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Patient oriented evidence that matters

Sean C Glasgow, Arden M Morris, Nancy N Baxter, James W Fleshman, Karim S Alavi, Martin A Luchtefeld, John R T Monson, George J Chang, Larissa K Temple
BACKGROUND: There is excellent evidence that surgical safety checklists contribute to decreased morbidity and mortality. OBJECTIVE: The purpose of this study was to develop a surgical checklist composed of the key phases of care for patients with rectal cancer. DESIGN: A consensus-oriented decision-making model involving iterative input from subject matter experts under the auspices of The American Society of Colon and Rectal Surgeons was designed...
July 2016: Diseases of the Colon and Rectum
Muireann Irish, Nadine Eyre, Nadene Dermody, Claire O'Callaghan, John R Hodges, Michael Hornberger, Olivier Piguet
The ability to envisage personally relevant events at a future time point represents an incredibly sophisticated cognitive endeavor and one that appears to be intimately linked to episodic memory integrity. Far less is known regarding the neurocognitive mechanisms underpinning the capacity to envisage non-personal future occurrences, known as semantic future thinking. Moreover the degree of overlap between the neural substrates supporting episodic and semantic forms of prospection remains unclear. To this end, we sought to investigate the capacity for episodic and semantic future thinking in Alzheimer's disease (n = 15) and disease-matched behavioral-variant frontotemporal dementia (n = 15), neurodegenerative disorders characterized by significant medial temporal lobe (MTL) and frontal pathology...
2016: Frontiers in Behavioral Neuroscience
Mark H Ebell, Roland Grad
In 2015, a group of primary care clinicians with expertise in evidence-based practice performed monthly surveillance of more than 110 English-language clinical research journals. They identified 251 studies that addressed a primary care question and had the potential to change practice if valid (patient-oriented evidence that matters, or POEMs). Each study was critically appraised and disseminated to subscribers via e-mail, including members of the Canadian Medical Association who had the option to use a validated tool to assess the clinical relevance of each POEM and the benefits they expect for their practice...
May 1, 2016: American Family Physician
Mark H Ebell, Roland Grad
A team of primary care clinicians with expertise in evidence-based medicine performed monthly surveillance of more than 110 English-language clinical research journals during 2014, and identified 255 studies that had the potential to change how family physicians practice. Each study was critically appraised and summarized, focusing on its relevance to primary care practice, validity, and likelihood that it could change practice. A validated tool was used to obtain feedback from members of the Canadian Medical Association about the clinical relevance of each POEM (patient-oriented evidence that matters) and the benefits they expect for their practice...
September 1, 2015: American Family Physician
Luca Prosperini, Maria Cristina Piattella, Costanza Giannì, Patrizia Pantano
Rehabilitation is recognized to be important in ameliorating motor and cognitive functions, reducing disease burden, and improving quality of life in patients with multiple sclerosis (MS). In this systematic review, we summarize the existing evidences that motor and cognitive rehabilitation may enhance functional and structural brain plasticity in patients with MS, as assessed by means of the most advanced neuroimaging techniques, including diffusion tensor imaging and task-related and resting-state functional magnetic resonance imaging (MRI)...
2015: Neural Plasticity
Roland Grad, Pierre Pluye, David Tang, Michael Shulha, David C Slawson, Allen F Shaughnessy
OBJECTIVE: We propose a method of identifying clinical topics for campaigns like Choosing Wisely. METHODS: In the context of an ongoing continuing medication education program, we analyzed ratings on every patient-oriented evidence that matters (POEM) synopsis delivered in 2012 and 2013. Given the objective of the Choosing Wisely campaign, we focused this analysis on 1 specific item in the validated questionnaire used by physicians to rate POEMs. This questionnaire item is about "avoiding an unnecessary diagnostic test or treatment...
