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https://www.readbyqxmd.com/read/29036503/implementing-electronic-health-records-ehrs-health-care-provider-perceptions-before-and-after-transition-from-a-local-basic-ehr-to-a-commercial-comprehensive-ehr
#1
Marie Krousel-Wood, Allison B McCoy, Chad Ahia, Elizabeth W Holt, Donnalee N Trapani, Qingyang Luo, Eboni G Price-Haywood, Eric J Thomas, Dean F Sittig, Richard V Milani
Objective: We assessed changes in the percentage of providers with positive perceptions of electronic health record (EHR) benefit before and after transition from a local basic to a commercial comprehensive EHR. Methods: Changes in the percentage of providers with positive perceptions of EHR benefit were captured via a survey of academic health care providers before (baseline) and at 6-12 months (short term) and 12-24 months (long term) after the transition. We analyzed 32 items for the overall group and by practice setting, provider age, and specialty using separate multivariable-adjusted random effects logistic regression models...
September 23, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/29036464/the-mimic-code-repository-enabling-reproducibility-in-critical-care-research
#2
Alistair E W Johnson, David J Stone, Leo A Celi, Tom J Pollard
Objective: Lack of reproducibility in medical studies is a barrier to the generation of a robust knowledge base to support clinical decision-making. In this paper we outline the Medical Information Mart for Intensive Care (MIMIC) Code Repository, a centralized code base for generating reproducible studies on an openly available critical care dataset. Materials and Methods: Code is provided to load the data into a relational structure, create extractions of the data, and reproduce entire analysis plans including research studies...
September 27, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/29036444/the-elephant-in-the-room-toward-a-more-ethical-approach-with-accountability-toward-intended-beneficiaries-in-humanitarian-aid
#3
Ramin Asgary, Ronald J Waldman
There is considerable tension between the concept of accountability to beneficiaries and its practice in humanitarian aid. The beneficiaries live in a relationship that is asymmetric; upward or horizontal accountability within the aid system alone-even with the best of intentions-might be short-sighted. Could beneficiaries be effectively involved in programing, priority setting or allocation of resources? Is there space for a rights-based approach in aid delivery and operations? The mind-set, governance and structure of operations in aid agencies may need significant institutional reform to share the process of decision-making, and to transform the current dynamic from connecting resources to brokering better governance, true collaboration and co-operation among all stakeholders...
September 28, 2017: International Health
https://www.readbyqxmd.com/read/29036406/effects-of-computerized-decision-support-system-implementations-on-patient-outcomes-in-inpatient-care-a-systematic-review
#4
Julian Varghese, Maren Kleine, Sophia Isabella Gessner, Sarah Sandmann, Martin Dugas
Objectives: To systematically classify the clinical impact of computerized clinical decision support systems (CDSSs) in inpatient care. Materials and Methods: Medline, Cochrane Trials, and Cochrane Reviews were searched for CDSS studies that assessed patient outcomes in inpatient settings. For each study, 2 physicians independently mapped patient outcome effects to a predefined medical effect score to assess the clinical impact of reported outcome effects. Disagreements were measured by using weighted kappa and solved by consensus...
September 23, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/29036378/the-effect-of-costs-on-kenyan-households-demand-for-medical-care-why-time-and-distance-matter
#5
Matt Kukla, Niccie McKay, Richard Rheingans, Jeff Harman, Jessica Schumacher, Karen L Kotloff, Myrone M Levine, Robert Breiman, Tamer Farag, Damian Walker, Dilruba Nasrin, Richard Omore, Ciara O'Reilly, Eric Mintz
In an environment of constrained resources, policymakers must identify solutions for financing and delivering health services that are efficient and sustainable. However, such solutions require that policymakers understand the complex interaction between household utilization patterns, factors influencing household medical decisions, and provider performance. This study examined whether and under what conditions out-of-pocket, transportation, and time costs influenced Kenyan households' choice of medical provider for childhood diarrhoeal illnesses...
