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E/M Medical Decision Making

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121. A clinical model for decision-making (PubMed)

A clinical model for decision-making 739517 1979 04 26 2008 11 20 0306-6800 4 4 1978 Dec Journal of medical ethics J Med Ethics A clinical model for decision-making. 200-6 Martin R M RM eng Journal Article England J Med Ethics 7513619 0306-6800 E IM Decision Making Ethicists Ethics, Medical Logic Social Values 07950 KIE BoB Subject Heading: PHYSICIANS/ETHICS/DECISION MAKING Full author name: Martin, Richard M 1978 12 1 1978 12 1 0 1 1978 12 1 0 0 ppublish 739517 PMC1154684

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1978 Journal of medical ethics

122. Impact of Coronary Computed Tomography Angiography Findings on Initiation of Cardioprotective Medications. (PubMed)

of Emergency Medicine, Wake Forest School of Medicine, Winston-Salem, NC (C.D.M.). Singh Harjit H Department of Radiology, Pennsylvania State Hershey Medical Center (H.S.). O'Conor Katie J KJ Johns Hopkins School of Medicine, Baltimore, MD (K.J.O.). Hollander Judd E JE Department of Emergency Medicine, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA (A.M.C., J.EH.). eng K12 HL108974 HL NHLBI NIH HHS United States Comparative Study Letter Multicenter Study Randomized (...) Controlled Trial Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't United States Circulation 0147763 0009-7322 0 Hydroxymethylglutaryl-CoA Reductase Inhibitors 0 Platelet Aggregation Inhibitors R16CO5Y76E Aspirin AIM IM Acute Coronary Syndrome diagnostic imaging drug therapy epidemiology Adult Angina Pectoris epidemiology Aspirin therapeutic use Clinical Decision-Making Computed Tomography Angiography Coronary Angiography methods Coronary Stenosis diagnostic imaging drug therapy

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2019 Circulation Controlled trial quality: uncertain

123. Prevention of Acute Nausea and Vomiting due to Antineoplastic Medication in Pediatric Cancer Patients

, PhD Erin O’Shaughnessy RN, MScN, CPHON Lillian Sung MD, PhD Recommended citation: Dupuis LL, Boodhan S, Holdsworth M, Robinson PD, Hain R, Portwine C, O’Shaughnessy E and Sung L. Guideline for the Prevention of Acute Nausea and Vomiting due to Antineoplastic Medication in Pediatric Cancer Patients. Pediatric Oncology Group of Ontario; Toronto. 2012. 2 Version date: February 28, 2013 The Pediatric Oncology Group of Ontario (POGO) Guideline for the Prevention of Acute Nausea and Vomiting due (...) Literature Search for Pediatric Studies 14 • Search Strategy 14 • Selection Criteria and Appraisal 14 • Meta-analysis 14 Decision-making Process for Formulation of the Recommendations 14 Evidence Synthesis and Recommendations 16 Identification and Appraisal of Existing Guidelines 16 Primary Literature Review of Pediatric Oncology Studies 16 Health Question #1: How is optimal control of acute AINV defined? 17 • Recommendation • Evidence Summary and Discussion Health Question #2a: What pharmacological

2013 SickKids Supportive Care Guidelines

124. Medical therapies to reduce chronic kidney disease progression and cardiovascular risk: lipid lowering therapy

)[37] (SHARP Study) Simvastatin+E 131/ 4630 174/ 4620 0.75 [0.60, 0.94] -0.01 [-0.02, -0.00] Critical Methodological quality, consistency across studies and directness of the evidence (generalisability/applicability). ** The GRADE system uses the following 3 categories to rank the importance of end points: critical for decision making important but not critical for decision making not important for decision making (of lower importance to patients) * NA – not applicable (...) Tonelli et al (2004) [39] *NA NA NA Methodological quality, consistency across studies and directness of the evidence (generalisability/applicability). ** The GRADE system uses the following 3 categories to rank the importance of end points: critical for decision making important but not critical for decision making not important for decision making (of lower importance to patients) * NA – not applicable

