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https://www.readbyqxmd.com/read/28224317/comparison-study-of-judged-clinical-skills-competence-from-standard-setting-ratings-generated-under-different-administration-conditions
#1
William L Roberts, John Boulet, Jeanne Sandella
When the safety of the public is at stake, it is particularly relevant for licensing and credentialing exam agencies to use defensible standard setting methods to categorize candidates into competence categories (e.g., pass/fail). The aim of this study was to gather evidence to support change to the Comprehensive Osteopathic Medical Licensing-USA Level 2-Performance Evaluation standard setting design and administrative process. Twenty-two video recordings of candidates assessed for clinical competence were randomly selected from the 2014-2015 Humanistic domain test score distribution ranging from the highest to lowest quintile of performance...
February 21, 2017: Advances in Health Sciences Education: Theory and Practice
https://www.readbyqxmd.com/read/28222381/domain-specific-and-domain-general-processes-underlying-metacognitive-judgments
#2
Lisa M Fitzgerald, Mahnaz Arvaneh, Paul M Dockree
Metacognition and self-awareness are commonly assumed to operate as global capacities. However, there have been few attempts to test this assumption across multiple cognitive domains and metacognitive evaluations. Here, we assessed the covariance between "online" metacognitive processes, as measured by decision confidence judgments in the domains of perception and memory, and error awareness in the domain of attention to action. Previous research investigating metacognition across task domains have not matched stimulus characteristics across tasks raising the possibility that any differences in metacognitive accuracy may be influenced by local task properties...
February 17, 2017: Consciousness and Cognition
https://www.readbyqxmd.com/read/28216720/biostatistics-series-module-7-the-statistics-of-diagnostic-tests
#3
Avijit Hazra, Nithya Gogtay
Crucial therapeutic decisions are based on diagnostic tests. Therefore, it is important to evaluate such tests before adopting them for routine use. Although things such as blood tests, cultures, biopsies, and radiological imaging are obvious diagnostic tests, it is not to be forgotten that specific clinical examination procedures, scoring systems based on physiological or psychological evaluation, and ratings based on questionnaires are also diagnostic tests and therefore merit similar evaluation. In the simplest scenario, a diagnostic test will give either a positive (disease likely) or negative (disease unlikely) result...
January 2017: Indian Journal of Dermatology
https://www.readbyqxmd.com/read/28212963/clinician-reported-outcome-assessments-of-treatment-benefit-report-of-the-ispor-clinical-outcome-assessment-emerging-good-practices-task-force
#4
John H Powers, Donald L Patrick, Marc K Walton, Patrick Marquis, Stefan Cano, Jeremy Hobart, Maria Isaac, Spiros Vamvakas, Ashley Slagle, Elizabeth Molsen, Laurie B Burke
A clinician-reported outcome (ClinRO) assessment is a type of clinical outcome assessment (COA). ClinRO assessments, like all COAs (patient-reported, observer-reported, or performance outcome assessments), are used to 1) measure patients' health status and 2) define end points that can be interpreted as treatment benefits of medical interventions on how patients feel, function, or survive in clinical trials. Like other COAs, ClinRO assessments can be influenced by human choices, judgment, or motivation. A ClinRO assessment is conducted and reported by a trained health care professional and requires specialized professional training to evaluate the patient's health status...
January 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28212147/monitoring-hospitalized-adult-patients-for-opioid-induced-sedation-and-respiratory-depression
#5
Carla R Jungquist, Kirsten Smith, Kelly L Wiltse Nicely, Rosemary C Polomano
: Opioid analgesics are commonly administered to hospitalized patients to treat acute pain, but these drugs put patients at risk for serious adverse events, such as unintended advancing sedation, respiratory depression, and death. Nurses play an important role in keeping patients safe by making clinical decisions about the frequency and intensity with which patients receiving IV and epidural opioids should be monitored. To make sound clinical judgments, nurses must be aware of the factors that place patients at elevated risk for adverse opioid-related effects and know how to screen and assess patients for these risks...
