Search results for "decision."

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…

Are go/no-go tasks preferable to two-choice tasks in response time experiments with older adults?

2015

Epub ahead of print 02/11/2015 Recent research has shown that, in response time (RT) tasks, the go/no-go response procedure produces faster (and less noisy) RTs and fewer errors than the two-choice response procedure in children, although these differences are substantially smaller in college-aged adults. Here we examined whether the go/no-go procedure can be preferred to the two-choice procedure in RT experiments with older adults (i.e. another population with slower and more error-prone responding than college-aged individuals). To that end, we compared these response procedures in two experiments with older adults (Mage = 83 years): a visual word recognition task (lexical decision) and a…

"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…

Why are Cochrane hepato-biliary reviews undervalued by physicians as an aid for clinical decision-making?

2009

Abstract Background Cochrane systematic reviews are of higher quality than reviews published in scientific journals, yet are used less than other sources for clinical decision-making. Aim To assess whether the characteristics of the Cochrane systematic reviews can account for their scant use by physicians. Materials and methods We analysed the 87 Cochrane hepato-biliary reviews dealing with therapeutic topics posted in the Cochrane Database of Systematic Reviews through December 2008, which we classified according to four characteristics: empty reviews; outdated reviews; content of reviews; implications for practice. Results Six empty reviews found no eligible randomised trials and six foun…

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…

ESMO Consensus Conferences: another source of ESMO Clinical Practice Guidelines.

2012

23 SUPPL. 7 vii7 vii10

Efficiency of telemedicine for acute stroke: a cost-effectiveness analysis from a French pilot study

2020

AbstractObjectivesTelestroke is an effective way to improve care and health outcomes for stroke patients. This study evaluates the cost-effectiveness of a French telestroke network.MethodsA decision analysis model was built using population-based data. We compared short-term clinical outcomes and costs for the management of acute ischemic stroke patients before and after the implementation of a telestroke network from the point of view of the national health insurance system. Three effectiveness endpoints were used: hospital death, death at 3 months, and severe disability 3 months after stroke (assessed with the modified Rankin scale). Most clinical and economic parameters were estimated fr…

Optimal savings and health spending over the life cycle

2010

This paper investigates the relationship between saving and health spending in a two-period overlapping generations economy. Individuals work in the first period of life and live in retirement in old age. Health spending is an activity that increases quality of life and longevity. Empirical evidence shows that both health spending and saving behave as luxury goods but their behaviour differs markedly according to the level of per capita GDP. The share of saving on GDP has a concave shape with respect to per capita GDP, whereas the share of health spending on GDP increases more than proportionally with respect to per capita GDP. The ratio of saving to spending is nonlinear with respect to in…

Home treatment of pulmonary embolism: are all the questions answered now after the HOME-PE trial?

2020

A score model for the continuous grading of early allograft dysfunction severity

2014

Early allograft dysfunction (EAD) dramatically influences graft and patient outcomes. A lack of consensus on an EAD definition hinders comparisons of liver transplant outcomes and management of recipients among and within centers. We sought to develop a model for the quantitative assessment of early allograft function [Model for Early Allograft Function Scoring (MEAF)] after transplantation. A retrospective study including 1026 consecutive liver transplants was performed for MEAF score development. Multivariate data analysis was used to select a small number of postoperative variables that adequately describe EAD. Then, the distribution of these variables was mathematically modeled to assig…