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Cognitive bias and patient safety

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https://www.readbyqxmd.com/read/28270884/critical-imperative-for-the-reform-of-british-interpretation-of-fetal-heart-rate-decelerations-analysis-of-figo-and-nice-guidelines-post-truth-foundations-cognitive-fallacies-myths-and-occam-s-razor
#1
REVIEW
Shashikant L Sholapurkar
Cardiotocography (CTG) has disappointingly failed to show good predictability for fetal acidemia or neonatal outcomes in several large studies. A complete rethink of CTG interpretation will not be out of place. Fetal heart rate (FHR) decelerations are the most common deviations, benign as well as manifestation of impending fetal hypoxemia/acidemia, much more commonly than FHR baseline or variability. Their specific nomenclature is important (center-stage) because it provides the basic concepts and framework on which the complex "pattern recognition" of CTG interpretation by clinicians depends...
April 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/28073958/rudeness-and-medical-team-performance
#2
Arieh Riskin, Amir Erez, Trevor A Foulk, Kinneret S Riskin-Geuz, Amitai Ziv, Rina Sela, Liat Pessach-Gelblum, Peter A Bamberger
OBJECTIVES: Rudeness is routinely experienced by medical teams. We sought to explore the impact of rudeness on medical teams' performance and test interventions that might mitigate its negative consequences. METHODS: Thirty-nine NICU teams participated in a training workshop including simulations of acute care of term and preterm newborns. In each workshop, 2 teams were randomly assigned to either an exposure to rudeness (in which the comments of the patient's mother included rude statements completely unrelated to the teams' performance) or control (neutral comments) condition, and 2 additional teams were assigned to rudeness with either a preventative (cognitive bias modification [CBM]) or therapeutic (narrative) intervention...
February 2017: Pediatrics
https://www.readbyqxmd.com/read/28048788/mo-fg-207a-03-radiation-and-cancer-perspectives-from-the-trenches-are-we-providing-care-or-promoting-scare
#3
D Frush
There has been increasing use of CT scans globally. This increased use is not in itself of concern, and largely reflects the remarkable clinical benefits of CT. Inappropriate use of CT is, however, of concern, particularly as the potential for carcinogenic effects is yet to be fully understood. The first major media attention to cancer risk from CT scan arose from a series of papers and an Editorial published in AJR in 2001. This was followed by another series of papers in 2007 and associated media attention to the estimation of the number of cancer deaths that may occur in US as a result of radiation exposure from CT...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048056/mo-fg-207a-00-radiation-and-cancer-reality-extrapolations-myths-practice
#4
Madan Rehani, Donald Miller
There has been increasing use of CT scans globally. This increased use is not in itself of concern, and largely reflects the remarkable clinical benefits of CT. Inappropriate use of CT is, however, of concern, particularly as the potential for carcinogenic effects is yet to be fully understood. The first major media attention to cancer risk from CT scan arose from a series of papers and an Editorial published in AJR in 2001. This was followed by another series of papers in 2007 and associated media attention to the estimation of the number of cancer deaths that may occur in US as a result of radiation exposure from CT...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047397/mo-fg-207a-01-overview-of-global-usage-of-x-rays-for-diagnostic-purpose-issues-and-approaches-for-safety
#5
M Rehani
There has been increasing use of CT scans globally. This increased use is not in itself of concern, and largely reflects the remarkable clinical benefits of CT. Inappropriate use of CT is, however, of concern, particularly as the potential for carcinogenic effects is yet to be fully understood. The first major media attention to cancer risk from CT scan arose from a series of papers and an Editorial published in AJR in 2001. This was followed by another series of papers in 2007 and associated media attention to the estimation of the number of cancer deaths that may occur in US as a result of radiation exposure from CT...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046733/mo-fg-207a-02-what-do-we-really-know-about-cancer-risks-at-doses-pertinent-to-ct-scans
#6
D Brenner
There has been increasing use of CT scans globally. This increased use is not in itself of concern, and largely reflects the remarkable clinical benefits of CT. Inappropriate use of CT is, however, of concern, particularly as the potential for carcinogenic effects is yet to be fully understood. The first major media attention to cancer risk from CT scan arose from a series of papers and an Editorial published in AJR in 2001. This was followed by another series of papers in 2007 and associated media attention to the estimation of the number of cancer deaths that may occur in US as a result of radiation exposure from CT...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/27529826/non-pharmacological-interventions-for-cognitive-impairment-due-to-systemic-cancer-treatment
#7
REVIEW
Charlene J Treanor, Una C McMenamin, Roisin F O'Neill, Chris R Cardwell, Mike J Clarke, Marie Cantwell, Michael Donnelly
BACKGROUND: It is estimated that up to 75% of cancer survivors may experience cognitive impairment as a result of cancer treatment and given the increasing size of the cancer survivor population, the number of affected people is set to rise considerably in coming years. There is a need, therefore, to identify effective, non-pharmacological interventions for maintaining cognitive function or ameliorating cognitive impairment among people with a previous cancer diagnosis. OBJECTIVES: To evaluate the cognitive effects, non-cognitive effects, duration and safety of non-pharmacological interventions among cancer patients targeted at maintaining cognitive function or ameliorating cognitive impairment as a result of cancer or receipt of systemic cancer treatment (i...
