scholarly journals Opioid maintenance treatment in the Czech Republic, Norway and Denmark: a study protocol of a comparative registry linkage study

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e047028
Author(s):  
Roman Gabrhelík ◽  
Marte Handal ◽  
Viktor Mravčík ◽  
Blanka Nechanská ◽  
Christian Tjagvad ◽  
...  
Keyword(s):  
Czech Republic ◽  
Maintenance Treatment ◽  
Clinical Decision Making ◽  
Treatment Success ◽  
Ethics Committees ◽  
Clinical Decision ◽  
International Classification Of Diseases ◽  
Linkage Study ◽  
Opioid Maintenance Treatment ◽  
The Czech Republic

IntroductionOpioid maintenance treatment (OMT) varies across settings and between countries. We plan to use data from several nationwide health and population registers to further improve the knowledge base established from earlier studies. Our aim is to study OMT adherence trajectories and to identify factors associated with improved outcomes for OMT patients across the Czech Republic, Norway and Denmark, in order to further improve OMT and our understanding of the key elements of treatment success.Methods and analysisThe registry-based cohort approach across the three countries allows us to link data from a range of registers on the individual level, by using personal identifiers in nationwide cohorts of OMT and non-OMT patients and the general non-using populations. A total of ~21 500 OMT patients over the last two decades in all three countries will be included in the study. The following outcome variables (based on the International Classification of Diseases, 10th Revision codes) will be obtained from relevant registers: treatment adherence to OMT, comorbidity (somatic and mental health), and all-cause and cause-specific mortality. Outcomes of the country-specific analyses will be pooled.Ethics and disseminationThe national OMT cohorts have been approved by the ethics committees in the respective countries. Data will be stored according to national and local guidelines and treated confidentially, and all data will be analysed separately for each country and compared across countries. Findings will be disseminated in peer-reviewed scientific journals, national and international conferences, and in briefings to inform clinical decision-making.

Introduction

2018 ◽  
Author(s):  
John R. Peteet ◽  
Mary Lynn Dell ◽  
Wai Lun Alan Fung
Keyword(s):  
Decision Making ◽  
Clinical Decision Making ◽  
Ethics Committees ◽  
Clinical Decision ◽  
Cultural Formulation ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Dsm 5 ◽  
Religious Professionals ◽  
The Relationship

Historical tensions between psychiatry and religion continue to hinder dialogue and restrict consensus on how to approach areas of overlap in clinical decision making. In Part One, contributors to this volume discuss concerns arising in the general areas of values, religious and psychiatric ethics, diagnosis and treatment, and the work of religious professionals and ethics committees. In Part Two, chapter authors consider these issues as they arise within various subspecialties of psychiatric practice, often using the Jonsen Four Topics (or Four Quadrants) Model. The theme of the relationship between religion and culture runs throughout and is addressed more directly than in the Outline for Cultural Formulation in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).

The clinical utility of the ICD-11 classification of personality disorders and related traits: A preliminary scoping review

2021 ◽  
pp. 000486742110256
Author(s):  
Mikaela Tracy ◽  
Nikolaos Tiliopoulos ◽  
Louise Sharpe ◽  
Bo Bach
Keyword(s):  
Clinical Utility ◽  
Clinical Decision Making ◽  
Strong Support ◽  
Diagnostic System ◽  
Clinical Decision ◽  
International Classification Of Diseases ◽  
Ease Of Use ◽  
Electronic Screening ◽  
Study Characteristics

Objectives: A diagnostic system that fails to deliver clinically useful information will not be utilized and consequently will be unable to provide valuable data for health policy and clinical decision making. Therefore, it is imperative to obtain an accurate depiction of the clinical utility of the eleventh revision of the International Classification of Diseases (ICD-11) Personality Disorder (PD) model. The current mixed-methods systematic review aimed to determine the clinical utility of the ICD-11 PD classification system. Method: An electronic screening of six databases was conducted and resulting studies were subjected to specific exclusion criteria, which elicited eight studies of interest. Study characteristics were tabulated and methodological quality was appraised. Results: Four studies offered strong support for the model’s clinical utility, three offered some support accompanied by notable limitations and one study could only offer criticisms. Conclusion: Future investigation of the ICD-11 PD classification system’s (a) communicative value between clinicians and their patients, and between clinicians and their patient’s families; (b) ease of use; and (c) feasibility in terms of practical application is required to achieve a complete understanding of its clinical utility and ultimately bring clarity to the current ambiguous findings.

scholarly journals Representation of Parkinson's disease and atypical Parkinson's syndromes in the Czech Republic—A nationwide retrospective study

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246342
Author(s):  
Jiří Búřil ◽  
Petra Búřilová ◽  
Andrea Pokorná ◽  
Ingrid Kováčová ◽  
Marek Baláž
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Czech Republic ◽  
Basal Ganglia ◽  
National Health ◽  
International Classification Of Diseases ◽  
The Czech Republic ◽  
Classification Of Diseases ◽  
Icd 10

