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E/M Medical Decision Making

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41. Methodology for Creating Expert Consensus Decision Pathways

; Michael E. DeBakey Medical Center—Director, Cardiac Care Unit Melissa Magwire Content Reviewer—Expert Consensus Decision Pathway Writing Committees Shawnee Mission Endocrinology & Diabetes—Clinical Supervisor Catherine M. Otto Content Reviewer—Expert Consensus Decision Pathway Writing Committees J. Ward Kennedy-Hamilton Endowed Chair in Cardiology—Editor-in-Chief, Heart; University of Washington—Professor of Medicine Sarah A. Spinler Content Reviewer—Roundtable Planning Committee Philadelphia College (...) Methodology for Creating Expert Consensus Decision Pathways METHODOLOGY DOCUMENT 2019 Methodology for Creating Expert Consensus Decision Pathways A Report of the American College of Cardiology Methodology Writing Committee James L. Januzzi JR, MD, FACC, Chair Tariq Ahmad, MD, MPH, FACC Lea G. Binder, MA William J. Hucker, MD, PHD Dharam J. Kumbhani, MD, SM, FACC Thomas M. Maddox, MD, MSC, FACC Joseph E. Marine, MD, MBA, FACC Pamela Bowe Morris, MD, FACC Solution Set Oversight Committee Ty J

2019 American College of Cardiology

42. Responsible use of high-risk medical devices: the example of 3D printed medical devices

” Creative Commons Licence http://kce.fgov.be/content/about-copyrights-for-kce-publications. How to refer to this document? Vinck I, Vijverman A, Vollebregt E, Broeckx N, Wouters K, Piët M, Bacic N, Vlayen J, Thiry N, Neyt M.Responsible use of high-risk medical devices: the example of 3D printed medical devices. Health Technology Assessment (HTA) Brussels: Belgian Health Care Knowledge Centre (KCE). 2018. KCE Reports . D/2018/10.273/03. This document is available on the website of the Belgian Health Care (...) Responsible use of high-risk medical devices: the example of 3D printed medical devices 2018 www.kce.fgov.be KCE REPORT 297 RESPONSIBLE USE OF HIGH-RISK MEDICAL DEVICES: THE EXAMPLE OF 3D PRINTED MEDICAL DEVICES 2018 www.kce.fgov.be KCE REPORT 297 HEALTH TECHNOLOGY ASSESSMENT RESPONSIBLE USE OF HIGH-RISK MEDICAL DEVICES: THE EXAMPLE OF 3D PRINTED MEDICAL DEVICES IRM VINCK, AN VIJVERMAN, ERIK VOLLEBREGT, NILS BROECKX, KARLIEN WOUTERS, MARIEL PIËT, NATALIJA BACIC, JOAN VLAYEN, NANCY THIRY

2018 Belgian Health Care Knowledge Centre

43. E-learning of evidence-based healthcare (EBHC) to increase EBHC competencies in healthcare professionals

learning is most effective in increasing evidence-based health care competencies of health workers E-learning is a useful strategy to increase EBHC knowledge and skills, and when combined with face-to-face learning, to increase EBHC attitude and behaviour. The review in brief Evidence-based health care (EBHC) is decision-making for health care, informed by the best research evidence. Doctors, nurses and allied health professionals need to have the necessary knowledge and skills to apply EBHC. The use (...) , CONDITION OR ISSUE The need for evidence-based health care competencies Evidence-based medicine (EBM), introduced in 1991, has its roots in the field of clinical epidemiology and was listed as “one of the 15 greatest medical milestones since 1840” in the British Medical Journal (Montori & Guyatt, 2008). The most commonly used definition of evidence-based medicine (EBM) describes it as “the conscientious, explicit and judicious use of the current best evidence in making decisions about the care

