23,963 results match your criteria decision tool


Effect of point-of-care gastrointestinal ultrasound on decision-making and management in inflammatory bowel disease.

Aliment Pharmacol Ther 2021 Jun 22. Epub 2021 Jun 22.

Department of Gastroenterology, Alfred Hospital and Monash University, Melbourne, Vic., Australia.

Background: Gastrointestinal ultrasound is increasingly used for point of care assessment of inflammatory bowel disease.

Aims: To explore the utility of gastrointestinal ultrasound as a point-of-care assessment tool from the perspectives of the clinician and patient.

Methods: A prospective, observational cohort study was designed utilising routine outpatient consultations. Read More

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Enhancing Obstructive Sleep Apnea Diagnosis With Screening Through Disease Phenotypes: Algorithm Development and Validation.

JMIR Med Inform 2021 Jun 22;9(6):e25124. Epub 2021 Jun 22.

MEDCIDS-FMUP - Community Medicine, Information and Decision Sciences, Faculty of Medicine of the University of Porto, Porto, Portugal.

Background: The American Academy of Sleep Medicine guidelines suggest that clinical prediction algorithms can be used in patients with obstructive sleep apnea (OSA) without replacing polysomnography, which is the gold standard.

Objective: This study aims to develop a clinical decision support system for OSA diagnosis according to its standard definition (apnea-hypopnea index plus symptoms), identifying individuals with high pretest probability based on risk and diagnostic factors.

Methods: A total of 47 predictive variables were extracted from a cohort of patients who underwent polysomnography. Read More

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TOTAL MANDIBULAR DEFECT RECONSTRUCTION BY TOTAL TITANIUM PATIENT-SPECIFIC IMPLANT: CLINICAL EFFICACY AND LONG TERM FOLLOW UP. CLINICAL CASE.

Wiad Lek 2021 ;74(4):1037-1041

O.O. BOGOMOLETS NATIONAL MEDICAL UNIVERSITY, KYIV, UKRAINE; KYIV REGIONAL CLINICAL HOSPITAL, KYIV, UKRAINE.

The aim of this clinical case in demonstrating the possibility of replacing total defect of the mandible with a patient specific implant and the result of long-term follow up. Literature data on the replacement of total mandibular defects are extremely limited and they are presented by only several clinical cases where various surgical approaches were used. In the available literature, there are two approaches to solving this problem, including the replacement of the jaw with vascularised bone grafts, of which the fibula flap is the most promising, and the implantation of endoprostheses of the jaws, of which patient-specific anatomical endoprostheses made using additive technologies are the most advanced. Read More

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January 2021

Computerised decision support in veterinary medicine, exemplified in a canine idiopathic epilepsy care pathway.

J Small Anim Pract 2021 Jun 21. Epub 2021 Jun 21.

Department of Veterinary Medicine, University of Cambridge, Cambridge, CB3 0ES, UK.

Computerised decision support is of emerging and increasing importance in human medicine, but as yet has not been thoroughly applied or evaluated in veterinary medicine. In this essay, the authors report on the first example of a veterinary care pathway, a specific form of computerised decision support, which guides clinicians through a clinical workflow and incorporates individual patient data to inform patient-specific decision recommendations. The veterinary care pathway was designed using consensus statements and specialist neurologist opinion to create a decision support tool concerning canine idiopathic epilepsy. Read More

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Preferences for nutrients and sensory food qualities identify biological sources of economic values in monkeys.

Proc Natl Acad Sci U S A 2021 Jun;118(26)

Department of Physiology, Development and Neuroscience, University of Cambridge, CB2 3DY Cambridge, United Kingdom;

Value is a foundational concept in reinforcement learning and economic choice theory. In these frameworks, individuals choose by assigning values to objects and learn by updating values with experience. These theories have been instrumental for revealing influences of probability, risk, and delay on choices. Read More

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[Prescription of phosphorus, calcium and magnesium: choice of the millimole unit to establish the equivalence of doses between oral and injectable forms].

Ann Pharm Fr 2021 Jun 18. Epub 2021 Jun 18.

