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The relationship between dose and serotonin transporter occupancy of antidepressants-a systematic review.

Mol Psychiatry 2021 Sep 21. Epub 2021 Sep 21.

Centre for Evidence-Based Medicine Odense (CEBMO) and Cochrane Denmark, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.

Brain imaging techniques enable the visualization of serotonin transporter (SERT) occupancy as a measure of the proportion of SERT blocked by an antidepressant at a given dose. We aimed to systematically review the evidence on the relationship between antidepressant dose and SERT occupancy. We searched PubMed and Embase (last search 20 May 2021) for human in vivo, within-subject PET, or SPECT studies measuring SERT occupancy at any dose of any antidepressant with highly selective radioligands ([C]-DASB, [I]-ADAM, and [C]-MADAM). Read More

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September 2021

Achieving consistency in measures of HIV-1 viral suppression across countries: derivation of an adjustment based on international antiretroviral treatment cohort data.

J Int AIDS Soc 2021 Sep;24 Suppl 5:e25776

UNAIDS, Geneva, Switzerland.

Introduction: The third of the Joint United Nations Programme on HIV/AIDS (UNAIDS) 90-90-90 targets is to achieve a 90% rate of viral suppression (HIV viral load <1000 HIV-1 RNA copies/ml) in patients on antiretroviral treatment (ART) by 2020. However, some countries use different thresholds when reporting viral suppression, and there is thus a need for an adjustment to standardize estimates to the <1000 threshold. We aim to propose such an adjustment, to support consistent monitoring of progress towards the "third 90" target. Read More

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September 2021

Community-based Lung Cancer Screening Results in Relation to Patient and Radiologist Characteristics: the PROSPR Consortium.

Ann Am Thorac Soc 2021 Sep 20. Epub 2021 Sep 20.

Kaiser Permanente Colorado, Institute for Health Research, Denver, United States.

Rationale: Lung-RADS classification was developed to standardize reporting and management of lung cancer screening using low-dose computed tomography (LDCT). While variation in Lung-RADS distribution between healthcare systems has been reported, it is unclear if this is explained by patient characteristics, radiologist experience with lung cancer screening, or other factors.

Objective: Our objective was to determine if patient or radiologist factors are associated with Lung-RADS score. Read More

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September 2021

Placental pathology in women with HIV.

Placenta 2021 Sep 11;115:27-36. Epub 2021 Sep 11.

Division of Anatomical Pathology, Department of Pathology, University of Cape Town, Cape Town, South Africa; National Health Laboratory Services, Groote Schuur Hospital, Cape Town, South Africa. Electronic address:

Recognizing the importance of placental features and their unique functions can provide insight into maternal health, the uterine environment during the course of pregnancy, birth outcomes and neonatal health. In the context of HIV and antiretroviral therapy (ART), there have been great strides in the prevention of mother to child transmission of HIV. However, there is still paucity of data on the impact of HIV/ART exposure on placental pathology and studies available only examine specific patterns of placental injury, further justifying the need for a more defined and comprehensive approach to the differential diagnoses of HIV/ART-exposed placentae. Read More

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September 2021

Risk Stratification of Breast Fine-Needle Aspiration Biopsy Specimens Performed without Radiologic Guidance by Application of the International Academy of Cytology Yokohama System for Reporting Breast Fine-Needle Aspiration Cytopathology.

Acta Cytol 2021 Sep 14:1-11. Epub 2021 Sep 14.

Department of Radiation Oncology, All India Institute of Medical Sciences (AIIMS), Jodhpur, India.

Background And Objective: The International Academy of Cytology (IAC) Yokohama system for reporting breast fine-needle aspiration biopsy (FNAB) cytopathology has been proposed to standardize breast FNAB reporting. The aim of this study was to categorize breast FNAB cases performed by palpation without radiological guidance according to the IAC system, establish the risk of malignancy (ROM) for the categories and assess the system's utility, pitfalls, and implications in low-resource/financial constraint settings.

Methods: A retrospective analysis of palpation-guided FNAB of breast lesions performed without radiological guidance between January 2016 and December 2019 was carried out and was correlated with follow-up biopsies wherever available. Read More

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September 2021

Key Performance Indicators in Claims Management: Definition of a set of indicators for the evaluation of the Medico-Legal Activity.

Curr Pharm Biotechnol 2021 Sep 16. Epub 2021 Sep 16.

Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Viale Regina Elena 336, Rome, 00185. Italy.

