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https://www.readbyqxmd.com/read/28427076/application-of-clinical-trial-results-to-clinical-practice
#1
Marco A Zarbin, Neelakshi Bhagat, Lekha K Mukkamala
Two critical questions one must answer as one applies the results of a clinical trial to clinical practice are: (1) Regardless of whether the trial result is likely to be replicated or reproduced in a second large-scale trial, are the results likely to be reproduced in one's practice? (2) Regardless of whether the experimental treatment was better than the alternative on average for a population of patients, are the results clinically important for a given patient in one's practice? To determine if a study result is likely to be reproduced in one's clinical practice, it may be helpful to answer 5 questions: (1) Have steps been taken to minimize bias? (2) Is the result likely due to the treatment? (3) Is the result unlikely due to chance? (4) Is the study population representative of one's patients? (5) Is the totality of evidence consistent? If the answer to all 5 questions is "yes," then we posit that the trial result is likely to be reproduced in one's practice...
2017: Developments in Ophthalmology
https://www.readbyqxmd.com/read/28427025/psychiatric-symptoms-after-temporal-epilepsy-surgery-a-one-year-follow-up-study
#2
Carmen Iranzo-Tatay, Teresa Rubio-Granero, Antonio Gutierrez, Mercedes Garcés, Rebeca Conde, Asier Gómez-Ibáñez, Sergio Arques-Egea, Lucia Sancho-Miñana, David Hervas-Marín, Vicente Villanueva
Psychiatric symptoms must be considered in patients with refractory temporal lobe epilepsy after epilepsy surgery. The main objectives of our study were to describe clinical and socio-demographical characteristics of a cohort of patients with pharmacoresistant temporal lobe epilepsy who underwent temporal lobe epilepsy surgery, and moreover, to evaluate possible risk factors for developing psychiatric symptoms. In order to achieve those goals, we conducted a prospective evaluation of psychopathology throughout the first year after surgery in a clinical sample of 72 patients, by means of three clinical rated measures; the Hamilton Anxiety Rating Scale (HARS), the Hamilton Depression Rating Scale (HDRS), and the Brief Psychiatric Rating Scale (BPRS)...
April 17, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28426872/importance-and-difficulties-of-pursuing-rtms-research-in-acute-stroke
#3
James R Carey, Diane M Chappuis, Marsha J Finkelstein, Kate L Frost, Lynette K Leuty, Allison L McNulty, Lars I E Oddsson, Erin M Seifert, Teresa J Kimberley
Although much research has been done on repetitive transcranial magnetic stimulation (rTMS) in chronic stroke, only sparse research has been done in acute stroke despite the particularly rich potential for neuroplasticity in this stage. We attempted a preliminary clinical trial in one active, high-quality inpatient rehabilitation facility (IRF) in the -United States. But after enrolling only 4 patients in the grant period, the study was stopped because of low enrollment. The purpose of this paper is to offer a perspective describing the important physiologic rationale for including rTMS in the early phase of stroke, the reasons for our poor patient enrollment in our attempted study, and recommendations to help future studies succeed...
March 1, 2017: Physical Therapy
https://www.readbyqxmd.com/read/28426673/lymph-node-volume-predicts-survival-but-not-nodal-clearance-in-stage-iiia-iiib-nsclc
#4
Vishesh Agrawal, Thibaud P Coroller, Ying Hou, Stephanie W Lee, John L Romano, Elizabeth H Baldini, Aileen B Chen, David Kozono, Scott J Swanson, Jon O Wee, Hugo J W L Aerts, Raymond H Mak
BACKGROUND: Locally advanced non-small cell lung cancer (LA-NSCLC) patients have poorer survival and local control with mediastinal node (N2) tumor involvement at resection. Earlier assessment of nodal burden could inform clinical decision-making prior to surgery. This study evaluated the association between clinical outcomes and lymph node volume before and after neoadjuvant therapy. MATERIALS AND METHODS: CT imaging of patients with operable LA-NSCLC treated with chemoradiation and surgical resection was assessed...