2017 Campbell Collaboration

44. MammaPrint test for personalised management of adjuvant chemotherapy decisions in early breast cancer

patients KCE Report 298 ¦ SCIENTIFIC REPORT a http://www.eunethta.eu/ 1 INTRODUCTION AND SCOPE Gene expression profiling (GEP) tests aim to improve decision-making related to adjuvant chemotherapy treatment for women with early breast cancer. In 2014, KCE performed a rapid HTA on this topic 1 and concluded that there were no data on the clinical utility of such tests and that an update of the review should be performed as soon as RCT results on such aspect became available. Following the publication (...) , decisions on when the use of adjuvant chemotherapy is appropriate and necessary to minimise the risk of recurrence and improve the prognosis of ER+, HER2- early breast cancer patients with up to 3 affected lymph nodes (i.e. the subject of interest of this review), remain in some cases challenging. d http://www.predict.nhs.uk/ e http://www.pmidcalc.org 8 MammaPrint ® test in adjuvant chemotherapy decisions for early breast cancer patients KCE Report 298 3 MAMMAPRINT® IN EARLY BREAST CANCER 3.1 MammaPrint

2018 Belgian Health Care Knowledge Centre

45. Joanna M Zakrzewska and Mark E Linskey: Trigeminal neuralgia—gaps in the evidence

Joanna M Zakrzewska and Mark E Linskey: Trigeminal neuralgia—gaps in the evidence Joanna M Zakrzewska and Mark E Linskey: Trigeminal neuralgia—gaps in the evidence - The BMJ ---> This blog is part of a series of blogs linked with , a database of systematic overviews of the best available evidence on the effectiveness of commonly used interventions. Trigeminal neuralgia is a rare condition that causes excruciating intermittent short-lasting, usually unilateral facial pain especially provoked (...) , there are no biomarkers but magnetic resonance imaging with and without contrast of the brain is providing more data to help with decision making. Management is further complicated in that both drug and surgical options are available. The disease can suddenly become extremely acute with longer lasting bouts of pain, and there are no studies on how these should be managed. In emergency circumstances, patients are often given opioids which provide little, if any, pain relief. The most effective drugs for this condition

2015 The BMJ Blog

46. Added value of using gene-expression signature for adjuvant chemotherapy decisions in early breast cancer

Added value of using gene-expression signature for adjuvant chemotherapy decisions in early breast cancer Nov2015 © EUnetHTA, 2015. Reproduction is authorised provided EUnetHTA is explicitly acknowledged EUnetHTA Joint Action 3 WP4 Rapid assessment of other technologies using the HTA Core Model ® for Rapid Relative Effectiveness Assessment MammaPrint ® Added value of using the gene expression signature test MammaPrint® for adjuvant chemotherapy decision-making in early breast cancer Project ID (...) , patients can be divided into low- and high-risk groups, which in turn supports clinical decision- making for adjuvant treatment. MammaPrint ® has been prospectively validated for use in early- stage breast cancer patients with tumours 5% or HR 5% at =3 years follow-up and a GRADE B survival improvement as between 3% and 5%. In the case that mature survival data is not available, GRADE A clinical benefit is assigned when DFS improvements are found in which the HR is 70 19 (0.7) 11 (1.9) 16 (1.0) 10 (0.6

2018 EUnetHTA

47. A resource for developing an evidence synthesis report for policy-making

A resource for developing an evidence synthesis report for policy-making Leena Eklund Karlsson | Ryoko Takahashi HEALTH EVIDENCE NETWORK SYNTHESIS REPORT 50 A resource for developing an evidence synthesis report for policy-makingThe Health Evidence Network HEN – the Health Evidence Network – is an information service for public health decision-makers in the WHO European Region, in action since 2003 and initiated and coordinated by the WHO Regional Office for Europe under the umbrella (...) of the European Health Information Initiative (a multipartner network coordinating all health information activities in the European Region). HEN supports public health decision-makers to use the best available evidence in their own decision-making and aims to ensure links between evidence, health policies and improvements in public health. The HEN synthesis report series provides summaries of what is known about the policy issue, the gaps in the evidence and the areas of debate. Based on the synthesized

2017 WHO Health Evidence Network

48. Moving Toward a Recovery-Oriented System of Care: A Resource for Service Providers and Decision Makers

Moving Toward a Recovery-Oriented System of Care: A Resource for Service Providers and Decision Makers www.ccsa.ca • www.ccdus.ca Moving Toward a Recovery- Oriented System of Care A Resource for Service Providers and Decision Makers September 2017 Moving Toward a Recovery- Oriented System of Care A Resource for Service Providers and Decision Makers Suggested citation: Canadian Centre on Substance Use and Addiction (2017). Moving Toward a Recovery-Oriented System of Care: A Resource for Service (...) Providers and Decision Makers. Ottawa, Ont.: Author. © Canadian Centre on Substance Use and Addiction, 2017. CCSA, 500–75 Albert Street Ottawa, ON K1P 5E7 Tel.: 613-235-4048 Email: recovery@ccsa.ca Production of this document has been made possible through a financial contribution from Health Canada. The views expressed herein do not necessarily represent the views of Health Canada. This document can also be downloaded as a PDF at www.ccsa.ca Ce document est également disponible en français sous le

