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https://www.readbyqxmd.com/read/27922750/pre-implementation-guidelines-for-infectious-disease-point-of-care-testing-in-medical-institutions
#1
Annemiek A van der Eijk, Andrei N Tintu, John P Hays
Infectious disease point-of-care test (ID-POCT) devices are becoming widely available, and in this respect, international quality standards and guidelines are available for consultation once ID-POCT has been implemented into medical institutions. However, specific guidelines for consultation during the initial pre-implementation decision-making process are currently lacking. Further, there exist pre-implementation issues specific to ID-POCT. Here we present pre-implementation guidelines for consultation when considering the implementation of ID-POCT in medical institutions...
December 6, 2016: Future Microbiology
https://www.readbyqxmd.com/read/27922167/cost-effectiveness-of-primarily-surgical-versus-primarily-conservative-treatment-of-acute-and-subacute-radiculopathies-due-to-intervertebral-disc-herniation-from-the-swiss-perspective
#2
Zanfina Ademi, Viktoria Gloy, Dominik Glinz, Heike Raatz, Joris Van Stiphout, Heiner C Bucher, Matthias Schwenkglenks
AIMS OF THE STUDY: To assess the cost-effectiveness of primarily surgical treatment (PST) versus primarily conservative treatment (PCT) in adults with intermediate severity, acute or subacute, lumbar radicular syndrome due to intervertebral disc herniation. METHODS: A decision analytic model from healthcare system and societal perspectives was used to compare outcomes and costs of PST with those of PCT (physiotherapy, epidural injection and medication). Treatment pathways and quality of life were obtained from published clinical trials...
2016: Swiss Medical Weekly
https://www.readbyqxmd.com/read/27922143/attitudes-and-concerns-of-diabetic-patients-towards-bariatric-surgery-as-treatment-of-diabetes
#3
Hui Wen Chua, Hui Jun Zhou, Chin Meng Khoo, Asim Shabbir, Davide Lomanto, Jimmy By So
INTRODUCTION: Bariatric surgery is increasingly recognised as an effective treatment for type 2 diabetes that significantly improves glycaemic control, even achieving remission. This study examined perceptions and concerns of diabetic patients towards bariatric surgery as a treatment option for diabetes. MATERIALS AND METHODS: A total of 150 patients were recruited from a specialised diabetic outpatient clinic and completed a questionnaire (items were rated on a Likert scale from slightly important [lowest score of 1] to extremely important [maximum score of 5])...
November 2016: Annals of the Academy of Medicine, Singapore
https://www.readbyqxmd.com/read/27921276/relationship-between-physician-adjudicated-adverse-events-and-patient-reported-health-related-quality-of-life-in-a-phase-ii-clinical-trial-nct01143402-of-patients-with-metastatic-uveal-melanoma
#4
Thomas M Atkinson, Jennifer L Hay, Alexander Shoushtari, Yuelin Li, Daniel J Paucar, Sloane C Smith, Ragini R Kudchadkar, Austin Doyle, Jeffrey A Sosman, Jorge Fernando Quevedo, Mohammed M Milhem, Anthony M Joshua, Gerald P Linette, Thomas F Gajewski, Jose Lutzky, David H Lawson, Christopher D Lao, Patrick J Flynn, Mark R Albertini, Takami Sato, Karl Lewis, Brian Marr, David H Abramson, Mark Andrew Dickson, Gary K Schwartz, Richard D Carvajal
PURPOSE: Clinical trials commonly use physician-adjudicated adverse event (AE) assessment via the common terminology criteria for adverse events (CTCAE) for decision-making. Patient-reported health-related quality of life (HRQoL) data are becoming more frequent in oncology; however, the relationship between physician-adjudicated AE assessment and HRQoL is understudied. METHODS: Data from a phase II trial (clinicaltrials.gov identifier: NCT01143402) where patients with metastatic uveal melanoma were randomized to receive selumetinib, an oral MEK inhibitor, or chemotherapy were analyzed...
