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Patient decision aid

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https://www.readbyqxmd.com/read/28636186/views-of-general-practice-staff-about-the-use-of-a-patient-oriented-treatment-decision-aid-in-shared-decision-making-for-patients-with-type-2-diabetes-a-mixed-methods-study
#1
Anita Wildeboer, Esther du Pon, Jan Schuling, Flora M Haaijer-Ruskamp, Petra Denig
BACKGROUND: Decision aids can be used to support shared decision making (SDM). A patient-oriented treatment decision aid (DA) was developed for type 2 diabetes but its use by general practice staff appeared to be limited. OBJECTIVES: To explore views of practice staff towards SDM and the DA. DESIGN: A mixed-methods study within the Dutch PORTDA-diab trial. SETTING AND PARTICIPANTS: Included were 17 practices with staff members who were responsible for routine diabetes care and had worked with the DA, and 209 of their patients...
June 21, 2017: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://www.readbyqxmd.com/read/28633634/the-development-and-appraisal-of-a-tool-designed-to-find-patients-harmed-by-falsely-labelled-falsified-counterfeit-medicines
#2
Marija Anđelković, Einar Björnsson, Virgilio De Bono, Nenad Dikić, Katleen Devue, Daniel Ferlin, Miroslav Hanževački, Freyja Jónsdóttir, Mkrtich Shakaryan, Sabine Walser
BACKGROUND: Falsely labelled, falsified (counterfeit) medicines (FFCm's) are produced or distributed illegally and can harm patients. Although the occurrence of FFCm's is increasing in Europe, harm is rarely reported. The European Directorate for the Quality of Medicines & Health-Care (EDQM) has therefore coordinated the development and validation of a screening tool. METHODS: The tool consists of a questionnaire referring to a watch-list of FFCm's identified in Europe, including symptoms of their use and individual risk factors, and a scoring form...
June 20, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28631959/advance-care-planning-for-patients-with-amyotrophic-lateral-sclerosis
#3
Benjamin H Levi, Zachary Simmons, Courtney Hanna, Allyson Brothers, Erik Lehman, Elana Farace, Megan Bain, Renee Stewart, Michael J Green
PURPOSE: To determine whether an advance care planning (ACP) decision-aid could improve communication about end-of-life treatment wishes between patients with amyotrophic lateral sclerosis (ALS) and their clinicians. METHODS: Forty-four patients with ALS (>21, English-speaking, without dementia) engaged in ACP using an interactive computer based decision-aid. Before participants completed the intervention, and again three months later, their clinicians reviewed three clinical vignettes, and made treatment decisions (n = 18) for patients...
March 5, 2017: Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration
https://www.readbyqxmd.com/read/28629552/comparative-analysis-of-four-scores-to-stratify-patients-with-heart-failure-and-reduced-ejection-fraction
#4
Pedro Freitas, Carlos Aguiar, António Ferreira, António Tralhão, António Ventosa, Miguel Mendes
There are several prognostic risk scores available for patients with heart failure with reduced ejection fraction (HFrEF) that can aid in the decision of listing candidates for heart transplant (HTx). A direct comparison between these scores has not been performed. Therefore, our objective was to evaluate the calibration and discriminative power of 4 contemporary HF scores. A retrospective analysis of 259 patients with HFrEF who underwent cardiopulmonary exercise test was conducted. The Heart Failure Survival Score (HFSS), Seattle Heart Failure Model (SHFM), Meta-analysis Global Group in Chronic Heart Failure (MAGGIC), and Metabolic Exercise Cardiac Kidney Index (MECKI) were compared...
May 11, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28629329/personalised-informed-choice-on-evidence-and-controversy-on-mammography-screening-study-protocol-for-a-randomized-controlled-trial
#5
Anna Roberto, Cinzia Colombo, Giulia Candiani, Livia Giordano, Paola Mantellini, Eugenio Paci, Roberto Satolli, Mario Valenza, Paola Mosconi
BACKGROUND: In Italy women aged 50-69 are invited for a population-based breast cancer (BC) screening. Physicians, policy makers and patients associations agree on the need to inform women about the benefits and harms in order to permit an informed decision. Decision aids (DA) are an effective way to support people in their decisions about health. This trial aims to assess women's informed choices, according to their health literacy and values, on participating or not in BC screening for the first time...
