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https://www.readbyqxmd.com/read/29159958/evaluation-of-a-low-risk-mild-traumatic-brain-injury-and-intracranial-hemorrhage-emergency-department-observation-protocol
#1
Brian J Yun, Pierre Borczuk, Lulu Wang, Stephen Dorner, Benjamin A White, Ali S Raja
OBJECTIVES: Among emergency physicians, there is wide variation in admitting practices for patients who suffered a mild traumatic brain injury (TBI) with an intracranial hemorrhage (ICH). The purpose of this study was to evaluate the effects of implementing a protocol in the emergency department (ED) observation unit for patients with mild TBI and ICH. METHODS: This retrospective cohort study was approved by the Institutional Review Board. Study subjects were patients ≥18 years of age with an International Classification of Diseases (ICD) code corresponding to a traumatic IC, and admitted to an ED observation unit (EDOU) of an urban, academic level 1 trauma center between February 1, 2015 and January 31, 2017...
November 20, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29159602/competitive-advantage-of-mba-for-physician-executives-a-systematic-literature-review
#2
REVIEW
Anthony D Turner, Stanislaw P Stawicki, Weidun Alan Guo
In response to systemic challenges facing the US healthcare system, many medical students, residents and practicing physicians are pursuing a Master in Business Administration (MBA) degree. The value of such proposition remains poorly defined. The aim of this review is to analyze current literature pertaining to the added value of MBA training for physician executives (PEs). We hypothesized that physicians who supplement their clinical expertise with business education gain a significant competitive advantage...
November 20, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29159545/clinician-stakeholders-perspectives-on-using-patient-portals-to-return-lynch-syndrome-screening-results
#3
Diane M Korngiebel, Kathleen M West, Wylie Burke
Test results for genetic conditions, such as Lynch Syndrome (LS), have traditionally been returned by genetic counselors or other providers who can explain results implications and provide psychosocial support. Returning genetic results through an Electronic Health Record's patient portal may increase the efficiency of returning results and could activate patient follow-up; however, stakeholder input is necessary to determine acceptability and appropriate implementation for LS. Twenty interviews were conducted with clinicians from six specialties involved in LS screening that represent a range of settings...
November 21, 2017: Journal of Genetic Counseling
https://www.readbyqxmd.com/read/29159310/factors-associated-with-gender-affirming-surgery-and-age-of-hormone-therapy-initiation-among-transgender-adults
#4
Noor Beckwith, Sari L Reisner, Shayne Zaslow, Kenneth H Mayer, Alex S Keuroghlian
Purpose: Gender-affirming surgeries and hormone therapy are medically necessary treatments to alleviate gender dysphoria; however, significant gaps exist in the research and clinical literature on surgery utilization and age of hormone therapy initiation among transgender adults. Methods: We conducted a retrospective review of electronic health record data from a random sample of 201 transgender patients of ages 18-64 years who presented for primary care between July 1, 2010 and June 30, 2015 (inclusive) at an urban community health center in Boston, MA...
2017: Transgender Health
https://www.readbyqxmd.com/read/29158993/antimicrobial-consumption-on-austrian-dairy-farms-an-observational-study-of-udder-disease-treatments-based-on-veterinary-medication-records
#5
Clair L Firth, Annemarie Käsbohrer, Corina Schleicher, Klemens Fuchs, Christa Egger-Danner, Martin Mayerhofer, Hermann Schobesberger, Josef Köfer, Walter Obritzhauser
Background: Antimicrobial use in livestock production is an important contemporary issue, which is of public interest worldwide. Antimicrobials are not freely available to Austrian farmers and can only be administered to livestock by veterinarians, or by farmers who are trained members of the Animal Health Service. Since 2015, veterinarians have been required by law to report antimicrobials dispensed to farmers for use in food-producing animals. The study presented here went further than the statutory framework, and collected data on antimicrobials dispensed to farmers and those administered by veterinarians...
