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E/M Medical Decision Making

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21. Standards and guidelines for the interpretation of sequence variants: a joint consensus recommendation of the American College of Medical Genetics and Genomics and the Association for Molecular Pathology. Published in the March 2015 issue of Genetics in M Full Text available with Trip Pro

Standards and guidelines for the interpretation of sequence variants: a joint consensus recommendation of the American College of Medical Genetics and Genomics and the Association for Molecular Pathology. Published in the March 2015 issue of Genetics in M Standards and guidelines for the interpretation of sequence variants: a joint consensus recommendation of the American College of Medical Genetics and Genomics and the Association for Molecular Pathology | Genetics in Medicine Thank you (...) for Molecular Pathology , , , , , , , , , , , , , , , & ; on behalf of the ACMG Laboratory Quality Assurance Committee Genetics in Medicine volume 17 , pages 405 – 423 (2015) | Subjects Abstract Disclaimer: These ACMG Standards and Guidelines were developed primarily as an educational resource for clinical laboratory geneticists to help them provide quality clinical laboratory services. Adherence to these standards and guidelines is voluntary and does not necessarily assure a successful medical outcome

2015 Association for Molecular Pathology

22. Clinical Decision-Making and Best Practices for Potential Organ and Tissue Donors: Guidelines

Management to Optimize Donor Organ Potential. CMAJ [Internet]. 2006 Mar 14 [cited 2012 Apr 5];174(6):S13-S32. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1402396 PubMed: PM16534070 PREPARED BY: Canadian Agency for Drugs and Technologies in Health Tel: 1-866-898-8439 www.cadth.ca Clinical Decision-Making and Best Practices for Potential Organ and Tissue Donors 3 APPENDIX – FURTHER INFORMATION: Practice Guidelines and Recommendations 6. Kucewicz E, Wojarski J, Zeglen S, Saucha W (...) ://www.organsandtissues.ca/s/wp-content/uploads/2011/11/Donor- Clinical Decision-Making and Best Practices for Potential Organ and Tissue Donors 4 Organ-Mgmt-Lit-Review.pdf Prepared for the forum: Medical management to optimize donor organ potential. February 23-25, 2004. 15. Van Raemdonck DE, Rega FR, Neyrinck AP, Jannis N, Verleden GM, Lerut TE. Non- heart-beating donors. Semin Thorac Cardiovasc Surg. 2004;16(4):309-21. PubMed: PM15635535 Additional References 16. Browne A. The ethics of organ donation after

2012 Canadian Agency for Drugs and Technologies in Health - Rapid Review

23. Multi-criteria decision analysis for the appraisal of medical needs: a pilot study

? REFERENCES 126 KCE Report 272 Multi-criteria decision analysis for the appraisal of medical needs 3 LIST OF FIGURES Figure 1 – Standard reimbursement decision procedure 7 Figure 2 – Early temporary reimbursement process 9 Figure 3 – Criteria and conditions for reimbursement identified by the citizen panel 19 Figure 4 – Steps to be taken in the development of an MCDA framework 20 Figure 5 – MCDA process in decision making 21 Figure 6 – MCDA process applied in Colombia 25 Figure 7 – Patient clusters 34 (...) d’avis en cas d’intervention temporaire pour l’utilisation d’un medicament” CMD College of Medical Directors ETR Early Temporary Reimbursement FAMHP Federal Agency for Medicines and Health Products HTAi Health Technology Assessment International ICER Incremental cost-effectiveness ratio KBF King Baudouin Foundation LUSS Ligue des Usagers des Services de Santé MCDA Multi-criteria decision analysis NIH National Institute of Health PCIG Patient and Citizen Interest Group P.H. Public Health PROMIS

2016 Belgian Health Care Knowledge Centre

24. How Returning Aggregate Research Results Impacts Interest in Research Engagement and Planned Actions Relevant to Health Care Decision Making: Cohort Study. Full Text available with Trip Pro

a "virtuous cycle" of research engagement, especially where ARRs are experienced favorably and affect plans to share and discuss ARRs in support of a child's chronic disease care and treatment. Reactions to ARRs vary with education level, underscoring the need for attention to equity for this model.©Elissa R Weitzman, Kara M Magane, Lauren E Wisk. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 21.12.2018. (...) How Returning Aggregate Research Results Impacts Interest in Research Engagement and Planned Actions Relevant to Health Care Decision Making: Cohort Study. Collection of patient-reported outcomes measures (PROs) may augment clinical data and inform health research, improving care, yet approaches to sustaining interest among patient cohorts in research participation are needed. One approach may involve returning aggregate research results (ARRs), which may help patients contextualize personal

