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Physician judgment

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https://www.readbyqxmd.com/read/29788923/the-segmentation-of-bones-in-pelvic-ct-images-based-on-extraction-of-key-frames
#1
Hui Yu, Haijun Wang, Yao Shi, Ke Xu, Xuyao Yu, Yuzhen Cao
BACKGROUND: Bone segmentation is important in computed tomography (CT) imaging of the pelvis, which assists physicians in the early diagnosis of pelvic injury, in planning operations, and in evaluating the effects of surgical treatment. This study developed a new algorithm for the accurate, fast, and efficient segmentation of the pelvis. METHODS: The proposed method consists of two main parts: the extraction of key frames and the segmentation of pelvic CT images...
May 22, 2018: BMC Medical Imaging
https://www.readbyqxmd.com/read/29782597/low-dose-radiation-18f-fluoride-pet-ct-in-the-assessment-of-unilateral-condylar-hyperplasia-of-the-mandible-preliminary-results-of-a-single-centre-experience
#2
G M Lima, S Diodato, E Costabile, G Cicoria, S Civollani, C Marchetti, P L Guidalotti, C Pettinato, C Nanni, S Fanti
Background: Unilateral condylar hyperplasia (UCH) of the mandible, or Hypercondylia, is a pathological condition that determines an abnormal growth of the affected condyle.Bone SPECT with Tc99m-diphosphonates is a successful tool in the diagnosis of UCH. EANM guidelines also suggest the use of 18F-NaF PET/CT, though it leads to a higher radiation exposure. Aim: As UCH patients are young, we aimed to develop a low dose 18F-Fluoride PET/CT protocol and compare it to a standard injected activity scan, to assess if the image quality remains unchanged...
2018: European journal of hybrid imaging
https://www.readbyqxmd.com/read/29781232/predictors-of-outcomes-in-managing-breast-abscesses-a-large-retrospective-single-center-analysis
#3
Miriam David, Priyanka Handa, Maria Castaldi
We have retrospectively examined a wide range of clinical characteristics, sonographic features, microbiology, and antibiotic regimens in patients with breast abscesses to seek predictive features related to outcome. Because consensus for optimal treatment of breast abscesses has moved toward minimally invasive management using single or repeated needle aspiration (ASP) coupled with adjuvant antibiotics, we assessed whether any factors correlate with the need for repeat procedures by analyzing the number of ASPs and/or surgical incision and drainage (I&D) per abscess...
May 20, 2018: Breast Journal
https://www.readbyqxmd.com/read/29774804/patient-preferences-and-urologist-judgments-on-prostate-cancer-therapy-in-japan
#4
Masahiko Nakayama, Hisanori Kobayashi, Masateru Okazaki, Keiichiro Imanaka, Kazutake Yoshizawa, Jörg Mahlich
The purpose of the present study is to investigate the concordance of treatment preferences between patients and physicians in prostate cancer (PCa) in Japan. An internet-based discrete choice experiment was conducted. Patients and physicians were asked to select their preferred treatment from a pair of hypothetical treatments consisting of four attributes: quality of life (QOL), treatment effectiveness, side effects, and accessibility of treatment. The data were analyzed using a conditional logistic regression model to calculate coefficients and the relative importance (RI) of each attribute...
May 1, 2018: American Journal of Men's Health
https://www.readbyqxmd.com/read/29771249/-new-italian-law-about-end-of-life-self-determination-and-shared-care-pathway
#5
Rosagemma Ciliberti, Matteo Gulino, Ilaria Gorini
The Italian Parliament has recently approved the Law n. 219/2017 concerning "Rules on informed consent and advance directives". The manuscript points out the main key points of the new law, in order to clarify the role of the advance directives and to provide clear operational guidelines for healthcare personnel. Taking into consideration the Italian deontological and juridical context, along with the main jurisprudential judgements, the law has been analysed. The Authors discussed the new rules and the bioethical issues also in relation to the provisions stated by the Convention on Human Rights and Biomedicine (Convention of Oviedo)...
May 2018: Recenti Progressi in Medicina
https://www.readbyqxmd.com/read/29767338/-beginners-operations-and-medical-specialist-standards-avoidance-of-criminal-liability-and-civil-liability
#6
REVIEW
H Schneider
BACKGROUND: In all phases, patients are entitled to receive medical treatment according to medical specialist standards. This does not mean that patients necessarily have to be treated by a medical specialist. Operations performed by "beginners", e. g. assistant physicians, are permitted. However, there are increased liability risks, both for the specialist and the assistant physician. Furthermore, there are risks of criminal responsibility for causing bodily harm by negligence or negligent manslaughter...
