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https://www.readbyqxmd.com/read/28651410/-application-of-tipping-point-analysis-to-address-missing-data-in-clinical-studies
#1
S J Zhang, Y Wang, W Li
To use a visualized method, tipping-point analysis to address missing data in clinical study and discuss related problems. All the possible outcomes caused by missing data were listed and the tipping points where P-values of hypothesis test changed at 0.05 significant level were found out, then the ratio of P<0.05 was calculated, reflecting the reliability of the study's result. Tipping-point analysis can be applied to both continuous and binary data to help find points where p-values are changed. The area of P<0...
May 10, 2017: Zhonghua Liu Xing Bing Xue za Zhi, Zhonghua Liuxingbingxue Zazhi
https://www.readbyqxmd.com/read/28651030/clinical-alerts-to-decrease-high-risk-medication-use-in-older-adults
#2
Wilhelmina Lord-Adem, Nicole J Brandt
High-risk medications (HRMs) account for 14.6% to 54.6% of all medications used in older adults, and have been linked to >50% of adverse drug events (ADEs). HRM-related ADEs lead to increased morbidity and mortality, increased hospital length of stay, and financial costs for patients and health care systems. It has been well documented that incorporating information technology in patient care in the form of clinical alert systems can effectively decrease HRM use and improve patient safety. The current article seeks to identify and discuss clinical alert systems focusing on HRMs, their impact on prescribing for older adults, and challenges to the implementation of electronic decision systems...
July 1, 2017: Journal of Gerontological Nursing
https://www.readbyqxmd.com/read/28650989/tumor-tissue-protein-signatures-reflect-histological-grade-of-breast-cancer
#3
Petter Skoog, Mattias Ohlsson, Mårten Fernö, Lisa Rydén, Carl A K Borrebaeck, Christer Wingren
Histological grade is one of the most commonly used prognostic factors for patients diagnosed with breast cancer. However, conventional grading has proven technically challenging, and up to 60% of the tumors are classified as histological grade 2, which represents a heterogeneous cohort less informative for clinical decision making. In an attempt to study and extend the molecular puzzle of histologically graded breast cancer, we have in this pilot project searched for additional protein biomarkers in a new space of the proteome...
2017: PloS One
https://www.readbyqxmd.com/read/28650892/the-2017-hormone-therapy-position-statement-of-the-north-american-menopause-society
#4
(no author information available yet)
The 2017 Hormone Therapy Position Statement of The North American Menopause Society (NAMS) updates the 2012 Hormone Therapy Position Statement of The North American Menopause Society and identifies future research needs. An Advisory Panel of clinicians and researchers expert in the field of women's health and menopause was recruited by NAMS to review the 2012 Position Statement, evaluate new literature, assess the evidence, and reach consensus on recommendations, using the level of evidence to identify the strength of recommendations and the quality of the evidence...
June 22, 2017: Menopause: the Journal of the North American Menopause Society
https://www.readbyqxmd.com/read/28650869/the-2017-hormone-therapy-position-statement-of-the-north-american-menopause-society
#5
(no author information available yet)
The 2017 Hormone Therapy Position Statement of The North American Menopause Society (NAMS) updates the 2012 Hormone Therapy Position Statement of The North American Menopause Society and identifies future research needs. An Advisory Panel of clinicians and researchers expert in the field of women's health and menopause was recruited by NAMS to review the 2012 Position Statement, evaluate new literature, assess the evidence, and reach consensus on recommendations, using the level of evidence to identify the strength of recommendations and the quality of the evidence...
July 2017: Menopause: the Journal of the North American Menopause Society
https://www.readbyqxmd.com/read/28650863/prediction-models-for-prostate-cancer-outcomes-what-is-the-state-of-the-art-in-2017
#6
James T Kearns, Daniel W Lin
PURPOSE OF REVIEW: Prostate cancer (PCa) remains a significant public health burden, with multiple points for decision-making at all stages of the disease. Given the amount and variety of data that may influence disease management, prediction models have been published to assist clinicians and patients in making decisions about the best next course of action at many disease states. We sought to review the most important studies related to PCa prediction models since 2016 and evaluate their impact upon the evolving field of risk modeling in PCa...
June 24, 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28650413/community-priorities-for-hospital-based-prevention-initiatives-results-from-a-deliberating-public
#7
Marthe R Gold, Lindsey Realmuto, Maya Scherer, Alexandra Kamler, Linda Weiss
CONTEXT: Internal revenue service provisions require not-for-profit hospitals to provide "community benefit." In addition, the Affordable Care Act requires these hospitals to conduct community health needs assessments that involve appropriate stakeholders. These requirements signal government interest in creating opportunities for developing programs that are well tailored and responsive to the needs of the communities served. Gaining meaningful input from residents is a critical aspect of these processes...