March 2017: American Journal of Nursing
https://www.readbyqxmd.com/read/28210388/topical-treatment-for-onychomycosis-is-it-more-effective-than-the-clinical-data-suggests
#6
REVIEW
Boni E Elewski, Tracey C Vlahovic, Andrew Korotzer
Background: The current definition of complete cure is considered too stringent to reflect the true benefit of onychomycosis treatment seen in general practice and may limit the use of newer topical agents in mild-to-moderate disease. In addition, outcomes reported in clinical trials do not consistently report secondary endpoints, making data comparison difficult. Methods: The authors review the clinical data reported on two new topical antifungals, efinaconazole and tavaborole, in light of the latest thinking of more practical approaches to assess improvement and treatment success...
November 2016: Journal of Clinical and Aesthetic Dermatology
https://www.readbyqxmd.com/read/28207004/patch-testing-for-adverse-drug-reactions
#7
Sahil Sekhon, Susan T Nedorost
Adverse drug reactions result in a substantial number of hospital admissions and inpatient events. Diagnosis usually is made with clinical judgment and circumstantiality without diagnostic testing. Furthermore, even in situations where diagnostic testing is performed, no safe gold standard tests exist. Oral rechallenge is currently the gold standard but carries the risk of recrudescence of severe allergic symptoms. Other tests include skin prick tests, the lymphocyte transformation test, immunohistochemistry, and patch testing...
January 2017: Cutis; Cutaneous Medicine for the Practitioner
https://www.readbyqxmd.com/read/28206671/surgery-for-cataracts-in-people-with-age-related-macular-degeneration
#8
REVIEW
Heather Casparis, Kristina Lindsley, Irene C Kuo, Shameema Sikder, Neil M Bressler
BACKGROUND: Cataract and age-related macular degeneration (AMD) are common causes of decreased vision that often occur simultaneously in people over age 50. Although cataract surgery is an effective treatment for cataract-induced visual loss, some clinicians suspect that such an intervention may increase the risk of worsening of underlying AMD and thus have deleterious effects on vision. OBJECTIVES: The objective of this review was to evaluate the effectiveness and safety of cataract surgery compared with no surgery in eyes with AMD...
February 16, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28205230/forensic-identification-of-bipartite-patella-misdiagnosed-as-patella-fracture
#9
Jingyuan Ma, Fang Shi, Chongya Huang, Shanzhi Gu
Bipartite patella is recognized as a developmental anomaly of ossification. Most of them are asymptomatic and are discovered incidentally. Bipartite patella is sometimes misdiagnosed as a patella fracture, because the x-ray images of both these conditions may appear very similar. In this case, the patient complained of left knee pain after x-ray films revealed a fracture-like line in the left patella. The patient was then diagnosed as having a patella fracture. In China, the injury degree is categorized as serious injury, minor injury, and trivial injury...
February 15, 2017: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/28203628/the-structured-interview-for-insight-and-judgment-in-dementia-development-and-validation-of-a-new-instrument-to-assess-awareness-in-patients-with-dementia
#10
Teresa Parrao, Simone Brockman, Romola S Bucks, David G Bruce, Wendy A Davis, Katherine K Hatch, Tammy L Leavy, Christine A P Axten, Sergio E Starkstein
INTRODUCTION: Poor insight about their cognitive and functional deficits is highly prevalent in patients with Alzheimer's disease (AD); however, there is a lack of reliable, valid instrumentation to measure this construct. The aim of this study was to develop and validate a semistructured interview to assess insight and judgment in patients with AD and to provide information regarding the assessment of competency and risk in this population. METHODS: We validated the Structured Clinical Interview for Insight and Judgment in Dementia (SIJID) in a consecutive series of 124 patients with probable AD...
