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E/M Medical Decision Making

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8781. Cost-effectiveness of routine endoscopic biopsies for Helicobacter pylori detection in patients with non-ulcer dyspepsia

. Dates to which data relate The effectiveness data were derived from studies published between 1966 and 2003. The price year was 1999. Source of effectiveness data The effectiveness data were derived from a review and synthesis of published studies, supplemented by assumptions made by an expert panel. Modelling A clinical decision-making model was conducted to compare the costs and effectiveness of the two strategies (taking a biopsy for the detection of H. pylori with an RUT, or not taking a biopsy (...) P, Fennerty M. Therapy for Helicobacter pylori in patient with nonulcer dyspepsia. A meta-analysis of randomized controlled trials. Annals of Internal Medicine 2001;134:361-9. Moayyedi P, Soo S, Deeks J, Forman D, Mason J, Innes M, et al. Systematic review and economic evaluation of Helicobacter pylori eradication treatment for nonulcer dyspepsia. BMJ 2000;321:659-64. Talley N, Vakil N, Ballaed E, Fennerty M. Absence of benefit of eradication Helicobacter pylori in patients with nonulcer

2003 NHS Economic Evaluation Database.

8782. Projected clinical benefits and cost-effectiveness of a human papillomavirus 16/18 vaccine

Goldie S J, Kohli M, Grima D, Weinstein M C, Wright T C, Bosch F X, Franco E. Projected clinical benefits and cost-effectiveness of a human papillomavirus 16/18 vaccine. Journal of the National Cancer Institute 2004; 96(8): 604-615 PubMedID Other publications of related interest Shireman TI, Tsevat J, Goldie SJ. Time costs associated with cervical cancer screening. Intl J Technol Assess Health Care 2001;17:146-52. Straton K, Durch J, Lawrence R, eds. Vaccines for 21st century, a tool for decision (...) Projected clinical benefits and cost-effectiveness of a human papillomavirus 16/18 vaccine Projected clinical benefits and cost-effectiveness of a human papillomavirus 16/18 vaccine Projected clinical benefits and cost-effectiveness of a human papillomavirus 16/18 vaccine Goldie S J, Kohli M, Grima D, Weinstein M C, Wright T C, Bosch F X, Franco E Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief

2004 NHS Economic Evaluation Database.

8783. Empirical anti-candida therapy among selected patients in the intensive care unit: a cost-effectiveness analysis

. Bibliographic details Golan Y, Wolf M P, Pauker S G, Wong J B, Hadley S. Empirical anti-candida therapy among selected patients in the intensive care unit: a cost-effectiveness analysis. Annals of Internal Medicine 2005; 143: 857-869 PubMedID Other publications of related interest Rex J H, Bennett J E, Sugar A M et al. A randomized trial comparing fluconazole with amphotericin B for the treatment of candidemia in patients without neutropenia. Candidemia Study Group and the National Institute. New England (...) Empirical anti-candida therapy among selected patients in the intensive care unit: a cost-effectiveness analysis Empirical anti-candida therapy among selected patients in the intensive care unit: a cost-effectiveness analysis Empirical anti-candida therapy among selected patients in the intensive care unit: a cost-effectiveness analysis Golan Y, Wolf M P, Pauker S G, Wong J B, Hadley S Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion

2005 NHS Economic Evaluation Database.

8784. Cost-effectiveness of alternative treatments for women with osteoporosis in Canada

, De Nigris E, et al. A systematic review and economic evaluation of alendronate, etindronate, risendronate, raloxifene and teriparatide for the prevention and treatment of postmenopausal osteoporosis. Health Technol Assess 2005;22(1). Kanis JA, Brazier JE, Stevenson M, et al. Treatment of established osteoporosis: a systematic review and cost-utility analysis. Health Technol Assess 2002;6(29). Kanis JA, Borgstrom F, Johnell O, et al. Cost-effectiveness of raloxifene in the UK: an economic (...) myocardial infarction (AMI), unrecognised AMI, angina pectoris, coronary insufficiency, and sudden death. Every year, women could remain in the same health state, move into one of the other health states, or die from "other causes". A simplified structure of the model was represented graphically. Outcomes assessed in the review The outcomes assessed were: the risk of disease events included in the decision model, the mortality risk, the effect of treatment, and the utility weights associated