June 21, 2017: Journal of Public Health Management and Practice: JPHMP
https://www.readbyqxmd.com/read/28650347/electronic-health-telemedicine-and-new-paradigms-for-training-and-care
#8
Catherine S Todd, Stephen J Mills, Anh L Innes
PURPOSE OF REVIEW: HIV prevention and care is changing rapidly; guideline revisions and programmatic scale-up require innovative approaches to in-service training and care extension to improve provider practice and care access. We assessed recent (≤12 months) peer-reviewed publications on electronic health (eHealth), telemedicine, and other innovative provider-targeted interventions for HIV-related care. RECENT FINDINGS: Key developments included systems merging electronic medical records (EMR) with provider clinical decision aids to prompt action, demonstration eHealth, and telemedicine projects, reviews or descriptions of technology to improve connectivity in lower resource settings, and a few trials on provider-centered interventions...
June 23, 2017: Current Opinion in HIV and AIDS
https://www.readbyqxmd.com/read/28650346/real-time-monitoring-through-the-use-of-technology-to-enhance-performances-throughout-hiv-cascades
#9
Matthew Avery, Stephen J Mills, Eric Stephan
PURPOSE OF REVIEW: Controlling the HIV epidemic requires strong linkages across a 'cascade' of prevention, testing, and treatment services. Information and communications technology (ICT) offers the potential to monitor and improve the performance of this HIV cascade in real time. We assessed recent (<18 months) peer-reviewed publications regarding uses of ICT to improve performance through expanded and targeted reach, improved clinical service delivery, and reduced loss to follow-up...
June 23, 2017: Current Opinion in HIV and AIDS
https://www.readbyqxmd.com/read/28650253/diagnosis-and-treatment-of-osteoporosis-before-and-after-fracture-a-side-by-side-analysis-of-commercially-insured-and-medicare-advantage-osteoporosis-patients
#10
Jessica Weaver, Shiva Sajjan, E Michael Lewiecki, Steven T Harris
BACKGROUND: Although treatment for osteoporosis is recommended by U.S. clinical guidelines, a lack of diagnosis and treatment is common among patients with osteoporotic fractures. OBJECTIVE: To determine the rates of osteoporosis diagnosis and treatment before and after various types of fractures. METHODS: This was a retrospective claims analysis using data from the Humana Medicare Advantage claims (Medicare group) and Optum Insight Clinformatics Data Mart commercial claims (Commercial group)...
July 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28650252/the-effect-of-endometriosis-symptoms-on-absenteeism-and-presenteeism-in-the-workplace-and-at-home
#11
Ahmed M Soliman, Karin S Coyne, Katharine S Gries, Jane Castelli-Haley, Michael C Snabes, Eric S Surrey
BACKGROUND: Characterized by pain symptoms, endometriosis affects women's productivity in their prime working years. OBJECTIVE: To evaluate the effect of individual endometriosis symptoms on household chore and employment productivity as measured by presenteeism and absenteeism in a population survey of women with endometriosis. METHODS: An online survey of U.S. women was conducted to evaluate the prevalence of endometriosis, as well as symptoms, demographics, and clinical characteristics of the respondents...
July 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28650246/economic-outcomes-of-first-line-regimen-switching-among-stable-patients-with-hiv
#12
Lisa Rosenblatt, Ami R Buikema, Jerry Seare, Lindsay G S Bengtson, Jonathan Johnson, Feng Cao, Angelina Villasis-Keever
BACKGROUND: Although switching of antiretroviral therapy (ART) is a valid approach for addressing treatment failure in patients with human immunodeficiency virus (HIV), ART changes among those who are well maintained on their current regimens may lead to the development of new side effects or resistance. OBJECTIVE: To examine the effect of first-line regimen switching on subsequent health care utilization and cost among stable HIV patients. METHODS: This was a retrospective claims data study of adult patients with HIV who initiated ART between 2007 and 2013 and had been treated with their initial regimens for at least 6 continuous months...
July 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28650086/systemic-thrombolysis-catheter-directed-thrombolysis-and-anticoagulation-for-intermediate-risk-pulmonary-embolism-a-simulation-modeling-analysis
#13
Christopher Kabrhel, Ayman Ali, Jin Choi, Chin Hur
OBJECTIVES: Decision-making around the use of thrombolysis for patients with intermediate-risk (submassive) PE remains challenging. Studies indicate favorable clinical outcomes with systemic thrombolytics (IV tPA), but the risk of major bleeding and hemorrhagic stroke is a deterrent. Catheter-directed thrombolysis (CDT) may be a preferable strategy, as it has been shown to have a lower risk of bleeding than systemic thrombolysis. However, a three-arm randomized control study comparing IV tPA, CDT, and anticoagulation alone, with long-term follow up, would be costly and is unlikely to be performed...
June 26, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28649802/punctal-occlusion-for-dry-eye-syndrome
#14
REVIEW
Ann-Margret Ervin, Andrew Law, Andrew D Pucker
BACKGROUND: Dry eye syndrome is a disorder of the tear film that is associated with symptoms of ocular discomfort. Punctal occlusion is a mechanical treatment that blocks the tear drainage system in order to aid in the preservation of natural tears on the ocular surface. OBJECTIVES: To assess the effects of punctal plugs versus no punctal plugs, different types of punctal plugs, and other interventions for managing dry eye. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Trials Register) (2016, Issue 11), MEDLINE Ovid (1946 to 8 December 2016), Embase...