October 5, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/29036012/a-fresh-perspective-on-a-familiar-problem-examining-disparities-in-knee-osteoarthritis-using-a-markov-model
#6
Taruja D Karmarkar, Anne Maurer, Michael L Parks, Thomas Mason, Ana Bejinez-Eastman, Melvyn Harrington, Randall Morgan, Mary I O'Connor, James E Wood, Darrell J Gaskin
BACKGROUND: Disparities in the presentation of knee osteoarthritis (OA) and in the utilization of treatment across sex, racial, and ethnic groups in the United States are well documented. OBJECTIVES: We used a Markov model to calculate lifetime costs of knee OA treatment. We then used the model results to compute costs of disparities in treatment by race, ethnicity, sex, and socioeconomic status. RESEARCH DESIGN: We used the literature to construct a Markov Model of knee OA and publicly available data to create the model parameters and patient populations of interest...
October 13, 2017: Medical Care
https://www.readbyqxmd.com/read/29034438/the-pathways-fertility-preservation-decision-aid-website-for-women-with-cancer-development-and-field-testing
#7
Terri L Woodard, Aubri S Hoffman, Laura A Covarrubias, Deborah Holman, Leslie Schover, Andrea Bradford, Derek B Hoffman, Aakrati Mathur, Jerah Thomas, Robert J Volk
PURPOSE: To improve survivors' awareness and knowledge of fertility preservation counseling and treatment options, this study engaged survivors and providers to design, develop, and field-test Pathways: a fertility preservation patient decision aid website for young women with cancer©. METHODS: Using an adapted user-centered design process, our stakeholder advisory group and research team designed and optimized the Pathways patient decision aid website through four iterative cycles of review and revision with clinicians (n = 21) and survivors (n = 14)...
October 15, 2017: Journal of Cancer Survivorship: Research and Practice
https://www.readbyqxmd.com/read/29033060/a-review-of-international-coverage-and-pricing-strategies-for-personalized-medicine-and-orphan-drugs
#8
REVIEW
Irina Degtiar
BACKGROUND: Personalized medicine and orphan drugs share many characteristics-both target small patient populations, have uncertainties regarding efficacy and safety at payer submission, and frequently have high prices. Given personalized medicine's rising importance, this review summarizes international coverage and pricing strategies for personalized medicine and orphan drugs as well as their impact on therapy development incentives, payer budgets, and therapy access and utilization...
September 29, 2017: Health Policy
https://www.readbyqxmd.com/read/29032790/formative-qualitative-research-to-develop-community-based-interventions-addressing-low-birth-weight-in-the-plains-of-nepal
#9
Joanna Morrison, Sophiya Dulal, Helen Harris-Fry, Machhindra Basnet, Neha Sharma, Bhim Shrestha, Dharma Manandhar, Anthony Costello, David Osrin, Naomi Saville
OBJECTIVE: To explore the factors affecting intra-household food allocation practices to inform the development of interventions to prevent low birth weight in rural plains of Nepal. DESIGN: Qualitative methodology using purposive sampling to explore the barriers and facilitating factors to improved maternal nutrition. SETTING: Rural Dhanusha District, Nepal. SUBJECTS: We purposively sampled twenty-five young daughters-in-law from marginalised groups living in extended families and conducted semi-structured interviews with them...
October 16, 2017: Public Health Nutrition
https://www.readbyqxmd.com/read/29031415/usefulness-of-the-crt-score-for-shared-decision-making-in-cardiac-resynchronization-therapy-in-patients-with-a-left-ventricular-ejection-fraction-of-%C3%A2-35
#10
Ulas Höke, Bart Mertens, Mand J H Khidir, Martin J Schalij, Jeroen J Bax, Victoria Delgado, Nina Ajmone Marsan
Individualized estimation of prognosis after cardiac resynchronization therapy (CRT) remains challenging. Our aim was to develop a multiparametric prognostic risk score (CRT-SCORE) that could be used for patient-specific clinical shared decision making about CRT implantation. The CRT-SCORE was derived from an ongoing CRT registry, including 1,053 consecutive patients (age 67 ± 10 years, 76% male). Using preimplantation variables, 100 multiple imputed datasets were generated for model calibration. Based on multivariate Cox regression models, cross-validated linear prognostic scores were calculated, as well as survival fractions at 1 and 5 years...