2006 NHS Economic Evaluation Database.

8785. MRI for the detection of foetal abnormalities

defect, 12 MRI for the detection of foetal abnormalities with the correct diagnosis resulting in no change in clinical management or decision making. Several studies did, however, report on discordant diagnoses between US and MRI which changed the diagnosis from a suspected CNS abnormality to normal (Fjortoft et al 2007; Griffiths et al 2006; Salomon et al 2006). A small retrospective study of foetuses with suspected CNS abnormalities (n=7) found complete agreement between the diagnosis by US and MRI (...) in this report. This report is not intended to be used as medical advice and it is not intended to be used to diagnose, treat, cure or prevent any disease, nor should it be used for therapeutic purposes or as a substitute for a health professional's advice. The Commonwealth does not accept any liability for any injury, loss or damage incurred by use of or reliance on the information. The production of this Horizon scanning report was overseen by the Health Policy Advisory Committee on Technology (HealthPACT

2007 Australia and New Zealand Horizon Scanning Network

8786. USCOM: Ulstrasound cardiac output monitor for patients requiring haemodynamic monitoring

. The Commonwealth does not guarantee the accuracy, currency or completeness of the information in this report. This report is not intended to be used as medical advice and it is not intended to be used to diagnose, treat, cure or prevent any disease, nor should it be used for therapeutic purposes or as a substitute for a health professional's advice. The Commonwealth does not accept any liability for any injury, loss or damage incurred by use of or reliance on the information. The production of this Horizon (...) scanning report was overseen by the Health Policy Advisory Committee on Technology (HealthPACT), a sub-committee of the Medical Services Advisory Committee (MSAC). HealthPACT comprises representatives from health departments in all states and territories, the Australia and New Zealand governments; MSAC and ASERNIP-S. The Australian Health Ministers’ Advisory Council (AHMAC) supports HealthPACT through funding. This Horizon scanning report was prepared by Ms Linda Mundy, Ms Tracy Merlin, A/Prof Annette

2007 Australia and New Zealand Horizon Scanning Network

8787. Telemedicine for the implementation of stroke therapy

hospitals', Intern Med J, 35 (8), 447-450. Schwamm, L. H., Rosenthal, E. S. et al (2004). 'Virtual TeleStroke support for the emergency department evaluation of acute stroke', Acad Emerg Med, 11 (11), 1193-1197. Senes, S. (2006). How we manage stroke, Australian Institute of Health and Welfare, Canberra. Szoeke, C. E., Parsons, M. W. et al (2003). 'Acute stroke thrombolysis with intravenous tissue plasminogen activator in an Australian tertiary hospital', Med J Aust, 178 (7), 324-328. Wang, S., Gross, H (...) not guarantee the accuracy, currency or completeness of the information in this summary. This summary is not intended to be used as medical advice and it is not intended to be used to diagnose, treat, cure or prevent any disease, nor should it be used for therapeutic purposes or as a substitute for a health professional's advice. The Commonwealth does not accept any liability for any injury, loss or damage incurred by use of or reliance on the information. The production of this Horizon scanning

2006 Australia and New Zealand Horizon Scanning Network

8788. Magnetic resonance imaging for the detection of foetal abnormalities

Neonatal Med, 10 (5), 421-428. Morris J, W. E., Paley M (2005). 'Magnetic Resonance Imaging of the Fetus: Physicists', Technologists' and Radiologists' Perspectives', Imaging Decisions, 4. Salomon, L. J., Ouahba, J. et al (2006). 'Third-trimester fetal MRI in isolated 10- to 12-mm ventriculomegaly: is it worth it?' BJOG, 113 (8), 942-947. The South Australian Birth Defects Register. (2005). The South Australian Birth Defects Register. Annual Report 2003. Adelaide: Women's and Children's Hospital Whitby (...) and urinary tract (Ultrasound Obstet Gynecol 2006). CONCLUSION: The results of foetal MRI imaging, whether verifying presence or absence of abnormalities, or discovering new abnormalities not detected by ultrasound have shown to affect clinical decision making. At the time of preparing this prioritising summary it was advised that there is increasing interest in and acceptance of its prenatal use in clinical practice in Australia. HEALTHPACT ACTION: MRI for the detection of foetal abnormalities

