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E/M Medical Decision Making


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161. Systematic review of needs for medical devices for ageing populations

Systematic review of needs for medical devices for ageing populations Systematic review of needs for medical devices for ageing populations Commissioned to the Australian Safety and Ef? cacy Register of New Interventional Procedures – Surgical (ASERNIP-S) by the World Health Organization (WHO) Department of Essential Medicines and Health Products World Health Organization 20 Avenue Appia CH-1211 Geneva 27 Switzerland Tel: +41 22 791 21 11 E-mail: (...) 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 to ascertain the availability and affordability of these devices. For low-income countries and low- resource settings, needs of priority core devices will be defined, especially for devices

2015 Publication 80

162. Improving Adherence to Therapy and Clinical Outcomes While Containing Costs: Opportunities From the Greater Use of Generic Medications: Best Practice Advice From the Clinical Guidelines Committee of the American College of Physicians Full Text available with Trip Pro

decision making ( ), and commitment devices ( ) have shown promise in other areas of medicine and may be effective for promoting generic drug use. Harmonization of the appearance of generic and brand-name products, formally called “trade dress,” could also increase uptake of generic drugs ( , ). Finally, policy levers, such as tiered formularies, have been the most effective strategies for driving patients to adopt generics, but current copayment differentials between generic and brand-name medications (...) in the management of chronic disease, yet physicians and other providers frequently treat patients with more expensive brand-name products even when equally effective, well-proven, and less expensive generic therapies are available ( ). The purpose of this article is to help guide internists and other clinicians in making high-value, cost-conscious decisions about the use of generic drugs. This review sought to address 5 questions: 1) How commonly are brand-name medications used when a generic version

2015 American College of Physicians

163. American Academy of Sleep Medicine (AASM) Position Paper for the Use of Telemedicine for the Diagnosis and Treatment of Sleep Disorders

decisions. The data stored can include an array of medical records, images of anatomical findings, sleep study data with/without video recordings, PAP device data or other data, and mobile technologies. An example could include requests from primary care providers or other clinicians for the sleep medicine provider to review a patient's record for a specific clinical question without the provider examining the patient formally. E-MESSAGING E-messaging (e.g., through email or online asynchronous (...) SYSTEMS This refers to a method of providing consultations and clinical decision-making to referring providers or patients, rather than direct, interactive care to patients. A sleep medicine history with certain diagnostic/therapeutic data are collected at the point of care and transmitted to the sleep medicine provider for review. In turn, the sleep medicine specialist provides clinical advice via a written or electronic report to the referring provider within a reasonable time frame to make clinical

2015 American Academy of Sleep Medicine

164. American Heart Association Response to the 2015 Institute of Medicine Report on Strategies to Improve Cardiac Arrest Survival Full Text available with Trip Pro

. Jollis , Monica E. Kleinman , Laurie J. Morrison , Mary Ann Peberdy , Alejandro Rabinstein , Thomas D. Rea , and Sue Sendelbach Originally published 30 Jun 2015 Circulation. 2015;132:1049–1070 You are viewing the most recent version of this article. Previous versions: Abstract The American Heart Association (AHA) commends the recently released Institute of Medicine (IOM) report, Strategies to Improve Cardiac Arrest Survival: A Time to Act (2015). The AHA recognizes the unique opportunity created (...) Recommendation 5 Adopt continuous quality improvement programs Recommendation 6 Accelerate research on pathophysiology, new therapies, and translation of science for cardiac arrest Recommendation 7 Accelerate research on the evaluation and adoption of cardiac arrest therapies Recommendation 8 Create a national cardiac arrest collaborative EMS indicates emergency medical services; and IOM, Institute of Medicine. The AHA recognizes the unique opportunity created by the report to meaningfully advance

2015 American Heart Association

165. A Practice Guideline from the American College of Medical Genetics and Genomics and the National Society of Genetic Counselors: Referral Indications for Cancer Predisposition Assessment

of Genetic Counselors (NSGC) are developed by members of the ACMG and NSGC to assist medical geneticists, genetic counselors, and other health-care providers in making decisions about appropriate management of genetic concerns, including access to and/or delivery of services. Each practice guideline focuses on a clinical or practice-based issue and is the result of a review and analysis of current professional literature believed to be reliable. As such, information and recom- mendations within the ACMG (...) by qualified clinicians has been associated with negative patient and societal outcomes such as misinterpretation of genetic test results, inappropriate medical management, lack of informed decision making, viola- tion of established ethical standards, adverse psychosocial out- comes, and costly, unnecessary genetic testing. 1–3 Cancer genetic consultation is an important aspect of the care of individuals at increased risk of a hereditary cancer syn- drome. 4–8 Yet, several patient, clinician, and system

