scholarly journals Meta-analysis of predictive models to assess the clinical validity and utility for patient-centered medical decision making: application to the CAncer of the Prostate Risk Assessment (CAPRA)

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Marine Lorent ◽  
Haïfa Maalmi ◽  
Philippe Tessier ◽  
Stéphane Supiot ◽  
Etienne Dantan ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Decision Making ◽  
Predictive Models ◽  
Medical Decision Making ◽  
Meta Analysis ◽  
Medical Decision ◽  
Clinical Validity ◽  
Patient Centered ◽  
Cancer Of The Prostate

Overview of Legal Issues in Psychiatry

2017 ◽  
Author(s):  
Tracy D. Gunter
Keyword(s):  
Risk Assessment ◽  
Decision Making ◽  
Forensic Psychiatry ◽  
Medical Decision Making ◽  
Third Parties ◽  
Legal Issues ◽  
Medical Decision ◽  
Patient Relationship ◽  
Treatment Provider ◽  
Regulatory Issues

Psychiatrists routinely encounter legal and regulatory issues in the practice of psychiatry. This review provides an overview of the psychiatrist’s duties and responsibilities in the doctor-patient relationship and common legal issues arising in clinical practice, with reference to US statutory and regulatory practices. The field of forensic psychiatry is described, and the roles of the forensic evaluator and the treatment provider are compared. This review contains 2 figures, 5 tables, and 64 references. Key words: civil commitment, confidentiality, duty to third parties, forensic psychiatry, guardianship, gun ownership, medical decision making, medical marijuana, risk assessment 

scholarly journals Evaluating the Effects of Symptom Monitoring on Menopausal Health Outcomes: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 2 ◽  
Author(s):  
Robin Andrews ◽  
Gabrielle Hale ◽  
Bev John ◽  
Deborah Lancastle
Keyword(s):  
Systematic Review ◽  
Decision Making ◽  
Medical Decision Making ◽  
Meta Analysis ◽  
Menopausal Symptoms ◽  
Medical Decision ◽  
Health Awareness ◽  
Symptom Monitoring ◽  
Hot Flush ◽  
Doctor Communication

Evidence suggests that monitoring and appraising symptoms can result in increased engagement in medical help-seeking, improved patient-doctor communication, and reductions in symptom prevalence and severity. To date, no systematic reviews have investigated whether symptom monitoring could be a useful intervention for menopausal women. This review explored whether symptom monitoring could improve menopausal symptoms and facilitate health-related behaviours. Results suggested that symptom monitoring was related to improvements in menopausal symptoms, patient-doctor communication and medical decision-making, heightened health awareness, and stronger engagement in setting treatment goals. Meta-analyses indicated large effects for the prolonged use of symptom diaries on hot flush frequencies. Between April 2019 and April 2021, PsychInfo, EMBASE, MEDLINE, CINAHL, Cochrane, ProQuest, PsychArticles, Scopus, and Web of Science were searched. Eighteen studies met the eligibility criteria and contributed data from 1,718 participants. Included studies quantitatively or qualitatively measured the impact of symptom monitoring on menopausal populations and symptoms. Research was narratively synthesised using thematic methods, 3 studies were examined via meta-analysis. Key themes suggest that symptom monitoring is related to improvements in menopausal symptoms, improved patient-doctor communication and medical decision-making, increased health awareness, and stronger engagement in goal-setting behaviours. Meta-analysis results indicated large effects for the prolonged use of symptom diaries on hot flush frequency: 0.73 [0.57, 0.90]. This review is limited due to the low number of studies eligible for inclusion, many of which lacked methodological quality. These results indicate that symptom monitoring has potential as an effective health intervention for women with menopausal symptoms. This intervention may be beneficial within healthcare settings, in order to improve patient-doctor relations and adherence to treatment regimes. However, findings are preliminary and quality assessments suggest high risk of bias. Thus, further research is needed to support these promising outcomes.Systematic Review Registration Number:https://www.crd.york.ac.uk/prospero/display_record.php?, PROSPERO, identifier: CRD42019146270.

Overview of Legal Issues in Psychiatry

2017 ◽  
Author(s):  
Tracy D. Gunter
Keyword(s):  
Risk Assessment ◽  
Decision Making ◽  
Forensic Psychiatry ◽  
Medical Decision Making ◽  
Third Parties ◽  
Legal Issues ◽  
Medical Decision ◽  
Patient Relationship ◽  
Treatment Provider ◽  
Regulatory Issues

Psychiatrists routinely encounter legal and regulatory issues in the practice of psychiatry. This review provides an overview of the psychiatrist’s duties and responsibilities in the doctor-patient relationship and common legal issues arising in clinical practice, with reference to US statutory and regulatory practices. The field of forensic psychiatry is described, and the roles of the forensic evaluator and the treatment provider are compared. This review contains 2 figures, 5 tables, and 64 references. Key words: civil commitment, confidentiality, duty to third parties, forensic psychiatry, guardianship, gun ownership, medical decision making, medical marijuana, risk assessment 

Medical decision making: paternalism versus patient-centered (autonomous) care

2008 ◽  
Vol 14 (6) ◽  
pp. 708-713 ◽  
Author(s):  
Carlos A Rodriguez-Osorio ◽  
Guillermo Dominguez-Cherit
Keyword(s):  
Decision Making ◽  
Medical Decision Making ◽  
Medical Decision ◽  
Patient Centered

Patient-reported satisfaction with reconstructed breasts in the long-term survivorship period: Comparison of autologous and nonautologous breast reconstruction.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 9043-9043 ◽  
Author(s):  
Amie Scott ◽  
Adelyn Ho ◽  
Anne Klassen ◽  
Stefan Cano ◽  
Nancy VanLaeken ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Patient Satisfaction ◽  
Breast Reconstruction ◽  
Medical Decision Making ◽  
Univariate Analysis ◽  
Medical Decision ◽  
Patient Centered ◽  
Patient Reported ◽  
Type Of Surgery

9043 Background: Breast cancer patients undergoing mastectomy may choose to have reconstruction performed using either their own tissue or an implant. As many patients are candidates for both, valid and reliable patient-centered outcomes data are crucial to shared medical decision-making. The objective of this study is to determine whether patient-reported satisfaction with their reconstructed breasts is dependent on type of reconstructive surgery and length of time from reconstruction. Methods: Participants were recruited from Memorial Sloan-Kettering Cancer, NY and the University of British Columbia, Canada. Patients completed the BREAST-Q, a new patient-reported outcome measure for breast surgery patients. The dependent variable was the BREAST-Q Satisfaction with Breast score, a 16-item scale scored from 0-100. Procedure type, time since surgery, and patient characteristics were independent variables. Univariate analysis and clinical judgment were used to identify variables included in the model, and multivariate linear regression models were constructed to control for confounders. Results: The study sample consisted of 510 women (response rate 62%). The sample was on average aged 54.3 ± 9.3 (range 21-81), surveyed 3.71 years ± 1.55 (range 1-9) after surgery, 66% were reconstructed using an implant. Type of surgery and laterality were found to be variables that predicted higher patient satisfaction with their breasts after controlling for radiation therapy, follow-up time, timing of surgery, age, body mass index, and major complications (surgery type p<0.001; laterality p<0.001, R-square=0.17). Conclusions: As there is a growing population of breast cancer survivors, understanding how a woman’s satisfaction with her reconstructed breasts changes over time is essential. This study suggests that patient satisfaction with breast reconstruction depends on the type of reconstruction a woman undergoes. This patient-centered outcome data can be used to enhance shared medical decision-making by providing patients with information about realistic expectations for satisfaction with breasts related to type of surgery chosen.

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