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Patient decision aid

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https://www.readbyqxmd.com/read/28433485/in-hospital-mortality-in-cirrhotic-patients-at-a-tertiary-care-center
#1
R Zubieta-Rodríguez, J Gómez-Correa, R Rodríguez-Amaya, K A Ariza-Mejia, N A Toloza-Cuta
INTRODUCTION: Cirrhosis of the liver is known for its high risk of mortality associated with episodes of acute decompensation. There is an even greater risk in patients that present with acute-on-chronic liver failure. The identification of patients at higher risk for adverse outcomes can aid in making the clinical decisions that will improve the prognosis for these patients. AIMS: To determine in-hospital mortality and evaluate the epidemiologic and clinical characteristics of patients with cirrhosis of the liver seen at a tertiary referral hospital...
April 19, 2017: Revista de Gastroenterología de México
https://www.readbyqxmd.com/read/28429679/mycobacterium-avium-complex-disease
#2
Charles L Daley
Despite the ubiqitous nature of Mycobacterium avium complex (MAC) organisms in the environment, relatively few of those who are infected develop disease. Thus, some degree of susceptibility due to either underlying lung disease or immunosuppression is required. The frequency of pulmonary MAC disease is increasing in many areas, and the exact reasons are unknown. Isolation of MAC from a respiratory specimen does not necessarily mean that treatment is required, as the decision to treatment requires the synthesis of clinical, radiographic, and microbiologic information as well as a weighing of the risks and benefits for the individual patient...
April 2017: Microbiology Spectrum
https://www.readbyqxmd.com/read/28421425/the-role-of-alaska-s-tribal-health-workers-in-supporting-families
#3
Miriam Chernoff, Katie Cueva
Alaska's Community Health Aides/Practitioners (CHA/Ps) are often the sole medical workers in their communities in rural Alaska, and are instrumental in providing healthcare services and education to otherwise underserved individuals. This qualitative study explored how CHA/Ps support healthy families. Six CHA/Ps from two rural communities in western Alaska were interviewed about their scope of practice, interactions with mothers, infants, families, and teens, relationship to other medical providers, and perceptions of their work...
April 18, 2017: Journal of Community Health
https://www.readbyqxmd.com/read/28421386/technology-assessment-and-cost-effectiveness-in-orthopedics-how-to-measure-outcomes-and-deliver-value-in-a-constantly-changing-healthcare-environment
#4
REVIEW
Jeremy M Burnham, Fabien Meta, Vincent Lizzio, Eric C Makhni, Kevin J Bozic
PURPOSE OF REVIEW: The purpose of this study is to review the basic concepts of healthcare value, patient outcome measurement, and cost-effectiveness analyses as they relate to the introduction of new surgical techniques and technologies in the field of orthopedic surgery. RECENT FINDINGS: An increased focus on financial stewardship in healthcare has resulted in a plethora of cost-effectiveness and patient outcome research. Recent research has made great progress in identifying orthopedic technologies that provide exceptional value and those that do not meet adequate standards for widespread adoption...
April 19, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28420596/the-behaviors-and-experiences-of-the-community-pharmacy-team-on-the-provision-of-multi-compartment-compliance-aids
#5
Derek Stewart, Craig McDonald, Joan MacLeod, Katie MacLure, Gwen Gray, Trudi McIntosh
BACKGROUND: Multi-compartment compliance aids (MCAs) are repackaging systems for solid dosage form medicines. Acknowledging the lack of evidence that MCAs improve adherence or clinical outcomes, the Royal Pharmaceutical Society has expressed concern that MCAs have 'become regarded as a panacea for medicines use'. OBJECTIVES: To determine the behaviors and experiences of the community pharmacy team around MCA provision. METHODS: A cross-sectional survey was conducted in 26 community pharmacies in the north east of Scotland...