2017 Canadian Centre on Substance Abuse

49. Use of Biomarkers to Guide Decisions on Adjuvant Systemic Therapy for Women With Early-Stage Invasive Breast Cancer

/JCO.2017.74.0472 Journal of Clinical Oncology - published online before print July 10, 2017 PMID: Use of Biomarkers to Guide Decisions on Adjuvant Systemic Therapy for Women With Early-Stage Invasive Breast Cancer: American Society of Clinical Oncology Clinical Practice Guideline Focused Update x Ian Krop , x Nofisat Ismaila , x Fabrice Andre , x Robert C. Bast , x William Barlow , x Deborah E. Collyar , x M. Elizabeth Hammond , x Nicole M. Kuderer , x Minetta C. Liu , x Robert G. Mennel , x (...) Catherine Van Poznak , x Antonio C. Wolff , and x Vered Stearns Ian Krop, Dana-Farber Cancer Institute, Boston, MA; Nofisat Ismaila, American Society of Clinical Oncology, Alexandria, VA; Fabrice Andre, Institute Gustave Roussy, Paris, France; Robert C. Bast, The University of Texas MD Anderson Cancer Center, Houston; Robert G. Mennel, Baylor University Medical Center, Texas Oncology PA, Dallas, TX; William Barlow, Cancer Research and Biostatistics, Seattle, WA; Deborah E. Collyar, Patient Advocates

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2017 American Society of Clinical Oncology Guidelines

50. Does advance care planning alter management decisions made by healthcare professionals?

/AdvanceCarePlanning.pdf Although there is a significant body of literature informing the development and implementation of advance care planning processes, the impact of completed advance care plans on the decision making of healthcare professionals at the time of a medical event is less clear. Evidence for the impact of advance care planning programmes on the quality of care provided is required to underpin funding and delivery of integrated advance care planning across care settings. The purpose of this rapid (...) in the ACP, there is no direct correlation with preferences expressed in the ACP and outcomes, so the specific impact of stated patient preferences on outcome is unclear Cohen- Mansfield et al 2008 Study Setting & Design – A single care home, USA; Retrospective observational study. Study Objective To ascertain the role that advance directives (ADs) play in actual decision making in nursing homes at the time of a medical event. Participants 6 physicians and 3 nurses 64 patients with an AD in place

2017 Palliative Care Evidence Review Service (PaCERS)

51. Deceased organ and tissue donation after medical assistance in dying and other conscious and competent donors: guidance for policy

. This avoids the potential distress of making a request or obtaining consent for donation only to have to inform the patient that they are medically or logistically ineligible. Conversations about donation The decision to proceed with MAiD or WLSM must be separate from, and must precede, the decision to donate. Treating physicians, MAiD providers and MAiD assessors should be educated on how to respond to inquiries concerning organ donation. This should include how the decision to donate may affect the end (...) providers and policy-makers. This document is intended to inform policies related to offering organ and tissue donation to patients who have made a decision that will lead to imminent death. These are conscious, competent patients who have chosen to withdraw mechanical ventilation, including invasive or noninvasive GUIDELINE | GUIDANCE FOR POLICY CPD Deceased organ and tissue donation after medical assistance in dying and other conscious and competent donors: guidance for policy James Downar MDCM MHSc

2019 CPG Infobase

52. Medical Training to Achieve Competency in Lifestyle Counseling: An Essential Foundation for Prevention and Treatment of Cardiovascular Diseases and Other Chronic Medical Conditions: A Scientific Statement From the American Heart Association

in all US medical schools by 1995. , The brief physician counseling approach that was recommended for training was a variant of the 5 A’s intervention that has proved effective for treating many chronic disease risk behaviors, which the US Preventive Services Task Force continues to endorse today. The approach delineates 5 counseling steps that a provider can complete in a few minutes: (1) assess the risk behavior, (2) advise change, (3) agree on goals and an action plan via shared decision making (...) of medical training curricula of US medical schools. The learning objectives were adapted from the nutrition care process in collaboration with registered dietitians and registered dietitian nutritionists. The nutrition care process guides clinical practice for registered dietitians and registered dietitian nutritionists and is designed to provide a consistent and systematic approach for critical thinking and decision making to provide optimal patient care. Adams and colleagues previously proposed

