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https://www.readbyqxmd.com/read/28538948/exploring-audiologists-language-and-hearing-aid-uptake-in-initial-rehabilitation-appointments
#1
Anna Sciacca, Carly Meyer, Katie Ekberg, Caitlin Barr, Louise Hickson
Purpose: The study aimed (a) to profile audiologists' language during the diagnosis and management planning phase of hearing assessment appointments and (b) to explore associations between audiologists' language and patients' decisions to obtain hearing aids. Method: Sixty-two audiologist-patient dyads participated. Patient participants were aged 55 years or older. Hearing assessment appointments were audiovisually recorded and transcribed for analysis. Audiologists' language was profiled using two measures: general language complexity and use of jargon...
May 23, 2017: American Journal of Audiology
https://www.readbyqxmd.com/read/28532698/validation-of-the-mayo-clinic-staging-system-in-determining-prognoses-of-patients-with-perihilar-cholangiocarcinoma
#2
Robert J S Coelen, Marcia P Gaspersz, Tim A Labeur, Jeroen L A van Vugt, Susan van Dieren, François E J A Willemssen, Chung Y Nio, Jan N M IJzermans, Heinz-Josef Klümpen, Bas Groot Koerkamp, Thomas M van Gulik
BACKGROUND AND AIMS: Most systems for staging perihilar cholangiocarcinoma (PHC) have been developed for the minority of patients with resectable disease. The recently developed Mayo Clinic system for staging PHC requires only clinical and radiological variables, but has not yet been validated. We performed a retrospective study to validate the Mayo Clinic staging system. METHODS: We identified consecutive patients with suspected PHC evaluated and treated at 2 tertiary centers in The Netherlands, from January 2002 through December 2014...
May 19, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28532629/shared-decision-making-in-the-uk-moving-towards-wider-uptake
#3
Angela Coulter, Adrian Edwards, Vikki Entwistle, Graham Kramer, Alan Nye, Richard Thomson, Emma Walker
Shared decision making (SDM) is firmly on the policy agenda in the UK and a recent legal ruling has confirmed its importance. Policymakers, ethicists, professional regulators and societies, patient organisations and now the courts are committed to ensuring that SDM becomes the norm throughout the NHS, but an unfavourable economic climate makes this especially challenging. Considerable progress has been made over the last few years, with new learning from demonstration sites, various initiatives in capacity building and training, wider availability of patient decision aids, and important leadership initiatives...
May 20, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28532628/milestones-barriers-and-beacons-shared-decision-making-in-canada-inches-ahead
#4
France Légaré, Dawn Stacey, Pierre-Gerlier Forest, Marie-France Coutu, Patrick Archambault, Laura Boland, Holly O Witteman, Annie LeBlanc, Krystina B Lewis, Anik M C Giguere
Canada's approach to shared decision making (SDM) remains as disparate as its healthcare system; a conglomerate of 14 public plans - ten provincial, three territorial and one federal. The healthcare research funding environment has been largely positive for SDM because there was funding for knowledge translation research which also encompassed SDM. The funding climate currently places new emphasis on patient involvement in research and on patient empowerment in healthcare. SDM fields have expanded from primary care to elder care, paediatrics, emergency and critical care medicine, cardiology, nutrition, occupational therapy and workplace rehabilitation...
May 19, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28532596/costs-and-cost-efficacy-analysis-of-the-2017-gesida-spanish-national-aids-plan-recommended-guidelines-for-initial-antiretroviral-therapy-in-hiv-infected-adults
#5
Antonio Rivero, José Antonio Pérez-Molina, Antonio Javier Blasco, José Ramón Arribas, Víctor Asensi, Manuel Crespo, Pere Domingo, José Antonio Iribarren, Pablo Lázaro, José López-Aldeguer, Fernando Lozano, Esteban Martínez, Santiago Moreno, Rosario Palacios, Juan Antonio Pineda, Federico Pulido, Rafael Rubio, Jesús Santos, Javier de la Torre, Montserrat Tuset, Josep M Gatell
INTRODUCTION: GESIDA and the Spanish National AIDS Plan panel of experts have recommended preferred (PR), alternative (AR) and other regimens (OR) for antiretroviral therapy (ART) as initial therapy in HIV-infected patients for 2017. 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-efficacy) based on decision tree analyses. Efficacy was defined as the probability of reporting a viral load <50copies/mL at week 48, in an intention-to-treat analysis...
