Evaluation of radiological contribution to patient management: the orthopedist's point of view

2021 ◽  
pp. 028418512110572
Author(s):  
Betul Guney ◽  
Erdal Uzun
Keyword(s):  
Decision Making ◽  
Patient Management ◽  
Time Pressure ◽  
Descriptive Analysis ◽  
Influential Factors ◽  
Point Of View ◽  
University Hospital ◽  
Radiology Report ◽  
Radiology Reports ◽  
The Impact

Background Orthopedists prefer imaging studies for the diagnosis, treatment, and follow-up of patients. Purpose To determine the effect of orthopedists’ characteristics, including subspecialty, age, education, and professional experience, in collaboration with radiologists and the usefulness of radiology reports for orthopedists in diagnosis and patient management. Material and Methods Questionnaires, consisting of 21 questions investigating the orthopedists’ characteristics, their behavior with radiology reports, their thoughts on communication, and collaboration with radiologists, were distributed to 205 orthopedists. Descriptive analysis was performed, and the effects of orthopedist characteristics on the outcomes was evaluated. Results In total, 161 out of 205 enrolled participants were included in the analysis. A total of 156 (96.9%) participants stated that they reviewed at least one official radiology report, with MRI receiving the highest rate (92.4%). The main reason provided for not reviewing the radiology reports and requests regarding changes to radiology report formats seemed to be mostly related to time pressure. Despite a significant portion of the participants stating that clinical and surgical findings were inconsistent with radiology reports, less than half were inclined to contact the radiologist most of the time or always. Increasing age ( P = 0.005), experience ( P = 0.016), and university hospital specialization ( P = 0.007) increased the tendency to form multidisciplinary team meetings. Communication with radiologists increased with age ( P < 0.001), while more experience reduced the impact of radiology reports on decision-making ( P = 0.035). Conclusion Increasing cooperation between orthopedists and radiologists will make a significant contribution to decision-making and treatment processes. Orthopedists’ characteristics are influential factors in establishing this communication.

Abstract 27: Patients' Perspectives on a Decision Aid to Facilitate Cost-sensitive Decisions for Sacubitril-Valsartan

2020 ◽  
Vol 13 (Suppl_1) ◽  
Author(s):  
Andrea R Mitchell ◽  
Grace Venechuk ◽  
Larry A Allen ◽  
Dan D Matlock ◽  
Miranda Moore ◽  
...  
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Decision Aid ◽  
Decision Aids ◽  
Descriptive Analysis ◽  
Patient Specific ◽  
Shared Decision ◽  
Cost Information ◽  
Reduced Ejection Fraction ◽  
The Impact

Background: Decision aids frequently focus on decisions that are preference-sensitive due to an absence of superior medical option or qualitative differences in treatments. Out of pocket cost can also make decisions preference-sensitive. However, cost is infrequently discussed with patients, and cost has not typically been considered in developing approaches to shared decision-making or decision aids. Determining a therapy’s value to a patient requires an individualized assessment of both benefits and cost. A decision aid addressing cost for sacubitril-valsartan in heart failure with reduced ejection fraction (HFrEF) was developed because this medication has clear medical benefits but can entail appreciable out-of-pocket cost. Objective: To explore patients’ perspectives on a decision aid for sacubitril-valsartan in HFrEF. Methods: Twenty adults, ages 32-73, with HFrEF who met general eligibility for sacubitril-valsartan were recruited from outpatient HF clinics and inpatient services at 2 geographically-distinct academic health systems. In-depth interviews were conducted by trained interviewers using a semi-structured guide after patients reviewed the decision aid. Interviews were audio-recorded and transcribed; qualitative descriptive analysis was conducted using a template analytic method. Results: Participants confirmed that cost was relevant to this decision and that cost discussions with clinicians are infrequent but welcomed. Participants cited multiple ways that this decision aid could be helpful beyond informing a choice; these included serving as a conversation starter, helping inform questions, and serving as a reference later. The decision aid seemed balanced; several participants felt that it was promotional, while others wanted a more “positive” presentation. Participants valued the display of benefits of sacubitril-valsartan but had variable views about how to apply data to themselves and heterogenous interpretations of a 3% absolute reduction in mortality over 2 years. None felt this benefit was overwhelming; about half felt it was very small. The decision aid incorporated a novel “gist statement” to contextualize benefits and counter tendencies to dismiss this mortality reduction as trivial. Several participants liked this statement; few had strong impressions. Conclusion: Out of pocket cost should be part of shared decision-making. These data suggest patients are receptive to inclusion of cost in decision aids and that a “middle ground” between being promotional and negative may exist. The data, however, raise concerns regarding potential dismissal of clinically meaningful benefits and illustrate challenges identifying appropriate contextualizing language. The impact of various framings warrants further study, as does integration of decision aids with patient-specific out-of-pocket cost information during clinical encounters.