2018 Journal of medical Internet research

25. “What matters most to you?” How decision aids help patients make better choices

a choice about antibiotic treatment for a child with an ear infection. It’s great to see projects under way such as Portsmouth Hospital NHS Trust’s ‘My Birthplace’ project to develop an app to help women decide where to have their baby. The voices clamoring for patients to be at the centre of their care, at the centre of evidence and at the centre of decision-making are growing louder and can be heard in the current debate about ‘Real Evidence-based Medicine’ (check out #RealEBM on Twitter). Dr Richard (...) and that research is needed on interventions that support shared decision-making between women considering mode of birth in a pregnancy after a caesarean birth and their care providers. (1) Horey D, Kealy M, Davey MA, Small R, Crowther CA. Interventions for supporting pregnant women’s decision-making about mode of birth after a caesarean. Cochrane Database of Systematic Reviews 2013, Issue 7. Art. No.: CD010041. DOI: 10.1002/14651858.CD010041.pub2. (2) Elwyn G, Frosch D, Volandes A, Edwards A, Montori V

2014 Evidently Cochrane

26. Making Immunization Decisions for School-aged Children: A Rapid Review

studies (two [-] and one [++] found that a range of perceived risks of immunization may influence some parental decisions to delay or avoid immunizations for their children. ? 1 study [-] found concerns around fear of vaccines being contraindicated for existing medical conditions 48 ? 3 studies ([-], [+], [++]) found concerns about combined antigens putting too much stress on a baby's immune system ? 4 studies (three [-], one [+]) found that when parents are making the decision to immunize (...) Making Immunization Decisions for School-aged Children: A Rapid Review 2 Making immunization decisions for school-aged children: A Rapid Review Anita Tsang-Sit, Analyst, Research and Policy Paulette Whyte, Supervisor Loretta Rowan, Manager August 25, 2014 i Table of Contents Key Messages 2 Executive Summary 3 1 Issue 6 2 Context 7 3 Conceptual Framework 9 4 Literature Review Question 10 5 Literature Search 10 6 Relevance Assessment 11 7 Results of the Search 12 8 Critical Appraisal 12 9

2014 Peel Health Library

27. Protocol for a Prospective (P) study to develop a model to stratify the risk (RI) of medication (M) related harm in hospitalized elderly (E) patients in the UK (The PRIME study). Full Text available with Trip Pro

Protocol for a Prospective (P) study to develop a model to stratify the risk (RI) of medication (M) related harm in hospitalized elderly (E) patients in the UK (The PRIME study). Medication related harm (MRH) is a common cause of morbidity and hospital admission in the elderly, and has significant cost implications for both primary and secondary healthcare resources. The development of risk prediction models has become an increasingly common phenomenon in medicine and can be useful to guide (...) objective clinical decision making, resource allocation and intervention. There are no risk prediction models that are widely used in clinical practice to identify elderly patients at high risk of MRH following hospital discharge. The aim of this study is to develop a risk prediction model (RPM) to identify elderly patients at high risk of MRH upon discharge from hospital, and to compare this with routine clinical judgment.This is a multi-centre, prospective observational study following a cohort

2016 BMC Geriatrics

28. 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

29. Rammya Mathew: Acknowledging clinician bias in shared decision making Full Text available with Trip Pro

decision between patient and doctor. In practice this might involve the use of shared decision aids, employing the use of multidisciplinary decision-making in patients with complex multimorbidity , and most of all, keeping the person in mind rather than treating single diseases based solely on clinical guidelines which often fail to take account of the wider bio-psychosocial model. [2] Rammya Mathew is a GP at Wembley Park Drive Medical Centre and Quality Improvement Clinical Lead, Islington Federation (...) Rammya Mathew: Acknowledging clinician bias in shared decision making Rammya Mathew: Acknowledging clinician bias in shared decision making - The BMJ ---> A piece of improvement work I’ve been involved in has thrown up some questions for me around anticoagulation in atrial fibrillation (AF). indicates that we are undertreating people with AF in terms of anticoagulation, and as a result, they are unnecessarily being put at risk of having a stroke. [1] Looking at this in more detail, it seems

