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E/M Medical Decision Making

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141. 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

142. 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

143. 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

144. Beyond consent--the ethics of decision-making in emergency medicine. (PubMed)

Beyond consent--the ethics of decision-making in emergency medicine. 847978 1977 05 12 2018 11 13 0093-0415 126 2 1977 Feb The Western journal of medicine West. J. Med. Beyond consent--the ethics of decision-making in emergency medicine. 156-9 Tait K K Winslow G G eng Journal Article United States West J Med 0410504 0093-0415 E IM Decision Making Emergency Medicine Ethics, Medical Humans Informed Consent Paternalism Personal Autonomy Wounds and Injuries therapy 06292 KIE BoB Subject Heading (...) : PROLONGATION OF LIFE/EMERGENCY CARE Full author name: Tait, Karen M Full author name: Winslow, Gerald 1977 2 1 1977 2 1 0 1 1977 2 1 0 0 ppublish 847978 PMC1237490 JAMA. 1974 Jul 8;229(2):172-6 4406917 N Engl J Med. 1974 Apr 18;290(16):907-8 4816967 J Leg Med (N Y). 1975 Oct;3(9):15-9 1081111 Hastings Cent Rep. 1975 Jun;5(3):9-10, 47 1150424 J Pediatr. 1975 Aug;87(2):327-8 1151575 J Trauma. 1975 Feb;15(2):94-8 1113362 Neb Law Rev. 1975;54(1):66-92 11664487 New Engl Law Rev. 1974 Winter;9(2):293-310

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1977 Western Journal of Medicine

145. 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

146. 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

147. 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

148. 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

149. 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.

150. Michigan HB 5126: Endangering children by making nonmedical vaccine exemptions easier to obtain

eradicated many diseases from our population, but they're making a dangerous comeback. In 2014, Michigan had a drop of 5% in the number of children immunized and we now rank 47th in the nation. Michigan has the sixth highest rate of non-medical immunization waivers for kindergarten entry—meaning we have many children entering school who are not immunized. Two bills introduced this week in the state Legislature would curtail efforts to improve Michigan’s childhood immunization rate and further endanger (...) their exit. to post comments By Gizmo (not verified) on 14 Dec 2015 to post comments By Science Mom (not verified) on 14 Dec 2015 The Macomb County medical director is interviewed saying it's not really changing people's minds about the vaccinations: "The parents who are making these waiver appointments are very committed [to getting those waivers.] I'm not aware of any changing minds," he says. Instead, the TAXPAYERS are paying a ton of money in vain on these classes and staff members for thousands

2015 Respectful Insolence

151. Personalized Health Assessment Related to Medications (Project PHARM)

information United States, Washington University of Washington Recruiting Seattle, Washington, United States, 98105 Contact: Irene M Geisner, Ph.D. 206-419-8999 Contact: Nicole Fossos-Wong, B.S. 206-685-1499 Principal Investigator: Irene M Geisner, Ph.D. Principal Investigator: Jason R Kilmer, Ph.D. Principal Investigator: M. Dolores Cimini, Ph.D. Principal Investigator: Amelia M Arria, Ph.D. Sub-Investigator: Mary E Larimer, Ph.D. Sub-Investigator: Christine M Lee, Ph.D. Sub-Investigator: Isaac C Rhew (...) Personalized Health Assessment Related to Medications (Project PHARM) Personalized Health Assessment Related to Medications (Project PHARM) - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Personalized

2017 Clinical Trials

152. An Interactive Patient-Centered Consent for Research Using Medical Records

to assess voluntary consent (Miller et. al.,2011); 9-items, 5-point Likert Scale (Strongly disagree-Strongly Agree) Change from Baseline Perceived Voluntariness [ Time Frame: 1-week follow-up from Baseline ] Decision Making Control instrument to assess voluntary consent (Miller et. al.,2011); 9-items, 5-point Likert Scale (Strongly disagree-Strongly Agree) Baseline Trust in medical researchers [ Time Frame: Prior to consent ] Trust In Medical Researchers Scale (Mainous et al. 2006); 12 items, 5-point (...) . An Interactive Patient-Centered Consent for Research Using Medical Records The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT03063268 Recruitment Status : Active, not recruiting First Posted : February 24, 2017 Last Update Posted : February 18, 2019 Sponsor: University of Florida Collaborators: Richard M

