BMC Med Inform Decis Mak - Development of a tool to improve the quality of decision making in atrial fibrillation.

Tópicos

{ decis(3086) make(1611) patient(1517) }
{ risk(3053) factor(974) diseas(938) }
{ visual(1396) interact(850) tool(830) }
{ use(2086) technolog(871) perceiv(783) }
{ survey(1388) particip(1329) question(1065) }
{ framework(1458) process(801) describ(734) }
{ error(1145) method(1030) estim(1020) }
{ care(1570) inform(1187) nurs(1089) }
{ research(1085) discuss(1038) issu(1018) }
{ clinic(1479) use(1117) guidelin(835) }
{ perform(1367) use(1326) method(1137) }
{ studi(1119) effect(1106) posit(819) }
{ state(1844) use(1261) util(961) }
{ research(1218) medic(880) student(794) }
{ first(2504) two(1366) second(1323) }
{ time(1939) patient(1703) rate(768) }
{ analysi(2126) use(1163) compon(1037) }
{ method(2212) result(1239) propos(1039) }
{ design(1359) user(1324) use(1319) }
{ data(3963) clinic(1234) research(1004) }
{ studi(1410) differ(1259) use(1210) }
{ model(2341) predict(2261) use(1141) }
{ record(1888) medic(1808) patient(1693) }
{ model(2656) set(1616) predict(1553) }
{ data(2317) use(1299) case(1017) }
{ cost(1906) reduc(1198) effect(832) }
{ data(1737) use(1416) pattern(1282) }
{ system(1976) rule(880) can(841) }
{ assess(1506) score(1403) qualiti(1306) }
{ concept(1167) ontolog(924) domain(897) }
{ method(1557) propos(1049) approach(1037) }
{ control(1307) perform(991) simul(935) }
{ general(901) number(790) one(736) }
{ featur(1941) imag(1645) propos(1176) }
{ perform(999) metric(946) measur(919) }
{ age(1611) year(1155) adult(843) }
{ data(3008) multipl(1320) sourc(1022) }
{ use(1733) differ(960) four(931) }
{ model(3404) distribut(989) bayesian(671) }
{ can(774) often(719) complex(702) }
{ imag(1947) propos(1133) code(1026) }
{ inform(2794) health(2639) internet(1427) }
{ measur(2081) correl(1212) valu(896) }
{ imag(1057) registr(996) error(939) }
{ bind(1733) structur(1185) ligand(1036) }
{ sequenc(1873) structur(1644) protein(1328) }
{ method(1219) similar(1157) match(930) }
{ featur(3375) classif(2383) classifi(1994) }
{ imag(2830) propos(1344) filter(1198) }
{ network(2748) neural(1063) input(814) }
{ imag(2675) segment(2577) method(1081) }
{ patient(2315) diseas(1263) diabet(1191) }
{ take(945) account(800) differ(722) }
{ studi(2440) review(1878) systemat(933) }
{ motion(1329) object(1292) video(1091) }
{ treatment(1704) effect(941) patient(846) }
{ surgeri(1148) surgic(1085) robot(1054) }
{ problem(2511) optim(1539) algorithm(950) }
{ chang(1828) time(1643) increas(1301) }
{ learn(2355) train(1041) set(1003) }
{ algorithm(1844) comput(1787) effici(935) }
{ extract(1171) text(1153) clinic(932) }
{ data(1714) softwar(1251) tool(1186) }
{ model(2220) cell(1177) simul(1124) }
{ method(984) reconstruct(947) comput(926) }
{ search(2224) databas(1162) retriev(909) }
{ case(1353) use(1143) diagnosi(1136) }
{ howev(809) still(633) remain(590) }
{ system(1050) medic(1026) inform(1018) }
{ import(1318) role(1303) understand(862) }
{ compound(1573) activ(1297) structur(1058) }
{ blood(1257) pressur(1144) flow(957) }
{ spatial(1525) area(1432) region(1030) }
{ health(3367) inform(1360) care(1135) }
{ model(3480) simul(1196) paramet(876) }
{ monitor(1329) mobil(1314) devic(1160) }
{ ehr(2073) health(1662) electron(1139) }
{ patient(2837) hospit(1953) medic(668) }
{ medic(1828) order(1363) alert(1069) }
{ signal(2180) analysi(812) frequenc(800) }
{ group(2977) signific(1463) compar(1072) }
{ sampl(1606) size(1419) use(1276) }
{ gene(2352) biolog(1181) express(1162) }
{ intervent(3218) particip(2042) group(1664) }
{ activ(1138) subject(705) human(624) }
{ patient(1821) servic(1111) care(1106) }
{ can(981) present(881) function(850) }
{ health(1844) social(1437) communiti(874) }
{ structur(1116) can(940) graph(676) }
{ high(1669) rate(1365) level(1280) }
{ cancer(2502) breast(956) screen(824) }
{ use(976) code(926) identifi(902) }
{ drug(1928) target(777) effect(648) }
{ result(1111) use(1088) new(759) }
{ implement(1333) system(1263) develop(1122) }
{ estim(2440) model(1874) function(577) }
{ process(1125) use(805) approach(778) }
{ activ(1452) weight(1219) physic(1104) }
{ method(1969) cluster(1462) data(1082) }
{ detect(2391) sensit(1101) algorithm(908) }

