scholarly journals Current Indications of Secondary Enucleation in Retinoblastoma Management: A Position Paper on Behalf of the European Retinoblastoma Group (EURbG)

Cancers ◽  
2021 ◽  
Vol 13 (14) ◽  
pp. 3392
Author(s):  
Christina Stathopoulos ◽  
Livia Lumbroso-Le Rouic ◽  
Annette C. Moll ◽  
Manoj Parulekar ◽  
Philippe Maeder ◽  
...  
Keyword(s):  
Decision Making ◽  
Optic Nerve ◽  
Disease Progression ◽  
Optic Nerve Head ◽  
Conservative Management ◽  
Position Paper ◽  
Evidence Based ◽  
The Past ◽  
Biologic Markers ◽  
Disease Persistence

Secondary enucleation (SE) puts an irreversible end to eye-preserving therapies, whenever their prolongation is expected to violate the presumed state of metastatic grace. At present, it must be acknowledged that clear criteria for SE are missing, leading to empiric and subjective indications commonly related to disease progression or relapse, disease persistence masking the optic nerve head or treatment-related complications obscuring the fundus view. This absence of evidence-based consensus regarding SE is explained by the continuously moving frontiers of the conservative management as a result of diagnostic and therapeutic advances, as well as by the lack of studies sufficiently powered to accurately stratify the risk of metastasis in conservatively treated patients. In this position paper of the European Retinoblastoma Group (EURbG), we give an overview of the progressive shift in the indications for SE over the past decades and propose guidelines to assist decision-making with respect to when SE becomes imperative or recommended, with corresponding absolute and relative SE indications. Further studies and validation of biologic markers correlated with the risk of metastasis are expected to set more precisely the frontiers of conservative management and thus consensual criteria for SE in the future.

Evidence-based Assessment

2010 ◽  
pp. 76-98
Author(s):  
John Hunsley ◽  
Eric J. Mash
Keyword(s):  
Decision Making ◽  
Clinical Assessment ◽  
Assessment Process ◽  
Evidence Based ◽  
The Past ◽  
Specific Assessment ◽  
The Many ◽  
Selection Of ◽  
Made In

Evidence-based assessment relies on research and theory to inform the selection of constructs to be assessed for a specific assessment purpose, the methods and measures to be used in the assessment, and the manner in which the assessment process unfolds. An evidence-based approach to clinical assessment necessitates the recognition that, even when evidence-based instruments are used, the assessment process is a decision-making task in which hypotheses must be iteratively formulated and tested. In this chapter, we review (a) the progress that has been made in developing an evidence-based approach to clinical assessment in the past decade and (b) the many challenges that lie ahead if clinical assessment is to be truly evidence-based.

scholarly journals What Role Can Process Mining Play in Recurrent Clinical Guidelines Issues? A Position Paper

2020 ◽  
Vol 17 (18) ◽  
pp. 6616
Author(s):  
Roberto Gatta ◽  
Mauro Vallati ◽  
Carlos Fernandez-Llatas ◽  
Antonio Martinez-Millana ◽  
Stefania Orini ◽  
...  
Keyword(s):  
Medical Informatics ◽  
Clinical Guidelines ◽  
Process Mining ◽  
State Of The Art ◽  
Position Paper ◽  
Evidence Based ◽  
The Past ◽  
Relevant Role ◽  
Indispensable Tool ◽  
Based Medicine

In the age of Evidence-Based Medicine, Clinical Guidelines (CGs) are recognized to be an indispensable tool to support physicians in their daily clinical practice. Medical Informatics is expected to play a relevant role in facilitating diffusion and adoption of CGs. However, the past pioneering approaches, often fragmented in many disciplines, did not lead to solutions that are actually exploited in hospitals. Process Mining for Healthcare (PM4HC) is an emerging discipline gaining the interest of healthcare experts, and seems able to deal with many important issues in representing CGs. In this position paper, we briefly describe the story and the state-of-the-art of CGs, and the efforts and results of the past approaches of medical informatics. Then, we describe PM4HC, and we answer questions like how can PM4HC cope with this challenge? Which role does PM4HC play and which rules should be employed for the PM4HC scientific community?

