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Physician judgement

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https://www.readbyqxmd.com/read/29327616/nintedanib-for-the-treatment-of-idiopathic-pulmonary-fibrosis
#1
Francesco Varone, Giacomo Sgalla, Bruno Iovene, Teresa Bruni, Luca Richeldi
Idiopathic Pulmonary Fibrosis (IPF) is an interstitial lung disease characterized by the progressive loss of pulmonary function, ultimately leading to respiratory failure and death. Two novel compounds, nintedanib and pirfenidone, have shown efficacy in reducing the rate of decline of lung function in IPF patients. The multiple tyrosine kinase inhibitor nintedanib has extensively being studied as a potential angiogenesis inhibitor in clinical against various neoplastic disorders. Afterwards, this compound was successfully tested in IPF...
January 12, 2018: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/29306883/clinical-decisions-presented-to-patients-in-hospital-encounters-a-cross-sectional-study-using-a-novel-taxonomy
#2
Eirik Hugaas Ofstad, Jan C Frich, Edvin Schei, Richard M Frankel, Jūratė Šaltytė Benth, Pål Gulbrandsen
OBJECTIVE: To identify and classify all clinical decisions that emerged in a sample of patient-physician encounters and compare different categories of decisions across clinical settings and personal characteristics. DESIGN: Cross-sectional descriptive evaluation of hospital encounters videotaped in 2007-2008 using a novel taxonomy to identify and classify clinically relevant decisions (both actions and judgements). PARTICIPANTS AND SETTING: 372 patients and 58 physicians from 17 clinical specialties in ward round (WR), emergency room (ER) and outpatient (OP) encounters in a Norwegian university hospital...
January 5, 2018: BMJ Open
https://www.readbyqxmd.com/read/29246213/the-role-of-emotion-in-clinical-decision-making-an-integrative-literature-review
#3
Desirée Kozlowski, Marie Hutchinson, John Hurley, Joanne Rowley, Joanna Sutherland
BACKGROUND: Traditionally, clinical decision making has been perceived as a purely rational and cognitive process. Recently, a number of authors have linked emotional intelligence (EI) to clinical decision making (CDM) and calls have been made for an increased focus on EI skills for clinicians. The objective of this integrative literature review was to identify and synthesise the empirical evidence for a role of emotion in CDM. METHODS: A systematic search of the bibliographic databases PubMed, PsychINFO, and CINAHL (EBSCO) was conducted to identify empirical studies of clinician populations...
December 15, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/29240509/mild-bleeding-disorders-what-every-clinician-should-know
#4
H K Hussein, Plr Nicolson, K Fordwor, G C Lowe
Patients with mild bleeding disorders are under-recognized and frequently present to general physicians. The underlying reasons for bleeding are multifactorial. There is little evidence to guide diagnostic and management decision making in patients with mild bleeding disorders. This article outlines different types of mild bleeding disorders, with a particular focus on bleeding associated with low levels of von Willebrand factor and mild platelet defects. It gives practical, evidence-based advice on the investigation and management of patients with a suspected or known mild bleeding disorder, considering the scenarios of an acute bleed, stable outpatient, peri-surgical management and thrombosis...
December 2, 2017: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/29238847/which-pre-hospital-triage-parameters-indicate-a-need-for-immediate-evaluation-and-treatment-of-severely-injured-patients-in-the-resuscitation-area
#5
K O Jensen, R Heyard, D Schmitt, L Mica, C Ossendorf, H P Simmen, G A Wanner, C M L Werner, L Held, K Sprengel
PURPOSE: To find ways to reduce the rate of over-triage without drastically increasing the rate of under-triage, we applied a current guideline and identified relevant pre-hospital triage predictors that indicate the need for immediate evaluation and treatment of severely injured patients in the resuscitation area. METHODS: Data for adult trauma patients admitted to our level-1 trauma centre in a one year period were collected. Outpatients were excluded. Correct triage for trauma team activation was identified for patients with an ISS or NISS ≥ 16 or the need for ICU treatment due to trauma sequelae...
