Coverage with evidence development (CED) has been developed as a response to the uncertainty in evidence when new technologies, including pharmaceuticals, are introduced into the market. Rather than deny coverage for these technologies or grant them unlimited coverage, CED attempts to ensure that patients' access to new medications is not ...

There is much discussion on medical ethics literature regarding the importance of the patients' right for self-determination. We discuss some of the limitations of patient's autonomy with the aim to draw attention to the ethical complexity of medical decision making in the everyday clinical practice.

MyRxPad (rxp.nlm.nih.gov) is a prototype application intended to enable a practitioner-patient collaborative approach towards e-prescribing: patients play an active role by maintaining up-to-date and accurate medication lists. Prescribers make well-informed and safe prescribing decisions based on personal medication records contributed by patients. MyRxPad is thus the vehicle for collaborations with ...

In order to understand how to effectively approach end-of-life disputes, this study surveyed physicians' attitudes towards one process for resolving end-of-life disputes, namely, the Consent and Capacity Board of Ontario. In this case, the process involved examining interpretation of best interests between substitute decision-makers and medical teams.

Atopic conditions account for approximately 35% of medical disqualifications among West Point applicants each year. There are limited outcome data concerning the utility of the atopic disqualification standards in predicting military success. Cadets entering the United States Military Academy (USMA) from 2001-2004 were selected as the cohort for this study. ...

Objective: to explore the relevance and usability of using a computerized patient simulator as a tool for continuous medical education and decision support for health professionals in district hospitals in Sub-Saharan Africa. Methods: based on the diagnosis pathway and decision analysis in uncertainty context, interactive clinical vignettes are developed using ...

The genealogy of observation as a philosophical term goes back to the ancient Greek astronomical and medical traditions, and the revival of the concept in the Renaissance also happened in the astronomical and medical context. This essay focuses primarily on the medical genealogy of the concept of observation. In ancient ...

Norman SP, Song PXK, Hu Y, Ojo AO. Transition from donor candidates to live kidney donors: the impact of race and undiagnosed medical disease states. Clin Transplant 2011: 25: 136-145. © 2009 John Wiley & Sons A/S. Abstract:  Background:  Living kidney donors (LKD) allow for increased access to lifesaving organs ...

Abstract The authors examine the practice characteristics of dynamic psychiatrists, including the combined use of medication and psychotherapy, and adherence by self-report to psychodynamic, supportive, and cognitive behavioral therapy theoretical principles and techniques. Method: Survey of 555 members of the American Academy of Psychoanalysis and Dynamic Psychiatry conducted in 2009. ...

On February 4, 2010 the Illinois Supreme Court struck down Illinois' medical practice reform bill, P.A. 94-677, when it decided Lebron v. Gottlieb Memorial Hospital. Although the court only considered the unconstitutionality of the cap on non-economic damages contained in that bill, an inseverability provision resulted in the invalidation of ...

Genetic dispositions play a major role in individual disease risk and treatment response. Genomic medicine, in which medical decisions are refined by genetic information of particular patients, is becoming increasingly important. Here we describe our work and future visions around the creation of a distributed infrastructure for pharmacogenetic data and ...

This research explored the decision-making process of selecting medicines for prescription on hospital ward-rounds. We aimed to determine when and with whom medications were discussed, and in particular, whether shared decision making (SDM) occurred on ward-rounds. As a low level of computerized decision support was in place in the hospital ...

Clinical Decision Support Systems (CDSSs) are implemented in clinical settings in order to improve patient outcomes and/or clinical practices. However, they are still not widely accepted by healthcare professionals due to over-alerting. The aim of the "Patient Safety through Intelligent Procedures in medication" (PSIP) project is to develop and demonstrate ...

In randomized controlled trials (RCTs), the odds ratio (OR) can substantially overestimate the risk ratio (RR) if the incidence of the outcome is over 10%. This study determined the frequency of use of ORs, the frequency of overestimation of the OR as compared with its accompanying RR in published RCTs, ...

Clinical reasoning plays a major role in the ability of doctors to make diagnoses and decisions. It is considered as the physician's most critical competence, and has been widely studied by physicians, educationalists, psychologists and sociologists. Since the 1970s, many theories about clinical reasoning in medicine have been put forward. ...

Abstract:This article presents a recent disconcerting event that took place at a rehabilitative nursing home in Tel Aviv in light of Israel's Dying Patient Law, which came into effect in 2005. It probes the double effect doctrine as it is relevant to the case at hand and the role of ...

Although amphetamine was thoroughly tested by leading scientists for its effects in boosting or maintaining physical and mental performance in fatigued subjects, the results never provided solid grounds for approving the drug's use, and, in any case, came too late to be decisive. The grounds on which amphetamine was actually ...

