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Patient decision aid

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https://www.readbyqxmd.com/read/28918408/effectiveness-cost-utility-and-implementation-of-a-decision-aid-for-patients-with-localised-prostate-cancer-and-their-partners-study-protocol-of-a-stepped-wedge-cluster-randomised-controlled-trial
#1
Hoda H M Al-Itejawi, Cornelia F van Uden-Kraan, Peter M van de Ven, Veerle M H Coupé, André N Vis, Jakko A Nieuwenhuijzen, Jeroen A van Moorselaar, Irma M Verdonck-de Leeuw
INTRODUCTION: Patient decision aids (PDAs) have been developed to help patients make an informed choice for a treatment option. Despite proven benefits, structural implementation falls short of expectations. The present study aims to assess the effectiveness and cost-utility of the PDA among newly diagnosed patients with localised prostate cancer and their partners, alongside implementation of the PDA in routine care. METHODS/ANALYSIS: A stepped-wedge cluster randomised trial will be conducted...
September 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/28918132/assessing-precision-bias-and-sigma-metrics-of-53-measurands-of-the-alinity-ci-system
#2
Sten Westgard, Victoria Petrides, Sharon Schneider, Marvin Berman, Jörg Herzogenrath, Anthony Orzechowski
Assay performance is dependent on the accuracy and precision of a given method. These attributes can be combined into an analytical Sigma-metric, providing a simple value for laboratorians to use in evaluating a test method's capability to meet its analytical quality requirements. Sigma-metrics were determined for 37 clinical chemistry assays, 13 immunoassays, and 3 ICT methods on the Alinity ci system. METHODS: Analytical Performance Specifications were defined for the assays, following a rationale of using CLIA goals first, then Ricos Desirable goals when CLIA did not regular the method, and then other sources if the Ricos Desirable goal was unrealistic...
September 13, 2017: Clinical Biochemistry
https://www.readbyqxmd.com/read/28915078/pediatric-specific-end-of-life-care-quality-measures-an-unmet-need-of-a-vulnerable-population
#3
Emily E Johnston, Abby R Rosenberg, Arif H Kamal
We must ensure that the 20,000 US children (age 0 to 19 years) who die as a result of serious illness annually receive high-quality end-of-life care. Ensuring high-quality end-of-life care requires recognition that pediatric end-of-life care is conceptually and operationally different than that for adults. For example, in-hospital adult death is considered an outcome to be avoided, whereas many pediatric families may prefer hospital death. Because pediatric deaths are comparatively rare, not all centers offer pediatric-focused palliative care and hospice services...
September 15, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28913817/return-to-play-in-2017-and-the-role-of-shared-decision-making-in-patients-with-inherited-and-acquired-channelopathies-and-cardiomyopathies
#4
REVIEW
Kia Afshar, T Jared Bunch
Shared decision-making is based upon a physician-patient encounter in which there is adequate education using aids if needed, a mutual discussion of how to assist the patient in weighing risks and benefits, and a supportive environment that allows the patient to deliberate on the clinical decision and make their own choice. This decision-making paradigm centers on the principles of autonomy and self-determination. Physical activity is a critical part of healthy lifestyle choices that helps lower risk of cardiovascular disease or the progression of it...
September 14, 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28910812/what-can-be-expected-from-prostate-cancer-biomarkers-a-clinical-perspective
#5
Piotr Zapała, Bartosz Dybowski, Sławomir Poletajew, Piotr Radziszewski
Along with significant advances in prostate cancer biology research, we also observe the rapid development of modern diagnostic tests. New biomarkers are derived to detect disease while it is organ-confined to stratify the risk and to aid clinical decision-making. Majority of these tools have already been validated clinically, but only a few have received premarket clearance and administration approval. Superiority of novel tests is visible not only in improved detection accuracy but predominantly in the assessment of tumour aggressiveness and selection of patients eligible for conservative management...
