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Medical decision making

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https://www.readbyqxmd.com/read/28527066/community-pharmacies-as-epidemiological-sentinels-of-headache-first-experience-in-italy
#1
Paola Brusa, Marco Parente, Gianni Allais, Sara Rolando, Giuseppe Costa, Roberto Gnavi, Teresa Spadea, Mario Giaccone, Andrea Mandelli, Massimo Mana, Francesca Baratta, Chiara Benedetto, Gennaro Bussone
Migraine is a disabling neurovascular syndrome which affects 12-15% of the global population and it represents the third cause in years lived with disability in both males and females aged 15-49 years. Among migraineurs, the symptomatic drug abuse may be a risk factor in the development of medication overuse headache (MOH). Detecting cases of MOH is not straightforward; community pharmacists may, therefore, be in a strategic position to identify individuals who self-medicate, particularly with respect to prevent the development of MOH...
May 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28526675/iterative-user-interface-design-for-automated-sequential-organ-failure-assessment-score-calculator-in-sepsis-detection
#2
Christopher Ansel Aakre, Jaben E Kitson, Man Li, Vitaly Herasevich
BACKGROUND: The new sepsis definition has increased the need for frequent sequential organ failure assessment (SOFA) score recalculation and the clerical burden of information retrieval makes this score ideal for automated calculation. OBJECTIVE: The aim of this study was to (1) estimate the clerical workload of manual SOFA score calculation through a time-motion analysis and (2) describe a user-centered design process for an electronic medical record (EMR) integrated, automated SOFA score calculator with subsequent usability evaluation study...
May 18, 2017: JMIR Human Factors
https://www.readbyqxmd.com/read/28526664/effect-of-a-counseling-session-bolstered-by-text-messaging-on-self-selected-health-behaviors-in-college-students-a-preliminary-randomized-controlled-trial
#3
Janice Sandrick, Doreen Tracy, Arn Eliasson, Ashley Roth, Jeffrey Bartel, Melanie Simko, Tracy Bowman, Karen Harouse-Bell, Mariam Kashani, Marina Vernalis
BACKGROUND: The college experience is often the first time when young adults live independently and make their own lifestyle choices. These choices affect dietary behaviors, exercise habits, techniques to deal with stress, and decisions on sleep time, all of which direct the trajectory of future health. There is a need for effective strategies that will encourage healthy lifestyle choices in young adults attending college. OBJECTIVE: This preliminary randomized controlled trial tested the effect of coaching and text messages (short message service, SMS) on self-selected health behaviors in the domains of diet, exercise, stress, and sleep...
May 17, 2017: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/28526230/shared-decision-making-in-taiwan
#4
Hsun-Hsiang Liao, Huey-Wen Liang, Hou-Chaung Chen, Ching-I Chang, Pa-Chun Wang, Chung-Liang Shih
The paper aims to introduce the current status of shared decision making (SDM) in Taiwan under its mixed health care system and single-payer health insurance system. With experiences in promoting both evidence based medicine and patient safety, the Joint Commission of Taiwan has implemented a nationwide SDM program under the aegis of the Ministry of Health and Welfare since 2016, incorporating multiple approaches such as developing patient decision aids (PDAs), executing the Medical Decision Aids Campaign, establishing a SDM platform, and integrating SDM in clinical practice...
May 17, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28526191/aiding-risk-information-learning-through-simulated-experience-arise-using-simulated-outcomes-to-improve-understanding-of-conditional-probabilities-in-prenatal-down-syndrome-screening
#5
Pete Wegier, Victoria A Shaffer
OBJECTIVE: To determine whether the use of simulated experiences to communicate statistical information can improve an individual's understanding of conditional probabilities-specifically the positive predictive value (PPV) of prenatal screening tests for Down syndrome. METHODS: In Experiment 1 (N=64) and Experiment 2 (N=180) participants were asked to estimate the PPV of a prenatal screening test for Down syndrome based on either (1) explicit statistics regarding the prevalence of Down syndrome and the sensitivity and specificity of a prenatal screening test for Down syndrome, or (2) experiencing up to 5000 simulated test results over a short time...