2017 Clinical Trials

153. Systematic review on needs for medical devices for older people

for longer. With financial support from the Japanese Ministry of Health, Labour and Welfare, the WHO has begun research regarding this initiative in the Western Pacific Region. To prepare a foundation for future decisions, a detailed mapping of the need for medical devices for older people in the region is to be conducted. This will determine the technological needs for diagnosis and treatment of the diseases of this population. Further research and surveys will be conducted at a country-by-country level (...) Systematic review on needs for medical devices for older people ROYAL AUSTRALASIAN COLLEGE OF SURGEONS SYSTEMATIC REVIEW ON NEEDS FOR MEDICAL DEVICES FOR OLDER PEOPLE ASERNIP-S REPORT NO. 81 Commissioned to the Australian Safety and Efficacy Register of New Interventional Procedures - Surgical (ASERNIP-S) by the World Health Organization (WHO) February 2013 Disclaimer WHO Systematic Review on Needed Devices for the Elderly | 2013 page 1 Contents WHO Systematic Review on Needed Devices

2013 ASERNIP-S

154. Cystic Fibrosis Pulmonary Guidelines: Chronic Medications for Maintenance of Lung Health

to determine the effectiveness of medications previously recommended for use in older children and adults ( ). We anticipate that, as more medications are studied in young children, evidence-based decision making for this vulnerable population will become easier. There has been a multiplication of delivery devices for inhaled medications designed to decrease administration time and improve efficacy. Inhaled therapeutics are often paired with a specific device optimized for delivery, creating the potential (...) . We have undertaken a new review of the literature to update the recommendations, including consideration of new medications and additional evidence on previously reviewed therapies. A multidisciplinary committee of experts in CF pulmonary care was established to review the evidence for use of chronic medications for CF lung disease and make treatment recommendations. Published evidence for chronic lung therapies was systematically reviewed and resulting treatment recommendations were graded based

2013 Cystic Fibrosis Foundation

155. Long-Term Medical Management of the Pediatric Patient After Liver Transplantation

Long-Term Medical Management of the Pediatric Patient After Liver Transplantation SPECIAL ARTICLE Long-Term Medical Management of the Pediatric Patient After Liver Transplantation: 2013 Practice Guideline by the American Association for the Study of Liver Diseases and the American Society of Transplantation Deirdre A. Kelly, 1 John C. Bucuvalas, 2 Estella M. Alonso, 3 Saul J. Karpen, 4 Upton Allen, 5 Michael Green, 6 Douglas Farmer, 7 Eyal Shemesh, 8 and Ruth A. McDonald 9 1 Liver Unit (...) and the American Gastroenterological Association policy statement on the use of medical practice guidelines 2 ; and (4) the experience of the authors in managing children under- going liver transplantation (LT). Intended for use by pediatricians and physicians, these recommendations suggest preferred approaches to the diagnostic, thera- peutic, and preventive aspects of care. They are intended to be ?exible, in contrast to standards of care, which are in?exible policies to be followed in every case. Speci?c

2013 American Association for the Study of Liver Diseases

156. Beyond Medications and Diet: Alternative Approaches to Lowering Blood Pressure

, and a substantial modification in medical education and training would be required to make acupuncture accessible and available for the management of hypertension in many regions of the world. In addition to logistical difficulties in the real-world setting, meta-analyses have reported a small risk of developing uncontrolled hypertension while deferring active medical treatment and the rare potential for minor adverse events, including pain and bleeding at needle sites. Given the paucity of data, no specific (...) Beyond Medications and Diet: Alternative Approaches to Lowering Blood Pressure Beyond Medications and Diet: Alternative Approaches to Lowering Blood Pressure | Hypertension Search Hello Guest! Login to your account Email Password Keep me logged in Search April 2019 March 2019 February 2019 January 2019 Free Access article Share on Jump to Free Access article Beyond Medications and Diet: Alternative Approaches to Lowering Blood Pressure A Scientific Statement From the American Heart Association

