Search results for "decision."

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…

Author's reply: Comment on “Why are Cochrane hepato-biliary reviews undervalued by physicians as an aid for clinical decision making?”

2010

Chondrocostal grafting for lateral osteochondral injury of the metacarpal head

2020

Abstract Osteochondral injuries of the metacarpal head require anatomical restoration to prevent limitations in range of motion and osteoarthritis. Osteochondral bone grafting is a viable option, especially in younger patients. Central injuries allow for different types of grafting, but when the injured area is on the lateral portion of the metacarpal head, the graft must include both a cortical and a cartilaginous portion. We present here the pearls and pitfalls in the surgical technique of chondrocostal grating from the 6th rib and an example of its use within a case of comminuted fracture of the metacarpal head. This technique provides a graft with cortical bone that allows for a stable …

Oral leukoplakia: the ongoing discussion on definition and terminology

2015

In the past decades several definitions of oral leukoplakia have been proposed, the last one, being authorized by the World Health Organization (WHO), dating from 2005. In the present treatise an adjustment of that definition and the 1978 WHO definition is suggested, being : “A predominantly white patch or plaque that cannot be characterized clinically or pathologically as any other disorder; oral leukoplakia carries an increased risk of cancer development either in or close to the area of the leukoplakia or elsewhere in the oral cavity or the head-and-neck region”. Furthermore, the use of strict diagnostic criteria is recommended for predominantly white lesions for which a causative factor…

PS-039 DokuPIK – Pharmaceutical interventions: Do ward pharmacists know how to document?

2014

Background The internet-based categorical, hierarchical documentation system for routine pharmaceutical interventions (PIs) DokuPIK is widely used especially among German ward-based pharmacists. Purpose To conduct a survey-based study on its clinical usability. Materials and methods Out of 498 registered DokuPIK users, 37 volunteered to independently evaluate 24 standardised case reports 1 between 01–03 2012. Case evaluation was restricted to the reason for PI and was performed based on 26 given survey items with no limit on the number of items chosen. Ratings were conducted electronically and anonymously. In order to define meaningful reference item selections, majority decisions made by 5…

Comparison between statistical and fuzzy approaches for improving diagnostic decision making in patients with chronic nasal symptoms

2014

This paper compares a fuzzy model, expressed in rule-form, with a well known statistical approach (i.e. logistic regression model) for diagnostic decision making in patients with chronic nasal symptoms. The analyses were carried out using a database obtained from a questionnaire administered to 1359 patients with nasal symptoms containing personal data, clinical data and skin prick test (SPT) results. Both the fuzzy model and the logistic regression model developed were validated using a data set obtained from another medical institution. The accuracy of the two models in identifying patients with positive or negative SPT was similar. This study is a preliminary step to the creation of a so…

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 …

Survival prediction in patients undergoing ischemic cardiopathy

2009

The ischemic cardiopathy is the main cause of death in developed countries. New improved drugs and therapies have appeared last years. However, the interventionist strategy and the most powerful drugs may have complications, and hence, it is very important to know the risk of death associated with patients during their stay in the hospital, or in the next six months. Thus, it is possible to tune the best treatment for each individual patient. In this framework, the use of artificial neural networks is proposed with a double objective: survival prediction and the extraction of the parameters with best predictive capabilities. A cohort of 691 patients treated in the Hospital Clinic, in Barcel…

Learning from experience. Proposal of a refined definition and staging system for bisphosphonate-related osteonecrosis of the jaw (BRONJ)

2012

Dear Editor, It is the authors’ belief that the internationally accepted definition of bisphosphonate-related osteonecrosis of the jaws (BRONJ) (Ruggiero et al, 2009) has several limitations that prevent clinicians from being confident with the diagnosis of the disease. Following recognition of the non-exposed BRONJ clinical variant (Lazarovici et al, 2009), we all became aware that the presence of ‘exposed necrotic bone in the oral cavity’, as outlined in the American Association of Oral and Maxillofacial Surgery (AAOMS) case definition, is just one of the possible clinical manifestations of BRONJ and is not found in all BRONJ patients. As ‘bone exposure’ is certainly not the initial sign …

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…