Novel Video-Based Assessment Tool for Laparoscopic Intraoperative Decision-Making

2014 ◽  
Vol 219 (3) ◽  
pp. S119-S120
Author(s):  
Isabelle Raiche ◽  
Matthew G. Mutch ◽  
Stanley J. Hamstra ◽  
Matthew L. Silviera ◽  
Steven R. Hunt ◽  
...  
Keyword(s):  
Decision Making ◽  
Assessment Tool

scholarly journals How Do We Assess Patient Skills in a Competence-Based Program? Assessment of Patient Competences Using the Spanish Version of the Prolapse and Incontinence Knowledge Questionnaire and Real Practical Cases in Women with Pelvic Floor Disorders

2021 ◽  
Vol 18 (5) ◽  
pp. 2377
Author(s):  
Beatriz Sánchez-Sánchez ◽  
Beatriz Arranz-Martín ◽  
Beatriz Navarro-Brazález ◽  
Fernando Vergara-Pérez ◽  
Javier Bailón-Cerezo ◽  
...  
Keyword(s):  
Decision Making ◽  
Pelvic Floor ◽  
Discriminant Validity ◽  
Pelvic Floor Disorders ◽  
Assessment Tool ◽  
Pelvic Organ ◽  
Assessment Tools ◽  
Measurement Properties ◽  
Competence Assessment ◽  
Knowledge Questionnaire

Therapeutic patient education programs must assess the competences that patients achieve. Evaluation in the pedagogical domain ensures that learning has taken place among patients. The Prolapse and Incontinence Knowledge Questionnaire (PIKQ) is a tool for assessing patient knowledge about urinary (UI) and pelvic organ prolapse (POP) conditions. The aim of this study was to translate the Prolapse and Incontinence Knowledge Questionnaire (PIKQ) into Spanish and test its measurement properties, as well as propose real practical cases as a competence assessment tool. The cross-cultural adaptation was conducted by a standardized translation/back-translation method. Measurement properties analysis was performed by assessing the validity, reliability, responsiveness, and interpretability. A total of 275 women were recruited. The discriminant validity showed statistically significant differences in the PIKQ scores between patients and expert groups. Cronbach’s alpha revealed good internal consistency. The test–retest reliability showed excellent correlation with UI and POP scales. Regarding responsiveness, the effect size, and standardized response mean demonstrated excellent values. No floor or ceiling effects were shown. In addition, three “real practical cases” evaluating skills in identifying and analyzing, decision making, and problem-solving were developed and tested. The Spanish PIKQ is a comprehensible, valid, reliable, and responsive tool for the Spanish population. Real practical cases are useful competence assessment tools that are well accepted by women with pelvic floor disorders (PFD), improving their understanding and their decision-making regarding PFD.

scholarly journals How Many Urine Samples Are Needed to Accurately Assess Exposure to Non-Persistent Chemicals? The Biomarker Reliability Assessment Tool (BRAT) for Scientists, Research Sponsors, and Risk Managers

2020 ◽  
Vol 17 (23) ◽  
pp. 9102
Author(s):  
Marc-André Verner ◽  
Hassan Salame ◽  
Conrad Housand ◽  
Linda S. Birnbaum ◽  
Maryse F. Bouchard ◽  
...  
Keyword(s):  
Decision Making ◽  
Monte Carlo ◽  
Human Exposure ◽  
Assessment Tool ◽  
Reliability Assessment ◽  
Population Based ◽  
Environmental Chemicals ◽  
Urine Samples ◽  
Risk Managers

In epidemiologic and exposure research, biomonitoring is often used as the basis for assessing human exposure to environmental chemicals. Studies frequently rely on a single urinary measurement per participant to assess exposure to non-persistent chemicals. However, there is a growing consensus that single urine samples may be insufficient for adequately estimating exposure. The question then arises: how many samples would be needed for optimal characterization of exposure? To help researchers answer this question, we developed a tool called the Biomarker Reliability Assessment Tool (BRAT). The BRAT is based on pharmacokinetic modeling simulations, is freely available, and is designed to help researchers determine the approximate number of urine samples needed to optimize exposure assessment. The BRAT performs Monte Carlo simulations of exposure to estimate internal levels and resulting urinary concentrations in individuals from a population based on user-specified inputs (e.g., biological half-life, within- and between-person variability in exposure). The BRAT evaluates—through linear regression and quantile classification—the precision/accuracy of the estimation of internal levels depending on the number of urine samples. This tool should guide researchers towards more robust biomonitoring and improved exposure classification in epidemiologic and exposure research, which should in turn improve the translation of that research into decision-making.