Background: In recent decades, in the field of healthcare, awareness of the problems inherent to the quality has steadily increased. Currently, the evaluation of healthcare activities is one of the ways in which health systems regulate internal relationships and define strategic decisions.

Objective: The study aims to describe in detail the entire process of developing a group of Key Performance Indicators for monitoring and implementing the management of litigation due to medical liability. Read More

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September 2021

Comparison of cgmanalysis, a free, open-source continuous glucose monitoring (CGM) data management and analysis software to commercially available CGM platforms: Data standardization for diabetes technology research.

Diabetes Technol Ther 2021 Sep 15. Epub 2021 Sep 15.

University of Colorado Denver, Pediatrics, Aurora, Colorado, United States.

Background: Cgmanalysis is open-source software based on the R programming language for data management and descriptive analysis of data from continuous glucose monitors (CGM). We sought to validate the summary measures calculated by cgmanalysis against the results from proprietary software associated with 4 CGM commercially available models.

Methods: Two weeks of data from 188 patients with type 1 diabetes using commercially available CGMs. Read More

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September 2021

Measuring the Value of a Practical Text Mining Approach to Identify Patients With Housing Issues in the Free-Text Notes in Electronic Health Record: Findings of a Retrospective Cohort Study.

Front Public Health 2021 27;9:697501. Epub 2021 Aug 27.

Center for Population Health IT, Johns Hopkins School of Public Health, Baltimore, MD, United States.

Despite the growing efforts to standardize coding for social determinants of health (SDOH), they are infrequently captured in electronic health records (EHRs). Most SDOH variables are still captured in the unstructured fields (i.e. Read More

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Review of consensus test methods in medical imaging and current practices in photoacoustic image quality assessment.

J Biomed Opt 2021 Sep;26(9)

Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, Maryla, United States.

Significance: Photoacoustic imaging (PAI) is a powerful emerging technology with broad clinical applications, but consensus test methods are needed to standardize performance evaluation and accelerate translation.

Aim: To review consensus image quality test methods for mature imaging modalities [ultrasound, magnetic resonance imaging (MRI), x-ray CT, and x-ray mammography], identify best practices in phantom design and testing procedures, and compare against current practices in PAI phantom testing.

Approach: We reviewed scientific papers, international standards, clinical accreditation guidelines, and professional society recommendations describing medical image quality test methods. Read More

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September 2021

Management of patients with medically intractable epilepsy and anterior temporal lobe encephaloceles.

J Neurosurg 2021 Sep 10:1-8. Epub 2021 Sep 10.

Departments of1Neurosurgery.

Objective: Temporal lobe encephaloceles (TLENs) are a significant cause of medically refractory epilepsy, but there is little consensus regarding their workup and treatment. This study characterizes these lesions and their role in seizures and aims to standardize preoperative evaluation and surgical management.

Methods: Patients with TLEN who had undergone resective epilepsy surgery from December 2015 to August 2020 at a single institution were included in the study. Read More

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September 2021

Standardization of the psychometric hepatic encephalopathy score in a French population.

PLoS One 2021 10;16(9):e0257136. Epub 2021 Sep 10.

Brain Liver Pitié-Salpêtrière (BLIPS) Study Group, Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Sorbonne Université, Paris, France.

The Psychometric Hepatic Encephalopathy Score (PHES) has previously been standardized in thirteen countries on three continents, confirming its status of gold standard test to detect minimal hepatic encephalopathy (MHE). In the meantime, performance has also been shown to vary with variables such as age, education, and barely sex. The present study aimed at standardizing the PHES in a French population. Read More

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September 2021

Predicting premature termination of exercise during Bruce protocol stress echocardiography.

Echocardiography 2021 Sep 9. Epub 2021 Sep 9.

National Heart Centre Singapore, 5 Hospital Drive, Singapore, Singapore.

Aims: Clinical guidelines recommend that the exercise protocol of a stress echocardiogram is selected to induce volitional exhaustion after a target duration of at least 8 minutes. While the Bruce protocol is very commonly used for clinical stress tests, it is known to be "steep", and many patients therefore fail to reach 8 minutes. We studied predictors of failure and developed a method for identifying patients not suitable for Bruce protocol which was accurate and yet simple enough to be used as a point-of-care decision support tool. Read More

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September 2021

Landscape of Biomarkers and Actionable Gene Alterations in Adenocarcinoma of GEJ and Stomach-A Real World Data Analysis.

Cancers (Basel) 2021 Sep 3;13(17). Epub 2021 Sep 3.

Institute of Translational Molecular Tumor Research, 85354 Freising, Germany.

