scholarly journals Basics of Dental Implantology for the Oral Surgeon

2021 ◽  
pp. 385-405
Author(s):  
Supriya Ebenezer ◽  
Vinay V. Kumar ◽  
Andreas Thor
Keyword(s):  
Decision Making ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
The Other ◽  
Oral Surgical Procedures ◽  
Implant Placement ◽  
Treatment Concepts ◽  
Implant Dentistry ◽  
New Treatment ◽  
Implant Treatment

AbstractOver the past decades, implant dentistry has evolved to be a very predictable treatment modality for the replacement of lost teeth and has now become one of the most common oral surgical procedures carried out worldwide. This chapter introduces the history and evolution of dental implants, discusses the concept of osseointegration, mentions the types of implants and discusses clinical decision making and execution of straight forward implant placement. It must be noted that the field of implantology is rapidly developing with new treatment concepts and increasing use of digital technology. The surgical part of implant treatment although extremely important, is only a part of the overall treatment, the other important factors being the laboratory and prosthodontics. This chapter only provides a basic surgical overview of implantology for the beginner surgeon clinician.

scholarly journals Probability and loss: two sides of the risk assessment coin

2011 ◽  
Vol 35 (11) ◽  
pp. 413-418 ◽  
Author(s):  
Matthew M. Large ◽  
Olav B. Nielssen
Keyword(s):  
Mental Health ◽  
Risk Assessment ◽  
Decision Making ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
The Other ◽  
Current Form ◽  
Mental Health Settings ◽  
Future Harm ◽  
Two Sides

SummaryRisk assessment has been widely adopted in mental health settings in the hope of preventing harms such as violence to others and suicide. However, risk assessment in its current form is mainly concerned with the probability of adverse events, and does not address the other component of risk – the extent of the resulting loss. Although assessments of the probability of future harm based on actuarial instruments are generally more accurate than the categorisations made by clinicians, actuarial instruments are of little assistance in clinical decision-making because there is no instrument that can estimate the probability of all the harms associated with mental illness, or estimate the extent of the resulting losses. The inability of instruments to distinguish between the risk of common but less serious harms and comparatively rare catastrophic events is a particular limitation of the value of risk categorisations. We should admit that our ability to assess risk is severely limited, and make clinical decisions in a similar way to those in other areas of medicine – by informed consideration of the potential consequences of treatment and non-treatment.

To report or not to report: a proposal on how to deal with altered test results in hemolytic samples

2017 ◽  
Vol 55 (8) ◽  
pp. 1109-1111 ◽  
Author(s):  
Janne Cadamuro ◽  
Cornelia Mrazek ◽  
Elisabeth Haschke-Becher ◽  
Sverre Sandberg
Keyword(s):  
Decision Making ◽  
Clinical Decision Making ◽  
Clinical Information ◽  
Clinical Decision ◽  
General Information ◽  
The Other ◽  
Test Results ◽  
Scientific Discussion ◽  
Laboratory Values ◽  
Test Result

Abstract Preanalytically altered test results are a challenge every laboratory has to face. The release of such results may be to the harm of the patient by triggering wrong clinical decision making in monitoring or treatment. On the other hand, their deletion also might be to the harm of the patient by delaying the time to decision making as the exact value sometimes is not even necessary but rather an answer to the question “Is it raised or lowered”. Based on this dilemma and forced to produce laboratory values without any clinical information on the respective patient, laboratories have developed their own preferred way on how to deal with preanalytically altered test results. Some release the value with a comment, some reject the value with or without a comment and others again provide only general information about the hemolytic sample. To date there is no guideline or standardization to this postanalytical topic. Therefore, with this opinion paper, we want to start the scientific discussion on this important issue by providing one possible method to overcome the lack of clinical information which the laboratory would need to correctly decide whether or not to release an altered test result. We suggest providing the clinician with all the information on the hemolytic sample and its impact on the respective parameter needed to make his/her own decision on the usage of the respective test result. We believe that reporting a preanalytically altered laboratory value including a respective comment is preferable to not reporting it.

