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Shared decision-making

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https://www.readbyqxmd.com/read/28933653/patient-navigation-improves-subsequent-breast-cancer-screening-after-a-noncancerous-result-evidence-from-the-patient-navigation-in-medically-underserved-areas-study
#1
Yamile Molina, Sage J Kim, Nerida Berrios, Anne Elizabeth Glassgow, Yazmin San Miguel, Julie S Darnell, Heather Pauls, Ganga Vijayasiri, Richard B Warnecke, Elizabeth A Calhoun
BACKGROUND: Past efforts to assess patient navigation on cancer screening utilization have focused on one-time uptake, which may not be sufficient in the long term. This is partially due to limited resources for in-person, longitudinal patient navigation. We examine the effectiveness of a low-intensity phone- and mail-based navigation on multiple screening episodes with a focus on screening uptake after receiving noncancerous results during a previous screening episode. METHODS: The is a secondary analysis of patients who participated in a randomized controlled patient navigation trial in Chicago...
September 21, 2017: Journal of Women's Health
https://www.readbyqxmd.com/read/28932930/understanding-and-resolving-conflicting-traditions-a-macintyrean-approach-to-shared-deliberation-in-medical-ethics
#2
Jessica Adkins
The position of clinical ethicist exists to help resolve conflicts in the hospital. Sometimes these conflicts arise because of fundamental cultural differences between the patient and the medical team, and such cases present special challenges. Should the ideology of modern medicine reject the wishes of those who hold ideologies from differing cultures? How can the medical ethicist help resolve such conflicts? To answer these questions, I rely on the works of Alasdair MacIntyre. Using MacIntyre's philosophy, we can better understand why traditions exist, how conflicts arise, and how opposing traditions can collaborate in shared decision making...
September 20, 2017: HEC Forum: An Interdisciplinary Journal on Hospitals' Ethical and Legal Issues
https://www.readbyqxmd.com/read/28932579/patient-reported-outcomes-following-video-assisted-thoracoscopic-vats-resection-or-stereotactic-ablative-body-radiotherapy-sabr-for-treatment-of-non-small-cell-lung-cancer-protocol-for-an-observational-pilot-study-lilac
#3
Cecilia Pompili, Kevin N Franks, Alessandro Brunelli, Yusuf S Hussain, Patricia Holch, Matthew E Callister, Jonathan M Robson, Kostas Papagiannopoulos, Galina Velikova
BACKGROUND: Lung cancer is increasingly a disease of the elderly and frail population with a median age of 70 years at diagnosis. Therefore, consideration of the impact of interventions on health-related quality of life (HRQOL) and not only absolute survival is especially important. For non-small cell lung cancer (NSCLC), video-assisted thoracoscopic surgery (VATS) has been gaining popularity over the last few decades, replacing traditional open lobectomies. For high-risk patients who are not deemed suitable for surgery, stereotactic ablative body radiotherapy (SABR) provides a potentially curative alternative...
August 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28930235/current-usage-of-traditional-chinese-medicine-for-breast-cancer-a-narrative-approach-to-the-experiences-of-women-with-breast-cancer-in-australia-a-pilot-study
#4
Dianna Porter, Suzanne Cochrane, Xiaoshu Zhu
Background: The use of Traditional Chinese Medicine (TCM) by breast cancer patients is growing. Few studies have examined the complexity of breast cancer survivors' attitudes, lived experiences, barriers, and perceptions in using TCM as part of their treatment journey. This article examines breast cancer survivors' experiences, perceptions of, and benefits (or not) in using TCM. Methods: Qualitative research, using semi-structured interviews, was the chosen methodology. Results: Participants used TCM as a form of self-help and as a complement, not an alternative, to standard care...