2013 KHA-CARI Guidelines

125. Medical therapies to reduce chronic kidney disease progression and cardiovascular risk: anti-hypertensive/anti-proteinuric agents

Canadian Medical Association Journal. 2008; 179: 1154-62. 29. National Vascular Disease Prevention Alliance, Guidelines for the management of absolute cardiovascular disease risk. 2012: Melbourne, Victoria. 30. Escape Trial Group, Wuhl E, Trivelli A et al. Strict blood-pressure control and progression of renal failure in children. New England Journal of Medicine. 2009; 361: 1639-50. 31. Agha A, Amer W, Anwar E et al. Reduction of microalbuminuria by using losartan in normotensive patients with type 2 (...) and overt nephropathy. Nephrology Dialysis Transplantation. 2008; 23: 3174-83. 34. Makino H, Haneda M, Babazono T et al. Microalbuminuria reduction with telmisartan in normotensive and hypertensive Japanese patients with type 2 diabetes: a post-hoc analysis of The Incipient to Overt: Angiotensin II Blocker, Telmisartan, Investigation on Type 2 Diabetic Nephropathy (INNOVATION) study. Hypertension Research - Clinical & Experimental. 2008; 31: 657-64. 35. Burgess E, Muirhead N, Rene de Cotret P et al

2013 KHA-CARI Guidelines

126. Secure Messaging between Providers and Patients, and Patients? Access to Their Own Medical Record

Los Angeles, CA Paul G. Shekelle, M.D., Ph.D., Director Investigators: Principal Investigator: Caroline Lubick Goldzweig, M.D., M.S. Co-Investigators: Paul G. Shekelle, M.D., Ph.D. Ali Alexander Towfigh, M.D. Neil M. Paige, M.D., M.S.H.S. Greg Orshansky, M.D. David A. Haggstrom, M.D., M.A.S. Research Associates: Isomi Miake-Lye, B.A. Jessica M. Beroes, B.S. Systematic Review: Secure Messaging between Providers and Patients, and Patients’ Access to Their Own Medical Record Evidence on Health (...) Limitations 30 Discussion 30 Recommendations for Future Research 31 Conclusions 31 REFERENCES 32 APPENDIX A. SEARCH STRA TEg Y 36 APPENDIX B. STUDY SELECTION FORM 38 APPENDIX C. CRITERIA USED IN QUALITY ASSESSMENT 39 APPENDIX D. PEER REVIEw COMMENTS/AUTHOR RESPONSE 40 APPENDIX E. EVIDENCE TABLES 48iii Secure Messaging between Providers and Patients, and Patients’ Access to Their Own Medical Record Evidence-based Synthesis Program FIgURES AND TABLES Figure 1. Literature Flow 12 Table 1. Tethered Personal

2012 Veterans Affairs Evidence-based Synthesis Program Reports

127. Triaging Patients from the Emergency Department to Other Medical Centres: A Review of the Clinical Evidence and Guidelines

appropriate to make the decision (doctor versus nurse) Study Designs Health technology assessments, systematic reviews, meta-analyses, randomized controlled trials, non-randomized studies. Triaging Patients from the Emergency Department to Other Medical Centres 3 Exclusion Criteria Articles were excluded if they did not meet the selection criteria outlined in Table 1, were published prior to 2006, or did not provide methods to describe how the results or guidance was reached. SUMMARY OF EVIDENCE: Quantity (...) consume a small fraction of emergency department resources and may not be substantial contributors to overcrowding. 2 There is, however, some evidence that two to seven percent are admitted to hospital among patients assigned to the lowest triage levels. The literature, therefore, suggests that triage status alone may not be sufficient to make decisions with regards to transfer out of the emergency department. 6 In addition to potential safety concerns, there may be legal and ethical implications

