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Decision support tools

Martin C Gulliford, Dorota Juszczyk, A Toby Prevost, Jamie Soames, Lisa McDermott, Kirin Sultana, Mark Wright, Robin Fox, Alastair D Hay, Paul Little, Michael Moore, Lucy Yardley, Mark Ashworth, Judith Charlton
BACKGROUND: Unnecessary prescribing of antibiotics in primary care is contributing to the emergence of antimicrobial drug resistance. OBJECTIVES: To develop and evaluate a multicomponent intervention for antimicrobial stewardship in primary care, and to evaluate the safety of reducing antibiotic prescribing for self-limiting respiratory infections (RTIs). INTERVENTIONS: A multicomponent intervention, developed as part of this study, including a webinar, monthly reports of general practice-specific data for antibiotic prescribing and decision support tools to inform appropriate antibiotic prescribing...
March 2019: Health Technology Assessment: HTA
Dharushana Muthulingam, Joshua Bia, Lynn M Madden, Scott O Farnum, Declan T Barry, Frederick L Altice
BACKGROUND: The opioid crisis requires rapid scale-up of evidence-based interventions to treat opioid use disorder (OUD), of which pharmacologic therapies with methadone, buprenorphine or long-acting naltrexone are most effective. With recently-developed formulations, there are unprecedented treatment options. Even when pharmacologic treatment is accessible, however, uptake remains low, suggesting individual-level barriers. Decision aids are an evidence-based strategy that may overcome these barriers...
May 2019: Journal of Substance Abuse Treatment
Eric Horlick, Clifford J Kavinsky, Zahid Amin, Konstantinos Dean Boudoulas, John D Carroll, Ziyad M Hijazi, Dana Leifer, Helmi L Lutsep, John F Rhodes, Jonathan M Tobis
Until recently, evidence to support Patent Foramen Ovale (PFO) closure for secondary prevention of recurrent stroke has been controversial. Publication of high-quality evidence from randomized clinical trials and the subsequent FDA approval of two devices for percutaneous PFO closure is expected to increase the volume of PFO closure procedures not only in the United States but worldwide. As this technology is disseminated broadly to the public, ensuring the safe and efficacious performance of PFO closure is essential to mitigate risk and avoid unnecessary procedures...
March 21, 2019: Catheterization and Cardiovascular Interventions
Katherine Labonté, Sébastien Tremblay, François Vachon
In complex dynamic work environments, the consequences of task interruptions on performance can put public safety at risk. If not designed carefully, current tools aiming to facilitate interruption recovery can instead hamper performance because of information overload. Although a simpler solution-the forewarning of an imminent interruption-has proven effective in static contexts, existing theories of task interruption do not clearly predict its impact on the resumption of dynamically evolving tasks. The current study examined the effects of a preinterruption warning in dynamic settings to develop a better understanding of task resumption and supplement current theoretical accounts...
March 21, 2019: Journal of Experimental Psychology. Applied
Marie Bruun, Kristian S Frederiksen, Hanneke F M Rhodius-Meester, Marta Baroni, Le Gjerum, Juha Koikkalainen, Timo Urhemaa, Antti Tolonen, Mark van Gils, Daniel Rueckert, Nadia Dyremose, Birgitte B Andersen, Afina W Lemstra, Merja Hallikainen, Sudhir Kurl, Sanna-Kaisa Herukka, Anne M Remes, Gunhild Waldemar, Hilkka Soininen, Patrizia Mecocci, Wiesje M van der Flier, Jyrki Lötjönen, Steen G Hasselbalch
BACKGROUND: In clinical practice, it is often difficult to predict which patients with cognitive complaints or impairment will progress or remain stable. We assessed the impact of using a clinical decision support system, the PredictND tool, to predict progression in patients with subjective cognitive decline (SCD) and mild cognitive impairment (MCI) in memory clinics. METHODS: In this prospective multicenter study, we included 429 patients with SCD (n = 230) and MCI (n = 199) (female 54%, age 67 ± 9, MMSE 28 ± 2) and followed them for at least 12 months...
March 20, 2019: Alzheimer's Research & Therapy
Samuel Trachsel, Thanda Dhliwayo, Lorena Gonzalez Perez, Jose Alberto Mendoza Lugo, Mathias Trachsel
High throughput phenotyping technologies are lagging behind modern marker technology impairing the use of secondary traits to increase genetic gains in plant breeding. We aimed to assess whether the combined use of hyperspectral data with modern marker technology could be used to improve across location pre-harvest yield predictions using different statistical models. A maize bi-parental doubled haploid (DH) population derived from F1, which consisted of 97 lines was evaluated in testcross combination under heat stress as well as combined heat and drought stress during the 2014 and 2016 summer season in Ciudad Obregon, Sonora, Mexico (27°20" N, 109°54" W, 38 m asl)...