2017: Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring
https://www.readbyqxmd.com/read/28196577/ambiguity-within-nursing-practice-an-evolutionary-concept-analysis
#11
Michelle A McMahon, Nancy M Dluhy
PURPOSE: To analyze the concept of ambiguity in a nursing context. BACKGROUND: Ambiguity is inherent within nursing practice. As health care becomes increasingly complex, nurses must continue to successfully deal with greater amounts of clinical ambiguity. Although ambiguity is discussed in nursing, minimal concept refinement exists to capture the contextual intricacies from a nursing lens. Nurse perception of an ambiguous clinical event, in combination with nurse tolerance level for ambiguity, can impact nurse response...
February 1, 2017: Research and Theory for Nursing Practice
https://www.readbyqxmd.com/read/28193297/pre-hospital-transfusion-of-packed-red-blood-cells-in-147-patients-from-a-uk-helicopter-emergency-medical-service
#12
Richard M Lyon, Eleanor de Sausmarez, Emily McWhirter, Gary Wareham, Magnus Nelson, Ashley Matthies, Anthony Hudson, Leigh Curtis, Malcolm Q Russell
BACKGROUND: Early transfusion of packed red blood cells (PRBC) has been associated with improved survival in patients with haemorrhagic shock. This study aims to describe the characteristics of patients receiving pre-hospital blood transfusion and evaluate their subsequent need for in-hospital transfusion and surgery. METHODS: The decision to administer a pre-hospital PRBC transfusion was based on clinical judgment. All patients transfused pre-hospital PRBC between February 2013 and December 2014 were included...
February 14, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28191631/the-role-of-histological-presentation-in-erythroderma
#13
Matteo Megna, Akmal A Sidikov, Denis V Zaslavsky, Igor N Chuprov, Elena A Timoshchuk, Uliya Egorova, Joerg Wenzel, Ruslan A Nasyrov
BACKGROUND: Erythroderma is a serious medical condition characterized by inflamed red skin involving over 90% of the body. It can be the common presentation of different diseases, therefore clinical diagnosis can be problematic. Controversial data are reported regarding the diagnostic value of histological examination in erythroderma subjects. METHODS: A retrospective study was performed, investigating histological skin specimens of patients with a clinical diagnosis of erythroderma admitted to the Department of Dermatology of State Pediatric Medical University, Saint Petersburg, from 2001 to 2014...
February 12, 2017: International Journal of Dermatology
https://www.readbyqxmd.com/read/28190695/ethical-dimensions-of-the-fetus-as-a-patient
#14
REVIEW
Frank A Chervenak, Laurence B McCullough
In this chapter, we present an account of the ethical concept of the fetus as a patient to guide clinical judgment and decision-making in the obstetrician-patient relationship. We explicate this concept and explore its clinical implications on the basis of the professional responsibility model of obstetric ethics. We will emphasize a preventive ethics approach, which is based on the recognition of the potential for ethical conflict in patient care and adopts ethically justified strategies to prevent those conflicts from occurring...
January 23, 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28178365/development-and-clinical-validation-of-a-novel-photography-based-skin-erythema-evaluation-system-a-comparison-with-the-calculated-consensus-of-dermatologists
#15
M Cho, D-H Lee, E J Doh, Y Kim, J H Chung, H C Kim, S Kim
Erythema is the most common presenting sign of skin conditions [1,2]. Erythema reflects the degree of inflammation associated with various diseases, such as atopic dermatitis, psoriasis, and lupus erythematosus; it is also cosmetically troublesome in subjects with flushing, rosacea, and photoaging [3,4]. In addition, there are vascular disorders that present with erythema, such as nevus flammeus, telangiectasia, and post-acne erythema [5]. Various therapeutic devices, medicines, and cosmetics have been developed to improve these dermatological conditions [6,7]...
February 8, 2017: International Journal of Cosmetic Science
https://www.readbyqxmd.com/read/28178028/statins-and-cardiovascular-health-controversy-consensus-and-clinical-judgment
#16
Laura L Hayman, Cheryl Dennison Himmelfarb
No abstract text is available yet for this article.
