scholarly journals The Importance of Telemedicine in a Post COVID World

2021 ◽  
Vol 5 (7) ◽  
pp. RV11-RV14
Author(s):  
Bhupesh Sharma ◽  
Sanjana Manocha ◽  
Nyagam Zangzom
Keyword(s):  
Time Management ◽  
Healthcare Sector ◽  
Patient Decision Making ◽  
Practical Applications ◽  
Patient Decision ◽  
Referral Systems ◽  
Consultation Time ◽  
Shed Light

Telemedicine has found immense popularity, especially in a COVID-19 affected world.  Its application shall improve the quality of health care provided to patients and help in time management as it help facilitates optimized referral systems which are based on the immediate/follow up needs of the patient, decision-making, reduction in patient’s waiting time as well as consultation time.  This review is an effort to shed light on the main practical applications of teledentistry for emphasizing potentialities, problems, and applications of this relatively new branch in medicine. The paper also highlighted highlight the various aspects of telemedicine in relation to the healthcare sector, its advantages/disadvantages in a post COVID-19 world.

scholarly journals Immune Checkpoints Expression in Chronic Lung Allograft Rejection

2021 ◽  
Vol 12 ◽  
Author(s):  
Ilaria Righi ◽  
Valentina Vaira ◽  
Letizia Corinna Morlacchi ◽  
Giorgio Alberto Croci ◽  
Valeria Rossetti ◽  
...  
Keyword(s):  
T Lymphocytes ◽  
Bronchiolitis Obliterans Syndrome ◽  
Immune Checkpoints ◽  
Hla Antibodies ◽  
Restrictive Allograft Syndrome ◽  
And Function ◽  
Shed Light

Chronic lung allograft dysfunction (CLAD) is the main cause of poor survival and low quality of life of lung transplanted patients. Several studies have addressed the role of dendritic cells, macrophages, T cells, donor specific as well as anti-HLA antibodies, and interleukins in CLAD, but the expression and function of immune checkpoint molecules has not yet been analyzed, especially in the two CLAD subtypes: BOS (bronchiolitis obliterans syndrome) and RAS (restrictive allograft syndrome). To shed light on this topic, we conducted an observational study on eight consecutive grafts explanted from patients who received lung re-transplantation for CLAD. The expression of a panel of immune molecules (PD1/CD279, PDL1/CD274, CTLA4/CD152, CD4, CD8, hFoxp3, TIGIT, TOX, B-Cell-Specific Activator Protein) was analyzed by immunohistochemistry in these grafts and in six control lungs. Results showed that RAS compared to BOS grafts were characterized by 1) the inversion of the CD4/CD8 ratio; 2) a higher percentage of T lymphocytes expressing the PD-1, PD-L1, and CTLA4 checkpoint molecules; and 3) a significant reduction of exhausted PD-1-expressing T lymphocytes (PD-1pos/TOXpos) and of exhausted Treg (PD-1pos/FOXP3pos) T lymphocytes. Results herein, although being based on a limited number of cases, suggest a role for checkpoint molecules in the development of graft rejection and offer a possible immunological explanation for the worst prognosis of RAS. Our data, which will need to be validated in ampler cohorts of patients, raise the possibility that the evaluation of immune checkpoints during follow-up offers a prognostic advantage in monitoring the onset of rejection, and suggest that the use of compounds that modulate the function of checkpoint molecules could be evaluated in the management of chronic rejection in LTx patients.

scholarly journals Evaluating the Quality of Patient Decision-Making Regarding Post-Acute Care

2018 ◽  
Vol 33 (5) ◽  
pp. 678-684 ◽  
Author(s):  
Robert E. Burke ◽  
Jacqueline Jones ◽  
Emily Lawrence ◽  
Amy Ladebue ◽  
Roman Ayele ◽  
...  
Keyword(s):  
Decision Making ◽  
Acute Care ◽  
Patient Decision Making ◽  
Patient Decision ◽  
Post Acute Care

scholarly journals Transanal Endoscopic Microsurgery (TEMS) for Rectal Cancer: Patient Decision-making, Postoperative Experience and Quality of Life

In Vivo ◽  
2021 ◽  
Vol 35 (2) ◽  
pp. 1235-1245
Author(s):  
ALEXANDRA KORELI ◽  
GEORGE BRIASSOULIS ◽  
MICHAIL SIDERIS ◽  
ANASTAS PHILALITHIS ◽  
SAVVAS PAPAGRIGORIADIS
Keyword(s):  
Quality Of Life ◽  
Decision Making ◽  
Rectal Cancer ◽  
Cancer Patient ◽  
Transanal Endoscopic Microsurgery ◽  
Rectal Cancer Patient ◽  
Patient Decision Making ◽  
Patient Decision ◽  
Endoscopic Microsurgery

Patient decision making, satisfaction, and quality of life following contralateral prophylactic mastectomy.