April 9, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/28419533/a-new-approach-for-radiosynoviorthesis-a-dose-optimized-planning-method-based-on-monte-carlo-simulation-and-synovial-measurement-using-3d-slicer-and-mri
#6
Mirta Bárbara Torres Berdeguez, Sylvia Thomas, Patricia Rafful, Tiago Arruda Sanchez, Susie Medeiros Oliveira Ramos, Marta Souza Albernaz, Lidia Vasconcellos de Sá, Sergio Augusto Lopes de Souza, Felix Mas Milian, Ademir Xavier da Silva
PURPOSE: Recently, there has been a growing interest in a methodology for dose planning in radiosynoviorthesis to substitute fixed activity. Clinical practice based on fixed activity frequently does not embrace radiopharmaceutical dose optimization in patients. The aim of this paper is to propose and discuss a dose planning methodology considering the radiological findings of interest obtained by three-dimensional magnetic resonance imaging combined with Monte Carlo simulation in radiosynoviorthesis treatment applied to hemophilic arthropathy...
April 17, 2017: Medical Physics
https://www.readbyqxmd.com/read/28419488/interferon-%C3%AE-3-gene-il28b-is-associated-with-spontaneous-or-treatment-induced-viral-clearance-in-hepatitis%C3%A2-c-virus-infected-multitransfused-patients-with-thalassemia
#7
Aritra Biswas, Rushna Firdaus, Debanjali Gupta, Monika Ghosh, Kallol Saha, Prosanto Chowdhury, Maitreyee Bhattacharyya, Provash C Sadhukhan
BACKGROUND: Hepatitis C virus (HCV) is the major posttransfusion infection in multitransfused individuals in India with thalassemia major. To our knowledge, this study is the first conducted to correlate and comprehend the effects of the host interleukin (IL)28B gene polymorphism at loci rs12979860 and rs8099917 in spontaneous or interferon (IFN)-induced treatment response in the HCV-seroreactive individuals with thalassemia major. STUDY DESIGN AND METHODS: A total of 557 HCV-seroreactive individuals with thalassemia were processed for HCV viral genotyping and host IL28B single-nucleotide polymorphism analysis at loci rs12979860 and rs8099917...
April 16, 2017: Transfusion
https://www.readbyqxmd.com/read/28418342/transsexual-mastectomy-selection-of-appropriate-technique-according-to-breast-characteristics
#8
Hüsamettin Top, Serkan Balta
BACKGROUND: Subcutaneous mastectomy for female- to-male transsexuals is usually the first surgical pro- cedure in sexual reassignment. The main objective of subcutaneous mastectomy is to create an aesthetically pleasing male chest contour by removing all glandular tissue while minimizing chest wall scars. AIMS: In this paper, we present our experience with subcutaneous mastectomy performed in female-to- male transsexual patients. The authors recommend their point of view to aid in selecting the most suitable subcutaneous mastectomy technique depending on breast characteristics...
April 5, 2017: Balkan Medical Journal
https://www.readbyqxmd.com/read/28413361/cost-effectiveness-analysis-of-the-national-decentralization-policy-of-antiretroviral-treatment-programme-in-zambia
#9
Shinsuke Miyano, Gardner Syakantu, Kenichi Komada, Hiroyoshi Endo, Tomohiko Sugishita
BACKGROUND: In resource-limited settings with a high prevalence of human immunodeficiency virus (HIV) infection such as Zambia, decentralization of HIV/acquired immunodeficiency syndrome (HIV/AIDS) treatment and care with effective use of resources is a cornerstone of universal treatment and care. OBJECTIVES: This research aims to analyse the cost effectiveness of the National Mobile Antiretroviral Therapy (ART) Services Programme in Zambia as a means of decentralizing ART services...
2017: Cost Effectiveness and Resource Allocation: C/E
https://www.readbyqxmd.com/read/28412948/a-computerized-tablet-system-for-evaluating-treatment-of-essential-tremor-by-magnetic-resonance-guided-focused-ultrasound
#10
Fred Tam, Yuexi Huang, Michael L Schwartz, Tom A Schweizer, Kullervo Hynynen, Simon J Graham
BACKGROUND: Transcranial magnetic resonance guided focused ultrasound is an emerging technology under evaluation for treatment of essential tremor, a prevalent movement disorder. A qualitative evaluation is performed by a clinician periodically during the procedure to maximize treatment effects and minimize adverse effects. The present work demonstrates a magnetic resonance-compatible method to enable more precise, quantitative measurement of tremor severity. METHODS: Tremor severity was measured in 12 patients pre-, post-, and intra-operatively, using a magnetic resonance-compatible tablet and a computerized adaptation of drawing tasks from the widely-used Fahn-Tolosa-Marin Tremor Rating Scale...