December 13, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29218803/community-pharmacist-led-clinical-services-physician-s-understanding-perceptions-and-readiness-to-collaborate-in-a-midwestern-state-in-the-united-states
#6
Cameron Gordon, Elizabeth Unni, Jaime Montuoro, Diane B Ogborn
OBJECTIVES: Many pharmacists are actively enhancing their role in the delivery of health care by offering a variety of pharmacist-led clinical services. The delivery of these services within community pharmacies can contribute to overcoming the cost and accessibility challenges currently facing U.S. health care, especially when pharmacist-physician collaborative efforts are utilized. The study purpose was to identify general and family practice physicians' awareness of pharmacists' delivery of clinical services, uncover their perceived barriers to collaboration with community pharmacists, and collect their input on how to overcome such barriers in order to better understand how pharmacist-led clinical services can be integrated, improved and more widely utilized as a healthcare delivery mechanism...
December 7, 2017: International Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29217723/-at-risk-individuals-responses-to-direct-to-consumer-advertising-of-prescription-drugs-a-nationally-representative-cross-sectional-study
#7
Neda Khalil Zadeh, Kirsten Robertson, James A Green
OBJECTIVES: The factors determining individuals' self-reported behavioural responses to direct to consumer advertising of prescription drugs were explored with an emphasis on 'at-risk' individuals' responses. DESIGN: Nationally representative cross-sectional survey. SETTING: Community living adults in New Zealand. PARTICIPANTS: 2057 adults (51% women). PRIMARY OUTCOME MEASURES: Self-reported behavioural responses to drug advertising (asking a physician for a prescription, asking a physician for more information about an illness, searching the internet for more information regarding an illness and asking a pharmacist for more information about a drug)...
December 6, 2017: BMJ Open
https://www.readbyqxmd.com/read/29216637/iluvien-in-diabetic-macular-edema-the-choice-of-second-line-corticosteroid-should-be-left-to-the-clinical-judgement-of-the-treating-physician
#8
John Hall
No abstract text is available yet for this article.
December 8, 2017: Ophthalmologica. Journal International D'ophtalmologie
https://www.readbyqxmd.com/read/29194529/2017-infectious-diseases-society-of-america-clinical-practice-guidelines-for-the-diagnosis-and-management-of-infectious-diarrhea
#9
Andi L Shane, Rajal K Mody, John A Crump, Phillip I Tarr, Theodore S Steiner, Karen Kotloff, Joanne M Langley, Christine Wanke, Cirle Alcantara Warren, Allen C Cheng, Joseph Cantey, Larry K Pickering
These guidelines are intended for use by healthcare professionals who care for children and adults with suspected or confirmed infectious diarrhea. They are not intended to replace physician judgement regarding specific patients or clinical or public health situations. This document does not provide detailed recommendations on infection prevention and control aspects related to infectious diarrhea.
November 29, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29185246/is-there-a-role-for-procalcitonin-in-differentiating-uncomplicated-and-complicated-diverticulitis-in-order-to-reduce-antibiotic-therapy-a-prospective-diagnostic-cohort-study
#10
Victor Jeger, Roxana Pop, Farschad Forudastan, Jean Pierre Barras, Markus Zuber, Rein Jan Piso
AIMS OF THE STUDY: While studies show that antibiotic treatment for uncomplicated diverticulitis seems to have no benefit, most experts advocate antimicrobial therapy for complicated diverticulitis. However, even for uncomplicated diverticulitis, most clinicians are very reluctant to withhold antibiotics. Biomarkers could help to guide antibiotic therapy as this approach has been shown to be effective for acute respiratory infections. In this diagnostic cohort study we evaluated whether procalcitonin could be a biomarker to distinguish complicated from uncomplicated cases of diverticulitis...
