ABSTRACT: BACKGROUND: The role of patient race in medical decision-making is heavily debated. While some evidence suggests that patient race can be used by physicians to predict disease risk and determine drug therapy, other studies document bias and stereotyping by physicians based on patient race. It is critical, then, to ...

BACKGROUND:: Recent litigation involving medical examiners has caused concern over certifying deaths. METHODS:: We administered a survey of 716 medical examiners regarding the effects of the threat of litigation. RESULTS:: Two hundred twenty-two medical examiners responded (31%). Of those who responded, approximately 13.5% admitted to having modified their diagnostic findings ...

We report the history of military humanitarian medical operations, define the current science of process and outcome evaluation, and propose a set of generic metrics for monitoring and evaluation in military humanitarian operations. We comprehensively reviewed the unclassified literature and used our own experiences in military humanitarian activities. Our literature ...

In this work we present an enhanced medical workflow and a decision support system for atherosclerotic risk assessment and treatment, that is based both on existing medical guidelines and on patient specific multiscale data. The medical expert that uses the system is able to apply both existing medical guidelines as ...

Objective To evaluate the incidence of duplicate medication orders before and after computerized provider order entry (CPOE) with clinical decision support (CDS) implementation and identify contributing factors. Design CPOE with duplicate medication order alerts was implemented in a 400-bed Northeastern US community tertiary care teaching hospital. In a pre-implementation post-implementation ...

Whether a person will suffer harm from a medication or how severe that harm will be is difficult to predict precisely. As a result, many adverse drug events (ADEs) occur in patients in whom it was reasonable to believe that the drug's benefits exceeded its risks. Improving safety and reducing ...

The search for molecules that may contribute to better identify patients at risk for cardiovascular diseases (CVD) represents today an active field in clinical research. Few biomarkers have already been identified as reliable and useful tools in medical decision making, such as cardiac troponin (cTn) and NT-proBNP. At the same ...

LIU W, MANIAS E and GERDTZ M. Nursing Inquiry 2011; 18: 290-302 Understanding medication safety in healthcare settings: a critical review of conceptual models Communication can impact on the way in which medications are managed across healthcare settings. Organisational cultures and the environmental context provide an added complexity to how ...

Cognitive theories on decision making show that individuals often do not decide in a full and rationale way, but instead use cognitive strategies that allow them to overcome the limitations imposed by their limited rationality and the difficulties derived from uncertainty. The first part of the paper will discuss the ...

Historically physicians have had close relationships with the pharmaceutical or other medically related industry. This has come under close scrutiny by the public, with articles appearing in medical journals and the lay press. The reality is that physicians depend on industry to bring products to market as well as to ...

Abstract The United States Food and Drug Administration (FDA) Amendments Act of 2007 mandated that Risk Evaluation and Mitigation Strategies (REMS) be required of manufacturers. These REMS are strategies implemented to manage known or potential risks associated with drugs and to ensure ongoing pharmacovigilance throughout the life of a pharmaceutical ...

The physician signout note is a widely used clinical document that supports patient safety and care continuity during patient handoff in the hospital. Despite its centrality to patient care, the signout note is not considered an official document, and it is, therefore, not generally standardized or taught to medical trainees, ...

High-alert medications are frequently responsible for adverse drug events and present significant hazards to inpatients, despite technical improvements in the way they are ordered, dispensed, and administered. A real-time surveillance application was designed and implemented to enable pharmacy review of high-alert medication orders to complement existing computerized provider order entry ...

Implementing an electronic health record (EHR) system that links medical facilities in three states taught PeaceHealth these valuable lessons: Establish clinical standards. Talk to clinicians early on. Look for an EHR with clinical decision support capabilities.

Resuscitation should always be attempted in a patient who has at least a theoretical chance of survival. This assumes that there are patent cerebral, coronary and pulmonary vessels, a reasonable time from cardiac arrest has not been exceeded, and cardiac arrest did not occur as a result of a terminal ...

We propose a set of recommendations and practices to optimize the use of quality control of medical biology examinations. The fundamentals are reviewed: definition of a series of analysis, IQC at one or more level, Westgard alert rules and rejection, practical remedial actions to take for the technician, corrective and ...

To elucidate the specialty preferences of Pakistani medical students and the factors which influence medical students to make the decision regarding which specialty to pursue. Both basic sciences and clinical students from four medical colleges of Pakistan, i.e., Dow Medical College, Sindh Medical College, Liaquat National Medical College and Muhammad ...

