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Decision aid

Caroline Constant, Isabelle Masseau, Marie Babkine, Sylvain Nichols, David Francoz, Gilles Fecteau, Emma Marchionatti, Helene Larde, Andre Desrochers
OBJECTIVES:  (1) To develop an evaluation grid to provide a systematic interpretation of calves' articular radiographs, (2) to describe radiographic lesions of septic arthritis in dairy calves less than 6 months of age, (3) to investigate potential associations between demographic data or synovial bacteriological culture results and radiographic lesions (4) to determine whether an association is present between radiographic lesions, their severity and the long-term outcome. METHODS:  Medical records of 54 calves less than 180 days old treated for septic arthritis between 2009 and 2014 with radiographic images performed in the first 2 days after admission were reviewed...
June 16, 2018: Veterinary and Comparative Orthopaedics and Traumatology: V.C.O.T
Marc A Probst, Craig F Tschatscher, Christine M Lohse, M Fernanda Bellolio, Erik P Hess
BACKGROUND: Shared decision-making in the Emergency Department (ED) can increase patient engagement for patients presenting with chest pain. However, little is known regarding which factors are associated with actual patient involvement in decision-making or patients' desired involvement in emergency care decisions. We examined which factors were associated with patients' actual and desired involvement in decision-making among ED chest pain patients. METHODS: This is a secondary analysis of data from a randomized trial of a shared decision-making intervention in ED patients with low-risk chest pain...
June 15, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Stephen J Luen, Rebecca Asher, Chee Khoon Lee, Peter Savas, Roswitha Kammler, Patrizia Dell'Orto, Olivia Maria Biasi, David Demanse, Lellean JeBailey, Sinead Dolan, Wolfgang Hackl, Beat Thuerlimann, Giuseppe Viale, Marco Colleoni, Meredith M Regan, Sherene Loi
Importance: A range of somatic driver alterations has been described in estrogen receptor-positive, HER2-negative (ER+/HER2-) early breast cancer (BC); however, the clinical relevance is unknown. Objective: To investigate associations of driver alterations with prognosis and the role of PIK3CA mutations in prediction of benefit associated with endocrine therapy in postmenopausal patients with ER+/HER2- early BC treated with tamoxifen or letrozole. Design, Setting, and Participants: The Breast International Group (BIG) 1-98 trial randomized 8010 postmenopausal patients with hormone receptor-positive, operable, invasive BC to monotherapy with letrozole, tamoxifen, or a sequential strategy for 5 years...
June 14, 2018: JAMA Oncology
Samuel C Peter, James P Whelan, Rory A Pfund, Andrew W Meyers
Although readability has been traditionally operationalized and even become synonymous with the concept of word and sentence length, modern text analysis theory and technology have shifted toward multidimensional comprehension-based analytic techniques. In an effort to make use of these advancements and demonstrate their general utility, 6 commonly used measures of gambling disorder were submitted to readability analyses using 2 of these advanced approaches, Coh-Metrix and Question Understanding Aid (QUAID), and one traditional approach, the Flesch-Kincaid Grade Level...
June 14, 2018: Psychological Assessment
Guoxing Wan, Lihua Ji, Wenbin Xia, Lan Cheng, Yonggang Zhang
Neutrophil‑to‑lymphocyte ratio (NLR) is commonly considered a useful prognostic index for many cardiovascular diseases; however, it has limited sensitivity and specificity. Factors associated with elevated NLR may aid in the prediction of prognosis with heart failure (HF) in combination with NLR. The present study sought to identify decisive factors associated with NLR in HF patients and investigate their association with elevated NLR. The gene expression profile for blood samples from 197 individuals with chronic heart failure (CHF), with corresponding hematological parameters and clinical data were obtained from the public database, GSE77343...
June 5, 2018: Molecular Medicine Reports
Michael D Miedema, Zeina A Dardari, Sina Kianoush, Salim S Virani, Joseph Yeboah, Thomas Knickelbine, Veit Sandfort, Carlos J Rodriguez, Khurram Nasir, Michael J Blaha
BACKGROUND: The potential impact of the 2016 United States Preventive Services Task Force (USPSTF) guidelines on statins for primary prevention of atherosclerotic cardiovascular disease (ASCVD) warrants further analysis. METHODS AND RESULTS: We studied participants from MESA (Multi-Ethnic Study of Atherosclerosis) aged 40 to 75 years and not on statins. We compared statin eligibility at baseline (2000-2002) and over follow-up between USPSTF and the 2013 American College of Cardiology/American Heart Association (ACC/AHA) guidelines...
