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https://www.readbyqxmd.com/read/29150794/shunt-surgery-in-idiopathic-normal-pressure-hydrocephalus-is-cost-effective-a-cost-utility-analysis
#1
Mats Tullberg, Josefine Persson, Jakob Petersen, Per Hellström, Carsten Wikkelsø, Åsa Lundgren-Nilsson
BACKGROUND: The objective was to evaluate the cost-effectiveness of shunt surgery in patients with idiopathic normal pressure hydrocephalus (iNPH). METHODS: Health-related quality of life was evaluated before and 6 months after surgery using the EQ-5D-3 L (EuroQOL group five-dimensions health survey) in 30 patients (median age, 71 years; range, 65-89 years) diagnosed with iNPH. The costs associated with shunt surgery were assessed by a detailed survey with interviews and extraction of register data concerning the cost of hospital care, primary care, residential care, home-care service and informal care...
November 17, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29150349/frontal-sinus-revision-rate-after-nasal-polyposis-surgery-including-frontal-recess-clearance-and-middle-turbinectomy-a-long-term-analysis
#2
Hakim Benkhatar, Idir Khettab, Philippe Sultanik, Ollivier Laccourreye, Pierre Bonfils
OBJECTIVE: To determine the frontal sinus revision rate after nasal polyposis (NP) surgery including frontal recess clearance (FRC) and middle turbinectomy (MT), to search for predictive factors and to analyse surgical management. METHODS: Longitudinal analysis of 153 patients who consecutively underwent bilateral sphenoethmoidectomy with FRC and MT for NP with a minimum follow-up of 7 years. Decision of revision surgery was made in case of medically refractory chronic frontal sinusitis or frontal mucocele...
November 14, 2017: Auris, Nasus, Larynx
https://www.readbyqxmd.com/read/29150095/-towards-a-better-use-of-midazolam-in-end-of-life-a-survey-in-a-department-of-medical-oncology
#3
Aurélie Beneton, Alexis Vallard, Christelle Brosse, Géraldine Poenou, Cécile Pacaut, Nicolas Magné, Stéphanie Morisson
INTRODUCTION: At the end of life of cancer patients, sedation is sometimes needed, in order to palliate unbearable symptoms that other treatments fail to relieve. Midazolam is currently recommended for sedation and its prescription is guided by national guidelines. The aim of the present study was to evaluate the practices of midazolam prescription in a department of medical oncology and to compare the results with French national recommendations in order to improve the midazolam use in case of sedation...
November 14, 2017: Bulletin du Cancer
https://www.readbyqxmd.com/read/29149946/organ-donation-a-comparison-of-donating-and-nondonating-families-in-turkey
#4
F Can, S Hovardaoglu
Based on public opinion surveys, although 75% of people state that they would donate the organs of one of their relatives, in reality, the rate of the people who donate the organs of their relatives is 24%. To decrease the organ shortage, the key point is to understand the difference between intention and real behavior. For this reason, in this study, analyses of variables related to the potential organ donor families' decisions of approval or refusal for organ harvesting were analyzed. The interviews were conducted with 101 families who made a decision about organ donation between 2010 and 2014...
November 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29149872/process-quality-of-decision-making-in-multidisciplinary-cancer-team-meetings-a-structured-observational-study
#5
Pola Hahlweg, Sarah Didi, Levente Kriston, Martin Härter, Yvonne Nestoriuc, Isabelle Scholl
BACKGROUND: The quality of decision-making in multidisciplinary team meetings (MDTMs) depends on the quality of information presented and the quality of team processes. Few studies have examined these factors using a standardized approach. The aim of this study was to objectively document the processes involved in decision-making in MDTMs, document the outcomes in terms of whether a treatment recommendation was given (none vs. singular vs. multiple), and to identify factors related to type of treatment recommendation...