2017: PeerJ
https://www.readbyqxmd.com/read/29158509/clinical-utility-of-the-prostate-health-index-phi-for-biopsy-decision-management-in-a-large-group-urology-practice-setting
#6
Jay White, B Vittal Shenoy, Ronald F Tutrone, Lawrence I Karsh, Daniel R Saltzstein, William J Harmon, Dennis L Broyles, Tamra E Roddy, Lori R Lofaro, Carly J Paoli, Dwight Denham, Mark A Reynolds
BACKGROUND: Deciding when to biopsy a man with non-suspicious DRE findings and tPSA in the 4-10 ng/ml range can be challenging, because two-thirds of such biopsies are typically found to be benign. The Prostate Health Index (phi) exhibits significantly improved diagnostic accuracy for prostate cancer detection when compared to tPSA and %fPSA, however only one published study to date has investigated its impact on biopsy decisions in clinical practice. METHODS: An IRB approved observational study was conducted at four large urology group practices using a physician reported two-part questionnaire...
November 20, 2017: Prostate Cancer and Prostatic Diseases
https://www.readbyqxmd.com/read/29158243/point-of-care-lactate-testing-for-sepsis-at-presentation-to-health-care-a-systematic-review-of-patient-outcomes
#7
Elizabeth Morris, David McCartney, Daniel Lasserson, Ann Van den Bruel, Rebecca Fisher, Gail Hayward
BACKGROUND: Lactate is measured in hospital settings to identify patients with sepsis and severe infections, and to guide initiation of early treatment. Point-of-care technology could facilitate measurement of lactate by clinicians in the community. However, there has been little research into its utility in these environments. AIM: To investigate the effect of using point-of-care lactate at presentation to health care on mortality and other clinical outcomes, in patients presenting with acute infections...
November 20, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/29157323/prevalence-and-factors-associated-with-multidrug-resistant-gram-negative-organisms-in-patients-with-spinal-cord-injury
#8
Charlesnika T Evans, Margaret A Fitzpatrick, Makoto M Jones, Stephen P Burns, Linda Poggensee, Swetha Ramanathan, Sherri L LaVela, Nasia Safdar, Katie J Suda
OBJECTIVE Infections caused by multidrug-resistant gram-negative organisms (MDRGNOs) have been increasing every year. The objective of this study was to describe the prevalence of MDRGNOs and factors associated with MDRGNOs in patients with spinal cord injury or disorder (SCI/D). DESIGN Retrospective cohort study. METHODS Department of Veterans Affairs (VA) electronic health record data from 142 VA facilities were evaluated for 19,642 patients with SCI/D. Multivariable cluster-adjusted models were fit to identify factors associated with MDRGNO...
November 21, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29157182/do-surveys-with-paper-and-electronic-devices-differ-in-quality-and-cost-experience-from-the-rufiji-health-and-demographic-surveillance-system-in-tanzania
#9
Oscar Mukasa, Hildegalda P Mushi, Nicolas Maire, Amanda Ross, Don de Savigny
BACKGROUND: Data entry at the point of collection using mobile electronic devices may make data-handling processes more efficient and cost-effective, but there is little literature to document and quantify gains, especially for longitudinal surveillance systems. OBJECTIVE: To examine the potential of mobile electronic devices compared with paper-based tools in health data collection. METHODS: Using data from 961 households from the Rufiji Household and Demographic Survey in Tanzania, the quality and costs of data collected on paper forms and electronic devices were compared...
2017: Global Health Action
https://www.readbyqxmd.com/read/29156917/advance-care-planning-for-patients-with-advanced-neurology-diseases
#10
Ka-Chi Cheung, Vikki Wai-Kee Lau, Ka-Chun Un, Man-Sheung Wong, Kwok-Ying Chan
BACKGROUND: Advanced neurology diseases including motor neuron disease (MND) are usually progressive life-limiting illness and could be devastating for patients, families and caregivers. Although medical technologies, such as enteral feeding and non-invasive ventilation, may prolong life expectancy of the patients, their utilization prompts important ethical questions in regard to their quality of life (QoL). Little attention had been paid on how ACP practice would practically help with patients suffering from different neurology diseases...
