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Physician judgement

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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
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
https://www.readbyqxmd.com/read/29056564/a-nationwide-survey-about-palliative-sedation-involving-japanese-palliative-care-specialists-intentions-and-key-factors-used-to-determine-sedation-as-proportionally-appropriate
#10
Jun Hamano, Tatsuya Morita, Masayuki Ikenaga, Hirofumi Abo, Yoshiyuki Kizawa, Satoru Tunetou
CONTEXT: Although there has long been debate about physicians' intentions and what physicians consider to be proportionally appropriate when performing palliative sedation, few large studies have been performed. OBJECTIVES: To identify physicians' intentions when starting continuous deep sedation and to clarify what factors determine whether physicians regard sedation as proportionally appropriate in relation to expected survival, the patients' wishes, and refractoriness...
October 19, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29053792/2017-infectious-diseases-society-of-america-clinical-practice-guidelines-for-the-diagnosis-and-management-of-infectious-diarrhea
#11
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.
October 19, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28951417/association-between-subjective-risk-perception-and-objective-risk-estimation-in-patients-with-atrial-fibrillation-a-cross-sectional-study
#12
David Zweiker, Robert Zweiker, Elisabeth Winkler, Konstantina Roesch, Martin Schumacher, Vinzenz Stepan, Peter Krippl, Norbert Bauer, Martin Heine, Gerhard Reicht, Gudrun Zweiker, Martin Sprenger, Norbert Watzinger
OBJECTIVE: Oral anticoagulation (OAC) is state-of-the-art therapy for atrial fibrillation (AF), the most common arrhythmia worldwide. However, little is known about the perception of patients with AF and how it correlates with risk scores used by their physicians. Therefore, we correlated patients' estimates of their own stroke and bleeding risk with the objectively predicted individual risk using CHA2DS2-VASc and HAS-BLED scores. DESIGN: Cross-sectional prevalence study using convenience sampling and telephone follow-up...
September 25, 2017: BMJ Open
https://www.readbyqxmd.com/read/28929873/assessing-the-prospects-for-physician-supply-and-demand-in-canada-wishing-it-was-rocket-science
#13
Owen Adams, Tara S Chauhan, Lynda Buske
"It's not rocket science" is an often used phrase to describe tasks that are not very difficult. Although rocketry has proven to be an exacting science with highly predictable results, the same cannot be said for physician workforce planning in Canada. The "boom" in physician supply in the 1960s and 1970s was followed by a "bust" in the early 1990s and a further boom in the 2000s. A large generational shift in the physician population is anticipated between now and 2030; the proportion of "boomers" (1946-1964) will drop from 43% to 16% of the practising profession...
July 2017: Healthcare Management Forum
https://www.readbyqxmd.com/read/28906154/moving-toward-consensus-on-diagnosis-and-management-of-severe-asthma-in-adults
#14
Daniel Colodenco, Oscar Palomares, Carlos Celis, Alan Kaplan, Christian Domingo
Asthma is a considerable health problem with an increasing global prevalence. The burden of severe asthma is expected to notably increase in the following years. Some misleading concepts that sometimes appear in the literature can drive the physician responsible for the patient's management to make incorrect decisions. Furthermore, some of the concepts that appear in the literature and in the guidelines may be not be clear to understand, to follow or to adapt to the regional and local realities. This could again drive the physicians responsible of the patient's management to make incorrect clinical judgements...
September 14, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28905303/measuring-what-matters-to-the-patient-health-related-quality-of-life-after-aortic-valve-and-thoracic-aortic-surgery
#15
Frederiek de Heer, Arjen L Gökalp, Jolanda Kluin, Johanna J M Takkenberg
With improved outcomes following cardiac surgery, health related quality of life (HRQoL) gains increasing importance for the better judgement of choosing the preferred treatment strategy in the individual patient. The physician perception of patient preferences can differ considerably from actual patient preferences, underlining the importance of gathering evidence of actual patient preferences before and quality of life after cardiac surgery. The objective of the current review is to provide an overview of current insights into the quality of life measurements after aortic valve and thoracic aortic surgery and to provide starting points for the application of HRQoL measurements toward the future...