November 17, 2017: BMC Cancer
https://www.readbyqxmd.com/read/29149505/an-international-continence-society-ics-report-on-the-terminology-for-adult-neurogenic-lower-urinary-tract-dysfunction-anlutd
#6
Jerzy B Gajewski, Brigitte Schurch, Rizwan Hamid, Márcio Averbeck, Ryuji Sakakibara, Enrico F Agrò, Tamara Dickinson, Christopher K Payne, Marcus J Drake, Bernie T Haylen
INTRODUCTION: The terminology for adult neurogenic lower urinary tract dysfunction (ANLUTD) should be defined and organized in a clinically based consensus Report. METHODS: This Report has been created by a Working Group under the auspices and guidelines of the International Continence Society (ICS) Standardization Steering Committee (SSC) assisted at intervals by external referees. All relevant definitions for ANLUTD were updated on the basis of research over the last 14 years...
November 17, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/29149333/misleading-by-omission-rethinking-the-obligation-to-inform-research-subjects-about-funding-sources
#7
Neil C Manson
Informed consent requirements for medical research have expanded over the past half-century. The Declaration of Helsinki now includes an explicit positive obligation to inform subjects about funding sources. This is problematic in a number of ways and seems to oblige researchers to disclose information irrelevant to most consent decisions. It is argued here that such a problematic obligation involves an "informational fallacy." The aim in the second part of the paper is to provide a better approach to making sense of how a failure to inform about funding sources wrongs subjects: by making appeals to obligations to refrain from misleading by omission...
November 15, 2017: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/29149134/financial-toxicity-management-as-an-adverse-effect-of-cancer-treatment%C3%A2
#8
Kristen L Fessele
Along with many physical and emotional adverse effects associated with cancer therapy, attention has been directed to defining and identifying interventions to manage financial strain that can occur because of high medical payments and reduced income from employment interruption. Nurses can support patients and families by encouraging open communication during shared treatment decision making and throughout the cancer experience.
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December 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/29148907/impact-of-patients-expressed-wishes-on-their-surrogate-decision-makers-preferred-decision-making-roles-in-japan
#9
Shuji Tsuda, Mieko Nakamura, Shigeru Aoki, Hiroshi Ono, Mitsuru Takagi, Hiroki Ohashi, Junichiro Miyachi, Yoshinori Matsui, Toshiyuki Ojima
BACKGROUND: Home medical care (HMC) patients and their families are expected to prepare for end-of-life decision making. OBJECTIVE: We investigated the decision readiness of HMC patients and their family surrogates. DESIGN: Cross-sectional survey. SETTING/SUBJECTS: We collected data from dyads, consisting of a HMC patient aged 65 years or older and a family member of the patient, recruited at four Japanese primary care clinics from January 2016 to November 2016...
November 17, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29148849/towards-an-overarching-model-for-electronic-medical-record-systems-including-problem-oriented-goal-oriented-and-other-approaches
#10
Huibert Tange, Zsolt Nagykaldi, Jan De Maeseneer
There is no consensus among health professionals on how to structure medical records to serve clinical decision-making. Three approaches co-exist (source-oriented, problem-oriented, goal-oriented), each suiting a different subset of patients. In primary care, the problem-oriented approach is dominant, but for patients with multiple conditions (multimorbidity) the goal-oriented approach seems more appropriate. There is a need to combine different approaches in one medical-record system. In this article, we explain some misconceptions about 'problems' and 'goals' that hinder the way to consensus...
December 2017: European Journal of General Practice
https://www.readbyqxmd.com/read/29148314/clinical-decision-support-systems-in-hospital-care-using-ubiquitous-devices-current-issues-and-challenges
#11
Mirza Mansoor Baig, Hamid GholamHosseini, Aasia A Moqeem, Farhaan Mirza, Maria Lindén
Supporting clinicians in decision making using advanced technologies has been an active research area in biomedical engineering during the past years. Among a wide range of ubiquitous systems, smartphone applications have been increasingly developed in healthcare settings to help clinicians as well as patients. Today, many smartphone applications, from basic data analysis to advanced patient monitoring, are available to clinicians and patients. Such applications are now increasingly integrating into healthcare for clinical decision support, and therefore, concerns around accuracy, stability, and dependency of these applications are rising...