August 16, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27237931/an-updated-meta-analysis-of-the-efficacy-and-safety-of-acupuncture-treatment-for-vascular-cognitive-impairment-without-dementia
#8
REVIEW
Deng Min, Wang Xu-Feng
Vascular cognitive impairment with no dementia (VCIND) refers to a transitional state and will progress to dementia. Currently, effective medicines to control VCIND are surprisingly scarce. Acupuncture intervention is frequently advocated as an adjunct treatment for VCIND in recent studies. So the aim of this meta-analysis was to assess the clinical efficacy and safety of acupuncture for VCIND. The literature search was conducted in English and Chinese databases from inception until July 2015, and 15 study populations were included in the meta-analysis...
2016: Current Neurovascular Research
https://www.readbyqxmd.com/read/27016244/chinese-herbal-medicine-for-patients-with-vascular-cognitive-impairment-no-dementia-protocol-for-a-systematic-review
#9
Mei Feng, Jingmin Lu, Brian H May, Shaonan Liu, Xinfeng Guo, Anthony Lin Zhang, Charlie Changli Xue, Chuanjian Lu
INTRODUCTION: The aim of this systematic review is to assess the efficacy and safety of Chinese herbal medicine for the treatment of patients with vascular cognitive impairment but no dementia. METHODS AND ANALYSIS: We will perform a comprehensive retrieval in the following electronic databases: PubMed, Cochrane Library, EMBASE, CINAHL, Chinese Biomedical Literature Service System (SinoMed), China National Knowledge Infrastructure (CNKI), Chinese Scientific Journals Database (VIP), Wan-fang database and other sources...
March 25, 2016: BMJ Open
https://www.readbyqxmd.com/read/26969128/the-efficacy-of-a-new-translational-treatment-for-persecutory-delusions-study-protocol-for-a-randomised-controlled-trial-the-feeling-safe-study
#10
RANDOMIZED CONTROLLED TRIAL
Daniel Freeman, Felicity Waite, Richard Emsley, David Kingdon, Linda Davies, Ray Fitzpatrick, Graham Dunn
BACKGROUND: Persecutory delusions (strong unfounded fears that others intend harm to the person) occur in more than 70 % of the patients diagnosed with schizophrenia. This major psychotic experience is a key clinical target, for which substantial improvement in treatment is needed. Our aim is to use advances in theoretical understanding to develop a much more efficacious treatment that leads to recovery in at least 50 % of people with persistent persecutory delusions. Our cognitive conceptualisation is that persecutory delusions are threat beliefs, developed in the context of genetic and environmental risk, maintained by a number of psychological processes including excessive worry, low self-confidence, intolerance of anxious affect and other internal anomalous experiences, reasoning biases, and safety-seeking strategies...