Application of Level 2 PSA in the Design of Cavity Injection System for Nuclear Power Plant

2018 ◽  
Author(s):  
Wentao Zhu ◽  
Wenjing Li
Keyword(s):  
Decision Making ◽  
Power Plant ◽  
Nuclear Power Plant ◽  
Nuclear Power ◽  
Assessment Tool ◽  
Quantitative Risk Assessment ◽  
Severe Accident ◽  
Injection System ◽  
Retention Strategy ◽  
Level 2

After Fukushima nuclear power plant accident, severe accident is getting more and more concerns all over the world. In order to mitigate severe accident and improve the safety of nuclear power plant, two different strategies are applied in different plants. One is in-vessel melt retention strategy, and the other is ex-vessel melt retention strategy. Tianwan nuclear power plant is an improved Gen II nuclear power plant and in-vessel melt retention strategy is adopted in the plant. In order to achieve this strategy, cavity injection system is designed for the plant. Probabilistic Safety Analysis is the most commonly used quantitative risk assessment tool for decision-making in selecting the optimal design among alternative options. For this plant, in order to optimize the design of cavity injection system, improve the safety level of nuclear power plant, and meanwhile, improve the engineering implementation and economization, Level 2 PSA was used for this decision-making process. In this paper, the Level 2 PSA for this plant and the application for the design of cavity injection system are introduced.

Bridging the Gap: A Priorities Assessment Tool to Support Shared Decision Making, Maximize Appointment Time, and Increase Patient Satisfaction in Women With Ovarian Cancer

2020 ◽  
Vol 16 (2) ◽  
pp. e148-e154 ◽  
Author(s):  
Melissa K. Frey ◽  
Annie Ellis ◽  
Savannah Shyne ◽  
Ryan Kahn ◽  
Eloise Chapman-Davis ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Decision Making ◽  
Patient Satisfaction ◽  
Shared Decision Making ◽  
Assessment Tool ◽  
Shared Decision ◽  
Feedback Form ◽  
Patient Centered ◽  
Symptom Index ◽  
Increase Patient Satisfaction

PURPOSE: Women with ovarian cancer identify patient-physician communication as an essential element in determining treatment course and believe a discussion about goals and values should precede treatment decisions. We sought to develop a patient-centered priorities assessment tool for women with ovarian cancer that could streamline communication, enhance treatment discussions, and increase patient satisfaction. MATERIALS AND METHODS: We designed a priorities assessment tool using a validated ovarian cancer symptom index (National Comprehensive Cancer Center–Functional Assessment of Cancer Therapy Ovarian Symptom Index-18) combined with an index to assess daily quality-of-life priorities. The tool was distributed to women with ovarian cancer in small focus group settings and online, followed by a postactivity feedback form. RESULTS: In this pilot study, 36 women completed the priorities assessment tool and 35 completed the postactivity feedback form between September 2015 and May 2016. All participants reported that the tool was easy to understand and comprehensive in scope. Twenty-nine participants (82.9%) completed the tool in 10 minutes or less. Most participants (n = 31, 86.1%) were able to stratify their priorities and identify 5 top treatment-related priorities. Participants who indicated that their goals and priorities had changed since diagnosis (n = 25, 69.4%) reported that the tool helped to identify current goals and priorities (22 [88%] of 25 participants) and would help them feel more comfortable participating in shared decision making with their medical team (21 [84%] of 25 participants). CONCLUSION: A patient-centered priorities assessment tool was easy to complete and viewed as comprehensive and useful in a pilot cohort of women with ovarian cancer. Use of a priorities assessment tool has the potential to enhance communication, promote shared decision making, and improve patient satisfaction.

scholarly journals Validation of the French Version of the MacArthur Competence Assessment Tool for Treatment (MacCAT-T) in a French Sample of Individuals with Schizophrenia: Validation de la version française de l’instrument d’évaluation des compétences MacArthur-traitement (MacCAT-T) dans un échantillon français de personnes souffrant de schizophrénie