March 2015: Journal of the American Board of Family Medicine: JABFM
Salvatore Nigro, Luca Passamonti, Roberta Riccelli, Nicola Toschi, Federico Rocca, Paola Valentino, Rita Nisticò, Francesco Fera, Aldo Quattrone
BACKGROUND: Major depression (MD) is a common psychiatric disorder in multiple sclerosis (MS). Despite the negative impact of MD on the quality of life of MS patients, little is known about its underlying brain mechanisms. OBJECTIVE: We studied the whole-brain connectivity patterns that were associated with MD in MS. Alterations were mainly expected within limbic circuits. METHODS: Diffusion tensor imaging data were collected in 20 MS patients with MD, 22 non-depressed MS patients and 16 healthy controls...
July 2015: Multiple Sclerosis: Clinical and Laboratory Research
Mark H Ebell, Roland Grad
In 2013, we performed monthly surveillance of more than 110 English-language clinical research journals, and identified approximately 250 studies that had the potential to change the practice of family physicians. Each study was critically appraised and summarized by a group of primary care clinicians with expertise in evidence-based medicine. Studies were evaluated based on their relevance to primary care practice, validity, and likelihood that they could change practice. These summaries, called POEMs (patient-oriented evidence that matters), are e-mailed to subscribers, including members of the Canadian Medical Association...
September 15, 2014: American Family Physician
Nils Muhlert, Varun Sethi, Lisa Cipolotti, Hamied Haroon, Geoff J M Parker, Tarek Yousry, Claudia Wheeler-Kingshott, David Miller, Maria Ron, Declan Chard
OBJECTIVE: People with multiple sclerosis (MS) have difficulties with decision-making but it is unclear if this is due to changes in impulsivity, risk taking, deliberation or risk adjustment, and how this relates to brain pathology. METHODS: We assessed these aspects of decision-making in 105 people with MS and 43 healthy controls. We used a novel diffusion MRI method, diffusion orientational complexity (DOC), as an index of grey matter pathology in regions associated with decision-making and also measured grey matter tissue volumes and white matter lesion volumes...
May 2015: Journal of Neurology, Neurosurgery, and Psychiatry
Alessandro De Benedictis, Hugues Duffau, Beatrice Paradiso, Enrico Grandi, Sergio Balbi, Enrico Granieri, Enzo Colarusso, Franco Chioffi, Carlo Efisio Marras, Silvio Sarubbo
The temporo-parieto-occipital (TPO) junction is a complex brain territory heavily involved in several high-level neurological functions, such as language, visuo-spatial recognition, writing, reading, symbol processing, calculation, self-processing, working memory, musical memory, and face and object recognition. Recent studies indicate that this area is covered by a thick network of white matter (WM) connections, which provide efficient and multimodal integration of information between both local and distant cortical nodes...
August 2014: Journal of Anatomy
Adibe Maxwell Ogochukwu, Ukwe Chinwe Victoria
The objective of this study was to review published articles on the issues surrounding tight blood pressure control in hypertensive diabetics. Relevant medical subject headings (MeSH) terms and keywords to review scientific literatures were developed. These MeSH terms were used to generate MEDLINE searches that focused on English-language, peer-reviewed scientific literature. In reviewing the exceptionally large body of research literature in anti-hypertension therapies in diabetic patients , the review focused on outcomes of importance to patients and effects of sufficient magnitude to warrant changes in medical practice ("patient oriented evidence that matters" [POEMs])...
June 2010: Journal of Basic and Clinical Pharmacy
Daniel D Kurylo, Gabriella Brick Larkin, Richard Waxman, Farhan Bukhari
Evidence exists that damage to white matter connections may contribute to reduced speed of information processing in traumatic brain injury and stroke. Damage to such axonal projections suggests a particular vulnerability to functions requiring integration across cortical sites. To test this prediction, measurements were made of perceptual grouping, which requires integration of stimulus components. A group of traumatic brain injury and cerebral vascular accident patients and a group of age-matched healthy control subjects viewed arrays of dots and indicated the pattern into which stimuli were perceptually grouped...
September 2014: Experimental Brain Research. Experimentelle Hirnforschung. Expérimentation Cérébrale
Cindy Crawford, Courtney Lee, Todd May
OBJECTIVES: Chronic pain management typically consists of prescription medications or provider-based, behavioral, or interventional procedures that are often ineffective, may be costly, and can be associated with undesirable side effects. Because chronic pain affects the whole person (body, mind, and spirit), patient-centered complementary and integrative medicine (CIM) therapies that acknowledge the patients' roles in their own healing processes have the potential to provide more efficient and comprehensive chronic pain management...