After several years of negative phase III trials in gastric and esophageal cancer, a significant breakthrough in the treatment of metastatic adenocarcinomas of the gastroesophageal junction (GEJ) and stomach (GC) is now becoming evident with the emerging of precision oncology and implementation of molecular targets in tumor treatment. In addition, new generation studies such as umbrella and basket trials are focused on these molecular targets, which makes an early molecular diagnosis based on IHC/ISH and NGS necessary. The required companion diagnostics of Her2neu overamplification or PD-L1 expression is based on immunohistochemistry (IHC) or additionally in situ hybridization (ISH) in case of an IHC Her2neu score of 2+. Read More

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September 2021

[Surgical interventions have been shown to improve the function in patients with foot drop after a stroke].

Lakartidningen 2021 Aug 24;118. Epub 2021 Aug 24.

docent, institutionen för kliniska vetenskaper, Lunds universitet.

Foot drop (FD) can be caused by a variety of diseases and injuries. FD leads to walking difficulties and reduced balance which also can lead to a higher risk of falling. Patient with a stroke often have an equinovarus deformity of the foot together with the DF. Read More

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Psychometric properties of the Beck Depression Inventory-II in progressive supranuclear palsy.

Brain Behav 2021 Sep 7:e2344. Epub 2021 Sep 7.

Neuroscience Section, Department of Medicine, Surgery and Dentistry, Center for Neurodegenerative Diseases (CEMAND), University of Salerno, Fisciano, Italy.

Objectives: Depression is one of the most common neuropsychiatric symptoms in progressive supranuclear palsy (PSP). Yet, few studies have examined the ability of available instruments to detect depressive symptoms in PSP. Aims of the present study were to (I) report psychometric properties of the Beck Depression Inventory Second Edition (BDI-II) in PSP, (II) establish the BDI-II cut-off indicating the presence of depression in PSP and (III) describe clinical correlates as well as correlation with quality of life of depressive symptoms in PSP. Read More

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September 2021

The QIBA Profile for MRI-based Compositional Imaging of Knee Cartilage.

Radiology 2021 Sep 7:204587. Epub 2021 Sep 7.

From the Department of Radiology, Division of Musculoskeletal Imaging and Intervention, University of Washington, UW Radiology-Roosevelt Clinic, 4245 Roosevelt Way NE, Box 354755, Seattle, WA 98105 (M.C.); Department of Biomedical Engineering, Program of Advanced Musculoskeletal Imaging (PAMI) (X.L.), and Department of Biostatistics (N.A.O.), Cleveland Clinic, Cleveland, Ohio; Department of Radiology, Boston University School of Medicine, Boston, Mass (A.G.); Department of Radiology and Imaging, Hospital for Special Surgery, New York, NY (J.A.C.); Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands (E.H.O.); European Imaging Biomarkers Alliance (E.H.O.); and Department of Radiology and Biomedical Imaging, University of California, San Francisco, Calif (T.M.L.).

MRI-based cartilage compositional analysis shows biochemical and microstructural changes at early stages of osteoarthritis before changes become visible with structural MRI sequences and arthroscopy. This could help with early diagnosis, risk assessment, and treatment monitoring of osteoarthritis. Spin-lattice relaxation time constant in rotating frame (T1ρ) and T2 mapping are the MRI techniques best established for assessing cartilage composition. Read More

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September 2021

Adverse Events During Supervised Exercise Interventions in Pediatric Oncology-A Nationwide Survey.

Front Pediatr 2021 19;9:682496. Epub 2021 Aug 19.

Department of Pediatric Hematology and Oncology, Pediatrics III, West German Cancer Center, University Hospital Essen, Essen, Germany.

Exercise interventions during and after treatment for pediatric cancer are associated with beneficial physical, psychological, and social effects. However, valid data about adverse events (AEs) of such interventions have rarely been evaluated. This retrospective study evaluates AEs that occurred during supervised oncological exercise programs for pediatric cancer patients and survivors. Read More

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Challenges for the standardized reporting of NGS HLA genotyping: Surveying gaps between clinical and research laboratories.

Hum Immunol 2021 Aug 31. Epub 2021 Aug 31.

Department of Pediatrics, University of California, San Francisco, Oakland, CA 94501, USA.

Next generation sequencing (NGS) is being applied for HLA typing in research and clinical settings. NGS HLA typing has made it feasible to sequence exons, introns and untranslated regions simultaneously, with significantly reduced labor and reagent cost per sample, rapid turnaround time, and improved HLA genotype accuracy. NGS technologies bring challenges for cost-effective computation, data processing and exchange of NGS-based HLA data. Read More

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Health Data, Information, and Knowledge Sharing for Addressing the COVID-19.

