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"Individualized decision"

Todd J Anderson, Jean Grégoire, Glen J Pearson, Arden R Barry, Patrick Couture, Martin Dawes, Gordon A Francis, Jacques Genest, Steven Grover, Milan Gupta, Robert A Hegele, David C Lau, Lawrence A Leiter, Eva Lonn, G B John Mancini, Ruth McPherson, Daniel Ngui, Paul Poirier, John L Sievenpiper, James A Stone, George Thanassoulis, Richard Ward
Since the publication of the 2012 guidelines new literature has emerged to inform decision-making. The 2016 guidelines primary panel selected a number of clinically relevant questions and has produced updated recommendations, on the basis of important new findings. In subjects with clinical atherosclerosis, abdominal aortic aneurysm, most subjects with diabetes or chronic kidney disease, and those with low-density lipoprotein cholesterol ≥ 5 mmol/L, statin therapy is recommended. For all others, there is an emphasis on risk assessment linked to lipid determination to optimize decision-making...
July 25, 2016: Canadian Journal of Cardiology
Wei Zeng, Meiling Fang, Junming Shao, Mingsheng Shang
Recommender systems are designed to effectively support individuals' decision-making process on various web sites. It can be naturally represented by a user-object bipartite network, where a link indicates that a user has collected an object. Recently, research on the information backbone has attracted researchers' interests, which is a sub-network with fewer nodes and links but carrying most of the relevant information. With the backbone, a system can generate satisfactory recommenda- tions while saving much computing resource...
September 29, 2016: Scientific Reports
Christoph Langenstein, Diana Schork, Klaus Badenhoop, Eva Herrmann
PROBLEM: Graves' disease (GD) is an important and prevalent thyroid autoimmune disorder. Standard therapy for GD consists of antithyroid drugs (ATD) with treatment periods of around 12 months but relapse is frequent. Since predictors for relapse are difficult to identify the individual decision making for optimal treatment is often arbitrary. METHODS: After reviewing the literature on this topic we summarize important factors involved in GD and with respect to their potential for relapse prediction from markers before and after treatment...
September 16, 2016: Reviews in Endocrine & Metabolic Disorders
Hu Hei, Yongping Song, Jianwu Qin
BACKGROUND AND OBJECTIVES: Central compartment neck dissection (CCND) is recommended for patients with papillary thyroid carcinoma (PTC). However, whether to perform contralateral CCND remains unclear. An individualized estimation of the contralateral central neck metastasis (CNM) risk would assist in the tailoring of treatment for PTC patients. METHODS: Consecutive patients who underwent bilateral CCND for unilateral PTC between 2012 and 2014 in a tertiary center were identified...
September 16, 2016: Journal of Surgical Oncology
Nelmin Rios, Nina Adaskina, Cornelia Frömke, Frank Papendorf, Cordula Schippert, Armin Koch, Peter Hillemanns, Tjoung-Won Park-Simon
BACKGROUND: Despite recommendations of international societies, use of baseline staging in breast cancer varies considerably. We retrospectively analyzed the prevalence of metastases in each pTN stage to estimate the benefit of staging. PATIENTS AND METHODS: The prevalence of metastases at primary diagnosis (M1) and in the first year after diagnosis (M112) was determined in 2,906 patients. RESULTS: The prevalence of M1 was 0.95% [95% confidence interval (CI)=0...
September 2016: Anticancer Research
Savvas Papagrigoriadis
Recent guidelines on elective surgery for recurrent diverticulitis have removed generalized recommendations for elective preventive surgery and advice individualized decision per patient. We discuss the clinical evidence and potential use of risk factors to help with decision-making for patient selection for elective surgery in the presence of a history of diverticulitis.
October 2016: Journal of Clinical Gastroenterology
Perry Gardner Rigby, Ramnaryan Paragi Gururaja
In the aftermath of Hurricane Katrina 10 years ago, acute changes were recognized and reported; acute kinetic destruction and desperation. Physicians performed heroically, but after the flood and the closing of hospitals, most left at least briefly. The chronic recovery began with spirit, but was uncharted and unplanned with the recognition that individual decisions were a necessity. The documentation of physician numbers of practicing doctors, residents and fellows, from the AMA as related to geography, population, and other circumstances tells an additional story of renewal, more objectively without the hype...
