scholarly journals Patients after persistent foramen ovale (PFO) closure: long-term benefits and risks. A contemporary approach to guide clinical decision making.

2021 ◽  
Author(s):  
Christian Pristipino ◽  
Fausta Barbara Filice
Keyword(s):  
Decision Making ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Foramen Ovale ◽  
Persistent Foramen Ovale ◽  
Pfo Closure ◽  
Contemporary Approach

scholarly journals Blood transfusion prescribing in the ACT: an insight into clinical decision making

2005 ◽  
Vol 29 (2) ◽  
pp. 240 ◽  
Author(s):  
Philip J Crispin ◽  
Bethany J Crowe ◽  
Anne M McDonald
Keyword(s):  
Decision Making ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Early Discharge ◽  
Organisation Of Care ◽  
Metropolitan Hospital ◽  
Loss Of Appetite ◽  
Insight Into ◽  
Structured Questionnaire

This study aimed to determine the perspectives of a group of patients categorised as ?long-stay outliers? at a large South Australian metropolitan hospital about aspects of organisation of care and the perceived impact of long-term hospitalisation. Nineteen patients were interviewed using a semi-structured questionnaire. Eighty-nine percent of participants stated that they had no knowledge of how long they were to be in hospital. Forty-two percent indicated that they did not know when they would be discharged from hospital. This was of concern, especially considering the vulnerability of this patient group and the known benefits of patient involvement in decision making and the improvements this can make to health outcomes and early discharge. Participants indicated concern about sleep deprivation, diet, ability to return to paid employment, and missing their family as the main areas of impact of their long hospitalisation. Concerns about being discharged from hospital included: apprehension as to whether they were well enough to leave; the recurrence of infection; whether they would be able to sleep well when they got home; their recent loss of appetite and associated weight loss; mobility concerns; and what supports they would have when they were discharged home. All these issues require staff to be more patient and family-centred in their approach to preparing for discharge.

scholarly journals CLINICAL DECISION MAKING FOR THE HEMODYNAMIC GRAY ZONE (FFR 0.75-0.80) AND IMPACT ON LONG TERM OUTCOMES

2016 ◽  
Vol 67 (13) ◽  
pp. 379 ◽  
Author(s):  
Shiv Kumar Agarwal ◽  
Mohan Edupuganti ◽  
Ahmed Almomani ◽  
Naga Venkata Pothineni ◽  
Jason Payne ◽  
...  
Keyword(s):  
Decision Making ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Gray Zone ◽  
Long Term Outcomes

Can we identify who will adhere to long-term physical activity? Signal detection methodology as a potential aid to clinical decision making.

1997 ◽  
Vol 16 (4) ◽  
pp. 380-389 ◽  
Author(s):  
Abby C. King ◽  
Michaela Kiernan ◽  
Roy F. Oman ◽  
Helena C. Kraemer ◽  
Mary Hull ◽  
...  
Keyword(s):  
Physical Activity ◽  
Decision Making ◽  
Signal Detection ◽  
Clinical Decision Making ◽  
Clinical Decision

Closure of persistent foramen ovale with the BioSTAR biodegradable PFO closure device: Feasibility and long-term outcome

2011 ◽  
Vol 45 (5) ◽  
pp. 267-272 ◽  
Author(s):  
Alexia Karagianni ◽  
Putte Abrahamsson ◽  
Eva Furenäs ◽  
Peter Eriksson ◽  
Mikael Dellborg
Keyword(s):  
Closure Device ◽  
Foramen Ovale ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Persistent Foramen Ovale ◽  
Pfo Closure

scholarly journals Diagnostic Accuracy of Contrast Transthoracic Echocardiography, Contrast Transcranial Doppler and Transesophageal Echocardiography in Patients Undergoing Patent Foramen Ovale Closure

2021 ◽  
Author(s):  
Kaijing Wang ◽  
Xianda Ni ◽  
Yuxin Wu ◽  
Chen Chen
Keyword(s):  
Diagnostic Accuracy ◽  
Cardiac Catheterization ◽  
Patent Foramen Ovale ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Diagnostic Value ◽  
Foramen Ovale ◽  
Group A ◽  
Group B ◽  
Pfo Closure