May 19, 2017: Enfermedades Infecciosas y Microbiología Clínica
https://www.readbyqxmd.com/read/28532503/an-updated-predict-breast-cancer-prognostication-and-treatment-benefit-prediction-model-with-independent-validation
#6
Francisco J Candido Dos Reis, Gordon C Wishart, Ed M Dicks, David Greenberg, Jem Rashbass, Marjanka K Schmidt, Alexandra J van den Broek, Ian O Ellis, Andrew Green, Emad Rakha, Tom Maishman, Diana M Eccles, Paul D P Pharoah
BACKGROUND: PREDICT is a breast cancer prognostic and treatment benefit model implemented online. The overall fit of the model has been good in multiple independent case series, but PREDICT has been shown to underestimate breast cancer specific mortality in women diagnosed under the age of 40. Another limitation is the use of discrete categories for tumour size and node status resulting in 'step' changes in risk estimates on moving between categories. We have refitted the PREDICT prognostic model using the original cohort of cases from East Anglia with updated survival time in order to take into account age at diagnosis and to smooth out the survival function for tumour size and node status...
May 22, 2017: Breast Cancer Research: BCR
https://www.readbyqxmd.com/read/28532459/mechanical-ventilation-in-idiopathic-pulmonary-fibrosis-a-nationwide-analysis-of-ventilator-use-outcomes-and-resource-burden
#7
Joshua J Mooney, Karina Raimundo, Eunice Chang, Michael S Broder
BACKGROUND: Idiopathic pulmonary fibrosis (IPF) is associated with increased risk of respiratory-related hospitalizations. Studies suggest mechanical ventilation (MV) use in IPF does not improve outcomes and guidelines recommend against its general use. Our objective was to investigate MV use and association with cost and mortality in IPF. METHODS: This retrospective study, using a nationwide sample, included claims with IPF (ICD-9-CM: 516.3) in 2009-2011 and principal respiratory disease diagnosis (ICD-9-CM: 460-519); excluding lung transplant...
May 22, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28532194/cost-effectiveness-of-ceftolozane-tazobactam-plus-metronidazole-compared-with-piperacillin-tazobactam-as-empiric-therapy-for-the-treatment-of-complicated-intra-abdominal-infections-based-on-the-in-vitro-surveillance-of-bacterial-isolates-in-the-uk
#8
Vimalanand Prabhu, Jason Foo, Harblas Ahir, Eric Sarpong, Sanjay Merchant
AIMS: An increase in the prevalence of antimicrobial resistance among gram-negative pathogens has been noted recently.[1] A challenge in empiric treatment of complicated intra-abdominal infection (cIAI) is identifying initial appropriate antibiotic therapy, which is associated with reduced length of stay and mortality compared with inappropriate therapy. The objective of this study was to assess the cost-effectiveness of ceftolozane/tazobactam+metronidazole compared with piperacillin/tazobactam (commonly used in this indication) in the treatment of patients with cIAI in United Kingdom (UK) hospitals...
May 22, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28531306/association-of-long-term-opioid-therapy-with-functional-status-adverse-outcomes-and-mortality-among-patients-with-polyneuropathy
#9
E Matthew Hoffman, James C Watson, Jennifer St Sauver, Nathan P Staff, Christopher J Klein
Importance: Polyneuropathy is one of the most common painful conditions managed within general and specialty clinics. Neuropathic pain frequently leads to decisions about using long-term opioid therapy. Understanding the association of long-term opioid use with functional status, adverse outcomes, and mortality among patients with polyneuropathy could influence disease-specific decisions about opioid treatment. Objectives: To quantify the prevalence of long-term opioid use among patients with polyneuropathy and to assess the association of long-term opioid use with functional status, adverse outcomes, and mortality...
