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"Personalized decision"

S C Bertog, P A Sobotka, M D Lobo, K Sievert, L Vaskelyte, H Sievert, Roland E Schmieder
PURPOSE OF REVIEW: Provision of a summary on the physiologic effects of arteriovenous fistula creation and description of previously published human data on the efficacy of a percutaneously implanted device creating an arteriovenous fistula. Though antihypertensive therapy is effective, some patient's blood pressure remains poorly controlled despite adherence to optimal medical therapy. Moreover, some patients are not compliant with recommended medical therapy due to side effects or personal decision...
March 19, 2018: Current Hypertension Reports
Ioannis N Mammas, Demetrios A Spandidos
According to Professor Basil T. Darras, Professor of Neurology (Pediatrics) at Harvard Medical School and Director of the Spinal Muscular Atrophy (SMA) Program at Boston Children's Hospital in Boston (MA, USA), the diagnosis of SMA type I is clinical and is based on detailed general physical and neurological examinations. SMA type I remains the most common genetic disease resulting in death in infancy and is really devastating for the child, the parents, as well as the medical professionals with the privilege of caring for patients with SMA and their parents...
April 2018: Experimental and Therapeutic Medicine
Ying Liu, Brent Logan, Ning Liu, Zhiyuan Xu, Jian Tang, Yanzhi Wang
In this paper, we propose the first deep reinforcement learning framework to estimate the optimal Dynamic Treatment Regimes from observational medical data. This framework is more flexible and adaptive for high dimensional action and state spaces than existing reinforcement learning methods to model real life complexity in heterogeneous disease progression and treatment choices, with the goal to provide doctor and patients the data-driven personalized decision recommendations. The proposed deep reinforcement learning framework contains a supervised learning step to predict the most possible expert actions; and a deep reinforcement learning step to estimate the long term value function of Dynamic Treatment Regimes...
August 2017: Healthcare Informatics: the Business Magazine for Information and Communication Systems
Jildou Hoekstra, Aafke H C van Roon, Frank C Bekkering, Antonie J P van Tilburg, Rachel L West
INTRODUCTION: The aim of this study was to evaluate information provided on pregnancy, personal decision making, disease course, and outcome of pregnancy from a patient's perspective in a population of patients with inflammatory bowel disease (IBD) attending two general hospitals. PATIENTS AND METHODS: A questionnaire was sent to all female patients with IBD in two general hospitals in the Netherlands. The questionnaire comprised four sections: (i) demographic data and medication use (ii) details on previous pregnancies and reasons for not becoming pregnant, (iii) outcome of pregnancies before IBD diagnosis, and (iv) outcome of pregnancies after IBD diagnosis...
March 14, 2018: European Journal of Gastroenterology & Hepatology
Kate Laver, Emmanuel Gnanamanickam, Craig Whitehead, Susan Kurrle, Megan Corlis, Julie Ratcliffe, Wendy Shulver, Maria Crotty
Objectives Health services worldwide are increasingly adopting consumer directed care approaches. Traditionally, consumer directed care models have been implemented in home care services and there is little guidance as to how to implement them in residential care. This study used a citizens' jury to elicit views of members of the public regarding consumer directed care in residential care. Methods A citizens' jury involving 12 members of the public was held over two days in July 2016, exploring the question: For people with dementia living in residential care facilities, how do we enable increased personal decision making to ensure that care is based on their needs and preferences? Jury members were recruited through a market research company and selected to be broadly representative of the general public...
January 1, 2018: Journal of Health Services Research & Policy
Fangying Xie, Juliana C N Chan, Ronald C W Ma
Diabetes has become a major burden of healthcare expenditure. Diabetes management following a uniform treatment algorithm is often associated with progressive treatment failure and development of diabetic complications. Recent advances in our understanding in the genomic architecture of diabetes and its complications have provided the framework for development of precision medicine to personalize diabetes prevention and management. In this review, we summarized recent advances in the understanding of the genetic basis of diabetes and its complications...