2017: PloS One
https://www.readbyqxmd.com/read/28426536/exploring-the-interaction-between-nursing-decision-making-and-patient-outcomes-in-2-european-cancer-centers-a-qualitative-study
#5
Dario Valcarenghi, Annamaria Bagnasco, Giuseppe Aleo, Gianluca Catania, Milko Zanini, Bruno Cavaliere, Franco Carnevale, Loredana Sasso
BACKGROUND: In some clinical settings, nurses have difficulty describing the outcomes of their caring activities. Understanding the reasons for this could help nurse leaders to improve the effectiveness and visibility of nursing practice and safeguard nurses' working conditions. OBJECTIVE: The aims of this study were to understand how nurses working in 2 different adult cancer centers make healthcare decisions and assess the respective outcomes on their patients...
April 20, 2017: Cancer Nursing
https://www.readbyqxmd.com/read/28426520/nursing-practice-research-and-education-in-the-west-the-best-is-yet-to-come
#6
Heather M Young, Susan Bakewell-Sachs, Linda Sarna
PURPOSE: This paper celebrates the 60th anniversary of the Western Institute of Nursing, the nursing organization representing 13 states in the Western United States, and envisions a preferred future for nursing practice, research, and education. BACKGROUND: Three landmark calls to action contribute to transforming nursing and healthcare: the Patient Protection and Affordable Care Act of 2010; the Institute of Medicine report Future of Nursing: Leading Change, Advancing Health; and the report Advancing Healthcare Transformation: A New Era for Academic Nursing...
April 20, 2017: Nursing Research
https://www.readbyqxmd.com/read/28426362/predicting-change-in-an-integrated-dual-diagnosis-substance-abuse-intensive-outpatient-program
#7
Edward A Wise, David L Streiner, Robert J Gallop
Research on routine outcome monitoring in psychotherapy settings is plentiful but not without implementation obstacles. In fact, there is a relative dearth of real-time outcome monitoring in substance use treatment settings. Numerous barriers to the development and implementation of clinical decision support tools and outcome monitoring of substance use patients, including the need to establish expected trajectories of change and use of reliable change indices have been identified (Goodman, McKay, & DePhilippis, 2013 )...
June 7, 2017: Substance Use & Misuse
https://www.readbyqxmd.com/read/28426313/substance-use-criteria-to-restrict-medicaid-coverage-of-hepatitis-c-treatment-cost-versus-ethics
#8
Joshua M Liao, Michael A Fischer
Medicaid programs provide health insurance coverage for many patients with hepatitis C, a public health problem for which effective but very expensive treatments are now available. Facing constrained budgets, most states adopted prior authorization criteria for sofosbuvir, the first of these agents. Using fee-for-service utilization data from 42 Medicaid programs in 2014, we found that strict behavioral criteria-those that limited coverage on the basis of drug or alcohol use and included specific abstinence or treatment requirements-were associated with significantly less spending on sofosbuvir...
April 20, 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/28426107/controversies-and-consensus-in-the-innovation-access-for-cancer-therapy-in-the-european-countries-on-the-subject-of-metastatic-prostate-cancer
#9
S Oudard, F Courbon
Innovative cancer therapies and advances in drug development have created new hopes for patients and health providers. The purpose of this article was to evaluate the discrepancies in the assessment of the magnitude of benefit of four new drugs (abiraterone acetate, enzalutamide, cabazitaxel, radium-223 dichloride) for the treatment of metastatic castration-resistant prostate cancer (mCRPC). The comparison was done among three European countries (UK, Germany and France) and Canada, according to the statement of each country and to the European Society of Medical Oncology (ESMO) Magnitude of Clinical Benefit Scale...
