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E/M Medical Decision Making

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141. Routine psychosocial care in infertility and medically assisted reproduction ? A guide for fertility staff

infertility. Hum Reprod 2012;27: 488-495. Boivin J, Appleton TC, Baetens P, Baron J, Bitzer J, Corrigan E, Daniels KR, Darwish J, Guerra-Diaz D, Hammar M, McWhinnie A, Strauss B, Thorn P, Wischmann T, Kentenich H, European Society of Human Reproduction and Embryology. Guidelines for counselling in infertility: outline version. Hum Reprod 2001;16: 1301-1304. Boivin J, Domar AD, Shapiro DB, Wischmann TH, Fauser BC, Verhaak C. Tackling burden in ART: an integrated approach for medical staff. Hum Reprod (...) to the emotional impact of infertility.(A) • that both partners are involved in the treatment process.(A) • being involved in decision-making.(A) • receiving psychosocial care from sensitive and trustworthy staff members.(A) • receiving attention to their distinct needs related to their medical history.(B) Clinic characteristics Fertility staff should be aware that patients value • minimal waiting times, not being hurried in medical consultations, and continuity of care.(A) • the professional competence

2015 European Society of Human Reproduction and Embryology

142. Reprocessing of Single-Use Medical Devices

nation’s legislation regulates this practice differently throughout Europe. For example, in Germany, the existing regulatory framework addresses only quality standards and validated procedures for reprocessing and makes no legal distinction between single- and multiple-use medical devices. 22 Both in-house and third-party reprocessing are allowed but must conform to German regulations on reprocessing, which stipulate that institutions reprocessing SUMDs must adopt and implement a quality management (...) of International Conference on Nosocomial Infections. Chicago: American Hospital Association; 1970. p. 254-74. 3. Hailey D, Jacobs PD, Ries NM, Polisena J. Reuse of single use medical devices in Canada: clinical and economic outcomes, legal and ethical issues, and current hospital practice. Int J Technol Assess Health Care. 2008;24(4):430-6. 4. Canadian Agency for Drugs and Technologies in Health. Supporting informed decisions reprocessing of single-use medical devices: national survey of Canadian acute-care

2015 Canadian Agency for Drugs and Technologies in Health - Rapid Review

143. Person-centred care in CAMHS: how can we make it happen? #SoWhatSeminars #WeMHNs

Person-centred care in CAMHS: how can we make it happen? #SoWhatSeminars #WeMHNs Person-centred care in CAMHS: how can we make it happen? Search National Elf Service Search National Elf Service » » » » Person-centred care in CAMHS: how can we make it happen? #SoWhatSeminars #WeMHNs Apr 25 2017 Posted by “[A] person-centred health care system [is] one that supports us to make informed decisions, helps us to successfully manage our own health and care, and delivers care with respect for our (...) evidence that we’re actually doing it? Previous research suggests not (Wolpert et al, 2015), which means we run the risk of losing patients who may rightly feel alienated, but there is evidence that including young people in the decision making around their mental health care leads to better involvement and engagement (e.g. Simmons et al, 2011). To date, work in this area has focused on adult service user-involvement in care planning (Bee et al, 2015), so it’s good to see a qualitative systematic

2017 The Mental Elf

144. E/M Emergency Services

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

2015 FP Notebook

145. Comparing data accuracy between structured abstracts and full-text journal articles: implications in their use for informing clinical decisions Full Text available with Trip Pro

Association Journal and the Journal of the American Medical Association: a 10-year follow-up study . Sackett DL , Rosenberg WM , Gray JA , et al . Evidence based medicine: what it is and what it isn't . McGowan J , Hogg W , Campbell C , et al . Just-in-time information improved decision-making in primary care: a randomized controlled trial . Crowley SD , Owens TA , Schardt CM , et al . A Web-based compendium of clinical questions and medical evidence to educate internal medicine residents . Westbrook JI (...) ’ of the published research. Methods Between 11 February and 14 March, 2011, 60 articles listed as the ‘most read’, ‘most cited’ or ‘most e-mailed’ were selected from six clinical journals : American Journal of Emergency Medicine, British Medical Journal, Journal of the American Medical Association, Lancet, New England Journal of Medicine and Obstetrics and Gynaecology . These journals were chosen because they were highly regarded , and ‘most read’ in the medical community. Using the IMRAD format as a model, we