March 11, 2016: Trials
https://www.readbyqxmd.com/read/26770817/aviation-and-healthcare-a-comparative-review-with-implications-for-patient-safety
#11
Narinder Kapur, Anam Parand, Tayana Soukup, Tom Reader, Nick Sevdalis
Safety in aviation has often been compared with safety in healthcare. Following a recent article in this journal, the UK government set up an Independent Patient Safety Investigation Service, to emulate a similar well-established body in aviation. On the basis of a detailed review of relevant publications that examine patient safety in the context of aviation practice, we have drawn up a table of comparative features and a conceptual framework for patient safety. Convergence and divergence of safety-related behaviours across aviation and healthcare were derived and documented...
January 2016: JRSM Open
https://www.readbyqxmd.com/read/26619758/who-am-i-to-decide-whether-this-person-is-to-die-today-physicians-life-or-death-decisions-for-elderly-critically-ill%C3%A2-patients-at-the-emergency-department-icu-interface-a%C3%A2-qualitative-study
#12
Thomas Fassier, Elizabeth Valour, Cyrille Colin, François Danet
STUDY OBJECTIVE: We explored physicians' perceptions of and attitudes toward triage and end-of-life decisions for elderly critically ill patients at the emergency department (ED)-ICU interface. METHODS: This was a qualitative study with thematic analysis of data collected through semistructured interviews (15 emergency physicians and 9 ICU physicians) and nonparticipant observations (324 hours, 8 units, in 2 hospitals in France). RESULTS: Six themes emerged: (1) Physicians revealed a representation of elderly patients that comprised both negative and positive stereotypes, and expressed the concept of physiologic age...
July 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/26608976/an-open-label-self-control-prospective-study-on-cognitive-function-academic-performance-and-tolerability-of-osmotic-release-oral-system-methylphenidate-in-children-with-attention-deficit-hyperactivity-disorder
#13
MULTICENTER STUDY
Yi Zheng, Jian-Min Liang, Hong-Yun Gao, Zhi-Wei Yang, Fu-Jun Jia, Yue-Zhu Liang, Fang Fang, Rong Li, Sheng-Nan Xie, Jian-Min Zhuo
BACKGROUND: Attention-deficit hyperactivity disorder (ADHD) is the most common mental and behavioral disorder in school-aged children. This study evaluated the effect of osmotic-release oral system (OROS) methylphenidate (MPH) on cognitive function and academic performance of Chinese school-aged children with ADHD. METHODS: This 12-week, prospective, multicenter, open-label, self-controlled study enrolled 153 Chinese school-aged children with ADHD and 41 non-ADHD children...
November 20, 2015: Chinese Medical Journal
https://www.readbyqxmd.com/read/26560739/adjuvant-corticosteroids-for-reducing-death-in-neonatal-bacterial-meningitis
#14
REVIEW
Tinuade A Ogunlesi, Chibuzo C Odigwe, Olufemi T Oladapo
BACKGROUND: Bacterial meningitis remains a significant cause of neonatal and childhood morbidity and mortality in many countries of the world, particularly in developing countries. In some instances, children recover but remain impaired as a result of neurological sequelae such as hearing loss, developmental delay and cognitive impairment. OBJECTIVES: To assess the effectiveness and safety of adjunctive corticosteroids in reducing death and neurological sequelae in neonates with bacterial meningitis...
November 11, 2015: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/26549957/efficacy-and-safety-of-treating-patients-with-refractory-schizophrenia-with-antipsychotic-medication-and-adjunctive-electroconvulsive-therapy-a-systematic-review-and-meta-analysis
#15
REVIEW
Wenzheng Wang, Chengcheng Pu, Jiangling Jiang, Xinyi Cao, Jijun Wang, Min Zhao, Chunbo Li
BACKGROUND: The efficacy and safety of the combined treatment of refractory schizophrenia with antipsychotic medications and electroconvulsive therapy (ECT) remain uncertain. AIMS: Conduct systematic review and meta-analysis of available literature in English and Chinese about ECT in the treatment of refractory schizophrenia. METHODS: English and Chinese databases were searched for studies published prior to May 20, 2015 regarding the efficacy and safety of the combined treatment of refractory schizophrenia with antipsychotic medications and ECT...
