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https://www.readbyqxmd.com/read/28530524/is-real-world-evidence-used-in-p-t-monographs-and-therapeutic-class-reviews
#1
Jason T Hurwitz, Mary Brown, Jennifer S Graff, Loretta Peters, Daniel C Malone
BACKGROUND: Payers are faced with making coverage and reimbursement decisions based on the best available evidence. Often these decisions apply to patient populations, provider networks, and care settings not typically studied in clinical trials. Treatment effectiveness evidence is increasingly available from electronic health records, registries, and administrative claims. However, little is known about when and what types of real-world evidence (RWE) studies inform pharmacy and therapeutic (P&T) committee decisions...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28527861/cellular-computational-generalized-neuron-network-for-frequency-situational-intelligence-in-a-multi-machine-power-system
#2
Yawei Wei, Ganesh Kumar Venayagamoorthy
To prevent large interconnected power system from a cascading failure, brownout or even blackout, grid operators require access to faster than real-time information to make appropriate just-in-time control decisions. However, the communication and computational system limitations of currently used supervisory control and data acquisition (SCADA) system can only deliver delayed information. However, the deployment of synchrophasor measurement devices makes it possible to capture and visualize, in near-real-time, grid operational data with extra granularity...
April 4, 2017: Neural Networks: the Official Journal of the International Neural Network Society
https://www.readbyqxmd.com/read/28526822/shortest-paths-in-multiplex-networks
#3
Saeed Ghariblou, Mostafa Salehi, Matteo Magnani, Mahdi Jalili
The shortest path problem is one of the most fundamental networks optimization problems. Nowadays, individuals interact in extraordinarily numerous ways through their offline and online life (e.g., co-authorship, co-workership, or retweet relation in Twitter). These interactions have two key features. First, they have a heterogeneous nature, and second, they have different strengths that are weighted based on their degree of intimacy, trustworthiness, service exchange or influence among individuals. These networks are known as multiplex networks...
May 12, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28526666/a-smart-toy-to-enhance-the-decision-making-process-at-children-s-psychomotor-delay-screenings-a-pilot-study
#4
María Angeles Gutiérrez García, María Luisa Martín Ruiz, Diego Rivera, Laura Vadillo, Miguel Angel Valero Duboy
BACKGROUND: EDUCERE ("Ubiquitous Detection Ecosystem to Care and Early Stimulation for Children with Developmental Disorders") is an ecosystem for ubiquitous detection, care, and early stimulation of children with developmental disorders. The objectives of this Spanish government-funded research and development project are to investigate, develop, and evaluate innovative solutions to detect changes in psychomotor development through the natural interaction of children with toys and everyday objects, and perform stimulation and early attention activities in real environments such as home and school...
May 19, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28521139/global-representations-of-goal-directed-behavior-in-distinct-cell-types-of-mouse-neocortex
#5
William E Allen, Isaac V Kauvar, Michael Z Chen, Ethan B Richman, Samuel J Yang, Ken Chan, Viviana Gradinaru, Benjamin E Deverman, Liqun Luo, Karl Deisseroth
The successful planning and execution of adaptive behaviors in mammals may require long-range coordination of neural networks throughout cerebral cortex. The neuronal implementation of signals that could orchestrate cortex-wide activity remains unclear. Here, we develop and apply methods for cortex-wide Ca(2+) imaging in mice performing decision-making behavior and identify a global cortical representation of task engagement encoded in the activity dynamics of both single cells and superficial neuropil distributed across the majority of dorsal cortex...
May 17, 2017: Neuron
https://www.readbyqxmd.com/read/28516441/decision-making-in-the-surgical-management-of-invasive-breast-cancer-part-2-expanded-applications-for-breast-conserving-surgery
#6
REVIEW
Lisa A Newman
Treatment of early-stage invasive breast cancer with breast-conserving surgery plus radiation therapy (RT) yields overall survival outcomes equivalent to those achieved with mastectomy. Further, breast-conserving surgery is endorsed by the National Comprehensive Cancer Network as being supported by the highest-level, category 1 evidence. Advances in pathologic evaluation, management of multiple tumors, oncoplastic lumpectomy techniques, neoadjuvant chemotherapy, and hypofractionated RT can expand the pool of patients eligible for breast-conserving surgery...
May 15, 2017: Oncology (Williston Park, NY)
https://www.readbyqxmd.com/read/28514359/-the-mathematical-approaches-to-differential-diagnostics-of-acute-pharyngeal-diseases
#7
A P Yastremsky, A I Izvin
The objective of the present study was to elaborate the program for differential diagnostics of acute pharyngeal diseases based on the 'ENT-Neuro' artificial neuronal network. The study group was formed by means of sampling patients with acute pharyngeal diseases from a set of case histories of the subjects presenting with acute inflammatory diseases. The data thus obtained were employed to develop the expert system to support the decision making process with the use of the 'ENT-Neuro' artificial neuronal network that allows to carry out diagnostics of various inflammatory diseases of the pharynx including the following nosological entities: paratonsillitis, parapharyngitis, acute tonsillitis, and acute pharyngitis, with the minimal probability of erroneous diagnosis (4%)...