2016 American Heart Association

53. Evidence-Based Policy Making: Assessment of the American Heart Association?s Strategic Policy Portfolio

such as electronic cigarettes (e-cigarettes). In general, facilitating tobacco cessation remains a highly cost-effective strategy, although it is very difficult for most people to quit this deadly, addictive habit. Available forms of nicotine replacement therapy (gum, transdermal patch, drugs for smoking cessation, nasal spray, inhaler, and lozenges) increase quit rates by 50% to 100% compared with not using any of these products; however, <1 in 5 smokers making an attempt to quit takes advantage (...) Evidence-Based Policy Making: Assessment of the American Heart Association?s Strategic Policy Portfolio Evidence-Based Policy Making: Assessment of the American Heart Association’s Strategic Policy Portfolio | Circulation Search Hello Guest! Login to your account Email Password Keep me logged in Search March 2019 March 2019 March 2019 March 2019 March 2019 February 2019 February 2019 February 2019 February 2019 January 2019 January 2019 January 2019 January 2019 January 2019 This site uses

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2016 American Heart Association

54. Evidence Brief - Barriers and Facilitators to Use of Medications for Opioid Use Disorder

Evidence Brief - Barriers and Facilitators to Use of Medications for Opioid Use Disorder 4 August 2019 Prepared for: Department of Veterans Affairs Veterans Health Administration Health Services Research & Development Service Washington, DC 20420 Prepared by: Evidence Synthesis Program (ESP) Coordinating Center Portland VA Medical Center Portland, OR Mark Helfand, MD, MPH, MS, Director Evidence Brief: Barriers and Facilitators to Use of Medication s for Opioid Use Disorder Authors: Katherine (...) Mackey, MD, MPP Stephanie Veazie, MPH Johanna Anderson, MPH Donald Bourne, MPH Kim Peterson, MS Evidence Synthesis Program Evidence Brief: Barriers and Facilitators to Use of Medications for OUD Evidence Synthesis Program i PREFACE The VA Evidence Synthesis Program (ESP) was established in 2007 to provide timely and accurate syntheses of targeted healthcare topics of importance to clinicians, managers, and policymakers as they work to improve the health and healthcare of Veterans. These reports help

2019 Veterans Affairs Evidence-based Synthesis Program Reports

55. Management of Cancer Medication-Related Infusion Reactions

practice guideline, informed by best available evidence and expert consensus, was developed to help standardize the prevention and management of IRs across the province. Definitions The term IR is a broad classification; therefore, a standardized definition is needed to facilitate accurate documentation of reactions and provide guidance on treatment and re-challenge decision-making. An infusion reaction (IR) is any adverse sign or symptom that occurs during the infusion of a medication or within (...) Management of Cancer Medication-Related Infusion Reactions Management of Cancer Medication- Related Infusion Reactions Care has been taken in the preparation of the information contained in this report. Nonetheless, any person seeking to apply or consult the report is expected to use independent medical judgment in the context of individual clinical circumstances or seek out the supervision of a qualified clinician. Cancer Care Ontario makes no representation or guarantees of any kind

2019 Cancer Care Ontario

56. Simplified guideline for prescribing medical cannabinoids in primary care

Simplified guideline for prescribing medical cannabinoids in primary care Vol 64: FEBRUARY | FÉVRIER 2018 | Canadian Family Physician | Le Médecin de famille canadien 111 CLINICAL PRACTICE GUIDELINES Abstract Objective To develop a clinical practice guideline for a simplified approach to medical cannabinoid use in primary care; the focus was on primary care application, with a strong emphasis on best available evidence and a promotion of shared, informed decision making. Methods The Evidence (...) , and content is offered to support shared, informed decision making. Conclusion This simplified medical cannabinoid prescribing guideline provides practical recommendations for the use of medical cannabinoids in primary care. All recommendations are intended to assist with, not dictate, decision making in conjunction with patients. Editor’s key points ? This simplified prescribing guideline was developed with a primary care focus. Guideline contributors were selected based on profession, practice setting