Service pharmaceutique, hospices civils de Lyon, hôpital de la Croix-Rousse, groupement hospitalier Nord, 103 grande rue de la Croix Rousse, 69317 Lyon Cedex 04, France.

Objectives: Information available on the packaging of drugs indicated for patients electrolytes replenishment differs from one manufacturer to another. They relate, for example, the unit chosen to express elemental electrolyte concentration. These differences constitute a risk factor for medication errors. Read More

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Utility of telemedicine in the treatment of patients with chronic HCV infection using DAAs in remote areas with limited resources.

Liver Int 2021 Jun 21. Epub 2021 Jun 21.

Endemic medicine and hepatology department, Cairo, Egypt.

Telemedicine is a novel tool that could assist in the delivery of medical care, therefore, we aimed to assess the utility of using telemedicine in the Egyptian hepatitis C (HCV) treatment program to provide care to patients in remote areas. A telemedicine viral hepatitis treatment center was established in the Bahariya Oases, a remote area in the Egyptian western desert. We enrolled 208 HCV patients who were eligible to be treated using direct acting antivirals. Read More

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Are Cost-of-Care Conversations Best Practice? A Qualitative Study of Oncologists' Attitudes and Practice.

JCO Oncol Pract 2021 Jun 21:OP2100042. Epub 2021 Jun 21.

Department of Communication, University of Kentucky, Lexington, KY.

Purpose: Patients' desire for cost conversations exceeds the incidence of such conversations, and many oncologists report avoiding cost conversations despite reporting willingness to have them. Our objective was to examine oncologists' attitudes toward cost conversations and how those attitudes affect practice.

Methods: An experienced investigator conducted individual interviews with oncologists practicing in Kentucky. Read More

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Characterizing Decisional Conflict in Patients Presenting to Sleep Surgery Clinic and an Exploration of Resource Limitations.

Laryngoscope 2021 Jun 21. Epub 2021 Jun 21.

Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco School of Medicine, San Francisco, California, U.S.A.

Objectives: Numerous therapies exist for adult obstructive sleep apnea (OSA), creating potential for patient decisional conflict (DC) that impacts treatment adherence and post-treatment regret. We evaluated the prevalence of elevated DC in OSA patients presenting for positive airway pressure (PAP) alternative therapies and identified gaps in available resources about OSA therapies.

Study Design: Cross-sectional study. Read More

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Redevelopment of the Predict: Breast Cancer website and recommendations for developing interfaces to support decision-making.

Cancer Med 2021 Jun 21. Epub 2021 Jun 21.

Winton Centre for Risk and Evidence Communication, University of Cambridge, Cambridge, UK.

Objectives: To develop a new interface for the widely used prognostic breast cancer tool: Predict: Breast Cancer. To facilitate decision-making around post-surgery breast cancer treatments. To derive recommendations for communicating the outputs of prognostic models to patients and their clinicians. Read More

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Preoperative prediction of histologic grade in invasive breast cancer by using contrast-enhanced spectral mammography-based radiomics.

J Xray Sci Technol 2021 Jun 13. Epub 2021 Jun 13.

Department of Radiology, Yantai Yuhuangding Hospital, Qingdao University, Yantai, Shandong, P. R. China.

Objective: To develop and validate a radiomics model based on contrast-enhanced spectral mammography (CESM), and preoperatively discriminate low-grade (grade I/II) and high-grade (grade III) invasive breast cancer.

Method: A total of 205 patients with CESM examination and pathologically confirmed invasive breast cancer were retrospectively enrolled. We randomly divided patients into two independent sets namely, training set (164 patients) and test set (41 patients) with a ratio of 8:2. Read More

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Assessment of a Cellular Host Response Test as a Sepsis Diagnostic for Those With Suspected Infection in the Emergency Department.

Crit Care Explor 2021 Jun 15;3(6):e0460. Epub 2021 Jun 15.

Louisiana State University Health Sciences Center, Baton Rouge, LA.

