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Patient decision aid

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https://www.readbyqxmd.com/read/27933181/what-are-the-pros-and-cons-of-electronically-monitoring-inhaler-use-in-asthma-a-multistakeholder-perspective
#1
Sam Howard, Alexandra Lang, Sarah Sharples, Dominick Shaw
INTRODUCTION: Electronic monitoring devices (EMDs) are the optimal method for collecting objective data on inhaler use in asthma. Recent research has investigated the attitudes of patients with asthma towards these devices. However, no research to date has formally considered the opinions of stakeholders and decision-makers in asthma care. These individuals have important clinical requirements that need to be taken into account if EMDs are to be successfully provisioned, making collecting their opinions on the key barriers facing these devices a valuable process...
2016: BMJ Open Respiratory Research
https://www.readbyqxmd.com/read/27928439/coping-behavior-and-risk-and-resilience-stress-factors-in-french-regional-emergency-medicine-unit-workers-a-cross-sectional-survey
#2
Lala Ai, Sturzu Lm, Picard Jp, Druot F, Grama F, Bobirnac G
The Emergency Department (ED) has the highest workload in a hospital, offering care to patients in their most acute state of illness, as well as comforting their families and tending to stressful situations of the physical and psychological areal. Method. A cross-sectional survey of 366 Emergency Unit staff members including medical doctors, medical residents, medical nurses and ward aids, was undergone. Study participants came from four periphery hospitals in the Moselle Department of Eastern France with similar workforce and daily patient loads statistics...
October 2016: Journal of Medicine and Life
https://www.readbyqxmd.com/read/27927491/age-at-initiation-and-deformity-magnitude-influence-complication-rates-of-surgical-treatment-with-traditional-growing-rods-in-early-onset-scoliosis
#3
Vidyadhar V Upasani, Kevin C Parvaresh, Jeff B Pawelek, Patricia E Miller, George H Thompson, David L Skaggs, John B Emans, Michael P Glotzbecker
STUDY DESIGN: Multi-center retrospective review. OBJECTIVE: The purpose of this study was to identify preoperative variables associated with postoperative complications in early-onset scoliosis (EOS) patients treated with traditional growing rods (TGR); and to develop a model to predict the incidence of postoperative complications based on preoperative variables. SUMMARY OF BACKGROUND DATA: TGRs are commonly used to treat progressive EOS. Prior research has demonstrated a high rate of postoperative complications using this technique; however, few studies have identified preoperative factors that contribute to such complications...
September 2016: Spine Deformity
https://www.readbyqxmd.com/read/27927162/use-of-low-density-lipoprotein-particle-number-levels-as-an-aid-in-statin-treatment-decisions-for-intermediate-risk-patients-a-cost-effectiveness-analysis
#4
Dov Shiffman, Andre R Arellano, Michael P Caulfield, Judy Z Louie, Lance A Bare, James J Devlin, Olle Melander
BACKGROUND: The 2013 ACC/AHA guideline recommended either no statin therapy or moderate-intensity statin therapy (MST) for intermediate risk patients-those with 5-7.5% 10-year risk and without cardiovascular disease (CVD), hypercholesterolemia or diabetes. The guideline further suggested that the therapy choice be based on patient-clinician discussions of risks and benefits. Since low-density lipoprotein particle (LDL-P) levels were reported to be associated with CVD independently of traditional risk factors in intermediate and low risk patients, we investigated the cost-effectiveness of using LDL-P levels to identify intermediate risk patients likely to benefit from initiating or intensifying statin therapy...
December 7, 2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27923674/impact-of-a-decision-aid-on-newly-diagnosed-prostate-cancer-patients-understanding-of-the-rationale-for-active-surveillance
#5
Margaret K Formica, Shaun Wason, John D Seigne, Telisa M Stewart
OBJECTIVE: To compare newly diagnosed localized prostate cancer patients who did and did not view a decision aid (DA) on their knowledge of the rationale for active surveillance (AS). METHODS: A cross-sectional study was conducted among 452 newly diagnosed low-risk localized prostate cancer patients. Patients were mailed the video/DVD DA and completed a web-based questionnaire that contained two multiple choice questions assessing knowledge of the rationale for AS...