May 16, 2018: Der Urologe. Ausg. A
https://www.readbyqxmd.com/read/29763443/understanding-how-patients-perceive-physician-wellness-and-its-links-to-patient-care-a-qualitative-study
#7
Jane B Lemaire, Darby Ewashina, Alicia J Polachek, Jaya Dixit, Verna Yiu
Despite increased interest in physician wellness, little is known about patients' views on the topic. We explore patients' perceptions of physician wellness and how it links to patient care. This exploratory, qualitative study employed semi-structured interviews with a convenience sample of 20 patients from outpatient care settings in a western Canadian city. Using inductive thematic analysis, interview transcripts were independently coded by two authors and then discussed to ensure consensus and to abstract into higher-level themes...
2018: PloS One
https://www.readbyqxmd.com/read/29761677/pleural-fluid-b-type-natriuretic-peptide-level-as-an-additional-indicator-for-the-fluid-s-etiology
#8
Ronen Zalts, Tomer Twizer, Ronit Leiba, Amir Karban
BACKGROUND: The identification of the etiology of a pleural effusion can be difficult. Measurement of serum B-type natriuretic peptide (BNP) levels is helpful in the diagnosis of congestive heart failure (CHF) as a cause of respiratory failure, but pleural fluid BNP measurement is still not part of the workup for pleural effusion. OBJECTIVES: To identify the correlation between pleural fluid BNP levels and clinical diagnosis. METHODS: In this cross-sectional study, data from 107 patients admitted to the department of internal medicine between November 2009 and January 2015 were obtained from medical records...
May 2018: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/29757036/determinants-of-antibiotics-prescribing-among-doctors-in-a-nigerian-urban-tertiary-hospital
#9
Olayinka O Ogunleye, Joseph O Fadare, Adesola F Yinka-Ogunleye, Bene D Anand Paramadhas, Brian Godman
BACKGROUND AND OBJECTIVE: The problem of antimicrobial resistance (AMR) has assumed pandemic dimensions especially among low and middle-income countries such as Nigeria. Irrational use of currently available antimicrobial agents is a major contributory factor. There remains a paucity of documented information on the determinants of antibiotics prescribing among physicians in Nigeria to guide future strategies to reduce AMR. This study therefore aimed to investigate the patterns and determinants of antibiotics prescription among doctors in a tertiary hospital in Nigeria as the first step to improve future antibiotic use in hospitals...
May 14, 2018: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/29720237/factors-associated-with-physicians-prescriptions-for-rheumatoid-arthritis-drugs-not-filled-by-patients
#10
Hong J Kan, Kirill Dyagilev, Peter Schulam, Suchi Saria, Hadi Kharrazi, David Bodycombe, Charles T Molta, Jeffrey R Curtis
BACKGROUND: This study estimated the extent and predictors of primary nonadherence (i.e., prescriptions made by physicians but not initiated by patients) to methotrexate and to biologics or tofacitinib in rheumatoid arthritis (RA) patients who were newly prescribed these medications. METHODS: Using administrative claims linked with electronic health records (EHRs) from multiple healthcare provider organizations in the USA, RA patients who received a new prescription for methotrexate or biologics/tofacitinib were identified from EHRs...
May 2, 2018: Arthritis Research & Therapy
https://www.readbyqxmd.com/read/29702348/exploring-diagnosis-and-imaging-biomarkers-of-parkinson-s-disease-via-iterative-canonical-correlation-analysis-based-feature-selection
#11
Luyan Liu, Qian Wang, Ehsan Adeli, Lichi Zhang, Han Zhang, Dinggang Shen
Parkinson's disease (PD) is a neurodegenerative disorder that progressively hampers the brain functions and leads to various movement and non-motor symptoms. However, it is difficult to attain early-stage PD diagnosis based on the subjective judgment of physicians in clinical routines. Therefore, automatic and accurate diagnosis of PD is highly demanded, so that the corresponding treatment can be implemented more appropriately. In this paper, we focus on finding the most discriminative features from different brain regions in PD through T1-weighted MR images, which can help the subsequent PD diagnosis...