Student paramedic decision-making: a critical exploration of a patient interaction

2021 ◽  
Vol 13 (2) ◽  
pp. 76-80
Author(s):  
Barry Costello ◽  
Simon Downs
Keyword(s):  
Decision Making ◽  
Clinical Reasoning ◽  
Health Professionals ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Lead Author ◽  
Evidence Based ◽  
Patient Encounter ◽  
The Past ◽  
Patient Interaction

Clinical decision-making is a multifaceted construct, requiring the practitioner to gather, interpret and evaluate data to select and implement an evidence-based choice of action. Clinical reasoning is a difficult skill for students to develop due in part to the inability to guarantee awareness or opportunity to develop within time spent in practice. While professional developments within the past few years have established a supportive preceptorship programme within NHS trusts for new paramedic registrants, enhancing activities to develop these crucial skills within a pre-registrant programme should be prioritised to enhance the abilities of students and subsequent new registrants. A better understanding of the reasoning processes used during clinical decision-making may help health professionals with less experience to develop their processes in their own clinical reasoning. To embed such awareness and enhanced practice, the lead author, a third-year student paramedic at the time of writing, presents a reflective consideration of a patient encounter using the hypothetico-deductive model to evaluate and critically explore his own reasoning and processing within a meaningful patient interaction.

Evidence-based Assessment

2014 ◽  
pp. 75-91
Author(s):  
John Hunsley ◽  
Eric J. Mash
Keyword(s):  
Decision Making ◽  
Clinical Assessment ◽  
Assessment Process ◽  
Evidence Based ◽  
The Past ◽  
Specific Assessment ◽  
The Many ◽  
Selection Of ◽  
Made In

Evidence-based assessment relies on research and theory to inform the selection of constructs to be assessed for a specific assessment purpose, the methods and measures to be used in the assessment, and the manner in which the assessment process unfolds. An evidence-based approach to clinical assessment necessitates the recognition that, even when evidence-based instruments are used, the assessment process is a decision-making task in which hypotheses must be iteratively formulated and tested. In this chapter, we review (a) the progress that has been made in developing an evidence-based approach to clinical assessment in the past decade and (b) the many challenges that lie ahead if clinical assessment is to be truly evidence-based.

Abstraction: An alternative neurocognitive account of recognition, prediction, and decision making

2020 ◽  
Vol 43 ◽  
Author(s):  
Valerie F. Reyna ◽  
David A. Broniatowski
Keyword(s):  
Decision Making ◽  
Software Engineering ◽  
Systems Engineering ◽  
Evidence Based ◽  
Extensive Literature ◽  
Trace Theory ◽  
Fuzzy Trace Theory ◽  
Abstract Representations ◽  
Technical Systems

Abstract Gilead et al. offer a thoughtful and much-needed treatment of abstraction. However, it fails to build on an extensive literature on abstraction, representational diversity, neurocognition, and psychopathology that provides important constraints and alternative evidence-based conceptions. We draw on conceptions in software engineering, socio-technical systems engineering, and a neurocognitive theory with abstract representations of gist at its core, fuzzy-trace theory.

Debates in Dysphagia Management: How Do You Use Evidence-Based Practice in Your Dysphagia Patient Care?

2011 ◽  
Vol 20 (4) ◽  
pp. 121-123
Author(s):  
Jeri A. Logemann
Keyword(s):  
Decision Making ◽  
Patient Care ◽  
Clinical Outcomes ◽  
Clinical Judgment ◽  
Clinical Decision Making ◽  
Evidence Based Practice ◽  
Clinical Decision ◽  
Evidence Based ◽  
Clinical Method ◽  
Do So

Evidence-based practice requires astute clinicians to blend our best clinical judgment with the best available external evidence and the patient's own values and expectations. Sometimes, we value one more than another during clinical decision-making, though it is never wise to do so, and sometimes other factors that we are unaware of produce unanticipated clinical outcomes. Sometimes, we feel very strongly about one clinical method or another, and hopefully that belief is founded in evidence. Some beliefs, however, are not founded in evidence. The sound use of evidence is the best way to navigate the debates within our field of practice.

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