"Value-based"

Aim: Use long-term follow-up data from the IMPERIAL study to determine whether drug-eluting polymer-based nitinol stent treatment can delay the time to repeat intervention for femoropopliteal artery disease and how such a delay may result in cost savings in a value-based episode of care. Patients & methods: The IMPERIAL randomized controlled trial was an international study of a paclitaxel-eluting polymer-coated stent (Eluvia, Boston Scientific, MA, USA) versus a polymer-free paclitaxel-coated stent (Zilver PTX, Cook Corporation, IN, USA) for treating lesions of the femoropopliteal arterial segment...

INTRODUCTION: In response to the increasing demand for long-term care services for older people, the Chinese government has launched a pilot program for long-term care insurance (LTCI) since 2016. The objective of this study is to evaluate the performance and effectiveness of this program in China and provide recommendations for the future development and expansion of the LTCI system. METHODS: We developed a comprehensive evaluation framework to assess these LTCI policies implemented in all 49 pilot cities in China...

BACKGROUND: The medical pricing system strongly influences physicians' job satisfaction and patient health outcomes. This study aimed to investigate the current relative value unit (RVU)-based pricing and utility of patients in commonly performed surgical procedures in South Korea. METHODS: Fifteen common surgical procedures were selected from OECD statistics, and three additional orthopedic procedures were examined. The current pricing of each surgical procedure was retrieved from the Korea National Health Insurance Service, and the corresponding utilities were obtained as quality-adjusted life year (QALY) gains from previous studies...

INTRODUCTION: Arthrofibrosis is a debilitating postoperative complication, and a major cause of patient dissatisfaction following total knee arthroplasty (TKA). There is no consensus regarding the optimal treatment for stiffness after TKA. For cases not amenable to manipulation under anesthesia (MUA), one component or full revision are both suitable options. In a value-based healthcare era, maximizing cost-effectiveness with optimized clinical outcomes for patients remains the ultimate goal...

How might concepts of 'value' and 'population' illuminate the present and future of urban density? The COVID-19 pandemic prompted a public debate on density in the city. While some initially blamed density for the spread of the virus, others rightly cautioned against those claims. As the pandemic progressed, an imaginary of density-as-pathology gave way to a more nuanced geographical understanding of the urban dimensions of the crisis, focused on connections, spatial conditions, domestic 'overcrowding' and poverty...

Over the past decade, entrustable professional activities (EPAs) have become an important element in the competency-based medical education movement. In this Commentary, the authors explore informed consent as an EPA within resident surgical training. In doing so, they foreground the concept of culture and reexamine the nature of trust and entrustment decisions from within a cultural framework. The authors identify role modeling and professional identity formation as core elements in the training process and suggest that faculty are sometimes better off using these tools than uncritically adopting a formal EPA framework for what is, in essence, a professionally oriented and values-based moral enterprise...

This study aimed to investigate the role of families in instilling social values that enhance children's awareness of the culture of giving. A descriptive research design was used, and a sample survey method was employed, with 174 children participating. Results showed that the family's role in instilling social values was rated as moderate (weighted relative weight of 61.97%), with a total weight of 9705. The study also found that children face difficulties in adhering to the encouraging social values of volunteering...

No abstract text is available yet for this article.

The pedigree likelihood ratio (LR) can be used for determining kinship in the forensic kinship testing. LR can be obtained by analyzing the DNA data of Short tandem repeat (STR) and single nucleotide polymorphism (SNP) loci. With the advancement of biotechnology, increasing number of genetic markers have been identified, thereby expanding the pedigree range of kinship testing. Moreover, some of the loci are physically closer to each other and genetic linkage between loci is inevitable. LRs can be calculated by accounting for linkage or ignoring linkage (LRlinkage and LRignore , respectively)...

PURPOSE OF REVIEW: This review highlights the timely relevance of artificial intelligence in enhancing assisted reproductive technologies (ARTs), particularly in-vitro fertilization (IVF). It underscores artificial intelligence's potential in revolutionizing patient outcomes and operational efficiency by addressing challenges in fertility diagnoses and procedures. RECENT FINDINGS: Recent advancements in artificial intelligence, including machine learning and predictive modeling, are making significant strides in optimizing IVF processes such as medication dosing, scheduling, and embryological assessments...