October 13, 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/29156900/implementation-of-an-advance-directive-focus-in-a-chronic-multi-organ-rare-disease-clinic
#11
Nancy Elorreaga, Deanna Allred, Gloria Ortiz, Constance McNeill, Mary Beth Scholand, Tracy M Frech
BACKGROUND: Education about an advance directive is frequently not addressed in the outpatient, ambulatory care setting. The objective of this study was to identify patients that do not have an advance directive in a Chronic Multi-Organ Rare Disease Clinic model, and define the role of a social worker in providing advance care planning (ACP). METHODS: The Chronic Multi-Organ Rare Disease Clinic in-corporates a multi-disciplinary team to provide outpatient care to over 600 patients...
August 31, 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/29156896/proutine-a-feasibility-study-assessing-surveillance-of-electronic-patient-reported-outcomes-and-adherence-via-smartphone-app-in-advanced-cancer
#12
Gesine Benze, Friedemann Nauck, Bernd Alt-Epping, Giuseppe Gianni, Thomas Bauknecht, Johannes Ettl, Anna Munte, Luisa Kretzschmar, Jan Gaertner
BACKGROUND: In advanced cancer, quality of life (QoL) is a major treatment goal. In order to achieve this, the identification of suffering by screening for patient-reported-outcomes (PROs, i.e., symptoms) is of utmost importance. The use of paper-pencil questionnaires is associated with significant shortcomings due to missing data, recall bias and transcription errors. Other than that, the electronic recording of PROs by mobile Health (mHealth) offers a number of advantages. The aim of this study was to test whether the routine assessment of PROs via a newly developed smartphone application (MeQoL®) is feasible...
October 26, 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/29155848/an-electronic-health-record-based-model-predicts-statin-adherence-ldl-cholesterol-and-cardiovascular-disease-in-the-united-states-military-health-system
#13
Joseph E Lucas, Taylor C Bazemore, Celan Alo, Patrick B Monahan, Deepak Voora
HMG-CoA reductase inhibitors (or "statins") are important and commonly used medications to lower cholesterol and prevent cardiovascular disease. Nearly half of patients stop taking statin medications one year after they are prescribed leading to higher cholesterol, increased cardiovascular risk, and costs due to excess hospitalizations. Identifying which patients are at highest risk for not adhering to long-term statin therapy is an important step towards individualizing interventions to improve adherence. Electronic health records (EHR) are an increasingly common source of data that are challenging to analyze but have potential for generating more accurate predictions of disease risk...
2017: PloS One
https://www.readbyqxmd.com/read/29155639/when-machines-think-radiology-s-next-frontier
#14
Keith J Dreyer, J Raymond Geis
Artificial intelligence (AI), machine learning, and deep learning are terms now seen frequently, all of which refer to computer algorithms that change as they are exposed to more data. Many of these algorithms are surprisingly good at recognizing objects in images. The combination of large amounts of machine-consumable digital data, increased and cheaper computing power, and increasingly sophisticated statistical models combine to enable machines to find patterns in data in ways that are not only cost-effective but also potentially beyond humans' abilities...
December 2017: Radiology
https://www.readbyqxmd.com/read/29155555/medication-exposure-in-highly-adherent-psychiatry-patients
#15
Jeffrey J Sutherland, Thomas M Daly, Karen Jacobs, Elias A Khawam, Leo Pozuelo, Ryan D Morrison, Stephen B Milne, J Scott Daniels, Timothy Patrick Ryan
Medication exposure is dependent upon many factors, the single most important being if the patient took the prescribed medication as indicated. To assess medication exposure for psychotropic and other medication classes, we enrolled 115 highly adherent psychiatry patients prescribed five or more medications. In these patients, we measured 21 psychotropic and 38 non-psychotropic medications comprising a 59-medication multiplex assay panel. Strict enrollment criteria and reconciliation of the electronic health record medication list prior to study initiation produced a patient cohort that was compliant with 91% of their prescribed medications as determined by comparing medications detected empirically in blood to the electronic health record medication list...