June 26, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28649642/disparities-in-contralateral-prophylactic-mastectomy-use-among-women-with-early-stage-breast-cancer
#15
Younji Kim, Anne Marie McCarthy, Mirar Bristol, Katrina Armstrong
Contralateral prophylactic mastectomy use has increased over the past decades among women with early-stage breast cancer. Racial differences in contralateral prophylactic mastectomy use are well described, but with unclear causes. This study examined contralateral prophylactic mastectomy use among black and white women and the contribution of differences in perceived risk to differences in use. We surveyed women diagnosed with early-stage unilateral breast cancer between ages 41-64 in Pennsylvania and Florida between 2007-2009 to collect data on breast cancer treatment, family history, education, income, insurance, and perceived risk...
2017: NPJ Breast Cancer
https://www.readbyqxmd.com/read/28649599/semi-automated-annotation-of-signal-events-in-clinical-eeg-data
#16
S Yang, S López, M Golmohammadi, I Obeid, J Picone
To be effective, state of the art machine learning technology needs large amounts of annotated data. There are numerous compelling applications in healthcare that can benefit from high performance automated decision support systems provided by deep learning technology, but they lack the comprehensive data resources required to apply sophisticated machine learning models. Further, for economic reasons, it is very difficult to justify the creation of large annotated corpora for these applications. Hence, automated annotation techniques become increasingly important...
December 2016: ... IEEE Signal Processing in Medicine and Biology Symposium. IEEE Signal Processing in Medicine and Biology Symposium
https://www.readbyqxmd.com/read/28649205/support-vector-machine-analysis-of-functional-magnetic-resonance-imaging-of-interoception-does-not-reliably-predict-individual-outcomes-of-cognitive-behavioral-therapy-in-panic-disorder-with-agoraphobia
#17
Benedikt Sundermann, Jens Bode, Ulrike Lueken, Dorte Westphal, Alexander L Gerlach, Benjamin Straube, Hans-Ulrich Wittchen, Andreas Ströhle, André Wittmann, Carsten Konrad, Tilo Kircher, Volker Arolt, Bettina Pfleiderer
BACKGROUND: The approach to apply multivariate pattern analyses based on neuro imaging data for outcome prediction holds out the prospect to improve therapeutic decisions in mental disorders. Patients suffering from panic disorder with agoraphobia (PD/AG) often exhibit an increased perception of bodily sensations. The purpose of this investigation was to assess whether multivariate classification applied to a functional magnetic resonance imaging (fMRI) interoception paradigm can predict individual responses to cognitive behavioral therapy (CBT) in PD/AG...
2017: Frontiers in Psychiatry
https://www.readbyqxmd.com/read/28648893/assessment-of-self-determination-in-adolescents-with-neonatal-brachial-plexus-palsy
#18
Donna Bergman, Lynnette Rasmussen, Kate Wan-Chu Chang, Lynda J-S Yang, Virginia S Nelson
BACKGROUND: The term self-determination refers to decision-making, goal setting, and perseverance to achieve those goals. Numerous studies have established the importance of self-determination to enhance learning and improve post-school outcomes. However, most studies evaluate students with learning disabilities, cognitive impairment, or behavioral disabilities. There is an absence of research on self-determination for adolescents with physical disabilities. OBJECTIVE: To assess self-determination of adolescents with neonatal brachial plexus palsy (NBPP) compared to their typically developing peers via self-reported measures of function...
June 22, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28648871/creation-of-an-open-framework-for-point-of-care-computer-assisted-reporting-and-decision-support-tools-for-radiologists
#19
Tarik K Alkasab, Bernardo C Bizzo, Lincoln L Berland, Sujith Nair, Pari V Pandharipande, H Benjamin Harvey
Decreasing unnecessary variation in radiology reporting and producing guideline-concordant reports is fundamental to radiology's success in value-based payment models and good for patient care. In this article, we present an open authoring system for point-of-care clinical decision support tools integrated into the radiologist reporting environment referred to as the computer-assisted reporting and decision support (CAR/DS) framework. The CAR/DS authoring system, described herein, includes: (1) a definition format for representing radiology clinical guidelines as structured, machine-readable Extensible Markup Language documents and (2) a user-friendly reference implementation to test the fidelity of the created definition files with the clinical guideline...
June 22, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28648701/universal-genomic-testing-the-next-step-in-oncological-decision-making-or-a-dead-end-street
#20
Julian Walter Holch, Klaus Hans Metzeler, Andreas Jung, Kristina Riedmann, Philipp Jakob Jost, Wilko Weichert, Thomas Kirchner, Volker Heinemann, Christoph Benedikt Westphalen
The concept of 'personalised medicine' aims at allocating patients to different treatment options based on individual characteristics to optimise treatment benefit and side effects. In oncology, personalised treatments coupled to biomarkers have led to the approval of targeted agents with high anti-tumour activity. However, these therapies are often limited to narrow, molecularly defined subsets of patients with a specific morphomolecular tumour profile. Recently, it became obvious that the same molecular alteration might drive oncogenesis in many different tumours, and it might be beneficial to target the alteration in a histology informed but entity-overarching way...
June 22, 2017: European Journal of Cancer
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