April 26, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/28525542/semiparametric-model-and-inference-for-spontaneous-abortion-data-with-a-cured-proportion-and-biased-sampling
#6
Jin Piao, Jing Ning, Christina D Chambers, Ronghui Xu
Evaluating and understanding the risk and safety of using medications for autoimmune disease in a woman during her pregnancy will help both clinicians and pregnant women to make better treatment decisions. However, utilizing spontaneous abortion (SAB) data collected in observational studies of pregnancy to derive valid inference poses two major challenges. First, the data from the observational cohort are not random samples of the target population due to the sampling mechanism. Pregnant women with early SAB are more likely to be excluded from the cohort, and there may be substantial differences between the observed SAB time and those in the target population...
May 18, 2017: Biostatistics
https://www.readbyqxmd.com/read/28525473/is-total-disk-replacement-a-cost-effective-treatment-for-cervical-degenerative-disk-disease
#7
Bernd Wiedenhöfer, Joachim Nacke, Mike Stephan, Wiltrud Richter, Claus Carstens, Markus Eichler
STUDY DESIGN: A retrospective study. OBJECTIVE: The objective of this study was to assess the cost-effectiveness and clinical outcome of motion-preserving versus fusion procedures in cervical spine surgery. SUMMARY OF BACKGROUND DATA: During the last decade there has been a huge growth in spine surgery with a concurrent increase in the economic burden. Currently, there appear to be no differences in clinical outcome between cervical total disk replacement (TDR) and spinal fusion (SF)...
June 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28524793/moral-dilemmas-of-women-undergoing-pregnancy-termination-for-medical-reasons-in-poland
#8
Kornelia Zaręba, Michał Ciebiera, Małgorzata Bińkowska, Grzegorz Jakiel
OBJECTIVES: We explored the religious views and dilemmas of Polish women making the decision to terminate a pregnancy. The article discusses the highly restrictive legislation and significant influence of the Church on the lives of Polish citizens. METHODS: This study was designed to investigate the effect of religious and political beliefs, social and moral conditioning and professional support on the decision to abort a fetus. A 65-item questionnaire was administered to 60 participants at the time of their pregnancy termination...
May 19, 2017: European Journal of Contraception & Reproductive Health Care
https://www.readbyqxmd.com/read/28523960/the-health-literacy-dyad-the-contribution-of-future-gps-in-england
#9
Oana R Groene, Jane Wills, Nicola Crichton, Gill Rowlands, Rima R Rudd
BACKGROUND: Health literacy studies have primarily focused on the cognitive and social skills of individuals needed to gain access to, understand, and use health information. This area of study is undergoing a paradigm shift with increased attention being paid to the skills of practitioners and an examination of their contribution to the link between literacy and health outcomes. The aim of this study was to describe the health literacy related competencies of General Practice (GP) trainees who will soon be responsible for the clinical encounter...
May 19, 2017: Education for Primary Care
https://www.readbyqxmd.com/read/28523862/transatlantic-medical-consultation-and-second-opinion-in-pediatric-cardiology-has-benefit-past-patient-care-a-case-study-in-videoconferencing
#10
Lubica Kovacikova, Martin Zahorec, Peter Skrak, Brian D Hanna, R Lee Vogel
BACKGROUND: Telemedicine is a rapidly evolving form of modern information and communication technology used to deliver clinical services and educational activities. OBJECTIVE: The aim of this article is to report and analyze our experience with transatlantic consultation via videoconferencing in pediatric cardiology. METHODS: In February, 2013, videoconferencing project was launched between a medium-volume pediatric cardiac center in Bratislava, Slovakia and subspecialty experts from a high-volume pediatric cardiac program at The Children's Hospital of Philadelphia (CHOP), USA...