November 1, 2017: Health Informatics Journal
https://www.readbyqxmd.com/read/29147954/a-fully-automatic-end-to-end-method-for-content-based-image-retrieval-of-ct-scans-with-similar-liver-lesion-annotations
#12
A B Spanier, N Caplan, J Sosna, B Acar, L Joskowicz
PURPOSE: The goal of medical content-based image retrieval (M-CBIR) is to assist radiologists in the decision-making process by retrieving medical cases similar to a given image. One of the key interests of radiologists is lesions and their annotations, since the patient treatment depends on the lesion diagnosis. Therefore, a key feature of M-CBIR systems is the retrieval of scans with the most similar lesion annotations. To be of value, M-CBIR systems should be fully automatic to handle large case databases...
November 16, 2017: International Journal of Computer Assisted Radiology and Surgery
https://www.readbyqxmd.com/read/29147896/genetic-diagnosis-before-surgery-has-an-impact-on-surgical-decision-in-brca-mutation-carriers-with-breast-cancer
#13
Sungmin Park, Jeong Eon Lee, Jai Min Ryu, Issac Kim, Soo Youn Bae, Se Kyung Lee, Jonghan Yu, Seok Won Kim, Seok Jin Nam
BACKGROUND: The first aim of our study was to evaluate surgical decision-making by BRCA mutation carriers with breast cancer based on the timing of knowledge of their BRCA mutation status. The second aim was to evaluate breast cancer outcome following surgical treatment. METHODS: This was a retrospective study of 164 patients diagnosed with invasive breast cancer, tested for BRCA mutation, and treated with primary surgery between 2004 and 2015 at Samsung Medical Center in Seoul, Korea...
November 16, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29146652/dynamic-treatment-selection-and-modification-for-personalised-blood-pressure-therapy-using-a-markov-decision-process-model-a-cost-effectiveness-analysis
#14
Sung Eun Choi, Margaret L Brandeau, Sanjay Basu
OBJECTIVE: Personalised medicine seeks to select and modify treatments based on individual patient characteristics and preferences. We sought to develop an automated strategy to select and modify blood pressure treatments, incorporating the likelihood that patients with different characteristics would benefit from different types of medications and dosages and the potential severity and impact of different side effects among patients with different characteristics. DESIGN, SETTING AND PARTICIPANTS: We developed a Markov decision process (MDP) model to incorporate meta-analytic data and estimate the optimal treatment for maximising discounted lifetime quality-adjusted life-years (QALYs) based on individual patient characteristics, incorporating medication adjustment choices when a patient incurs side effects...
November 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/29146568/health-seeking-influence-reflected-by-online-health-related-messages-received-on-social-media-cross-sectional-survey
#15
Rahila Iftikhar, Bahaa Abaalkhail
BACKGROUND: Major social networking platforms, such as Facebook, WhatsApp, and Twitter, have become popular means through which people share health-related information, irrespective of whether messages disseminated through these channels are authentic. OBJECTIVE: This study aims to describe the demographic characteristics of patients that may demonstrate their attitudes toward medical information shared on social media networks. Second, we address how information found through social media affects the way people deal with their health...
November 16, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/29146289/off-label-treatments-were-not-consistently-better-or-worse-than-approved-drug-treatments-in-randomized-trials
#16
Aviv Ladanie, John P A Ioannidis, Randall S Stafford, Hannah Ewald, Heiner C Bucher, Lars G Hemkens
BACKGROUND: Off-label drug use is highly prevalent, but controversial and often discouraged assuming generally inferior medical effects associated with off-label use. METHODS: We searched Medline, PubMed Health and the Cochrane Library up to May 2015 for systematic reviews including meta-analyses of randomized clinical trials (RCTs) comparing off-label and approved drugs head-to-head in any population and on any medical outcome. We combined the comparative effects in meta-analyses providing summary odds ratios (sOR) for each treatment comparison and outcome, and then calculated an overall summary of the sOR across all comparisons (ssOR)...