2018 CPG Infobase

57. E-edition: Return to Play

, Anthony Schneiders, Erik Witvrouw, Benjamin Clarsen, Ann Cools, Boris Gojanovic, Steffan Griffin, Karim M Khan, Håvard Moksnes, Stephen A Mutch, Nicola Phillips, Gustaaf Reurink, Robin Sadler, Karin Grävare Silbernagel, Kristian Thorborg, Arnlaug Wangensteen, Kevin E Wilk, Mario Bizzini PODCAST- Dr Clare Ardern shares the latest on Return to Play – World Congress Consensus Statement Dr Clare Ardern is a sports physiotherapy researcher at Linkoping University in Sweden and soon to be Editor in Chief (...) of Orthopaedic & Sports Physical Therapy Considerations in the Diagnosis and Accelerated Return to Sport of a Professional Basketball Player with a Triceps Surae Injury Philip A. Anloague, Donald S. Strack YouTube – Craig Purdam – Return to competition in athletes with tendinopathy Craig Purdam presents at the Swiss Sportfisio conference 2017 Editorial – Return to play in elite sport: a shared decision-making process Paul Dijkstra, Noel Pollock, Robin Chakraverty, et al. INFOGRAPHIC – 4 KEY HABITS OF ATHLETE

2019 British Journal of Sports Medicine Blog

58. The Patient Centred Medical Home: barriers and enablers to implementation

teamwork. Staff experience: Without adequate staff/staff support, the model cannot be adequately implemented or sustained. • Inadequate staff • Staff dissatisfied with roles • Staff burnout. • Participatory decision-making • Having adequate staff • Trust-building exercises. Time: Major change initiatives such as PCMH take time. Beyond implementation, many of the facets of PCMH take time (e.g. preventative measures, care coordination). • Inadequate time allocated to transition to a PCMH • Inadequate (...) time allocated to undertake comprehensive assessments and holistic interventions. • Recognition of the time it takes to make changes • Separate visits for preventive care • The use of electronic medical records (provided they have a user-friendly interface). Health information technology: Benefits of health information technology are widely • Time, effort and other resources for implementation. • Available technology is inadequate to support quality initiatives • Training, specifically, • Applied

2018 Sax Institute Evidence Check

59. Medical management of abortion

the option of starting hormonal contraception immediately after the first pill of the medical abortion regimen. Notes: • All individuals who can become pregnant should be provided with all of the necessary information to make an informed decision regarding the use of contraception. Immediate initiation of intramuscular (IM) depot medroxyprogesterone acetate (DMPA) is associated with a slight decrease in the effectiveness of medical abortion regimens (67). However, immediate initiation of DMPA should (...) still be offered as an available contraceptive method after an abortion. • Indirect evidence was used as a basis for decision-making on initiation of hormonal contraception as an option for individuals undergoing medical abortion with misoprostol alone. • No data were available on the use of combined hormonal contraception (pills or injections) by those undergoing medical abortion. RECOMMENDATION TYPE: NEW OR UPDATED Recommendation 4a is a new recommendation. 3.5.2 Timing of post-abortion

2019 World Health Organisation Guidelines

60. American Gastroenterological Association Institute Guideline on the Medical Management of Opioid-Induced Constipation

results from the specific effects of opioids, it differs mechanistically from other forms of constipation, and therefore, medical management of this disorder deserves dedicated attention. x 8 Camilleri, M., Drossman, D.A., Becker, G. et al. Emerging treatments in neurogastroenterology: a multidisciplinary working group consensus statement on opioid-induced constipation. Neurogastroenterol Motil . 2014 ; 26 : 1386–1395 | | | Opioid-induced bowel dysfunction refers to the set of gastrointestinal adverse (...) individuals make decisions consistent with their values and preferences. Conditional “The AGA suggests…” The majority of individuals in this situation would want the suggested course of action, but many would not. Different choices will be appropriate for different patients. Decision aids may be useful in helping individuals in making decisions consistent with their values and preferences. Clinicians should expect to spend more time with patients when working towards a decision. No recommendation “The AGA

2019 American Gastroenterological Association Institute

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