Persons over models: shared decision-making for person-centered medicine

2020 ◽  
Vol 8 (3) ◽  
pp. 355
Author(s):  
Marco Annoni ◽  
Charlotte Blease
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Clinical Decision Making ◽  
Clinical Care ◽  
Clinical Decision ◽  
The Other ◽  
Shared Decision ◽  
Patient Relationship ◽  
New Paradigm ◽  
The Core

In the last decades “shared decision-making” has been hailed as the new paradigm for the doctor-patient relationship. However, different models of clinical decision-making appear to be compatible with the core tenets of “shared decision-making”. Reconsidering Emanuel and Emanuel (1992) classic analysis, in this paper we distinguish five possible models of clinical decision-making: (i) the ‘instrumental’; (ii) the ‘paternalistic’; (iii) the ‘informative’; (iv) the ‘interpretative’; and (v) the ‘persuasive’ models. For each model we present its fundamental assumptions as well as the role that patients and doctors are expected to play with respect to value-laden dilemmas. We argue that, with the exception of the instrumental model, each of the other four models may be appropriate depending on the circumstances. We conclude by highlighting the importance of structuring clinical care around actual persons - and their unique lives and philosophies - rather than around abstract frameworks.

Value-based practice: introducing a skills-based approach to balanced cinical decision-making

2013 ◽  
Vol 6 (5) ◽  
pp. 312-317
Author(s):  
Bill K. W. M. Fulford ◽  
Ed Peile ◽  
Heidi Carroll
Keyword(s):  
Decision Making ◽  
Clinical Decision Making ◽  
Evidence Based Practice ◽  
Clinical Skills ◽  
Clinical Decision ◽  
The Other ◽  
Evidence Based

Whilst the importance of evidence-based practice is well recognised by most GPs, perhaps less well recognised is that there are two bases or feet’ on which sound clinical decision-making is based—the other being values-based practice (V-BP). This article does not attempt to be a comprehensive manual on the processes of V-BP. We aim to help you understand the rationale of V-BP and to demonstrate some of its processes which, as you will see, build on your existing clinical skills and knowledge. In view of the importance of clinical decision-making, it is unsurprising that the GP curriculum underlines the importance of values-based practice.

Debates in Dysphagia Management: How Do You Use Evidence-Based Practice in Your Dysphagia Patient Care?

2011 ◽  
Vol 20 (4) ◽  
pp. 121-123
Author(s):  
Jeri A. Logemann
Keyword(s):  
Decision Making ◽  
Patient Care ◽  
Clinical Outcomes ◽  
Clinical Judgment ◽  
Clinical Decision Making ◽  
Evidence Based Practice ◽  
Clinical Decision ◽  
Evidence Based ◽  
Clinical Method ◽  
Do So

Evidence-based practice requires astute clinicians to blend our best clinical judgment with the best available external evidence and the patient's own values and expectations. Sometimes, we value one more than another during clinical decision-making, though it is never wise to do so, and sometimes other factors that we are unaware of produce unanticipated clinical outcomes. Sometimes, we feel very strongly about one clinical method or another, and hopefully that belief is founded in evidence. Some beliefs, however, are not founded in evidence. The sound use of evidence is the best way to navigate the debates within our field of practice.

Management of thoracic aortic lesions - the future is endovascular

VASA ◽  
2012 ◽  
Vol 41 (3) ◽  
pp. 163-176 ◽  
Author(s):  
Weidenhagen ◽  
Bombien ◽  
Meimarakis ◽  
Geisler ◽  
A. Koeppel
Keyword(s):  
Thoracic Aorta ◽  
Clinical Decision Making ◽  
Treatment Options ◽  
Clinical Decision ◽  
Clinical Results ◽  
Treatment Modalities ◽  
Traumatic Rupture ◽  
Descending Thoracic Aorta ◽  
New Treatment ◽  
Aneurysm Dissection

Open surgical repair of lesions of the descending thoracic aorta, such as aneurysm, dissection and traumatic rupture, has been the “state-of-the-art” treatment for many decades. However, in specialized cardiovascular centers, thoracic endovascular aortic repair and hybrid aortic procedures have been implemented as novel treatment options. The current clinical results show that these procedures can be performed with low morbidity and mortality rates. However, due to a lack of randomized trials, the level of reliability of these new treatment modalities remains a matter of discussion. Clinical decision-making is generally based on the experience of the vascular center as well as on individual factors, such as life expectancy, comorbidity, aneurysm aetiology, aortic diameter and morphology. This article will review and discuss recent publications of open surgical, hybrid thoracic aortic (in case of aortic arch involvement) and endovascular repair in complex pathologies of the descending thoracic aorta.

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