September 15, 2017: Urologia Internationalis
https://www.readbyqxmd.com/read/28905146/long-range-temporal-correlations-reflect-treatment-response-in-the-electroencephalogram-of-patients-with-infantile-spasms
#6
Rachel J Smith, Amanda Sugijoto, Neggy Rismanchi, Shaun A Hussain, Daniel W Shrey, Beth A Lopour
Infantile spasms syndrome is an epileptic encephalopathy in which prompt diagnosis and treatment initiation are critical to therapeutic response. Diagnosis of the disease heavily depends on the identification of characteristic electroencephalographic (EEG) patterns, including hypsarrhythmia. However, visual assessment of the presence and characteristics of hypsarrhythmia is challenging because multiple variants of the pattern exist, leading to poor inter-rater reliability. We investigated whether a quantitative measurement of the control of neural synchrony in the EEGs of infantile spasms patients could be used to reliably distinguish the presence of hypsarrhythmia and indicate successful treatment outcomes...
September 13, 2017: Brain Topography
https://www.readbyqxmd.com/read/28901005/delivery-arrangements-for-health-systems-in-low-income-countries-an-overview-of-systematic-reviews
#7
REVIEW
Agustín Ciapponi, Simon Lewin, Cristian A Herrera, Newton Opiyo, Tomas Pantoja, Elizabeth Paulsen, Gabriel Rada, Charles S Wiysonge, Gabriel Bastías, Lilian Dudley, Signe Flottorp, Marie-Pierre Gagnon, Sebastian Garcia Marti, Claire Glenton, Charles I Okwundu, Blanca Peñaloza, Fatima Suleman, Andrew D Oxman
BACKGROUND: Delivery arrangements include changes in who receives care and when, who provides care, the working conditions of those who provide care, coordination of care amongst different providers, where care is provided, the use of information and communication technology to deliver care, and quality and safety systems. How services are delivered can have impacts on the effectiveness, efficiency and equity of health systems. This broad overview of the findings of systematic reviews can help policymakers and other stakeholders identify strategies for addressing problems and improve the delivery of services...
September 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28895808/shared-decision-making-after-severe-stroke-how-can-we-improve-patient-and-family-involvement-in-treatment-decisions
#8
Akila Visvanathan, Martin Dennis, Gillian Mead, William N Whiteley, Julia Lawton, Fergus Neil Doubal
People who are well may regard survival with disability as being worse than death. However, this is often not the case when those surviving with disability (e.g. stroke survivors) are asked the same question. Many routine treatments provided after an acute stroke (e.g. feeding via a tube) increase survival, but with disability. Therefore, clinicians need to support patients and families in making informed decisions about the use of these treatments, in a process termed shared decision making. This is challenging after acute stroke: there is prognostic uncertainty, patients are often too unwell to participate in decision making, and proxies may not know the patients' expressed wishes (i...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28894545/comparing-performances-of-intelligent-classifier-algorithms-for-predicting-type-of-pain-in-patients-with-spinal-cord-injury
#9
Nasrolah Nasr HeidarAbadi, Laleh Hakemi, Pirhossein Kolivand, Reza Safdari, Marjan Ghazi Saeidi
BACKGROUND AND AIM: In this study, performances of classification techniques were compared in order to predict type of pain in patients with spinal cord injury. Pain is one of the main problems in people with spinal cord injury. Identifying the optimal classification technique will help improve decision support systems in clinical settings. METHODS: A descriptive retrospective analysis was performed in 253 patients. We compared performances of "Bayesian Networks", "Decision Tree", neural networks: "Multi-Layer Perceptron" (MLP), and "Support Vector Machines" (SVM)...
July 2017: Electronic Physician
https://www.readbyqxmd.com/read/28891235/financial-arrangements-for-health-systems-in-low-income-countries-an-overview-of-systematic-reviews
#10
REVIEW
Charles S Wiysonge, Elizabeth Paulsen, Simon Lewin, Agustín Ciapponi, Cristian A Herrera, Newton Opiyo, Tomas Pantoja, Gabriel Rada, Andrew D Oxman
BACKGROUND: One target of the Sustainable Development Goals is to achieve "universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all". A fundamental concern of governments in striving for this goal is how to finance such a health system. This concern is very relevant for low-income countries. OBJECTIVES: To provide an overview of the evidence from up-to-date systematic reviews about the effects of financial arrangements for health systems in low-income countries...