2013 Evidence-Based Medicine

146. British Pain Society/Faculty of Pain Medicine (RCA) Consensus Statement on the use of Corticosteroids for Neuraxial Procedures in the UK

in supporting their clinical decision making. The British Pain Society and the Faculty of Pain Medicine of the Royal College of Anaesthetists established a working group tasked to create a summary for clinicians to inform decision making in this area. Summary of evidence considered: ? We recognise that evidence in this field is rapidly progressing. ? There have been a number of reported catastrophic neurological complications with transforaminal injections in the cervical region with particulate steroids (...) of lumbar transforaminal epidural injection with particulate and nonparticulate corticosteroids in lumbar radiating pain. Pain Medicine 2010; 11: 1654–1658. 16. Rathmell JP, Michna E, Fitzgibbon DR, Stephens LS, Posner KL, Domino KB: Injury and liability associated with cervical procedures for chronic pain. Anesthesiology 2011; 114: 918–26 ? 17. Rozin L, Rozin R, Koehler SA, Shakir A, Ladham S, Barmada M, Dominick J, Wecht CH. Death during transforaminal epidural steroid nerve root block (C7) due

2016 Faculty of Pain Medicine

147. How to speak to your psychiatrist: are we ready for shared decision making in mental health?

we shouldn’t read too much into the results, but it will be interesting to see further studies published in this area over the coming years. The authors of this study certainly seem keen. They concluded by saying: Training in shared decision making was highly accepted by patients and changed attitudes toward participation in decision making. There were some hints that it might generate beneficial long-term effects. Links Hamann J, Mendel R, Meier A, Asani F, Pausch E, Leucht S, Kissling W. “How (...) to speak to your psychiatrist”: shared decision-making training for inpatients with schizophrenia. Psychiatr Serv. 2011 Oct;62(10):1218-21. [ ] Duncan E, Best C, Hagen S. . Cochrane Database of Systematic Reviews 2010, Issue 1. Art. No.: CD007297. DOI: 10.1002/14651858.CD007297.pub2. Bhugra D, Easter A, Mallaris Y, Gupta S. Clinical decision making in psychiatry by psychiatrists. Acta Psychiatr Scand. 2011 Nov;124(5):403-11. doi: 10.1111/j.1600-0447.2011.01737.x. Epub 2011 Jul 8. [ ] Share on Facebook

2012 The Mental Elf

148. Conducting Quality Consultations in Pain Medicine

and in the pati ent’s best interest and support the pati ent to manage distress (GMC 16). • You must ensure that the pati ent understands the nature and purpose of any proposed treatment or investi gati on and any signi? cant side e? ects associated with it, thereby enabling them to make an informed decision (GMC 49a). • You must obtain appropriate informed consent for procedures or interventi ons (GMC 17).8 • You must adhere to the laws and codes of practi ce relevant to pain medicine, including controlled (...) 1. Pendleton D. Scho? eld T. Tate P . Havelock P . The Consultati on: An Approach to Learning and Teaching. Oxford: OUP; 1984. 2. General Medical Council. Good Medical Practi ce; 2013. 3. Faculty of Pain Medicine. What is a Pain Medicine Doctor; 2013. 4. Maguire P . Pitceathly C. Key communicati on skills and how to acquire them. BMJ 2002; 325: 697-700. 5. Silverman J. et al. Skills for Communicati ng with Pati ents. 3rd editi on. Radcli? e Medical Press: Oxford; 2013. 6. Balint M. The Doctor