December 5, 2016: Journal of Cancer Research and Clinical Oncology
https://www.readbyqxmd.com/read/27920623/factors-influencing-decision-making-for-or-against-adjuvant-and-neoadjuvant-chemotherapy-in-postmenopausal-hormone-receptor-positive-breast-cancer-patients-in-the-evaluate-tm-study
#5
Paul Gaß, Peter A Fasching, Tanja Fehm, Johann de Waal, Mahdi Rezai, Bernd Baier, Gerold Baake, Hans-Christian Kolberg, Martin Guggenberger, Mathias Warm, Nadia Harbeck, Rachel Wuerstlein, Jörg-Uwe Deuker, Peter Dall, Barbara Richter, Grischa Wachsmann, Cosima Brucker, Jan W Siebers, Nikos Fersis, Thomas Kuhn, Christopher Wolf, Hans-Walter Vollert, Georg-Peter Breitbach, Wolfgang Janni, Robert Landthaler, Andreas Kohls, Daniela Rezek, Thomas Noesselt, Gunnar Fischer, Stephan Henschen, Thomas Praetz, Volker Heyl, Thorsten Kühn, Thomas Krauss, Christoph Thomssen, Andre Hohn, Hans Tesch, Christoph Mundhenke, Alexander Hein, Claudia Rauh, Christian M Bayer, Adib Jacob, Katja Schmidt, Erik Belleville, Peyman Hadji, Sara Y Brucker, Matthias W Beckmann, Diethelm Wallwiener, Sherko Kümmel, Christian R Löhberg
BACKGROUND: Decision-making for or against neoadjuvant or adjuvant chemotherapy in postmenopausal patients with hormone receptor-positive breast cancer does not follow any clear guidelines, and some patients may unnecessarily undergo chemotherapy and be exposed to the associated toxicity. The aim of this study was to identify the patient population for whom this issue may bear relevance. METHODS: Patients being treated with letrozole in the prospective multicenter noninterventional EvAluate-TM study were recruited...
October 2016: Breast Care
https://www.readbyqxmd.com/read/27920510/the-clock-in-the-box-a-brief-cognitive-screen-is-associated-with-failure-to-return-home-in-an-elderly-hospitalized-sample
#6
Colleen E Jackson, Laura J Grande, Kelly Doherty, Elizabeth Archambault, Brittany Kelly, Jane A Driver, William P Milberg, Regina McGlinchey, James L Rudolph
PURPOSE: Cognitive screening upon hospital admission can provide important information about the patient's ability to process information during the inpatient stay. The Clock-in-the-Box (CIB) is a rapidly administered cognitive screening measure which has been previously validated with cognitive screening and neuropsychological assessments. The purpose of this study is to demonstrate the predictive validity of the CIB for discharge location among a sample of older medical inpatients. PATIENTS AND METHODS: Hospitalized Veterans (N=218), aged 55 years and older, were recruited on the day after admission after they gave their consent...
2016: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/27920399/anticoagulation-for-stroke-prevention-in-elderly-patients-with-non-valvular-atrial-fibrillation-what-are-the-obstacles
#7
C W Wong
The elderly with atrial fibrillation are more prone to stroke. Oral anticoagulants such as warfarin are effective in the prevention of atrial fibrillation-associated stroke and systemic embolism. The CHADS2 or CHA2D2-VASc score and HAS-BLED score were developed to stratify stroke risk associated with atrial fibrillation and bleeding risk in a patient with atrial fibrillation, respectively, to facilitate the decision for and safe use of oral anticoagulant. Nonetheless, the decision for anticoagulation is not straightforward and the elderly with non-valvular atrial fibrillation are often precluded from anticoagulant prescription...
December 2016: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/27919934/development-and-validation-of-risk-prediction-model-for-venous-thromboembolism-in-postpartum-women-multinational-cohort-study
#8
Alyshah Abdul Sultan, Joe West, Matthew J Grainge, Richard D Riley, Laila J Tata, Olof Stephansson, Kate M Fleming, Catherine Nelson-Piercy, Jonas F Ludvigsson
OBJECTIVE:  To develop and validate a risk prediction model for venous thromboembolism in the first six weeks after delivery (early postpartum). DESIGN:  Cohort study. SETTING:  Records from England based Clinical Practice Research Datalink (CPRD) linked to Hospital Episode Statistics (HES) and data from Sweden based registry. PARTICIPANTS:  All pregnant women registered with CPRD-HES linked data between 1997 and 2014 and Swedish medical birth registry between 2005 and 2011 with postpartum follow-up...
December 5, 2016: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/27919771/the-initiation-of-chronic-opioids-a-survey-of-chronic-pain-patients-characterizing-chronic-opioid-use
#9
Catherine E Callinan, Mark D Neuman, Kim E Lacy, Claudia Gabison, Michael A Ashburn
: This study reports the results of a researcher-administered survey with 115 patients receiving chronic opioid therapy (>90 days) to obtain information regarding how chronic opioid therapy was started. Chronic opioids were started following surgery (27.0%; 95% CI:18.5-35.5) or for the treatment of acute injury-related pain (27.0%; 95% CI:18.5-35.5). Many who initiated opioid therapy after surgery reported post-operative complications (61.3%; 95% CI:50.8-71.8) and many with injury-related pain reported follow-up corrective surgery (58...