2017: Vestnik Otorinolaringologii
https://www.readbyqxmd.com/read/28508802/knowledge-engineering-as-a-component-of-the-curriculum-for-medical-cybernetists
#8
Sergey Karas, Arthur Konev
According to a new state educational standard, students who have chosen medical cybernetics as their major must develop a knowledge engineering competency. Previously, in the course "Clinical cybernetics" while practicing project-based learning students were designing automated workstations for medical personnel using client-server technology. The purpose of the article is to give insight into the project of a new educational module "Knowledge engineering". Students will acquire expert knowledge by holding interviews and conducting surveys, and then they will formalize it...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28503228/network-meta-analysis-a-technique-to-gather-evidence-from-direct-and-indirect-comparisons
#9
Fernanda S Tonin, Inajara Rotta, Antonio M Mendes, Roberto Pontarolo
Systematic reviews and pairwise meta-analyses of randomized controlled trials, at the intersection of clinical medicine, epidemiology and statistics, are positioned at the top of evidence-based practice hierarchy. These are important tools to base drugs approval, clinical protocols and guidelines formulation and for decision-making. However, this traditional technique only partially yield information that clinicians, patients and policy-makers need to make informed decisions, since it usually compares only two interventions at the time...
January 2017: Pharmacy Practice
https://www.readbyqxmd.com/read/28503196/synthesis-and-analysis-of-separation-networks-for-the-recovery-of-intracellular-chemicals-generated-from-microbial-based-conversions
#10
Kirti M Yenkie, Wenzhao Wu, Christos T Maravelias
BACKGROUND: Bioseparations can contribute to more than 70% in the total production cost of a bio-based chemical, and if the desired chemical is localized intracellularly, there can be additional challenges associated with its recovery. Based on the properties of the desired chemical and other components in the stream, there can be multiple feasible options for product recovery. These options are composed of several alternative technologies, performing similar tasks. The suitability of a technology for a particular chemical depends on (1) its performance parameters, such as separation efficiency; (2) cost or amount of added separating agent; (3) properties of the bioreactor effluent (e...
2017: Biotechnology for Biofuels
https://www.readbyqxmd.com/read/28500765/developing-bayesian-networks-from-a-dependency-layered-ontology-a-proof-of-concept-in-radiation-oncology
#11
Alan M Kalet, Jason N Doctor, John H Gennari, Mark H Phillips
PURPOSE: Bayesian networks (BNs) are graphical representations of probabilistic knowledge that offer normative reasoning under uncertainty and are well suited for use in medical domains. Traditional knowledge-based network development of BN topology requires that modeling experts establish relevant dependency links between domain concepts by searching and translating published literature, querying domain experts, or applying machine learning algorithms on data. For initial development these methods are time-intensive and this cost hinders the growth of BN applications in medical decision making...
May 13, 2017: Medical Physics
https://www.readbyqxmd.com/read/28500273/fundamental-trade-offs-between-information-flow-in-single-cells-and-cellular-populations
#12
Ryan Suderman, John A Bachman, Adam Smith, Peter K Sorger, Eric J Deeds
Signal transduction networks allow eukaryotic cells to make decisions based on information about intracellular state and the environment. Biochemical noise significantly diminishes the fidelity of signaling: networks examined to date seem to transmit less than 1 bit of information. It is unclear how networks that control critical cell-fate decisions (e.g., cell division and apoptosis) can function with such low levels of information transfer. Here, we use theory, experiments, and numerical analysis to demonstrate an inherent trade-off between the information transferred in individual cells and the information available to control population-level responses...
May 12, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28498864/green-material-selection-for-sustainability-a-hybrid-mcdm-approach
#13
Honghao Zhang, Yong Peng, Guangdong Tian, Danqi Wang, Pengpeng Xie
Green material selection is a crucial step for the material industry to comprehensively improve material properties and promote sustainable development. However, because of the subjectivity and conflicting evaluation criteria in its process, green material selection, as a multi-criteria decision making (MCDM) problem, has been a widespread concern to the relevant experts. Thus, this study proposes a hybrid MCDM approach that combines decision making and evaluation laboratory (DEMATEL), analytical network process (ANP), grey relational analysis (GRA) and technique for order performance by similarity to ideal solution (TOPSIS) to select the optimal green material for sustainability based on the product's needs...
2017: PloS One
https://www.readbyqxmd.com/read/28496399/the-effect-of-wealth-shocks-on-loss-aversion-behavior-and-neural-correlates
#14
V S Chandrasekhar Pammi, Sergio Ruiz, Sangkyun Lee, Charles N Noussair, Ranganatha Sitaram
Kahneman and Tversky (1979) first demonstrated that when individuals decide whether or not to accept a gamble, potential losses receive more weight than possible gains in the decision. This phenomenon is referred to as loss aversion. We investigated how loss aversion in risky financial decisions is influenced by sudden changes to wealth, employing both behavioral and neurobiological measures. We implemented an fMRI experimental paradigm, based on that employed by Tom et al. (2007). There are two treatments, called RANDOM and CONTINGENT...