July 2016: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
Ralf Brand, Wanja Wolff, Matthias Ziegler
Neuroenhancement (NE) is the non-medical use of psychoactive substances to produce a subjective enhancement in psychological functioning and experience. So far empirical investigations of individuals' motivation for NE however have been hampered by the lack of theoretical foundation. This study aimed to apply drug instrumentalization theory to user motivation for NE. We argue that NE should be defined and analyzed from a behavioral perspective rather than in terms of the characteristics of substances used for NE...
2016: Frontiers in Psychology
A Neufang, S Savvidis
BACKGROUND: The use of autologous superficial femoral veins (SFV) as an arterial or venous substitute represents a valuable technique in modern vascular surgery with versatile indications. The SFV autografts exhibit excellent control of infection and durable long-term results in terms of graft patency in prosthetic or arterial infections. In cases of elective use of the SFV, duplex ultrasound evaluation of the deep leg vein system should be implemented to confirm the patency of the profunda femoris vein...
2016: Gefässchirurgie: Zeitschrift Für Vaskuläre und Endovaskuläre Chirurgie
H Le, I Marchant, J P Boissel, P Nony, B Kassai, C Cornu, F Gueyffier
OBJECTIVE: Sudden cardiac death (SCD) is at the first rank of cardiovascular death causes in patients with type 2 diabetes (T2D). ACEIs and statins, but not antidiabetic agents were known to be effective in preventing this accident in these patients, until the EMPAREG OUTCOME trial. This study reported a significant protective effect on SCD by empagliflozin, a hypoglycemic drug inhibiting sodium-glucose cotransporter.We aimed here to estimate the public health impact of this tri-therapy in preventing SCD in a French type 2 diabetic virtual realistic population (VRP)...
September 2016: Journal of Hypertension
Beth Rachlis, Violet Naanyu, Juddy Wachira, Becky Genberg, Beatrice Koech, Regina Kamene, Jackie Akinyi, Paula Braitstein
BACKGROUND: Sub-Saharan Africa is increasingly being challenged in providing care and treatment for chronic diseases, both communicable and non-communicable. In order to address the challenges of linkage to and retention in chronic disease management, there is the need to understand the factors that can influence engagement in care. We conducted a qualitative study to identify barriers and facilitators to linkage and retention in chronic care for HIV, tuberculosis (TB) and Hypertension (HTN) as part of the Academic Model Providing Access to Healthcare (AMPATH) program in western Kenya...
2016: BMC Public Health
Mary Ann O'Brien, Miriam Tsao, Sylvie D Cornacchi, Nicole Hodgson, Susan Reid, Marko Simunovic, Som D Mukherjee, Barbara Strang, Lehana Thabane, Peter J Lovrics
BACKGROUND: Recently the impact of completion axillary lymph node dissection (cALND) after positive sentinel lymph node biopsy on significant outcomes has been questioned, leading to variation in surgical practice. To address this variation, a multidisciplinary working group created a regional guideline for cALND. We explored the views and experiences of surgeons, medical oncologists (MOs), radiation oncologists (ROs) in a qualitative study that examined guideline implementation in practice...
October 2016: Breast: Official Journal of the European Society of Mastology
Frouke A P Nijhuis, Jolien van Heek, Bastiaan R Bloem, Bart Post, Marjan J Faber
BACKGROUND: In advanced Parkinson's disease (PD), neurologists and patients face a complex decision for an advanced therapy. When choosing a treatment, the best available evidence should be combined with the professional's expertise and the patient's preferences. OBJECTIVE: The objective of this study was to explore current decision-making in advanced PD. METHODS: We conducted focus group discussions and individual interviews with patients (N = 20) who had received deep brain stimulation, Levodopa-Carbidopa intestinal gel, or subcutaneous apomorphine infusion, and with their caregivers (N = 16)...