November 29, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/29170302/5%C3%A2-a-study-analysing-the-diagnostic-performance-of-ecg-interpretation-for-30-day-major-cardiac-events-in-the-emergency-department
#11
Niall Morris, Rick Body
STUDY OBJECTIVE: This study evaluates the diagnostic accuracy of an Emergency Medicine (EM) clinician at identifying ischaemia on an ECG using 30-day major adverse cardiac events (MACE) as the primary outcome. METHODS: This is a secondary analysis of a prospective, multi-centre, observational cohort at 14 centres: the Bedside Evaluation of Sensitive Troponin study. All fourteen Emergency Departments were based in the United Kingdom. Emergency physicians' assessments of the ECG were collected using a standardised form...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29156896/proutine-a-feasibility-study-assessing-surveillance-of-electronic-patient-reported-outcomes-and-adherence-via-smartphone-app-in-advanced-cancer
#12
Gesine Benze, Friedemann Nauck, Bernd Alt-Epping, Giuseppe Gianni, Thomas Bauknecht, Johannes Ettl, Anna Munte, Luisa Kretzschmar, Jan Gaertner
BACKGROUND: In advanced cancer, quality of life (QoL) is a major treatment goal. In order to achieve this, the identification of suffering by screening for patient-reported-outcomes (PROs, i.e., symptoms) is of utmost importance. The use of paper-pencil questionnaires is associated with significant shortcomings due to missing data, recall bias and transcription errors. Other than that, the electronic recording of PROs by mobile Health (mHealth) offers a number of advantages. The aim of this study was to test whether the routine assessment of PROs via a newly developed smartphone application (MeQoL®) is feasible...
October 26, 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/29156853/the-importance-of-routine-bedside-biliary-ultrasonography-in-the-management-of-patients-admitted-to-the-emergency-department-with-isolated-acute-epigastric-pain
#13
Vermi Değerli, Tanzer Korkmaz, Hülya Mollamehmetoğlu, Cem Ertan
Background/aim: The aim of our study was to emphasize the importance of routine bedside biliary ultrasonography (USG) for the differential diagnosis of biliary tract disorders in patients admitted with acute isolated epigastric pain. Materials and methods: Adult patients who were admitted to the emergency department with acute isolated epigastric pain were included in the study. Emergency residents (ERs) were asked whether they planned to perform biliary USG during the initial evaluation and following diagnosis/treatment (secondary evaluation) of these patients...
August 23, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/29151227/significance-of-prostate-specific-antigen-kinetics-after-three-dimensional-conformal-radiotherapy-with-androgen-deprivation-therapy-in-patients-with-localized-prostate-cancer
#14
Wataru Fukuokaya, Sangji Kim, Takao Natsuyama, Kanako Matsuzaki, Homare Shiomi, Hiroki Kitoh, Nobuko Utsumi, Hiromasa Kurosaki, Masafumi Inoue, Koichiro Akakura
BACKGROUND: To evaluate the relationship between biochemical recurrence and post-radiation prostate-specific antigen (PSA) kinetics in patients with localized prostate cancer treated by radiotherapy with various durations of androgen deprivation therapy (ADT). METHODS: We reviewed our single-institution, retrospectively maintained data of 144 patients with T1c-T3N0M0 prostate cancer who underwent three-dimensional conformal radiotherapy (3D-CRT) between December 2005 and December 2015 and 113 patients were fulfilled the inclusion criteria...
November 18, 2017: International Journal of Clinical Oncology
https://www.readbyqxmd.com/read/29136209/use-of-18f-fluorodeoxyglucose-positron-emission-tomography-in-the-diagnosis-of-polymyalgia-rheumatica-a-prospective-study-of-99-patients
#15
Liesbet Henckaerts, Olivier Gheysens, Steven Vanderschueren, Karolien Goffin, Daniel Blockmans
Objective: Previous studies have shown that the majority of patients with PMR have increased 18F-fluorodeoxyglucose (FDG) uptake around the shoulders, hips and processes of the cervical and lumbar spine on PET. The specificity of these findings for PMR is, however, not known. Methods: We prospectively included 99 consecutive patients with a possible clinical diagnosis of PMR. All patients underwent 18F-FDG-PET scanning before treatment with glucocorticoids was started...
