State and Federal Statutes and Regulations Concerning Patient Counseling

2020 ◽  
pp. 7-11
Author(s):  
Harvey M. Rappaport ◽  
Kelly S. Straker ◽  
Tracy S. Hunter ◽  
Joseph F. Roy
Keyword(s):  
Patient Counseling

A feature-based hybrid recommender system for risk prediction : Machine learning approach (Preprint)

2020 ◽  
Author(s):  
Uzair Bhatti
Keyword(s):  
Machine Learning ◽  
Risk Prediction ◽  
Predictive Accuracy ◽  
Correct Diagnosis ◽  
Recommendation Systems ◽  
Data Integrity ◽  
Machine Learning Algorithms ◽  
Patient Counseling ◽  
Hybrid Filtering ◽  
Novel Algorithm

BACKGROUND In the era of health informatics, exponential growth of information generated by health information systems and healthcare organizations demands expert and intelligent recommendation systems. It has become one of the most valuable tools as it reduces problems such as information overload while selecting and suggesting doctors, hospitals, medicine, diagnosis etc according to patients’ interests. OBJECTIVE Recommendation uses Hybrid Filtering as one of the most popular approaches, but the major limitations of this approach are selectivity and data integrity issues.Mostly existing recommendation systems & risk prediction algorithms focus on a single domain, on the other end cross-domain hybrid filtering is able to alleviate the degree of selectivity and data integrity problems to a better extent. METHODS We propose a novel algorithm for recommendation & predictive model using KNN algorithm with machine learning algorithms and artificial intelligence (AI). We find the factors that directly impact on diseases and propose an approach for predicting the correct diagnosis of different diseases. We have constructed a series of models with good reliability for predicting different surgery complications and identified several novel clinical associations. We proposed a novel algorithm pr-KNN to use KNN for prediction and recommendation of diseases RESULTS Beside that we compared the performance of our algorithm with other machine algorithms and found better performance of our algorithm, with predictive accuracy improving by +3.61%. CONCLUSIONS The potential to directly integrate these predictive tools into EHRs may enable personalized medicine and decision-making at the point of care for patient counseling and as a teaching tool. CLINICALTRIAL dataset for the trials of patient attached

scholarly journals The Emerging Role of Community Pharmacists in Remote Patient Monitoring Services

Pharmacy ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 166
Author(s):  
Amina Abubakar ◽  
Jessica Sinclair
Keyword(s):  
Medication Management ◽  
Community Pharmacists ◽  
Healthcare Team ◽  
Remote Patient Monitoring ◽  
Patient Counseling ◽  
State Evaluation ◽  
Remote Patient ◽  
Enhance Patient Care ◽  
Pharmacist Services

Remote physiologic monitoring (RPM) services involve the transmission of patient-collected physiologic data to the healthcare team. These data are then analyzed to determine what changes may be needed to enhance patient care. While pharmacists may not be recognized as billing providers through some payers, there are opportunities for pharmacist collaboration with providers to enhance patient access to RPM services. Community pharmacist services are traditionally tied to a product, but pharmacists are skilled in medication management, disease state evaluation, and patient counseling, which are skills that can contribute to an elevated RPM program.

Recovery of Vocal Cord Motion Among Pediatric Patients

2021 ◽  
pp. 000348942110333
Author(s):  
Courtney Ann Prestwood ◽  
Ashley B. Brown ◽  
Romaine F. Johnson
Keyword(s):  
Vocal Cord ◽  
Spontaneous Recovery ◽  
Vocal Cord Paralysis ◽  
Pediatric Population ◽  
Current Evidence ◽  
Symptom Improvement ◽  
Patient Counseling ◽  
Early Recovery ◽  
Kaplan Meier ◽  
Recovery Group

Objectives: Patients with vocal cord paralysis can experience feeding, respiratory, and vocal problems leading to disability and decreased quality of life. Current evidence suggests waiting a period of 12 months for spontaneous recovery before permanent interventions. This study aims to determine the time to recover spontaneously and vocal cord movement in a pediatric population and create a model for evidence-based patient counseling. Study Design: Retrospective longitudinal cohort study. Methods: The report is a single institution longitudinal study on vocal cord paralysis recovery. Patients were categorized based on spontaneous recovery with vocal cord movement or no recovery. Recovery rates were determined using the Kaplan-Meier method. Results: Of 158 cases of vocal cord paralysis over a 4-year period, 36 had spontaneous recovery with symptom improvement and motion return. The average recovery was 8.8 months for those who recovered, and 78% recovered within 9 months. Two groups emerged from the data: an early recovery group with spontaneous recovery before 12 months and a late recovery group after 12 months. Children with dysphonia and paralysis due to cardiac surgery were less likely to recover, and children with aspiration were more likely to recover. Children with gastrointestinal comorbidities were less likely to recover; however, those who did recover were more likely to have recovered after 12 months. Based on our model, there is about a 3% chance of recovery between 9 and 12 months. Conclusions: Patients should be counseled about earlier interventions. Waiting the conventional 12 months for only a 3% chance of spontaneous recovery without intervention or laryngeal EMG may not be the preferred option for some patients and their families.