June 13, 2018: Journal of the American Heart Association
Masaya Shinohara, Tadashi Fujino, Shinntaro Yao, Kensuke Yano, Katsuya Akitsu, Hideki Koike, Toshio Kinoshita, Hitomi Yuzawa, Takeya Suzuki, Kenzaburo Kobayashi, Takanori Ikeda
BACKGROUND: Physicians estimate the frailty in elderly patients with atrial fibrillation (AF) to aid in the decision making with respect to oral anticoagulant (OAC) therapy. There are limited data on the safety of OAC therapy in non-severe frail elderly patients. We evaluated the risk factors of bleeding among non-severe frail octogenarians with AF taking OACs. METHODS: Among 430 consecutive AF patients aged 80 years and over with non-severe frailty, we enrolled 346 patients [167 men, 83...
June 10, 2018: Journal of Cardiology
F C C van Rhijn-Brouwer, H Gremmels, J O Fledderus, M C Verhaar
Administration of mesenchymal stromal cells (MSCs) is a promising strategy to treat cardiovascular disease (CVD). As progenitor cells may be negatively affected by both age and comorbidity, characterization of MSC function is important to guide decisions regarding use of allogeneic or autologous cells. Definitive answers on which factors affect MSC function can also aid in selecting which MSC donors would yield the most therapeutically efficacious MSCs. Here we provide a narrative review of MSC function in CVD based on a systematic search...
January 1, 2018: Cell Transplantation
Melanie Ward, Amy J Schulz, Barbara A Israel, Kristina Rice, Sheena E Martenies, Evan Markarian
Community-based participatory research (CBPR) approaches present strong opportunities to promote health equity by improving health within low-income communities and communities of color. CBPR principles and evaluation frameworks highlight an emphasis on equitable group dynamics (e.g., shared leadership and power, participatory decision-making, two-way open communication) that promote both equitable processes within partnerships and health equity in the communities with whom they engage. The development of an evaluation framework that describes the manner in which equitable group dynamics promote intermediate and long-term equity outcomes can aid partners in assessing their ability to work together effectively and improve health equity in the broader community...
April 30, 2018: Evaluation and Program Planning
Xian Zhu, Zhanglong Hu, LIli Fang, Jie Li, Haifeng Cheng, Daming Jiang
Hemolysis combined with renal injury is a rare but serious complication after mitral valve repair. Here, we report two representative cases of hemolysis combined with renal injury. Although timely reoperation was not possible for several reasons, different clinical outcomes were observed that could aid in future decisions.
May 17, 2018: Heart Surgery Forum
Daniel Runde, Joshua Beiner
The PECARN Pediatric Head Injury Prediction Rule is a well-validated clinical decision aid that allows clinicians to safely rule out the presence of clinically important traumatic brain injuries.
June 1, 2018: Pediatric Emergency Medicine Practice
T R Ayodele, A S O Ogunjuyigbe, O Odigie, A A Jimoh
The increasing demand for energy and the need for clean and affordable energy in Nigeria have necessitated the need for renewable energy resource assessment and subsequent determination of suitable sites within the country. One of the promising renewable energy resources with good potentials of meeting the energy requirements is wind. One of the main challenges of wind power development in Nigeria is lack of scientific data for policy formulation and decision making that will aid the development of wind power utilization...
August 2018: Data in Brief
Manon Westra, Jaap J van Netten, Hendrik A Manning, Jeff G van Baal, Sicco A Bus
BACKGROUND: Non-removable knee-high devices, such as a total contact cast (TCC), are recommended for offloading diabetic plantar forefoot ulcers. However, it is insufficiently known how each of the different design characteristics of these devices contribute to offloading the diabetic foot. RESEARCH QUESTION: What is the offloading effect of the different design characteristics that make up a non-removable knee-high cast for people with diabetes and active or previous plantar forefoot ulcers? METHODS: Sixteen persons with diabetes, peripheral neuropathy and a healed or active plantar forefoot ulcer had their plantar pressures measured during walking in a non-removable knee-high device (TCC), in that device made removable (BTCC), in that device made below-ankle (cast shoe), in that cast shoe worn with a different walking sole and in a newly made cast shoe without a custom-moulded foot-device interface...
May 22, 2018: Gait & Posture
Hua Fang, Zhaoyang Zhang
Big longitudinal data provide more reliable information for decision making and are common in all kinds of fields. Trajectory pattern recognition is in an urgent need to discover important structures for such data. Developing better and more computationally-efficient visualization tool is crucial to guide this technique. This paper proposes an enhanced projection pursuit (EPP) method to better project and visualize the structures (e.g. clusters) of big high-dimensional (HD) longitudinal data on a lower-dimensional plane...
