scholarly journals CLINICAL DECISION MAKING FOR THE HEMODYNAMIC GRAY ZONE (FFR 0.75-0.80) AND IMPACT ON LONG TERM OUTCOMES

2016 ◽  
Vol 67 (13) ◽  
pp. 379 ◽  
Author(s):  
Shiv Kumar Agarwal ◽  
Mohan Edupuganti ◽  
Ahmed Almomani ◽  
Naga Venkata Pothineni ◽  
Jason Payne ◽  
...  
Keyword(s):  
Decision Making ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Gray Zone ◽  
Long Term Outcomes

scholarly journals Blood transfusion prescribing in the ACT: an insight into clinical decision making

2005 ◽  
Vol 29 (2) ◽  
pp. 240 ◽  
Author(s):  
Philip J Crispin ◽  
Bethany J Crowe ◽  
Anne M McDonald
Keyword(s):  
Decision Making ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Early Discharge ◽  
Organisation Of Care ◽  
Metropolitan Hospital ◽  
Loss Of Appetite ◽  
Insight Into ◽  
Structured Questionnaire

This study aimed to determine the perspectives of a group of patients categorised as ?long-stay outliers? at a large South Australian metropolitan hospital about aspects of organisation of care and the perceived impact of long-term hospitalisation. Nineteen patients were interviewed using a semi-structured questionnaire. Eighty-nine percent of participants stated that they had no knowledge of how long they were to be in hospital. Forty-two percent indicated that they did not know when they would be discharged from hospital. This was of concern, especially considering the vulnerability of this patient group and the known benefits of patient involvement in decision making and the improvements this can make to health outcomes and early discharge. Participants indicated concern about sleep deprivation, diet, ability to return to paid employment, and missing their family as the main areas of impact of their long hospitalisation. Concerns about being discharged from hospital included: apprehension as to whether they were well enough to leave; the recurrence of infection; whether they would be able to sleep well when they got home; their recent loss of appetite and associated weight loss; mobility concerns; and what supports they would have when they were discharged home. All these issues require staff to be more patient and family-centred in their approach to preparing for discharge.

scholarly journals Current Role of Surgery in Pancreatic Cancer With Synchronous Liver Metastasis

2020 ◽  
Vol 27 (1) ◽  
pp. 107327482097659
Author(s):  
Wentao Zhou ◽  
Dansong Wang ◽  
Wenhui Lou
Keyword(s):  
Pancreatic Cancer ◽  
Liver Metastasis ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Synchronous Liver Metastasis ◽  
Long Term Outcomes ◽  
Short And Long Term ◽  
Current Guidelines

Pancreatic cancer with synchronous liver metastasis has an extremely poor prognosis, and surgery is not recommended for such patients by the current guidelines. However, an increasing body of studies have shown that concurrent resection of pancreatic cancer and liver metastasis is not only technically feasible but also beneficial to the survival in the selected patients. In this review, we aim to summarize the short- and long-term outcomes following synchronous liver metastasectomy for pancreatic cancer patients, and discuss the potential criteria in selecting appropriate surgical candidates, which might be helpful in clinical decision-making.

Can we identify who will adhere to long-term physical activity? Signal detection methodology as a potential aid to clinical decision making.

1997 ◽  
Vol 16 (4) ◽  
pp. 380-389 ◽  
Author(s):  
Abby C. King ◽  
Michaela Kiernan ◽  
Roy F. Oman ◽  
Helena C. Kraemer ◽  
Mary Hull ◽  
...  
Keyword(s):  
Physical Activity ◽  
Decision Making ◽  
Signal Detection ◽  
Clinical Decision Making ◽  
Clinical Decision

Health-Related Quality of Life Measurement in Randomized Clinical Trials in Surgical Oncology

2006 ◽  
Vol 24 (19) ◽  
pp. 3178-3186 ◽  
Author(s):  
Jane M. Blazeby ◽  
Kerry Avery ◽  
Mirjam Sprangers ◽  
Hynek Pikhart ◽  
Peter Fayers ◽  
...  
Keyword(s):  
Decision Making ◽  
Randomized Trials ◽  
Clinical Decision Making ◽  
Surgical Oncology ◽  
Clinical Decision ◽  
Surgical Trials ◽  
Related Quality ◽  
Health Related

