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https://www.readbyqxmd.com/read/28445314/bc-prom-validation-of-a-patient-reported-outcomes-measure-for-patients-with-breast-cancer
#1
Xiaojuan Hu, Chunsen Zhang, Yanbo Zhang
Key issues of treatment for patients with breast cancer such as patient satisfaction with treatments, compliance, and some side effects are essential for evaluating quality of life by patient-reported outcomes in clinical trials. The study aimed to develop and evaluate a specific patient-reported measure which included physical, psychological, social, and therapeutic domain for assessing the survival of patients with breast cancer.The pool of items was drafted after a theoretical revision and cognitive interviews with women with breast cancer...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28441255/european-society-of-gynaecological-oncology-guidelines-for-the-management-of-patients-with-vulvar-cancer
#2
Maaike H M Oonk, François Planchamp, Peter Baldwin, Mariusz Bidzinski, Mats Brännström, Fabio Landoni, Sven Mahner, Umesh Mahantshetty, Mansoor Mirza, Cordula Petersen, Denis Querleu, Sigrid Regauer, Lukas Rob, Roman Rouzier, Elena Ulrikh, Jacobus van der Velden, Ignace Vergote, Linn Woelber, Ate G J van der Zee
OBJECTIVE: The aim of this study was to develop clinically relevant and evidence-based guidelines as part of European Society of Gynaecological Oncology's mission to improve the quality of care for women with gynecologic cancers across Europe. METHODS: The European Society of Gynaecological Oncology Council nominated an international development group made of practicing clinicians who provide care to patients with vulvar cancer and have demonstrated leadership and interest in the management of patients with vulvar cancer (18 experts across Europe)...
May 2017: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/28440718/problematizing-the-concept-of-the-borderline-group-in-performance-assessments
#3
Matt Homer, Godfrey Pell, Richard Fuller
INTRODUCTION: Many standard setting procedures focus on the performance of the "borderline" group, defined through expert judgments by assessors. In performance assessments such as Objective Structured Clinical Examinations (OSCEs), these judgments usually apply at the station level. METHODS AND RESULTS: Using largely descriptive approaches, we analyze the assessment profile of OSCE candidates at the end of a five year undergraduate medical degree program to investigate the consistency of the borderline group across stations...
May 2017: Medical Teacher
https://www.readbyqxmd.com/read/28438783/mistakes-and-missed-opportunities-regarding-cosmetic-surgery-and-conscientious-objection
#4
Toni C Saad
In her paper 'Cosmetic surgery and conscientious objection', Minerva rightly identifies cosmetic surgery as an interesting test case for the question of conscientious objection in medicine. Her treatment of this important subject, however, seems problematic. It is argued that Minerva's suggestion that a doctor has a prima facie duty to satisfy patient preferences even against his better clinical judgment, which we call Patient Preference Absolutism, must be regarded with scepticism. This is because (1) it overlooks an important distinction regarding autonomy's meaning and place in clinical practice, and (2) it makes obsolete the important concepts of expert clinical judgment and beneficence...
April 24, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28435491/agreement-between-serum-assays-performed-in-ed-point-of-care-and-hospital-central-laboratories
#5
Meir Dashevsky, Steven L Bernstein, Carol L Barsky, Richard A Taylor
INTRODUCTION: Point-of-care (POC) testing allows for more time-sensitive diagnosis and treatment in the emergency department (ED) than sending blood samples to the hospital central laboratory (CL). However, many ED patients have blood sent to both, either out of clinical custom, or because clinicians do not trust the POC values. The objective of this study was to examine the level of agreement between POC and CL values in a large cohort of ED patients. METHODS: In an urban, Level I ED that sees approximately 120,000 patients/year, all patients seen between March 1, 2013, and October 1, 2014, who had blood sent to POC and CL labs had levels of agreement measured between serum sodium, potassium, blood urea nitrogen (BUN), creatinine, and hematocrit...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28433926/discredited-legacy-stigma-and-familial-amyloid-polyneuropathy-in-northwestern-portugal
#6
Álvaro Mendes, Liliana Sousa, Jorge Sequeiros, Angus Clarke
RATIONALE: Genetic inherited conditions may result in feelings of stigmatisation, mainly because of visible physical appearance and its transmissibility to offspring. OBJECTIVE: This article reports accounts of stigmatisation from Portuguese patients affected by the inherited neurodegenerative disease, familial amyloid polyneuropathy (FAP), living in the largest cluster of patients worldwide. METHOD: We draw on semi-structured interviews conducted with individuals at-risk or affected by FAP, recruited through the national patients' association, about their experiences of stigmatisation related to the illness...