2018 The BMJ Blog

30. Decision Making in Advanced Heart Failure

Decision Making in Advanced Heart Failure AHA Scientific Statement Decision Making in Advanced Heart Failure A Scientific Statement From the American Heart Association Endorsed by Heart Failure Society of America, American Association of Heart Failure Nurses, and Society for Medical Decision Making Larry A. Allen, MD, MHS, Co-Chair; Lynne W. Stevenson, MD, Co-Chair; Kathleen L. Grady, PhD, APN, FAHA, Co-Chair; Nathan E. Goldstein, MD; Daniel D. Matlock, MD, MPH; Robert M. Arnold, MD; Nancy R (...) therapeutic options may be considered unreasonable and there- fore independent of patient demands, although situations of medicalfutilityarerelativelyrare. 6 Althoughnotallpatientswill be able to clearly articulate decisions that are congruent with their stated goals, shared decision making aims to ensure that patients’ values, goals, and preferences are explored and incor- porated into the medical decision-making process. Patient-centered medicine has been suggested as the next phaseinhealthcare. 11

2012 American Heart Association

31. Shared Decision-Making in Intensive Care Units. Executive Summary of the American College of Critical Care Medicine and American Thoracic Society Policy Statement Full Text available with Trip Pro

.201602-0269ED Kon Alexander A AA 1 Naval Medical Center San Diego San Diego, California. 2 University of California San Diego San Diego, California. Davidson Judy E JE 3 University of California Health System San Diego, California. Morrison Wynne W 4 Children's Hospital of Philadelphia Philadelphia, Pennsylvania. Danis Marion M 5 National Institutes of Health Bethesda, Maryland and. White Douglas B DB 6 University of Pittsburgh School of Medicine Pittsburgh, Pennsylvania. eng Journal Article Practice (...) Shared Decision-Making in Intensive Care Units. Executive Summary of the American College of Critical Care Medicine and American Thoracic Society Policy Statement 27097019 2017 12 26 2018 11 13 1535-4970 193 12 2016 06 15 American journal of respiratory and critical care medicine Am. J. Respir. Crit. Care Med. Shared Decision-Making in Intensive Care Units. Executive Summary of the American College of Critical Care Medicine and American Thoracic Society Policy Statement. 1334-6 10.1164/rccm

2016 American Journal of Respiratory and Critical Care Medicine

32. Health Information Systems Supporting Health and Resiliency Through Improved Decision-making Full Text available with Trip Pro

Health Information Systems Supporting Health and Resiliency Through Improved Decision-making 28144677 2018 03 01 2018 12 02 2511-705X 56 Open 2017 02 01 Methods of information in medicine Methods Inf Med Health Information Systems Supporting Health and Resiliency Through Improved Decision-making. e11-e12 10.3414/ME16-25-0001 Ring David D Tierney William M WM William M. Tierney, MD, Professor and Chair, Department of Population Health, Dell Medical School, University of Texas at Austin, 1912 (...) Speedway, Suite 562, Austin, Texas 78712, USA, E-mail: tierney@utexas.edu. eng Editorial Comment 2017 02 01 Germany Methods Inf Med 0210453 0026-1270 IM Methods Inf Med. 2017 Feb 01;56(Open):e13-e19 28144682 Clinical Decision-Making methods Decision Support Systems, Clinical trends Electronic Health Records trends Forecasting Health Information Systems trends Precision Medicine trends 2017 2 2 6 0 2017 2 2 6 0 2018 3 2 6 0 epublish 28144677 16-25-0001 10.3414/ME16-25-0001 PMC5388924 J Am Med Inform

2017 Methods of information in medicine

33. Preface: ‘The 2013–2016 West African Ebola epidemic: data, decision-making and disease control’ Full Text available with Trip Pro