April 21, 2017: Medicines (Basel, Switzerland)
https://www.readbyqxmd.com/read/28929865/false-positive-screens-and-lung-cancer-risk-in-the-national-lung-screening-trial-implications-for-shared-decision-making
#5
Paul F Pinsky, Christina R Bellinger, David P Miller
Objectives Low-dose computed tomography lung cancer screening has been shown to reduce lung cancer mortality but has a high false-positive rate. The precision medicine approach to low-dose computed tomography screening assesses subjects' benefits versus harms based on their personal lung cancer risk, where harms include false-positive screens and resultant invasive procedures. We assess the relationship between lung cancer risk and the rate of false-positive LDCT screens. Methods The National Lung Screening Trial randomized high-risk subjects to three annual screens with low-dose computed tomography or chest radiographs...
January 1, 2017: Journal of Medical Screening
https://www.readbyqxmd.com/read/28929855/the-patients-as-partners-movement-and-the-emerging-health-leader
#6
Melinda Young
Over the past decade, the Patients as Partners Movement has spread throughout healthcare systems across Canada. This movement aims to overcome the paternalistic approach, where the system and its providers act for or deliver services to the patient. Instead, decision-making at all levels is to be shared with the patient. Delivering patient- and family-centred care is the goal of the Patients as Partners Movement and authentic engagement is at its core. This article aims to explore the link between the Patients as Partners Movement and authentic engagement...
May 2017: Healthcare Management Forum
https://www.readbyqxmd.com/read/28929818/improving-accountability-in-vaccine-decision-making
#7
James Kenneth Timmis, Steven Black, Rino Rappuoli
Introduction Healthcare decisions, in particular those affecting entire populations, should be evidence-based and taken by decision-makers sharing broad alignment with affected stakeholders. However, criteria, priorities and procedures for decision-making are sometimes non-transparent, frequently vary considerably across equivalent decision-bodies, do not always consider the broader benefits of new health-measures, and therefore do not necessarily adequately represent the relevant stakeholder-spectrum. Areas covered To address these issues in the context of the evaluation of new vaccines, we have proposed a first baseline set of core evaluation criteria, primarily selected by members of the vaccine research community, and suggested their implementation in vaccine evaluation procedures...
September 20, 2017: Expert Review of Vaccines
https://www.readbyqxmd.com/read/28927690/forensic-drug-intelligence-and-the-rise-of-cryptomarkets-part-i-studying-the-australian-virtual-market
#8
Julian Broséus, Marie Morelato, Mark Tahtouh, Claude Roux
Analysing and understanding cryptomarkets is essential to become proactive in the fight against the illicit drug trade. Such a research seeks to combine a diversity of indicators related to the virtual (darknet markets) and physical (the traditional "offline" market) aspects of the illicit drug trade to provide information on the distribution and consumption as well as to assess similarities/differences between the virtual and physical markets. This study analysed data that had previously been collected on cryptomarkets from December 2013 to March 2015...
September 12, 2017: Forensic Science International
https://www.readbyqxmd.com/read/28927493/review-of-patient-reported-experience-within-patient-centered-medical-homes-insights-for-australian-health-care-homes
#9
Mary O'Loughlin, Jane Mills, Robyn McDermott, Linton Harriss
Understanding patient experience is necessary to advance the patient-centred approach to health service delivery. Australia's primary healthcare model, the 'Health Care Home', is based on the 'Patient-Centered Medical Home' (PCMH) model developed in the United States. Both these models aim to improve patient experience; however, the majority of existing PCMH model evaluations have focussed on funding, management and quality assurance measures. This review investigated the scope of evidence reported by adult patients using a PCMH...
September 20, 2017: Australian Journal of Primary Health
https://www.readbyqxmd.com/read/28927463/towards-precision-medicine-discovering-novel-gynecological-cancer-biomarkers-and-pathways-using-linked-data
#10
Alokkumar Jha, Yasar Khan, Muntazir Mehdi, Md Rezaul Karim, Qaiser Mehmood, Achille Zappa, Dietrich Rebholz-Schuhmann, Ratnesh Sahay
BACKGROUND: Next Generation Sequencing (NGS) is playing a key role in therapeutic decision making for the cancer prognosis and treatment. The NGS technologies are producing a massive amount of sequencing datasets. Often, these datasets are published from the isolated and different sequencing facilities. Consequently, the process of sharing and aggregating multisite sequencing datasets are thwarted by issues such as the need to discover relevant data from different sources, built scalable repositories, the automation of data linkage, the volume of the data, efficient querying mechanism, and information rich intuitive visualisation...