2020 ◽  
pp. 070674372096644
Author(s):  
Stéphane Raffard ◽  
Cindy Lebrun ◽  
Yasmine Laraki ◽  
Delphine Capdevielle
Keyword(s):  
Decision Making ◽  
Factor Analysis ◽  
Assessment Tool ◽  
Competence Assessment ◽  
Rater Reliability ◽  
French Version ◽  
Capacity To Consent ◽  
Decision Making Capacity ◽  
Consent To Treatment ◽  
High Degree

Background: Assessing an individual’s capacity to consent to treatment is a complex and challenging task for psychiatrists and health-care professionals. Diminished capacity to consent to pharmacological treatment is a common concern in individuals with schizophrenia. The MacArthur Competence Assessment Tool for Treatment (MacCAT-T) is the most common tool used in individuals with schizophrenia to evaluate the decision-making abilities for judgments about competence to consent to treatment. This instrument assesses patients’ competence to make treatment decisions by examining their capacities in 4 areas: understanding information relevant to their condition and the recommended treatment, reasoning about the potential risks and benefits of their choices, appreciating the nature of their situation and the consequences of their choices, and expressing a choice. Despite its importance, there is no French version of this scale. Furthermore, its factor structure has never been explored, although validated measures are strongly needed to further detect deficits in patients’ decision-making abilities. The goal of this study was thus to empirically validate a French version of the MacCAT-T in a French sample of individuals with schizophrenia. Method: In this cross-sectional study, we included 125 inpatients with a diagnosis of schizophrenia from the University Department of Adult Psychiatry in Montpellier. The MacCAT-T was administered to patients by a trained psychologist. Patients were also assessed for severity of symptoms, insight into illness, and depressive and anxiety symptoms. Inter-rater reliability and psychometric properties including internal consistency, construct validity, and discriminant and divergent validity were also investigated. Results: The MacCAT-T’s internal consistency was high (Cronbach α of 0.91). A high degree of inter-rater reliability was found for all the areas of the MacCAT-T (intraclass correlation coefficient range, 0.92 to 0.98). Exploratory factor analysis revealed a 2-factor model. The factor analysis explained 50.03% of the total score variation. Component 1 included all subparts of “understanding.” Component 2 included all subparts of “appreciation” and “reasoning” and was therefore labeled “reflexivity.” After Bonferroni corrections, decision-making capacity was positively associated with insight and the severity of psychotic symptoms but not with sociodemographic variables except for education. Conclusions: The MacCAT-T demonstrated a high degree of inter-rater reliability and strong psychometric properties. The French version of the MacCAT-T is a valid instrument to assess the decision-making capacity to consent to treatment in a French sample of individuals with schizophrenia.

scholarly journals NSQIP Impacts Patient Experience

2018 ◽  
Vol 7 (1) ◽  
pp. 89-95
Author(s):  
Maria Castaldi ◽  
Geena George ◽  
Pamela Turner ◽  
John McNelis
Keyword(s):  
Risk Assessment ◽  
Decision Making ◽  
Shared Decision Making ◽  
Patient Experience ◽  
Assessment Tool ◽  
Shared Decision ◽  
Patient Centered ◽  
Improvement Project ◽  
National Quality ◽  
Venous Thromboembolic Events

National Quality Improvement Project (NSQIP) semiannual reports (SARs) revealed high observed to expected ratios for venous thromboembolic events (VTEs) on the surgical service. Press Ganey scores identified an area of particular weakness in shared decision-making in patient care. Patients reported little to no participation in shared decision-making. A performance improvement project was developed with a 2-fold objective: decrease the percentages of patients sustaining VTE through adequate screening and prophylaxis (VTEP) and to engage patients in shared decision-making to accept VTEP through enhanced patient-centered discussions and education on the risks and benefits of VTEP. A clinical pathway was developed to implement VTEP using a standardized risk assessment tool. Patient-centered discussion introduced VTEP and impact on perioperative safety. Results included telephone survey, NSQIP SARs, and Press Ganey patient experience survey. Using NSQIP data and a pathway developed for both VTE risk assessment and patient engagement, the authors observe immediate improvements in patient experience and decreased rates of VTE.