May 19, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28523579/primary-care-and-hepatology-provider-perceived-barriers-to-and-facilitators-of-hepatitis-c-treatment-candidacy-and-adherence
#11
Shari S Rogal, Rory McCarthy, Andrea Reid, Keri L Rodriguez, Linda Calgaro, Krupa Patel, Molly Daley, Naudia L Jonassaint, Susan L Zickmund
BACKGROUND: Provider perceptions regarding barriers to and facilitators of hepatitis C (HCV) treatment initiation and adherence have not been fully evaluated in the interferon-free treatment era. New treatments have provided opportunities for non-specialists to treat HCV, underscoring the importance of understanding primary care provider (PCP) and specialist perspectives. METHODS: Based on qualitative sampling principles, 12 PCPs and 12 hepatology providers (HPs) from the VA Pittsburgh Healthcare System completed audio-recorded semi-structured interviews...
May 18, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28523207/effects-and-satisfaction-of-medical-device-safety-information-reporting-system-using-electronic-medical-record
#12
Hye Jung Jang, Young Deuk Choi, Nam Hyun Kim
OBJECTIVES: This paper describes an evaluation study on the effectiveness of developing an in-hospital medical device safety information reporting system for managing safety information, including adverse incident data related to medical devices, following the enactment of the Medical Device Act in Korea. METHODS: Medical device safety information reports were analyzed for 190 cases that took place prior to the application of a medical device safety information reporting system and during a period when the reporting system was used...
April 2017: Healthcare Informatics Research
https://www.readbyqxmd.com/read/28521826/practitioners-perspectives-on-evaluating-treatment-outcomes-in-traditional-chinese-medicine
#13
Yan-Hong Zhang, Jing Lv, Wei Gao, Jun Li, Ji-Qian Fang, Li-Yun He, Bao-Yan Liu
BACKGROUND: There are no generally accepted standards for evaluation of treatment outcomes in traditional Chinese medicine (TCM). Pattern differentiation and individual treatments are recognized as the most distinguishing features of TCM. Therefore, how practitioners determine curative effects is an issue worthy of research, though little has been done in this area up to this point. This study examines perceptions of the effectiveness of TCM treatments and the means of evaluating clinical outcomes from the practitioners' perspective...
May 18, 2017: BMC Complementary and Alternative Medicine
https://www.readbyqxmd.com/read/28521810/estimation-of-the-burden-of-varicella-in-europe-before-the-introduction-of-universal-childhood-immunization
#14
Margarita Riera-Montes, Kaatje Bollaerts, Ulrich Heininger, Niel Hens, Giovanni Gabutti, Angel Gil, Bayad Nozad, Grazina Mirinaviciute, Elmira Flem, Audrey Souverain, Thomas Verstraeten, Susanne Hartwig
BACKGROUND: Varicella is generally considered a mild disease. Disease burden is not well known and country-level estimation is challenging. As varicella disease is not notifiable, notification criteria and rates vary between countries. In general, existing surveillance systems do not capture cases that do not seek medical care, and most are affected by underreporting and underascertainment. We aimed to estimate the overall varicella disease burden in Europe to provide critical information to support decision-making regarding varicella vaccination...
May 18, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28521785/expect-with-me-development-and-evaluation-design-for-an-innovative-model-of-group-prenatal-care-to-improve-perinatal-outcomes
#15
Shayna D Cunningham, Jessica B Lewis, Jordan L Thomas, Stephanie A Grilo, Jeannette R Ickovics
BACKGROUND: Despite biomedical advances and intervention efforts, rates of preterm birth and other adverse outcomes in the United States have remained relatively intransigent. Evidence suggests that group prenatal care can reduce these risks, with implications for maternal and child health as well as substantial cost savings. However, widespread dissemination presents challenges, in part because training and health systems have not been designed to deliver care in a group setting. This manuscript describes the design and evaluation of Expect With Me, an innovative model of group prenatal care with a strong integrated information technology (IT) platform designed to be scalable nationally...
