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Decision Analysis

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1. Decision tree analysis in subarachnoid hemorrhage: prediction of outcome parameters during the course of aneurysmal subarachnoid hemorrhage using decision tree analysis. Full Text available with Trip Pro

Decision tree analysis in subarachnoid hemorrhage: prediction of outcome parameters during the course of aneurysmal subarachnoid hemorrhage using decision tree analysis. OBJECTIVEThe aim of this study was to create prediction models for outcome parameters by decision tree analysis based on clinical and laboratory data in patients with aneurysmal subarachnoid hemorrhage (aSAH).METHODSThe database consisted of clinical and laboratory parameters of 548 patients with aSAH who were admitted (...) outcome at all time points had a prediction accuracy of 71.1% in the training data set, with procalcitonin on day 1 being the most important differentiating factor at all time points. A total of 148 patients (27%) developed VP shunt dependency. The most important differentiating factor was hyperglycemia on admission.CONCLUSIONSThe multiple variable analysis capability of decision trees enables exploration of dependent variables in the context of multiple changing influences over the course

2018 Journal of Neurosurgery

2. Additive Multicriteria Decision Analysis Models: Misleading Aids for Life-Critical Shared Decision Making. (Abstract)

Additive Multicriteria Decision Analysis Models: Misleading Aids for Life-Critical Shared Decision Making. Background. There is growing interest in multicriteria decision analysis (MCDA) for shared decision making (SDM). A distinguishing feature is that a preferred treatment should extend years of life and/or improve health-related quality of life (HRQL). Additive MCDA models are inadequate for the task. A plethora of MCDA models exist, each claiming that it can correctly solve real-world

2019 Medical Decision Making

3. Comorbidities and the decision to undergo or forego destination therapy left ventricular assist device implantation: An analysis from the Trial of a Shared Decision Support Intervention for Patients and their Caregivers Offered Destination Therapy for End (Abstract)

Comorbidities and the decision to undergo or forego destination therapy left ventricular assist device implantation: An analysis from the Trial of a Shared Decision Support Intervention for Patients and their Caregivers Offered Destination Therapy for End Patients considering destination therapy left ventricular assist devices (DT LVAD) often have high comorbid burden but the association between these comorbidities and post-decision outcomes is unknown.We included subjects in DECIDE-LVAD (...) younger regardless of LVAD implantation status. After adjusting for age, overall and amongst LVAD recipients, patients with ≥1 comorbidity had higher mean decision conflict at baseline (23.2 ± 1.5 vs. 17.4 ± 2.2), and at 6 months, higher stress (13.0 ± 0.6 vs. 10.4 ± 1.0) and struggle with illness (13.3 ± 0.4 vs. 11.1 ± 0.6) than those without comorbidities (P < .05). No difference was noted in decision regret, PHQ-2, EQ-VAS, acceptance of illness and survival overall and amongst LVAD recipients

2019 American Heart Journal Controlled trial quality: uncertain

4. Patient decision aids: a content analysis based on a decision tree structure. Full Text available with Trip Pro

Patient decision aids: a content analysis based on a decision tree structure. This paper presents the preliminary results of a decision-tree analysis of Patient Decision Aids (PDA). PDAs are online or offline tools used to structure health information, elicit relevant values and emphasize the decision as a process, in ways that help patients make more informed health decisions individually or with relevant others.Twenty PDAs are randomly selected from the International Patient Decision Aids (...) Standards (IPDAS) ( https://decisionaid.ohri.ca/AZlist.html ) approved list. An evaluation tool is built bottom-up and top-down and results are described in terms of communicating uncertainty, completeness of the decision tree, ambiguous or misleading phrasing, overall strategies suggested within personal stories.Twelve of the analyzed PDAs had branches of the decision tree which were not discussed in the tool and 6 had logically ambiguous phrasing. Many tools included dichotomous options, when

2019 Medical Informatics and Decision Making

5. Interactivity in a Decision Aid: Findings From a Decision Aid to Technologically Enhance Shared Decision Making RCT (Abstract)

Interactivity in a Decision Aid: Findings From a Decision Aid to Technologically Enhance Shared Decision Making RCT Colorectal cancer screening (CRCS) remains underutilized. Decision aids (DAs) can increase patient knowledge, intent, and CRCS rates compared with "usual care," but whether interactivity further increases CRCS rate remains unknown.A two-armed RCT compared the effect of a web-based DA that interactively assessed patient CRC risk and clarified patient preference for specific CRCS (...) test to a web-based DA with the same content but without the interactive tools.The study sites were 12 community- and three university-based primary care practices (56 physicians) in southeastern Michigan. Participants were men and women aged 50-75 years not current on CRCS.Random allocation to interactive DA (interactive arm) or non-interactive DA (non-interactive arm).Primary outcome was medical record documentation of CRCS 6 months after the intervention. Secondary outcome was patient decision

2019 EvidenceUpdates

6. Decision aid tools to support women's decision making in pregnancy and birth: a systematic review and meta-analysis

Decision aid tools to support women's decision making in pregnancy and birth: a systematic review and meta-analysis Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.