This paper aims at developing electronic business solutions to increase value for the home medical equipment industry. First, an electronic strategic value chain model was developed for the home medical equipment industry. Second, electronic business solutions were mapped from this model. Third, the top 20 dominant companies in the home ...

ABSTRACT: Citation metrics have rapidly gained importance in today's landscape and are being increasingly utilized as a yardstick in making several important decisions regarding academic funding and appointments. The impact factor has traditionally been the metric most often employed in this regard. However, the emergence of the Hirsch index has ...

Formularies are highly variable, which limits physicians ability to prescribe cost effective medications for their patients. In this study we explore the composition of 3,346 formularies in terms of outpatient prescription coverage, medication class coverage, and cost implications. Our analysis revealed that 42% of formularies are duplicative and that the ...

Analysis of the kinematics of the FINE Total Knee System (Nakashima Medical, Okayama, Japan) revealed that the medial condyle is fixed and the lateral condyle shows lateral posterior movement and tibial internal rotation. Analysis of the kinematics of the ADVANCE Total Knee System (Wright Medical Technology, Arlington, Tenn) revealed that ...

In today's world, as evinced in various human rights provisions, emphasis is placed on the assertion and protection of the entrenched rights of every human and particularly the dignity of humans and respect of human autonomy. Medical/health workers are concerned about protecting every patient's right to the dignity of his ...

The aim of this study was to evaluate visual fatigue objectively by measuring accommodation time and critical fusion frequency (CFF) before and after reading posteroanterior chest radiographs displayed on medical-grade liquid-crystal displays (LCDs) under different monitor conditions. A color LCD (500, 170 cd/m²) and a monochrome LCD (500 cd/m²) were ...

The authors propose a process to improve the medical management of a cutaneous contamination in two ways: firstly by analysis of practices and products of decontamination used; secondly, by developing computer tools for the occupational physicians. This software will allow them to have a rapid dosimetric assessment in the event ...

BACKGROUND: Ultrasonography is increasingly used in elderly individuals for screening of occult malignancy and abdominal aortic aneurysm. Its utility as a screening tool in healthy asymptomatic individuals is not yet established. The current study was undertaken to evaluate the utility of abdominal and pelvic ultrasonographic screening as an adjunct to ...

Principal component analysis (PCA) was applied to the ground reaction force (GRF) for evaluating the deep brain stimulation of the subthalamic nucleus (DBS-STN) effects in Parkinson's disease (PD) subjects with and without medication. Ten subjects who underwent DBS-STN were evaluated under the following four conditions: without treatment (mof-sof), with stimulation ...

PURPOSE: To determine the psychometric properties of a theoretically based continuing medical education (CME) evaluation instrument examining attitudinal determinants of physicians' changes in medical practices after a CME intervention. The instrument's scales represented constructs from the theory of planned behavior. METHOD: The authors based the template instrument on educational objectives ...

Over the past 30 years, a general consensus has emerged within the medical community regarding the essential role served by grading guidelines in evaluating the quality of evidence produced by a medical research study. Specifically, consensus exists regarding the hierarchy of evidence, where randomized controlled trials (RCTs) are considered the ...

Even in ancient times, medical liability occupied man. Various civilizations had their own interpretation and solutions for this. Original writings are very rare and articles on the subject are equally hard to find. The only relatively trustworthy sources are of a legal nature with their origin in Roman law and ...

The purpose of this study was to develop a method for evaluating accessibility of medical equipment for patients with disabilities. The researchers reviewed videotapes of patient-participants with various physical and sensory disabilities using different types of medical equipment. For each of 11 videotapes, four observers independently identified and documented access ...

Fixed drug eruption (FDE) is an uncommon medication-induced cutaneous reaction. A case of fluconazole-induced FDE is described. A 64-year-old woman presented with eight ovoid hyperpigmented patches on the arms, palm and lower leg that had recurred multiple times at the identical sites at seemingly random intervals over the prior six ...

Objective: The Medical Assessment and Planning Unit (MAPU) model provides a multidisciplinary and 'front end loading' approach to acute medical care. The objective of this study was to evaluate the impact of a 10-bed MAPU in Royal Melbourne Hospital (RMH) on hospital length of stay. METHODS: A pre-post study design ...

Our previous article described the principles of conducting an economic evaluation for evidence-based medical decision making. This article provides some tips for reading, critically appraising and applying the findings of an economic evaluation in clinical practice.