October 7, 2017: Rheumatology
https://www.readbyqxmd.com/read/29135293/-from-the-hallervorden-spatz-eponym-to-the-molecular-terminology
#16
Ferenc Garzuly
INTRODUCTION AND AIM: A combination of Niemann-Pick- and Hallervorden-Spatz diseases led to the death of a 17-year-old boy in 1994. Genetic counseling necessitated further investigations in 2017. Meanwhile, the nomenclature of Hallervorden-Spatz disease has been abandoned. The author analyze the reasons for this change. METHOD: Professional activities of Hallervorden and Spatz during and after the Nazi euthanasia program are presented. Also, the scientific efforts that led to the discovery of the genetic background of the disease and ultimately to its new name are highlighted...
October 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/29124766/direct-costs-of-transfusion-reactions-an-expert-judgement-approach
#17
M P Janssen, A J W van Tilborgh, K M K de Vooght, A G Bokhorst, J C Wiersum-Osselton
BACKGROUND AND OBJECTIVES: Despite increasingly meticulous haemovigilance reporting throughout the world, a systematic assessment of the cost of transfusion reactions is still lacking. This is partly caused by the fact that such an assessment requires a subjective expert assessment of the additional costs linked to the adverse reaction. Data on the cost of transfusion reactions could support decision-making regarding blood transfusion safety measures. MATERIALS AND METHODS: Thirteen experts from nine hospitals were asked to estimate the additional care required following various types of transfusion reactions...
November 9, 2017: Vox Sanguinis
https://www.readbyqxmd.com/read/29105556/twenty-five-years-of-french-jurisprudence-in-criminal-medical-liability
#18
Maxime Faisant, Frédérique Papin-Lefebvre, Camille Rerolle, Pauline Saint-Martin, Clotilde Rougé-Maillart
We report on a comprehensive 25-year study on criminal medical liability in France, undertaken to establish trends in the number of cases being brought before the criminal courts. We did this by querying the database on the Légifrance website using a Boolean equation (' pénal' (criminal) AND ' médecin' (physician) OR ' docteur' (doctor)). In total 539 cases were selected, in which the status of the physician either influenced the punishment imposed, or was a prerequisite for the commission of the offence...
January 1, 2017: Medicine, Science, and the Law
https://www.readbyqxmd.com/read/29080001/the-relevance-of-the-hippocratic-oath-to-the-ethical-and-moral-values-of-contemporary-medicine-part-i-the-hippocratic-oath-from-antiquity-to-modern-times
#19
REVIEW
Helen Askitopoulou, Antoniοs N Vgontzas
The present paper discusses the relevance and significance of the Hippocratic Oath to contemporary medical ethical and moral values. It attempts to answer the questions about some controversial issues related to the Oath. The text is divided in two parts. Part I discusses the general attributes and ethical values of the Oath, while Part II presents a detailed analysis of each passage of the Oath with regard to perennial ethical principles and moral values. Part I starts with the contribution of Hippocrates and his School of Cos to medicine...
October 27, 2017: European Spine Journal
https://www.readbyqxmd.com/read/29074515/euthanasia-and-physician-assisted-suicide-not-meeting-due-care-criteria-in-the-netherlands-a-qualitative-review-of-review-committee-judgements
#20
David Gibbes Miller, Scott Y H Kim
ObjectivesTo assess how Dutch regional euthanasia review committees (RTE) apply the euthanasia and physician-assisted suicide (EAS) due care criteria in cases where the criteria are judged not to have been met ('due care not met' (DCNM)) and to evaluate how the criteria function to set limits in Dutch EAS practice. DESIGN: A qualitative review using directed content analysis of DCNM cases in the Netherlands from 2012 to 2016 published on the RTE website (https://www.euthanasiecommissie...
October 25, 2017: BMJ Open
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