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E/M Medical Decision Making


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121. Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline

Medicine Clinical Practice Guideline Vishesh K. Kapur, MD, MPH 1 ; Dennis H. Auckley, MD 2 ; Susmita Chowdhuri, MD 3 ; David C. Kuhlmann, MD 4 ; Reena Mehra, MD, MS 5 ; Kannan Ramar, MBBS, MD 6 ; Christopher G. Harrod, MS 7 1 University of Washington, Seattle, WA; 2 MetroHealth Medical Center and Case Western Reserve University, Cleveland, OH; 3 John D. Dingell VA Medical Center and Wayne State University, Detroit, MI; 4 Bothwell Regional Health Center, Sedalia, MO; 5 Cleveland Clinic, Cleveland, OH; 6 (...) (funding sources), the TF determined their overall confidence that the estimated effect found in the body of evidence was representative of the true treatment effect that patients would see. For diagnostic accuracy studies, the QUADAS-2 tool was used in addition to the quality domains for the assessment of risk of bias in intervention studies. The quality of evidence was based on the outcomes that the TF deemed critical for decision-making. Benefits versus harms: based on the meta-analysis

2017 American Academy of Sleep Medicine

122. American Academy of Sleep Medicine Position Paper for the Use of a Home Sleep Apnea Test for the Diagnosis of OSA in Children

distribution, electronic or otherwise, of the article without the written permission of the AASM. Further, purchase does not permit the posting of article text on an online forum or website. E-mail Share Slides Please login to download PDF Subscribers can download and print full articles from current and past issues of the JCSM Not a subscriber? and receive a subscription to JCSM with your membership Special Articles American Academy of Sleep Medicine Position Paper (...) , Colorado; 5 Children's Hospital of Orange County, Orange, California; 6 University of Michigan Medical Center, Ann Arbor, Michigan; 7 University of Michigan, Ann Arbor, Michigan; 8 Seattle Children's Hospital, Seattle, Washington; 9 American Academy of Sleep Medicine, Darien, Illinois; 10 Saint Louis University, St. Louis, Missouri ABSTRACT Introduction: The purpose of this position paper is to establish the American Academy of Sleep Medicine's (AASM) position on the use of a home sleep apnea test

2017 American Academy of Sleep Medicine

123. Economic Evaluation of Unfractionated Heparin Versus Low-Molecular-Weight Heparin to Prevent Venous Thromboembolism in General Medical and Non Orthopedic Surgical Patients

is an important decision, both from a hospital formulary and a clinical perspective. In order to inform decision-making within provincial and territorial regional health authorities (RHAs) and hospitals, a health technology assessment (HTA) of anticoagulants for the prevention of VTE in the hospital setting was undertaken. This HTA project was a collaboration between the Drug Safety and Effectiveness Network (DSEN) of the Canadian Institute of Health Research and CADTH. A research group affiliated with DSEN (...) in the sensitivity analysis. Discount Rate Costs and benefits were discounted at 5%, and rates of 0% and 3% were tested in the sensitivity analysis. 3 Modelling A combination of a decision tree and a Markov model was created to examine the two cohorts: hospitalized medical patients and hospitalized non-orthopedic surgical patients who are at risk for VTE and require VTE prevention therapy. The decision tree captured events during index hospitalization, and the Markov model considered health states after

2017 CADTH - Plasma Products

124. Folic Acid for the Prevention of Neural Tube Defects: Preventive Medication

of Health and Human Services. Collapse All The US Preventive Services Task Force (USPSTF) makes recommendations about the effectiveness of specific preventive care services for patients without obvious related signs or symptoms. It bases its recommendations on the evidence of both the benefits and harms of the service and an assessment of the balance. The USPSTF does not consider the costs of providing a service in this assessment. The USPSTF recognizes that clinical decisions involve more (...) considerations than evidence alone. Clinicians should understand the evidence but individualize decision making to the specific patient or situation. Similarly, the USPSTF notes that policy and coverage decisions involve considerations in addition to the evidence of clinical benefits and harms. Importance Neural tube defects are major birth defects of the brain and spine that occur early in pregnancy due to improper closure of the embryonic neural tube, which may lead to a range of disabilities or death