February 1, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/28425920/development-of-a-fast-monte-carlo-dose-calculation-system-for-online-adaptive-radiation-therapy-quality-assurance
#10
Yuhe Wang, Thomas Mazur, Justin Park, Deshan Yang, Sasa Mutic, H Harold Li
Online adaptive radiation therapy (ART) based on real-time magnetic resonance imaging represents a paradigm-changing treatment scheme. However, conventional quality assurance (QA) methods based on phantom measurements are not feasible with the patient on the treatment couch. The purpose of this work is to develop a fast Monte Carlo system for validating online re-optimized tri-60Co IMRT adaptive plans with both high accuracy and speed. The Monte Carlo system is based on Dose Planning Method (DPM) code with further simplification of electron transport and consideration of external magnetic fields...
April 20, 2017: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/28425833/management-of-missing-second-premolars-using-miniscrews-an-elective-solution-for-critical-anchorage-conditions
#11
Aldo Giancotti, Federica Paoncelli, Francesco Germano
Growing patients with congenital missing second premolars should be accurately evaluated in order to establish an appropriate treatment plan. The decision whether to close or maintain spaces in dental arches caused by missing teeth should be based on the consideration of biomechanical factors and the aesthetic traits of individual patients. Accordingly, the choice of closing spaces requires an adequate consideration of biomechanical principles in order to avoid detrimental effects on the occlusion and profile...
April 20, 2017: Journal of Orthodontics
https://www.readbyqxmd.com/read/28425748/a-field-analysis-trial-comparing-the-turnaround-times-of-routine-and-stat-red-blood-cell-immunohematology-testing
#12
Katie Sackett, Andrea Kjell, Abigail M Schneider, Claudia S Cohn
The turnaround time (TAT) for pre-transfusion testing is important for prompt clinical decision-making. TAT includes the time between the arrival of the sample and the initiation of testing, plus the processing time (PT) required to generate and report a result. The TAT in larger blood banks is mostly dependent upon the capability of the analyzer used. In smaller blood banks, where manual work is often performed, the TAT is dependent on availability and experience of staff, testing resources, and workload. Our site performed a comparative analysis of the ORTHO VISION® (Ortho Clinical Diagnostics, Raritan, NJ) and the Echo® (Immucor, Norcross, GA) blood bank analyzers, using the TAT and PT of standard blood bank tests as the outcome metrics...
January 2017: Immunohematology
https://www.readbyqxmd.com/read/28425472/label-free-single-cell-separation-and-imaging-of-cancer-cells-using-an-integrated-microfluidic-system
#13
Maria Antfolk, Soo Hyeon Kim, Saori Koizumi, Teruo Fujii, Thomas Laurell
The incidence of cancer is increasing worldwide and metastatic disease, through the spread of circulating tumor cells (CTCs), is responsible for the majority of the cancer deaths. Accurate monitoring of CTC levels in blood provides clinical information supporting therapeutic decision making, and improved methods for CTC enumeration are asked for. Microfluidics has been extensively used for this purpose but most methods require several post-separation processing steps including concentration of the sample before analysis...
April 20, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28425194/unlocking-the-limitations-living-with-chronic-obstructive-pulmonary-disease-and-receiving-care-through-telemedicine-a-phenomenological-study
#14
Tina Lien Barken, Elin Thygesen, Ulrika Söderhamn
AIMS AND OBJECTIVES: The aim of this study was to describe the lived experiences of quality of life among a group of patients living with chronic obstructive pulmonary disease (COPD) who were included in a telemedical intervention after hospitalization for disease exacerbation. BACKGROUND: Patients with COPD have high symptom burden, poor control of symptoms, and a need for greater requirements in care. Telemedicine (TM) can provide benefits for patients with COPD by improving self-management...
April 20, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28425153/nursing-students-preferences-for-clinical-placements-in-the-residential-aged-care-setting
#15
Emma Lea, Annette Marlow, Erika Altmann, Helen Courtney-Pratt
AIMS AND OBJECTIVES: To examine nursing student placement preferences submitted as online comments to a university's placement management system, to inform strategies for positive residential aged care experiences. BACKGROUND: There are predicted shortages of nurses to service an ageing population. Clinical placements undertaken by undergraduate nursing students help shape their attitudes and are a key determinant of career decision-making, yet there is little research about why students prefer particular placement areas...