August 30, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29030329/effect-of-a-website-that-presents-patients-experiences-on-self-efficacy-and-patient-competence-of-colorectal-cancer-patients-web-based-randomized-controlled-trial
#11
Jürgen M Giesler, Bettina Keller, Tim Repke, Rainer Leonhart, Joachim Weis, Rebecca Muckelbauer, Nina Rieckmann, Jacqueline Müller-Nordhorn, Gabriele Lucius-Hoene, Christine Holmberg
BACKGROUND: Patients often seek other patients' experiences with the disease. The Internet provides a wide range of opportunities to share and learn about other people's health and illness experiences via blogs or patient-initiated online discussion groups. There also exists a range of medical information devices that include experiential patient information. However, there are serious concerns about the use of such experiential information because narratives of others may be powerful and pervasive tools that may hinder informed decision making...
October 13, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/29029759/patient-centered-research-priorities-in-ovarian-cancer-a-systematic-review-of-potential-determinants-of-guideline-care
#12
REVIEW
Rachel A Pozzar, Donna L Berry
OBJECTIVE: To (a) determine what is known about the individual and contextual factors that may influence whether a woman with ovarian cancer receives guideline care, and (b) identify patient-centered research priorities in ovarian cancer. METHODS: A systematic review of the PubMed, MEDLINE, CINAHL Complete, and PsycInfo online databases. Eligible articles were published in English, described original research, and either (a) identified factors associated with the receipt of guideline care for ovarian cancer, or (b) described treatment decision making by women with ovarian cancer...
October 10, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/29029375/treatment-and-disease-management-of-multiple-sclerosis-patients-a-review-for-nurse-practitioners
#13
Cortnee Roman, Kara Menning
BACKGROUND AND PURPOSE: This review discusses the role of the nurse practitioner (NP) in evaluating the clinical effects, potential side effects, and monitoring requirements for treatment options in multiple sclerosis (MS) and provides guidance on how to help patients understand these issues. METHODS: A literature search was conducted on PubMed to identify publications on monitoring and disease management of MS patients. Additional resources included drug information web sites and package inserts...
October 2017: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/29029029/a-manifesto-for-cardiovascular-imaging-addressing-the-human-factor
#14
Alan G Fraser
Our use of modern cardiovascular imaging tools has not kept pace with their technological development. Diagnostic errors are common but seldom investigated systematically. Rather than more impressive pictures, our main goal should be more precise tests of function which we select because their appropriate use has therapeutic implications which in turn have a beneficial impact on morbidity or mortality. We should practise analytical thinking, use checklists to avoid diagnostic pitfalls, and apply strategies that will reduce biases and avoid overdiagnosis...
September 28, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/29024162/sexuality-and-individual-support-plans-for-people-with-intellectual-disabilities
#15
J M T Stoffelen, M A Herps, W H E Buntinx, D Schaafsma, G Kok, L M G Curfs
BACKGROUND: Sexual rights and sexuality are important aspects of quality of life, also for people with intellectual disabilities (IDs). However, providing support in this area to people with ID poses some challenges. In this study, the content of individual support plan (ISP) documents was analysed to determine the extent to which sexuality and sexual rights are addressed in part of the ISP documents. METHOD: Content analysis was carried out on a sample of 187 ISP documents from seven different service provider organisations in the Netherlands...