August 25, 2015: Shanghai Archives of Psychiatry
https://www.readbyqxmd.com/read/26548380/efficacy-tolerability-and-safety-of-cannabinoid-treatments-in-the-rheumatic-diseases-a-systematic-review-of-randomized-controlled-trials
#16
Mary-Ann Fitzcharles, Peter A Ste-Marie, Winfried Häuser, Daniel J Clauw, Shahin Jamal, Jacob Karsh, Tara Landry, Sharon Leclercq, Jason J Mcdougall, Yoram Shir, Kam Shojania, Zach Walsh
OBJECTIVE: To assess the efficacy, tolerability, and safety of cannabinoids (phyto- and syntheto-) in the management of rheumatic diseases. METHODS: Multiple databases, including Medline, Embase, and CENTRAL, were searched. Randomized controlled trials with outcomes of pain, sleep, quality of life, tolerability (dropouts due to adverse events), and safety (serious adverse events), with comparison of cannabinoids with any type of control, were included. Study methodology quality was evaluated with the Cochrane risk of bias tool...
May 2016: Arthritis Care & Research
https://www.readbyqxmd.com/read/26393402/rivastigmine-for-alzheimer-s-disease
#17
REVIEW
Jacqueline S Birks, Lee Yee Chong, John Grimley Evans
BACKGROUND: Alzheimer's disease is the commonest cause of dementia affecting older people. One of the therapeutic strategies aimed at ameliorating the clinical manifestations of Alzheimer's disease is to enhance cholinergic neurotransmission in the brain by the use of cholinesterase inhibitors to delay the breakdown of acetylcholine released into synaptic clefts. Tacrine, the first of the cholinesterase inhibitors to undergo extensive trials for this purpose, was associated with significant adverse effects including hepatotoxicity...
September 22, 2015: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/26140864/are-cognitive-insomnia-processes-involved-in-the-development-and-maintenance-of-delayed-sleep-wake-phase-disorder
#18
REVIEW
Cele E Richardson, Michael Gradisar, Sebastian C Barbero
Although individuals with delayed sleep wake phase disorder (DSWPD) and chronic insomnia disorder (CID) share many of the same phenomenological experiences, theories relating to the development and maintenance of these disorders are distinct in focus. Unlike CID, theory relating to DSWPD is primarily physiologically based and assumes almost no cognitive pathway. However, recent research findings suggest that individuals with DSWPD also display many of the sleep-disordered cognitive processes that were previously assumed to be unique to the insomnia experience...
April 2016: Sleep Medicine Reviews
https://www.readbyqxmd.com/read/26102272/regional-cerebral-blood-flow-single-photon-emission-computed-tomography-for-detection-of-frontotemporal-dementia-in-people-with-suspected-dementia
#19
REVIEW
Hilary A Archer, Nadja Smailagic, Christeena John, Robin B Holmes, Yemisi Takwoingi, Elizabeth J Coulthard, Sarah Cullum
BACKGROUND: In the UK, dementia affects 5% of the population aged over 65 years and 25% of those over 85 years. Frontotemporal dementia (FTD) represents one subtype and is thought to account for up to 16% of all degenerative dementias. Although the core of the diagnostic process in dementia rests firmly on clinical and cognitive assessments, a wide range of investigations are available to aid diagnosis.Regional cerebral blood flow (rCBF) single-photon emission computed tomography (SPECT) is an established clinical tool that uses an intravenously injected radiolabelled tracer to map blood flow in the brain...
June 23, 2015: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/26058321/efficacy-and-safety-of-pharmacological-treatments-for-acute-lyme-neuroborreliosis-a-systematic-review
#20
REVIEW
R Dersch, M H Freitag, S Schmidt, H Sommer, S Rauer, J J Meerpohl
BACKGROUND AND PURPOSE: Our aim was to evaluate the available evidence for pharmacological treatment of acute Lyme neuroborreliosis as a basis for evidence-based clinical recommendations in a systematic review. METHODS: A systematic literature search of Medline, EMBASE, the Cochrane Library and three trial registries was performed. Randomized controlled trials (RCTs) and non-randomized studies (NRS) were evaluated. Risk of bias was assessed using the Cochrane risk of bias tools...
September 2015: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
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