2017 U.S. Preventive Services Task Force

125. Shared Medical Appointments for Chronic Medical Conditions: A Systematic Review

John W Williams Jr., M.D., M.H.Sc., Director Shared Medical Appointments for Chronic Medical Conditions: A Systematic Review Investigators: Principal Investigator: David Edelman, M.D. Co-Investigators: Jennifer R. McDuffie, Ph.D. Eugene Oddone, M.D., M.H.Sc. Jennifer M. Gierisch, Ph.D., M.P .H. John W. Williams Jr., M.D., M.H.Sc. Research Associate: Avishek Nagi, M.S. Medical Editor: Liz Wing, M.A.i Shared Medical Appointments for Chronic Medical Conditions Evidence-based Synthesis Program PREFACE (...) . Comments on this evidence report are welcome and can be sent to Nicole Floyd, ESP Coordinating Center Program Manager, at Recommended citation: Edelman D, McDuffie JR, Oddone E, Gierisch JM, Nagi A, Williams JW Jr. Shared Medical Appointments for Chronic Medical Conditions: A Systematic Review. VA- ESP Project #09-010; 2012. This report is based on research conducted by the Evidence-based Synthesis Program (ESP) Center located at the Durham VA Medical Center, Durham, NC, funded

2012 Veterans Affairs Evidence-based Synthesis Program Reports

126. Shared decision making in antipsychotic prescribing: the perspective of psychiatrists

Shared decision making in antipsychotic prescribing: the perspective of psychiatrists Shared decision making in antipsychotic prescribing Search National Elf Service Search National Elf Service » » » » Shared decision making in antipsychotic prescribing: the perspective of psychiatrists Jul 11 2014 Posted by Despite the growth in psychosocial interventions for people with psychosis (specifically cognitive behavioural therapy and family interventions), antipsychotic medication remains (...) . Research shows that side-effects are common with both the older typical antipsychotics and the newer atypical antipsychotics The roots of collaborative practice The idea of collaborative practice in prescribing psychiatric medication has been around for many years and developed with the emergence of “compliance therapy” in the 1990s (Kemp and David, 1996), which recognised the importance of dialogue around medication beliefs and choices, and attempted to see prescribing decisions and medicines

2014 The Mental Elf

127. Making Healthy Choices: Does Having an Online Health Coach Help?

Healthy Lifestyle Choices: Does Having a Telehealth Personal Health Coach Help? Actual Study Start Date : October 1, 2018 Estimated Primary Completion Date : September 2019 Estimated Study Completion Date : September 2019 Resource links provided by the National Library of Medicine related topics: Arms and Interventions Go to Arm Intervention/treatment Experimental: Intervention Group (1) 12 weekly interactive sessions with a health coach to help them set goals and make changes toward becoming (...) % of the intervention sessions (i.e., 8/12) Acceptability of intervention: Semi-structured interviews [ Time Frame: Post-intervention (12 weeks) ] Participants will be asked what they liked, disliked, and experienced during the intervention Eligibility Criteria Go to Information from the National Library of Medicine Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your

2018 Clinical Trials

128. Vitamin E infused Polyethylene Liners, Regular Polyethylene Liners, Cross-Linked Polyethylene Liners for Knee Articular Surfacing in Adults : A Review of Clinical Effectiveness and Cost Effectiveness

of polymer. It is believed the process of crosslinking may reduce fracture strength or toughness and fatigue resistance. 4,5 It has been suggested these factors could make individuals uneasy when selecting highly cross- linked polyethylene in TKA. 4 However, some sources suggest cross-linking increases wear resistance of polyethylene knee bearing by as much as 100 fold. 5 The addition of vitamin E to the polyethylene “cushion” component of knee resurfacing could be a promising approach to increase (...) to observe typical proportions of failures observed over a long-term period in the real world; as a result, the findings of the studies may have limited external validity. In addition, because none of the included studies were conducted in Canada, it is unclear if the surgical techniques used in the studies are generalizable to Canadian setting. CONCLUSIONS AND IMPLICATIONS FOR DECISION OR POLICY MAKING There was no evidence to suggest a difference in revision surgery/failure between highly cross- linked

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

129. Making choices about living with motor neurone disease

to those making decisions about treatments to help them manage the symptoms of MND and possibly prolong their lives. What is MND? Amyotrophic lateral sclerosis (ALS) is the commonest form of motor neurone disease (MND) and the terms are often used interchangeably. It’s a progressive disease that attacks the nerves in the brain and spinal cord. Messages gradually stop reaching muscles; MND can affect lots of basic functions such as walking, talking and breathing, and failure of the respiratory muscles (...) decisions about health. Before joining Cochrane, Sarah also worked on systematic reviews for the University of Oxford and the Royal College of Nursing Institute, and obtained degrees in History from the University of Oxford and in the history of women’s health and illness in early modern England (MPhil., University of Reading). Making choices about living with motor neurone disease by Sarah Chapman is licensed under a 2 Comments on this post I have only just had confirmation that I have MND after 6