December 2, 2016: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/27919451/gastrostomy-tube-placement-an-opportunity-for-establishing-patient-centered-goals-of-care
#10
Christopher M McGreevy, Sri Ram Pentakota, Omar Mohamed, Kevin Sigler, Anne C Mosenthal, Ana Berlin
BACKGROUND: Surgeons and other health care providers are frequently consulted for gastrostomy tube placement in seriously ill patients at risk of outcomes poorly aligned with patient goals. Palliative care assessments have been recommended to guide decision-making in this setting. We aimed to characterize patient-centered outcomes and define the extent of unmet palliative care need in patients receiving gastrostomy tubes. METHODS: This is a retrospective study of all adult, nontrauma inpatients who underwent gastrostomy tube placement over 16 months at an urban academic medical center...
December 2, 2016: Surgery
https://www.readbyqxmd.com/read/27919397/a-national-standards-based-assessment-on-functionality-of-electronic-medical-records-systems-used-in-kenyan-public-sector-health-facilities
#11
REVIEW
Samuel Kang'a, Nancy Puttkammer, Steven Wanyee, Davies Kimanga, Jason Madrano, Veronica Muthee, Patrick Odawo, Anjali Sharma, Tom Oluoch, Katherine Robinson, James Kwach, William B Lober
BACKGROUND: Variations in the functionality, content and form of electronic medical record systems (EMRs) challenge national roll-out of these systems as part of a national strategy to monitor HIV response. To enforce the EMRs minimum requirements for delivery of quality HIV services, the Kenya Ministry of Health (MoH) developed EMRs standards and guidelines. The standards guided the recommendation of EMRs that met a preset threshold for national roll-out. METHODS: Using a standards-based checklist, six review teams formed by the MoH EMRs Technical Working Group rated a total of 17 unique EMRs in 28 heath facilities selected by individual owners for their optimal EMR implementation...
January 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/27919396/think-time-a-novel-approach-to-analysis-of-clinicians-behavior-after-reduction-of-drug-drug-interaction-alerts
#12
Richard Schreiber, Julia A Gregoire, Jacob E Shaha, Steven H Shaha
OBJECTIVES: Pharmacologic interaction alerting offers the potential for safer medication prescribing, but research reveals persistent concerns regarding alert fatigue. Research studies have tried various strategies to resolve this problem, with low overall success. We examined the effects of targeted alert reduction on clinician behavior in a resource constrained hospital. METHODS: A physician and a pharmacy informaticist reduced alert levels of several drug-drug interactions (DDI) that clinicians almost always overrode with approval from and knowledge of the medical staff...
January 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/27919385/usability-problems-do-not-heal-by-themselves-national-survey-on-physicians-experiences-with-ehrs-in-finland
#13
Johanna Kaipio, Tinja Lääveri, Hannele Hyppönen, Suvi Vainiomäki, Jarmo Reponen, Andre Kushniruk, Elizabeth Borycki, Jukka Vänskä
PURPOSE: Survey studies of health information systems use tend to focus on availability of functionalities, adoption and intensity of use. Usability surveys have not been systematically conducted by any healthcare professional groups on a national scale on a repeated basis. This paper presents results from two cross-sectional surveys of physicians' experiences with the usability of currently used EHR systems in Finland. The research questions were: To what extent has the overall situation improved between 2010 and 2014? What differences are there between healthcare sectors? METHODS: In the spring of 2014, a survey was conducted in Finland using a questionnaire that measures usability and respondents' user experiences with electronic health record (EHR) systems...
January 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/27919373/improving-the-effectiveness-of-drug-safety-alerts-to-increase-adherence-to-the-guideline-for-gastrointestinal-prophylaxis
#14
Soufiane Lilih, Marieke Pereboom, Ruud T M van der Hoeven, Aukje K Mantel-Teeuwisse, Matthijs L Becker
OBJECTIVE: Gastrointestinal bleedings are the most frequently occurring reason for medication-related hospital admissions, which are potentially preventable. We implemented a clinical decision support system that recommends to prescribe gastrointestinal prophylaxis in patients with an increased risk according to the Dutch guideline. Our primary objective was to determine whether the implementation resulted in improved compliance with this guideline for gastrointestinal prophylaxis. A secondary objective was to determine whether implementation resulted in a reduction of the number of drug safety alerts...