June 19, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28625620/prognostic-impact-of-uncertain-parietal-pleural-invasion-at-adhesion-sites-in-non-small-cell-lung-cancer-patients
#6
Masashi Mikubo, Hiroyasu Nakashima, Masahito Naito, Yoshio Matsui, Kazu Shiomi, Shi-Xu Jiang, Yukitoshi Satoh
OBJECTIVES: Pleural invasion has been recognized as an important negative prognostic factor in non-small cell lung cancer (NSCLC), and therefore, accurate evaluation is required. However, when the visceral pleura adheres to the parietal pleura around a tumor and parietal pleural structures are destroyed and unrecognizable as a result of inflammation, it is often difficult to accurately evaluate pleural invasion, and classification of the T stage is unclear. To aid in categorization, we defined this status as pl1-3 and investigated the prognostic impact of the pl1-3 status on NSCLC...
June 2017: Lung Cancer: Journal of the International Association for the Study of Lung Cancer
https://www.readbyqxmd.com/read/28624294/patient-decision-aids-for-patients-considering-total-joint-replacement-a-cost-effectiveness-analysis-alongside-a-randomised-controlled-trial
#7
Logan Trenaman, Dawn Stacey, Stirling Bryan, Monica Taljaard, Gillian Hawker, Geoff Dervin, Peter Tugwell, Nick Bansback
BACKGROUND: Shared decision-making (SDM) is a key priority to improve patient-centred care, and can play an important role in helping patients decide whether to undergo total joint arthroplasty (TJA). Patient decision aids can support SDM; however, they may incur an upfront cost. We aimed to estimate the health and economic effects of patient decision aids for TJA. METHODS: A cost-effectiveness analysis of a randomised controlled trial with 2-year follow-up. 343 patients were recruited from two orthopedic screening clinics in Ottawa, Canada...
June 14, 2017: Osteoarthritis and Cartilage
https://www.readbyqxmd.com/read/28623628/does-patient-preference-measurement-in-decision-aids-improve-decisional-conflict-a-randomized-trial-in-men-with-prostate-cancer
#8
Joseph D Shirk, Catherine M Crespi, Josemanuel D Saucedo, Sylvia Lambrechts, Ely Dahan, Robert Kaplan, Christopher Saigal
BACKGROUND: Shared decision making (SDM) has been advocated as an approach to medical decision making that can improve decisional quality. Decision aids are tools that facilitate SDM in the context of limited physician time; however, many decision aids do not incorporate preference measurement. OBJECTIVES: We aim to understand whether adding preference measurement to a standard patient educational intervention improves decisional quality and is feasible in a busy clinical setting...
June 16, 2017: Patient
https://www.readbyqxmd.com/read/28622155/triad-ix-can-a-patient-testimonial-safely-help-ensure-prehospital-appropriate-critical-versus-end-of-life-care
#9
Ferdinando Mirarchi, Christopher Cammarata, Timothy E Cooney, Kristin Juhasz, Stanley A Terman
OBJECTIVE: The present study sought to assess the clarity of Physician Orders for Life-Sustaining Treatment (POLST) or Living Will (LW) documents alone or in combination with a video message/testimonial (VM). METHODS: Emergency medical services (EMS) personnel responded to survey questions about the meaning of stand-alone POLST and LW documents and those used in conjunction with emergent care scenarios. Personnel were randomized to receive documents only or documents with VM...
June 16, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28621318/natural-killer-like-signature-observed-post-therapy-in-locally-advanced-rectal-cancer-is-a-determinant-of-pathological-response-and-improved-survival
#10
Matthew Alderdice, Philip D Dunne, Aidan J Cole, Paul G O'Reilly, Darragh G McArt, Vicky Bingham, Marc-Aurel Fuchs, Stephen McQuaid, Maurice B Loughrey, Graeme I Murray, Leslie M Samuel, Mark Lawler, Richard H Wilson, Manuel Salto-Tellez, Vicky M Coyle
Around 12-15% of patients with locally advanced rectal cancer undergo a pathologically complete response (tumor regression grade 4) to long-course preoperative chemoradiotherapy; the remainder exhibit a spectrum of tumor regression (tumor regression grade 1-3). Understanding therapy-related transcriptional alterations may enable better prediction of response as measured by progression-free and overall survival, in addition to aiding the development of improved strategies based on the underlying biology of the disease...