March 2017: Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/28174327/stroke-with-unknown-time-of-symptom-onset-baseline-clinical-and-magnetic-resonance-imaging-data-of-the-first-thousand-patients-in-wake-up
#17
Götz Thomalla, Florent Boutitie, Jochen B Fiebach, Claus Z Simonsen, Norbert Nighoghossian, Salvador Pedraza, Robin Lemmens, Pascal Roy, Keith W Muir, Martin Ebinger, Ian Ford, Bastian Cheng, Ivana Galinovic, Tae-Hee Cho, Josep Puig, Vincent Thijs, Matthias Endres, Jens Fiehler, Christian Gerloff
BACKGROUND AND PURPOSE: We describe clinical and magnetic resonance imaging (MRI) characteristics of stroke patients with unknown time of symptom onset potentially eligible for thrombolysis from a large prospective cohort. METHODS: We analyzed baseline data from WAKE-UP (Efficacy and Safety of MRI-Based Thrombolysis in Wake-Up Stroke: A Randomized, Doubleblind, Placebo-Controlled Trial), an investigator-initiated, randomized, placebo-controlled trial of MRI-based thrombolysis in stroke patients with unknown time of symptom onset...
February 7, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28173877/bilateral-ovarian-micrometastatic-adenocarcinoma-upon-prophylactic-oophorectomy-concurrent-with-low-anterior-resection-for-rectal-cancer
#18
Robin Irons, Erin McIntosh, Alexandre Hageboutros, David Warshal, Steven McClane
BACKGROUND: This case report draws attention to the debated role of prophylactic oophorectomy in women undergoing definitive surgical resection of colon and rectal cancers. It can be challenging to discern the indications and appropriate patient population for this procedure based on the current literature. Potential benefits include treatment and prevention of metastatic disease, preventing development of primary ovarian cancer, and prolonging survival. Negative effects include an increase in operative time and potential morbidity, development of osteoporosis, the risk of cardiac events, and decreasing sexual function...
February 7, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28169811/am%C3%A3-lioration-de-la-mesure-d%C3%A2-extravasation-des-cath%C3%A3-ters-veineux-p%C3%A3-riph%C3%A3-riques-par-les-infirmi%C3%A3-res-en-p%C3%A3-diatrie-gr%C3%A3-ce-%C3%A3-l%C3%A2-utilisation-d%C3%A2-un-instrument-d%C3%A2-%C3%A3-valuation-sp%C3%A3-cifique
#19
Nathalie Bochaton, Anne Sylvie Ramelet, Peter Rimensberger, Jean-Marie Januel
<ce:para>In pediatric and neonatal intensive care units, severity assessment of extravasation is difficult, considering the specificity of this population. The purpose of this study was to demonstrate the ability to improve the measurement of extravasation by nurses with the establishment of a standardized instrument and suitable for children. 66 nurses, randomly assigned to two groups, assessed the severity of extravasations using 15 clinical vignettes.The intervention group with the Pediatric Peripheral Intravenous Infiltration Scale (PIV Scale) (n=33) and the control group based on clinical judgment only (n=33)...
October 27, 2016: Recherche en Soins Infirmiers
https://www.readbyqxmd.com/read/28169135/case-study-and-case-based-research-in-emergency-nursing-and-care-theoretical-foundations-and-practical-application-in-paramedic-pre-hospital-clinical-judgment-and-decision-making-of-patients-with-mental-illness
#20
Ramon Z Shaban, Julie Considine, Margaret Fry, Kate Curtis
Generating knowledge through quality research is fundamental to the advancement of professional practice in emergency nursing and care. There are multiple paradigms, designs and methods available to researchers to respond to challenges in clinical practice. Systematic reviews, randomised control trials and other forms of experimental research are deemed the gold standard of evidence, but there are comparatively few such trials in emergency care. In some instances it is not possible or appropriate to undertake experimental research...
February 3, 2017: Australasian Emergency Nursing Journal: AENJ
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