September 19, 2017: Journal of Biomedical Semantics
https://www.readbyqxmd.com/read/28927443/towards-achieving-semantic-interoperability-of-clinical-study-data-with-fhir
#11
Hugo Leroux, Alejandro Metke-Jimenez, Michael J Lawley
BACKGROUND: Observational clinical studies play a pivotal role in advancing medical knowledge and patient healthcare. To lessen the prohibitive costs of conducting these studies and support evidence-based medicine, results emanating from these studies need to be shared and compared to one another. Current approaches for clinical study management have limitations that prohibit the effective sharing of clinical research data. METHODS: The objective of this paper is to present a proposal for a clinical study architecture to not only facilitate the communication of clinical study data but also its context so that the data that is being communicated can be unambiguously understood at the receiving end...
September 19, 2017: Journal of Biomedical Semantics
https://www.readbyqxmd.com/read/28924687/comskil-communication-training-in-oncology-adaptation-to-german-cancer-care-settings
#12
Tim J Hartung, David Kissane, Anja Mehnert
Medical communication is a skill which can be learned and taught and which can substantially improve treatment outcomes, especially if patients' communication preferences are taken into account. Here, we give an overview of communication training research and outline the COMSKIL program as a state-of-the-art communication skills training in oncology. COMSKIL has a solid theoretical foundation and teaches core elements of medical communication in up to ten fully operationalized modules. These address typical situations ranging from breaking bad news to responding to difficult emotions, shared decision-making, and communicating via interpreters...
2018: Recent Results in Cancer Research
https://www.readbyqxmd.com/read/28923844/red-flag-screening-for-low-back-pain-nothing-to-see-here-move-along-a-narrative-review
#13
REVIEW
Chad E Cook, Steven Z George, Michael P Reiman
Screening for red flags in individuals with low back pain (LBP) has been a historical hallmark of musculoskeletal management. Red flag screening is endorsed by most LBP clinical practice guidelines, despite a lack of support for their diagnostic capacity. We share four major reasons why red flag screening is not consistent with best practice in LBP management: (1) clinicians do not actually screen for red flags, they manage the findings; (2) red flag symptomology negates the utility of clinical findings; (3) the tests lack the negative likelihood ratio to serve as a screen; and (4) clinical practice guidelines do not include specific processes that aid decision-making...
September 18, 2017: British Journal of Sports Medicine
https://www.readbyqxmd.com/read/28923833/nephrology-provider-prognostic-perceptions-and-care-delivered-to-older-adults-with-advanced-kidney-disease
#14
Huzaifah Salat, Andrei Javier, Edward D Siew, Rocio Figueroa, Loren Lipworth, Edmond Kabagambe, Aihua Bian, Thomas G Stewart, Maie H El-Sourady, Mohana Karlekar, Cesar Y Cardona, T Alp Ikizler, Khaled Abdel-Kader
BACKGROUND AND OBJECTIVES: Prognostic uncertainty is one barrier that impedes providers in engaging patients with CKD in shared decision making and advance care planning. The surprise question has been shown to identify patients at increased risk of dying. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: In our prospective observational study, 488 patients ≥60 years of age with CKD stage 4 or 5 were enrolled. Binary surprise question (i.e., "Would you be surprised if this patient died in the next 12 months?") responses were recorded, and dialysis planning preferences, presence of advance care planning documentation, and care preceding death were abstracted...
