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Patient decision aid

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https://www.readbyqxmd.com/read/28329300/personalising-the-decision-for-prolonged-dual-antiplatelet-therapy-development-validation-and-potential-impact-of-prognostic-models-for-cardiovascular-events-and-bleeding-in-myocardial-infarction-survivors
#1
Laura Pasea, Sheng-Chia Chung, Mar Pujades-Rodriguez, Alireza Moayyeri, Spiros Denaxas, Keith A A Fox, Lars Wallentin, Stuart J Pocock, Adam Timmis, Amitava Banerjee, Riyaz Patel, Harry Hemingway
Aims: The aim of this study is to develop models to aid the decision to prolong dual antiplatelet therapy (DAPT) that requires balancing an individual patient's potential benefits and harms. Methods and results: Using population-based electronic health records (EHRs) (CALIBER, England, 2000-10), of patients evaluated 1 year after acute myocardial infarction (MI), we developed (n = 12 694 patients) and validated (n = 5613) prognostic models for cardiovascular (cardiovascular death, MI or stroke) events and three different bleeding endpoints...
February 27, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28327203/an-appraisal-of-analytical-tools-used-in-predicting-clinical-outcomes-following-radiation-therapy-treatment-of-men-with-prostate-cancer-a-systematic-review
#2
Elspeth Raymond, Michael E O'Callaghan, Jared Campbell, Andrew D Vincent, Kerri Beckmann, David Roder, Sue Evans, John McNeil, Jeremy Millar, John Zalcberg, Martin Borg, Kim Moretti
BACKGROUND: Prostate cancer can be treated with several different modalities, including radiation treatment. Various prognostic tools have been developed to aid decision making by providing estimates of the probability of different outcomes. Such tools have been demonstrated to have better prognostic accuracy than clinical judgment alone. METHODS: A systematic review was undertaken to identify papers relating to the prediction of clinical outcomes (biochemical failure, metastasis, survival) in patients with prostate cancer who received radiation treatment, with the particular aim of identifying whether published tools are adequately developed, validated, and provide accurate predictions...
March 21, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28327157/factors-influencing-implementation-of-a-patient-decision-aid-in-a-developing-country-an-exploratory-study
#3
Wen Ting Tong, Yew Kong Lee, Chirk Jenn Ng, Ping Yein Lee
BACKGROUND: Most studies on barriers and facilitators to implementation of patient decision aids (PDAs) are conducted in the west; hence, the findings may not be transferable to developing countries. This study aims to use a locally developed insulin PDA as an exemplar to explore the barriers and facilitators to implementing PDAs in Malaysia, an upper middle-income country in Asia. METHODS: Qualitative methodology was adopted. Nine in-depth interviews (IDIs) and three focus group discussions (FGDs) were conducted with policymakers (n = 6), medical officers (n = 13), diabetes educators (n = 5) and a nurse, who were involved in insulin initiation management at an academic primary care clinic...
March 21, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28327125/facilitating-informed-decisions-about-breast-cancer-screening-development-and-evaluation-of-a-web-based-decision-aid-for-women-in-their-40s
#4
Elena B Elkin, Valerie H Pocus, Alvin I Mushlin, Tessa Cigler, Coral L Atoria, Margaret M Polaneczky
BACKGROUND: Expert groups and national guidelines recommend individualized decision making about screening mammography for women in their 40s at low-to-average risk of breast cancer. We created Breast Screening Decisions (BSD), a personalized, web-based decision aid, to help women decide when to start and how often to have routine screening mammograms. We evaluated BSD in a large, prospective pilot trial of women and their clinicians. METHODS: Women ages 40-49 were invited to use BSD before a scheduled preventive care visit...
March 21, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28325441/a-review-of-fuzzy-cognitive-maps-in-medicine-taxonomy-methods-and-applications
#5
REVIEW
Abdollah Amirkhani, Elpiniki I Papageorgiou, Akram Mohseni, Mohammad R Mosavi
BACKGROUND AND OBJECTIVE: A high percentage of medical errors, committed because of physician's lack of experience, huge volume of data to be analyzed, and inaccessibility to medical records of previous patients, can be reduced using computer-aided techniques. Therefore, designing more efficient medical decision-support systems (MDSSs) to assist physicians in decision-making is crucially important. Through combining the properties of fuzzy logic and neural networks, fuzzy cognitive maps (FCMs) are among the latest, most efficient, and strongest artificial intelligence techniques for modeling complex systems...