April 15, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28431419/creation-and-validation-of-an-automated-algorithm-to-determine-postoperative-ventilator-requirements-after-cardiac-surgery
#7
Eilon Gabel, Ira S Hofer, Nancy Satou, Tristan Grogan, Richard Shemin, Aman Mahajan, Maxime Cannesson
BACKGROUND: In medical practice today, clinical data registries have become a powerful tool for measuring and driving quality improvement, especially among multicenter projects. Registries face the known problem of trying to create dependable and clear metrics from electronic medical records data, which are typically scattered and often based on unreliable data sources. The Society for Thoracic Surgery (STS) is one such example, and it supports manually collected data by trained clinical staff in an effort to obtain the highest-fidelity data possible...
May 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28430672/lamotrigine-uses-in-psychiatric-practice-beyond-bipolar-prophylaxis-a-hope-or-hype
#8
Ahmed Naguy, Najah Al-Enezi
BACKGROUND: Lamotrigine (LAM), an antiepileptic, with panoply of indications and uses in neurology, is FDA approved, in psychiatry, for bipolar prophylaxis. Apart from this indication, trend of its use in psychiatry is on the rise addressing a multitude of disorders. STUDY QUESTION: LAM remains one of only few psychotropic drugs with antiglutamate activity. This might render LAM a potential therapeutic option in treatment-resistant major psychiatric disorders. We reviewed LAM pharmacology and its diverse indications while examining the extant evidence...
April 19, 2017: American Journal of Therapeutics
https://www.readbyqxmd.com/read/28428729/the-risk-of-bias-in-randomized-controlled-trials-in-otorhinolaryngology-hardly-any-improvement-since-1950
#9
Jeroen P M Peters, Inge Stegeman, Wilko Grolman, Lotty Hooft
BACKGROUND: Randomized Controlled Trials (RCTs) represent the most valuable study design to evaluate the effectiveness of therapeutic interventions. However, flaws in design, conduct, analysis, and reporting of RCTs can cause the effect of an intervention to be under- or overestimated. These biased RCTs may be included in literature reviews. To make the assessment of Risk of Bias (RoB) consistent and transparent, Cochrane published a RoB tool, with which RoB is assessed per item as "low", "unclear" or "high"...
2017: BMC Ear, Nose, and Throat Disorders
https://www.readbyqxmd.com/read/28427076/application-of-clinical-trial-results-to-clinical-practice
#10
Marco A Zarbin, Neelakshi Bhagat, Lekha K Mukkamala
Two critical questions one must answer as one applies the results of a clinical trial to clinical practice are: (1) Regardless of whether the trial result is likely to be replicated or reproduced in a second large-scale trial, are the results likely to be reproduced in one's practice? (2) Regardless of whether the experimental treatment was better than the alternative on average for a population of patients, are the results clinically important for a given patient in one's practice? To determine if a study result is likely to be reproduced in one's clinical practice, it may be helpful to answer 5 questions: (1) Have steps been taken to minimize bias? (2) Is the result likely due to the treatment? (3) Is the result unlikely due to chance? (4) Is the study population representative of one's patients? (5) Is the totality of evidence consistent? If the answer to all 5 questions is "yes," then we posit that the trial result is likely to be reproduced in one's practice...