Objectives: Sepsis is a common cause of morbidity and mortality. A reliable, rapid, and early indicator can help improve efficiency of care and outcomes. To assess the IntelliSep test, a novel in vitro diagnostic that quantifies the state of immune activation by measuring the biophysical properties of leukocytes, as a rapid diagnostic for sepsis and a measure of severity of illness, as defined by Sequential Organ Failure Assessment and Acute Physiology and Chronic Health Evaluation-II scores and the need for hospitalization. Read More

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Converting to an open research platform: focus group and AI review tool research results.

Access Microbiol 2021 19;3(4):000232. Epub 2021 Apr 19.

Microbiology Society, London, UK.

The Microbiology Society will be launching an open research platform in October 2021. Developed using funding from the Wellcome Trust and the Howard Hughes Medical Institute (HHMI), the platform will combine our current sound-science journal, , with artificial intelligence (AI) review tools and many of the elements of a preprint server. In an effort to improve the rigour, reproducibility and transparency of the academic record, the platform will host both preprints of articles and their Version of Record (VOR) publications, as well as the reviewer reports, Editor's decision, authors' response to reviewers and the AI review reports. Read More

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Updates on Clinical Use of Liquid Biopsy in Colorectal Cancer Screening, Diagnosis, Follow-Up, and Treatment Guidance.

Front Cell Dev Biol 2021 24;9:660924. Epub 2021 May 24.

GES-LCM2E, FPN, Mohamed First University, Oujda, Morocco.

Colorectal cancer (CRC) is one of the most common cancers worldwide, being the third most diagnosed in the world and the second deadliest. Solid biopsy provides an essential guide for the clinical management of patients with colorectal cancer; however, this method presents several limitations, in particular invasiveness, and cannot be used repeatedly. Recently, clinical research directed toward the use of liquid biopsy, as an alternative tool to solid biopsy, showed significant promise in several CRC clinical applications, as (1) detect CRC patients at early stage, (2) make treatment decision, (3) monitor treatment response, (4) predict relapses and metastases, (5) unravel tumor heterogeneity, and (6) detect minimal residual disease. Read More

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Integration of Advanced Health Technology Within the Healthcare System to Fight the Global Pandemic: Current Challenges and Future Opportunities.

Innov Clin Neurosci 2021 Jan-Mar;18(1-3):31-34. Epub 2021 Jan 1.

Drs. Darwish and IsHak and Mr. Korouri, Ms. Pasini, and Ms. Cortez are with the Department of Psychiatry and Behavioral Neurosciences at Cedars-Sinai Medical Center in Los Angeles, California.

The COVID-19 pandemic presents a significant challenge for providing adequate healthcare services in the context of patient isolation.

Discussion: The ability of our current healthcare system to cope with the current situation is mainly dependent on advanced health technology, such as telehealth, chatbots, virtual reality (VR), and artificial intelligence (AI). Telehealth can be a novel tool for improving our current healthcare system and allowing for greater delivery of healthcare services during global crises (i. Read More

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January 2021

Developing a model to predict air pollution (case study: Tehran City).

J Environ Health Sci Eng 2021 Jun 7;19(1):71-80. Epub 2021 Jan 7.

ESL, Simmons College in Boston, Boston, MA USA.

The technology development, population growth, development of metropolises and subsequent pollution are serious threats to the environment and public health. Therefore, monitoring and evaluation of various emissions and their sources, and also providing practical strategies of pollution reduction, are necessary to solve these problems. In this regard, the use of modern methods to predict the concentration of pollutants can improve decision-making and provide appropriate solutions. Read More

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Health geo-governance to assess the vulnerability of Batna, Algeria to COVID-19: the role of GIS in the fight against a pandemic.

GeoJournal 2021 Jun 13:1-14. Epub 2021 Jun 13.

Laboratory of Natural Hazards and Spatial Planning (LRNAT), University of Batna 2, 53, Route de Constantine, Fesdis, 05078 Batna, Algeria.