November 22, 2016: Patient Education and Counseling
https://www.readbyqxmd.com/read/27922845/continued-under-recognition-of-acute-respiratory-distress-syndrome-after-the-berlin-definition-what-is-the-solution
#6
John G Laffey, Tài Pham, Giacomo Bellani
PURPOSE OF REVIEW: Timely recognition of acute respiratory distress syndrome (ARDS) may allow for more prompt management and less exacerbation of lung injury. However, the absence of a diagnostic test for ARDS means that the diagnosis of ARDS requires clinician recognition in what is usually a complicated and evolving illness. We review data concerning the extent of recognition of ARDS in the era of the Berlin definition of ARDS. RECENT FINDINGS: ARDS continues to be under-recognized - even in the era of the more recent 'Berlin' definition, and significant delay in its recognition is common...
December 5, 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27919865/shared-decision-making-in-patients-with-low-risk-chest-pain-prospective-randomized-pragmatic-trial
#7
Erik P Hess, Judd E Hollander, Jason T Schaffer, Jeffrey A Kline, Carlos A Torres, Deborah B Diercks, Russell Jones, Kelly P Owen, Zachary F Meisel, Michel Demers, Annie Leblanc, Nilay D Shah, Jonathan Inselman, Jeph Herrin, Ana Castaneda-Guarderas, Victor M Montori
OBJECTIVE:  To compare the effectiveness of shared decision making with usual care in choice of admission for observation and further cardiac testing or for referral for outpatient evaluation in patients with possible acute coronary syndrome. DESIGN:  Multicenter pragmatic parallel randomized controlled trial. SETTING:  Six emergency departments in the United States. PARTICIPANTS:  898 adults (aged >17 years) with a primary complaint of chest pain who were being considered for admission to an observation unit for cardiac testing (451 were allocated to the decision aid and 447 to usual care), and 361 emergency clinicians (emergency physicians, nurse practitioners, and physician assistants) caring for patients with chest pain...
December 5, 2016: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/27918253/placental-growth-factor-alone-or-in-combination-with-soluble-fms-like-tyrosine-kinase-1-as-an-aid-to-the-assessment-of-women-with-suspected-pre-eclampsia-systematic-review-and-economic-analysis
#8
Geoff K Frampton, Jeremy Jones, Micah Rose, Liz Payne
BACKGROUND: Pre-eclampsia (PE) prediction based on blood pressure, presence of protein in the urine, symptoms and laboratory test abnormalities can result in false-positive diagnoses. This may lead to unnecessary antenatal admissions and preterm delivery. Blood tests that measure placental growth factor (PlGF) or the ratio of soluble fms-like tyrosine kinase 1 (sFlt-1) to PlGF could aid prediction of PE if either were added to routine clinical assessment or used as a replacement for proteinuria testing...
November 2016: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/27915463/the-our-hope-approach-for-ethics-and-communication-about-neonatal-neurological-injury
#9
REVIEW
Eric Racine, Emily Bell, Barbara Farlow, Steven Miller, Antoine Payot, Lisa Anne Rasmussen, Michael I Shevell, Donna Thomson, Pia Wintermark
Predicting neurological outcomes of neonates with acute brain injury is an essential component of shared decision-making, in order to guide the development of treatment goals and appropriate care plans. It can aid parents in imagining the child's future, and guide timely and ongoing treatment decisions, including shifting treatment goals and focusing on comfort care. However, numerous challenges have been reported with respect to evidence-based practices for prognostication such as biases about prognosis among clinicians...