July 25, 2016: Journal of Parkinson's Disease
Motaz Hamed, Patrick Schuss, Frederick H Daher, Valeri Borger, Ági Güresir, Hartmut Vatter, Erdem Güresir
BACKGROUND: Traumatic acute subdural hematoma (aSDH) is a severe disease. Surgical treatment is still controversially discussed, especially in patients with additional signs of cerebral herniation. However, previously investigated patient populations were heterogeneous. We therefore performed an analysis of our institutional data in a large homogenous selection of patients with traumatic aSDH to analyze factors determining clinical outcome. METHODS: Between 2010 and 2014, 196 patients with aSDH underwent surgical treatment in our department...
October 2016: World Neurosurgery
Sushma Jonna, Leslie Chiang, Jingxia Liu, Maria B Carroll, Kellie Flood, Tanya M Wildes
PURPOSE: Survival in older adults with cancer varies given differences in functional status, comorbidities, and nutrition. Prediction of factors associated with mortality, especially in hospitalized patients, allows physicians to better inform their patients about prognosis during treatment decisions. Our objective was to analyze factors associated with survival in older adults with cancer following hospitalization. METHODS: Through a retrospective cohort study, we reviewed 803 patients who were admitted to Barnes-Jewish Hospital's Oncology Acute Care of Elders (OACE) unit from 2000 to 2008...
November 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Qing Zeng-Treitler, Bryan Gibson, Brent Hill, Jorie Butler, Carrie Christensen, Douglas Redd, Yijun Shao, Bruce Bray
BACKGROUND: Shared decision-making can improve patient satisfaction and outcomes. To participate in shared decision-making, patients need information about the potential risks and benefits of treatment options. Our team has developed a novel prototype tool for shared decision-making called hearts like mine (HLM) that leverages EHR data to provide personalized information to patients regarding potential outcomes of different treatments. These potential outcomes are presented through an Icon array and/or simulated narratives for each "person" in the display...
2016: BMC Research Notes
Zhenyu Wei, Zhiying Zhao, Yong Zheng
Prosocial behaviors are susceptible to individuals' preferences regarding payoffs and social context. In the present study, we combined individual differences with social influence and attempted to discover the effect of social value orientation (SVO) and social influence on prosocial behavior in a trust game and a dictator game. Prosocial behavior in the trust game could be motivated by strategic considerations whereas individuals' decisions in the dictator game could be associated with their social preference...
2016: Frontiers in Psychology
Nathan L Liang, Louis H Alarcon, Geetha Jeyabalan, Efthymios D Avgerinos, Michel S Makaroun, Rabih A Chaer
OBJECTIVE: Lower extremity arterial injury may result in limb loss after blunt or penetrating trauma. This study examined outcomes of civilian lower extremity arterial trauma and predictors of delayed amputation. METHODS: The records of patients presenting to a major level I trauma center from 2004 to 2014 with infrainguinal arterial injury were identified from a prospective institutional trauma registry, and outcomes were reviewed. Standard statistical methods were used for data analysis...
September 2016: Journal of Vascular Surgery
Ralf H J M Kurvers, Stefan M Herzog, Ralph Hertwig, Jens Krause, Patricia A Carney, Andy Bogart, Giuseppe Argenziano, Iris Zalaudek, Max Wolf
Collective intelligence refers to the ability of groups to outperform individual decision makers when solving complex cognitive problems. Despite its potential to revolutionize decision making in a wide range of domains, including medical, economic, and political decision making, at present, little is known about the conditions underlying collective intelligence in real-world contexts. We here focus on two key areas of medical diagnostics, breast and skin cancer detection. Using a simulation study that draws on large real-world datasets, involving more than 140 doctors making more than 20,000 diagnoses, we investigate when combining the independent judgments of multiple doctors outperforms the best doctor in a group...
August 2, 2016: Proceedings of the National Academy of Sciences of the United States of America
Olav Thorsen, Miriam Hartveit, Jan Olav Johannessen, Lars Fosse, Geir Egil Eide, Jörn Schulz, Anders Bærheim
BACKGROUND: GPs' individual decisions to refer and the various ways of working when they refer are important determinants of secondary care use. The objective of this study was to explore and describe potential characteristics of GPs' referral practice by investigating their opinions about referring and their self-reported experiences of what they do when they refer. METHODS: Observational cross-sectional study using data from 128 Norwegian GPs who filled in a questionnaire with statements on how they regarded the referral process, and who were invited to collect data when they actually referred to hospital during one month...
July 18, 2016: BMC Family Practice
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