Background Parkinson's disease is a progressive neurodegenerative disease which causes health problem that affects more patients in the past few years. To be able to offer appropriate care, epidemiological analyses are crucial at the national level and its comparison with the international situation. Aim The demographic description of reported patients with parkinsonism (including Parkinson's disease and atypical parkinsonian syndromes) according to the International Classification of Diseases (ICD-10) from the national health registries. Methods Retrospective analysis of data available from the National Health Information System–NHIS and the National Registry of Reimbursed Health Services (NRRHS). Analyzed epidemiological data are intending to determine the regional and specific prevalence of Parkinsonism in the Czech Republic. The International Classification of Diseases diagnoses (ICD-10) of G20 (Parkinson’s disease—PD) and G23.1, G23.2, G23.3 (other degenerative disorders of basal ganglia), and G31.8 (another degenerative disease of basal ganglia) from the period of 2012 to 2018 were included into the analysis. Results We identified 78 453 unique patients from national registries in the period 2012 to 2018. Diagnoses of G20, G23.1, G23.2, and G31.8 were registered as the principal diagnoses in 76.6% of all individual patients. Conclusion We have found a growing number of patients coded with ICD-10 of dg. G20, G23.1, G23.2, G23.3, or G31.8 (N = 27 891 in 2012, and N = 30 612 in 2018). We have proven regional differences in the prevalence of Parkinson´s diagnoses. Therefore we assume most likely also differences in the care of patients with PD based on the availability of specialty care centers.

scholarly journals Reassessing “Praecox Feeling” in Diagnostic Decision Making in Schizophrenia: A Critical Review

2018 ◽  
Vol 45 (5) ◽  
pp. 966-970 ◽  
Author(s):  
Tudi Gozé ◽  
Marcin Moskalewicz ◽  
Michael A Schwartz ◽  
Jean Naudin ◽  
Jean-Arthur Micoulaud-Franchi ◽  
...  
Keyword(s):  
Decision Making ◽  
Clinical Judgment ◽  
Critical Review ◽  
Clinical Decision Making ◽  
Reliability And Validity ◽  
Clinical Decision ◽  
International Classification Of Diseases ◽  
Diagnostic Methods ◽  
Medical Decision ◽  
Clinical Expertise

AbstractThe “Praecox Feeling” (PF) is a classical concept referring to a characteristic feeling of bizarreness experienced by a psychiatrist while encountering a person with schizophrenia. Although the PF used to be considered a core symptom of the schizophrenia spectrum, it fell into disuse since the spread of operationalized diagnostic methods (Diagnostic and Statistical Manual of Mental Disorders/International Classification of Diseases systems). In contemporary research on schizophrenia, it remains largely unaddressed. This critical review investigates the evolution of the PF in historical and contemporary literature and presents an exhaustive overview of empirical evidence on its prevalence in clinical decision making, its reliability and validity. The review demonstrates that the PF is a real determinant of medical decision making in schizophrenia, although, without further research, there is not enough evidence to sustain its rehabilitation as a reliable and valid clinical criterion. PF-like experiences should not be opposed to any criteriological attitude in diagnosis and would be clinically useful if the conditions of descriptive precaution and rigorous epistemology are maintained. The aim of teaching clinical expertise is to transform this basic experience into a well-founded clinical judgment. Finally, the article discusses the possible relevance of the PF for basic science and clinical research according to a translational approach inspired by phenomenology.

scholarly journals A Digital Twins Machine Learning Model for Forecasting Disease Progression in Stroke Patients

2021 ◽  
Vol 11 (12) ◽  
pp. 5576
Author(s):  
Angier Allen ◽  
Anna Siefkas ◽  
Emily Pellegrini ◽  
Hoyt Burdick ◽  
Gina Barnes ◽  
...  
Keyword(s):  
Machine Learning ◽  
Clinical Trials ◽  
Ischemic Stroke ◽  
Clinical Decision Making ◽  
Simulated Data ◽  
Clinical Decision ◽  
International Classification Of Diseases ◽  
Real Patient ◽  
Digital Twin ◽  
Twin Model

Background: Machine learning methods have been developed to predict the likelihood of a given event or classify patients into two or more diagnostic categories. Digital twin models, which forecast entire trajectories of patient health data, have potential applications in clinical trials and patient management. Methods: In this study, we apply a digital twin model based on a variational autoencoder to a population of patients who went on to experience an ischemic stroke. The digital twin’s ability to model patient clinical features was assessed with regard to its ability to forecast clinical measurement trajectories leading up to the onset of the acute medical event and beyond using International Classification of Diseases (ICD) codes for ischemic stroke and lab values as inputs. Results: The simulated patient trajectories were virtually indistinguishable from real patient data, with similar feature means, standard deviations, inter-feature correlations, and covariance structures on a withheld test set. A logistic regression adversary model was unable to distinguish between the real and simulated data area under the receiver operating characteristic (ROC) curve (AUCadversary = 0.51). Conclusion: Through accurate projection of patient trajectories, this model may help inform clinical decision making or provide virtual control arms for efficient clinical trials.

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