December 4, 2016: Developmental Medicine and Child Neurology
https://www.readbyqxmd.com/read/27913528/mutations-in-mpns-prognostic-implications-window-to-biology-and-impact-on-treatment-decisions
#10
Jamile M Shammo, Brady L Stein
The last decade has witnessed tremendous scientific advances, ushered in by the JAK2 V617F discovery, contributing to enhanced diagnostic capability and understanding of the biology of myeloproliferative neoplasms (MPNs). Discovery of the calreticulin mutations filled a diagnostic gap; more recent work sheds light on its contribution to disease pathogenesis, and prognosis. Recent studies have also identified novel JAK2 and MPL mutations in patients with essential thrombocythemia and myelofibrosis (MF). Especially in MF, the driver mutational profile has prognostic implications, with additive contributions from the acquisition of additional somatic mutations...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27913500/fitness-in-the-elderly-how-to-make-decisions-regarding-acute-myeloid-leukemia-induction
#11
Arati V Rao
Acute myeloid leukemia (AML) is a disease of the elderly, but less than half of these patients are offered therapy despite the evidence of better survival with treatment in this patient population. Assessing fit, vulnerable, and frail older adults with AML remains a challenge for the treating oncologist. A majority of AML patients are elderly and often have significant comorbidities, lack of social support, and older caregivers. Performance status (PS), a subjective measure of how a patient will tolerate cancer chemotherapy, has been strongly correlated with mortality in older AML patients...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27912043/palliative-care-interventions-for-patients-with-heart-failure-a-systematic-review-and-meta-analysis
#12
Michelle S Diop, James L Rudolph, Kristin M Zimmerman, Mary A Richter, L Michal Skarf
OBJECTIVE: To systematically characterize interventions and effectiveness of palliative care for advanced heart failure (HF) patients. BACKGROUND: Patients with advanced heart failure experience a high burden of distressing symptoms and diminished quality of life. Palliative care expertise with symptom management and healthcare decision-making benefits HF patients. METHODS: A systematic PubMed search was conducted from inception to June 2016 for studies of palliative care interventions for HF patients...
December 2, 2016: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27908167/computer-aided-prognosis-for-cell-death-categorization-and-prediction-in-vivo-using-quantitative-ultrasound-and-machine-learning-techniques
#13
M J Gangeh, A Hashim, A Giles, L Sannachi, G J Czarnota
PURPOSE: At present, a one-size-fits-all approach is typically used for cancer therapy in patients. This is mainly because there is no current imaging-based clinical standard for the early assessment and monitoring of cancer treatment response. Here, the authors have developed, for the first time, a complete computer-aided-prognosis (CAP) system based on multiparametric quantitative ultrasound (QUS) spectroscopy methods in association with texture descriptors and advanced machine learning techniques...
December 2016: Medical Physics
https://www.readbyqxmd.com/read/27907968/palliative-care-practice-in-neurocritical-care
#14
Andrea K Knies, David Y Hwang
Many neurocritically ill patients and their families have high amounts of palliative care needs. Multiple professional societies relevant to neurocritical care have released consensus statements on meeting palliative care needs in neuroscience intensive care units. In this review, the authors discuss the ongoing debate regarding what model of palliative care delivery is optimal, focus on the process of shared decision making during goals-of-care discussions, and briefly comment on transitions from intensive care to comfort care...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27905172/recommendations-for-pathologic-staging-ptnm-of-cancer-of-the-esophagus-and-esophagogastric-junction-for-the-8th-edition-ajcc-uicc-staging-manuals
#15
T W Rice, H Ishwaran, W L Hofstetter, D P Kelsen, C Apperson-Hansen, E H Blackstone
We report analytic and consensus processes that produced recommendations for pathologic stage groups (pTNM) of esophageal and esophagogastric junction cancer for the AJCC/UICC cancer staging manuals, 8th edition. The Worldwide Esophageal Cancer Collaboration provided data for 22,654 patients with epithelial esophageal cancers; 13,300 without preoperative therapy had pathologic assessment after esophagectomy or endoscopic treatment. Risk-adjusted survival for each patient was developed using random survival forest analysis to identify data-driven pathologic stage groups wherein survival decreased monotonically with increasing group, was distinctive between groups, and homogeneous within groups...
