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https://www.readbyqxmd.com/read/28544648/effects-of-a-web-based-patient-decision-aid-on-biologic-and-small-molecule-agents-for-rheumatoid-arthritis-answer-2-a-proof-of-concept-study
#1
Linda C Li, Chris Shaw, Diane Lacaille, Elaine Yacyshyn, C Allyson Jones, Cheryl Koehn, Alison M Hoens, Jasmina Geldman, Eric C Sayre, Graham Macdonald, Jenny Leese, Nick Bansback
OBJECTIVES: To assess the extent to which ANSWER-2, an interactive online patient decision aid, reduces patients' decisional conflict and improves their medication-related knowledge and self-management capacity. METHODS: We used a pre-post study design. Eligible participants had a diagnosis of rheumatoid arthritis (RA), had been recommended to start using a biologic or small molecule agent or to switch to a new one, and had Internet access. Access to ANSWER-2 was provided immediately after enrollment...
May 23, 2017: Arthritis Care & Research
https://www.readbyqxmd.com/read/28544171/effectiveness-of-shared-goal-setting-and-decision-making-to-achieve-treatment-targets-in-type-2-diabetes-patients-a-cluster-randomized-trial-optimal
#2
Henk Den Ouden, Rimke C Vos, Guy E H M Rutten
OBJECTIVE: About 20% of patients with type 2 diabetes achieve all their treatment targets. Shared decision making (SDM) using a support aid based on the 5-years results of the ADDITION study on multifactorial treatment, could increase this proportion. RESEARCH DESIGN AND METHODS: Cluster-randomized trial in 35 former ADDITION primary care practices. Practices were randomized to SDM or care as usual (1:1). Both ADDITION and non-ADDITION type 2 diabetes patients, 60-80 years, known with diabetes for 8-12 years, were included...
May 24, 2017: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://www.readbyqxmd.com/read/28543973/advancing-the-adverse-outcome-pathway-framework-an-international-horizon-scanning-approach
#3
Carlie A LaLone, Gerald T Ankley, Scott E Belanger, Michelle R Embry, Geoff Hodges, Dries Knapen, Sharon Munn, Edward J Perkins, Murray A Rudd, Daniel L Villeneuve, Maurice Whelan, Catherine Willett, Xiaowei Zhang, Markus Hecker
Our ability to conduct whole-organism toxicity tests to understand chemical safety has been outpaced by the synthesis of new chemicals for a wide variety of commercial applications. As a result, scientists and risk assessors are turning to mechanistically based studies to increase efficiencies in chemical risk assessment and making greater use of in vitro and in silico methods to evaluate potential environmental and human health hazards. In this context, the adverse outcome pathway (AOP) framework has gained traction in regulatory science because it offers an efficient and effective means for capturing available knowledge describing the linkage between mechanistic data and the apical toxicity end points required for regulatory assessments...
June 2017: Environmental Toxicology and Chemistry
https://www.readbyqxmd.com/read/28541583/consumer-decision-making-abilities-and-long-term-care-insurance-purchase
#4
Brian E McGarry, Helena Tempkin-Greener, David C Grabowski, Benjamin P Chapman, Yue Li
Objectives: To determine the impact of consumer decision-making abilities on making a long-term care insurance (LTCi) purchasing decision that is consistent with normative economic predictions regarding policy ownership. Method: Using data from the Health and Retirement Study, multivariate analyses are implemented to estimate the effect of decision-making ability factors on owning LTCi. Stratified multivariate analyses are used to examine the effect of decision-making abilities on the likelihood of adhering to economic predictions of LTCi ownership...
May 25, 2017: Journals of Gerontology. Series B, Psychological Sciences and Social Sciences
https://www.readbyqxmd.com/read/28541453/critical-health-literacy-in-american-deaf-college-students
#5
Poorna Kushalnagar, Claire Ryan, Scott Smith, Raja Kushalnagar
This study investigates the relationship between critical health literacy (CHL) and discussion of health information among college deaf students who use American Sign Language. CHL is crucial in making appropriate health-related decisions for oneself and aiding others in making good health-choices. Research on general youth population shows that frequent health-related discussions with both friends and family is associated with higher health literacy. However, for our sample of deaf college-aged students who might have had less access to communication at home, we hypothesize that health-related discussions with same-age peers may be more important for critical health literacy...