The legal and medical systems both strive for truth while acknowledging that there are no absolutes. Both systems require evidence, which they categorize in a hierarchy of levels, on which to base decisions that can have major effects on the quality and even quantity of people's lives. In law, the ...

ABSTRACT: This analysis reports on Irish regulatory policies for in vitro fertilisation (IVF) from 2004-2009, in the context of membership changes within the Medical Council of Ireland. To achieve this, the current (2009) edition of the Guide to Professional Conduct & Ethics was compared with the immediately preceding version (2004). ...

Background Although medical ethicists and educators emphasise patient-centred decision-making, previous studies suggest that patients often prefer their doctors to make the clinical decisions. Objective To examine the associations between a preference for physician-directed decision-making and patient health status and sociodemographic characteristics. Methods Sociodemographic and clinical information from all consenting general ...

The move from paper to electronic prescribing (EP) and medicine administration systems has long been advocated. Initial studies in the adult setting showed a significant reduction in medication errors. However, there are additional challenges to overcome to tailor these systems to paediatrics. Building on the basic elements of EP with ...

Monicelli's suicide has reawakened a political and legal dispute about the medical role in end-of-life decisions, allowing us to discuss medical, ethical, legal, religious and political debate in various paradigmatic conscious and unconscious cases of end-of-life decision. We analyse the uncertainty about the 'a priori' choice between different specific legislative ...

We investigate the discharge practices at a large medical center. Specifically, we look for indications that patients are being discharged sooner because of hospital bed-capacity constraints. Using survival analysis techniques, we find statistically significant evidence to indicate that surgeons adjust their discharge practices to accommodate the surgical schedule and number ...

ABSTRACT: BACKGROUND: The Albanian medical system and Albanian health legislation have adopted a paternalistic position with regard to individual decision making. This reflects the practices of a not-so-remote past when state-run facilities and a totalitarian philosophy of medical care were politically imposed. Because of this history, advance directives concerning treatment ...

Objective To assess whether a low level of decision support within a hospital computerized provider order entry system has an observable influence on the medication ordering process on ward-rounds and to assess prescribers' views of the decision support features. Methods 14 specialty teams (46 doctors) were shadowed by the investigator ...

Despite government efforts to increase healthcare insurance and access in China, many individuals, regardless of insurance status, continue to engage in high levels of self-medication. To understand the factors influencing common self-medication behaviour in a community of food market vendors in Fuzhou China, a total of 30 market vendors were ...

This is the final article in a series of three that examines the legal role of medical professionals in decisions to withhold or withdraw life-sustaining treatment from adults who lack capacity. This article considers the position in Victoria. A review of the law in this State reveals that medical professionals ...

The inquest into the death of Kerrie Wooltorton in Norfolk, England, ignited extensive public debate on the scope of the common law right to refuse medical treatment where a patient is distressed, depressed or actively suicidal. In Australia, a patient's wishes need not be honoured if the patient is not ...

The making of an end of life decision represents worldwide one of the most difficult issues that physicians can be confronted with --not only should it be regarded as consisting of medical and legal aspects, but ethics and moral values are present as well. Furthermore, it shall not be supposed ...

The 'four principle' view of medical ethics has a strong international pedigree. Despite wide acceptance, there is controversy about the meaning and use of the principles in clinical practice as a checklist for moral behaviour. Recent attempts by medical regulatory authorities to use the four principles to judge medical practitioner ...

ABSTRACT: BACKGROUND: The medical tourism industry, which assists patients with accessing non-emergency medical care abroad, has grown rapidly in recent years. A lack of reliable data about medical tourism makes it difficult to create policy, health system, and public health responses to address the associated risks and shortcomings, such as ...

ABSTRACT: BACKGROUND: Scant information exists about the time-course of events during withdrawal of life-sustaining treatment. We investigated the time required for end-of-life decisions, subsequent withdrawal of life-sustaining treatment and the time to death. METHODS: Prospective, observational study in the ICU of a tertiary paediatric hospital. RESULTS: Data on 38 cases ...

AIM: This study was designed to document the factors influencing therapeutic decisions in the management of diabetes in relation to stage of medical career. METHODS: An anonymous survey was distributed among medical students, resident medical officers (RMOs) and general practitioners (GPs) presenting a hypothetical case of a 58 year old ...