June 16, 2017: Modern Pathology: An Official Journal of the United States and Canadian Academy of Pathology, Inc
https://www.readbyqxmd.com/read/28620874/moving-from-significance-to-real-world-meaning-methods-for-interpreting-change-in-clinical-outcome-assessment-scores
#11
Cheryl D Coon, Karon F Cook
PURPOSE: Clinical outcome assessments (COAs) require evidence not only of reliability, validity, and ability to detect change, but also a definition of what constitutes a meaningful change on the instrument. The responder definition specifies the amount of change on the COA that may be interpreted as a treatment benefit and is critical for interpreting what constitutes a meaningful change on the COA scores. However, the literature that describes methods for developing and applying responder definitions can be difficult to navigate...
June 15, 2017: Quality of Life Research
https://www.readbyqxmd.com/read/28618868/appropriate-use-criteria-for-hyaluronic-acid-in-the-treatment-of-knee-osteoarthritis-in-the-united-states
#12
Arup K Bhadra, Roy Altman, Vinod Dasa, Karen Myrick, Jeffrey Rosen, Vijay Vad, Peter Vitanzo, Michelle Bruno, Hillary Kleiner, Caryn Just
OBJECTIVE: A workgroup of clinical experts has developed an Appropriate Use Criteria (AUC) for the use of hyaluronic acid (HA) in the treatment of osteoarthritis (OA) of the knee. The increasingly broad and varied use of HA injections, lack of published clinical guidance, and limited coverage for their use has created the imperative to establish appropriateness criteria. METHODS: The experts of this workgroup represent rheumatology, orthopedic surgery, physiatry, sports medicine, and nursing clinicians with substantive knowledge of intra-articular HA therapy...
July 2017: Cartilage
https://www.readbyqxmd.com/read/28616116/the-pubovaginal-sling-reintroducing-an-old-friend
#13
REVIEW
Gregory G Bailly, Kevin V Carlson
The surgical management of female stress urinary incontinence (SUI) has evolved over the past century, using various techniques of retropubic colposuspensions and sling procedures. In the past two decades, the sling has become the mainstay of surgical treatment of SUI, with the synthetic midurethral sling (MUS) leading the way. With the recent concerns raised by the U.S. Food and Drug Administration (FDA) and Health Canada about the safety of vaginal surgery using mesh implants, including the MUS, urologists and gynecologists should be familiar with suitable alternatives, including the pubovaginal sling (PVS), which often incorporates autologous fascia...
June 2017: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/28615391/practical-approach-to-evaluating-testicular-status-in-infants-and-children
#14
REVIEW
Elke E Mau, Michael P Leonard
OBJECTIVE: To review the differences between normal, retractile, ectopic, ascended, and undescended testes and to describe the optimal way to perform a testicular examination to distinguish one from the other, as well as to demonstrate that ultrasound imaging is not necessary and to clarify when to consider specialist referral. SOURCES OF INFORMATION: This paper is based on selected findings from a MEDLINE search on undescended testes and orchiopexy referrals, and on our experience at the Urology Clinic at the Children's Hospital of Eastern Ontario in Ottawa, including review of referrals to our clinic for undescended testes and the resultant findings of normal variants versus surgical cases...
June 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/28614954/using-visual-aids-to-enhance-physician-patient-discussions-and-increase-health-literacy
#15
Michelle Pratt, Gordon E Searles
Health literacy refers to the comprehension required to make well-informed decisions regarding one's health. It is a critical component in helping patients to understand how to take their medications appropriately. However, many patients do not possess the comprehension necessary for medication adherence. The result of poor literacy is a higher incidence of misunderstanding medication instructions. Visual aids have the ability to transcend language and numeracy barriers and can therefore improve the effectiveness of communication and broaden target audiences...