2013 DARE.

7. Systematic review with meta-analysis: Parenting concerns, parental identity and functional status influence medical treatment decisions of patients with advanced cancer

Systematic review with meta-analysis: Parenting concerns, parental identity and functional status influence medical treatment decisions of patients with advanced cancer Parenting concerns, parental identity and functional status influence medical treatment decisions of patients with advanced cancer | Evidence-Based Nursing We use cookies to improve our service and to tailor our content and advertising to you. You can manage your cookie settings via your browser at any time. To learn more about (...) decisions of patients with advanced cancer Article Text Nursing issues Systematic review with meta-analysis Parenting concerns, parental identity and functional status influence medical treatment decisions of patients with advanced cancer Free Carmen G Loiselle , Ariane Santerre-Theil Statistics from Altmetric.com Commentary on: Park EM, Check DK, Song MK, et al . Parenting while living with advanced cancer: A qualitative study. Palliat Med 2017;31:231–8. Implications for practice and research Parents

2017 Evidence-Based Nursing

8. Analysis of How Emergency Physicians' Decisions to Hospitalize or Discharge Patients With Acute Heart Failure Match the Clinical Risk Categories of the MEESSI-AHF Scale (Abstract)

Analysis of How Emergency Physicians' Decisions to Hospitalize or Discharge Patients With Acute Heart Failure Match the Clinical Risk Categories of the MEESSI-AHF Scale The Multiple Estimation of Risk Based on the Emergency Department Spanish Score in Patients With Acute Heart Failure (MEESSI-AHF) is a validated clinical decision tool that characterizes risk of mortality in emergency department (ED) acute heart failure patients. The objective of this study is to compare the distribution of risk (...) to determine the adjusted association between ED disposition decision and the outcomes among patients who were stratified into low- and increased-risk categories.We included 7,930 patients (80.5 years [SD 10.1 years]; women 54.7%; hospitalized 75.3%). Compared with that for low-risk MEESSI-AHF patients, odds ratios for hospitalization of patients in intermediate-, high-, and very-high-risk categories were 1.83 (95% confidence interval [CI] 1.64 to 2.05), 3.05 (95% CI 2.48 to 3.76), and 3.98 (95% CI 3.13

2019 EvidenceUpdates

9. Development of multi-criteria decision analysis (MCDA) framework for off-patent pharmaceuticals - an application on improving tender decision making in Indonesia. Full Text available with Trip Pro

Development of multi-criteria decision analysis (MCDA) framework for off-patent pharmaceuticals - an application on improving tender decision making in Indonesia. Off-patent pharmaceuticals (OPPs) hold vital importance in meeting public health objectives, especially in developing countries where resources are limited. OPPs are comprised of off-patent originals, branded generics and unbranded generics; nonetheless, these products are not identical and often there are differences (...) in their equivalence, manufacturing quality standards and reliability of supply. This necessitates reconsideration of the lowest price policy objective in pharmaceutical decision making. The aim of this study was to develop a Multi-Criteria Decision Analysis (MCDA) framework through a pilot workshop to inform the national procurement of OPPs in Indonesia.An initial list of potentially relevant criteria was identified based on previous work and a literature review. In a 2-day pilot policy workshop, twenty local

2018 BMC health services research

10. Effects of the Use of Multi Criterion Decision Analysis (MCDA) on Decision Quality in an Online Delphi

Effects of the Use of Multi Criterion Decision Analysis (MCDA) on Decision Quality in an Online Delphi Effects of the Use of Multi Criterion Decision Analysis (MCDA) on Decision Quality in an Online Delphi - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please (...) remove one or more studies before adding more. Effects of the Use of Multi Criterion Decision Analysis (MCDA) on Decision Quality in an Online Delphi (Delphi-MCDA) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT03498365 Recruitment Status : Enrolling by invitation First Posted : April 13, 2018 Last

2018 Clinical Trials

11. Applying Reflective Multicriteria Decision Analysis (MCDA) to Patient–Clinician Shared Decision-Making on the Management of Gastroenteropancreatic Neuroendocrine Tumors (GEP-NET) in the Spanish Context Full Text available with Trip Pro