Preface: ‘The 2013–2016 West African Ebola epidemic: data, decision-making and disease control’ 28396482 2018 05 31 2018 05 31 1471-2970 372 1721 2017 May 26 Philosophical transactions of the Royal Society of London. Series B, Biological sciences Philos. Trans. R. Soc. Lond., B, Biol. Sci. Preface: 'The 2013-2016 West African Ebola epidemic: data, decision-making and disease control'. 20170020 10.1098/rstb.2017.0020 Piot Peter P London School of Hygiene and Tropical Medicine, London WC1E (...) 7HT, UK. Coltart Cordelia E M CE http://orcid.org/0000-0003-0176-8831 Research Department of Infection and Population Health, University College London, London WC1E 6JB, UK cordelia.coltart@ucl.ac.uk. Atkins Katherine E KE http://orcid.org/0000-0001-5250-0558 London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK. Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK. eng Introductory Journal Article England Philos Trans R

2017 Philosophical Transactions of the Royal Society B: Biological Sciences

34. Neurosurgery concepts: Key perspectives on endoscopic versus microscopic resection for pituitary adenomas, surgical decision-making in tuberculum sellae meningiomas, optic nerve mobilization during resection of craniopharyngiomas, and evaluation of headac Full Text available with Trip Pro

Neurosurgery concepts: Key perspectives on endoscopic versus microscopic resection for pituitary adenomas, surgical decision-making in tuberculum sellae meningiomas, optic nerve mobilization during resection of craniopharyngiomas, and evaluation of headac 28480114 2018 11 13 2229-5097 8 2017 Surgical neurology international Surg Neurol Int Neurosurgery concepts: Key perspectives on endoscopic versus microscopic resection for pituitary adenomas, surgical decision-making in tuberculum sellae (...) , Los Angeles, California, USA. Smith Zachary A ZA Department of Neurosurgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA. Dahdaleh Nader S NS Department of Neurosurgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA. Bohnen Angela M AM Department of Neurosurgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA. Cho Jin M JM Department of Neurosurgery, Ajou University School of Medicine, Suwon, South Korea

2017 Surgical neurology international

35. Choosing Wisely Canada recommendation - Don’t routinely do screening mammography for average risk women aged 40 – 49. Individual assessment of each woman’s preferences and risk should guide the discussion and decision regarding mammography screening in th

Vitamin D levels in patients with significant renal or metabolic disease. 1 2 3 Family Medicine Thirteen Things Physicians and Patients Should Question by College of Family Physicians of Canada Last updated: January 2018 4 5 6Don’t routinely do screening mammography for average risk women aged 40 – 49. Individual assessment of each woman’s preferences and risk should guide the discussion and decision regarding mammography screening in this age group. If, after this careful assessment and discussion (...) : 22450938. Canadian Association of Radiologists. 2012 CAR diagnostic imaging referral guidelines. Section E: cardiovascular [Internet]. 2012 [cited 2017 May 9]. Canadian Association of Radiologists. Medical imaging primer with a focus on x-ray usage and safety [Internet]. 2013 [cited 2017 May 9]. Tigges S, et al. Routine chest radiography in a primary care setting. Radiology. 2004 Nov;233(2):575-8. PMID: 15516621. U.S. Preventive Services Task Force (USPSTF). Screening for coronary heart disease

2019 CPG Infobase

36. E/M Emergency Services

E/M Emergency Services E/M Emergency Services Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 E/M Emergency Services E/M Emergency (...) Services Aka: E/M Emergency Services , E/M Emergency , CPT 99281 , CPT 99282 , CPT 99283 , CPT 99284 , CPT 99285 II. Indication Emergency Department Services III. Approach Know your intended level of service from the start and document to meet that level of service HPI Code 99281 - 99283: Requires 1 of 8 component Code 99284 - 99285: Requires 4 of 8 components ROS Code 99281: Requires 0 component Code 99282 - 99283: Requires 1 component Code 99284: Requires 2 components Code 99285: Requires 10