April 2017: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/28325164/development-of-a-decision-making-tool-for-reporting-drivers-with-mild-dementia-and-mild-cognitive-impairment-to-transportation-administrators
#6
Duncan H Cameron, Carla Zucchero Sarracini, Linda Rozmovits, Gary Naglie, Nathan Herrmann, Frank Molnar, John Jordan, Anna Byszewski, David Tang-Wai, Jamie Dow, Christopher Frank, Blair Henry, Nicholas Pimlott, Dallas Seitz, Brenda Vrkljan, Rebecca Taylor, Mario Masellis, Mark J Rapoport
BACKGROUND: Driving in persons with dementia poses risks that must be counterbalanced with the importance of the care for autonomy and mobility. Physicians often find substantial challenges in the assessment and reporting of driving safety for persons with dementia. This paper describes a driving in dementia decision tool (DD-DT) developed to aid physicians in deciding when to report older drivers with either mild dementia or mild cognitive impairment to local transportation administrators...
March 22, 2017: International Psychogeriatrics
https://www.readbyqxmd.com/read/28323611/the-role-of-universal-health-literacy-precautions-in-minimizing-medspeak-and-promoting-shared-decision-making
#7
Lara Killian, Margo Coletti
Shared decision making (SDM), a collaborative process whereby patients and professionals make health care decisions together, is a cornerstone of ethical patient care. The patient-clinician communication necessary to achieve SDM depends on many factors, not the least of which is a shared language (sometimes with the aid of a medical interpreter). However, even when a patient and clinician are speaking the same mother tongue, the use of medical jargon can pose a large and unnecessary barrier. This article discusses how health care professionals can use "universal health literacy precautions" as a legal, practical, and ethical means to enhance SDM and improve health care outcomes...
March 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28320368/use-of-a-decision-aid-did-not-decrease-decisional-conflict-in-patients-with-carpal-tunnel-syndrome
#8
Hyun Sik Gong, Jin Woo Park, Young Ho Shin, Kahyun Kim, Kwan Jae Cho, Goo Hyun Baek
BACKGROUND: Although a model for shared decision-making is important for patient-centered care, decisional conflict can emerge when patients participate in the decision-making. A decision aid is proposed to provide information and to involve patients more comfortably in the decision-making process. We aimed to determine whether a decision aid helps patients with carpal tunnel syndrome (CTS) experience less decisional conflict regarding their decision-making for surgery. METHODS: Eighty patients with CTS were randomized into two groups...
March 21, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28320334/use-of-a-patient-decision-aid-for-prenatal-screening-for-down-syndrome-what-do-pregnant-women-say
#9
Maria Esther Leiva Portocarrero, Anik M C Giguère, Johanie Lépine, Mirjam M Garvelink, Hubert Robitaille, Agathe Delanoë, Isabelle Lévesque, Brenda J Wilson, François Rousseau, France Légaré
BACKGROUND: Patient decision aids (PtDAs) help people make difficult, values-sensitive decisions. Prenatal screening for assessing the risk of genetic conditions in the fetus is one such decision and patient decision aids are rarely used in this clinical context. We sought to identify factors influencing pregnant women's use of a patient decision aid for deciding about prenatal screening for Down syndrome (DS). METHODS: This qualitative study was embedded in a sequential mixed-methods research program whose main aim is to implement shared decision-making (SDM) in the context of prenatal screening for DS in the province of Quebec, Canada...