May 18, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28521082/training-doctors-briefly-and-in-situ-to-involve-their-patients-in-making-medical-decisions-preliminary-testing-of-a-newly-developed-module
#16
Jürgen Kasper, Katrin Liethmann, Christoph Heesen, Daniel R Reissmann, Friedemann Geiger
OBJECTIVE: To carry out preliminary evaluation of a training module for doctors to enhance their ability to involve their patients in medical decision making. The training refers to the shared decision-making (SDM) communication concept. METHODS: The training module includes a comprehensive manual, a corresponding video tutorial with communication examples and a 15-minute face-to-face feedback session based on an SDM analysis of a consultation recording provided by the trainee...
May 18, 2017: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://www.readbyqxmd.com/read/28520904/sources-of-unsafe-primary-care-for-older-adults-a-mixed-methods-analysis-of-patient-safety-incident-reports
#17
Alison Cooper, Adrian Edwards, Huw Williams, Huw P Evans, Anthony Avery, Peter Hibbert, Meredith Makeham, Aziz Sheikh, Liam J Donaldson, Andrew Carson-Stevens
Background: older adults are frequent users of primary healthcare services, but are at increased risk of healthcare-related harm in this setting. Objectives: to describe the factors associated with actual or potential harm to patients aged 65 years and older, treated in primary care, to identify action to produce safer care. Design and Setting: a cross-sectional mixed-methods analysis of a national (England and Wales) database of patient safety incident reports from 2005 to 2013...
May 16, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28520727/predictors-of-decision-ambivalence-and-the-differences-between-actual-living-liver-donors-and-potential-living-liver-donors
#18
Li-Chueh Weng, Hsiu-Li Huang, Hsiu-Hsin Tsai, Wei-Chen Lee
BACKGROUND: The decision to become a living liver donor is a stressful event. Ambivalence in decision making may result in psychological distress. Thus, the purpose of this study was to provide a description of the ambivalence of potential living liver donors, to examine the predictors of ambivalence, and to compare the ambivalence of potential living liver donors with that of actual living liver donors. METHODS: This descriptive and correlational study was conducted in a medical center from August 2013 to December 2015...
2017: PloS One
https://www.readbyqxmd.com/read/28516828/impact-on-the-medical-decision-making-process-of-multiplex-pcr-assay-for-respiratory-pathogens
#19
A Guillon, S Aymeric, C Gaudy-Graffin, J Sonke, M P Deblonde, J Capsec, P Diot, D Garot, A Goudeau, L Grammatico-Guillon
The objective of this study was to determine how clinicians make use of the modern multiplex PCR assays (MPAs) to manage patients hospitalized for community-acquired pneumonia (CAP). We studied the use of MPAs in 1648 patients hospitalized for CAP over a 3-year period at the moment of the setup of the new PCR assay. We observed that the use of MPAs for the identification of multiple respiratory pathogens marks a radical change in the investigation of CAP etiology. Surprisingly, the contribution of MPAs to the medical decision-making process varies drastically according to the units of care...
May 18, 2017: Epidemiology and Infection
https://www.readbyqxmd.com/read/28516341/fairness-the-hidden-challenge-for-competency-based-postgraduate-medical-education-programs
#20
Colleen Y Colbert, Judith C French, Mary Elizabeth Herring, Elaine F Dannefer
Competency-based medical education systems allow institutions to individualize teaching practices to meet the needs of diverse learners. Yet, the focus on continuous improvement and individualization of curricula does not exempt programs from treating learners in a fair manner. When learners fail to meet key competencies and are placed on probation or dismissed from training programs, issues of fairness may form the basis of their legal claims. In a literature search, we found no in-depth examination of fairness...
May 17, 2017: Perspectives on Medical Education
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