2007 Australia and New Zealand Horizon Scanning Network

8789. Affymetrix DNA microarrays (update)

. Available from: http://www.bio.davidson.edu/Biology/macampbell/strategies/chipsintro.html [Accessed 14th January 2004]. Gruvberger, S. K., Ringner, M. et al (2003). 'Expression profiling to predict outcome in breast cancer: the influence of sample selection', Breast Cancer Res, 5 (1), 23-26. Haviv, I. & Campbell, I. G. (2002). 'DNA microarrays for assessing ovarian cancer gene expression', Mol Cell Endocrinol, 191 (1), 121-126. Huang, E., Cheng, S. H. et al (2003). 'Gene expression predictors of breast (...) cancer outcomes', Lancet, 361 (9369), 1590-1596. Ntzani, E. E. & Ioannidis, J. P. (2003). 'Predictive ability of DNA microarrays for cancer outcomes and correlates: an empirical assessment', Lancet, 362 (9394), 1439-1444. Pusztai, L., Ayers, M. et al (2003). 'Clinical application of cDNA microarrays in oncology', Oncologist, 8 (3), 252-258. Schena, M. (1996). 'Genome analysis with gene expression microarrays', Bioessays, 18 (5), 427-431. Schena, M., Heller, R. A. et al (1998). 'Microarrays

2007 Australia and New Zealand Horizon Scanning Network

8790. Home studies for the diagnosis of sleep disorders

how results from PSG and home-based sleep studies might influence clinical decision-making and patient outcomes. Sleep specialists were required to estimate the likelihood of successful treatment as either greater than 50 per cent (defined as a predicted success) or less than 50 per cent (defined as a predicted failure) based on clinical data and results from the sleep studies. In the trial, success was defined as a one unit or greater increase in the Sleep Apnoea Quality of Life Index (SAQLI (...) or completeness of the information in this summary. This summary is not intended to be used as medical advice and it is not intended to be used to diagnose, treat, cure or prevent any disease, nor should it be used for therapeutic purposes or as a substitute for a health professional's advice. The Commonwealth does not accept any liability for any injury, loss or damage incurred by use of or reliance on the information. The production of this Horizon scanning prioritising summary was overseen by the Health

2007 Australia and New Zealand Horizon Scanning Network

8791. Delayed enhancement MRI

of the papers included in this assessment reported on patient outcomes when DE-MRI is used to assess cardiac viability as a decision making tool for the treatment of patients admitted to hospital with acute myocardial infarction. COST IMPACT DE-MRI can be conducted on a conventional MRI scanner installed with the appropriate software package. It is not covered by a MBS item number. However, assessment of the cardiovascular system may be conducted on patients with a congenital heart condition, tumour (...) No issues were identified/raised in the sources examined. CONCLUSION: Although the good quality studies included in this assessment indicate that DE-MRI correlates and agrees well with both PET and SPECT in the detection of scar tissue and cardiac viability, none of the studies reported on DE-MRI as a decision making tool for the treatment of patients admitted to hospital with acute myocardial infarction. HEALTHPACT ACTION: Currently Victoria is undertaking a feasibility trial of delayed enhancement MRI

2007 Australia and New Zealand Horizon Scanning Network

8792. Implantable miniature telescope for macualar degeneration (Update)

remain regarding the long-term safety of the device, its overall cost impact and the timeliness of its availability in Australia. It is recommended therefore that the following be conducted: Horizon Scanning Report Full Health Technology Assessment ? Monitor Archive SOURCES OF FURTHER INFORMATION: AIHW (2005). Vision problems among older Australians, Australian Institute of Health and Welfare, Canberra. Alio, J. L., Mulet, E. M. et al (2004). 'Intraocular telescopic lens evaluation in patients (...) evidence 1 AUGUST 2007: REFERENCES: FDA (2006). Ophthalmic devices panel of the Medical Devices Advisory Committee, U.S. Food and Drug Administration. http://www.fda.gov/OHRMS/DOCKETS/AC/06/transcripts/2006-4225t.pdf Garfinkel, R. A., Berinstein, D. M. & Frantz, R. (2006). 'Treatment of choroidal neovascularization through the implantable miniature telescope', Am J Ophthalmol, 141 (4), 766-767. Hudson, H. L., Lane, S. S. et al (2006). 'Implantable miniature telescope for the treatment of visual acuity