November 20, 2017: ACS Chemical Neuroscience
https://www.readbyqxmd.com/read/29154919/patient-reported-outcomes-and-opioid-use-by-outpatient-cancer-patients
#16
N Moryl, V Dave, P Glare, A Bokhari, V T Malhotra, A Gulati, J Hung, V Puttanniah, Y Griffo, R Tickoo, A Wiesenthal, S D Horn, C E Inturrisi
The Memorial Sloan-Kettering Pain Registry contains patient characteristics, treatments, and outcomes for a prospective cohort of 1534 chronic pain cancer patients who were seen at outpatient pain service clinics. Average pain intensity (Brief Pain Inventory) was reported as mild by 24.6% of patients, moderate by 41.5%, and severe by 33.9%. The patient's report of average percent pain relief and health state (EQ-5D) was inversely related to average pain intensity category, while measures of pain interference, number of worst pain locations, and physical and psychological distress were directly related to pain intensity category...
November 14, 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/29153922/e-health-in-switzerland-the-laborious-adoption-of-the-federal-law-on-electronic-health-records-ehr-and-health-information-exchange-hie-networks
#17
Carlo De Pietro, Igor Francetic
Within the framework of a broader e-health strategy launched a decade ago, in 2015 Switzerland passed a new federal law on patients' electronic health records (EHR). The reform requires hospitals to adopt interoperable EHRs to facilitate data sharing and cooperation among healthcare providers, ultimately contributing to improvements in quality of care and efficiency in the health system. Adoption is voluntary for ambulatories and private practices, that may however be pushed towards EHRs by patients. The latter have complete discretion in the choice of the health information to share...
November 10, 2017: Health Policy
https://www.readbyqxmd.com/read/29152808/observational-safety-study-of-specific-outcomes-after-trivalent-cell-culture-seasonal-influenza-vaccination-optaflu-%C3%A2-among-adults-in-thin-database-of-electronic-uk-primary-healthcare-records
#18
Gillian C Hall, Paul T G Davies, M Yousuf Karim, Mendel D M Haag, Caroline O'Leary
PURPOSE: To investigate the safety of trivalent seasonal influenza vaccine (TIVc) (Optaflu(®) ), the first cell culture seasonal trivalent influenza vaccine available in Europe. METHODS: Codes and unstructured text in adult electronic healthcare records (The Health Improvement Network) were searched for a TIVc brand name or batch number and possible outcomes within a 3 month pre- to 6 month post-TIVc exposure study period (2012-2015). The outcomes were severe allergic reactions, Bell's palsy, convulsions, demyelination, paresthesia, noninfectious encephalitis, neuritis (optic and brachial), vasculitis, inflammatory bowel disease, and thrombocytopenia...
November 20, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/29151719/reducing-social-distress-for-chronic-disease-patients-in-primary-care-an-intervention-for-latino-type-2-diabetes-patients-seen-at-community-health-centers
#19
Nancy A Allen, Sofija Zagarins, Garry Welch
Background: Social and behavioral factors have important direct and indirect effects on chronic disease onset and progression. The U.S. health care system is beginning to focus on assessment and management of social and behavioral problems through federal mandates related to meaningful use of electronic health records and improved patient outcomes. Methods: We examined the clinical adoption of a 20-item screening tool to measure social distress focusing on type 2 diabetes...
November 2017: Diabetes Spectrum: a Publication of the American Diabetes Association
https://www.readbyqxmd.com/read/29151367/surveillance-of-the-armed-forces-as-a-sentinel-system-for-detecting-adverse-effects-of-dietary-supplements-in-the-general-population
#20
Harris R Lieberman, Krista G Austin, Emily K Farina
OBJECTIVE: Half the US population takes dietary supplements, but surveillance systems available to regulatory and public health authorities to determine whether specific dietary supplements present a risk are inadequate and numerous severe injuries and deaths have occurred from their consumption. Uniformed military personnel regularly use dietary supplements and are more likely to use potentially dangerous supplements than civilians. Recently, the supplement 1,3-dimethylamylamine (DMAA) was marketed for physical performance-enhancement and weight loss...
November 20, 2017: Public Health Nutrition
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