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

128. A Decision Aid: Goals of Care for Patients with Dementia #SDM

a patient is admitted to a long term care facility. This video has been added to the part of the Less is More Medicine site, where you will find lots of other shared decision-making tools. Hanson LC, Zimmerman S, Song M-K, Lin F-C, Rosemond C, Carey TS, et al. Effect of the Goals of Care Intervention for Advanced Dementia. JAMA Internal Medicine. 2017; 177(1):24-31 Source: In , Tags , , , , , , , , , , , articles and Original Commentary on the topic of "Less is More in Medicine" and The "Right Care (...) , at the University of North Carolina at Chapel Hill, and her colleagues were, in short, exploring the following: Question Can a decision aid intervention about goals of care improve communication, decision-making, and palliative care for patients with advanced dementia? Findings In this randomized trial of 302 nursing home residents with advanced dementia, family decision makers reported better end-of-life communication with clinicians. Clinicians were more likely to address palliative care in treatment plans

2017 Less is More in Medicine Blog

129. A Decision Aid: Goals of Care for Patients with Dementia #SDM

a patient is admitted to a long term care facility. This video has been added to the part of the Less is More Medicine site, where you will find lots of other shared decision-making tools. Hanson LC, Zimmerman S, Song M-K, Lin F-C, Rosemond C, Carey TS, et al. Effect of the Goals of Care Intervention for Advanced Dementia. JAMA Internal Medicine. 2017; 177(1):24-31 Source: In , Tags , , , , , , , , , , , articles and Original Commentary on the topic of "Less is More in Medicine" and The "Right Care (...) , at the University of North Carolina at Chapel Hill, and her colleagues were, in short, exploring the following: Question Can a decision aid intervention about goals of care improve communication, decision-making, and palliative care for patients with advanced dementia? Findings In this randomized trial of 302 nursing home residents with advanced dementia, family decision makers reported better end-of-life communication with clinicians. Clinicians were more likely to address palliative care in treatment plans

2017 Less is More in Medicine Blog

130. Jennifer McCaughan and Aisling E Courtney: Is balancing risk the most important skill in clinical medicine?

and stressful cases in the past can distort our decision making in the present. This has the potential to result in suboptimal patient management. The ability to objectively balance the many aspects (surgical, anaesthetic, medical, immunological, psychological) of the risk associated with a treatment against that of avoiding the treatment is an essential skill for physicians. The capacity to do this effectively for each individual patient is the cornerstone of personalised medicine and an attribute (...) Jennifer McCaughan and Aisling E Courtney: Is balancing risk the most important skill in clinical medicine? Jennifer McCaughan and Aisling E Courtney: Is balancing risk the most important skill in clinical medicine? - The BMJ ---> Every decision, both in life and in medicine, involves a balance of risk: the decision to go on holiday balances the risk of travelling to and staying in a foreign country against the benefit of a fortnight’s sunshine and relaxation; the decision to treat bacterial

2017 The BMJ Blog

131. Dr. Kelly Brogan’s e-book “Vaccines and Brain Health”: A cornucopia of antivaccine misinformation and pseudoscience

: As a passionate believer in the power of informed consent, I feel that we have a right to know the full breadth of available data so that we’re empowered to make our own decisions about our bodies and our children . As a practicing psychiatrist, my major concern is how vaccines affect brain health, behavior, and cognition. As a mother and a woman, I bring special entitlements to the conversation about bodily integrity, health choice freedom, and autonomy. To make your own judgment, it’s important (...) vaccines to specific physiologies. As each person contains a unique signature of interrelated characteristics, people can react in wildly different ways to the same vaccines. This is the sort of spinning of science that makes individual points that are true and weaves them into a misleading argument that, because biology is complicated and there is variability in response to a medical intervention, we might as well throw up our hands and do nothing until we find out how to quantify exactly how each

2017 Respectful Insolence

132. Headache - medication overuse

. Da Silva AN, Lake AE ( 2014 ) Clinical aspects of medication overuse headaches. Headache 54 ( 1 ), 211 - 217 . Grande RB, Aaseth K, Benth JŠ, Lundqvist C, Russell MB. ( 2011 ) Reduction in medication-overuse headache after short information. The Akershus study of chronic headache. European Journal of Neurology 18 ( 1 ), 129 - 137 . Green, M. and Coleman, R. ( 2016 ) Tension-type headache. BMJ Best Practice. BMJ . Hainer B, Matheson E ( 2013 ) Approach to Acute Headache in Adults. American Family (...) on the editorial steering group, contacting expert patient groups, organizations and individuals. Evidence exclusion criteria Evidence exclusion criteria Our policy Scoping a literature search, and reviewing the evidence for CKS is a methodical and systematic process that is carried out by the lead clinical author for each topic. Relevant evidence is gathered in order that the clinical author can make fully informed decisions and recommendations. It is important to note that some evidence may be excluded