May 22, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28529124/shared-decision-making-in-spain-supportive-policies-and-research-initiatives-trends-and-directions-for-future
#10
Lilisbeth Perestelo-Perez, Amado Rivero-Santana, Yolanda Alvarez-Perez, Pablo Alonso-Coello, Carola Orrego, Pedro Serrano-Aguilar
Patients' rights to autonomy, information and participation in their own health care are recognized in the Spanish legal system from the early 2000's. Public institutions have progressively launched several initiatives to promote and improve patients' empowerment and self-care. However, the concept of Shared Decision Making (SDM), although embedded in the more general concept of "active/empowered patient", usually has not been specifically advocated as an essential requisite for improving the quality of health services, either in the legal normative or the existing educational proposals...
May 18, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28529123/implementing-shared-decision-making-in-denmark-first-steps-and-future-focus-areas
#11
Karina Dahl Steffensen, Vibe Hjelholt Baker, Mette Marianne Vinter
What about the political climate? Although there is no explicit description of patient involvement in Danish legislation, patient-centred care is on the political agenda in Denmark. It is integrated as one of eight new national indicators of quality in health care, as well as in the most recent national plan for cancer treatment. What about tools for patient decision support? Development of evidence-based patient decision aids (PDAs) are still at an early stage in Denmark, but recent national and private funding has helped push the field forward...
May 18, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28529122/shared-decision-making-a-buzz-word-in-the-netherlands-the-pace-quickens-towards-nationwide-implementation%C3%A2
#12
Trudy van der Weijden, Heleen Post, Paul L P Brand, Haske van Veenendaal, Ton Drenthen, Linda Aj van Mierlo, Peep Stalmeier, Olga C Damman, Anne Stiggelbout
Currently, shared decision making (SDM) is on the agenda among target patient representative groups, policy makers and professional bodies. Although the International Conference for Shared Decision Making (ISDM) 2011 generated a positive boost, hesitation was also felt among Dutch clinicians, who are challenged by many new tasks. No hesitation is seen among the majority of patients, opting mostly for the SDM model. We haven't reached these patients' needs fully yet, given disappointing research data on patients' experiences and professional behaviour...
May 18, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28527637/the-state-of-shared-decision-making-in-malaysia
#13
Yew Kong Lee, Chirk Jenn Ng
Shared decision making (SDM) activities in Malaysia began around 2010. Although the concept is not widespread, there are opportunities to implement SDM in both the public and private healthcare sectors. Malaysia has a multicultural society and cultural components (such as language differences, medical paternalism, strong family involvement, religious beliefs and complementary medicine) influence medical decision making. In terms of policy, the Ministry of Health has increasingly mentioned patient-centered care as a component of healthcare delivery while the Malaysian Medical Council's guidelines on doctors' duties mentioned collaborative partnerships as a goal of doctor-patient relationships...
May 17, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28527635/shared-decision-making-in-preventive-care-in-switzerland-from-theory-to-action
#14
Kevin Selby, Reto Auer, Jacques Cornuz
Switzerland with its decentralized, liberal health system and its tradition of direct democracy may be an ideal place for shared decision making (SDM) to take root organically, rather than using top-down regulations seen in other countries. There are now multiple directives and programmes in place to encourage SDM, with the creation of several decision aids and specific training programs in the five Swiss medical schools. There has been an emphasis on preventive care, with the integration of patient preference into an organized colorectal cancer screening program, clear recommendations for prostate cancer screening, and inroads into the primary prevention of cardiovascular disease...