Factors influencing cruise vacations: the impact of online reviews and environmental friendliness

2019 ◽  
Vol 74 (3) ◽  
pp. 400-415 ◽  
Author(s):  
Frida Bahja ◽  
Cihan Cobanoglu ◽  
Katerina Berezina ◽  
Carolin Lusby
Keyword(s):  
Decision Making ◽  
Influencing Factors ◽  
Online Reviews ◽  
Influential Factors ◽  
Decision Making Process ◽  
Relative Importance ◽  
Environmental Friendliness ◽  
Content Type ◽  
Cruise Line ◽  
The Impact

Purpose The purpose of the study was to discover the relative importance of influencing factors toward booking a cruise vacation. Based on a review of literature, this study focused on exploring the relative importance of six influential factors in cruise customers’ decision-making process: cruise vacation price, cruise duration, distance from the cruise port, itineraries, environmental friendliness of cruise line and cruise online reviews. Design/methodology/approach The complexity of cruise customers’ decision-making process for involving these six attributes with several levels was examined with choice-based conjoint (CBC) analysis. CBC was selected due to its realistic approach to purchase decisions, in the form of trade-offs. The online survey collected data anonymously. The survey was distributed through Amazon’s Mechanical Turk (Mturk) platform. The sample consisted of 450 cruise customers, who had experienced a cruise vacation before. Findings The findings of the study showed that online reviews were the most influential attribute for cruise customers in their cruise decision, followed very closely by the environmental friendliness of the cruise line. The next influential factor was the duration of the cruise vacation, which was followed by distance from the cruise port, cruise itinerary and cruise vacation price. The best and the worst cruise vacation profiles were generated based on the CBC analysis. Practical implications The findings of this study provide some insights with regard to cruise customers’ importance about influencing factors when deciding on a cruise vacation. Originality/value The research provides insides in understanding the influential factors at the last stage of cruise customers’ decision-making process. In this regard, cruise industry can pay more attention in promoting the attributes of a cruise offer as influential factors. Additionally, the findings of this study contribute to the general knowledge about cruise customers’ decision-making process.

scholarly journals Impact of programs on competency, career, and income on management graduates

2018 ◽  
Vol 53 (3) ◽  
pp. 441-458
Author(s):  
Roberto Brazileiro Paixão ◽  
Márcio Arcanjo de Souza
Keyword(s):  
Design Methodology ◽  
Graduate Programs ◽  
Descriptive Analysis ◽  
Analysis Data ◽  
Point Of View ◽  
Competency Development ◽  
Content Type ◽  
Income Development ◽  
Teaching Learning ◽  
The Impact

Purpose This paper aims to evaluate the impact of Federal University of Bahia’s Business Administration graduate programs on graduates’ competency, career and income development. Design/methodology/approach It is a descriptive study, for which a survey was applied and the data were analyzed using quantitative techniques (descriptive analysis, factorial analysis, t-test, Mann–Whitney test and regression analysis). Data collection was conducted through an electronic questionnaire sent to the graduates in the period between 1998 and 2012. Findings The results show that in general, the research participants perceive competency, career and income development after the course. At the same time, a comparison between the graduates of academic and professional axes (courses) was carried out, and in general, there is a certain similarity between perceptions. Originality/value This research contributes to the theoretical field on evaluation of graduates, both from a methodological point of view, because of conducted statistical analysis that is complementary to other methods used, and from a practical point of view, as it offers redesign and improvement elements to the program’s curricula and teaching-learning methodologies so that it can maximize competency development, career and income of graduates.

scholarly journals Advancing Pediatric Palliative Care In a Low-Middle Income Country: An  Implementation Study, A challenging but not impossible task

2020 ◽  
Author(s):  
Ximena Garcia-Quintero ◽  
Luis Gabriel Parra-Lara ◽  
Angelica Claros-Hulbert ◽  
Maria Isabel Cuervo-Suarez ◽  
Wendy Gomez-Garcia ◽  
...  
Keyword(s):  
Palliative Care ◽  
Service Providers ◽  
Pediatric Population ◽  
Descriptive Analysis ◽  
Tertiary Care ◽  
Care Program ◽  
University Hospital ◽  
Pediatric Palliative Care ◽  
Middle Income ◽  
The Impact