scholarly journals Postprocedural Endophthalmitis or Postprocedural Intraocular Inflammation: A Diagnostic Conundrum

2021 ◽  
pp. 418-424
Author(s):  
Aisha Al Busaidi ◽  
Ahmed Al-Hinai
Keyword(s):  
Pars Plana Vitrectomy ◽  
Povidone Iodine ◽  
Complete Recovery ◽  
Neovascular Glaucoma ◽  
Intraocular Inflammation ◽  
Aqueous Samples ◽  
Patient Counseling ◽  
Pars Plana ◽  
Culture Negative ◽  
Office Procedures

We experienced an atypical endophthalmitis occurring post consecutively performed in-office procedures; an intravitreal injection (IVI) of ranibizumab followed by an anterior chamber (AC) paracentesis performed twice in an eye with neovascular glaucoma (NVG). A 52-year-old diabetic male who was asymptomatic developed signs of endophthalmitis and decreased vision without pain in his left eye a few days post-IVI and AC paracentesis. The condition worsened after an initial vitreous tap and injection of antibiotics. Cultures of vitreous and aqueous samples were negative. Complete resolution occurred after a pars plana vitrectomy with IVI of antibiotics and steroid with removal of a dense “yellowish-brown” fibrinous plaque. The absence of pain, presence of a peculiar colored fibrin, mild-to-moderate vitritis without retinitis, negative cultures, and complete recovery despite the fulminant presentation; favor a diagnosis of inflammation over infection. We hypothesize that a micro-leak from a 26-gauge AC tap tract might have served as an entry port for 5% povidone-iodine from the ocular surface thus inciting inflammation. However, an exuberant inflammatory response that can be typically seen in NVG eyes after intraocular procedures cannot be excluded. Various causes of inflammation post-procedures, both toxic and nontoxic should be considered in atypical culture-negative fulminant endophthalmitis cases with good outcome posttreatment. Any minor ocular procedure may carry a risk of such complication. Patient counseling and care must be exercised in performing these procedures.

Improving Your Patient Counseling Skills

1993 ◽  
Vol 33 (4) ◽  
pp. 65-68
Author(s):  
Kenneth Leibowitz
Keyword(s):  
Counseling Skills ◽  
Patient Counseling

Culinary Medicine Training in Core Medical School Curriculum Improved Medical Student Nutrition Knowledge and Confidence in Providing Nutrition Counseling

2021 ◽  
pp. 155982762110217
Author(s):  
Christopher R. D’Adamo ◽  
Kayli Workman ◽  
Christine Barnabic ◽  
Norman Retener ◽  
Bernadette Siaton ◽  
...  
Keyword(s):  
Medical Student ◽  
Medical Students ◽  
Medical School ◽  
Patient Care ◽  
School Curriculum ◽  
Nutrition Knowledge ◽  
Medical School Curriculum ◽  
Nutrition Counseling ◽  
Patient Counseling ◽  
Culinary Medicine

Background: Elective culinary medicine education has become popular to help fill important gaps in physician nutrition training. The implementation and outcomes among the inaugural cohort of medical students who received culinary medicine training as a required component of medical school curriculum at the University of Maryland School of Medicine are described. Methods: Following a series of elective pilot sessions, culinary medicine training was provided to all first-year medical students in the 2019-2020 academic year. The 3-hour training included evidence-based nutrition lecture, cooking simple recipes, and group discussion of the application to personal and patient care. Pre-/postsession questionnaires assessed nutrition knowledge, skills, and attitudes as well as nutritional counseling confidence. Paired t-tests estimated mean differences in outcomes pre- and posttraining. Qualitative data were subjected to thematic analysis. Results: Overall, 119 of 125 (95.2%) students provided pre- and posttraining outcomes data. All nutritional and patient counseling outcomes improved ( P < .05). Themes of being better prepared to address healthy eating barriers in patient care and personal ability to make healthy dietary changes were noted in qualitative analysis. Conclusion: One session of culinary medicine training in core medical student curriculum was feasible and improved medical student nutrition knowledge, skills, and attitudes and confidence in patient nutrition counseling.

scholarly journals Adverse Pregnancy Outcomes by Degree of Maternal Serum Analyte Elevation: A Retrospective Cohort Study

2020 ◽  
Vol 10 (04) ◽  
pp. e369-e379
Author(s):  
Amanda Yeaton-Massey ◽  
Rebecca J. Baer ◽  
Larry Rand ◽  
Laura L. Jelliffe-Pawlowski ◽  
Deirdre J. Lyell
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Screening Program ◽  
Maternal Serum ◽  
Obstetric Complication ◽  
Patient Counseling ◽  
Increased Risk ◽  
Antenatal Management ◽  
Adverse Pregnancy