Purpose There is debate about the value of measuring health-related quality of life (HRQL) in clinical trials in oncology because of evidence suggesting that HRQL does not influence clinical decisions. Analysis of HRQL in surgical trials, however, may inform decision making because it provides detailed assessment of the immediate detrimental short-term impact of surgery on HRQL that needs to be considered against the long-term survival benefits and functional outcomes of surgery. This study evaluated whether HRQL in randomized trials in surgical oncology contributes to clinical decision making. Methods A systematic review identified randomized trials in surgical oncology with HRQL. Trials were evaluated independently by two reviewers and the value of HRQL in clinical decision making was categorized in three ways: whether trial investigators reported that HRQL influenced final treatment recommendations, whether trial investigators reported that HRQL would be useful for informed consent, and whether HRQL was assessed robustly according to predefined criteria. Results Thirty-three randomized trials with valid HRQL questionnaires were identified; 22 (67%) concluded that HRQL outcomes influenced treatment decisions or provided valuable data for informed consent, and seven of these trials had robust HRQL design. Another five trials had robust HRQL design but investigators reported that HRQL outcomes were not clinically important enough to influence treatment recommendations. Conclusion In surgical trials in oncology, HRQL informed clinical decision making. It is recommended that HRQL be included in relevant surgical trials, and that information be used to inform clinicians and patients about the impact of surgery on short- and long-term HRQL.

scholarly journals Understanding Neonatal Ventilation: Strategies for Decision Making in the NICU

2013 ◽  
Vol 32 (4) ◽  
pp. 246-261 ◽  
Author(s):  
Julia Petty
Keyword(s):  
Decision Making ◽  
Best Practice ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Current Evidence ◽  
Individual Level ◽  
Neonatal Ventilation ◽  
Ventilation Modes ◽  
Ventilation Strategies

AbstractNeonatal ventilation is an integral component of care delivered in the neonatal unit. The aim of any ventilation strategy is to support the neonate’s respiratory system during compromise while limiting any long-term damage to the lungs. Understanding the principles behind neonatal ventilation is essential so that health professionals caring for sick neonates and families have the necessary knowledge to understand best practice. Given the range of existing ventilation modes and parameters available, these require explanation and clarification in the context of current evidence. Many factors can influence clinical decision making on both an individual level and within the wider perspective of neonatal care.

Cancer Consultation Preparation Package: Changing Patients but Not Physicians Is Not Enough

2004 ◽  
Vol 22 (21) ◽  
pp. 4401-4409 ◽  
Author(s):  
Phyllis Butow ◽  
Rhonda Devine ◽  
Michael Boyer ◽  
Susan Pendlebury ◽  
Michael Jackson ◽  
...  
Keyword(s):  
Decision Making ◽  
Patient Involvement ◽  
Clinical Decision Making ◽  
Response Rate ◽  
Clinical Decision ◽  
Consultation Intervention ◽  
To Receive ◽  
Question Prompt

Purpose This study evaluated a cancer consultation preparation package (CCPP) designed to facilitate patient involvement in the oncology consultation. Patients and Methods A total of 164 cancer patients (67% response rate) were randomly assigned to receive the CCPP or a control booklet at least 48 hours before their first oncology appointment. The CCPP included a question prompt sheet, booklets on clinical decision making and patient rights, and an introduction to the clinic. The control booklet contained only the introduction to the clinic. Physicians were blinded to which intervention patients received. Patients completed questionnaires immediately after the consultation and 1 month later. Consultations were audiotaped, transcribed verbatim, and coded. Results All but one patient read the information. Before the consultation, intervention patients were significantly more anxious than were controls (mean, 42 v 38; P = .04); however anxiety was equivalent at follow-up. The CCPP was reported as being significantly more useful to family members than the control booklet (P = .004). Patients receiving the intervention asked significantly more questions (11 v seven questions; P = .005), tended to interrupt the physician more (1.01 v 0.71 interruptions; P = .08), and challenged information significantly more often (twice v once; P = .05). Patients receiving the CCPP were less likely to achieve their preferred decision making style (22%) than were controls (35%; P = .06). Conclusion This CCPP influences patients' consultation behavior and does not increase anxiety in the long-term. However, this intervention, without physician endorsement, reduced the percentage of patients whose preferred involvement in decision making was achieved.

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