May 24, 2017: Health Promotion International
https://www.readbyqxmd.com/read/28539115/quad-phased-data-mining-modeling-for-dementia-diagnosis
#6
Sunjoo Bang, Sangjoon Son, Hyunwoong Roh, Jihye Lee, Sungyun Bae, Kyungwon Lee, Changhyung Hong, Hyunjung Shin
BACKGROUND: The number of people with dementia is increasing along with people's ageing trend worldwide. Therefore, there are various researches to improve a dementia diagnosis process in the field of computer-aided diagnosis (CAD) technology. The most significant issue is that the evaluation processes by physician which is based on medical information for patients and questionnaire from their guardians are time consuming, subjective and prone to error. This problem can be solved by an overall data mining modeling, which subsidizes an intuitive decision of clinicians...
May 18, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28538948/exploring-audiologists-language-and-hearing-aid-uptake-in-initial-rehabilitation-appointments
#7
Anna Sciacca, Carly Meyer, Katie Ekberg, Caitlin Barr, Louise Hickson
Purpose: The study aimed (a) to profile audiologists' language during the diagnosis and management planning phase of hearing assessment appointments and (b) to explore associations between audiologists' language and patients' decisions to obtain hearing aids. Method: Sixty-two audiologist-patient dyads participated. Patient participants were aged 55 years or older. Hearing assessment appointments were audiovisually recorded and transcribed for analysis. Audiologists' language was profiled using two measures: general language complexity and use of jargon...
May 23, 2017: American Journal of Audiology
https://www.readbyqxmd.com/read/28538919/expert-communities-and-interest-formation-in-the-brazilian-aids-program
#8
Regina Ferro do Lago, Nilson do Rosário Costa
This paper examines the role of the Technical Advisory Committee for antiretroviral therapy of the Brazilian AIDS program in mediating the decision-making process of including new antiretroviral (ARV) drugs in the Unified Health System services by the end of the 2000s. We conducted documental analysis and interviews with key informants from the governmental sphere and professionals. The work features the Technical Advisory Committee as an "expert community", defined as a network of individuals with expertise and competence in a particular sphere and whose knowledge is relevant in critical public policy decision areas...
May 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28535447/application-of-a-life-cycle-assessment-to-compare-environmental-performance-in-coal-mine-tailings-management
#9
Joni Safaat Adiansyah, Nawshad Haque, Michele Rosano, Wahidul Biswas
This study compares coal mine tailings management strategies using life cycle assessment (LCA) and land-use area metrics methods. Hybrid methods (the Australian indicator set and the ReCiPe method) were used to assess the environmental impacts of tailings management strategies. Several strategies were considered: belt filter press (OPT 1), tailings paste (OPT 2), thickened tailings (OPT 3), and variations of OPT 1 using combinations of technology improvement and renewable energy sources (OPT 1A-D). Electrical energy was found to contribute more than 90% of the environmental impacts...
May 20, 2017: Journal of Environmental Management
https://www.readbyqxmd.com/read/28532994/johne-s-disease-in-the-eyes-of-irish-cattle-farmers-a-qualitative-narrative-research-approach-to-understanding-implications-for-disease-management
#10
Conor G McAloon, Áine Macken-Walsh, Lisa Moran, Paul Whyte, Simon J More, Luke O'Grady, Michael L Doherty
Bovine Johne's Disease (JD) is a disease characterised by chronic granulomatous enteritis which manifests clinically as a protein-losing enteropathy causing diarrhoea, hypoproteinaemia, emaciation and, eventually death. Some research exists to suggest that the aetiologic pathogen Mycobacterium avium subspecies paratuberculosis may pose a zoonotic risk. Nationally coordinated control programmes have been introduced in many of the major milk producing countries across the world. However, JD is challenging to control in infected herds owing to limitations of diagnostic tests and the long incubation period of the disease...
June 1, 2017: Preventive Veterinary Medicine
https://www.readbyqxmd.com/read/28532698/validation-of-the-mayo-clinic-staging-system-in-determining-prognoses-of-patients-with-perihilar-cholangiocarcinoma
#11
Robert J S Coelen, Marcia P Gaspersz, Tim A Labeur, Jeroen L A van Vugt, Susan van Dieren, François E J A Willemssen, Chung Y Nio, Jan N M IJzermans, Heinz-Josef Klümpen, Bas Groot Koerkamp, Thomas M van Gulik
BACKGROUND AND AIMS: Most systems for staging perihilar cholangiocarcinoma (PHC) have been developed for the minority of patients with resectable disease. The recently developed Mayo Clinic system for staging PHC requires only clinical and radiological variables, but has not yet been validated. We performed a retrospective study to validate the Mayo Clinic staging system. METHODS: We identified consecutive patients with suspected PHC evaluated and treated at 2 tertiary centers in The Netherlands, from January 2002 through December 2014...