Decision-making preferences of advanced cancer Hispanic patients from the United States and Latin America.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 9063-9063
Author(s):  
Henrique Afonseca Parsons ◽  
Sriram Yennurajalingam ◽  
Eva Rosina Duarte ◽  
Alejandra Palma ◽  
Sofia Bunge ◽  
...  
Keyword(s):  
Decision Making ◽  
Latin America ◽  
Advanced Cancer ◽  
Family Involvement ◽  
Assessment Tool ◽  
The United States ◽  
Demographic Variables ◽  
The Family ◽  
The Us ◽  
Hispanic Patients

9063 Background: To determine whether preferences in frequency of passive decision making differ between Hispanic patients from Latin America (HLA) and Hispanic-American (HA) patients. Methods: We conducted a survey of advanced cancer Hispanic patients referred to outpatient palliative care clinics in the U.S, Chile, Argentina, and Guatemala. Information on demographic variables, PS,andMarin Acculturation Assessment Tool (only U.S. patients) was collected. Decision-making preference was evaluated by the decision-making assessment tool. Results: A total of 387 patients with advanced cancer were surveyed: 91 (24%) in the US, 100 (26%) in Chile, 94 (25%) in Guatemala, and 99 (26%) in Argentina. Median age was 59 years, and 61% were female. HLA preferred passive decision-making strategies significantly more frequently with regard to involvement of the family (24% versus 10%, p=0.009) or the physician (35% versus 26%, p<0.001), even after controlling for age and education (OR 3.8, p<0.001 for physician and 2.4, p=0.03 for family) (Table 1). 76/91 HA (83.5%), and 242/293 HLA (82%) preferred family involvement in decision-making (p=NS). No differences were found in decision-making preferences between low- and highly acculturated U.S. Hispanics. Conclusions: HA prefer more active decision-making as compared to HLA. Among HA, acculturation did not seem to play a role in decision-making preference determination. Our findings in this study confirm the importance of family participation in decision making in both HA and HLA. However, HA patients were much less likely to want family members or physicians to make decisions on their behalf. [Table: see text] [Table: see text]

Science of quality: Communication, decision making, and behavior.

2013 ◽  
Vol 31 (31_suppl) ◽  
pp. 22-22 ◽  
Author(s):  
Deb Harrison ◽  
J. Russell Hoverman ◽  
Sabrina Q. Mikan ◽  
Kevin Donald Olson ◽  
Cynthia Taniguchi ◽  
...  
Keyword(s):  
Decision Making ◽  
Pilot Study ◽  
End Of Life ◽  
Advance Directives ◽  
Assessment Tool ◽  
Cancer Center ◽  
Measurement Tool ◽  
Physician Referral ◽  
Code Status ◽  
Values Assessment

22 Background: Addressing advance care planning (ACP) early in metastatic disease is a challenge for providers across oncology. Providing a systematic method to engage providers and patients in these discussions offers opportunities to improve end of life outcomes, improve patient quality of life and engage in shared decision making that supports effective transition to appropriate palliative care and hospice. Methods: A multidisciplinary group of oncology providers developed a framework for ACP which included defining a target population for early introduction, utilizing a standard patient-centered measurement tool (Values Assessment), reviewing practice workflow to schedule ACP conversations, and incorporating documentation elements embedded in the electronic health record. The model included physician referral of patients to a nurse practitioner or social worker who scheduled meetings with patients to assess values, assist patients with advance directives (AD), and explore patient end-of-life wishes based on disease. Seven cancer center sites of service engaged in the pilot study for a 90-day period to test tools, workflow and effectiveness of implementation methods. Documented values assessments, code status, and advance directives were pilot outcomes measures. Results: All sites in the pilot study implemented the framework and participated for 90 days. Workflows were validated to support scheduling of ACP conversations. Use of the values assessment tool was slow to be incorporated in ACP process as was physician referral for introduction. Conclusions: Engaging in a systematic approach to gather and assimilate information provides an opportunity to comparatively assess adoption of an ACP program. Providers are not inherently experienced in basic ACP introduction or deeper ACP discussions. Communications training, including conversations for values assessment and ACP, is in development for use with pilot and new practices engaging in the program, which supports program scalability. [Table: see text]

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