April 2014: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Laura Lynn Heinemann
This article highlights reciprocal webs of care and moral obligations toward kin during transplantation, using an expansive notion of "care" to include both its obvious and more hidden forms. Evidence from 24 months of ethnographic fieldwork among transplant patients, their loved ones, and clinical personnel in the U.S. Midwest suggests that patients are simultaneously caregivers to others and are considered vital members of reciprocal webs of care without whom their kin networks could not effectively operate...
March 2014: Medical Anthropology Quarterly
Mark H Ebell, Roland Grad
This is the second annual summary of top research studies in primary care. In 2012, through regular surveillance of more than 100 English-language clinical research journals, seven clinicians identified 270 studies with the potential to change primary care practice, called POEMs, or patient-oriented evidence that matters. These studies were then summarized in brief, structured critical appraisals and e-mailed to subscribers, including members of the Canadian Medical Association. A validated tool was used to obtain feedback from these physicians about the clinical relevance of each POEM and the benefits the physicians expected for their practice...
September 15, 2013: American Family Physician
Brent Duncan, Adrienne Z Ables
PURPOSE: To provide the best care, physicians must determine what published information is relevant, valid, and clinically useful. Patient-Oriented Evidence that Matters (POEMs) defines relevance as information that addresses clinical questions, measures clinical outcomes, and has the potential to change practice. The most useful clinical information is presented in terms of absolute risk reduction (ARR), number needed to treat (NNT), and number needed to harm (NNH). The purpose of this study was to estimate the percentage of drug treatment articles published in major medical journals that provide a calculated ARR, NNT, or NNH...
February 2013: Journal of Family Practice
Lampros Samartzis, Danai Dima, Paolo Fusar-Poli, Marinos Kyriakopoulos
Several lines of evidence suggest that the normal integration of cerebral communication may be compromised in schizophrenia, with white matter (WM) abnormalities being integral to these functional deficits. Diffusion tensor imaging (DTI) is a neuroimaging technique which has increasingly been used to study WM through quantitative indices of its structural and orientational characteristics. Identifying the WM differences early in the course of schizophrenia may assist in prevention, early diagnosis and identification of treatment targets...
March 2014: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
Mark H Ebell, Roland Grad
In 2011, through regular surveillance of more than 100 English-language research journals, a group of seven clinicians identified approximately 250 studies with the potential to improve the practice of primary care physicians and the outcomes of patients (designated as POEMs [patient-oriented evidence that matters]). Using a validated tool, Canadian primary care physicians have been rating the relevance of each POEM as they receive it in their e-mail. This article summarizes 20 of the most relevant, practice-changing POEMs from 2011 as determined by these raters...
November 1, 2012: American Family Physician
Ahmed G Elzubier
Doctor-patient communication is a skill essential for the satisfaction of the patients' needs and expectations. It involves an art that every practicing physician should have. The situations in health care delivery that demands good doctor-patient communication are many. Diabetes care, the management of hypertension, explaining serious disease diagnoses, prognosis, and investigative procedures are some of the common situations where good doctor-patient communication is very essential. Doctor-patient communication assumes a special status in Saudi Arabia where as a result of mixed ethnicity of the manpower in the health service and the expatriate community, there is a vast diversity of languages, health traditions and beliefs...
January 2002: Journal of Family & Community Medicine
Robert J Szczerba, Marco D Huesch
BACKGROUND: More than half a million new items of biomedical research are generated every year and added to Medline. How successful are we at applying this steady accumulation of scientific knowledge and so improving the practice of medicine in the USA? DISCUSSION: The conventional wisdom is that the US healthcare system is plagued by serious cost, access, safety and quality weaknesses. A comprehensive solution must involve the better translation of an abundance of clinical research into improved clinical practice...
2012: BMC Medical Informatics and Decision Making
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