September 18, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28922208/patient-centered-outcome-spectrum-an-evidence-based-framework-to-aid-in-shared-decision-making
#15
Angela M Ingraham, Suresh K Agarwal, Hee Soo Jung, Amy E Liepert, Ann P O'Rourke, John E Scarborough
OBJECTIVE: Our objective was to develop an alternate construct for reporting anticipated outcomes after emergency general surgery (EGS) that presents risk in terms of a composite measure. BACKGROUND: Currently available prediction tools generate risk outputs for discrete as opposed to composite measures of postoperative outcomes. A construct to synthesize multiple discrete estimates into a global understanding of a patient's likely postoperative health status is lacking and could augment shared decision-making conversations...
September 15, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28921599/the-stories-we-tell-introduction-to-the-special-issue-on-ethical-challenges-in-community-psychology-research-and-practice
#16
Rebecca Campbell, Michael Morris
This Special Issue examines ethical challenges in community psychology research and practice. The literature on ethics in community psychology has remained largely abstract and aspirational, with few concrete examples and case studies, so the goal of this Special Issue was to expand our written discourse about ethical dilemmas in our field. In these articles, researchers and practitioners share stories of specific ethical challenges they faced and how they sought to resolve them. These first-person narratives examine how ethical challenges come about, how community psychology values inform ethical decision making, and how lessons learned from these experiences can inform an ethical framework for community psychology...
September 18, 2017: American Journal of Community Psychology
https://www.readbyqxmd.com/read/28918669/unexpected-effects-of-a-system-distributed-mobile-application-in-maternity-care-a-randomized-controlled-trial
#17
Christy J W Ledford, Jasmyne J Womack, Heather A Rider, Angela B Seehusen, Stephen J Conner, Rebecca A Lauters, Joshua A Hodge
BACKGROUND: As pregnant mothers increasingly engage in shared decision making regarding prenatal decisions, such as induction of labor, the patient's level of activation may influence pregnancy outcomes. One potential tool to increase patient activation in the clinical setting is mobile applications. However, research is limited in comparing mobile apps with other modalities of patient education and engagement tools. AIM: This study was designed to test the effectiveness of a mobile app as a replacement for a spiral notebook guide as a patient education and engagement tool in the prenatal clinical setting...
September 1, 2017: Health Education & Behavior: the Official Publication of the Society for Public Health Education
https://www.readbyqxmd.com/read/28917833/values-based-shared-decision-making-in-the-antenatal-period
#18
REVIEW
Stephanie K Kukora, Renee D Boss
Despite advances in life-saving technology for critically ill neonates, challenges continue to arise for infants delivered with extreme prematurity, congenital anomalies, and genetic conditions that exceed the limits of currently available interventions. In these situations, parents are forced to make cognitively and emotionally difficult decisions, in discussion with a neonatologist, regarding how aggressively to provide supportive measures at the time of delivery and at what point burdens of therapy outweigh benefits...
September 13, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28916293/is-there-ever-a-role-for-the-unilateral-do-not-attempt-resuscitation-order-in-pediatric-care
#19
Jonathan M Marron, Emma Jones, Joanne Wolfe
Care for children as they near the end of life is difficult and very complex. More difficult still are the decisions regarding what interventions are and are not indicated during these trying times. Occasionally, families of children who are nearing the end of life disagree with the assessment of the medical team regarding these interventions. In rare cases, the medical team can be moved to enact a do not attempt resuscitation (DNAR) order against the wishes of the patient's parents. This manuscript presents one such illustrative case and discusses the ethical issues relevant to such challenging clinical scenarios...
September 12, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28913817/return-to-play-in-2017-and-the-role-of-shared-decision-making-in-patients-with-inherited-and-acquired-channelopathies-and-cardiomyopathies
#20
REVIEW
Kia Afshar, T Jared Bunch
Shared decision-making is based upon a physician-patient encounter in which there is adequate education using aids if needed, a mutual discussion of how to assist the patient in weighing risks and benefits, and a supportive environment that allows the patient to deliberate on the clinical decision and make their own choice. This decision-making paradigm centers on the principles of autonomy and self-determination. Physical activity is a critical part of healthy lifestyle choices that helps lower risk of cardiovascular disease or the progression of it...
September 14, 2017: Current Treatment Options in Cardiovascular Medicine
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