2015 American College of Medical Genetics and Genomics

166. The European Society of Regional Anaesthesia and Pain Therapy and the American Society of Regional Anesthesia and Pain Medicine Joint Committee Practice Advisory on Controversial Topics in Pediatric Regional Anesthesia Full Text available with Trip Pro

of Anesthesiology, Virginia Mason Medical Center, Seattle, WA. Accepted for publication May 5, 2015. Address correspondence to: Santhanam Suresh, MD, Ann & Robert H. Lurie Children’s Hospital of Chicago, 225 E Chicago Ave, Chicago, IL 60611 (e-mail: ). Identification of institution(s) where work is attributed: Ann & Robert H. Lurie Children’s Hospital of Chicago Northwestern University , Chicago, IL. The authors declare no conflict of interest. The American Society of Regional Anesthesia and Pain Medicine (ASRA (...) your personal information without your express consent. For more information, please refer to our Privacy Policy. Toggle navigation Articles & Issues Collections For Authors Journal Info > > The European Society of Regional Anaesthesia and Pain Therap... Email to a Colleague Colleague's E-mail is Invalid Your Name: (optional) Your Email: Colleague's Email: Separate multiple e-mails with a (;). Message: Thought you might appreciate this item(s) I saw at Regional Anesthesia and Pain Medicine. Send

2015 American Society of Regional Anesthesia and Pain Medicine

167. Eligibility and Disqualification Recommendations for Competitive Athletes With Cardiovascular Abnormalities: Task Force 15: Legal Aspects of Medical Eligibility and Disqualification Recommendations

to exclude Knapp from its basketball team was legally justified: “We do not believe that, in cases where medical experts disagree in their assessment of the extent of a real risk of serious harm or death, Congress intended that the courts—neutral arbiters but generally less skilled in medicine than the experts involved—should make the final medical decision. Instead, in the midst of conflicting expert testimony regarding the degree of serious risk of harm or death, the court’s place is to ensure (...) that the exclusion or disqualification of an individual was individualized, reasonably made, and based upon competent medical evidence. . . . [W]e wish to make clear that we are not saying Northwestern’s decision is necessarily the right decision. We say only that it is not an illegal one under the Rehabilitation Act.” The court recognized that one of the factors a physician may rely on is then-current consensus medical guidelines: “Although the Bethesda Conferences were not convened by public health officials

2015 American Heart Association

168. Interventional Spine and Pain Procedures in Patients on Antiplatelet and Anticoagulant Medications

ASA (aspirin), the platelet effects of these drugs are directly related to systemic plasma drug concentrations and influenced by the pharmacokinetic clearance of these medications. Once steady-state concentrations have been achieved, terminal half-life is a predictive time parameter to guide decision making. For NSAIDs, terminal half-lives and half-lives are interchangeable and equivalent. Because NSAIDs are well absorbed and absorption is not the limiting factor, half-life is more dependent (...) syndrome. Because of the lack of effect on platelet function with COX-2 selective inhibitors and perioperative bleeding risks, these medications do not need to be stopped. | Summary recommendation for aspirin A patient- and procedural-specific strategy is recommended when deciding whether to continue or discontinue aspirin in the perioperative period for interventional pain procedures. Decision making should include an understanding of the reason for aspirin utilization, vascular anatomy surrounding

2015 American Society of Regional Anesthesia and Pain Medicine

169. What is the effectiveness of motivational interviewing in changing risk behaviours (e.g. sex, drug use, medication adherence) for people living with HIV?