January 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/27919369/informing-the-development-of-an-internet-based-chronic-pain-self-management-program
#15
Amédé Gogovor, Regina Visca, Claudine Auger, Lucie Bouvrette-Leblanc, Iphigenia Symeonidis, Lise Poissant, Mark A Ware, Yoram Shir, Natacha Viens, Sara Ahmed
BACKGROUND: Self-management can optimize health outcomes for individuals with chronic pain (CP), an increasing fiscal and social burden in Canada. However, self-management is rarely integrated into the regular care (team activities and medical treatment) patients receive. Health information technology offers an opportunity to provide regular monitoring and exchange of information between patient and care team. OBJECTIVE: To identify information needs and gaps in chronic pain management as well as technology features to inform the development of an Internet-based self-management program...
January 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/27919368/clinical-reasoning-in-the-context-of-active-decision-support-during-medication-prescribing
#16
Jan Horsky, Jos Aarts, Leonie Verheul, Diane L Seger, Heleen van der Sijs, David W Bates
OBJECTIVE: Describe and analyze reasoning patterns of clinicians responding to drug-drug interaction alerts in order to understand the role of patient-specific information in the decision-making process about the risks and benefits of medication therapy. Insights could be used to inform the design of decision-support interventions. METHODS: Thirty-two clinicians working with five EHRs in two countries completed sets of six medication orders each and responded to high- and low-severity drug-drug interaction alerts while verbalizing their thoughts in a standard think-aloud protocol...
January 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/27919103/primary-care-based-models-for-the-treatment-of-opioid-use-disorder-a-scoping-review
#17
P Todd Korthuis, Dennis McCarty, Melissa Weimer, Christina Bougatsos, Ian Blazina, Bernadette Zakher, Sara Grusing, Beth Devine, Roger Chou
Greater integration of medication-assisted treatment (MAT) for opioid use disorder (OUD) in U.S. primary care settings would expand access to treatment for this condition. Models for integrating MAT into primary care vary in structure. This article summarizes findings of a technical report for the Agency for Healthcare Research and Quality describing MAT models of care for OUD, based on a literature review and interviews with key informants in the field. The report describes 12 representative models of care for integrating MAT into primary care settings that could be considered for adaptation across diverse health care settings...
December 6, 2016: Annals of Internal Medicine
https://www.readbyqxmd.com/read/27918336/resident-physicians-improve-nontechnical-skills-when-on-operating-room-management-and-leadership-rotation
#18
Devon C Cole, Christopher R Giordano, Terrie Vasilopoulos, Brenda G Fahy
BACKGROUND: Anesthesiology residency primarily emphasizes the development of medical knowledge and technical skills. Yet, nontechnical skills (NTS) are also vital to successful clinical practice. Elements of NTS are communication, teamwork, situational awareness, and decision making. METHODS: The first 10 consecutive senior residents who chose to participate in this 2-week elective rotation of operating room (OR) management and leadership training were enrolled in this study, which spanned from March 2013 to March 2015...
December 1, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27917768/iatrogenic-medication-errors-in-a-paediatric-intensive-care-unit-in-durban-south-africa
#19
A Gokhul, P M Jeena, A Gray
BACKGROUND: Iatrogenic medication errors due to calculation errors are an under-reported concern in children. OBJECTIVE: To determine the incidence and source of iatrogenic medication errors in a paediatric intensive care unit (PICU). METHODS: A prospective study was conducted in the PICU at Inkosi Albert Luthuli Hospital, Durban, South Africa, over a 3-month period in 2014. Medication-related calculation skills of medical practitioners and nurses were assessed through the voluntary anonymous completion of a questionnaire...
December 1, 2016: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/27917307/clinical-and-cost-impact-analysis-of-a-novel-prognostic-test-for-early-detection-of-preterm-birth
#20
Aaron B Caughey, John A F Zupancic, James M Greenberg, Susan S Garfield, Stephen F Thung, Jay D Iams
Objective The objective of this study was to evaluate the potential impact to the U.S. health care system by adopting a novel test that identifies women at risk for spontaneous preterm birth. Methods A decision-analytic model was developed to assess clinical and cost outcomes over a 1-year period. The use of a prognostic test to predict spontaneous preterm birth in a hypothetical population of women reflective of the U.S. population (predictive arm) was compared with the current baseline rate of spontaneous preterm birth and associated infant morbidity and mortality (baseline care arm)...
October 2016: American Journal of Perinatology Reports
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