May 17, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28526667/patient-centered-decision-support-formative-usability-evaluation-of-integrated-clinical-decision-support-with-a-patient-decision-aid-for-minor-head-injury-in-the-emergency-department
#15
Edward R Melnick, Erik P Hess, George Guo, Maggie Breslin, Kevin Lopez, Anthony J Pavlo, Fuad Abujarad, Seth M Powsner, Lori A Post
BACKGROUND: The Canadian Computed Tomography (CT) Head Rule, a clinical decision rule designed to safely reduce imaging in minor head injury, has been rigorously validated and implemented, and yet expected decreases in CT were unsuccessful. Recent work has identified empathic care as a key component in decreasing CT overuse. Health information technology can hinder the clinician-patient relationship. Patient-centered decision tools to support the clinician-patient relationship are needed to promote evidence-based decisions...
May 19, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28526230/shared-decision-making-in-taiwan
#16
Hsun-Hsiang Liao, Huey-Wen Liang, Hou-Chaung Chen, Ching-I Chang, Pa-Chun Wang, Chung-Liang Shih
The paper aims to introduce the current status of shared decision making (SDM) in Taiwan under its mixed health care system and single-payer health insurance system. With experiences in promoting both evidence based medicine and patient safety, the Joint Commission of Taiwan has implemented a nationwide SDM program under the aegis of the Ministry of Health and Welfare since 2016, incorporating multiple approaches such as developing patient decision aids (PDAs), executing the Medical Decision Aids Campaign, establishing a SDM platform, and integrating SDM in clinical practice...
May 17, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28526191/aiding-risk-information-learning-through-simulated-experience-arise-using-simulated-outcomes-to-improve-understanding-of-conditional-probabilities-in-prenatal-down-syndrome-screening
#17
Pete Wegier, Victoria A Shaffer
OBJECTIVE: To determine whether the use of simulated experiences to communicate statistical information can improve an individual's understanding of conditional probabilities-specifically the positive predictive value (PPV) of prenatal screening tests for Down syndrome. METHODS: In Experiment 1 (N=64) and Experiment 2 (N=180) participants were asked to estimate the PPV of a prenatal screening test for Down syndrome based on either (1) explicit statistics regarding the prevalence of Down syndrome and the sensitivity and specificity of a prenatal screening test for Down syndrome, or (2) experiencing up to 5000 simulated test results over a short time...
April 26, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/28525723/effectiveness-of-a-decision-aid-in-potentially-vulnerable-patients-a-secondary-analysis-of-the-chest-pain-choice-multicenter-randomized-trial
#18
Kristin L Rising, 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, Victor M Montori, Erik P Hess
BACKGROUND: We test the hypotheses that use of the Chest Pain Choice (CPC) decision aid (DA) would be similarly effective in potentially vulnerable subgroups but increase knowledge more in patients with higher education and trust in physicians more in patients from racial minority groups. METHODS: This was a secondary analysis of a multicenter randomized trial in adults with chest pain potentially due to acute coronary syndrome. The trial compared an intervention group engaged in shared decision making (SDM) using CPC to a control group receiving usual care (UC)...
May 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28523960/the-health-literacy-dyad-the-contribution-of-future-gps-in-england
#19
Oana R Groene, Jane Wills, Nicola Crichton, Gill Rowlands, Rima R Rudd
BACKGROUND: Health literacy studies have primarily focused on the cognitive and social skills of individuals needed to gain access to, understand, and use health information. This area of study is undergoing a paradigm shift with increased attention being paid to the skills of practitioners and an examination of their contribution to the link between literacy and health outcomes. The aim of this study was to describe the health literacy related competencies of General Practice (GP) trainees who will soon be responsible for the clinical encounter...
May 19, 2017: Education for Primary Care
https://www.readbyqxmd.com/read/28521441/the-context-of-prostate-cancer-genomics-in-personalized-medicine
#20
Yanling Liu
Prostate cancer is one of the most common types of cancer in males. Heterogeneous genomic aberrations may lead to prostate cancer onset, progression and metastasis. This heterogeneity also contributes to the variety in cancer risk and outcomes, different drug responses and progression, observed between individual patients. Classical prognostic factors, including prostate-specific antigen, Gleason Score and clinical tumor staging, are not sufficient to portray the complexity of a clinically relevant cancer diagnosis, risk prognosis, treatment choice and therapy monitoring...
May 2017: Oncology Letters
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