Interventions that make use of motivational interviewing can be effective in changing risk behaviours for people living with HIV (1-18); the longer the motivational interviewing intervention, the more it may help intervention participants to maintain healthier practices over time (19). For people living with HIV, motivational interviewing can have a positive effect on medication adherence (1;6-9;15;17;18), sexual risk behaviours (3-5;10;11), drug use (2;12;14), and numerous outcomes at the same time (13;16 (...) ambivalence they may feel and to encourage them to make healthy decisions for themselves that are aligned with their own values, beliefs and concerns. As a result, decisions are made by the individual for the individual rather than by an outside party. What We Found We found many studies reporting the efficacy of motivational interviewing interventions in changing behaviours among people living with HIV. Desired outcomes included better adherence (1;6-9;15;17;18), a decrease in sexual risk behaviours (3

2014 Ontario HIV Treatment Network

170. Nabilone for Non-chemotherapy-Associated Nausea and Weight Loss Due to Medical Conditions

of weight loss due to medical conditions or for the treatment of non-chemotherapy associated nausea and vomiting. CONCLUSIONS AND IMPLICATIONS FOR DECISION OR POLICY MAKING One low quality RCT and one low quality cohort study assessed the clinical effectiveness of nabilone in the treatment of non-chemotherapy associated nausea and vomiting or weight loss related to medical conditions, respectively. While both studies supported the use of nabilone for these indications, they had multiple limitations (...) Nabilone for Nausea or Weight Loss 8 REFERENCES 1. Ben Amar M. Cannabinoids in medicine: a review of their therapeutic potential. J Ethnopharmacol. 2006 Apr 21;105(1-2):1-25. 2. e-CPS [Internet]. Ottawa: Canadian Pharmacists Association; 2009 -. Cesamet®; 2009 [cited 2014 Aug 29]. Available from: Subscription required. 3. Keeley PW. Nausea and vomiting in people with cancer and other chronic diseases. Clin Evid (Online) [Internet]. 2009 [cited 2014 Sep 9

2014 Canadian Agency for Drugs and Technologies in Health - Rapid Review

171. Medicines related to valproate: risk of abnormal pregnancy outcomes

Medicines related to valproate: risk of abnormal pregnancy outcomes Medicines related to valproate: risk of abnormal pregnancy outcomes - GOV.UK GOV.UK uses cookies to make the site simpler. or Search Medicines related to valproate: risk of abnormal pregnancy outcomes Children exposed in utero to valproate are at a high risk of serious developmental disorders (in up to 30-40% of cases) and/or congenital malformations (in approximately 10% of cases). Published 22 January 2015 From: Therapeutic (...) ensure that all female patients are informed of and understand: risks associated with valproate during pregnancy need to use effective contraception need for regular review of treatment the need to rapidly consult if she is planning a pregnancy or becomes pregnant Please refer to the General Medical Council’s and guidance. Risk of abnormal pregnancy outcomes Valproate is associated with a dose-dependent risk of abnormal pregnancy outcomes, whether taken alone or in combination with other medicines

2015 MHRA Drug Safety Update

172. Impact of Coronary Computed Tomography Angiography Findings on Initiation of Cardioprotective Medications. Full Text available with Trip Pro

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 (...) Impact of Coronary Computed Tomography Angiography Findings on Initiation of Cardioprotective Medications. 29180497 2019 03 14 2019 03 14 1524-4539 136 22 2017 11 28 Circulation Circulation Impact of Coronary Computed Tomography Angiography Findings on Initiation of Cardioprotective Medications. 2195-2197 10.1161/CIRCULATIONAHA.117.029994 Chang Anna Marie AM Department of Emergency Medicine, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA (A.M.C., J.EH

2019 Circulation Controlled trial quality: uncertain

173. A clinical model for decision-making Full Text available with Trip Pro

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

1978 Journal of medical ethics

174. 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

175. 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 (...) diabetes mellitus: A randomized controlled trial. Saudi Journal of Kidney Diseases & Transplantation. 2009; 20: 429-35. 32. Bilous R, Chaturvedi N, Sjolie AK et al. Effect of candesartan on microalbuminuria and albumin excretion rate in diabetes: three randomized trials. Annals of Internal Medicine. 2009; 151: 11-20. 33. Galle J, Schwedhelm E, Pinnetti S et al. Antiproteinuric effects of angiotensin receptor blockers: telmisartan versus valsartan in hypertensive patients with type 2 diabetes mellitus

2013 KHA-CARI Guidelines

176. 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 (...) in a large managed care organization. Archives of Internal Medicine. 2004; 164: 659-63. 10. Kurth T, de Jong PE, Cook NR et al. Kidney function and risk of cardiovascular disease and mortality in women: a prospective cohort study. BMJ. 2009; 338: b2392. 11. Luthi J-C, Flanders WD, Burnier M et al. Anemia and chronic kidney disease are associated with poor outcomes in heart failure patients. BMC Nephrology. 2006; 7: 3. 12. Manjunath G, Tighiouart H, Coresh J et al. Level of kidney function as a risk