May 19, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28532629/shared-decision-making-in-the-uk-moving-towards-wider-uptake
#12
Angela Coulter, Adrian Edwards, Vikki Entwistle, Graham Kramer, Alan Nye, Richard Thomson, Emma Walker
Shared decision making (SDM) is firmly on the policy agenda in the UK and a recent legal ruling has confirmed its importance. Policymakers, ethicists, professional regulators and societies, patient organisations and now the courts are committed to ensuring that SDM becomes the norm throughout the NHS, but an unfavourable economic climate makes this especially challenging. Considerable progress has been made over the last few years, with new learning from demonstration sites, various initiatives in capacity building and training, wider availability of patient decision aids, and important leadership initiatives...
May 20, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28532628/milestones-barriers-and-beacons-shared-decision-making-in-canada-inches-ahead
#13
France Légaré, Dawn Stacey, Pierre-Gerlier Forest, Marie-France Coutu, Patrick Archambault, Laura Boland, Holly O Witteman, Annie LeBlanc, Krystina B Lewis, Anik M C Giguere
Canada's approach to shared decision making (SDM) remains as disparate as its healthcare system; a conglomerate of 14 public plans - ten provincial, three territorial and one federal. The healthcare research funding environment has been largely positive for SDM because there was funding for knowledge translation research which also encompassed SDM. The funding climate currently places new emphasis on patient involvement in research and on patient empowerment in healthcare. SDM fields have expanded from primary care to elder care, paediatrics, emergency and critical care medicine, cardiology, nutrition, occupational therapy and workplace rehabilitation...
May 19, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28532596/costs-and-cost-efficacy-analysis-of-the-2017-gesida-spanish-national-aids-plan-recommended-guidelines-for-initial-antiretroviral-therapy-in-hiv-infected-adults
#14
Antonio Rivero, José Antonio Pérez-Molina, Antonio Javier Blasco, José Ramón Arribas, Víctor Asensi, Manuel Crespo, Pere Domingo, José Antonio Iribarren, Pablo Lázaro, José López-Aldeguer, Fernando Lozano, Esteban Martínez, Santiago Moreno, Rosario Palacios, Juan Antonio Pineda, Federico Pulido, Rafael Rubio, Jesús Santos, Javier de la Torre, Montserrat Tuset, Josep M Gatell
INTRODUCTION: GESIDA and the Spanish National AIDS Plan panel of experts have recommended preferred (PR), alternative (AR) and other regimens (OR) for antiretroviral therapy (ART) as initial therapy in HIV-infected patients for 2017. The objective of this study was to evaluate the costs and the efficiency of initiating treatment with PR and AR. METHODS: Economic assessment of costs and efficiency (cost-efficacy) based on decision tree analyses. Efficacy was defined as the probability of reporting a viral load <50copies/mL at week 48, in an intention-to-treat analysis...
May 19, 2017: Enfermedades Infecciosas y Microbiología Clínica
https://www.readbyqxmd.com/read/28532503/an-updated-predict-breast-cancer-prognostication-and-treatment-benefit-prediction-model-with-independent-validation
#15
Francisco J Candido Dos Reis, Gordon C Wishart, Ed M Dicks, David Greenberg, Jem Rashbass, Marjanka K Schmidt, Alexandra J van den Broek, Ian O Ellis, Andrew Green, Emad Rakha, Tom Maishman, Diana M Eccles, Paul D P Pharoah
BACKGROUND: PREDICT is a breast cancer prognostic and treatment benefit model implemented online. The overall fit of the model has been good in multiple independent case series, but PREDICT has been shown to underestimate breast cancer specific mortality in women diagnosed under the age of 40. Another limitation is the use of discrete categories for tumour size and node status resulting in 'step' changes in risk estimates on moving between categories. We have refitted the PREDICT prognostic model using the original cohort of cases from East Anglia with updated survival time in order to take into account age at diagnosis and to smooth out the survival function for tumour size and node status...