2017: Developments in Ophthalmology
https://www.readbyqxmd.com/read/28419103/establishment-of-a-tear-protein-biomarker-panel-differentiating-between-graves-disease-with-or-without-orbitopathy
#11
Cecilie Aass, Ingrid Norheim, Erik Fink Eriksen, Ellen Charlotte Børnick, Per Medbøe Thorsby, Milaim Pepaj
BACKGROUND: Graves' orbitopathy (GO) is an autoimmune inflammatory ocular complication and one of the most frequent manifestations of Graves' disease (GD). Clinical judgment of GO is subjective sometimes leading to clinical and therapeutic challenges. Better tools to diagnose this severe complication are warranted. PATIENTS AND METHODS: The aim of the present study was to evaluate tear levels of LYZ, LACRT and AZGP1 in GD patients with or without GO, as possible biomarkers for GO...
2017: PloS One
https://www.readbyqxmd.com/read/28417478/point-of-care-lung-sonography-an-audit-of-1150-examinations
#12
Giuseppe Francesco Sferrazza Papa, Michele Mondoni, Giovanni Volpicelli, Paolo Carlucci, Fabiano Di Marco, Elena Maria Parazzini, Francesca Reali, Giulia Michela Pellegrino, Paola Fracasso, Simone Sferrazza Papa, Livio Colombo, Stefano Centanni
OBJECTIVES: Point-of-care lung sonography has theoretical usefulness in numerous diseases; however clinical indications and the impact of this technique have not been fully investigated. We aimed to describe the current use of point-of-care lung sonography. METHODS: A 2-year prospective observational study was performed by pulmonologists in an Italian university hospital. Techniques, indications, consequences of lung sonography, and barriers to the examination were analyzed...
April 18, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28414524/a-standardized-diagnostic-ontology-for-fibrotic-interstitial-lung-disease-an-international-working-group-perspective
#13
Christopher J Ryerson, Tamera J Corte, Joyce S Lee, Luca Richeldi, Simon L F Walsh, Jeffrey L Myers, Juergen Behr, Vincent Cottin, Sonye K Danoff, Kevin R Flaherty, David J Lederer, David A Lynch, Fernando J Martinez, Ganesh Raghu, William D Travis, Zarir Udwadia, Athol U Wells, Harold R Collard
Diagnosing fibrotic interstitial lung disease (ILD) requires multidisciplinary integration of clinical, radiological, and pathological features with assignment of a consensus classification. The current approach lacks a standardized ontology and therefore results in diagnostic heterogeneity. The objectives of this international working group perspective are to describe limitations of the current approach to fibrotic ILD diagnosis and to develop an ontological framework for standardizing the diagnostic classification...
April 17, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28413938/psychiatric-service-users-experiences-of-emergency-departments-a-cerqual-review-of-qualitative-studies
#14
Kathrine Carstensen, Stina Lou, Lotte Groth Jensen, Nina Konstantin Nissen, Lisbeth Ortenblad, Margarete Pfau, Pia Vedel Ankersen
BACKGROUND: There is increased clinical and political attention towards integrating general and psychiatric emergency departments (ED). However, research into psychiatric service users' experiences regarding general EDs is limited. AIM: To identify and summarize current, qualitative evidence regarding service users' experiences attending EDs. A secondary aim is to apply and test the newly developed CERQual approach to summarizing qualitative review findings. METHODS: A systematic literature review of five databases based on PRISMA guidelines yielded 3334 unique entries...
May 2017: Nordic Journal of Psychiatry
https://www.readbyqxmd.com/read/28410865/treatment-beyond-progression-in-patients-with-advanced-renal-cell-carcinoma-treated-with-nivolumab-in-checkmate-025
#15
Bernard Escudier, Robert J Motzer, Padmanee Sharma, John Wagstaff, Elizabeth R Plimack, Hans J Hammers, Frede Donskov, Howard Gurney, Jeffrey A Sosman, Pawel G Zalewski, Ulrika Harmenberg, David F McDermott, Toni K Choueiri, Martin Richardet, Yoshihiko Tomita, Alain Ravaud, Justin Doan, Huanyu Zhao, Helene Hardy, Saby George
BACKGROUND: Response patterns to nivolumab differ from those seen with other approved targeted therapies. OBJECTIVE: To investigate the efficacy of nivolumab in previously treated patients with advanced renal cell carcinoma who were treated beyond (Response Evaluation Criteria In Solid Tumors) RECIST progression. DESIGN, SETTING, AND PARTICIPANTS: This was a subgroup analysis of patients treated with nivolumab in the phase 3 CheckMate 025 study...