The health systems in many countries are still unable to control the evolution and persistence of the COVID-19 pandemic despite the large mobilisation of national resources. International attention has focussed on finding a cure, and preventive measures and national and international strategies to be adopted and implemented with regard to other future pandemics have been neglected despite their predictability and high probability of occurrence. This work aims to anticipate a reading on experience feedback in light of the current pandemic situation, and to identify the main spatial elements of vulnerability in Batna, Algeria, which seems to control the ability of an urban area to prevent the spread of the COVID-19 virus. Read More

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A brief diagnostic screen for cluster headache: Creation and initial validation of the Erwin Test for Cluster Headache.

Cephalalgia 2021 Jun 20:3331024211018138. Epub 2021 Jun 20.

Department of Neurosurgery, 12340University of Texas Health Science Center at Houston, Houston, TX, USA.

Objective: To use 1) newly generated data, 2) existing evidence, and 3) expert opinion to create and validate a new cluster headache screening tool.

Methods: In phase 1 of the study, we performed a prospective study of an English translation of an Italian screen on 95 participants (45 with cluster headache, 17 with other trigeminal autonomic cephalalgias, 30 with migraine, and 3 with trigeminal neuralgia). In phase 2, we performed a systematic review in PubMed of all studies until September 2019 with diagnostic screening tools for cluster headache. Read More

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FLASH: A Novel Tool to Identify Vision-Threating Eye Emergencies.

Int J Ophthalmic Res 2020 8;6(1):336-343. Epub 2020 Oct 8.

Department of Ophthalmology and Visual Sciences, University of Michigan, 1000 Wall Street, Ann Arbor, MI 48105.

Background: Two million patients visit emergency departments due to eye complaints annually in the United States, yet nearly one-quarter of these visits are for non-urgent ocular problems. Other patients often present a significant length of time after the onset of their symptoms, which may cause progression to irreversible vision loss. A major reason for this discrepancy is that many patients are unsure what symptoms constitute eye emergencies. Read More

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October 2020

Quantifying the Intra-Operative Hemodynamic Effects of Glue Embolization in Vein of Galen Malformations.

Proc IEEE Int Symp Biomed Imaging 2019 11;2019:754-758. Epub 2019 Jul 11.

School of Biomedical Engineering & Imaging Sciences, King's College London, UK.

Vein of Galen malformation is a rare congenital pathological intracranial arteriovenous shunt which carries 30% risk of death before 28 days-of-age. Treatment is by high risk minimally invasive endovascular glue embolization of shunt feeding arteries under angiographic control. A tool to support intra-operative decision making would be useful. Read More

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Shared decision making in breast cancer screening guidelines: a systematic review of their quality and reporting.

Eur J Public Health 2021 Jun 20. Epub 2021 Jun 20.

Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain.

Background: Shared decision making (SDM) is a key component of evidence-based and patient-centred care. The aim of this study is to systematically review the quality of SDM proposals in clinical practice guidelines (CPGs) and consensus statements (CSs) concerning breast cancer (BC) screening.

Methods: Guidances were identified, without language restrictions, using a prospectively planned systematic search (MEDLINE, EMBASE, Web of Science, Scopus and guideline websites) from January 2010 to August 2020. Read More

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Early head CT in post-cardiac arrest patients: a helpful tool or contributor to self-fulfilling prophecy?

Resuscitation 2021 Jun 17. Epub 2021 Jun 17.

Department of Neurology, Yale School of Medicine, New Haven, CT, 06510, United States.

Objective: Neuroprognostication guidelines suggest that early head computed tomography (HCT) might be useful in the evaluation of cardiac arrest (CA) patients following return of spontaneous circulation. We aimed to determine the impact of early HCT, performed within the first 6 hours following CA, on decision-making following resuscitation.

Methods: We identified a cohort of initially unconscious post-CA patients at a tertiary care academic medical center from 2012 to 2017. Read More

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Performance validation of the Mayo triage algorithm applied to individualize surgical management of advanced epithelial ovarian cancer.

Gynecol Oncol 2021 Jun 16. Epub 2021 Jun 16.

Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, People's Republic of China,; Key Laboratory of Obstetrics and Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, People's Republic of China,. Electronic address:

Objective: To externally validate the performance of the Mayo triage algorithm applied to treatment strategy management in advanced epithelial ovarian cancer (AEOC) patients.