2017: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/28495332/the-neural-correlates-of-theory-of-mind-and-their-role-during-empathy-and-the-game-of-chess-a-functional-magnetic-resonance-imaging-study
#15
Joanne L Powell, Davide Grossi, Rhiannon Corcoran, Fernand Gobet, Marta García-Fiñana
Chess involves the capacity to reason iteratively about potential intentional choices of an opponent and therefore involves high levels of explicit theory of mind [ToM] (i.e. ability to infer mental states of others) alongside clear, strategic rule-based decision-making. Functional magnetic resonance imaging was used on 12 healthy male novice chess players to identify cortical regions associated with chess, ToM and empathizing. The blood-oxygen-level-dependent (BOLD) response for chess and empathizing tasks was extracted from each ToM region...
May 8, 2017: Neuroscience
https://www.readbyqxmd.com/read/28489453/association-of-decision-making-with-patients-perceptions-of-care-and-knowledge-during-longitudinal-pulmonary-nodule-surveillance
#16
Donald R Sullivan, Sara E Golden, Linda Ganzini, Renda Soylemez Wiener, Karen B Eden, Christopher G Slatore
RATIONALE: Patient participation in medical decision making is widely advocated, but outcomes are inconsistent. OBJECTIVES: We examined the associations between medical decision making roles and patients' perceptions of their care and knowledge while undergoing pulmonary nodule surveillance. METHODS: The setting was an academically-affiliated Veterans Affairs hospital network where 121 participants had 319 decision making encounters. The Control Preferences Scale was used to assess patients' decision making roles...
May 10, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28488985/an-alternative-paradigm-for-evidence-based-medicine-revisiting-lawrence-weed-md-s-systems-approach
#17
Ali Rafik Shukor
Lawrence Weed, MD, is renowned for being the father of the Problem-Oriented Medical Record (POMR), the medical care standard for collecting, managing, and contextualizing patient data in medical records. What have been consistently overlooked are his teachings on knowledge coupling, which refers to matching patient data with associated medical knowledge. Together, the POMR standard and knowledge coupling are meant to form the basis of a systems approach that enables individualized evidence-based decision making within the context of multimorbidity and patient complexity...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28486973/sustainability-in-health-care-by-allocating-resources-effectively-share-5-developing-a-model-for-evidence-driven-resource-allocation-in-a-local-healthcare-setting
#18
Claire Harris, Kelly Allen, Cara Waller, Sally Green, Richard King, Wayne Ramsey, Cate Kelly, Malar Thiagarajan
BACKGROUND: This is the fifth in a series of papers reporting Sustainability in Health care by Allocating Resources Effectively (SHARE) in a local healthcare setting. This paper synthesises the findings from Phase One of the SHARE Program and presents a model to be implemented and evaluated in Phase Two. Monash Health, a large healthcare network in Melbourne Australia, sought to establish an organisation-wide systematic evidence-based program for disinvestment. In the absence of guidance from the literature, the Centre for Clinical Effectiveness, an in-house 'Evidence Based Practice Support Unit', was asked to explore concepts and practices related to disinvestment, consider the implications for a local health service and identify potential settings and methods for decision-making...
May 10, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28479121/ethical-considerations-and-palliative-care-in-patients-with-amyotrophic-lateral-sclerosis-a-review
#19
REVIEW
V Danel-Brunaud, L Touzet, L Chevalier, C Moreau, D Devos, S Vandolaeghe, L Defebvre
Amyotrophic lateral sclerosis (ALS) is not a curable disease, but it is treatable. By definition, much of the care provided to ALS patients is palliative, even though active life-sustaining strategies are available to prolong survival. Healthcare professionals must develop communication skills that help patients cope with the inexorable progression of the disease and the inevitability of death. Symptomatic treatments as well as respiratory insufficiency and nutritional life-sustaining therapies must be regularly evaluated as the disease progresses, without losing sight of the burden placed on the patient's non-professional caregivers...
May 4, 2017: Revue Neurologique
https://www.readbyqxmd.com/read/28478889/-interventions-to-improve-quality-of-life-in-oncological-patients
#20
Monika Klinkhammer-Schalke, Brunhilde Steinger, Michael Koller, Patricia Lindberg
The assessment of quality of life is a central aspect in the current debate in support groups, certified cancer centres, benefit assessment, and also in palliative care. Accordingly, quality of life has become an essential part of clinical trials for more than two decades. But most of the time results are presented in a descriptive manner without any concrete therapeutic consequences for the improvement of quality of life. Likewise, there are no uniform recommendations for considering quality of life data in the decision-making process...
May 3, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
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