2007 Australia and New Zealand Horizon Scanning Network

8793. Rapid point-of-care for the detection of Chlamydia in individuals at risk of trachoma

). The point-of-care FirstBurst Trachoma test has been proposed as a means to quickly and reliably determine active infection, enabling health care workers to make an informed decision on the distribution of antibiotics to the community (Wright & Taylor 2006). The FirstBurst Trachoma test is a dipstick immunoassay which detects chlamydial lipopolysaccharide and detects all C trachomatis serovars and other species of Chlamydia. The test can be easily performed in the field with minimal equipment (...) -of-care assay for targeting antibiotic treatment for trachoma control: a comparative study', The Lancet, 367 (9522), 1585. Solomon, A. W., Foster, A. & Mabey, D. C. (2006). 'Clinical examination versus Chlamydia trachomatis assays to guide antibiotic use in trachoma control programmes', Lancet Infect Dis, 6 (1), 5-6; author reply 7-8. Taylor, H. R. (2001). 'Trachoma in Australia', Med J Aust, 175 (7), 371-372. Taylor, H. R., Pezzullo, M. L. & Keeffe, J. E. (2006). 'The economic impact and cost

2006 Australia and New Zealand Horizon Scanning Network

8794. Magnetic resonance spectroscopy for the diagnosis of suspected breast malignancies

to individually estimate the probability of breast malignancy based on MRI results, and make a hypothetical recommendation based on these results as to whether a patient should undergo confirmatory biopsy. The radiologists were then required to re-examine their decisions following the disclosure of MRS results. For all four radiologists, the addition of MRS to the breast examination resulted in higher sensitivity, specificity and accuracy (as indicated by the area under the ROC curve) regarding the malignancy (...) be monitored until the results of the MSAC assessment are finalised. SOURCES OF FURTHER INFORMATION: AIHW (2006). BreastScreen Australia monitoring report 2002-2003, Australian Institute of Health and Welfare, Canberra. Bartella, L., Morris, E. A. et al (2006). 'Proton MR spectroscopy with choline peak as malignancy marker improves positive predictive value for breast cancer diagnosis: preliminary study', Radiology, 239 (3), 686-692. Cecil, K. M., Schnall, M. D. et al (2001). 'The evaluation of human

2006 Australia and New Zealand Horizon Scanning Network

8795. Screening for hypertrophic cardiomyopathy (Update)

Archive SOURCES OF FURTHER INFORMATION: AIHW (2006). National Hospital Morbidity Database [Internet]. Australian Institute of Health and Welfare. Available from: http://www.aihw.gov.au/cognos/cgi- in/ppdscgi.exe?DC=Q&E=/AHS/principaldiagnosis0304 [Accessed 24th January 2006]. Chung, M. W., Tsoutsman, T. & Semsarian, C. (2003). 'Hypertrophic cardiomyopathy: from gene defect to clinical disease', Cell Res, 13 (1), 9-20. Doolan, A., Langlois, N. & Semsarian, C. (2004a). 'Causes of sudden cardiac death (...) is not intended to be used as medical advice and intended to be used to diagnose, treat, cure or prevent any disease, nor should it be used therapeutic purposes or as a substitute for a health professional's advice. The Commonwealth does not accept any liability for any injury, loss or damage incurred by use of or reliance the information. The production of this Horizon scanning prioritising summary was overseen by the Health Policy Advisory Committee on Technology (HealthPACT), a sub-committee of the Medical

2007 Australia and New Zealand Horizon Scanning Network

8796. Pre-hospital administration of antibiotics by paramedics for suspected cases of meningococcal disease

for the United Kingdom ambulance service give approval and instructions to paramedics for the intravenous administration of benzylpenicillin (Todd 2004). The administration of medicines is viewed as a value judgment that should only be made by medical personnel. Therefore, in SA, paramedics contact the Medical Director of the Ambulance service by phone to describe the patient’s symptoms. The Director makes the final decision whether to administer antibiotics based on the described symptoms, current (...) : descriptive epidemiology, 1991-2000', J Paediatr Child Health, 37 (5), S13-19. Cooke, M. E. (2005). 'Prehospital Administration of Benzyl Penicillin by Paramedics in the UK', Journal of Emergency Primary Health Care, 3 (1-2). DoHA (2001). Guidelines for the early clinical and public health management of meningococcal disease in Australia, Deaprtment of Health and Ageing, Communicable Diseases Network Australia, Canberra. DoHA (2005). Childhood meningococcal C vaccination program [Internet]. Australian