2019: PloS One
Simon M Firestone, Yoko Hayama, Richard Bradhurst, Takehisa Yamamoto, Toshiyuki Tsutsui, Mark A Stevenson
A number of transmission network models are available that combine genomic and epidemiological data to reconstruct networks of who infected whom during infectious disease outbreaks. For such models to reliably inform decision-making they must be transparently validated, robust, and capable of producing accurate predictions within the short data collection and inference timeframes typical of outbreak responses. A lack of transparent multi-model comparisons reduces confidence in the accuracy of transmission network model outputs, negatively impacting on their more widespread use as decision-support tools...
March 18, 2019: Scientific Reports
Christos Stamatis, Stephen Goldrick, David Gruber, Richard Turner, Nigel J Titchener-Hooker, Suzanne S Farid
Chromatography remains the workhorse in antibody purification; however process development and characterisation still require significant resources. The high number of operating parameters involved requires extensive experimentation, traditionally performed at small- and pilot-scale, leading to demands in terms of materials and time that can be a challenge. The main objective of this research was the establishment of a novel High Throughput Process Development (HTPD) workflow combining scale-down chromatography experimentation with advanced decision-support techniques in order to minimise the consumption of resources and accelerate the development timeframe...
March 4, 2019: Journal of Chromatography. A
P Slade, K Balling, K Sheen, G Houghton
BACKGROUND: Fear of childbirth (FOC) can have a negative impact on a woman's psychological wellbeing during pregnancy and her experience of birth. It has also been associated with adverse obstetric outcomes and postpartum mental health difficulties. However the FOC construct is itself poorly defined. This study aimed to systematically identify the key elements of FOC as reported by women themselves. METHODS: Semi-structured interviews with pregnant women (n = 10) who reported to be fearful of childbirth and telephone interviews with consultant midwives (n = 13) who regularly work with women who are fearful of childbirth were conducted...
March 18, 2019: BMC Pregnancy and Childbirth
Simon Daniel Israeli-Korn, Tsviya Fay-Karmon, Steven Tessler, Gilad Yahalom, Sandra Benizri, Hanna Strauss, Zion Zibly, Roberto Spiegelmann, Sharon Hassin-Baer
BACKGROUND: People with Parkinson's disease (PD) treated with deep brain stimulation (DBS) with non-rechargeable implantable pulse generators (IPGs) require elective IPG replacement operations involving surgical and anesthesiologic risk. Life expectancy and the number of replacements per patient with DBS are increasing. OBJECTIVE: To determine whether IPG longevity is influenced by stimulation parameters alone or whether there is an independent effect of the number of battery replacements and IPG model...
February 22, 2019: Brain Stimulation
Jesús López-Alcalde, Elena Stallings, Sheila Cabir Nunes, Abelardo Fernández Chávez, Mathilde Daheron, Xavier Bonfill Cosp, Javier Zamora
BACKGROUND: Healthcare-associated infections (HAIs) are common and increase morbidity, mortality, and healthcare costs. Their control continues to be an unresolved issue worldwide. HAIs epidemiology shows sex/gender differences. Thus the lack of consideration of sex/gender in Cochrane reviews will limit their applicability and capacity to support informed decisions. This study aims to describe the extent to which Cochrane reviews of interventions for preventing HAIs consider sex and gender...
March 15, 2019: BMC Health Services Research
Yuhao Xu, Hong Wei, Yuanyuan Zhu, Yan Zhu, Ningning Zhang, Jiasheng Qin, Xiaolan Zhu, Ming Yu, Yuefeng Li
BACKGROUND: Although several pharmacological treatment options for depression are currently available, a large proportion of patients still do not achieve a complete remission or respond adequately to the initial antidepressant prescribed for reasons that remain relatively unknown. This study explored the application of serum biomarkers to the predict the efficacy of escitalopram for treating depression, to guide clinical drug selection. METHOD: In this study, 306 patients suffering from depression were treated with escitalopram (10 mg) for 6 weeks...
March 7, 2019: Journal of Affective Disorders
Moti Tolera Jalu, Abdurehman Ahmed, Abdiwahab Hashi, Alula Tekilu
INTRODUCTION: Health-seeking behaviours are influenced by internal and external contributing factors. Internal factors include attitudes, beliefs and core values, life adaptation skills, psychological disposition whereas external factors include social support, media, socio-cultural, political, economic and biological aspects, health care systems, environmental stressors and societal laws and regulations. This study was meant to explore factors affecting health-seeking behaviors in the Somali regional state of Ethiopia...
