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Shared decision-making

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https://www.readbyqxmd.com/read/29346041/post-treatment-mortality-after-surgery-and-stereotactic-body-radiotherapy-for-early-stage-non-small-cell-lung-cancer
#1
William A Stokes, Michael R Bronsert, Robert A Meguid, Matthew G Blum, Bernard L Jones, Matthew Koshy, David J Sher, Alexander V Louie, David A Palma, Suresh Senan, Laurie E Gaspar, Brian D Kavanagh, Chad G Rusthoven
Purpose In early-stage non-small cell lung cancer (NSCLC), post-treatment mortality may influence the comparative effectiveness of surgery and stereotactic body radiotherapy (SBRT), with implications for shared decision making among high-risk surgical candidates. We analyzed early mortality after these interventions using the National Cancer Database. Patients and Methods We abstracted patients with cT1-T2a, N0, M0 NSCLC diagnosed between 2004 and 2013 undergoing either surgery or SBRT. Thirty-day and 90-day post-treatment mortality rates were calculated and compared using Cox regression and propensity score-matched analyses...
January 18, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/29345224/therapy-interventions-for-children-with-neurodisabilities-a-qualitative-scoping-study
#2
Bryony Beresford, Susan Clarke, Jane Maddison
BACKGROUND: Therapy interventions emerged four times in the top 10 research priorities in a James Lind Alliance research prioritisation exercise for children with neurodisabilities (Morris C, Simkiss D, Busk M, Morris M, Allard A, Denness J, et al. Setting research priorities to improve the health of children and young people with neurodisability: a British Academy of Childhood Disability-James Lind Alliance Research Priority Setting Partnership. BMJ Open 2015;5:e006233). The National Institute for Health Research (NIHR) commissioned this study as part of an information-gathering exercise in response to this...
January 2018: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29343215/women-s-decision-making-processes-and-the-influences-on-their-mode-of-birth-following-a-previous-caesarean-section-in-taiwan-a-qualitative-study
#3
Shu-Wen Chen, Alison M Hutchinson, Cate Nagle, Tracey K Bucknall
BACKGROUND: Vaginal birth after caesarean (VBAC) is an alternative option for women who have had a previous caesarean section (CS); however, uptake is limited because of concern about the risks of uterine rupture. The aim of this study was to explore women's decision-making processes and the influences on their mode of birth following a previous CS. METHODS: A qualitative approach was used. The research comprised three stages. Stage I consisted of naturalistic observation at 33-34 weeks' gestation...
January 17, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29339041/factors-influencing-women-s-perceptions-of-shared-decision-making-during-labor-and-delivery-results-from-a-large-scale-cohort-study-of-first-childbirth
#4
Laura B Attanasio, Katy B Kozhimannil, Kristen H Kjerulff
OBJECTIVE: To examine correlates of shared decision making during labor and delivery. METHODS: Data were from a cohort of women who gave birth to their first baby in Pennsylvania, 2009-2011 (N = 3006). We used logistic regression models to examine the association between labor induction and mode of delivery in relation to women's perceptions of shared decision making, and to investigate race/ethnicity and SES as potential moderators. RESULTS: Women who were Black and who did not have a college degree or private insurance were less likely to report high shared decision making, as well as women who underwent labor induction, instrumental vaginal or cesarean delivery...
January 5, 2018: Patient Education and Counseling
https://www.readbyqxmd.com/read/29338893/the-desired-role-of-health-care-providers-in-guiding-older-patients-with-distal-radius-fractures-a-qualitative-analysis
#5
Helen E Huetteman, Melissa J Shauver, Jacob S Nasser, Kevin C Chung
PURPOSE: Understanding patient preferences for shared decision making is valuable for surgeons to advance patient-centered care, particularly in cases where there is not a clearly superior treatment option, like distal radius fracture. The existing evidence presents conflicting views on the desired role of the provider among older patients when making medical decisions. We aimed to investigate the perceived versus desired role of the provider in older adult patients with distal radius fracture...
January 12, 2018: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29336903/one-year-experience-of-a-regional-service-model-of-teleconsultation-for-planning-and-treatment-of-complex-thoracoabdominal-aortic-disease
#6
Emiliano Chisci, Gianmarco de Donato, Aaron Fargion, Giorgio Ventoruzzo, Gianbattista Parlani, Carlo Setacci, Leonardo Ercolini, Stefano Michelagnoli
OBJECTIVE: The objective of this study was to report the methodology and 1-year experience of a regional service model of teleconsultation for planning and treatment of complex thoracoabdominal aortic disease (TAAD). METHODS: Complex TAADs without a feasible conventional surgical repair were prospectively evaluated by vascular surgeons of the same public health service (National Health System) located in a huge area of 22,994 km2 with 3.7 million inhabitants and 11 tertiary hospitals...