2017 NICE Clinical Knowledge Summaries

133. People with severe mental illness have more adverse outcomes from medical or surgical treatment

strong evidence that adverse outcomes occur for people with SMI when being treated surgically or medically in hospital. Understanding the range of factors that could contribute to poorer quality care could have greater implications for clinical practice. Conflicts of interest None. We need to understand the full range of factors that contribute to poorer quality physical health care for people with severe mental illness. Links Primary paper Reeves E, Henshall C, Hutchinson M, Jackson D. (2018) . Int (...) that service-users and clinicians views of their physical health is not concordant (Renwick et al., 2018); while this evidence is relevant it is just one piece of a complicated puzzle of factors driving inequitable healthcare delivery, acceptance and receipt. Much more research is needed to illuminate service-users and clinicians beliefs and attitudes towards treatment to understand clinical and shared decision-making. In summary, the delivery of care is often delayed and inconsistently delivered

2018 The Mental Elf

134. Qualitative?other: People with coexisting diabetes, chronic kidney disease and hypertension report the psychosocial effects of being prescribed multiple medications

asymptomatic. In a cross-sectional study of 24 017 patients, 8% of respondents took less medication than prescribed because they felt better, while 34.3% took less medication due to a variety of health and medication beliefs. This type of medication non-adherence is often described as intentional non-adherence, reflecting active, rational decision-making on the part of the patient to not take their medication as prescribed. Herein lays a challenge for healthcare providers to improve medication adherence (...) to medication. References Haynes R , Ackloo E , Sahota N , et al . Interventions for enhancing medication adherence . Miller W , Rollnick S . Motivational interviewing: preparing people for change . New York, NY : Guilford Press , 2002 . Gadkari AS , McHorney CA . Unintentional non-adherence to chronic prescription medications: how unintentional is it really? Mitchell P , Wynia M , Golden R , et al . Core principles & values of effective team-based health care . Washington, DC : Institute of Medicine , 2012

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2015 Evidence-Based Nursing

135. Voluntary medical male circumcision: modeling the impact and cost of expanding male circumcision for HIV prevention in eastern and southern Africa

Voluntary medical male circumcision: modeling the impact and cost of expanding male circumcision for HIV prevention in eastern and southern Africa Voluntary medical male circumcision: modeling the impact and cost of expanding male circumcision for HIV prevention in eastern and southern Africa Voluntary medical male circumcision: modeling the impact and cost of expanding male circumcision for HIV prevention in eastern and southern Africa Njeuhmeli E, Forsythe S, Reed J, Opuni M, Bollinger L (...) V, Hankins C. Voluntary medical male circumcision: modeling the impact and cost of expanding male circumcision for HIV prevention in eastern and southern Africa. PLOS Medicine 2011; 8(11):e1001132 PubMedID DOI Original Paper URL Indexing Status Subject indexing assigned by NLM MeSH Adolescent; Adult; Africa, Eastern /epidemiology; Circumcision, Male /economics /statistics & Cost-Benefit Analysis; Decision Making, Organizational; Female; HIV Infections /economics /epidemiology /prevention

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2011 NHS Economic Evaluation Database.

136. The Effect of a Structured, Home-based Interview With a Patient on First-year Medical Students' Patient-centredness.

