patient case presentation of renal pathophysiology...
December 1, 2017: Advances in Physiology Education
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