March 2, 2018: Journal of Diabetes Investigation
Jane M Kurz
PURPOSE: To explore the reproductive decision-making process with women who were organ transplant recipients (renal, lung, & heart transplants). STUDY DESIGN AND METHODS: Grounded theory guided data collection and analyses. Mixed methods with audiotaped telephone interviews and a written survey measuring social support were used. As social support is critical for women who are organ transplant recipients considering pregnancy, a search for disconfirming evidence for social support via a survey and interviews was included...
March 2018: MCN. the American Journal of Maternal Child Nursing
F J Zhang, M S Sun
With the development of excimer laser and femtosecond laser equipment, application of diversified and customized surgical decision in modern corneal refractive surgery has been an inevitable trend. However, how to make a personalized decision with an accurate surgical design to achieve better visual quality becomes the main focus in clinical applications. Small-incision lenticule extraction (SMILE) and femtosecond assisted laser in situ keratomileusis (FS-LASIK) have been commonly acknowledged as the mainstream of corneal refractive surgery for ametropia correction nowadays...
January 11, 2018: [Zhonghua Yan Ke za Zhi] Chinese Journal of Ophthalmology
Johannes G Reiter, Christian Hilbe, David G Rand, Krishnendu Chatterjee, Martin A Nowak
Direct reciprocity is a mechanism for cooperation among humans. Many of our daily interactions are repeated. We interact repeatedly with our family, friends, colleagues, members of the local and even global community. In the theory of repeated games, it is a tacit assumption that the various games that a person plays simultaneously have no effect on each other. Here we introduce a general framework that allows us to analyze "crosstalk" between a player's concurrent games. In the presence of crosstalk, the action a person experiences in one game can alter the person's decision in another...
February 7, 2018: Nature Communications
Sarah L Rowe, Krisna Patel, Rebecca S French, Claire Henderson, Dennis Ougrin, Mike Slade, Paul Moran
BACKGROUND: Adolescents who self-harm are often unsure how or where to get help. We developed a Web-based personalized decision aid (DA) designed to support young people in decision making about seeking help for their self-harm. OBJECTIVE: The aim of this study was to evaluate the feasibility and acceptability of the DA intervention and the randomized controlled trial (RCT) in a school setting. METHODS: We conducted a two-group, single blind, randomized controlled feasibility trial in a school setting...
January 30, 2018: JMIR Mental Health
Akshat Kapoor, Priya Nambisan
PURPOSE: The specific objective of this research is to design and develop a personalized Web application to support breast cancer survivors after treatment, as they deal with post-treatment challenges, such as comorbidities and side effects of treatment. METHODOLOGY: A mixed-methods approach, utilizing a combination of think-aloud analysis, personal interviews, and surveys, was adopted for user acceptance and usability testing among a group of breast cancer survivors...
January 25, 2018: Journal of Cancer Survivorship: Research and Practice
Simone Lee, Andrea Miller
The objective of this scoping review is to examine and map the evidence on the range of factors influencing a person's decision to screen or not screen for colorectal cancer using a fecal occult blood test (FOBT) in Australia, with the view to identifying gaps in the research and informing appropriate questions for future systematic reviews.The question of this review is: what evidence is available around the barriers and facilitators that influence an individual's decision to screen or not screen for colorectal cancer using a fecal occult blood test in Australia?...
January 2018: JBI Database of Systematic Reviews and Implementation Reports
Jessica Bryant, Rohith Mohan, Brian Koottappillil, Kevin Wong, Paul H Yi
STUDY DESIGN: This is a cross-sectional study. OBJECTIVE: The purpose of this study is to evaluate the content of information available on the Internet regarding minimally invasive spine surgery (MISS). SUMMARY OF BACKGROUND DATA: Patients look to the Internet for quick and accessible information on orthopedic procedures to help guide their personal decision making process regarding the care they receive. However, the quality of internet-based orthopedic education material varies significantly with respect to accuracy and readability...