2019: PloS One
Kevin B Bennett, John Flach
OBJECTIVE: The objective is to provide a review of ecological interface design (EID), to illustrate its value to human factors/ergonomics, and to identify areas for future research and development. BACKGROUND: EID uses mature interface technologies to provide decision making and problem solving support. A variety of theoretical concepts and analytical tools have been developed to meet the associated challenges. EID provides support that is simultaneously grounded in the practical realities of a work domain and tailored to human capabilities and limitations...
March 15, 2019: Human Factors
Colin Mitchell, Corrette Ploem
Systems based on artificial intelligence and machine learning that facilitate decision making in health care are promising new tools in the era of 'personalized' or 'precision' medicine. As the volume of patient data and scientific evidence grows, these computerised decision support systems (DSS) have great potential to help healthcare professionals improve diagnosis and care for individual patients. However, the implementation of these tools in clinical care raises some foreseeable legal challenges for healthcare providers and DSS-suppliers in Europe: How does the use of complex and novel DSS relate to professional standards to provide a reasonable standard of care? What should be done in terms of testing before DSS can be used in regular practice? What are the potential liabilities of health care providers and DSS companies if a DSS fails to function well? How do legal requirements for the protection of patient data and general privacy rights apply to likely DSS scenarios? In this article, we provide an overview of the current law and its general implications for the use of DSS, from a European perspective...
December 17, 2018: Journal of Clinical and Translational Research
Lotte Keikes, Stephanie Medlock, Daniel J van de Berg, Shuxin Zhang, Onno R Guicherit, Cornelis J A Punt, Martijn G H van Oijen
Background and aim: Medical specialists aim to provide evidence-based care based on the most recent scientific insights, but with the ongoing expansion of medical literature it seems unfeasible to remain updated. "Black-box" decision support tools such as Watson for Oncology (Watson) are gaining attention as they offer a promising opportunity to conquer this challenging issue, but it is not known if the advice given is congruent with guidelines or clinically valid in other settings...
December 17, 2018: Journal of Clinical and Translational Research
(no author information available yet)
Background: Major depression is defined as a period of depression lasting at least 2 weeks characterized by depressed mood, most of the day, nearly every day, and/or markedly diminished interest or pleasure in all, or almost all, activities. Anxiety disorders encompass a broad range of disorders in which people experience feelings of fear and excessive worry that interfere with normal day-to-day functioning.Cognitive behavioural therapy (CBT) is a form of evidence-based psychotherapy used to treat major depression and anxiety disorders...
2019: Ontario Health Technology Assessment Series
Andressa Wanneska Martins da Silva, Micheline Marie Milward de Azevedo Meiners, Elza Ferreira Noronha, Maria Inês de Toledo
The effectiveness of antiretroviral therapy has rendered HIV infection a manageable chronic condition. Currently, the health systems face the challenge of adopting organizational healthcare models capable of ensuring the delivery of comprehensive care. The Chronic Care Model has been reported for its effectiveness, particularly in terms of delivery system design. In this study, the Assessment of Chronic Illness Care (ACIC) questionnaire, a soft technology widely used for other chronic conditions, was employed on a teaching hospital to evaluate healthcare provided to people living with HIV/AIDS...
2019: Frontiers in Pharmacology
Kanak Meena, Devendra K Tayal, Vaidehi Gupta, Aiman Fatima
Anemia in children is becoming a worldwide problem owing to the unawareness among people regarding the disease, its causes and preventive measures. This study develops a decision support system using data mining techniques that are applied to a database containing data about nutritional factors for children. The data set was taken from NFHS-4, a survey conducted by the Government of India in 2015-16. The work attempts to predict anemia among children and establish a relation between mother's health and diet during pregnancy and its effects on anemic status of her child...
March 2019: Artificial Intelligence in Medicine
David Requejo-Castro, Ricard Giné-Garriga, Agustí Pérez-Foguet
The water, sanitation and hygiene (WaSH) sector has witnessed the development of multiple tools for multidimensional monitoring. Hierarchical and composite indicator (CI)-based conceptual frameworks provide one illustrative example. However, this approach does not address the existing interrelationship of the indicators they comprise. Bayesian networks (BNs) are increasingly being exploited to assess WaSH issues and to support planning and decision-making processes. Here, we aim to evaluate the validity, reliability and feasibility of BNs in replicating an existing CI-based conceptual framework...
February 19, 2019: Science of the Total Environment
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