April 4, 2018: Computerized Medical Imaging and Graphics: the Official Journal of the Computerized Medical Imaging Society
https://www.readbyqxmd.com/read/29689323/appropriate-use-criteria-in-dermatopathology-initial-recommendations-from-the-american-society-of-dermatopathology
#12
Claudia I Vidal, Eric A Armbrect, Aleodor A Andea, Angela K Bohlke, Nneka I Comfere, Sarah R Hughes, Jinah Kim, Jessica A Kozel, Jason B Lee, Konstantinos Linos, Brandon R Litzner, Tricia A Missall, Roberto A Novoa, Uma Sundram, Brian L Swick, M Yadira Hurley, Murad Alam, Zsolt Argenyi, Lyn M Duncan, Dirk M Elston, Patrick O Emanuel, Tammie Ferringer, Maxwell A Fung, Gregory A Hosler, Alexander J Lazar, Lori Lowe, Jose A Plaza, Victor G Prieto, June K Robinson, Andras Schaffer, Antonio Subtil, Wei-Lien Wang
BACKGROUND: Appropriate use criteria (AUC) provide physicians guidance in test selection, can affect health care delivery, reimbursement policy, and physician decision-making. OBJECTIVES: The American Society of Dermatopathology (ASDP), with input from the American Academy of Dermatology (AAD) and the College of American Pathologists (CAP), sought to develop AUC in dermatopathology. METHODS: The RAND/UCLA appropriateness methodology, which combines evidence-based medicine, clinical experience and expert judgment, was used to develop AUC in dermatopathology...
April 21, 2018: Journal of the American Academy of Dermatology
https://www.readbyqxmd.com/read/29678380/performance-of-a-computer-aided-digital-dermoscopic-image-analyzer-for-melanoma-detection-in-1-076-pigmented-skin-lesion-biopsies
#13
Francis Del Rosario, Jessica M Farahi, Jesse Drendel, Talayesa Buntinx-Krieg, Joseph Caravaglio, Renee Domozych, Stephanie Chapman, Taylor Braunberger, Robert P Dellavalle, David A Norris, Ramin Fathi, Theodore Alkousakis
BACKGROUND: Digital dermoscopic image analysis of pigmented skin lesions (PSLs) has become increasingly popular, despite its unclear clinical utility. Unbiased, high-powered studies investigating the efficacy of commercially available systems are limited. OBJECTIVE: To investigate the diagnostic performance of the FotoFinder Mole-Analyzer in assessing PSLs for cutaneous melanoma. METHODS: In this 15-year retrospective study, the histopathologies of 1076 biopsied PSLs among a total of 2500 imaged PSLs were collected...
May 2018: Journal of the American Academy of Dermatology
https://www.readbyqxmd.com/read/29676952/associations-between-patient-characteristics-and-a-new-early-do-not-attempt-resuscitation-order-after-intracerebral-hemorrhage
#14
Jessica McFarlin, Claire E Hailey, Wenjing Qi, Peter G Kranz, Weiping Sun, Wei Sun, Marisa Gray, Nicolas King, Daniel T Laskowitz, Michael L James
BACKGROUND: Decisions to limit care, including use of a do-not-resuscitate (DNR) order, are associated with increased risk of death after intracerebral hemorrhage (ICH). Given the value that patient surrogates place on the physician's perception of prognosis, understanding prognostic indicators that influence clinical judgment of outcomes is critical. OBJECTIVE: The purpose of this study was to understand the patient variables and comorbid illnesses associated with DNR orders placed on patients within 72 hours after ICH...
April 20, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29665190/comparison-of-emergency-medicine-malpractice-cases-involving-residents-to-non-resident-cases
#15
Kiersten L Gurley, Shamai A Grossman, Margaret Janes, C Winnie Yu-Moe, Ellen Song, Carrie D Tibbles, Nathan I Shapiro, Carlo L Rosen
BACKGROUND: Data are lacking on how emergency medicine (EM) malpractice cases with resident involvement differs from cases that do not name a resident. OBJECTIVES: To compare malpractice case characteristics in cases where a resident is involved (resident case) to cases that do not involve a resident (non-resident case) and to determine factors that contribute to malpractice cases utilizing EM as a model for malpractice claims across other medical specialties. METHODS: We used data from the Controlled Risk Insurance Company (CRICO) Strategies' division Comparative Benchmarking System (CBS) to analyze open and closed EM cases asserted from 2009-2013...