April 12, 2017: European Urology
https://www.readbyqxmd.com/read/28406274/barriers-and-facilitators-to-hiv-testing-among-young-men-who-have-sex-with-men-and-transgender-women-in-kingston-jamaica-a-qualitative-study
#16
Carmen H Logie, Ashley Lacombe-Duncan, Natasha Brien, Nicolette Jones, Nakia Lee-Foon, Kandasi Levermore, Annecka Marshall, Laura Nyblade, Peter A Newman
INTRODUCTION: Young men who have sex with men (MSM) in Jamaica have the highest HIV prevalence in the Caribbean. There is little information about HIV among transgender women in Jamaica, who are also overrepresented in the Caribbean epidemic. HIV-related stigma is a barrier to HIV testing among Jamaica's general population, yet little is known of MSM and transgender women's HIV testing experiences in Jamaica. We explored perceived barriers and facilitators to HIV testing among young MSM and transgender women in Kingston, Jamaica...
March 3, 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/28403561/iron-deficiency-anemia-in-chronic-kidney-disease-uncertainties-and-cautions
#17
Rajiv Agarwal
Anemia in chronic kidney disease is common and iron deficiency is an important cause. To repair iron-deficiency anemia, replacement of iron is needed. Iron can be replaced either by the oral route or by the intravenous route. In a meta-analysis, 5 of the 6 trials were short-term, 1 to 3 months, and compared to oral iron, the mean increase in hemoglobin with intravenous iron was only 0.31 g/dL. However, one of the studies included in this meta-analysis was 6 months long and had a mean decline in hemoglobin of 0...
April 12, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28401728/developing-a-guideline-for-structured-content-and-process-in-mental-health-nursing-handover
#18
Darrin Cowan, Scott Brunero, Xiaoou Luo, Dean Bilton, Scott Lamont
The process of handover has received recent attention within Australian health care, as evidence linking patient safety with the quality of handover emerges. Such links between clinical handover and patient safety have been reported elsewhere in the literature, where it is posited that the safe care of patients relies not only on the expertise and judgment of individual clinicians, teamwork, and effective management, but hinges to a large extent on the quality of information transferred from team to team. The present qualitative, descriptive study used participant observations, focus groups, and interviews to investigate the nursing handover in two acute mental health inpatient units in New South Wales, Australia...
April 12, 2017: International Journal of Mental Health Nursing
https://www.readbyqxmd.com/read/28401708/how-veterans-health-administration-suicide-prevention-coordinators-assess-suicide-risk
#19
James L Pease, Jeri E Forster, Collin L Davidson, Brooke Dorsey Holliman, Emma Genco, Lisa A Brenner
This cross-sectional study was designed to examine the suicide risk assessment practices of Suicide Prevention Coordinators (SPCs) within the Veterans Health Administration. Specifically, this study sought to (1) identify factors SPCs consider most important in assessing risk and patient priority; (2) measure the level of consistency and agreement between SPCs in assessing suicide risk and prioritizing cases; and (3) measure individual SPC consistency between cases. SPCs (n = 63) responded to online survey questions about imminent and prolonged risk for suicide in response to 30 fictional vignettes...
March 2017: Clinical Psychology & Psychotherapy
https://www.readbyqxmd.com/read/28401326/clinical-judgment-moral-anxiety-and-the-limits-of-psychiatry
#20
Bradley Murray
It is common for clinicians working in psychiatry and related clinical disciplines to be called on to make diagnostic clinical judgments concerning moral anxiety, which is a kind of anxiety that is closely bound up with decisions individuals face as moral agents. To make such a judgment, it is necessary to make a moral judgment. Although it has been common to acknowledge that there are ways in which moral and clinical judgment interact, this type of interaction has remained unacknowledged. This raises questions as to the nature and limits of psychiatry-particularly concerning the extent to which psychiatric discourse ought to incorporate moral discourse, and the role of the clinician as an expert in identifying problematic anxiety...
April 11, 2017: Medicine, Health Care, and Philosophy
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