September 13, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28895664/severe-and-acute-complications-of-biologics-in-psoriasis
#16
Elias Oussedik, Nupur U Patel, Devin R Cash, Angela S Gupta, Steven R Feldman
Biologic therapies have revolutionized the approach to immune-mediated diseases such as psoriasis. Due to their favorable safety profiles and excellent efficacy, biologic agents are considered the gold standard for moderate-to-severe psoriasis. The aim of this paper is to saliently review the severe and acute complications of the Food and Drug Administration (FDA) approved biologic agents for psoriasis. Reviewed agents include tumor necrosis factor alpha inhibitors (etanercept, infliximab, and adalimumab), interleukin 12/23 inhibitors (ustekinumab), and interleukin 17 (IL-17) inhibitors (secukinumab and ixekizumab)...
December 2017: Giornale Italiano di Dermatologia e Venereologia: Organo Ufficiale, Società Italiana di Dermatologia e Sifilografia
https://www.readbyqxmd.com/read/28866703/clinical-judgement-perplexed-by-initially-undisclosed-use-of-herbal-medicine-and-unexpected-cross-reactivity-of-immunoassay
#17
K T Liu, C W Lee
We report a case of symptomatic bradycardia caused by consumption of a Chinese herbal medicine which was initially undisclosed to the attending emergency physician. The scientific name of the herb is Panax japonicus. Electrocardiogram revealed sinus bradycardia. Laboratory tests were normal except for the detection of a high serum digoxin level. Further interrogation of the patient eventually disclosed ingestion of the herb which, however, did not contain any digoxin. Other active ingredients in the herb include various types of ginsenoside...
August 2017: Malaysian Journal of Pathology
https://www.readbyqxmd.com/read/28859326/similar-efficacy-and-safety-of-initial-cobra-light-and-cobra-therapy-in-rheumatoid-arthritis-4-year-results-from-the-cobra-light-trial
#18
RANDOMIZED CONTROLLED TRIAL
Nicole P C Konijn, Lilian H D van Tuyl, Maarten Boers, Debby den Uyl, Marieke M Ter Wee, Lindsey K M van der Wijden, Irene E M Bultink, Pit J S M Kerstens, Alexandre E Voskuyl, Dirkjan van Schaardenburg, Michael T Nurmohamed, Willem F Lems
Objective: To assess the efficacy and safety of initial COBRA-light vs COBRA therapy in RA patients after a 4-year follow-up period. Methods: In the COBRA-light trial, 162 consecutive patients with recent-onset RA were randomized to either COBRA-light (prednisolone and MTX) or COBRA therapy (prednisolone, MTX and SSZ) for 1 year. After 1 year, treatment was continued without protocol, and adjusted by the treating physician according to clinical judgement, preferably with a treat-to-target strategy...
September 1, 2017: Rheumatology
https://www.readbyqxmd.com/read/28776437/warfarin-monitoring-in-nursing-homes-assessed-by-case-histories-do-recommendations-and-electronic-alerts-affect-judgements
#19
Reyes Serrano Teruel, Geir Thue, Svein Ivar Fylkesnes, Sverre Sandberg, Ann Helen Kristoffersen
PURPOSE: Older adults treated with warfarin are prone to complications, and high-quality monitoring is essential. The aim of this case history based study was to assess the quality of warfarin monitoring in a routine situation, and in a situation with an antibiotic-warfarin interaction, before and after receiving an electronic alert. MATERIALS AND METHODS: In April 2014, a national web-based survey with two case histories was distributed among Norwegian nursing home physicians and general practitioners working part-time in nursing homes...
September 2017: Scandinavian Journal of Primary Health Care
https://www.readbyqxmd.com/read/28741976/fampridine-response-in-ms-patients-with-gait-impairment-in-a-real-world-setting-need-for-new-response-criteria
#20
Francisco Alejandro Rodriguez-Leal, Rocco Haase, Katja Thomas, Judith Christina Eisele, Undine Proschmann, Thorsten Schultheiss, Raimar Kern, Tjalf Ziemssen
OBJECTIVE: The primary objective of this real-world study was to describe the response to fampridine and changes of gait parameters in multiple sclerosis (MS) patients' walking disability (Expanded Disability Status Scale (EDSS): 4-7) after treatment with fampridine for 2 weeks as recommended by the European Medicines Agency (EMA) and compare it with the overall physician's judgement. METHODS: A total of 211 adult MS patients were analyzed using a multimodal gait assessment including the timed 25-foot walk test (T25FW), 2-minute walking test (2-MWT), 12-item Multiple Sclerosis Walking Scale (MSWS-12), the GAITRite electronic walkway system, and the patients' clinical global impression (CGI)...
July 1, 2017: Multiple Sclerosis: Clinical and Laboratory Research
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