? London2017 [31 October 2017]. Available from: http://www.medicalprotection.org/uk/advice-booklets/professionalism-an-mps-guide/chapter-1-medical-professionalism-what-do-we-mean McWhinney IR. The need for a transformed clinical method. In: Stuart M, Roter D, editors. Communicasting with medical patients. London: Sage; 1989. de Silva D. Helping measure person-centred care. In: The Health Foundation, editor. London 2014. Archer E, Bezuidenhout J, Kidd MR, et al. Making use of an existing questionnaire (...) . Outcome Measures Go to Primary Outcome Measures : Changes in medical students' patient-centredness as assessed by the PPOS-D12 questionnaire [ Time Frame: 6-12 months ] Change in students' PPOS-D12 scores from base-line (at the start of the academic year) to the end of their year-long primary care attachment. The PPOS-D12 is the validated German-language version of the Patient-Provider Orientation Scale (Kiessling C, Fabry G, Rudolf Fischer M, et al., 2014), a self-completed questionnaire to assess

2018 Clinical Trials

137. Medication Free Treatment: Characteristics, Justification and Outcome

: Filled out by patients at start of treatment, end of treatment (typically at week 2-8) and at 6 months, 1 year, 2 years and 3 years ] Collaborate is a 3-item measure of shared decision making. CollaboRATE assesses three core SDM tasks: (1) explanation about health issues, (2) elicitation of patient preferences and (3) integration of patient preferences into decisions (Paul J. Barr et al., 2017). It has been found to have adequate psychometric properties in both simulated (Paul James Barr et al., 2014 (...) in the project "Bedre psykosebehandling" about perceived quality of help and information regarding medication (Prosjekt Bedre psykosebehandling, n.d.). 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 doctor may contact the study research staff using the contacts provided below

2018 Clinical Trials

138. Coding Discrepancies Between Medical Student and Physician Documentation. (PubMed)

, and documented low medical decision making. Diagnostic code was concordant between students and faculty for only 31% of documentation.Student documentation of clinical encounters is coded at a lower LOS than faculty documentation. These results likely reflect the lack of education regarding E/M coding in medical school, which is integral to real world practice.Accurate medical documentation is critical to the correct diagnostic coding and billing of a medical encounter. We found that compared to faculty (...) Coding Discrepancies Between Medical Student and Physician Documentation. Accurate medical documentation is a core competency in medical education and is critical to successful surgical practice. The following study aims to assess the coding accuracy of medical student documentation.Retrospective chart review identified patient encounters in a surgery clinic that contained documentation by both a faculty member and a third-year medical student. Records were de-identified and assigned a level

2018 Journal of Surgical Education

139. Variable rate insulin infusion (VRII) for medical inpatients with diabetes

infusion (VRIII) in adult inpatients with medical conditions and diabetes/hyperglycaemia, who require intravenous administration of insulin to keep their blood glucose within the recommended target range during an acute illness or a period of starvation. This guideline is not suitable for use in certain situations. We make the following recommendations for those circumstances. Scope of the guideline This document is designed to guide non specialist teams in the appropriate and safe use of a VRIII. Seek (...) in response to changes in the blood glucose, the safe and effective use of a VRIII will depend on close monitoring and decision making by health care professionals. The emphasis throughout this guideline is on the safe use of a VRIII when clinically indicated, aiming for target blood glucose levels that are appropriate for this group of patients. It should be used for as short a duration as possible, with plans for a safe and effective step-down to other agents as soon as the clinical situation allows

2014 Association of British Clinical Diabetologists

140. Medical management of first-trimester abortion

for authorization to make photocopies should be directed to Copyright Clearance Center, 222 Rosewood Drive, Danvers, MA 01923, (978) 750-8400. ???? ISSN 1099-3630 ? The American College of Obstetricians and Gynecologists, 409 12th Street, SW, PO Box 96920, Washington, DC 20090-6920 ?? Medical management of first-trimester abortion. Practice Bulletin No. 143. American College of Obstetricians and Gynecologists. Obstet Gynecol 2014;123:676-692. ??? Committee on Practice Bulletins — Gynecology and the Society (...) as early as 24 h after mifepristone administration [32,33]. Women can safelyandeffectivelyself-administermisoprostolathomeas part of a medical abortion regimen [32,34,35]. 4. Counseling patients 4.1. Medical abortion vs. surgical abortion Counselingmust firstemphasize early pregnancyoptions to ensure that a woman is certain about her decision to have an abortion. If she is uncertain, then the decision about abortion technique must be delayed until she has reached a firmdecision

2014 Society of Family Planning

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