Medicare is the largest single purchaser of health care in the United States and currently helps to pay medical expenses for approximately one-fifth of the US population. The impetus for Medicare to move away from fee-for-service and toward value-based care payments reflects the need to incentivize and improve healthcare quality while containing increasing costs. This primer provides a detailed overview of several interrelated topics for an improved understanding of the Medicare program for orthopaedic surgeons, other clinicians, healthcare administrators, policymakers, and business leaders...

OBJECTIVE: Prenatal genetic testing is routinely offered to all pregnant patients in the United States and is variably offered to certain pregnant populations globally [1]. To achieve value-based, informed decision-making, we argue for a shift away from the predominant "teaching" model of genetic counseling practice that prioritizes information and counselor dominance, toward a "counseling" model of practice that prioritizes the patient's narrative, values and beliefs. DISCUSSION: Since prenatal testing began, genetic counseling has aimed to facilitate informed decision-making...

BACKGROUND: Health state utility values provide the quality component of quality-adjusted life years and are essential for health economic analyses, such as the National Institute for Health and Care Excellence Technology Appraisal. The aims of this systematic review were to: catalogue utility values for health states experienced by patients with hand conditions; provide pooled utility estimates for common hand conditions; and determine how utilities have been estimated. METHODS: A PRISMA-compliant systematic review and meta-analysis was conducted (registered in PROSPERO, the international prospective register of systematic reviews (CRD42021226098))...

Contamination of aquatic ecosystems by potentially toxic elements (PTEs) is a concerning environmental issue, given their persistence, toxicity potential, and ability to accumulate in living organisms. Several studies have been conducted to assess the contamination of aquatic ecosystems by PTEs, using pollution and ecological risk indices that rely on the concentration of these elements in aquatic sediments. However, many of these studies use global reference values for calculating the indices, which can lead to misleading interpretations due to substantial variations in PTEs concentrations influenced by the geological characteristics of each region...

Values-based medicine (VsBM) is an ethical concept, and bioethical framework has been developed to ensure that medical ethics and values are implemented, pervasive, and powerful parameters influencing decisions about health, clinical practice, teaching, medical industry, career development, malpractice, and research. Neurosurgeons tend to adopt ethics according to their own values and to what they see and learn from teachers. Neurosurgeons, in general, are aware about ethical codes and the patient's rights...

In diamond wire saw cutting monocrystalline silicon (mono-Si), the material brittleness removal can cause microcrack damage in the subsurface of the as-sawn silicon wafer, which has a significant impact on the mechanical properties and subsequent processing steps of the wafers. In order to quickly and non-destructively obtain the subsurface microcrack damage depth (SSD) of as-sawn silicon wafers, this paper conducted research on the SSD prediction model for diamond wire saw cutting of mono-Si, and established the relationship between the SSD and the as-sawn surface roughness value (SR) by comprehensively considering the effect of tangential force and the influence of the elastic stress field and residual stress field below the abrasive on the propagation of median cracks...

Quality is central to value-based care and measurement is essential for assessing performance and understanding improvement over time. Both value-based care and methods for quality measurement are evolving. Infectious Diseases has been less engaged than other specialties in quality measure development, and Infectious Diseases providers must seize the opportunity to engage with quality measure development and research. Antimicrobial stewardship programs are an ideal starting point for Infectious Diseases-related quality measure development; antimicrobial stewardship program interventions and best practices are Infectious Diseases-specific, measurable, and impactful, yet grossly undercompensated...

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International development work involves external partners bringing expertise, resources, and management for local interventions in LMICs, but there is often a gap in understandings of relevant local shared values. There is a widespread need to better design interventions which accommodate relevant elements of local culture, as emphasised by recent discussions in global health research regarding neo-colonialism. One recent innovation is the concept of producing 'cultural protocols' to precede and guide community engagement or intervention design, but without suggestions for generating them...

BACKGROUND: The timing of treating cancer patients is an essential factor in the efficacy of treatment. So, patients who will not respond to current therapy should receive a different treatment as early as possible. Machine learning models can be built to classify responders and nonresponders. Such classification models predict the probability of a patient being a responder. Most methods use a probability threshold of 0.5 to convert the probabilities into binary group membership. However, the cutoff of 0...