2010 ◽  
Vol 28 (15_suppl) ◽  
pp. e19610-e19610 ◽  
Author(s):  
R. Tuli ◽  
R. A. Chandra ◽  
E. Sugar ◽  
J. P. Christodouleas ◽  
R. A. Flynn ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Decision Making ◽  
Prophylactic Mastectomy ◽  
Contralateral Prophylactic Mastectomy ◽  
Patient Decision Making ◽  
Patient Decision

Survey of the Use of Physician Review Websites in Patients Under Orthopaedic Care (Preprint)

2021 ◽  
Author(s):  
Peter Joo ◽  
Carolyn Cook ◽  
Ingabire Kayihura ◽  
Jennifer Paul ◽  
Emmanuel Menga ◽  
...  
Keyword(s):  
Decision Making ◽  
Care Delivery ◽  
Healthcare Sector ◽  
Patient Centered ◽  
Patient Decision Making ◽  
Orthopaedic Care ◽  
Physician Review ◽  
Patient Decision ◽  
Physician Rating ◽  
Value Based Care

BACKGROUND Physician-rating websites (PRWs) are rising in popularity as the healthcare sector focuses more on patient-centered value-based care delivery. Recent studies have reported that the vast majority of orthopaedic surgeons across subspecialties already have at least one rating or review on at least one PRW. However, there are few studies identifying patient-facing factors related to the knowledge and use of PRWs and the level of influence PRWs may have on patient decision-making. OBJECTIVE The objectives of this study are: 1) to determine the prevalence of PRW use by patients seeking orthopaedic care, 2) to identify the influence PRWs have on patient decision-making, and 3) to identify factors associated with knowledge and use of PRWs. METHODS Survey administration was performed at three outpatient orthopaedic multi-specialty. Patients were asked about demographic characteristics including age, sex, occupation, and education, as well as their familiarity with PRWs, use of PRWs, and how PRWs have influenced their decision to see their surgeon. RESULTS A total of 350 patients completed the survey. The majority were women (59%) and Caucasian (77%), and the mean age of the population was 58 years old (range 15-91). 155 patients (44%) reported being somewhat (31%) or very (13%) familiar with PRWs, and 195 patients (56%) reported no familiarity with PRWs. Patients most familiar with PRWs were between 45-64 years old (p = 0.02), women (p < 0.01), had graduate/professional degrees (p < 0.01), and seen by adult reconstruction surgeons (p = 0.02). Seventy-two percent of patients utilizing PRWs reported that PRWs had an impact on their decision to see their chosen provider, with 93% noting ratings and reviews as the most valuable information. CONCLUSIONS Many patients in this study were not familiar with PRWs and did not utilize PRWs prior to their visit. However, most patients who did consult PRWs reported that the ratings and reviews did have an impact in their decision to choose their orthopaedic specialist. As PRW use increases, factors that influence patient decision-making are important to understand for surgeons and administrators.

scholarly journals A Model-Agnostic Approach for Understanding Heart Failure Risk Factors

2021 ◽  
Author(s):  
Seyed M. Miran ◽  
Stuart J. Nelson ◽  
Qing Zeng-Treitler
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Type 2 Diabetes ◽  
Health Records ◽  
Developing Heart ◽  
Complex Models ◽  
Shed Light

Abstract Objective: Understanding the risk factors for developing heart failure among patients with type 2 diabetes can contribute to preventing deterioration of quality of life for those persons. Electronic health records (EHR) provide an opportunity to use sophisticated machine learning models to understand and compare the effect of different risk factors for developing HF. As the complexity of the model increases, however, the transparency of the model often decreases. To interpret the results, we aimed to develop a model-agnostic approach to shed light on complex models and interpret the effect of features on developing heart failure. Using the HealthFacts EHR database of the Cerner EHR, we extracted the records of 723 patients with type 2 diabetes (with at least 6 yeas of follow up), and 134 of them developed heart failure. Using age and comorbidities as the features and heart failure as the outcome, we trained logistic regression, random forest, XGBoost, neural network, and then applied our proposed approach to rank the effect of each factor on developing heart failure.Results: Comparing with “importance score” built-in function from XGBoost, our proposed approach was more accurate in ranking the effect of the different risk factors on developing heart failure.

Why clinical trials may not help patients make treatment decisions: results from focus group discussions with 22 patients

2020 ◽  
Vol 9 (9) ◽  
pp. 651-658
Author(s):  
Thomas W Concannon ◽  
Christine M Lundquist ◽  
Jennifer S Lutz ◽  
David M Kent ◽  
Jessica K Paulus
Keyword(s):  
Clinical Trials ◽  
Treatment Decisions ◽  
Individual Treatment ◽  
Group Discussions ◽  
Patient Decision Making ◽  
Patient Decision ◽  
Care Information ◽  
Trial Participants ◽  
Broad Interest

Aim: Despite broad interest in advancing personalized medicine, most evidence is currently derived from average results of clinical trials that may obscure heterogeneity of trial participants. Little is known currently about how patients view heterogeneity in trials and whether they can participate in methodological discussions about this concept. Materials & methods: In structured discussions with three focus groups involving 22 participants, we assessed how representatives of patient communities have used research to guide individual treatment decisions. Discussion themes were organized into a framework describing patient decision-making in four steps: decisions patients make in the course of care; information used to make decisions; sources for information; and quality of information. Results/conclusion: Patients prioritize information that reflects their own characteristics, preferences and values. They struggle applying clinical research to their own case.

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