January 11, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29336098/increasing-the-knowledge-identification-and-treatment-of-osteoporosis-through-education-and-shared-decision-making-with-residents-living-in-a-retirement-village-community
#7
Jane Anderson-Wurf, Catherine Harding, Alexa Seal
OBJECTIVE: This pilot study explored whether individual goal setting in a retirement village setting could improve strategies to strengthen bones in an ageing population and help prevent osteoporosis. METHODS: A two-phased osteoporosis prevention program was developed, piloted and evaluated involving a group education session followed by the development of individualised Bone Plans based upon personal understanding of individual fracture risk and lifestyle factors...
January 16, 2018: Australasian Journal on Ageing
https://www.readbyqxmd.com/read/29335723/review-in-primary-care-crp-testing-shared-decision-making-and-procalcitonin-reduce-antibiotic-prescribing-for-ari
#8
Timothy S Carey, Alan Kinlaw
No abstract text is available yet for this article.
January 16, 2018: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29334910/treatment-selection-of-early-stage-non-small-cell-lung-cancer-the-role-of-the-patient-in-clinical-decision-making
#9
S Mokhles, J J M E Nuyttens, M de Mol, J G J V Aerts, A P W M Maat, Ö Birim, A J J C Bogers, J J M Takkenberg
BACKGROUND: The objective of this study is to investigate the role and experience of early stage non-small cell lung cancer (NSCLC) patient in decision making process concerning treatment selection in the current clinical practice. METHODS: Stage I-II NSCLC patients (surgery 55 patients, SBRT 29 patients, median age 68) were included in this prospective study and completed a questionnaire that explored: (1) perceived patient knowledge of the advantages and disadvantages of the treatment options, (2) experience with current clinical decision making, and (3) the information that the patient reported to have received from their treating physician...
January 15, 2018: BMC Cancer
https://www.readbyqxmd.com/read/29334495/the-ethics-of-interventional-procedures-for-patients-too-ill-for-surgery
#10
Caroline G Kan, Michael Nurok
PURPOSE OF REVIEW: Minimally invasive interventional procedures are increasingly popular options for patients who are high-risk candidates for open surgical procedures. It is unclear how to proceed in the rare circumstance of a complication during an interventional procedure, where addressing the complication would require exposing the patient to the full risk that was being avoided with the minimally invasive technique. This review provides recommendations on how to approach this paradoxical scenario...
January 12, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29333577/prostate-cancer-patients-understanding-of-the-gleason-scoring-system-implications-for-shared-decision-making
#11
Erin K Tagai, Suzanne M Miller, Alexander Kutikov, Michael A Diefenbach, Ronak A Gor, Tahseen Al-Saleem, David Y T Chen, Sara Fleszar, Gem Roy
The Gleason scoring system is a key component of a prostate cancer diagnosis, since it indicates disease aggressiveness. It also serves as a risk communication tool that facilitates shared treatment decision-making. However, the system is highly complex and therefore difficult to communicate: factors which have been shown to undermine well-informed and high-quality shared treatment decision-making. To systematically explore prostate cancer patients' understanding of the Gleason scoring system (GSS), we assessed knowledge and perceived importance among men who had completed treatment (N = 50)...
January 15, 2018: Journal of Cancer Education: the Official Journal of the American Association for Cancer Education
https://www.readbyqxmd.com/read/29332301/evaluating-risk-tolerance-from-a-systematic-review-of-preferences-the-case-of-patients-with-psoriasis
#12
REVIEW
Juan Marcos Gonzalez
BACKGROUND: Stated-preference methods have been widely used to evaluate patient-relative preferences for the benefits and potential harms of psoriasis treatments. However, risk tolerance measures for treatment-related harms, a corollary of preferences, are rare despite their critical role in shared decision making and regulatory benefit-risk evaluations. This article presents a method to enhance information on patient risk tolerance through previously published preference results. OBJECTIVE: The objective of this article was to conduct the first meta-analysis of preferences to characterize the distribution of patients' maximum acceptable risk of harms associated with psoriasis treatments...
January 13, 2018: Patient
https://www.readbyqxmd.com/read/29332145/the-experiences-and-beliefs-of-older-people-in-scottish-very-sheltered-housing-about-using-multi-compartment-compliance-aids
#13
Derek Stewart, Kathrine Gibson Smith, Joan MacLeod, Alison Strath, Vibhu Paudyal, Katrina Forbes-McKay, Scott Cunningham, Katie MacLure
Background Multi-compartment compliance aids (MCAs) are promoted as a potential solution to medicines non-adherence despite the absence of high quality evidence of effectiveness of MCA use impacting medicines adherence or any clinical outcomes. Furthermore, there is a lack of qualitative research which focuses on the perspectives of older people receiving MCAs. Objectives To describe experiences and beliefs surrounding very sheltered housing (VSH) residents' use of MCAs with emphasis on issues of personalisation, reablement, shared decision-making, independence and support...