Abstract Background: The disparities in access to pediatric palliative care and pain management in Latin America remains an unaddressed global health issue. Efforts to improve the development of Palliative Care (PC) provision have traditionally targeted services for adults, leaving the pediatric population unaddressed. Examples of such services are scarce and should be portrayed in scientific literature to inform decision-makers and service providers on models of care available to tackle the burden of Pediatric Palliative Care (PPC) in Low-and middle-income countries (LMIC). The purpose of this study is to describe the implementation of a pediatric palliative care program, “Taking Care of You ” (TCY) , in a tertiary care, university hospital in Cali, Colombia. Methods: A program’s database was built with children between 0 to 18 years old and their families, from year 2017 to 2019. Descriptive analysis was carried out to evaluate the impact of the program and service delivery. A theory-based method was directed to describe the PPC program, according to the implementation of self-designed taxonomy, mapping theoretical levels and domains. Clinical outcomes in patients were included in the analysis. Results: Since 2017 the program has provided PPC services to 1.965 children. Most of them had an oncologic diagnosis and were referred from hospitalization services (53%). The number of ambulatory patients increased by 80% every trimester between 2017-2018. A 50% increase was reported in hospitalization, emergency, and intensive care units during the same time period. Conclusions: The program addressed a gap in the provision of PPC to children in Cali. It shows effective strategies used to implement a PPC program and how the referral times, coordination of care, communication with other hospital services were improved while providing compassionate/holistic care to children with life-limiting and threatening diseases and in end-of-life. The implementation of this program has required the onset of specific strategies and arrangements to promote awareness and education proving it a hard task, yet not impossible.

scholarly journals Behavioral Biases as An Effective Factor for the Firm Financial Decision-Making: A Literature Review

2016 ◽  
Vol 10 (2) ◽  
pp. 2103-2115
Author(s):  
Bilgehan TEKIN
Keyword(s):  
Decision Making ◽  
Behavioral Finance ◽  
Point Of View ◽  
Decision Making Process ◽  
International Studies ◽  
Negative Effects ◽  
Financial Decisions ◽  
Behavioral Biases ◽  
Effective Decision Making ◽  
The Impact

Decision-making process is a multi-faceted and complex process. Decision making can be defined like a process of choosing from among a number of alternatives. It will not contribute enough to be fully understood and to effective decision making to be addressed only from the rational point of view. Behavioral finance is an integral part of the decision-making process. Individuals can improve their performance by recognizing the biases which discussed in the framework of behavioral finance. Understanding the possible negative effects of biases allows to the individuals to make better choices and they can avoid repeating the expensive errors in future. Result of investigations of behavioral biases on decision-makers in the firms, managerial bias issue has been raised. The studies show the effect of managerial biases on many financial decisions in firms. This paper investigated the role of biases such as overconfidence, loss aversion, optimism, anchoring, narrow framing, self-serving attribution, disposition effect etc. on financial decisions such as investing, financing, equity market, capital structure etc. This study review of 30 international studies related with behavioral corporate finance and behavioral biases that affect financial decisions in firms. The studies were gleaned from Web of Science and Google Scholar. The main contribution of this study to the literature is this study brings out the impact of behavioral biases on financial decisions in the firms by summarizing the previous studies. In this sense, this work also has an assembly quality. Therefore, this is also intended with this study that to transfer the knowledge and intellectual formation about the impact of behavioral bias on the financial decisions. In this paper, most important behavioral biases in the behavioral finance literature will be addressed.

scholarly journals Influence of Behavioural Biases on Investment Decision Making in Bhubaneswar Region

2019 ◽  
Vol 8 (3) ◽  
pp. 8297-8301
Keyword(s):  
Decision Making ◽  
Investment Decision ◽  
Descriptive Analysis ◽  
Sampling Technique ◽  
Primary Data ◽  
Behavioural Finance ◽  
Investment Decision Making ◽  
Retail Investors ◽  
The Individual ◽  
The Impact