November 13, 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/29145934/economic-evaluations-on-antimicrobial-stewardship-programme-a-systematic-review
#17
Nor Haizan Ibrahim, Khalidah Maruan, Hasryn Azzuar Mohd Khairy, Yet Hoi Hong, Ahmad Fauzi Dali, Chin Fen Neoh
PURPOSE: To systematically review studies on cost-effectiveness of implementing Antimicrobial stewardship programmes (ASP) in the hospital setting. METHODS: A systematic literature search was performed using electronic databases, such as EMBASE, PubMed/Medline, CINAHL, NHS and CEA Registry from 2000 until 2017. The quality of each included study was assessed using Joanna Briggs Institute Critical Appraisal Checklist for Economic Evaluations and Consolidated Health Economic Evaluation Reporting Standards Statement checklist...
2017: Journal of Pharmacy & Pharmaceutical Sciences: a Publication of the Canadian Society for Pharmaceutical Sciences
https://www.readbyqxmd.com/read/29145673/imaging-characteristics-predict-operative-difficulty-mobilizing-the-sciatic-nerve-for-proximal-hamstring-repair
#18
Thomas J Wilson, B Matthew Howe, Robert J Spinner, Aaron J Krych
BACKGROUND: Repair of proximal hamstring avulsions requires mobilization of the sciatic nerve away from the tendon stump, which can be achieved with varying difficulty depending on the degree of scar formation and adherence. Predicting when a scarred, adherent, difficult-to-mobilize nerve will be encountered has been difficult. OBJECTIVE: To identify clinical and/or radiological factors predictive of a difficult intraoperative dissection of the sciatic nerve during proximal hamstring repair...
November 14, 2017: Neurosurgery
https://www.readbyqxmd.com/read/29145553/tumour-boards-in-geriatric-oncology
#19
Tanya Marya Wildes, Anita O'Donovan, Giuseppe Ferdinando Colloca, Kwok-Leung Cheung
Multidisciplinary tumour board is an integral part of cancer treatment planning. Although no definite survival benefits have yet been shown by mostly observational studies, other benefits of multidisciplinary tumour board have been identified. Traditionally the multidisciplinary tumour board involves participation of treating clinicians-medical, radiation and surgical oncologists. They tend to focus on the cancer alone. There is an increasing awareness that the treatment goal for cancer in older adults is not primarily on prolonging survival, with functional preservation and quality of life being particularly important for this population...
November 14, 2017: Age and Ageing
https://www.readbyqxmd.com/read/29145327/current-practice-and-usual-care-of-major-cervical-disorders-in-korea-a-cross-sectional-study-of-korean-health-insurance-review-and-assessment-service-national-patient-sample-data
#20
A Ryeon Choi, Joon-Shik Shin, Jinho Lee, Yoon Jae Lee, Me-Riong Kim, Min-Seok Oh, Eun-Jung Lee, Sungchul Kim, Mia Kim, In-Hyuk Ha
Neck pain is a highly common condition and is the 4th major cause of years lived with disability. Previous literature has focused on the effect of specific treatments, and observations of actual practice are lacking to date. This study examined Korean health insurance review and assessment service (HIRA) claims data to the aim of assessing prevalence and comparing current medical practice and costs of cervical disorders in Korea.Current practice trends were determined through assessment of prevalence, total expenses, per-patient expense, average days in care, average days of visits, sociodemographic characteristics, distribution of medical costs, and frequency of treatment types of high frequency cervical disorders (cervical sprain/strain, cervical intervertebral disc displacement [IDD], and cervicalgia)...
November 2017: Medicine (Baltimore)
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