September 11, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28888264/availability-of-patient-decision-aids-for-stroke-prevention-in-atrial-fibrillation-a-systematic-review
#11
REVIEW
Elizabeth S O'Neill, Stuart W Grande, Ariel Sherman, Glyn Elwyn, Megan Coylewright
BACKGROUND: Atrial fibrillation is a common irregular heart rhythm that increases patients' risk of stroke. Aspirin, warfarin, direct oral anticoagulants, and an implantable device can reduce this risk. Given the availability of multiple comparable options, this decision depends on patient preferences and is appropriate for the use of decision aids and other efforts to promote shared decision making. The objective of this review was to examine the existence and accessibility of, as well as select outcomes associated with, published, formally evaluated patient decision aids for stroke prevention in atrial fibrillation...
September 2017: American Heart Journal
https://www.readbyqxmd.com/read/28886808/assessing-skin-cancer-using-epidermal-genetic-information-retrieved-by-adhesive-patch-skin-surface-sampling
#12
REVIEW
Nayoung Lee, Alon Scope, Harold Rabinovitz
The detection of melanoma can be challenging. Many patients have clinically equivocal lesions in cosmetically sensitive areas or have multiple suspicious lesions. Epidermal genetic information retrieval is a noninvasive diagnostic method involving the application of adhesive tape onto the skin's surface to recover genomic material from the epidermis. This genomic material can then be used in assays to determine gene expression profiles. Studies have shown the potential of this technology to aid clinicians in differentiating between melanomas and nevi...
October 2017: Dermatologic Clinics
https://www.readbyqxmd.com/read/28885082/human-papillomavirus-testing-by-veterans-administration-women-s-health-providers-are-they-adhering-to-guidelines
#13
Laura D Hallett, Megan R Gerber
BACKGROUND: Evidence-based guidelines have been created by professional societies, including the United States Preventive Services Task Force (USPSTF) and American Society for Colposcopy and Cervical Pathology (ASCCP), for use of human papillomavirus (HPV) cotesting in cervical cancer screening. We investigated whether Veterans Health Administration (VA) providers at one VA medical center follow these guidelines. MATERIALS AND METHODS: Retrospective chart review of women aged 21-65 who had an HPV test ordered with pap testing in fiscal year 2014 at one Veterans Administration (VA) medical center to evaluate concordance of HPV ordering with screening (USPSTF) and management (ASCCP) guidelines...
September 8, 2017: Journal of Women's Health
https://www.readbyqxmd.com/read/28884617/strengths-and-gaps-in-physicians-risk-communication-a-scenario-study-of-the-influence-of-numeracy-on-cancer-screening-communication
#14
Dafina Petrova, Olga Kostopoulou, Brendan C Delaney, Edward T Cokely, Rocio Garcia-Retamero
OBJECTIVE: Many patients have low numeracy, which impedes their understanding of important information about health (e.g., benefits and harms of screening). We investigated whether physicians adapt their risk communication to accommodate the needs of patients with low numeracy, and how physicians' own numeracy influences their understanding and communication of screening statistics. METHODS: UK family physicians ( N = 151) read a description of a patient seeking advice on cancer screening...
September 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28884594/predicting-failure-of-nonoperative-treatment-for-insertional-achilles-tendinosis
#15
James F Stenson, Christopher W Reb, Joseph N Daniel, Sundeep S Saini, Mohammed F Albana
Nonoperative treatment for midportion Achilles tendinosis is well defined by the literature. Multiple modalities are described for the management of insertional Achilles pathology, but no consensus exists regarding efficacy. Surgical intervention for insertional Achilles tendinosis (IAT) is successful greater than 80% of the time. Our objective was to risk stratify patients who would fail nonsurgical management of IAT and thus benefit progressing to surgery. We reviewed the records of 664 patients with IAT...