Yearb Med Inform 2021 Aug 3;30(1):4-7. Epub 2021 Sep 3.

Université Sorbonne Paris Nord, INSERM UMR_S1142, LIMICS, Paris, France.

Objectives: To introduce the 2021 International Medical Informatics Association (IMIA) Yearbook by the editors.

Methods: The editorial provides an introduction and overview to the 2021 IMIA Yearbook whose special topic is "Managing Pandemics with Health Informatics - Successes and Challenges". The Special Topic, the keynote paper, and survey papers are discussed. Read More

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An Opioid-free Anesthesia Protocol for Pediatric Strabismus Surgery: A Quality Improvement Project.

Pediatr Qual Saf 2021 Sep-Oct;6(5):e462. Epub 2021 Aug 26.

Department of Anesthesiology and Pain Medicine. Seattle Children's Hospital. University of Washington, Seattle, Wash.

Introduction: This quality improvement (QI) project tracks a series of 2 Plan-Do-Study-Act (PDSA) cycles as we standardized and refined an ambulatory pediatric anesthesia strabismus protocol. We aimed to provide effective pain relief, reduce postoperative nausea and vomiting (PONV) rates, and be cost-efficient while minimizing perioperative opioids over 5 years.

Methods: We used statistical process control (SPC) charts to analyze real-world data captured from the medical record. Read More

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Algorithmic approaches to ostomy management: An integrative review.

Nurs Open 2021 Aug 31. Epub 2021 Aug 31.

North York General Hospital, Toronto, ON, Canada.

Objective: The aim of this review is to describe approaches to ostomy management utilizing algorithmic approaches found within the literature.

Design: An integrative review approach was used based on a modified Cooper's five-stage research review framework.

Data Sources: Systematic searches occurred using the CINAHL and MEDLINE databases searching for peer-reviewed, English publications. Read More

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Difficulties with Learning Musculoskeletal Physical Examination Skills: Student Perspectives and General Lessons Learned for Curricular Design.

Teach Learn Med 2021 Aug 28:1-12. Epub 2021 Aug 28.

Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.

The development of foundational clinical skills, such as physical examination, is essential to becoming a competent clinician. Musculoskeletal medicine is often considered a specialized area of practice despite the high prevalence of musculoskeletal conditions in the general population and presenting to general clinical practices. Prior work has shown that medical learners and practicing clinicians have low confidence in these skills but understanding of the student perspective on why these skills are more difficult to acquire is unclear. Read More

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Validation of the Reference Genes for the Gene Expression Studies in Different Cell Lines of Pig.

Biomed Res Int 2021 18;2021:5364190. Epub 2021 Aug 18.

State Key Laboratory of Animal Nutrition; Key Laboratory of Animal Genetics Breeding and Reproduction, Ministry of Agriculture and Rural Affairs, Institute of Animal Science, Chinese Academy of Agricultural Sciences, 100193 Beijing, China.

Reverse transcription quantitative real-time polymerase chain reaction is one of the important methods to investigate gene expression in cells and tissues. However, if the data cannot be normalized with appropriate reference genes, the results may be unreliable. In this study, we detected the expression of 15 reference genes in three pig cell lines. Read More

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September 2021

Deceptive Urine Studies and Inappropriate Antibiotic Use in Geriatric Psychiatry: The Impact of Bundled Interventions.

Int J Appl Basic Med Res 2021 Jul-Sep;11(3):166-170. Epub 2021 Jul 19.

Division Chief of Infectious Disease, Harvard Medical School, Cambridge Health Alliance, Cambridge, Massachusetts, USA.

Background: Indiscriminate orders for urinalysis and urine cultures (UC) drive inappropriate antibiotic treatment (Abx), especially in older adults with mental health disorders. Lack of data regarding the prevalence of and treatment for infections in acute geriatric psychiatric units (GPU) motivated us to initiate this project.

Aim: Our goal was to improve urine test utilization and reduce unnecessary Abx for asymptomatic bacteriuria (ASB) and contaminated UC. Read More

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Thecal Sac Contouring as a Surrogate for the Cauda Equina and Intra-Canal Spinal Nerve Roots for Spine Stereotactic Body Radiotherapy (SBRT): Contour Variability and Recommendations for Safe Practice.

Int J Radiat Oncol Biol Phys 2021 Aug 25. Epub 2021 Aug 25.

Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.

Purpose: To present inter observer variability (IOV) in thecal sac (TS) delineation based on contours generated by eight experienced spine stereotactic body radiotherapy (SBRT) radiation oncologists, and propose contouring recommendations to standardize practice.

Methods And Materials: In the setting of a larger contouring study that reported target volume delineation guidelines specific to sacral metastases, eight academically based radiation oncologists (RO) with dedicated spine SBRT programs independently contoured the TS as a surrogate for the cauda equina and intra-canal spinal nerve roots. Uniform treatment planning simulation CT datasets fused with T1, T2 and T1 post gadolinium magnetic resonance imaging (MRI) for each case were distributed to each RO. Read More

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Prevalence and risk factors of bronchiectasis in rheumatoid arthritis: A systematic review and meta-analysis.

Semin Arthritis Rheum 2021 Oct 20;51(5):1067-1080. Epub 2021 Aug 20.

Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, 60 Fenwood Road, 6016U, Boston, MA 02115, United States; Harvard Medical School, Boston, MA, United States. Electronic address:

Objectives: We performed a systematic review and meta-analysis for the prevalence and risk factors of rheumatoid arthritis-related bronchiectasis (RA-BR).

Methods: We queried PubMed and EMBASE databases to identify published literature related to prevalence and risk factors for RA-BR among patients with RA. Data extraction included study design, country, year, method of RA-BR detection, RA characteristics, numerator of RA-BR cases and denominator of patients with RA, and associations with RA-BR presence. Read More

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October 2021

Who Is the Most Vulnerable to Anxiety at the Beginning of the COVID-19 Outbreak in China? A Cross-Sectional Nationwide Survey.

Healthcare (Basel) 2021 Jul 30;9(8). Epub 2021 Jul 30.

Department of Laboratorial Science and Technology & Vaccine Research Center, School of Public Health, Peking University, Beijing 100191, China.

(1) Background: The COVID-19 pandemic has not only changed people's health behavior, but also induced a psychological reaction among the public. Research data is needed to develop scientific evidence-driven strategies to reduce adverse mental health effects. The aims of this study are to evaluate the anxiety reaction of Chinese people and the related determinants during the earliest phase of the COVID-19 outbreak in China. Read More

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Mouth Washing Impaired SARS-CoV-2 Detection in Saliva.

Diagnostics (Basel) 2021 Aug 22;11(8). Epub 2021 Aug 22.

Unité de Parasitologie et Entomologie, Département de Microbiologie et Maladies Infectieuses, Institut de Recherche Biomédicale des Armées, 13005 Marseille, France.

Background: A previous study demonstrated the performance of the Salivette (SARSTEDT, Numbrecht, Germany) as a homogeneous saliva collection system to diagnose COVID-19 by RT-qPCR, notably for symptomatic and asymptomatic patients. However, for convalescent patients, the corroboration of molecular detection of SARS-CoV-2 in paired nasopharyngeal swabs (NPS) and saliva samples was unsatisfactory.

Objectives: The aim of the present work was to assess the concordance level of SARS-CoV-2 detection between paired sampling of NPSs and saliva collected with Salivette at two time points, with ten days of interval. Read More

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A 10-Year Retrospective Review of Prenatal Applications, Current Challenges and Future Prospects of Three-Dimensional Sonoangiography.

Diagnostics (Basel) 2021 Aug 21;11(8). Epub 2021 Aug 21.

Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Bangkok 10700, Thailand.

Realistic reconstruction of angioarchitecture within the morphological landmark with three-dimensional sonoangiography (three-dimensional power Doppler; 3D PD) may augment standard prenatal ultrasound and Doppler assessments. This study aimed to (a) present a technical overview, (b) determine additional advantages, (c) identify current challenges, and (d) predict trajectories of 3D PD for prenatal assessments. PubMed and Scopus databases for the last decade were searched. Read More

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Implementation of Patient Engagement Tools in Electronic Health Records to Enhance Patient-Centered Communication: Protocol for Feasibility Evaluation and Preliminary Results.

JMIR Res Protoc 2021 Aug 26;10(8):e30431. Epub 2021 Aug 26.

Division of Biomedical Informatics, Department of Medicine, University of California San Diego, La Jolla, CA, United States.

Background: Patient-physician communication during clinical encounters is essential to ensure quality of care. Many studies have attempted to improve patient-physician communication. Incorporating patient priorities into agenda setting and medical decision-making are fundamental to patient-centered communication. Read More

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