We herein describe the design and performance evaluation of single-use whole-sterile "plug & play" kits for routine automated production of [(11)C]methionine and [(11)C]choline for human use. Kits were designed for maximal simplicity and ease of using modules from Eckert & Ziegler Modular Lab System. The use of all-disposable sterile medical-grade ...

An observational study (OS) is a non-interventional/non-experimental survey. In the OSs, the investigator observes and evaluates results of ongoing medical care without 'controlling' the therapy beyond normal medical practice. An OS is aimed: 1. to the evaluation of the safety profile of any medical procedure (drug, device, surgical procedure, radiotherapy, ...

We are revising the criteria in the Listing of Impairments (the listings) that we use to evaluate claims involving hearing loss under titles II and XVI of the Social Security Act (Act). The revisions reflect our adjudicative experience, advances in medical knowledge, treatment, and methods of evaluating hearing loss, and ...

To determine whether knowledge of medical diagnosis biases listeners with varied experience levels in their judgments of dysphonia. Prospective, mixed experimental and comparative design. Twenty-six speakers with dysphonia and four normal controls provided speech recordings. Twenty novice and eight experienced clinicians evaluated speech samples for roughness and breathiness using 100-mm ...

An essential goal of evaluation is to foster learning. Across the medical education spectrum, evaluation of clinical performance is dominated by subjective feedback to learners based on observation by expert supervisors. Research in non-medical settings has suggested that participants' perceptions of evaluation processes exert considerable influence over whether the feedback ...

A program evaluation of a pediatric primary care training clinic was conducted using the criteria of a "medical home" set forth by the American Academy of Pediatrics (AAP). A total of 107 parents completed questionnaires regarding demographics, satisfaction with care, and questions related to the definition of medical home. Medical ...

It is a matter of fact that rarely in the history of modern medicine has a physician gained such immediate and universal fame, and rarely has his contribution to medical knowledge and teaching been so promptly and almost unanimously recognized as a fundamental and, so to speak, a foundational one, ...

For the practitioner, choosing diagnosis codes is a non-intuitive operation. Mistakes are frequent, causing severe consequences on healthcare performance evaluation and funding. French physicians have to assign a code to all their activities and are frequently prone to these errors. Given that most of the time and particularly for chronic ...

Surveillance of healthcare-associated infections is essential to prevention. A new collaborative project, namely ALADIN, was launched in January 2009 and aims to develop an automated detection tool based on natural language processing of medical documents. The objective of this study was to evaluate the annotation of natural language medical reports ...

Preanesthetic evaluation purpose is to reduce morbidity and mortality through the review of the patient's medical history, clinical examination, and targeted clinical studies, providing referrals for medical consultations when appropriated. Changes in patient care, standards of health information management and patterns of perioperative care, have resulted in a re-conceptualization of ...

Medical education is at a crossroads. Although unique features exist at the undergraduate, graduate, and continuing education levels, shared aspects of all three levels are especially revealing, and form the basis for informed decision-making about the future of medical education.This paper describes some of the internal and external challenges confronting ...

This study evaluated the long-term effects of deep brain stimulation of the subthalamic nucleus (DBS-STN) on gait initiation. Six Parkinson's disease (PD) patients who had undergone DBS-STN and 31 control subjects were evaluated. PD subjects were assessed at two different time periods: 11.3 ± 10.3 (P1) and 78.9 ± 10.6 ...

The promotion of sport talents in Germany is federally standardised. Apart from the training and management support, annual sports-medical investigations with standardised procedures are mandatory for athletes' health and safety. For the first time, this study evaluates the prevalence ratio of medical findings in Hessian top athletes. The data of ...

Clinical studies on nasal topical medications require the standardization of 'nasosinusal normality' in order to establish control groups through a specific evaluation of the upper airways. to standardize the evaluation of candidates for control groups in clinical studies on nasal topical medications. healthy male volunteers of 18 to 50 years ...

We are revising some of the criteria in the Listing of Impairments (the listings) that we use to evaluate claims involving malignant neoplastic diseases (cancer) under titles II and XVI of the Social Security Act (Act). The revisions reflect our adjudicative experience, advances in medical knowledge, diagnosis, and treatment, and ...

CONTEXT: Assessing medical professionalism among medical residents is of great importance. The Professionalism Mini-Evaluation Exercise (P-MEX) is a tool for assessing professionalism that was developed, tested for reliability and validated in Canada. Prior to the present study, no Japanese version of the P-MEX had been tested. METHODS: We modified the ...

The standard tests for the biological evaluation of biomaterials, as promoted by the International Organisation for Standardisation, have evolved over the years to become an important part of the process for ensuring, as far as is possible, the biological safety of medical devices. There is, however, some scope for improvement, ...