June 1, 2017: Journal of Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28613918/new-sepsis-definition-sepsis-3-and-community-acquired-pneumonia-mortality-a-validation-and-clinical-decision-making-study
#16
Otavio T Ranzani, Elena Prina, Rosario Menéndez, Adrian Ceccato, Catia Cilloniz, Raul Méndez, Albert Gabarrus, Enric Barbeta, Gianluigi Li Bassi, Miquel Ferrer, Antoni Torres
RATIONALE: Sepsis-3 Task Force updated the clinical criteria for sepsis, excluding the need for systemic inflammatory response syndrome (SIRS) criteria. The clinical implications of the proposed flowchart including the quick Sequential (Sepsis-related) Organ Failure Assessment (qSOFA) and SOFA scores are unknown. OBJECTIVE: To perform a clinical decision-making analysis of Sepsis-3 in patients with community-acquired pneumonia (CAP). METHODS: Cohort study including adult patients with CAP from two Spanish university-hospitals...
June 14, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28606869/predicting-mental-conditions-based-on-history-of-present-illness-in-psychiatric-notes-with-deep-neural-networks
#17
Tung Tran, Ramakanth Kavuluru
BACKGROUND: Applications of natural language processing to mental health notes are not common given the sensitive nature of the associated narratives. The CEGS N-GRID 2016 Shared Task in Clinical Natural Language Processing (NLP) changed this scenario by providing the first set of neuropsychiatric notes to participants. This study summarizes our efforts and results in proposing a novel data use case for this dataset as part of the third track in this shared task. OBJECTIVE: We explore the feasibility and effectiveness of predicting a set of common mental conditions a patient has based on the short textual description of patient's history of present illness typically occurring in the beginning of a psychiatric initial evaluation note...
June 9, 2017: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/28602711/patients-perceptions-and-attitudes-on-recurrent-prostate-cancer-and-hormone-therapy-qualitative-comparison-between-decision-aid-and-control-groups
#18
Rita Gorawara-Bhat, Siobhan O'Muircheartaigh, Supriya Mohile, William Dale
OBJECTIVE: To compare patients' attitudes towards recurrent prostate cancer (PCa) and starting hormone therapy (HT) treatment in two groups-Decision-Aid (DA) (intervention) and Standard-of-care (SoC) (Control). METHODS: The present research was conducted at three academic clinics-two in the Midwest and one in the Northeast U.S. Patients with biochemical recurrence of PCa (n=26) and follow-up oncology visits meeting inclusion criteria were randomized to either the SoC or DA intervention group prior to their consultation...
June 8, 2017: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/28600753/involving-medical-students-in-providing-patient-education-for-real-patients-a-scoping-review
#19
Thomas W Vijn, Cornelia R M G Fluit, Jan A M Kremer, Thimpe Beune, Marjan J Faber, Hub Wollersheim
BACKGROUND: Studies suggest that involving students in patient education can contribute to the quality of care and medical education. Interventions and outcomes in this field, however, have not yet been systematically reviewed. The authors examined the scientific literature for studies on interventions and outcomes of student-provided patient education. METHODS: Four databases (MEDLINE, EMBASE, ERIC, PsycINFO) were searched for studies reporting patient education, undergraduate medical students, and outcomes of patient education, published between January 1990 and October 2015...
June 9, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28599828/a-doppler-echocardiographic-study-of-the-myocardial-inotropic-response-to-peak-semisupine-exercise-in-healthy-children-development-of-a-simplified-index-of%C3%A2-myocardial%C3%A2-reserve
#20
Anita T Cote, D Kathryn Duff, Carolina A Escudero, Astrid M De Souza, Lindsey D Williams, Raman Gill, M Terri Zadorsky, Kevin C Harris, James E Potts, George G S Sandor
BACKGROUND: Stress echocardiography has been advocated for the detection of abnormal myocardial function and unmasking diminished myocardial reserve in pediatric patients. The aim of this study was to create a simplified index of myocardial reserve, derived from the myocardial inotropic response to peak semisupine exercise in healthy children, and illustrate its applicability in a sample of pediatric oncology patients. METHODS: In this prospective analysis, children (7-18 years of age) with normal cardiac structure and function performed semisupine stress echocardiography to volitional fatigue...
June 6, 2017: Journal of the American Society of Echocardiography
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