Behavioural Finance has gained a lot more importance in recent era. In the fast moving world where the standard finance fails to explain the irrational behavior of the investors, behavioural finance tries to identify the cause for such behavior which otherwise called as behavioural anomalies. The purpose of this research paper is to identify such anomalies and also to examine whether the behavioural biases has any influence in the investment decision making by the retail investors. This paper also put an emphasis to find out which among the different biases has the most and least influence on the individual investment decision making process. This study has used primary data for knowing the impact of factors such as gender, age, occupation, income, sector preference, and instruments preferred for investments, source of information, intention behind investment and consideration before investment. Descriptive analysis has been done to check the impact of these factors along with correlation and other. The sampling technique used here is non-probabilistic convenience sampling. The data has been collected through structured questionnaire based on five point Likert scale from the retail investors of Bhubaneswar region. This research shall interest the company, policy makers and the issuers of securities about the interest and preferences of individuals before issuing securities in the market.

scholarly journals The impact of enterprise systems in management decision making

2012 ◽  
Vol 1 (1) ◽  
pp. 68-72
Author(s):  
Muthuvelayutham C ◽  
Sugantha lakshm T
Keyword(s):  
Decision Making ◽  
Enterprise Resource Planning ◽  
Local Level ◽  
Resource Planning ◽  
Management Control ◽  
Point Of View ◽  
Management Decision ◽  
Erp Systems ◽  
Erp System ◽  
The Impact

An Enterprise Resource Planning (ERP) system is composed of a basic transactional system and a management control system. Sammon et al. (2003) describesthese 2 components of ERP systems as the solution to “operational” integration problems and “informational” requirements of managers. Thus, the extreme standardisation of business process inherent in ERP systems creates huge volumes of data without providing a clue for how to exploit it and may therefore not beneficial from a decision-making point of view. In this paper, decision-making theory and models are reviewed, focusing on how an ERP implementation might impact on these constructs. This paper is an analysis about centralisation of decision making in an organisation and its impact on performance at a local level.

scholarly journals Analisis Kebijakan Penanganan Wabah Covid-19: Pengalaman Indonesia

2020 ◽  
Vol 16 (2) ◽  
pp. 253-270
Author(s):  
Leo Agustino
Keyword(s):  
Decision Making ◽  
Policy Analysis ◽  
Central Government ◽  
Virus Disease ◽  
Descriptive Analysis ◽  
Corona Virus ◽  
The Government ◽  
Data Collection Technique ◽  
The Impact ◽  
Weak Coordination

This article discusses the efforts of the Indonesian Government in handling the outbreak of Corona Virus Disease-19 (COVID-19). The handling strategies assessed by understanding the efforts, steps, and policies formulated and implemented by the government while the analysis used a deliberative policy analysis approach was used. This approach analyzes the narratives and arguments of the authorities to understand the decision making and policy implementation. The research used a qualitative approach by utilizing descriptive analysis methods. Then the data collection technique used literature studies. The findings found that, first, negative narratives and the slow response of the government. Before COVID-19 approached Indonesia, narratives delivered by the elite government showed that there was no sense of crisis so that it slow-down decision making. Second, weak coordination, especially between the central government and regional governments. This asynchronous coordination created uncertain handling for the control of Coronavirus. Third, citizen ignorance or disobey government instruction. The impact is, the handling effort has stalled because it is not supported by the wider community. The combination of these three factors complicates the government's efforts to control the outbreak of COVID-19 in Indonesia. Keywords: Indonesia, COVID-19, Coronavirus, Handling, Policy Abstrak Artikel ini mendiskusikan mengenai upaya Pemerintah Indonesia dalam menangani kasus penyebaran virus korona (Corona Virus Disease-19 (COVID-19). Dengan memahami upaya, langkah, dan kebijakan yang diformulasi dan diimplementasikan oleh pemerintah maka dapat dinilai strategi penanganan tersebut. Untuk menganalisis kasus ini, pendekatan deliberative policy analysis digunakan. Pendekatan ini menganalisis narasi dan argumentasi pihak berwenang untuk memahami pembuatan keputusan dan pelaksanaan kebijakan. Penulisan artikel ini menggunakan pendekatan kualitatif dengan memanfaatkan metode deskriptif analisis. Sementara itu, teknik pengumpulan data yang digunakan adalah studi kepustakaan yang memanfaatkan buku, artikel jurnal, surat kabar, berita online, serta website lembaga-lembaga otoritatif. Temuan penting dari tulisan ini adalah, pertama, narasi negatif dan lambannya respons pemerintah atas penyebaran COVID-19. Narasi-narasi yang disampaikan oleh elite politik sebelum COVID-19 masuk ke Indonesia menunjukkan nihilnya perasaan adanya krisis (sense of crisis) yang mengancam sehingga memperlambat pengambilan keputusan. Kedua, lemahnya koordinasi antar-stakeholder, khususnya antara pemerintah pusat dan pemerintah daerah. Ketidaksinkronan koordinasi ini mengakibatkan pengendalian virus korona menjadi terkatung-katung. Ketiga, ketidakacuhan atau ketidakpatuhan warga atas himbauan pemerintah. Impaknya, upaya penanganan menjadi tersendat karena tidak didukung oleh masyarakat luas. Kombinasi dari ketiga faktor inilah yang memperumit upaya pemerintah untuk mengendalikan penyebaran COVID-19 di Indonesia. Kata Kunci: Indonesia, COVID-19, Virus Korona, Penanganan, Kebijakan

scholarly journals Radiology report format preferred by requesting physicians: prospective analysis in a population of physicians at a university hospital