April 17, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28411911/risk-assessment-in-small-renal-masses-a-review-article
#11
REVIEW
Maxine Sun, Malte Vetterlein, Lauren C Harshman, Steven L Chang, Toni K Choueiri, Quoc-Dien Trinh
The incidence of localized renal cell carcinoma (RCC) has been steadily increasing, in large part because of the increased use of imaging. Optimizing the management of localized RCC has become one of the leading priorities and foremost challenges within the urologic-oncologic community. Adequate risk stratification of patients following the diagnosis of localized RCC has become meaningful in deciding whether to treat, how to treat, and how intensively to treat. This article characterizes the existing risk assessment models that can be useful as treatment decision aids for patients with localized RCC...
May 2017: Urologic Clinics of North America
https://www.readbyqxmd.com/read/28406039/a-methodology-to-compare-insulin-dosing-recommendations-in-real-life-settings
#12
Danielle Groat, Maria A Grando, Bithika Thompson, Pedro Neto, Hiral Soni, Mary E Boyle, Marilyn Bailey, Curtiss B Cook
BACKGROUND: We propose a methodology to analyze complex real-life glucose data in insulin pump users. METHODS: Patients with type 1 diabetes (T1D) on insulin pumps were recruited from an academic endocrinology practice. Glucose data, insulin bolus (IB) amounts, and self-reported alcohol consumption and exercise events were collected for 30 days. Rules were developed to retrospectively compare IB recommendations from the insulin pump bolus calculator (IPBC) against recommendations from a proposed decision aid (PDA) and for assessing the PDA's recommendation for exercise and alcohol...
April 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28402085/decision-aids-for-people-facing-health-treatment-or-screening-decisions
#13
REVIEW
Dawn Stacey, France Légaré, Krystina Lewis, Michael J Barry, Carol L Bennett, Karen B Eden, Margaret Holmes-Rovner, Hilary Llewellyn-Thomas, Anne Lyddiatt, Richard Thomson, Lyndal Trevena
BACKGROUND: Decision aids are interventions that support patients by making their decisions explicit, providing information about options and associated benefits/harms, and helping clarify congruence between decisions and personal values. OBJECTIVES: To assess the effects of decision aids in people facing treatment or screening decisions. SEARCH METHODS: Updated search (2012 to April 2015) in CENTRAL; MEDLINE; Embase; PsycINFO; and grey literature; includes CINAHL to September 2008...
April 12, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28401821/-70-gene-signature-as-an-aid-to-treatment-decisions-in-early-stage-breast-cancer
#14
J J M van der Hoeven
OBJECTIVE: The 70-gene signature test (MammaPrint) has been shown to improve prediction of clinical outcome in women with early-stage breast cancer. We sought to provide prospective evidence of the clinical utility of the addition of the 70-gene signature to standard clinical-pathological criteria in selecting patients for adjuvant chemotherapy. METHODS: In this randomized, phase 3 study, we enrolled 6693 women with early-stage breast cancer and determined their genomic risk (using the 70-gene signature) and their clinical risk (using a modified version of Adjuvant! Online)...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28401416/supporting-shared-decision-making-for-children-s-complex-behavioral-problems-development-and-user-testing-of-an-option-grid%C3%A2-decision-aid
#15
Erin R Barnett, Elizabeth A Boucher, William B Daviss, Glyn Elwyn
There is a lack of research to guide collaborative treatment decision-making for children who have complex behavioral problems, despite the extensive use of mental health services in this population. We developed and pilot-tested a one-page Option Grid™ patient decision aid to facilitate shared decision-making for these situations. An editorial team of parents, child psychiatrists, researchers, and other stakeholders developed the scope and structure of the decision aid. Researchers included information about a carefully chosen number of psychosocial and pharmacological treatment options, using descriptions based on the best available evidence...