Abstract Purpose: To compare diagnostic accuracy of cTTE, cTCD and TEE in patients undergoing patent foramen ovale closure (PFO) so as to provide evidence for clinical decision-making.Methods: The clinical data of 140 patients with cerebral infarction or migraine who successfully underwent PFO closure or whose right cardiac catheterization results showed no PFO in our hospital were analyzed retrospectively, including clinical baseline, data of cTTE, cTCD and TEE.Results: Patients who successfully underwent PFO closure or whose right cardiac catheterization results showed no PFO were divided into group A and group B, respectively. The differences of the shunt in cTTE and cTCD, the diameter of PFO in TEE and the appearance of bubbles in cTTE were compared. The results showed that the proportion of medium-large shunt in group A was significantly higher than group B in resting cTCD, post-Valsalva cTCD and total cTCD respectively (67.35% VS 42.86%，P=0.004；100% VS 71.42%，P=0.0003；81.63% VS 51.43%，P=0.002). The proportion of medium-large shunt in group A was higher than group B in cTCD (75.90% VS 19.35%，P＜0.001). The diameters of PFO of group A were larger than group B in TEE (2.18±0.78 VS 1.19±0.78，P＜0.001). Take the successful PFO closure as the state variable. The ROC curves of cTTE, cTCD and TEE were made, and the results showed that cTCD and TEE had better sensitivity and specificity. The proportion of appearance of bubbles within 5 cardiac cycles in cTTE in group A was significantly higher than group B (73.47% VS 42.86%，P=0.005).Conclusions: For the patients with PFO to be occluded, the success rate of operation could be improved by selecting patients with larger shunt, larger diameter of foramen ovale and shorter interval in the appearance of bubbles. Otherwise, there was perhaps no PFO. cTCD and TEE had better diagnostic value for PFO closure than that of cTTE.

scholarly journals Patent foramen ovale and cryptogenic stroke: diagnosis and updates in secondary stroke prevention

2018 ◽  
Vol 3 (2) ◽  
pp. 84-91 ◽  
Author(s):  
Kristy Yuan ◽  
Scott Eric Kasner
Keyword(s):  
Patient Selection ◽  
Stroke Prevention ◽  
Patent Foramen Ovale ◽  
Clinical Decision Making ◽  
Cryptogenic Stroke ◽  
Clinical Decision ◽  
Current Evidence ◽  
Secondary Stroke Prevention ◽  
Foramen Ovale ◽  
Pfo Closure

The patent foramen ovale (PFO), given its high prevalence in the general population and especially in patients with cryptogenic stroke, has long generated investigation and debate on its propensity for stroke by paradoxical embolism and its management for stroke prevention. The pendulum has swung for percutaneous PFO closure for secondary stroke prevention in cryptogenic stroke. Based on a review of current evidence, the benefit from PFO closure relies on careful patient selection: those under the age of 60 years with few to no vascular risk factors and embolic-appearing stroke deemed cryptogenic after thorough evaluation. As these data look towards influencing guideline statements and device approvals in the future, patient selection remains the crucial ingredient for clinical decision making and future trials.

Health-Related Quality of Life Measurement in Randomized Clinical Trials in Surgical Oncology

2006 ◽  
Vol 24 (19) ◽  
pp. 3178-3186 ◽  
Author(s):  
Jane M. Blazeby ◽  
Kerry Avery ◽  
Mirjam Sprangers ◽  
Hynek Pikhart ◽  
Peter Fayers ◽  
...  
Keyword(s):  
Decision Making ◽  
Randomized Trials ◽  
Clinical Decision Making ◽  
Surgical Oncology ◽  
Clinical Decision ◽  
Surgical Trials ◽  
Related Quality ◽  
Health Related

Purpose There is debate about the value of measuring health-related quality of life (HRQL) in clinical trials in oncology because of evidence suggesting that HRQL does not influence clinical decisions. Analysis of HRQL in surgical trials, however, may inform decision making because it provides detailed assessment of the immediate detrimental short-term impact of surgery on HRQL that needs to be considered against the long-term survival benefits and functional outcomes of surgery. This study evaluated whether HRQL in randomized trials in surgical oncology contributes to clinical decision making. Methods A systematic review identified randomized trials in surgical oncology with HRQL. Trials were evaluated independently by two reviewers and the value of HRQL in clinical decision making was categorized in three ways: whether trial investigators reported that HRQL influenced final treatment recommendations, whether trial investigators reported that HRQL would be useful for informed consent, and whether HRQL was assessed robustly according to predefined criteria. Results Thirty-three randomized trials with valid HRQL questionnaires were identified; 22 (67%) concluded that HRQL outcomes influenced treatment decisions or provided valuable data for informed consent, and seven of these trials had robust HRQL design. Another five trials had robust HRQL design but investigators reported that HRQL outcomes were not clinically important enough to influence treatment recommendations. Conclusion In surgical trials in oncology, HRQL informed clinical decision making. It is recommended that HRQL be included in relevant surgical trials, and that information be used to inform clinicians and patients about the impact of surgery on short- and long-term HRQL.

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