2015 Faculty of Pain Medicine

149. Towards a guided and phased introduction of high-risk medical devices in Belgium

(SANTE) to the Directorate-General for the Internal Market, Industry, Entrepreneurship and SMEs (GROW). International protest caused the decision regarding medicinal products to be reversed because Juncker agreed that these goods are not like any others. What we fail to understand however is why medical devices should be treated any differently. It all points to the fact that economic forces, backed by certain powerful Member States, are at work behind the scenes. With the result that the initially (...) -risk medical devices 1 ¦ FOREWORD If we genuinely want to nail our colours to the patient rights' mast - as we are all supposed to do - then it is high time that we pull up our socks when it comes to obtaining patients' informed consent and supporting patients' preferences. All too often, a patient's so-called informed choice makes for nothing other than a woeful caricature. A polite request to sign, here, at the bottom of this incomprehensible form, and that's the end of it. To be fair

2015 Belgian Health Care Knowledge Centre

150. Who Decides When a Patient Can’t? Statutes on Alternate Decision Makers Full Text available with Trip Pro

(D.M.D., D.B.K.), and the Richard A. and Susan F. Smith Center for Outcomes Research, Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center (D.B.K.) - all in Boston. Dudzinski David M DM From the Division of Pulmonary and Critical Care Medicine (E.S.D.), the Biomedical Ethics Research Program (E.S.D., B.P.S., P.S.M.), and the Division of General Internal Medicine (P.S.M.), Mayo Clinic, Rochester, MN; the MacLean Center for Clinical Medical Ethics, University of Chicago (...) in Chicago; the Departments of Medicine and Philosophy, Georgetown University, Washington, DC (D.P.S.); and the Division of Cardiology, Massachusetts General Hospital (D.M.D.), Harvard Medical School (D.M.D., D.B.K.), and the Richard A. and Susan F. Smith Center for Outcomes Research, Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center (D.B.K.) - all in Boston. Gregory Sarah E SE From the Division of Pulmonary and Critical Care Medicine (E.S.D.), the Biomedical Ethics

2017 The New England journal of medicine

151. Medical Assistance in Dying (MAID) in the ED: Implications for EM Practice

. 1996;3(10):938-945. [ ] 25. Leeman C. Distinguishing among irrational suicide and other forms of hastened death: implications for clinical practice. Psychosomatics . 2009;50(3):185-191. [ ] 26. Heinrich R, Morgan M, Rottman S. Advance directives, preemptive suicide and emergency medicine decision making. Narrat Inq Bioeth . 2011;1(3):189-197. [ ] (Visited 2,227 times, 1 visits today) Francis Bakewell Dr. Francis Bakewell is an 4th year Emergency Medicine resident at the University of Ottawa (...) in preparing for the uncommon but complicated that the practice of emergency medicine distinguishes itself. We’d be well served to plan for it now. References 1. Bill C-14: An Act to Amend the Criminal Code and to Make Related Amendments to Other Acts (Medical Assistance in Dying) . 1st reading, 42nd Parl. Session.; 2016. 2. Breitbart W, Rosenfeld B, Pessin H, et al. Depression, hopelessness, and desire for hastened death in terminally ill patients with cancer. JAMA . 2000;284(22):2907-2911. [ ] 3. Ganzini

2016 CandiEM

152. Ultrasound Guidelines: Emergency, Point-of-care, and Clinical Ultrasound Guidelines in Medicine

. In such pathways, applications may be mixed and utilized in a format and order that maximizes medical decision-making, outcomes, efficiency and patient safety tailored to the setting, resources, and patient characteristics. See Figure 1. Emergency physicians should have basic education in US physics, instrumentation procedural guidance, and Focused Assessment with Sonography in Trauma (FAST) as part of EM practice. It is not mandatory that every clinician performing emergency US examinations utilize (...) curricula through residency to postgraduate education of physicians, and extended to other providers such as nursing, advanced practice professionals, and prehospital providers. US curricula in undergraduate medical education is growing exponentially due to the leadership and advocacy of emergency physicians. US in emergency medicine (EM) residency training has now been codified in the Accreditation Council for Graduate Medical Education (ACGME) Next Accreditation System (NAS). Emergency US specialists