November 2016: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/27903462/radiomic-based-pathological-response-prediction-from-primary-tumors-and-lymph-nodes-in-nsclc
#16
Thibaud P Coroller, Vishesh Agrawal, Elizabeth Huynh, Vivek Narayan, Stephanie W Lee, Raymond H Mak, Hugo J W L Aerts
INTRODUCTION: Non-invasive biomarkers that capture the total tumor burden could provide important complementary information for precision medicine to aid clinical decision-making. We investigated the value of radiomic data, extracted from pre-treatment computed tomography (CT) images of the primary tumor and lymph nodes, in predicting pathological response following neoadjuvant chemoradiation prior to surgery. METHODS: Eighty-five patients with resectable locally-advanced (stage II-III) non-small cell lung cancer (NSCLC) (median age: 60...
November 26, 2016: Journal of Thoracic Oncology
https://www.readbyqxmd.com/read/27900206/esmo-magnitude-of-clinical-benefit-scale-v-1-0-questions-and-answers
#17
REVIEW
N I Cherny, R Sullivan, U Dafni, J M Kerst, A Sobrero, C Zielinski, M J Piccart, J Bogaerts, J Tabernero, N J Latino, E G E de Vries
The ESMO Magnitude of Clinical Benefit Scale (ESMO-MCBS) is a standardised, generic, validated tool to stratify the magnitude of clinical benefit that can be anticipated from anticancer therapies. The ESMO-MCBS is intended to both assist oncologists in explaining the likely benefits of a particular treatment to their patients as well as to aid public health decision makers' prioritise therapies for reimbursement. From its inception the ESMO-MCBS Working Group has invited questions and critiques to promote understanding and to address misunderstandings regarding the nuanced use of the scale, and to identify shortcomings in the scale to be addressed in future planned revisions and updates...
2016: ESMO Open
https://www.readbyqxmd.com/read/27899745/exploring-provider-reactions-to-decision-aid-distribution-and-shared-decision-making-lessons-from-two-specialties
#18
Clarissa Hsu, David T Liss, Dominick L Frosch, Emily O Westbrook, David Arterburn
BACKGROUND: A critical component of shared decision making (SDM) is the role played by health care providers in distributing decision aids (DAs) and initiating SDM conversations. Existing literature indicates that decisions about designing and implementing DAs must take provider perspectives into account. However, little is known about how differences in provider attitudes across specialties may impact DA implementation and how provider attitudes may shift after DA implementation. Group Health's Decision Aid Implementation project was carried out in six specialties using 12 video-based DAs for preference-sensitive conditions; this study focused on two of the six specialties...
January 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/27899103/time-to-event-versus-ten-year-absolute-risk-in-cardiovascular-risk-prevention-does-it-make-a-difference-results-from-the-optimizing-risk-communication-optrisk-randomized-controlled-trial
#19
Charles Christian Adarkwah, Nikita Jegan, Monika Heinzel-Gutenbrunner, Felicitas Kühne, Uwe Siebert, Uwe Popert, Norbert Donner-Banzhoff, Sarah Kürwitz
BACKGROUND: The concept of shared-decision-making is a well-established approach to increase the participation of patients in medical decisions. Using lifetime risk or time-to-event (TTE) formats has been increasingly suggested as they might have advantages, e.g. in younger patients, to better show consequences of unhealthy behaviour. In this study, the most-popular ten-year risk illustration in the decision-aid-software arriba(TM) (emoticons), is compared within a randomised trial to a new-developed TTE illustration, which is based on a Markov model...
November 29, 2016: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/27896294/a-qualitative-assessment-of-return-to-sport-after-hip-arthroscopy-for-femoroacetabular-impingement
#20
Vehniah K Tjong, Charles J Cogan, Brett D Riederman, Michael A Terry
BACKGROUND: Hip arthroscopy for femoroacetabular impingement (FAI) is known to produce excellent outcomes, yet some patients do not return to their preinjury level of sport participation. Much literature on return to sport has revolved around anterior cruciate ligament reconstruction and even shoulder instability, but none to date have used qualitative, semistructured patient interviews on patients with hip labral tears. PURPOSE: To understand the factors influencing the decision to return to sport after arthroscopic hip surgery for FAI...
November 2016: Orthopaedic Journal of Sports Medicine
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