Methods: AEOC patients who underwent primary debulking surgery (PDS) were included and were divided into two groups based on the Mayo triage algorithm: "high risk" and "triage appropriate". The surgery outcomes and complications of the patients were compared between the two groups. Read More

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Harmonization status of procalcitonin measurements: what do comparison studies and EQA schemes tell us?

Clin Chem Lab Med 2021 Jun 21. Epub 2021 Jun 21.

Laboratoire National de Métrologie et d'Essais, Paris, France.

Sepsis represents a global health priority because of its high mortality and morbidity. The key to improving prognosis remains an early diagnosis to initiate appropriate antibiotic treatment. Procalcitonin (PCT) is a recognized biomarker for the early indication of bacterial infections and a valuable tool to guide and individualize antibiotic treatment. Read More

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Utility of intraoperative digital scintigraphy in radioguided parathyroidectomy.

Head Neck 2021 Jun 19. Epub 2021 Jun 19.

Department of Otolaryngology-HNS, Southern Illinois University School of Medicine, Springfield, Illinois, USA.

Background: Intraoperative scintigraphy (IoS) has been proposed as a tool for real-time intraoperative decision-making regarding parathyroid adenoma localization and confirmation of excision.

Methods: Retrospective review of patients who underwent minimally invasive parathyroidectomies with scintigraphy performed intraoperatively. Preoperative neck ultrasound, 4D computed tomography, as well as intraoperative parathyroid hormone (IOPTH) and gamma probe measurements were conducted per standard practice. Read More

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BARD: A Structured Technique for Group Elicitation of Bayesian Networks to Support Analytic Reasoning.

Risk Anal 2021 Jun 19. Epub 2021 Jun 19.

Department of Psychological Sciences, Birkbeck, University of London, London, UK.

In many complex, real-world situations, problem solving and decision making require effective reasoning about causation and uncertainty. However, human reasoning in these cases is prone to confusion and error. Bayesian networks (BNs) are an artificial intelligence technology that models uncertain situations, supporting better probabilistic and causal reasoning and decision making. Read More

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"The Way you Interpret Health": Adolescent Definitions and Perceptions of Health Literacy.

J Sch Health 2021 Jun 17. Epub 2021 Jun 17.

Community Health and Social Sciences, CUNY Graduate School of Public Health and Health Policy, New York, NY, 10027, USA.

Background: Adolescents are required to take increased responsibility for their health. Although health literacy is implicated in adults' health decision-making and health behaviors, little is known about adolescents' health literacy and its relationship to their health behaviors. Furthermore, adolescent health literacy research overlooks adolescent development-specific needs and skills. Read More

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Lipid biomarkers in statin users with coronary artery disease annotated by coronary computed tomography angiography.

Sci Rep 2021 Jun 18;11(1):12899. Epub 2021 Jun 18.

Istituto di Fisiologia Clinica-CNR, via Giuseppe Moruzzi 1, 56124, Pisa, Italy.

Molecular markers are suggested to improve the diagnostic and prognostic accuracy in patients with coronary artery disease (CAD) beyond current clinical scores based on age, gender, symptoms and traditional risk factors. In this context, plasma lipids are emerging as predictors of both plaque composition and risk of future events. We aim to identify plasma lipid biomarkers associated to CAD indexes of stenosis severity, plaque lipid content and a comprensive score of CAD extent and its risk. Read More

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Development and validation of the OUTCoV score to predict the risk of hospitalisation among patients with SARS-CoV-2 infection in ambulatory settings: a prospective cohort study.

BMJ Open 2021 06 18;11(6):e044242. Epub 2021 Jun 18.

Division of Primary Care, Geneva University Hospitals, Geneva, Switzerland.

Objectives: To develop and validate a rule-out prediction model for the risk of hospitalisation among patients with SARS-CoV-2 infection in the ambulatory setting to derive a simple score to determine outpatient follow-up.

Design: Prospective cohort study.

Setting: Swiss university hospital. Read More

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