Applying Reflective Multicriteria Decision Analysis (MCDA) to Patient–Clinician Shared Decision-Making on the Management of Gastroenteropancreatic Neuroendocrine Tumors (GEP-NET) in the Spanish Context Unresectable, well-differentiated nonfunctioning gastroenteropancreatic neuroendocrine tumors (GEP-NETs) can be monitored (watchful waiting, WW) or treated with systemic therapy such as somatostatin analogues (SSAs) to delay progression. We applied a reflective multicriteria decision analysis (...) (MCDA) shared-decision framework (previously developed for the USA) to explore what matters to Spanish patients and clinicians considering GEP-NET treatment options.The EVIDEM-derived framework was updated and adapted to the Spanish context. During a Chatham House session, five patients and six physicians assigned criteria weights using hierarchical point allocation and direct rating scale (alternative analysis). Informed by synthesized evidence embedded in the framework, participants scored how

2018 Advances in therapy

12. Using Decision Analysis to Support Newborn Screening Policy Decisions: A Case Study for Pompe Disease Full Text available with Trip Pro

Using Decision Analysis to Support Newborn Screening Policy Decisions: A Case Study for Pompe Disease Newborn screening is a public health program to identify conditions associated with significant morbidity or mortality that benefit from early intervention. Policy decisions about which conditions to include in newborn screening are complex because data regarding epidemiology and outcomes of early identification are often incomplete.To describe expected outcomes of Pompe disease newborn (...) screening and how a decision analysis informed recommendations by a federal advisory committee.We developed a decision tree to compare Pompe disease newborn screening with clinical identification of Pompe disease in the absence of screening. Cases of Pompe disease were classified into three types: classic infantile-onset disease with cardiomyopathy, nonclassic infantile-onset disease, and late-onset disease. Screening results and 36-month health outcomes were projected for classic and nonclassic

2018 MDM Policy & Practice

13. Systematic review and meta-analysis of effectiveness of decision aids for vaccination decision-making

Systematic review and meta-analysis of effectiveness of decision aids for vaccination decision-making Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration record, any associated files (...) cell dose (linear); blinding of outcome assessment reported (stratified yes vs no). For stratified analyses, a minimum number of 8 studies per subgroup is required. ">Subgroup analyses A sensitivity analysis is conducted to assess the impact of decisions taken in the review process on the meta-analysis outcome. These decisions may have been made in various stages of the review, e.g. the decision to exclude certain disease models, the decision to pool certain units of measurement for an outcome

2020 PROSPERO

14. Multicriteria decision analysis in health care decision in oncology: a systematic review

Multicriteria decision analysis in health care decision in oncology: a systematic review Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites (...) cell dose (linear); blinding of outcome assessment reported (stratified yes vs no). For stratified analyses, a minimum number of 8 studies per subgroup is required. ">Subgroup analyses A sensitivity analysis is conducted to assess the impact of decisions taken in the review process on the meta-analysis outcome. These decisions may have been made in various stages of the review, e.g. the decision to exclude certain disease models, the decision to pool certain units of measurement for an outcome

2020 PROSPERO

15. Reasons For Physicians Not Adopting Clinical Decision Support Systems: Critical Analysis Full Text available with Trip Pro

Reasons For Physicians Not Adopting Clinical Decision Support Systems: Critical Analysis Clinical decision support systems (CDSSs) are an integral component of today's health information technologies. They assist with interpretation, diagnosis, and treatment. A CDSS can be embedded throughout the patient safety continuum providing reminders, recommendations, and alerts to health care providers. Although CDSSs have been shown to reduce medical errors and improve patient outcomes, they have (...) fallen short of their full potential. User acceptance has been identified as one of the potential reasons for this shortfall.The purpose of this paper was to conduct a critical review and task analysis of CDSS research and to develop a new framework for CDSS design in order to achieve user acceptance.A critical review of CDSS papers was conducted with a focus on user acceptance. To gain a greater understanding of the problems associated with CDSS acceptance, we conducted a task analysis to identify

2018 JMIR medical informatics

16. Tumour profiling tests to guide adjuvant chemotherapy decisions in early breast cancer

Registration and Analysis Service as described in the data collection arrangements agreed with NICE (see section 5.29). 1.2 MammaPrint is not recommended for guiding adjuvant chemotherapy decisions for people with ER-positive, HER2-negative and LN-negative early breast cancer because it is not cost effective. 1.3 IHC4+C is not recommended for guiding adjuvant chemotherapy decisions for people with ER-positive, HER2-negative and LN-negative early breast cancer because the analytical validity of the test (...) , regardless of LN status. 4.12 In adjusted analyses, a pooled analysis of patients with LN-negative and LN- positive disease showed that MammaPrint had statistically significant Tumour profiling tests to guide adjuvant chemotherapy decisions in early breast cancer (DG34) © NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 16 of 56prognostic accuracy for 10-year distant recurrence-free survival after adjusting for clinical