June 2018: IEEE Transactions on Big Data
Nicole Hättenschwiler, Yanik Sterchi, Marcia Mendes, Adrian Schwaninger
Bomb attacks on civil aviation make detecting improvised explosive devices and explosive material in passenger baggage a major concern. In the last few years, explosive detection systems for cabin baggage screening (EDSCB) have become available. Although used by a number of airports, most countries have not yet implemented these systems on a wide scale. We investigated the benefits of EDSCB with two different levels of automation currently being discussed by regulators and airport operators: automation as a diagnostic aid with an on-screen alarm resolution by the airport security officer (screener) or EDSCB with an automated decision by the machine...
October 2018: Applied Ergonomics
Nikita Roman A Jegan, Sarah Anna Kürwitz, Lena Kathrin Kramer, Monika Heinzel-Gutenbrunner, Charles Christian Adarkwah, Uwe Popert, Norbert Donner-Banzhoff
BACKGROUND: This study investigated the effects of three different risk displays used in a cardiovascular risk calculator on patients' motivation for shared decision-making (SDM). We compared a newly developed time-to-event (TTE) display with two established absolute risk displays (i.e. emoticons and bar charts). The accessibility, that is, how understandable, helpful, and trustworthy patients found each display, was also investigated. METHODS: We analysed a sample of 353 patients recruited in general practices...
June 9, 2018: BMC Family Practice
José Antonio Pérez-Molina, Esteban Martínez, Antonio Javier Blasco, José Ramón Arribas, Pere Domingo, José Antonio Iribarren, Hernando Knobel, Pablo Lázaro, José López-Aldeguer, Fernando Lozano, Ana Mariño, José M Miró, Santiago Moreno, Eugenia Negredo, Federico Pulido, Rafael Rubio, Jesús Santos, Javier de la Torre, Montserrat Tuset, Miguel A von Wichmann, Josep M Gatell
BACKGROUND: The GESIDA/National AIDS Plan expert panel recommended preferred regimens (PR), alternative regimens (AR) and other regimens (OR) for antiretroviral treatment (ART) as initial therapy in HIV-infected patients for 2018. The objective of this study was to evaluate the costs and the efficiency of initiating treatment with PR and AR. METHODS: Economic assessment of costs and efficiency (cost-effectiveness) based on decision tree analyses. Effectiveness was defined as the probability of reporting a viral load <50copies/mL at week 48, in an intention-to-treat analysis...
June 5, 2018: Enfermedades Infecciosas y Microbiología Clínica
Titilayo Tatiana Agbadjé, Matthew Menear, Michèle Dugas, Marie-Pierre Gagnon, Samira Abbasgholizadeh Rahimi, Hubert Robitaille, Anik M C Giguère, François Rousseau, Brenda J Wilson, France Légaré
BACKGROUND: For pregnant women and their partners, the decision to undergo Down syndrome prenatal screening is difficult. Patient decision aids (PtDA) can help them make an informed decision. We aimed to identify behaviour change techniques (BCTs) that would be useful in an intervention to promote the use of a PtDA for Down syndrome prenatal screening, and to identify which of these BCTs pregnant women found relevant and acceptable. METHODS: Using the Behaviour Change Wheel and the Theoretical Domains Framework, we conducted a qualitative descriptive study...
June 8, 2018: BMC Health Services Research
Tracy L Luks, Tracy Richmond McKnight, Llewellyn E Jalbert, Aurelia Williams, Evan Neill, Khadjia A Lobo, Anders I Persson, Arie Perry, Joanna J Phillips, Annette M Molinaro, Susan M Chang, Sarah J Nelson
The goal of this research was to elucidate the relationship between WHO 2016 molecular classifications of newly diagnosed, nonenhancing lower grade gliomas (LrGG), tissue sample histopathology, and magnetic resonance (MR) parameters derived from diffusion, perfusion, and 1 H spectroscopic imaging from the tissue sample locations and the entire tumor. A total of 135 patients were scanned prior to initial surgery, with tumor cellularity scores obtained from 88 image-guided tissue samples. MR parameters were obtained from corresponding sample locations, and histograms of normalized MR parameters within the T2 fluid-attenuated inversion recovery lesion were analyzed in order to evaluate differences between subgroups...
June 5, 2018: Translational Oncology
Jacob K Greenberg, Yan Yan, Christopher R Carpenter, Angela Lumba-Brown, Martin S Keller, Jose Pineda, Ross C Brownson, David Limbrick
While most children with mild TBI (mTBI) without intracranial injury (ICI) can be safely discharged home from the emergency department, many are admitted to the hospital. To support evidence-based practice, we developed a decision tool to help guide hospital admission decisions. This study was a secondary analysis of a prospective study conducted in 25 emergency departments. We included children under 18 years who had Glasgow Coma Scale score 13-15 head injuries and normal CT scans or skull fractures without significant depression...
June 8, 2018: Journal of Neurotrauma
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