May 22, 2017: Breast Cancer Research: BCR
https://www.readbyqxmd.com/read/28532482/-ensure-that-you-are-well-aware-of-the-risks-you-are-taking%C3%A2-actions-and-activities-medical-tourists-informal-caregivers-can-undertake-to-protect-their-health-and-safety
#16
Valorie A Crooks, Rebecca Whitmore, Jeremy Snyder, Leigh Turner
BACKGROUND: When seeking care at international hospitals and clinics, medical tourists are often accompanied by family members, friends, or other caregivers. Such caregiver-companions assume a variety of roles and responsibilities and typically offer physical assistance, provide emotional support, and aid in decision-making and record keeping as medical tourists navigate unfamiliar environments. While traveling abroad, medical tourists' caregiver-companions can find themselves confronted with challenging communication barriers, financial pressures, emotional strain, and unsafe environments...
May 22, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28532459/mechanical-ventilation-in-idiopathic-pulmonary-fibrosis-a-nationwide-analysis-of-ventilator-use-outcomes-and-resource-burden
#17
Joshua J Mooney, Karina Raimundo, Eunice Chang, Michael S Broder
BACKGROUND: Idiopathic pulmonary fibrosis (IPF) is associated with increased risk of respiratory-related hospitalizations. Studies suggest mechanical ventilation (MV) use in IPF does not improve outcomes and guidelines recommend against its general use. Our objective was to investigate MV use and association with cost and mortality in IPF. METHODS: This retrospective study, using a nationwide sample, included claims with IPF (ICD-9-CM: 516.3) in 2009-2011 and principal respiratory disease diagnosis (ICD-9-CM: 460-519); excluding lung transplant...
May 22, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28532308/contributions-of-national-and-global-health-estimates-to-monitoring-health-related-sustainable-development-goals-in-thailand
#18
Kanitta Bundhamcharoen, Supon Limwattananon, Khanitta Kusreesakul, Viroj Tangcharoensathien
The Millennium Development Goals (MDGs) triggered increased demand for data on child and maternal mortality for monitoring progress. With the advent of the Sustainable Development Goals (SDGs) and growing evidence of an epidemiological transition towards non-communicable diseases, policy makers need data on mortality and disease trends and distribution to inform effective policies and support monitoring progress. Where there are limited capacities to produce national health estimates (NHEs), global health estimates (GHEs) can fill gaps for global monitoring and comparisons...
January 2017: Global Health Action
https://www.readbyqxmd.com/read/28532194/cost-effectiveness-of-ceftolozane-tazobactam-plus-metronidazole-compared-with-piperacillin-tazobactam-as-empiric-therapy-for-the-treatment-of-complicated-intra-abdominal-infections-based-on-the-in-vitro-surveillance-of-bacterial-isolates-in-the-uk
#19
Vimalanand Prabhu, Jason Foo, Harblas Ahir, Eric Sarpong, Sanjay Merchant
AIMS: An increase in the prevalence of antimicrobial resistance among gram-negative pathogens has been noted recently.[1] A challenge in empiric treatment of complicated intra-abdominal infection (cIAI) is identifying initial appropriate antibiotic therapy, which is associated with reduced length of stay and mortality compared with inappropriate therapy. The objective of this study was to assess the cost-effectiveness of ceftolozane/tazobactam+metronidazole compared with piperacillin/tazobactam (commonly used in this indication) in the treatment of patients with cIAI in United Kingdom (UK) hospitals...
May 22, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28531306/association-of-long-term-opioid-therapy-with-functional-status-adverse-outcomes-and-mortality-among-patients-with-polyneuropathy
#20
E Matthew Hoffman, James C Watson, Jennifer St Sauver, Nathan P Staff, Christopher J Klein
Importance: Polyneuropathy is one of the most common painful conditions managed within general and specialty clinics. Neuropathic pain frequently leads to decisions about using long-term opioid therapy. Understanding the association of long-term opioid use with functional status, adverse outcomes, and mortality among patients with polyneuropathy could influence disease-specific decisions about opioid treatment. Objectives: To quantify the prevalence of long-term opioid use among patients with polyneuropathy and to assess the association of long-term opioid use with functional status, adverse outcomes, and mortality...
May 22, 2017: JAMA Neurology
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