January 8, 2018: Clinical Spine Surgery
Victoria Sit, Lana Stermac
Despite the extensive and often long-lasting sequelae of sexual assault, a significant majority of survivors do not seek assistance from formal support sources, such as police, medical or mental health professionals, and community-based agencies. While growing attention has been directed toward understanding the help-seeking barriers faced by sexual assault survivors, few studies have explored the experiences of survivors living in poverty and how help-seeking can be improved for this marginalized population...
November 1, 2017: Journal of Interpersonal Violence
S M Bruinsma, L Zhang, M J Roobol, C H Bangma, E W Steyerberg, D Nieboer, M Van Hemelrijck
OBJECTIVES: The Movember Foundation launched the Global Action Plan Prostate Cancer Active Surveillance (GAP3) initiative to create a global consensus on the selection and monitoring of men with low-risk prostate cancer (PCa) on active surveillance (AS). The aim of this study is to present data on inclusion and follow-up for AS in this unique global AS database. SUBJECTS/PATIENTS (OR MATERIALS) AND METHODS: Between 2014 and 2016, the database was created by combining patient data from 25 established AS cohorts worldwide (USA, Canada, Australasia, UK, Europe) (n=15,101)...
December 15, 2017: BJU International
David A Cort, Hsin Fei Tu
How are people's expression of HIV stigma beliefs connected to their own personal decisions concerning safe sexual practices? Does this relationship vary across countries and by the national context in which people reside? To answer these questions, we develop and test individual, contextual, and cross-level interactional hypotheses of the impact of instrumental HIV stigma attitudes on several measures of protective sexual behavior. Using Demographic and Health Survey data from 467,656 unpartnered individuals across 34 sub-Saharan African countries, we first find that counterintuitively, conservative HIV stigma attitudes are associated with lower likelihoods of participating in all types of protective sexual behaviors...
January 2018: Social Science & Medicine
Sarah BouDiab, Carolina Werle
This exploratory qualitative study examined the influence of injunctive and descriptive norms on breastfeeding, a health-improving behaviour related to a highly committed personal decision. The research explores the different mechanisms through which social norms impact breastfeeding behaviour pre or post-adoption of breastfeeding practice. A qualitative approach was used by performing in-depth analysis of cross-sectional accounts of women in Lebanon contemplating adoption of breastfeeding practice and women who already breastfed...
April 1, 2018: Appetite
M Leshno, U Goldbourt, I Pinchuk, D Lichtenberg
AIM: The meta-analysis was conducted to estimate of the cardiovascular benefits of indiscriminate supplementation of omega-3 capsules. The results, expressed in terms of quality adjusted life years (QALY) intuitively understood by the general public, can be the basis for the (personal) decision on whether to take omega-3 supplements. METHODS: The results of meta-analysis of eight double-blind, placebo-controlled clinical trials are expressed in terms of QALY, using the Markov model and Monte Carlo simulations...
November 24, 2017: International Journal of Food Sciences and Nutrition
Irina Danileiko, Michael D Lee
We apply the "wisdom of the crowd" idea to human category learning, using a simple approach that combines people's categorization decisions by taking the majority decision. We first show that the aggregated crowd category learning behavior found by this method performs well, learning categories more quickly than most or all individuals for 28 previously collected datasets. We then extend the approach so that it does not require people to categorize every stimulus. We do this using a model-based method that predicts the categorization behavior people would produce for new stimuli, based on their behavior with observed stimuli, and uses the majority of these predicted decisions...
November 2, 2017: Cognitive Science
Sebastian Stintzing
Colorectal carcinoma (CRC) is a major cause for cancer related death in Western countries. Particularly in the metastatic stage (mCRC) 5-year survival rate remains low at around 15 %. Treatment decisions are influenced by tumor stage, location of the primary, and extend of metastases. The multidisciplinary tumor board with an experienced hepato-biliary surgeon, an interventional radiologist, the medical oncologist, the molecular pathologist and the radiation oncologist will gain further importance in the quest for the optimal treatment for each patient...
November 2017: Deutsche Medizinische Wochenschrift
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