2018 FP Notebook

37. Options for national testing and surveillance for hepatitis E virus in the EU/EEA

1. Kamar N, Izopet J, Pavio N, Aggarwal R, Labrique A, Wedemeyer H, et al. Hepatitis E virus infection. Nat Rev Dis Primers. 2017 Nov 16;3:17086. 2. Stanaway JD, Flaxman AD, Naghavi M, Fitzmaurice C, Vos T, Abubakar I, et al. The global burden of viral hepatitis from 1990 to 2013: findings from the Global Burden of Disease Study 2013. Lancet. 2016 Sep 10;388(10049):1081-1088. 3. European Commission. Commission implementing Decision (EU) 2018/945 of 22 June 2018 on the communicable diseases (...) with the proposal to include the monitoring of chronic infections as a primary objective and suggested that the incidence of chronic infections could be a secondary objective if the surveillance system implemented allows for it. Otherwise, the chronic infections issue may be addressed through specific studies (on risk factors or immunopathogenesis). iv According to structure and decision by each country. TECHNICAL REPORT Options for national testing and surveillance for hepatitis E virus in the EU/EEA

2019 European Centre for Disease Prevention and Control - Technical Guidance

38. Focused Update of the 2017 ACC Expert Consensus Decision Pathway on the Management of Mitral Regurgitation

), and the results of landmark randomized controlled trials (RCTs) (4,5) published in 2018. Additional clinical context and practical advice are provided for medical and surgical decision making in complex patient scenarios. 2. METHODS The writing committee for this updated 2019 ECDP was formed in 2018. As outlined in Table 1, several revisions have been made to the 2017 ECDP in response to rapid developments in the field and the March 2019 FDA approval of an edge-to-edge transcatheter repair system (...) Focused Update of the 2017 ACC Expert Consensus Decision Pathway on the Management of Mitral Regurgitation Journal Pre-proof 2020 Focused Update of the 2017 ACC Expert Consensus Decision Pathway on the Management of Mitral Regurgitation Robert O. Bonow, MD, MS, MACC Chair, Writing Committee, Patrick T. O’Gara, MD, MACCVice-chair, Writing Committee, David H. Adams, MD, FACC, Writing Committee, Vinay Badhwar, MD, FACC, Writing Committee, Joseph E. Bavaria, MD, FACC, Writing Committee, Sammy

2020 American College of Cardiology

39. Knowledge-based clinical decision support systems

Assessment | 25 References 1. Bright TJ, Wong A, Dhurjati R, Bristow E, Bastian L, Coeytaux RR, et al. Effect of clinical decision support systems: a systematic review. Ann Intern Med. 2012;157(1):29-43. 2. Jia P, Zhang L, Chen J, Zhao P, Zhang M. The effects of clinical decision support systems on medication safety: an overview. PLoS ONE. 2016;11(12):e0167683. 3. TechTarget. Clinical decision support systems (CDSS). 2018 [cited 2020 Jan 30]; Available from: https://searchhealthit.techtarget.com (...) Psychiatry. 2017;26(11):1309-17. 11. Marasinghe KM. Computerised clinical decision support systems to improve medication safety in long-term care homes: a systematic review. BMJ Open. 2015;5(5):e006539. 12. Monteiro L, Maricoto T, Solha I, Ribeiro-Vaz I, Martins C, Monteiro-Soares M. Reducing potentially inappropriate prescriptions for older patients using computerized decision support tools: systematic review. J Med Internet Res. 2019;21(11):e15385. 13. NICE. Medicines optimisation: the safe

2020 SHTG Advice Statements

40. Don’t throw the E&M baby out with the bath water: the proposed CMS changes

, physicians often must document information that is not pertinent to the visit but must be present to choose the code, such as examining and documenting a detailed examination with at least 12 bullets from any organ system to bill a 99203. Instead, what CMS is proposing is that a physician may pick the E&M code based on the current system, the amount of time spent with the patient, or solely based on medical decision-making (MDM) guidelines for the code. The option to choose time would change (...) in that it would be based completely on total face-to-face time with the patient and not limited to visits where over 50 percent of the visit is counseling and/or coordination of care as it is at present. As an example of using MDM as the sole factor, if you have a patient with type II diabetes, hypertension, and hyperlipidemia, you review their pertinent history, review their recent labs, and advise them to continue their medications, you have moderate complexity medical decision-making and can choose 99214

2018 KevinMD blog

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