2013 American Heart Association

157. Medical treatment of ectopic pregnancy: a committee opinion

, that the difference in failure rates between the two protocols may not be as dra- maticinwomenwithanoverallgoodprognosisforsuccessful medical treatment. Ahybridprotocol,involvingtwoequaldosesofMTX(50 mg/m 2 ) administered on days 1 and 4 without leucovorin rescue and follow-up as described previously for the single- dose protocol, may offer a more optimal balance between convenience and ef?cacy (37, 38). The protocol also allows TABLE 1 Contraindications to MTX therapy (25, 26, 29–31). Absolute contraindications (...) abortion Rhogam if Rh negative 1 hCG MTX 50 mg/m 2 IM 4 hCG 7 hCG MTX 50 mg/m 2 IM if b-hCG decreased 4 cm) High initial hCG concentration (>5,000 mIU/mL) Presence of free peritoneal blood Rapidly increasing hCG concentrations (>50%/48 h) before MTX Continued rapid rise in hCG concentrations during MTX Note: MTX¼ methotrexate. Practice Committee. Medical treatment of ectopic pregnancy. Fertil Steril 2013. VOL. 100 NO. 3 / SEPTEMBER 2013 641 Fertility and Sterility®ADJUNCTIVEUSEOFMTX A persistent

2013 Society for Assisted Reproductive Technology

158. Periprocedural management of antithrombotic medications in patients with ischemic cerebrovascular disease

; and Departments of Neurology and Neurological Surgery (M.S.), Loyola Medicine, Maywood, IL. Summary of evidence-based guideline: Periprocedural management of antithrombotic medications in patients with ischemic cerebrovascular disease Melissa J. Armstrong , Gary Gronseth , David C. Anderson , José Biller , Brett Cucchiara , Rima Dafer , Larry B. Goldstein , Michael Schneck , Steven R. Messé Neurology May 2013, 80 (22) 2065-2069; DOI: 10.1212/WNL.0b013e318294b32d Citation Manager Formats Make Comment See (...) clinical scenarios for guideline application are presented in . RECOMMENDATIONS It is axiomatic that clinicians managing antithrombotic medications periprocedurally weigh bleeding risks from drug continuation against TE risks from discontinuation at the individual patient level, although high-quality evidence on which to base this decision is often unavailable. In addition, even when evidence is insufficient to exclude a difference in bleeding or shows a small increase in clinically important bleeding

2013 American Academy of Neurology

159. Coping With the Stress of Medical Professional Liability Litigation

in decision making cannot be avoided throughout one’s career. One of the healthiest responses is recognition of the error and the development of a plan to decrease the likelihood of future similar occurrences. This activity often provides comfort and healing to the physician. Obstetrician–gynecologists should recognize that being a defendant in a medical professional liability lawsuit can be one of life’s most stressful experiences. Negative emotions in response to a lawsuit are normal and physicians may (...) Medical News. November 2, 2009. Available at: . Retrieved July 13, 2012. References Gold KJ, Kuznia AL, Hayward RA. How physicians cope with stillbirth or neonatal death: a national survey of obstetricians. Obstet Gynecol 2008;112:29–34. Waterman AD, Garbutt J, Hazel E, Dunagan WC, Levinson W, Fraser VJ, et al. The emotional impact of medical errors on practicing physicians in the United States and Canada. Jt Comm J Qual Patient Saf 2007;33:467–76. West CP, Huschka MM, Novotny PJ, Sloan JA, Kolars JC

2013 American College of Obstetricians and Gynecologists

160. Methodological Choices for the Clinical Development of Medical Devices

of comparing the efficacy of two treatments, a well-conducted double-blind randomised controlled trial is the type of study that offers the highest level of evidence, enabling medical decisions to be backed up (1) and the efficacy of these treatments to be evaluated (2). Randomisation, blinding and intention-to-treat analysis 1 are the main criteria with regard to methodological quality. In most cases, a randomised controlled trial can be performed. However, in some very specific situations that require (...) justification, conducting randomised controlled trials on medical devices (MDs) is known to be difficult for reasons relating to: o the inability to randomise o the choice of comparator o the difficulties of implementing a double-blind procedure o non-acceptance by the patient or clinician o subjective endpoints in certain situations . Other types of trials and observational studies should be reserved for situations where a conventional randomised controlled trial is not possible; the decision to use

2013 Haute Autorite de sante

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