2013 KHA-CARI Guidelines

177. Realising the potential of stratified medicine

’ and the (saved) costs of treating non-responders, which will be larger the greater the health consequences of any adverse reaction. Therefore, as with any medical innovation, healthcare systems should prudently focus their adoption of stratification where it improves resource allocation. 7 Stratified medicine 10 Drivers for stratified medicine There are multiple drivers that make accelerating the development and adoption of stratified approaches to medicine both desirable and possible. There are ‘pull (...) Realising the potential of stratified medicine Realising the potential of stratified medicine July 2013Realising the potential of stratified medicine July 2013Acknowledgements and disclaimer The Academy of Medical Sciences (AMS) is most grateful to Professor Sir John Bell FRS HonFREng FMedSci and members of the oversight group who led this project. We thank the Academy’s Council members and staff, external review group, symposium attendees and all individuals who contributed to the report

2013 Academy of Medical Sciences

178. Medicinal Mushrooms (PDQ®): Health Professional Version

not provide formal guidelines or recommendations for making health care decisions. This summary is reviewed regularly and updated as necessary by the PDQ Integrative, Alternative, and Complementary Therapies Editorial Board, which is editorially independent of the National Cancer Institute (NCI). The summary reflects an independent review of the literature and does not represent a policy statement of NCI or the National Institutes of Health (NIH). Introduction Medicinal mushrooms have been used (...) This PDQ cancer information summary for health professionals provides comprehensive, peer-reviewed, evidence-based information about the use of medicinal mushrooms in the treatment of people with cancer. It is intended as a resource to inform and assist clinicians who care for cancer patients. It does not provide formal guidelines or recommendations for making health care decisions. Reviewers and Updates This summary is reviewed regularly and updated as necessary by the , which is editorially

2017 PDQ - NCI's Comprehensive Cancer Database

179. Complementary, Alternative and Traditional Medicine in HIV Care

. Impact of African herbal medi- cines on antiretroviral metabolism. AIDS 2005;19(1):95-7. 8) Liu JP, Manheimer E, Yang M. Herb- al medicines for treating HIV infec- tion and AIDS. Cochrane Database of Systematic Reviews 2005; (3):Art. No.: CD003937. DOI: 10.1002/14651858.CD003937.p ub2. 9) Langlois-Klassen D, Kipp W, Jhan- gri GS, Rubaale T. Use of traditional herbal medicine by AIDS patients in Kabarole District,Western Uganda. American Journal of Tropical Medi- cine and Hygiene 2007;77(4):757- 63 (...) : A bibliometric analy- sis. Medical Reference Services Quarterly 2003;22(3):23-32. 16) Munk K. Traditional healers, tradi- tional hospitals and HIV / AIDS: A case study in KwaZulu-Natal. AIDS Analysis Africa 1997;7(6):10-2. 17) Liu C, Yang Y, Gange SJ, Weber K, Sharp GB, Wilson TE et al. Disclo- sure of complementary and alter- native medicine use to health care providers among HIV-infected wom- en. AIDS Patient Care STDS 2009;23(11):965-71. 18) Lamorde M, Tabuti JR, Obua C, Kukunda-Byobona C, Lanvero H

2013 Ontario HIV Treatment Network

180. Selling an alternative medicine cancer cure testimonial as an “N-of-1” trial: Integrative medicine’s new propaganda technique?

, , a , or any number of believers in medical pseudoscience who use their testimonial of survival as evidence that quackery works. Sure, Sabin is less quacky than Somers or Wark, and—who knows?—maybe green tea extract has effects against CLL, but, whatever denials he might make otherwise, his book is selling the message that you don't necessarily need conventional medicine to treat cancer, that you can treat your cancer on your own with "natural" methods. That's a message that's bound to lead to preventable (...) this Last month, Penn Medicine put out a press release heralding a "cancer treatment breakthrough 20 years in the making." In a small clinical trial, three patients with advanced chronic lymphocytic leukemia (CLL) were treated with genetically engineered versions of their own T cells. Just a few weeks… Once upon a time, there was quackery. It was the term used to refer to medical practices that were not supported by evidence and were ineffective and potentially harmful. Physicians understood

2017 Respectful Insolence

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