2016 American College of Emergency Physicians

153. AACE/ACE/AME Medical Guidelines for Clinical Practice for the Diagnosis and Management of Thyroid Nodules

Nodules are systemati- cally developed statements to assist health care professionals in medical decision making for specific clinical conditions. Most of the content herein is based on literature reviews. In areas of uncertainty, professional judgment was applied. The first edition of the AACE/ACE/AME Guidelines for the Diagnosis and Management of Thyroid Nodules was published in 2006 after extensive review of the literature by representatives of endocrinologists, endocrine surgeons, and thyroid (...) tools and treatments, and addresses avoiding unneces - sary diagnostic procedures and risk of medical or surgical overtreatment. The importance of patient information and participation in clinical decision making and the role of a multidisciplinary approach to thyroid nodular disease are fully considered. These guidelines are a working document that reflects the state of the field at the time of publication. Because rapid changes in this area are expected, periodic revision is inevitable. We

2016 American Association of Clinical Endocrinologists

154. American Association of Clinical Endocrinologists and American College of Endocrinology Clinical Practice Guidelines for Comprehensive Medical Care of Patients with Obesity

; Elise M. Brett, MD, FACE, CNSC, ECNU 3 ; Alan J. Garber, MD, PhD, FACE 4 ; Daniel L. Hurley, MD, FACE 5 ; Ania M. Jastreboff, MD, PhD 6 ; Karl Nadolsky, DO 7 ; Rachel Pessah-Pollack, MD 8 ; Raymond Plodkowski, MD 9 ; and Reviewers of the AACE/ACE Obesity Clinical Practice Guidelines* American Association of Clinical Endocrinologists Medical Guidelines for Clinical Practice are systematically devel- oped statements to assist health care professionals in medical decision-making for specific clinical (...) . The presented recommendations may not be appropriate in all situations. Any decision by practitioners to apply these guidelines must be made in light of local resources and individual patient circumstances. From 1 Professor and Chair, Department of Nutrition Sciences, University of Alabama at Birmingham, Director, UAB Diabetes Research Center, GRECC Investigator & Staff Physician, Birmingham VA Medical Center, Birmingham, Alabama; 2 Director, Metabolic Support, Clinical Professor of Medicine, Division

2016 American Association of Clinical Endocrinologists

155. Clearing the Smoke on Cannabis: Medical Use of Cannabis and Cannabinoids ? An Update

Clearing the Smoke on Cannabis: Medical Use of Cannabis and Cannabinoids ? An Update Key Points • Healthcare practitioners need access to the best available scientific evidence to help patients make informed decisions about the medical use of cannabis and cannabinoids. There is a great need for well-designed prospective clinical trials in Canada that assess the efficacy of cannabis and cannabinoids in treating various conditions. • Evidence suggests that cannabis and cannabinoids are effective (...) to drive a motor vehicle, and pre- and post-natal development among offspring (McInnis & Porath-Waller, 2016; Porath- Waller, 2015; Beirness & Porath-Waller, 2015; McInnis & Plecas, 2016). However, cannabis and some of its derivatives also have a long history of use as a medicine in many parts of the world. Very thorough and extensively referenced monographs on the subject of medical cannabis have been published by Ben Amar (2006), Health Canada (2013a) and the World Health Organization (Madras, 2015

2016 Canadian Centre on Substance Abuse

156. Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: Preventive Medication

in this population will benefit from the intervention, so the decision to initiate use of low- to moderate-dose statins should reflect shared decision making that weighs the potential benefits and harms, the uncertainty about risk prediction, and individual patient preferences, including the acceptability of long-term use of daily medication. Suggestions for Practice Regarding the I Statement for Initiating Statin Therapy for Primary Prevention in Adults 76 Years and Older Potential Preventable Burden Adults 76 (...) , or hypertension and a 7.5% to 10% 10-year CVD event risk will benefit from statin use. As such, any decision to initiate use of low- to moderate-dose statins in this population should involve shared decision making that weighs the potential benefits and harms and the uncertainty surrounding individual CVD risk prediction. It should also take into consideration the personal preferences of each patient, including the acceptability of long-term use of daily medication. The USPSTF concludes that the balance

