Search results for "decision."

Non-Invasive Assessment of Liver Injury in Non-Alcoholic Fatty Liver Disease: A Review of Literature.

2016

NAFLD (Non-Alcoholic Fatty Liver Disease) is an increasingly significant public health issue, regarded as the most relevant liver disease of the twenty-first century. Approximately 20%-30% of NAFLD subjects develop a NASH (Non-Alcoholic Steato-Hepatitis), a condition which can potentially evolve to liver cirrhosis and hepatocellular carcinoma. For these reasons a proper evaluation of liver damage is a key point for diagnosis and prognosis and liver biopsy still remains the "gold standard" procedure both for discrimination between steatosis and steatohepatitis and assessment of the degree of liver fibrosis. Nonetheless, given it is an invasive, painful and costly procedure, a great research …

Informing MS patients on treatment options: a consensus on the process of consent taking

2020

Abstract\ud In the last years, change in multiple sclerosis (MS) therapeutic scenario has highlighted the need for an improved doctor-patient communication in advance of treatment initiation in order to allow patient’s empowerment in the decision-making process.\ud Aims\ud The aims of our project were to review the strategies used by Italian MS specialists to inform patients about treatment options and to design a multicentre shared document that homogenizes the information about disease-modifying treatment (DMTs) and the procedure of taking informed consent in clinical practice.\ud Results\ud The new resource, obtained by consensus among 31 neurologists from 27 MS Centres in Italy with the…

Cost-effectiveness analysis of robot-assisted vs. open partial nephrectomy

2017

Background The cost-effectiveness of robot-assisted partial nephrectomy (RAPN) vs. the open procedure is not established. Methods We estimated in-hospital complications and the cost of RAPN vs. open partial nephrectomy (OPN) using an economic model. Costs incurred both intraoperatively and in hospital were considered. US data were extracted from existing literature. Results Mean in-hospital costs were $14,824 (95% CI $13,368-$16,898) for RAPN and $15,094 (95% CI $13,491-$17,140) for OPN. Complications after RAPN occurred in 23.3% (95% CI 20.0-25.8%) and after OPN in 36.1% (95% CI 35.6-36.6%) of the patients. In a sensitivity analysis, limited centre experience was associated with relevant i…

Radiomics and radiogenomics in head and neck squamous cell carcinoma: Potential contribution to patient management and challenges

2021

Abstract The application of imaging biomarkers in oncology is still in its infancy, but with the expansion of radiomics and radiogenomics a revolution is expected in this field. This may be of special interest in head and neck cancer, since it can promote precision medicine and personalization of treatment by overcoming several intrinsic obstacles in this pathology. Our goal is to provide the medical oncologist with the basis to approach these disciplines and appreciate their main uses in clinical research and clinical practice in the medium term. Aligned with this objective we analyzed the most relevant studies in the field, also highlighting novel opportunities and current challenges.

A Decision Support Tool for Appropriate Glucose-Lowering Therapy in Patients with Type 2 Diabetes

2015

Contains fulltext : 152084.pdf (Publisher’s version ) (Open Access) BACKGROUND: Optimal glucose-lowering therapy in type 2 diabetes mellitus requires a patient-specific approach. Although a good framework, current guidelines are insufficiently detailed to address the different phenotypes and individual needs of patients seen in daily practice. We developed a patient-specific decision support tool based on a systematic analysis of expert opinion. MATERIALS AND METHODS: Based on the American Diabetes Association (ADA)/European Association for the Study of Diabetes (EASD) 2012 position statement, a panel of 12 European experts rated the appropriateness (RAND/UCLA Appropriateness Method) of tre…

Off-line control of the postprandial glycemia in type 1 diabetes patients by a fuzzy logic decision support

2012

The target of this paper is to describe the use of fuzzy techniques in the development of a decision support system that allows the optimization of postprandial glycemia in type 1 diabetes patients taking into account the kind of meal taken by patients, the preprandial glycemia and the insulin resistance (the response of the body to insulin dose injection therapy). The decision support system can, in many cases, provide patients with the correct number of rapid insulin units that must be assumed to assure an optimal glycemic profile, keeping the blood glucose level close to the homeostatic condition, several hours after the meal.

Abstracts from the 1st International Symposium on Decision Support in Anaesthesia and Intensive Care

1997

Clinical Decision Support System To Prevent Toxicity In Patients Treated With Digoxin

2011

In this chapter, authors develop a system for prevention and detection of congestive heart failure and fibrillation. Due to its narrow therapeutic range more than 10% of the patients treated with DGX can suffer toxic effects, but it is estimated that half of the cases of digitalis toxicity could be prevented. Two multivariate models were developed to prevent digitalis toxicity.

Assessment and management of agitation in psychiatry: Expert consensus

2016

International audience; BACKGROUND:Psychomotor agitation is associated with different psychiatric conditions and represents an important issue in psychiatry. Current recommendations on agitation in psychiatry are not univocal. Actually, an improper assessment and management may result in unnecessary coercive or sedative treatments. A thorough and balanced review plus an expert consensus can guide assessment and treatment decisions.METHODS:An expert task force iteratively developed consensus using the Delphi method. Initial survey items were based on systematic review of the literature. Subsequent surveys included new, re-worded or re-rated items.RESULTS:Out of 2175 papers assessing psychomo…

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…