March 20, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28320053/management-of-colorectal-trauma-a-review
#10
REVIEW
Ju Yong Cheong, Anil Keshava
Traumatic colorectal injuries are common during times of military conflict, and major improvements in their care have arisen in such periods. Since World War II, many classification systems for colorectal trauma have been proposed, including (i) Flint Grading System; (ii) Penetrating Abdominal Trauma Index; (iii) Colonic/Rectal Injury Scale; and (iv) destructive/non-destructive colonic injuries. The primary goal of these classifications was to aid surgical management and, more particularly, to determine whether a primary repair or faecal diversion should be performed...
March 20, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28317407/using-molecular-diagnostic-testing-to-personalize-the-treatment-of-patients-with-gastrointestinal-stromal-tumors
#11
Amber E Bannon, Lillian R Klug, Christopher L Corless, Michael C Heinrich
The diagnosis and treatment of gastrointestinal stromal tumor (GIST) has emerged as a paradigm for modern cancer treatment ("precision medicine"), as it highlights the importance of matching molecular defects with specific therapies. Over the past two decades, the molecular classification and diagnostic work up of GIST has been radically transformed, accompanied by the development of molecular therapies for specific subgroups of GIST. This review summarizes the developments in the field of molecular diagnosis of GIST, particularly as they relate to optimizing medical therapy...
March 20, 2017: Expert Review of Molecular Diagnostics
https://www.readbyqxmd.com/read/28300527/the-development-of-an-evacuation-protocol-for-patients-with-ventricular-assist-devices-during-a-disaster
#12
Katherine J Davis, Joseph Suyama, Jennifer Lingler, Michael Beach
Introduction Health care providers are on the forefront of delivering care and allocating resources during a disaster; however, very few are adequately trained to respond in these situations. Furthermore, there is a void in the literature regarding the specific care needs of patients with ventricular assist devices (VADs) in a disaster setting. This project aimed to develop an evidenced-based protocol to aid health care providers during the evacuation of patients with VADs during a disaster. METHODS: This is a qualitative study that used expert review, tabletop discussion, and a survey of health care professionals to develop and evaluate an evacuation protocol...
March 16, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28297050/preoperative-computer-simulation-for-planning-of-vascular-access-surgery-in-hemodialysis-patients
#13
Niek Zonnebeld, Wouter Huberts, Magda M van Loon, Tammo Delhaas, Jan H M Tordoir
INTRODUCTION: The arteriovenous fistula (AVF) is the preferred vascular access for hemodialysis patients. Unfortunately, 20-40% of all constructed AVFs fail to mature (FTM), and are therefore not usable for hemodialysis. AVF maturation importantly depends on postoperative blood volume flow. Predicting patient-specific immediate postoperative flow could therefore support surgical planning. A computational model predicting blood volume flow is available, but the effect of blood flow predictions on the clinical endpoint of maturation (at least 500 mL/min blood volume flow, diameter of the venous cannulation segment ≥4 mm) remains undetermined...
March 6, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28295964/respiratory-virus-infection-after-allogeneic-hematopoietic-stem-cell-transplant-in-a-tropical-center-predictive-value-of-the-immunodeficiency-scoring-index
#14
Lin Wang, John Allen, Colin Diong, Yeow-Tee Goh, Sathish Gopalakrishnan, Aloysius Ho, William Hwang, Francesca Lim, Lynette Oon, Thuan-Tong Tan, Yeh-Ching Linn, Ban-Hock Tan
BACKGROUND: Respiratory virus infection (RVI) is a prevalent infection in patients after allogeneic hematopoietic stem cell transplant (allo-HSCT) and can result in significant morbidity and mortality. Ability to assess the potential severity of RVI is important in the management of such patients. METHODS: We reviewed the cases of RVI in allo-HSCT recipients and explored the predictive value of the immunodeficiency scoring index (ISI) established for respiratory syncytial virus (RSV) and its applicability for RVI caused by other respiratory viruses...