October 11, 2017: Journal of Intellectual Disability Research: JIDR
https://www.readbyqxmd.com/read/29023930/evaluation-and-treatment-of-acute-and-subacute-hearing-loss-a-review-of-pharmacotherapy
#16
Maryam T Fazel, Patrick M Jedlowski, Robert B Cravens, Brian L Erstad
Among various forms of hearing loss, there are acute (within 72 hours) or sub-acute (weeks to months) presentations that may be reversible with early pharmacological intervention. The workup of a patient presenting with hypoacusia includes the usual history and physical examination in conjunction with an audiometric assessment in order to categorize the hearing loss as conductive, sensorineural, or mixed. Sudden sensorineural hearing loss (SSNHL) and autoimmune inner ear disease (AIED) are acute and subacute forms of sensorineural hypoacusia most likely to be reversed with prompt pharmacological intervention...
October 10, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/29023499/understanding-the-perceived-logic-of-care-by-vaccine-hesitant-and-vaccine-refusing-parents-a-qualitative-study-in-australia
#17
Paul R Ward, Katie Attwell, Samantha B Meyer, Philippa Rokkas, Julie Leask
In terms of public health, childhood vaccination programs have benefits that far outweigh risks. However, some parents decide not to vaccinate their children. This paper explores the ways in which such parents talked about the perceived risks and benefits incurred by vaccinating (or not vaccinating) their children. Between 2013-2016 we undertook 29 in-depth interviews with non-vaccinating and/or 'vaccine hesitant' parents in Australia. Interviews were conducted in an open and non-judgmental manner, akin to empathic neutrality...
2017: PloS One
https://www.readbyqxmd.com/read/29022226/parents-and-physicians-perceptions-of-children-s-participation-in-decision-making-in-paediatric-oncology-a-quantitative-study
#18
Michael Rost, Tenzin Wangmo, Felix Niggli, Karin Hartmann, Heinz Hengartner, Marc Ansari, Pierluigi Brazzola, Johannes Rischewski, Maja Beck-Popovic, Thomas Kühne, Bernice S Elger
The goal is to present how shared decision-making in paediatric oncology occurs from the viewpoints of parents and physicians. Eight Swiss Pediatric Oncology Group centres participated in this prospective study. The sample comprised a parent and physician of the minor patient (<18 years). Surveys were statistically analysed by comparing physicians' and parents' perspectives and by evaluating factors associated with children's actual involvement. Perspectives of ninety-one parents and twenty physicians were obtained for 151 children...
October 11, 2017: Journal of Bioethical Inquiry
https://www.readbyqxmd.com/read/29020932/difficult-conversations-australian-indigenous-patients-views-on-kidney-transplantation
#19
Jeannie Devitt, Kate Anderson, Joan Cunningham, Cilla Preece, Paul Snelling, Alan Cass
BACKGROUND: Indigenous Australians suffer a disproportionate burden of end stage kidney disease (ESKD) but are significantly less likely to receive a transplant. This study explores Indigenous ESKD patients' views on transplantation as a treatment option. METHODS: The Improving Access to Kidney Transplants (IMPAKT) research program investigated barriers to kidney transplantation for Indigenous Australians. An interview study, conducted in 2005-2006, elicited illness experience narratives from 146 Indigenous patients, including views on transplant...
October 11, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/29020854/shared-decision-making-at-the-end-of-life-a-focus-group-study-exploring-the-perceptions-and-experiences-of-multi-disciplinary-healthcare-professionals-working-in-the-home-setting
#20
Paula Brogan, Felicity Hasson, Sonja McIlfatrick
BACKGROUND: Globally recommended in healthcare policy, Shared Decision-Making is also central to international policy promoting community palliative care. Yet realities of implementation by multi-disciplinary healthcare professionals who provide end-of-life care in the home are unclear. AIM: To explore multi-disciplinary healthcare professionals' perceptions and experiences of Shared Decision-Making at end of life in the home. DESIGN: Qualitative design using focus groups, transcribed verbatim and analysed thematically...
October 1, 2017: Palliative Medicine
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