OBJECTIVE: To evaluate Chinese healthcare providers' knowledge regarding medical abortion, to understand provider preferences for abortion methods, and to investigate the role of remuneration on providers' decision making. METHODS: Between November 2009 and May 2010, 658 abortion service providers from family-planning service centers and hospitals in Shenzhen and Henan, China, ...

This article reviews diagnosis and treatment in the Commonwealth of Independent States in three clinical areas: tuberculosis, substance misuse, and neurological disorders in children. While the specific problems in each of these areas differ greatly, commonalities emerge, pointing to the continued influence of the Soviet past. Although progress in developing ...

Within the context of health and insurance law, an important question that arises is "to what extent is an applicant for private insurance truly capable of giving his/her 'free' and informed consent for a medical examination?". It should be borne in mind that it is the private insurer who requires ...

Since 2005, newly qualified doctors in the UK have had their time to prepare for career subspecialization application cut short to 16 months. To have enough time to become a competitive applicant, the choice of specialization may now have to be made as early as in medical school. This study ...

Intravenous infusion may present the greatest preventable medication administration error risk to hospitalized patients. Smart pumps can provide clinical decision support at the bedside for nurses who are administering intravenously administered medications with the potential to significantly reduce medication errors and subsequent patient harm. However, implementations of smart pumps have ...

OBJECTIVE: This study aims at two objectives: I) to develop a model capable of predicting the statistical distribution of the variable "time elapsed since the last medical visit"; II) to empirically test the theoretical model. METHODS: To develop the theoretical model, the author will use a demonstration that is statistical ...

Adequate assessment of adherence to medical treatment is critical for both research purposes and clinical practice. This study examined the factor structure and longitudinal invariance of the Medication Adherence Report Scale (MARS-A10) in a sample of asthmatic patients. We examined longitudinal data from 294 inner-city, adult participants with moderate to ...

Using a large national sample of women undergoing an abortion in France, we explore the factors associated with medical or surgical abortion. We draw particular attention to the influence of women's preferences in the decision-making process. The data are drawn from a nationally representative survey of 8245 women undergoing an ...

Migraine occurs in about 15% of the general population. Migraine is usually managed by medication, but some patients do not tolerate migraine medication due to side effects or prefer to avoid medication for other reasons. Non-pharmacological management is an alternative treatment option. We systematically reviewed randomized clinical trials (RCTs) on ...

This study in Saudi Arabia explored the determinants of physicians' prescribing behaviour in primary care in Riyadh city. A self-administered questionnaire designed to explore factors influencing prescribing (sociodemographic factors; practice setting; continuing education; access to educational materials; pharmaceutical company representatives; and patient factors) was completed by 87 PHC physicians. A ...

We report a case of early resolution of convergence spasms following the addition of antipsychotic medications and present it as a possible alternative to the conventional treatment for convergence spasms. The cessation of atropinization of the eyes and the use of reading glasses was achieved after only 2 months following ...

The paper presents a method connecting medical databases to a medical decision system, and describes a service created to extract the necessary information that is transferred based on standards. The medical decision can be improved based on many inputs from different medical locations. The developed solution is described for a ...

Deciding whether to open your own practice or work for someone else is a big decision every young physician has to face. Many start out with established medical groups, but they usually don't remain there as employees. TMA has tools and services to meet the needs of physicians just starting ...

In this paper, we investigated several approaches in literature that classify different aspects of medical simulators. We have merged these definitions to form a structured taxonomy. This new taxonomy should facilitate the design of new medical simulators and allow to analyze and classify existing simulators, algorithms, toolkits and hardware.

Medication errors and resulting Adverse Drug Events (ADEs) are an important issue of global healthcare. Within the European PSIP project that aims at developing solutions to improve medication safety, contextualized decision support modules aiming to prevent ADEs are being developed. The objective of this work was to thoroughly validate part ...

Objective: The purpose of the present study was to investigate and describe from the participants' perspectives the factors and processes influencing their choice as to whether to use prescribed psychiatric medication. Methods: Thematic content analysis of data was obtained from semi-structured interviews with 19 individuals diagnosed with mental illnesses. Results: ...

We have previously studied system failures involved in medication errors using a limited number of root cause analyses as source. The aim of this study was to describe a larger number of medication errors with respect to harm, involved medicines and involved system problems - thus providing information for the ...