April 11, 2017: Community Mental Health Journal
https://www.readbyqxmd.com/read/28400354/usability-of-a-novel-mobile-health-ipad-app-by-vulnerable-populations
#16
David P Miller, Kathryn E Weaver, L Doug Case, Donald Babcock, Donna Lawler, Nancy Denizard-Thompson, Michael P Pignone, John G Spangler
BACKGROUND: Recent advances in mobile technologies have created new opportunities to reach broadly into populations that are vulnerable to health disparities. However, mobile health (mHealth) strategies could paradoxically increase health disparities, if low socioeconomic status individuals lack the technical or literacy skills needed to navigate mHealth programs. OBJECTIVE: The aim of this study was to determine whether patients from vulnerable populations could successfully navigate and complete an mHealth patient decision aid...
April 11, 2017: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/28399381/adjuvant-chemotherapy-for-stage-ii-colon-cancer-a-clinical-dilemma
#17
Joseph Kannarkatt, Joe Joseph, Peter C Kurniali, Anas Al-Janadi, Borys Hrinczenko
The decision to treat a patient with stage II colon cancer with adjuvant chemotherapy can be challenging. Although the benefit of treatment is clear in most patients with stage III disease, the decision to provide chemotherapy after surgical resection in stage II disease must be made on an individual basis. Several trials have demonstrated the small but absolute benefits of receiving adjuvant chemotherapy for stage II colon cancer for disease-free survival and overall survival. In an attempt to better understand the role of chemotherapy, several studies were performed that identified high-risk characteristics that can be used prognostically and predictively to aid in the clinical decision making process...
April 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28398836/providing-quantitative-information-and-a-nudge-to-undergo-stool-testing-in-a-colorectal-cancer-screening-decision-aid
#18
Peter H Schwartz, Susan M Perkins, Karen K Schmidt, Paul F Muriello, Sandra Althouse, Susan M Rawl
BACKGROUND: Guidelines recommend that patient decision aids should provide quantitative information about probabilities of potential outcomes, but the impact of this information is unknown. Behavioral economics suggests that patients confused by quantitative information could benefit from a "nudge" towards one option. We conducted a pilot randomized trial to estimate the effect sizes of presenting quantitative information and a nudge. METHODS: Primary care patients (n = 213) eligible for colorectal cancer screening viewed basic screening information and were randomized to view (a) quantitative information (quantitative module), (b) a nudge towards stool testing with the fecal immunochemical test (FIT) (nudge module), (c) neither a nor b, or (d) both a and b...
March 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28392995/a-computer-aided-diagnostic-system-for-kidney-disease
#19
Farzad Firouzi Jahantigh, Behnam Malmir, Behzad Aslani Avilaq
BACKGROUND: Disease diagnosis is complicated since patients may demonstrate similar symptoms but physician may diagnose different diseases. There are a few number of investigations aimed to create a fuzzy expert system, as a computer aided system for disease diagnosis. METHODS: In this research, a cross-sectional descriptive study conducted in a kidney clinic in Tehran, Iran in 2012. Medical diagnosis fuzzy rules applied, and a set of symptoms related to the set of considered diseases defined...
March 2017: Kidney Research and Clinical Practice
https://www.readbyqxmd.com/read/28385954/using-m-health-tools-to-reduce-the-misuse-of-opioid-pain-relievers
#20
Elise Omaki, Renan Castillo, Karen Eden, Steve Davis, Eileen McDonald, Umbreen Murtaza, Andrea Gielen
BACKGROUND: Emergency department (ED) patients are among the many groups at risk for prescription drug overdose. There is limited research on how best to communicate with ED patients about options for pain management and the risks of opioids. The aim of this study is to pilot test a web-based, patient-centred educational programme that encourages the patient to have an informed discussion about pain medication options with their ED provider. METHODS: This multisite, randomised trial will evaluate an m-health programme designed to aid the patient in making an informed decision about their pain treatment...
April 6, 2017: Injury Prevention: Journal of the International Society for Child and Adolescent Injury Prevention
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