2014 Evidently Cochrane

130. ROS1 Targeting With Crizotinib in Advanced E-cadherin Negative, ER Positive Lobular Breast Cancer or Diffuse Gastric Cancer Study

place for this study. Masking: Single (Participant) Primary Purpose: Other Official Title: Phase II Study of ROS1 Targeting With Crizotinib in Advanced E-cadherin Negative, ER Positive Lobular Breast Cancer or Diffuse Gastric Cancer Estimated Study Start Date : August 13, 2018 Estimated Primary Completion Date : November 30, 2020 Estimated Study Completion Date : November 30, 2020 Resource links provided by the National Library of Medicine related topics: related topics: available for: resources (...) percent (%) relative increase and >/=5 millimeter (mm) of absolute increase in the sum of diameters (SD) of target lesions (TLs), taking as reference the smallest SD recorded since treatment started, or appearance of 1 or more new lesions. Eligibility Criteria Go to Information from the National Library of Medicine Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you

2018 Clinical Trials

131. Applying deep neural networks to unstructured text notes in electronic medical records for phenotyping youth depression Full Text available with Trip Pro

web-based system . 3. Kitterman DR , Cheng SK , Dilts DM , et al . The prevalence and economic impact of low-enrolling clinical studies at an academic medical center . 4. Schmickl CN , Li M , Li G , et al . The accuracy and efficiency of electronic screening for recruitment into a clinical trial on COPD . 5. Weng C , Batres C , Borda T , et al . A real-time screening alert improves patient recruitment efficiency . 6. Salem RM , Pandey B , Richard E , et al . The VA hypertension Primary Care (...) of publicly available Twitter data into several mental health diagnoses, including depression and bipolar disorder. A later publication identified patients with depression from free-text discharge summaries: a combination of NLP and ML algorithms was used, with the best performance coming from Medical Text Extraction, Reasoning and Mapping System's knowledge-based decision tree method, yielding an F-measure of 89.6%. To summarise the rationale for extracting diagnosis inclusion criteria from unstructured

2017 Evidence-Based Mental Health

132. Summary of the Committee to Advise on Tropical Medicine and Travel (CATMAT) statement on travellers' diarrhea

on Tropical Medicine and Travel (CATMAT) Statement on Travelers’ Diarrhea Libman M 1 , on behalf of CATMAT* Affiliation 1 Division of Infectious Disease, McGill University Health Centre, Montréal, QC Correspondence DOI Abstract Background: Most travellers' diarrhea (TD) infections occur during travel to low- and middle-income countries. Type of travel, duration of stay, age of traveller and presence of certain medical conditions are important factors to consider (...) be considered as options in the prevention and treatment of TD based on the particular situation of the traveller. Preamble The Committee to Advise on Tropical Medicine and Travel (CATMAT) provides the Public Health Agency of Canada with ongoing and timely medical, scientific, and public health advice relating to tropical infectious disease and health risks associated with international travel. The Agency acknowledges that the advice and recommendations set out in this Statement are based upon the best

2015 CPG Infobase

133. 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

134. Use of licensed medicines for unlicensed applications in psychiatric practice 2nd edition

: a one-year survey of spontaneous reports in Sweden. Pharmacoepidemiology and Drug Safety, 13: 147–52. Wilkes M, Johns M (2008) Informed consent and shared decision-making: a requirement to disclose to patients off-label prescriptions. PLoS Medicine, 5: 1553–6. Wittich CM, Burkle CM, Lanier WL (2012) Ten common questions (and their answers) about off-label drug use. Mayo Clinic Proceedings, 87: 982–90. (...) . Explain fully the anticipated benefits and potential risks of the proposed medication to the patient (and if possible their relative or partner) stating that the medicine will be used outside the restricted terms of its product licence and make a record of this explanation. 6. In a situation where prescribing an unlicensed medicine is supported by authorative guidance, describe in general terms why the medicine is not licensed for the proposed indication, but if you intend to prescribe an unlicensed

2017 British Association for Psychopharmacology

135. British Association for Psychopharmacology consensus guidance on the use of psychotropic medication preconception, in pregnancy and postpartum

analysis of psychotropic use in the perinatal period were criti- cally reviewed. Given the high levels of anxiety around the use of medication in the perinatal period, the consensus group were keen to achieve a guideline to support evidence-based shared decision making between clinician and patient. Development of this BAP guideline was paused pending the publication of NICE guidelines in 2015 (NICE, 2015a) to ensure that patients and cli- nicians were not faced with inconsistent advice. The residual (...) ; endorsed by the British Association for Psychopharmacology Abstract Decisions about the use of psychotropic medication in pregnancy are an ongoing challenge for clinicians and women with mental health problems, owing to the uncertainties around risks of the illness itself to mother and fetus/infant, effectiveness of medications in pregnancy and risks to the fetus/infant from in utero exposure or via breast milk. These consensus guidelines aim to provide pragmatic advice regarding these issues

