Search results for "DECISION-MAKING"
showing 10 items of 309 documents
Ethical reflections on Evidence Based Medicine
2013
BACKGROUND According to Potter’s point of view, medical ethics is the science of survival, a bridge between humanistic and scientific culture. The working out of judgements on right or wrong referred to the human being are studied by this science. Methodological quality is fundamental in clinical research, and several technical issues are of paramount importance in trying to answer to the final question “what is the true, the right thing?”. We know they are essential aspects as in medical ethics as in evidence based practice. AIM OF THE STUDY The aim of this paper is to talk about relationships and implications between ethical issues and Evidence Based Medicine (EBM). DISCUSSION EBM represe…
A Classification System for Decision-Making in the Management of Patients with Chronic Conditions
2021
Patients with chronic diseases are frequent users of healthcare services. The systematic use of stratification tools and predictive models for this group of patients can be useful for health professionals in decision-making processes. The aim of this study was to design two new classifier systems for detecting the risk of hospital admission for elderly patients with chronic conditions. In this retrospective cohort study, a set of variables related to hospital admission for patients with chronic conditions was obtained through focus groups, a health database analysis and statistical processing. To predict the probability of admission from the set of predictor variables, a logistic regression…
Patient Preferences for Lung Cancer Treatment: A Qualitative Study Protocol Among Advanced Lung Cancer Patients
2021
Introduction: Lung cancer is the deadliest and most prevalent cancer worldwide. Lung cancer treatments have different characteristics and are associated with a range of benefits and side effects for patients. Such differences may raise uncertainty among drug developers, regulators, payers, and clinicians regarding the value of these treatment effects to patients. The value of conducting patient preference studies (using qualitative and/or quantitative methods) for benefits and side effects of different treatment options has been recognized by healthcare stakeholders, such as drug developers, regulators, health technology assessment bodies, and clinicians. However, evidence-based guidelines …
Therapeutic decision-making for patients with fluctuating mitral regurgitation
2015
Mitral regurgitation (MR) is a common, progressive, and difficult-to-manage disease. MR is dynamic in nature, with physiological fluctuations occurring in response to various stimuli such as exercise and ischaemia, which can precipitate the development of symptoms and subsequent cardiac events. In both chronic primary and secondary MR, the dynamic behaviour of MR can be reliably examined during stress echocardiography. Dynamic fluctuation of MR can also have prognostic value; patients with a marked increase in regurgitant volume or who exhibit increased systolic pulmonary artery pressure during exercise have lower symptom-free survival than those who do not experience significant changes in…
The capacity to consent to treatment in amyotrophic lateral sclerosis: a preliminary report
2020
Background: Facing the relentless worsening of their condition, ALS patients are required to make decisions on treatments and end-of-life care. A cognitive impairment showed to be a negative prognostic factor in ALS patients, perhaps affecting the ability to make informed decisions. Notwithstanding its crucial role, the capacity to consent to treatment (CCT) has never been evaluated in these patients. Objectives: To assess the CCT in an ALS cohort in comparison to a control group, and to study the effects of demographic and clinical variables on this high-level cognitive function. Methods: 102 ALS patients and 106 healthy controls (HC) were enrolled. CCT was assessed using the MacArthur Com…
"Card sorting" : a tool for research in ethics on treatment decision-making at the end of life in Alzheimer patients with a life threatening complica…
2011
Abstract Background End stage dementia is a particularly difficult aspect of care for patients with Alzheimer's disease and related dementias. In care institutions, caregivers and family are concerned by treatment decision-making for an acute life threatening complication occurring in Alzheimer patients at the end of life. How should the best treatment pathway be decided: to treat or not to treat? Which arguments are used for decision-making? These are mainly ethical questions which are currently difficult to express and investigate. Methods/Design Cross sectional multicentre study of clinical cases involving 67 health centres (university hospitals, general hospitals, local hospitals and ho…
Rectal bleeding and prolapse… not always benign diseases rather anal cancer. The importance of a correct decision making since primary care
2016
Rectal bleeding is very common in general population with a prevalence of 10-20 %. Primary care physicians have to stratify patients basing on urgency and on the colo-rectal cancer risk and to conduct a decision making for the correct management. We report a case of a 61-years-old woman, complaining rectal bleeding and an anal mass attended to their family doctor who does a visit but without a digital rectal examination and diagnosed a hemorrhoidal prolapse suggesting medical therapy. For the persistence of symptoms she comes to our service from emergency attention. Inspection and digital rectal examination revealed an anal mass. CT scan was performed showing a large anal mass involving hal…
Home treatment of pulmonary embolism: are all the questions answered now after the HOME-PE trial?
2020
Next-generation three-dimensional modelling software for personalized surgery decision-making in perihilar cholangiocarcinoma: multicentre study
2021
Next-generation three-dimensional modelling software for personalized surgery allows spatially accurate depiction of the hepatic and vasculature anatomy based on the complexity and individual variation in each patient, and could facilitate decision-making about preoperative strategy in perihilar cholangiocarcinoma.
Nutritional self-care among a group of older home-living people in rural Southern Norway
2015
Bjørg Dale, Ulrika SöderhamnCentre for Caring Research – Southern Norway, Faculty of Health and Sport Sciences, University of Agder, Grimstad, NorwayBackground: Older home-living people are an at-risk group for undernutrition, particularly those who are living alone. Lack of knowledge about healthy dietary habits, altered taste sensation, and declined health status are shown to be some of the factors related to undernutrition. The aims of this study were to explore how a small group of older people in Southern Norway perceived their nutritional self-care.Methods: An exploratory qualitative approach, combined with a simple self-report questionnaire, was used. Fi…