Abstract Objective The aim of this study was to evaluate rates of preterm birth (PTB) and obstetric complication with maternal serum analytes > 2.5 multiples of the median (MoM) by degree of elevation. Study Design Retrospective cohort study of singleton live-births participating in the California Prenatal Screening Program (2005–2011) examining PTB and obstetric complication for α-fetoprotein (AFP), human chorionic gonadotropin (hCG), unconjugated estriol (uE3), and inhibin A (INH) by analyte subgroup (2.5 to < 6.0, 6.0 to < 10.0, and ≥ 10.0 MoM vs. < 2.5 MoM). Results The risk of obstetric complication increased with increasing hCG, AFP, and INH MoM, and were greatest for AFP and INH of 6.0 to <10.0 MoM. The greatest risk of any adverse outcome was seen for hCG MoM ≥ 10.0, with relative risk (RR) of PTB < 34 weeks of 40.8 (95% confidence interval [CI]: 21.7–77.0) and 13.8 (95% CI: 8.2–23.1) for obstetric complication. Conclusions In euploid, structurally normal fetuses, all analyte elevations > 2.5 MoM confer an increased risk of PTB and, except for uE3, obstetric complication, and risks for each are not uniformly linear. These data can help guide patient counseling and antenatal management.

scholarly journals Long-term outcome and quality of life after CNS cavernoma resection: eloquent vs. non-eloquent areas

2021 ◽  
Author(s):  
Loay Shoubash ◽  
Jörg Baldauf ◽  
Marc Matthes ◽  
Michael Kirsch ◽  
Matthias Rath ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Short Form ◽  
Preoperative Evaluation ◽  
Patient Counseling ◽  
Surgical Morbidity ◽  
Term Outcome ◽  
Long Term Outcome

AbstractThe aim of this study is to analyze the long-term quality of life after surgery of cavernoma. A monocentric retrospective study was conducted on 69 patients with cavernoma treated microsurgically between 2000 and 2016. The eloquence was adopted from Spetzler-Martin definition. A most recent follow-up was elicited between 2017 and 2019, in which the quality of life (QoL) was evaluated with the Short Form-12 questionnaire (SF12). Forty-one lesions were in eloquent group (EG), 22 in non-eloquent group (NEG), 3 in orbit, and 3 in the spinal cord. Postoperative worsening of the modified Rankin scale (mRS) occurred in 19.5% of cases in EG versus 4.5% in NEG. After a mean follow-up of 6.5 years (SD 4.6), the neurological status was better or unchanged compared to baseline in 85.4% of EG and 100% of NEG. Regarding QoL assessment of 44 patients (EG n = 27, NEG n = 14) attended the last follow-up. Patients after eloquent cavernoma resection reported a non-inferior QoL in most SF12 domains (except for physical role) compared to NEG. However, they reported general health perception inferior to norms, which was affected by the limited physical and emotional roles. At a late follow-up, the surgical morbidity was transient in the NEG and mostly recovered in the EG. The QoL comparison between eloquent and non-eloquent cavernomas created interesting and new data after prolonged follow-up. These results add value for decision-making as well as patient counseling for future encountered cases. Preoperative evaluation of QoL is recommended for future studies to assess QoL dynamics.

scholarly journals Impact of sarcopenia in advanced and metastatic soft tissue sarcoma

2021 ◽  
Author(s):  
Dennis Strassmann ◽  
Bennet Hensen ◽  
Viktor Grünwald ◽  
Katharina Stange ◽  
Hendrik Eggers ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Cox Regression ◽  
Therapy Response ◽  
Prognostic Impact ◽  
Patient Counseling ◽  
Skeletal Muscle Index ◽  
Prognostic Parameter ◽  
Dismal Prognosis ◽  
Metastatic Soft Tissue Sarcoma

Abstract Introduction Advanced or metastatic soft tissue sarcoma (a/mSTS) is associated with a dismal prognosis. Patient counseling on treatment aggressiveness is pivotal to avoid over- or undertreatment. Recently, evaluation of body composition markers like the skeletal muscle index (SMI) became focus of interest in a variety of cancers. This study focuses on the prognostic impact of SMI in a/mSTS, retrospectively. Methods 181 a/mSTS patients were identified, 89 were eligible due to prespecified criteria for SMI assessment. Baseline CT-Scans were analyzed using an institutional software solution. Sarcopenia defining cut-off values for the SMI were established by optimal fitting method. Primary end point was overall survival (OS) and secondary endpoints were progression free survival (PFS), disease control rate (DCR), overall response rate (ORR). Descriptive statistics as well as Kaplan Meier- and Cox regression analyses were administered. Results 28/89 a/mSTS patients showed sarcopenia. Sarcopenic patients were significantly older, generally tended to receive less multimodal therapies (62 vs. 57 years, P = 0.025; respectively median 2.5 vs. 4, P = 0.132) and showed a significantly lower median OS (4 months [95%CI 1.9–6.0] vs. 16 months [95%CI 8.8–23.2], Log-rank P = 0.002). Sarcopenia was identified as independent prognostic parameter of impaired OS (HR 2.40 [95%-CI 1.4–4.0], P < 0.001). Moreover, DCR of first palliative medical treatment was superior in non-sarcopenic patients (49.2% vs. 25%, P = 0.032). Conclusion This study identifies sarcopenia as a prognostic parameter in a/mSTS. Further on, the data suggest that sarcopenia shows a trend of being associated with first line therapy response. SMI is a promising prognostic parameter, which needs further validation.

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