2017 British Association for Psychopharmacology

136. The effect of mental health issues on sexual risk behaviours and antiretroviral medication adherence among men who have sex with men

social isolation and mental health issues for older sexual minority men. For two hours a week over the course of six weeks, participants met with a trained peer facilitator and one another over dinner, discussing topics such as decision-making, safer sex, activity scheduling, problem solving, partner communication and support networks. The researchers observed statistically significant changes post-intervention including fewer negative psychosocial outcomes and more self-efficacy in condom use (...) into Action The OHTN Rapid Response Service offers quick access to research evidence to help inform decision making, service delivery and advocacy. In response to a question from the field, the Rapid Response Team reviews the scientific and grey literature, consults with experts, and prepares a brief fact sheet summarizing the current evidence and its implications for policy and practice. Suggested Citation Rapid Response Service. The effect of mental health issues on sexual risk behaviours

2016 Ontario HIV Treatment Network

137. Off-label prescribing of psychotropic medication to children and adolescents

an adverse reaction. It is important to make it clear that independent prescribers can prescribe any med- ication (licensed, unlicensed or off-label) so long as this prescrip- tion would be supported by a reasonable body of medical opinion (UK Medical Act, 1983). Limitations of the marketing authori- sation should not preclude unlicensed use where clinically appropriate. Prescribing unlicensed medicines or medicines outside the recommendations of their marketing authorisation alters (and probably (...) choosing an off-label medication in preference to a licensed one, a non-pharmacological treatment or no treatment at all. The purpose of off-label use is to benefit the individual patient. Practitioners use their professional judg- ment to determine these uses. As such, the term off-label does not imply an improper, illegal, contraindicated or investigational use. ‘Therapeutic decision making must always rely on the best avail- able evidence and balance this against the risks and benefits

2017 British Association for Psychopharmacology

138. Impact of childhood sexual abuse on antiretroviral medication adherence, sexual risk behaviours and overall health among men who have sex with men

and bisexual men in Los Angeles who had a history of childhood sexual abuse was able to decrease sexual risk behaviours at six-month follow-up; however, there were no significant differences in the number of sex partners or depressive symptoms (11). The authors highlight the importance in addressing sexual decision-making while being sensitive to histories of childhood sexual abuse and sexual minority status (11). The EXPLORE study, conducted with HIV-negative gay men in six U.S. cities over 48 months (...) dysfunction, paraphilias and their relationship to childhood abuse in men who have sex with men. International Journal of Sexual Health 2009;(2):79-86. Springer A, Dushaj A, Azar M. The impact of DSM-IV mental disorders on adherence to combination antiretroviral therapy among adult persons living with HIV/AIDS: A systematic review. AIDS & Behavior 2012;16(8):2119-43. Suggested citation Rapid Response Service. Impact of childhood sexual abuse on antiretroviral medication adherence, sexual risk behaviours

2016 Ontario HIV Treatment Network

139. Medication Reconciliation at Discharge

and analyzes information about how a health intervention fits within current practice and existing treatment alternatives. Details about the diffusion of the intervention into current health care practices in Ontario add an important dimension to the review. Information concerning the health benefits, economic and human resources, and ethical, regulatory, social, and legal issues relating to the intervention may be included to assist in making timely and relevant decisions to optimize patient outcomes (...) Pharmaceutical Services/ 51222 27 (((medication* or medicine* or drug or drugs or pharmacist* or pharmacy or pharmacies or formulary or formularies or prescription* or prescrib*) adj3 (reconcil* or review* or discrepanc* or discontinuit* or assess* or audit*)) or (med* reconcil* or medrec* or med rec or stopp criteria* or beer's criteria)).ti,ab. 31691 28 or/22-27 103340 29 21 and 28 4660 30 Meta 52731 31 Meta-Analysis/ use mesz or exp Technology Assessment, Biomedical/ use mesz 61456 32 (meta

2015 Health Quality Ontario

140. Schizophrenia: omega-3 fatty acid medicines

or off-label medicines that are considered to be of significance to the NHS, where there are no clinically appropriate licensed alternatives. The summaries provide information for clinicians and patients to inform their decision-making and support the construction and updating of local formularies. The summaries support decision-making on the use of an unlicensed or off-label medicine for an individual patient, where there are good clinical reasons for its use, usually when there is no licensed (...) . Schizophrenia Research 49: 243–51 Schizophrenia: omega-3 fatty acid medicines (ESUOM19) © NICE 2018. All rights reserved. Subject to Notice of rights ( conditions#notice-of-rights). Page 21 of 27Peet M, Horrobin DF (2002) A dose-ranging exploratory study of the effects of ethyl- eicosapentaenoate in patients with persistent schizophrenic symptoms. Journal of Psychiatric Research 36: 7–18 Politi P , Rocchetti M, Emanuele E et al. (2013) Randomized placebo-controlled trials

2013 National Institute for Health and Clinical Excellence - Advice

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