2006 Australia and New Zealand Horizon Scanning Network

8797. ZstatFlu point of care influenza tests (Update)

that this technology be monitored. SOURCES OF FURTHER INFORMATION: Achyuthan, K. E., Pence, L. M. et al (2003). 'ZstatFlu-II test: a chemiluminescent neuraminidase assay for influenza viral diagnostics', Luminescence, 18 (3), 131-139. AIHW (2004). AIHW National Hospital Morbidity Database [Internet]. Australian Institute of Health and Welfare. Available from: http://www.aihw.gov.au [Accessed 28 th September 2004]. Centers for Disease Control and Prevention (1999). 'Neuraminidase Inhibitors for Treatment (...) of Influenza A and B Infections', Morbidity and Mortality Weekly, 48 (RR14), 1-9. Hamilton, M. S., Abel, D. M. et al (2002). 'Clinical evaluation of the ZstatFlu-II test: a chemiluminescent rapid diagnostic test for influenza virus', J Clin Microbiol, 40 (7), 2331- 2334. Rawlinson, W. D., Waliuzzaman, Z. M. et al (2004). 'New point of care test is highly specific but less sensitive for influenza virus A and B in children and adults', J Med Virol, 74 (1), 127- 131. Shimasaki, C. D., Achyuthan, K. E. et al

2007 Australia and New Zealand Horizon Scanning Network

8798. Niobe magnetic guidance system(Update)

. This report is not intended to be used as medical advice and intended to be used to diagnose, treat, cure or prevent any disease, nor should it be used therapeutic purposes or as a substitute for a health professional's advice. The Commonwealth does not accept any liability for any injury, loss or damage incurred by use of or reliance the information. The production of this Horizon scanning prioritising summary was overseen by the Health Policy Advisory Committee on Technology (HealthPACT), a sub (...) -committee of the Medical Services Advisory Committee (MSAC). HealthPACT comprises representatives from departments in all states and territories, the Australia and New Zealand governments; and ASERNIP-S. The Australian Health Ministers’ Advisory Council (AHMAC) supports HealthPACT through funding. This Horizon scanning prioritising summary was prepared by Adrian Purins and Professor Janet Hiller from the National Horizon Scanning Unit, Adelaide Health Technology Assessment, Discipline of Public Health

2007 Australia and New Zealand Horizon Scanning Network

8799. Racial and Ethnic Disparities in the VA Healthcare System

, by the influence of patient preferences on physician decision making, or by physician bias, was not determined. Blacks were more likely to delay seeking treatment for heart failure symptoms and were less adherent (both intentionally and unintentionally) to medication regimens. Among veterans with peripheral arterial disease, blacks had higher rates of limb amputation. The reasons underlying these findings of lower adherence and later presentation were not investigated. HSR&D Evidence Synthesis Pilot Program (...) be overutilized among white veterans with a low risk for GI bleeding. Black veterans rated their current analgesic and anti-inflammatory drugs as being more helpful than did whites, despite that symptom severity was greater among blacks in this study than whites. 3 Blacks had significantly greater odds of non-adherence to medication, in an analysis that adjusted for demographic factors, disease severity, participatory decision making (PDM), and medication side effects. No significant racial differences in PDM

2007 Veterans Affairs Evidence-based Synthesis Program Reports

8800. Self-Monitoring of Blood Glucose in Patients with Type 2 Diabetes Mellitus: Meta Analysis of Effectiveness

instructed to measure pre- and post-prandial blood glucose levels six days a week. Patients in both groups received dietitian counseling five times during the study. A nurse, who was blinded to whether the patient was in the treatment group or not, followed a detailed algorithm to make her therapeutic decisions. Her goals were to lower fasting glucose concentrations to ; Maryland: Agency for Healthcare Research and Quality. 8. Jansen JP. Self-monitoring of glucose in type 2 diabetes mellitus: a Bayesian (...) . Diabetes Educ 1990; 16:291-5. 22. Allen BT, DeLong ER, Feussner JR. Impact of glucose self-monitoring on non-insulin- treated patients with type II diabetes mellitus. Randomized controlled trial comparing blood and urine testing. Diabetes Care 1990; 13:1044-50. 23. Rutten G, van Eijk J, de Nobel E, Beek M, van der Velden H. Feasibility and effects of a diabetes type II protocol with blood glucose self-monitoring in general practice. Fam Pract 1990; 7:273-8. 24. Muchmore DB, Springer J, Miller M. Self

2007 Veterans Affairs Evidence-based Synthesis Program Reports

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