2019 National Institute for Health and Clinical Excellence - Diagnostics Guidance

17. Rapid Expert Consultation on Data Elements and Systems Design for Modeling and Decision Making for the COVID-19 Pandemic

Rapid Expert Consultation on Data Elements and Systems Design for Modeling and Decision Making for the COVID-19 Pandemic Rapid Expert Consultation | Rapid Expert Consultation on Data Elements and Systems Design for Modeling and Decision Making for the COVID-19 Pandemic (March 21, 2020) | The National Academies Press (2020) Chapter: Rapid Expert Consultation Unfortunately, this book can't be printed from the OpenBook. If you need to print pages from this book, we recommend downloading (...) Consultation on Data Elements and Systems Design for Modeling and Decision Making for the COVID-19 Pandemic (March 21, 2020) . Washington, DC: The National Academies Press. doi: 10.17226/25755. × Page 2 Suggested Citation: "Rapid Expert Consultation." National Academies of Sciences, Engineering, and Medicine. 2020. Rapid Expert Consultation on Data Elements and Systems Design for Modeling and Decision Making for the COVID-19 Pandemic (March 21, 2020) . Washington, DC: The National Academies Press. doi

2020 Covid-19 Ad hoc papers

18. Factors Informing Clinical Decisions about Ventilator Use during Ventilator Shortages in an Infectious Disease Pandemic

Factors Informing Clinical Decisions about Ventilator Use during Ventilator Shortages in an Infectious Disease Pandemic CLINICAL EVIDENCE ASSESSMENT © April 15, 2020 ECRI Factors Informing Clinical Decisions about Ventilator Use during Ventilator Shortages in an Infectious Disease Pandemic During infectious disease pandemics, hospitals can become overwhelmed if many patients require life-saving measures. Ventilator shortages are common, and clinicians must make critical decisions regarding (...) their use (i.e., who gets one, when to terminate care). Factors that may inform decision making during ventilator shortages include patient age, presence of comorbidities, expected survival, and existence of advanced directives. In this report, we examine the effectiveness of triage systems for identifying disease severity and mortality risk to inform decisions on scarce resource allocation during pandemics. The Evidence Bar™ Evidence raises concerns We identified 14 guidelines, 4 triage frameworks

2020 Covid-19 Ad hoc papers

19. When do cancer patients regret their treatment decision? A path analysis of the influence of clinicians' communication styles and the match of decision-making styles on decision regret. (Abstract)

When do cancer patients regret their treatment decision? A path analysis of the influence of clinicians' communication styles and the match of decision-making styles on decision regret. To test the influence of physician empathy (PE), shared decision making (SDM), and the match between patients' preferred and perceived decision-making styles on patients' decision regret.Patients with breast or colon cancer (n=71) completed questionnaires immediately following (T1) and three months after (...) a consultation (T2). Path analysis was used to examine the relationships among patient demographics, patient reports of PE, SDM, the match between preferred and perceived decision-making styles, and patient decision regret at T2.After controlling for clinician clusters, higher PE was directly associated with more SDM (β=0.43, p<0.01) and lower decision regret (β=-0.28, p<0.01). The match between patients' preferred and perceived roles was negatively associated with decision regret (β=-0.33, p<0.01). Patients

2017 Patient education and counseling Controlled trial quality: uncertain

20. The "Fill the Nutrient Gap" Analysis: an approach to strengthen nutrition situation analysis and decision-making towards multi-sectoral policies and systems change. Full Text available with Trip Pro

The "Fill the Nutrient Gap" Analysis: an approach to strengthen nutrition situation analysis and decision-making towards multi-sectoral policies and systems change. Improved nutrition situation analysis can increase the understanding of the likely magnitude and main causes of the nutrient gap among a particular target group, for example, children under 2 or pregnant and lactating women, in a particular context. The World Food Programme, with input from University of California Davis (...) , International Food Policy Research Institute, Epicentre, Harvard University, Mahidol University, Save the Children, and UNICEF, has developed a framework for strengthened nutrition situation analysis and decision making called the "Fill the Nutrient Gap" (FNG), which aims to support identification of strategies to increase availability, access, and choice of nutritious foods, to ultimately improve nutrient intake. The FNG engages stakeholders from different sectors throughout the analytical process

2019 Maternal & child nutrition

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