September 1, 2017: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/28884381/development-of-a-computer-aided-differential-diagnosis-system-to-distinguish-between-usual-interstitial-pneumonia-and-non-specific-interstitial-pneumonia-using-texture-and-shape-based-hierarchical-classifiers-on-hrct-images
#16
SangHoon Jun, BeomHee Park, Joon Beom Seo, SangMin Lee, Namkug Kim
A computer-aided differential diagnosis (CADD) system that distinguishes between usual interstitial pneumonia (UIP) and non-specific interstitial pneumonia (NSIP) using high-resolution computed tomography (HRCT) images was developed, and its results compared against the decision of a radiologist. Six local interstitial lung disease patterns in the images were determined, and 900 typical regions of interest were marked by an experienced radiologist. A support vector machine classifier was used to train and label the regions of interest of the lung parenchyma based on the texture and shape characteristics...
September 7, 2017: Journal of Digital Imaging: the Official Journal of the Society for Computer Applications in Radiology
https://www.readbyqxmd.com/read/28882552/prognostic-and-predictive-biomarkers-in-breast-cancer-past-present-and-future
#17
REVIEW
Andrea Nicolini, Paola Ferrari, Michael J Duffy
Following a diagnosis of breast cancer, the most immediate challenges in patient management are the determination of prognosis and identification of the most appropriate adjuvant systemic therapy. Determining prognosis can best be addressed with a combination of traditional clinicopathological prognostic factors, biomarkers such as HER2/neu and specific multigene genes tests. Amongst the best validated prognostic multigene tests are uPA/PAI1, Oncotype DX and MammaPrint. Oncotype DX and MammaPrint, may be used for predicting outcome and aiding adjunct therapy decision making in patients with ER-positive, HER2-negative breast cancers that are either lymph node-negative or node positive (1-3 metastatic nodes), while uPA/PAI-1 may be similarly used in ER-positive, lymph node-negative patients...
September 4, 2017: Seminars in Cancer Biology
https://www.readbyqxmd.com/read/28882377/lasting-impression-of-violence-retained-bullets-and-depressive-symptoms
#18
Randi N Smith, Mark J Seamon, Vinayak Kumar, Andrew Robinson, Justine Shults, Patrick M Reilly, Therese S Richmond
BACKGROUND: Over 70,000 nonfatal firearm injuries occur in the US annually, frequently leaving victims injured with retained bullets. The long-term psychological risks associated with retained bullets remains unstudied. By serving as a constant reminder of injury, we hypothesized that the presence of retained bullets after firearm injury is associated with increased PTSD and depression symptom severity. METHODS: We conducted a prospective cohort study (2013-2015) of Black male survivors of firearm injury at an urban Level I trauma center...
September 4, 2017: Injury
https://www.readbyqxmd.com/read/28881105/decision-aid-use-during-post-biopsy-consultations-for-localized-prostate-cancer
#19
Margaret Holmes-Rovner, Akshay Srikanth, Stephen G Henry, Aisha Langford, David R Rovner, Angela Fagerlin
BACKGROUND: Decision Aids (DAs) effectively translate medical evidence for patients but are not routinely used in clinical practice. Little is known about how DAs are used during patient-clinician encounters. OBJECTIVE: To characterize the content and communicative function of high-quality DAs during diagnostic clinic visits for prostate cancer. PARTICIPANTS: 252 men newly diagnosed with localized prostate cancer who had received a DA, 45 treating physicians at 4 US Veterans Administration urology clinics...
September 7, 2017: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://www.readbyqxmd.com/read/28881071/quantity-over-quality-findings-from-a-systematic-review-and-environmental-scan-of-patient-decision-aids-on-early-abortion-methods
#20
Kyla Z Donnelly, Glyn Elwyn, Rachel Thompson
BACKGROUND: The availability and effectiveness of decision aids (DAs) on early abortion methods remain unknown, despite their potential for supporting women's decision making. OBJECTIVE: To describe the availability, impact and quality of DAs on surgical and medical early abortion methods for women seeking induced abortion. SEARCH STRATEGY: For the systematic review, we searched MEDLINE, Cochrane Library, CINAHL, EMBASE and PsycINFO. For the environmental scan, we searched Google and App Stores and consulted key informants...
September 7, 2017: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
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