January 13, 2018: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/29331842/predicting-1-year-disability-and-mortality-of-injured-older-adults
#14
Alvin D Jeffery, Mary S Dietrich, Cathy A Maxwell
PURPOSE: The growing incidence of elderly patients injured from falls, combined with a growing understanding of the contribution of cognition and frailty to mortality, prompted this work. Our objective was to develop a clinical risk prediction model for prognosticating disability and mortality among injured older adults 1 year after hospitalization. METHODS: Secondary analysis of prospective longitudinal data from an urban Level 1 trauma center. A proportional odds regression model was used to model mortality and functional status as ordinal outcomes...
January 6, 2018: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/29331655/what-makes-it-so-difficult-for-nurses-to-coach-patients-in-shared-decision-making-a-process-evaluation
#15
Stephanie Anna Lenzen, Ramon Daniëls, Marloes Amantia van Bokhoven, Trudy van der Weijden, Anna Beurskens
BACKGROUND: Primary care nurses play a crucial role in coaching patients in shared decision making about goals and actions. This presents a challenge to practice nurses, who are frequently used to protocol-based working routines. Therefore, an approach was developed to support nurses to coach patients in shared decision making. OBJECTIVES: To investigate how the approach was implemented and experienced by practice nurses and patients. DESIGN: A process evaluation was conducted using quantitative and qualitative methods...
December 16, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/29330835/international-guidelines-for-groin-hernia-management
#16
(no author information available yet)
INTRODUCTION: Worldwide, more than 20 million patients undergo groin hernia repair annually. The many different approaches, treatment indications and a significant array of techniques for groin hernia repair warrant guidelines to standardize care, minimize complications, and improve results. The main goal of these guidelines is to improve patient outcomes, specifically to decrease recurrence rates and reduce chronic pain, the most frequent problems following groin hernia repair. They have been endorsed by all five continental hernia societies, the International Endo Hernia Society and the European Association for Endoscopic Surgery...
January 12, 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/29330241/primary-care-physician-involvement-in-shared-decision-making-for-critically-ill-patients-and-family-satisfaction-with-care
#17
Kevin B Huang, Urs Weber, Jennifer Johnson, Nathanial Anderson, Andrea K Knies, Belinda Nhundu, Cynthia Bautista, Kelly Poskus, Kevin N Sheth, David Y Hwang
PURPOSE: An intensive care unit (ICU) patient's primary care physician (PCP) may be able to assist family with certain ICU shared medical decisions. We explored whether families of patients in nonopen ICUs who nevertheless report involvement of a patient's PCP in medical decision making are more satisfied with ICU shared decision making than families who do not. METHODS: Between March 2013 and December 2015, we administered the Family Satisfaction in the ICU 24 survey to family members of adult neuroscience ICU patients...
January 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29329669/prevalence-and-predictors-of-symptom-resolution-and-functional-restoration-in-the-index-knee-following-knee-arthroplasty-a-longitudinal-study
#18
Daniel L Riddle
OBJECTIVES: To determine the prevalence of a one- to two-year postsurgical pain-free state and pain plus symptom-free state as well as function restoration following knee arthroplasty (KA). A second purpose was to identify predictors of these outcomes. DESIGN: An inception cohort from the Osteoarthritis Initiative (OAI) dataset, a nine-year NIH funded cohort study of persons with or at high risk for knee osteoarthritis was studied. SETTING: Subjects were recruited from the communities of four sites in the Midwest, Eastern and Southeastern United States...
January 9, 2018: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/29328744/asa-grading-a-step-forward
#19
Thogulava Kannan
ASA grading is universally used as a predictor of postoperative outcome. It has been incorporated as part of the WHO checklist to make everyone involved in patient care aware of the patient's physical status, and infer a possible postoperative outcome. Everyone in theatre involved in the care of the patient is aware of the patient's physical status, except the patient! This article is an innovative way of representing ASA physical status to enhance patient involvement and understanding, and to facilitate shared decision making...
March 2017: Journal of Perioperative Practice
https://www.readbyqxmd.com/read/29327445/don-t-just-do-something-stand-there-the-value-and-art-of-deliberate-clinical-inertia
#20
Gerben Keijzers, Louise Cullen, Diana Egerton-Warburton, Daniel M Fatovich
It can be difficult to avoid unnecessary investigations and treatments, which are a form of low-value care. Yet every intervention in medicine has potential harms, which may outweigh the potential benefits. Deliberate clinical inertia is the art of doing nothing as a positive response. This paper provides suggestions on how to incorporate deliberate clinical inertia into our daily clinical practice, and gives an overview of current initiatives such as 'Choosing Wisely' and the 'Right Care Alliance'. The decision to 'do nothing' can be complex due to competing factors, and barriers to implementation are highlighted...
January 12, 2018: Emergency Medicine Australasia: EMA
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