2016 U.S. Preventive Services Task Force

157. Aspirin Use to Prevent Cardiovascular Disease and Colorectal Cancer: Preventive Medication

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 Cardiovascular disease and CRC are major causes of death among U.S. adults. In 2011, more than one half of all deaths in the United States were caused by heart disease, cancer (...) or older are at increased risk for CVD because of their age. They have a high incidence of MI and stroke; thus, the potential benefit of aspirin could be substantial. Potential Harms The relationship between older age and GI bleeding is well-established; thus, the potential harms for adults older than 70 years are significant. The complexity of risk factors, medication use, and concomitant illness make it difficult to assess the balance of benefits and harms of initiating aspirin use in this age group

2016 U.S. Preventive Services Task Force

158. The false promises of shared decision making in rehabilitation

pain in vulnerable populations (ie: elderly, critical care). References [1] Oshima Lee E, Emanuel EJ. Shared decision making to improve care and reduce costs. The New England journal of medicine [Internet]. 2013;368(1):6–8. Available from: http://www.nejm.org/doi/full/10.1056/NEJMp1209500\nhttp://www.nejm.org/doi/pdf/10.1056/NEJMp1209500\nhttp://www.ncbi.nlm.nih.gov/pubmed/23281971 [2] Legare F, Witteman HO. Shared decision making: examining key elements and barriers to adoption into routine (...) The false promises of shared decision making in rehabilitation The false promises of shared decision making in rehabilitation Research into the role of the brain and mind in chronic pain The false promises of shared decision making in rehabilitation October 25, 2016 by In the recent years, Shared Decision Making (SDM) has been increasingly advocated as an ideal model of treatment decision-making during the medical encounter, as it has been shown to increase benefits for both clinicians

2016 Body in Mind blog

159. Acute Pain Medicine in the United States: A Status Report Full Text available with Trip Pro

Group of the American Academy of Pain Medicine. The panel met in Chicago, IL, in July 2014, to identify gaps and set priorities in APM research and education. Results The panel identified three areas of critical need: 1) an open-source acute pain data registry and clinical support tool to inform clinical decision making and resource allocation and to enhance research efforts; 2) a strong professional APM identity as an accredited subspecialty; and 3) educational goals targeted toward third-party (...) ., prehospital, emergency-department, and perioperative environments), the historical emphasis has been in the perioperative environment where acute pain management has logically fallen under the auspices of anesthesiology and regional anesthesiology, specifically . This aligns with the recently approved decision to make regional anesthesiology and the specialty of APM a distinct subspecialty fellowship of anesthesiology to be accredited through the Accreditation Council for Graduate Medical Education (ACGME

2015 American Academy of Pain Medicine

160. Medical eligibility criteria for contraceptive use

Medical eligibility criteria for contraceptive use Department of Reproductive Health and Research World Health Organization Avenue Appia 20, CH-1211 Geneva 27 Switzerland Fax: +41 22 791 4171 E-mail: reproductivehealth@who.int www.who.int/reproductivehealth For more information, please contact: COCs Barrier methods IUDs Fertility awareness-based methods Lactational Coitus interruptus Copper IUD for amenorrhoea Patch Female surgical sterilization Intrauterine devices CICs emergency contraception (...) device CVR combined contraceptive vaginal ring CYP3A4 cytochrome P450 3A4 enzyme DMPA depot medroxyprogesterone acetate DMPA-IM depot medroxyprogesterone acetate – intramuscular DMPA-SC depot medroxyprogesterone acetate – subcutaneous DVT deep vein thrombosis ECP emergency contraceptive pill EE ethinyl estradiol E-IUD emergency intrauterine device EMA European Medicines Agency ETG etonogestrel FAB fertility awareness-based methods FDA United States Food and Drug Administration GDG Guideline

2015 World Health Organisation Guidelines

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