2019 ◽  
Vol 52 (2) ◽  
pp. 97-103 ◽  
Author(s):  
Denise Maria Rissato Camilo ◽  
Tiago Kojun Tibana ◽  
Isa Félix Adôrno ◽  
Rômulo Florêncio Tristão Santos ◽  
Camila Klaesener ◽  
...  
Keyword(s):  
University Hospital ◽  
Radiology Report ◽  
Radiological Investigation ◽  
Residency Programs ◽  
Levels Of Detail ◽  
Radiology Reports ◽  
Structured Reports ◽  
Attending Physicians

Abstract Objective: To improve communication between attending physicians and radiologists by defining which information should be included in radiology reports and which reporting format is preferred by requesting physicians at a university hospital. Materials and Methods: Respondents were asked to choose among reports with different formats and levels of detail, related to three hypothetical cases, and questioned as to which characteristics commonly found in radiology reports are appropriate for inclusion. To assign the absolute order of preference of the different reports, the Kemeny-Young method was used. Results: Ninety-nine physicians completed the questionnaires (40.4% were resident physicians; 31.3% were preceptors of residency programs; and 28.3% were professors of medicine). For ultrasound with normal findings, ultrasound showing alterations, and computed tomography, respectively, 54%, 59%, and 53% of the respondents chose structured reports with an impression or comment. According to the respondents, the characteristics that should be included in the radiology report are the quality of the image, details of the clinical presentation, diagnostic impression, examination technique, and information about contrast administration, selected by 92%, 91%, 89%, 72%, and 68%, respectively. Other characteristics that were considered important were recommendations on follow-up and additional radiological or non-radiological investigation. Conclusion: Requesting physicians apparently prefer structured reports with a radiologist impression or comment. Information such as the quality of the examination, the contrast agent used, and suggestions regarding follow-up and additional investigation are valued.

scholarly journals Subspecialized Radiological Reporting Expedites Turnaround Time of Radiology Reports and Increases Productivity

2018 ◽  
Vol 190 (07) ◽  
pp. 623-629 ◽  
Author(s):  
Christoph Stern ◽  
Thomas Boehm ◽  
Burkhardt Seifert ◽  
Nadine Kawel-Boehm
Keyword(s):  
Turnaround Time ◽  
Radiology Department ◽  
Full Time ◽  
Imaging Studies ◽  
Radiology Report ◽  
Chi Square ◽  
Radiology Reports ◽  
Key Points ◽  
Chi Square Test ◽  
The Impact

Introduction To assess the impact of changing from general to subspecialized reporting on turnaround time of radiology reports (TAT), the fraction of radiology reports available within 24 hours (R< 24 h) and productivity. Materials and Methods Reporting workflow in our radiology department was changed from general reporting (radiologists report imaging studies of all areas [neuroradiological, abdominal, musculoskeletal imaging et cetera]) to subspecialized reporting (radiologists solely report imaging studies of their subspecialty field [e. g. musculoskeletal]). TAT, R< 24 h and productivity were calculated for a 12-month period of general reporting (January-December 2012) and compared to a 12-month period of subspecialized reporting (April 2014-March 2015) using Mann Whitney U-test, Pearson chi-square test and odds ratios, respectively. Results Report TAT decreased from a median of 17:04 hours (h) during general reporting to 3:38 h during subspecialized reporting, resulting in a 4.7-fold improvement (p < 0.001). R< 24 h improved significantly from 65 % to 87 % (p < 0.001). The odds of a radiology report being available < 24 h was 3.6- fold higher during subspecialized compared to general reporting. Productivity increased from a median of 301 to 376 (reports/full-time radiologist/month) (p = 0.001). Conclusion Changing the workflow from general to subspecialized reporting significantly improved the turnaround time of radiology reports, the fraction of radiology reports available within 24 hours and productivity. Key Points:  Citation Format

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