April 20, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28425002/beyond-study-participants-a-framework-for-engaging-patients-in-the-selection-or-development-of-clinical-outcome-assessments-for-evaluating-the-benefits-of-treatment-in-medical-product-development
#16
Hilary Wilson, Ebony Dashiell-Aje, Milena Anatchkova, Karin Coyne, Asha Hareendran, Nancy Kline Leidy, Colleen A McHorney, Kathy Wyrwich
BACKGROUND: Patients are participating more actively in health care decision-making with regard to their health, as well as in the broader realm of assessing the value of medical products and influencing decisions about their registration and reimbursement. There is an increasing trend to include patients' perspectives throughout the stages of medical product development by broadening the traditional study-participant role to that of an active partner throughout the process. Including patients in the selection and development of clinical outcome assessments (COAs) to evaluate the benefit of treatment is particularly important...
April 19, 2017: Quality of Life Research
https://www.readbyqxmd.com/read/28424993/performing-corneal-crosslinking-under-local-anaesthesia-in-patients-with-down-syndrome
#17
Nienke Soeters, Esmée Bennen, Robert P L Wisse
PURPOSE: To report on the ability to perform corneal crosslinking (CXL) under local anaesthesia for the treatment of keratoconus in patients with Down syndrome. METHODS: Nine eyes of seven patients with both keratoconus and Down syndrome were scheduled for an epithelium-off CXL procedure under local anaesthesia. Exclusion criteria were a corneal thickness under 400 µm and the presence of corneal scars. A standardized clinical decision tool was used to estimate patient cooperation and the likelihood for a successful procedure under local rather than general anaesthesia...
April 19, 2017: International Ophthalmology
https://www.readbyqxmd.com/read/28424901/driving-with-a-neurodegenerative-disorder-an-overview-of-the-current-literature
#18
REVIEW
Milou Jacobs, Ellen P Hart, Raymund A C Roos
Driving is important for employment, social activities, and for the feeling of independence. The decision to cease driving affects the quality of life and has been associated with reduced mobility, social isolation, and sadness. Patients with neurodegenerative disorders can experience difficulties while driving due to their cognitive, motor, and behavioral impairments. The aim of this review is to summarize the available literature on changes in driving competence and behavior in patients with neurodegenerative disorders, with a particular focus on Huntington's (HD), Parkinson's (PD), and Alzheimer's disease (AD)...
April 19, 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28424839/reirradiation-of-recurrent-node-positive-non-small-cell-lung-cancer-after-previous-stereotactic-radiotherapy-for-stage%C3%A2-i-disease-a%C3%A2-multi-institutional-treatment-recommendation
#19
Carsten Nieder, Dirk De Ruysscher, Laurie E Gaspar, Matthias Guckenberger, Minesh P Mehta, Patrick Cheung, Arjun Sahgal
BACKGROUND: Practice guidelines have been developed for early-stage and locally advanced non-small cell lung cancer (NSCLC). However, many common clinical scenarios still require individualized decision making. This is true for locoregional relapse after initial stereotactic radiotherapy (stereotactic body radiation therapy or stereotactic ablative radiotherapy; SBRT or SABR), an increasingly utilized curative treatment option for stage I NSCLC. METHODS: A consortium of expert radiation oncologists was established with the aim of providing treatment recommendations...
April 19, 2017: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
https://www.readbyqxmd.com/read/28424830/-when-is-a-nonsurgical-approach-possible-for-metastatic-primary-tumors-and-lymph-node-metastases-of-the-urinary-bladder-and-prostate
#20
R Fietkau
For metastatic carcinomas of the urinary bladder and prostate, systemic therapy is of primary importance. Due to technological advances in radiation oncology such as stereotactic radiotherapy, intensity-modulated radiotherapy, interstitial radiotherapy, and the combination of radiotherapy and chemotherapy, pelvic irradiation can nowadays be carried out effectively and without the risk of major side effects. New data from other tumor entities and retrospective analyses suggest that the use of these technologies can lead to a clinical benefit in terms of improvement in quality of life, local control, and overall survival...
April 19, 2017: Der Urologe. Ausg. A
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