April 17, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29618670/usage-of-continuous-glucose-monitoring-cgm-for-detecting-an-unrecognized-hypoglycemia-and-management-of-glucocorticoid-replacement-therapy-in-adult-patients-with-central-hypoadrenalism
#16
Takuya Watanabe, Atsushi Ozawa, Sumiyasu Ishii, Takuya Tomaru, Nobuyuki Shibusawa, Tsugumichi Saito, Eijiro Yamada, Kazuhiko Horiguchi, Yasuyo Nakajima, Shunichi Matsumoto, Satoshi Yoshino, Akiko Katano-Toki, Koshi Hashimoto, Masatomo Mori, Shuichi Okada, Tetsurou Satoh, Masanobu Yamada
Patients with adrenal insufficiency require appropriate glucocorticoid replacement therapy; however, reliable biological parameters for optimizing glucocorticoid supplementation are limited. The physician has to rely primarily on clinical judgment, carefully taking into account signs and symptoms potentially suggestive of over- or under-replacement. We have found that some patients who are viewed as receiving sufficient doses of glucocorticoids occasionally exhibit morning headache or morning discomfort, which may be caused by unrecognized nocturnal hypoglycemia...
April 4, 2018: Endocrine Journal
https://www.readbyqxmd.com/read/29570362/verbal-test-of-practical-judgment-vpj-a-new-test-of-judgment-that-predicts-functional-skills-for-older-adults
#17
William E Mansbach, Melissa A Tanner, Francis Schindler
OBJECTIVES: The clinical assessment of older adults' judgment is important for mitigating safety risks that often precipitate loss of independence. Our national survey of geriatric healthcare providers (N = 496; M years of experience = 17.11 ± 10.60) indicated that formal judgment tests are underutilized in clinical practice. We developed the Verbal Test of Practical Judgment (VPJ) as a new test of judgment for older adults intended to identify difficulty performing instrumental activities of daily living (IADL)...
March 23, 2018: Aging & Mental Health
https://www.readbyqxmd.com/read/29566273/appropriate-use-criteria-in-dermatopathology-initial-recommendations-from-the-american-society-of-dermatopathology
#18
Claudia I Vidal, Eric A Armbrect, Aleodor A Andea, Angela K Bohlke, Nneka I Comfere, Sarah R Hughes, Jinah Kim, Jessica A Kozel, Jason B Lee, Konstantinos Linos, Brandon R Litzner, Tricia A Missall, Roberto A Novoa, Uma Sundram, Brian L Swick, M Yadira Hurley, Murad Alam, Zsolt Argenyi, Lyn M Duncan, Dirk M Elston, Patrick O Emanuel, Tammie Ferringer, Maxwell A Fung, Gregory A Hosler, Alexander J Lazar, Lori Lowe, Jose A Plaza, Victor G Prieto, June K Robinson, Andras Schaffer, Antonio Subtil, Wei-Lien Wang
BACKGROUND: Appropriate use criteria (AUC) provide physicians guidance in test selection, can affect health care delivery, reimbursement policy, and physician decision-making. OBJECTIVES: The American Society of Dermatopathology (ASDP), with input from the American Academy of Dermatology (AAD) and the College of American Pathologists (CAP), sought to develop AUC in dermatopathology. METHODS: The RAND/UCLA appropriateness methodology, which combines evidence-based medicine, clinical experience and expert judgment, was used to develop AUC in dermatopathology...
March 22, 2018: Journal of Cutaneous Pathology
https://www.readbyqxmd.com/read/29565796/the-bedside-capacity-assessment-tool-further-development-of-a-clinical-tool-to-assist-with-a-growing-aging-population-with-increased-healthcare-complexities
#19
Maria Torroella Carney, Brian Emmert, Brian Keefer
BACKGROUND: As the population of the United States ages, chronic diseases increase and treatment options become technologically more complicated. As such, patients' autonomy, or the right of patients to accept or refuse a medical treatment, may become a more pressing and complicated issue. This autonomy rests upon a patient's capacity to make a decision. As more older, cognitively and functionally impaired individuals enter healthcare systems, quality assessments of decision-making capacity must be made...
2018: Journal of Clinical Ethics
https://www.readbyqxmd.com/read/29564370/modeling-sequential-context-effects-in-diagnostic-interpretation-of-screening-mammograms
#20
Folami Alamudun, Paige Paulus, Hong-Jun Yoon, Georgia Tourassi
Prior research has shown that physicians' medical decisions can be influenced by sequential context, particularly in cases where successive stimuli exhibit similar characteristics when analyzing medical images. This type of systematic error is known to psychophysicists as sequential context effect as it indicates that judgments are influenced by features of and decisions about the preceding case in the sequence of examined cases, rather than being based solely on the peculiarities unique to the present case...
July 2018: Journal of Medical Imaging
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