March 10, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28295915/effectiveness-of-a-decision-aid-for-patients-with-depression-a%C3%A2-randomized-controlled-trial
#15
Lilisbeth Perestelo-Perez, Amado Rivero-Santana, Juan Antonio Sanchez-Afonso, Jeanette Perez-Ramos, Carmen Luisa Castellano-Fuentes, Karen Sepucha, Pedro Serrano-Aguilar
BACKGROUND: Shared decision making is an important component of patient-centred care and decision aids are tools designed to support patients' decision making and help patients with depression to make informed choices. OBJECTIVE: The study aim was to assess the effectiveness of a web-based decision aid for patients with unipolar depression. DESIGN: Randomized controlled trial. SETTING AND PARTICIPANTS: Adults diagnosed with a major depressive disorder and recruited in primary care centres were included and randomized to the decision aid (n=68) or usual care (n=79)...
March 10, 2017: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://www.readbyqxmd.com/read/28292410/the-regulatory-perspectives-on-endoscopic-devices-for-obesity
#16
REVIEW
April K Marrone, Mark J Antonino, Joshua S Silverstein, Martha W Betz, Priya Venkataraman-Rao, Martin Golding, Diane Cordray, Jeffrey W Cooper
The recent increase in US Food and Drug Administration-approved weight-loss devices has diversified obesity treatment options. The regulatory pathways for endoscopically placed weight-loss devices and considerations for clinical trials are discussed, including the benefit-risk paradigm intended to aid in weight-loss-device trial development. Also discussed is the benefit-risk analysis of recently approved endoscopic devices. A strategic priority of the FDA Center for Devices and Radiological Health is to increase the use of patient input in decision making...
April 2017: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/28292204/a-national-survey-of-the-management-of-patients-with-incidental-meningioma-in-the-united-kingdom
#17
Mujtaba H Mohammad, Emmanuel Chavredakis, Rasheed Zakaria, Andrew Brodbelt, Michael D Jenkinson
BACKGROUND: Incidental meningiomas are increasingly being diagnosed due to widespread use of brain imaging. Treatment options include surveillance, surgery and stereotactic radiosurgery, but the natural history of these tumours is not fully understood and there are no accepted management guidelines to aid clinical decision-making. The aim of this study was to assess current practice in the United Kingdom and identify areas of variation for further study. METHODS: A questionnaire was distributed to all members of the Society of British Neurosurgeons (SBNS)...
March 15, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28291496/public-health-surveillance-via-template-management-in-electronic-health-records-tri-service-workflow-s-rapid-response-to-an-infectious-disease-crisis
#18
Holly Berkley, Matthew Barnes, David Carnahan, Janet Hayhurst, Archie Bockhorst, James Neville
OBJECTIVE: To describe the use of template-based screening for risk of infectious disease exposure of patients presenting to primary care medical facilities during the 2014 West African Ebola virus outbreak. METHODS: The Military Health System implemented an Ebola risk-screening tool in primary care settings in order to create early notifications and early responses to potentially infected persons. Three time-sensitive, evidence-based screening questions were developed and posted to Tri-Service Workflow (TSWF) AHLTA templates in conjunction with appropriate training...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28291105/escalation-of-commitment-in-the-surgical-icu
#19
Carla C Braxton, Celia N Robinson, Samir S Awad
OBJECTIVES: Escalation of commitment is a business term that describes the continued investment of resources into a project even after there is objective evidence of the project's impending failure. Escalation of commitment may be a contributor to high healthcare costs associated with critically ill patients as it has been shown that, despite almost certain futility, most ICU costs are incurred in the last week of life. Our objective was to determine if escalation of commitment occurs in healthcare settings, specifically in the surgical ICU...
April 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28290932/primary-care-of-men-who-have-sex-with-men-in-the-u-s-military-in-the-post-don-t-ask-don-t-tell-era-a-review-of-recent-progress-health-needs-and-challenges
#20
Wesley R Campbell, Mojgan Jahan, Mary F Bavaro, Robert J Carpenter
BACKGROUND: With repeal of "Don't Ask, Don't Tell" (DADT) in 2011 and the Supreme Court decision regarding Section 3 of the Defense of Marriage Act (DOMA) in 2013, military providers are now able to openly address unique health needs of lesbian, gay, and bisexual (LGB) service members and their same-sex spouse beneficiaries. These federal laws created health care barriers, either real or perceived, between providers and patients and often limited medical research involving LGB patients in the Military Health System (MHS)...
March 2017: Military Medicine
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