Resumo

CKGROUND: Decision-making about appropriate therapy to reduce the stroke risk associated with non-valvular atrial fibrillation (NVAF) involves the consideration of trade-offs among the benefits, risks, and inconveniences of different treatment options. The objective of this paper is to describe the development of a decision support tool for NVAF based on the provision of individualized risk estimates for stroke and bleeding and on preparing patients to communicate with their physicians about their values and potential treatment options.METHODS: We developed a tool based on the principles of the International Patient Decision Aids Standards. The tool focuses on the patient-physician dyad as the decision-making unit and emphasizes improving the interaction between the two. It is built on the recognition that the application of patient values to a specific treatment decision is complex and that the final treatment choice is best made through a process of patient-clinician communication.RESULTS: The tool provides education incorporating patients ' illness perceptions to explain the relationship between NVAF and stroke, and then presents individualized risk estimates, derived using separate risk calculators for stroke and bleeding over a clinically meaningful time period (5 years) associated with no treatment, aspirin, and warfarin. Sequelae of both stroke and bleeding outcomes are also described. Patients are encouraged to verbalize how they value the incremental risks and benefits associated with each option and write down specific concerns to address with their physician. A physician prompt to encourage patients to discuss their opinions is included as part of the decision support tool. In pilot testing with 11 participants (mean age 78 ? 9 years, 64% with = high-school education), 8 (72%) rated ease of completion as "very easy," and 9 (81%) rated amount of information as "just right."CONCLUSIONS: The risks and benefits of different treatment options for reduction of stroke in NVAF vary widely according to patients' comorbidities. This tool facilitates the provision of individualized outcome data and encourages patients to communicate with their physicians about these risks and benefits. Future studies will examine whether use of the tool is associated with improved quality of decision making.

Resumo Limpo

ckground decisionmak appropri therapi reduc stroke risk associ nonvalvular atrial fibril nvaf involv consider tradeoff among benefit risk inconveni differ treatment option object paper describ develop decis support tool nvaf base provis individu risk estim stroke bleed prepar patient communic physician valu potenti treatment optionsmethod develop tool base principl intern patient decis aid standard tool focus patientphysician dyad decisionmak unit emphas improv interact two built recognit applic patient valu specif treatment decis complex final treatment choic best made process patientclinician communicationresult tool provid educ incorpor patient ill percept explain relationship nvaf stroke present individu risk estim deriv use separ risk calcul stroke bleed clinic meaning time period year associ treatment aspirin warfarin sequela stroke bleed outcom also describ patient encourag verbal valu increment risk benefit associ option write specif concern address physician physician prompt encourag patient discuss opinion includ part decis support tool pilot test particip mean age year highschool educ rate eas complet easi rate amount inform just rightconclus risk benefit differ treatment option reduct stroke nvaf vari wide accord patient comorbid tool facilit provis individu outcom data encourag patient communic physician risk benefit futur studi will examin whether use tool associ improv qualiti decis make

Resumos Similares

BMC Med Inform Decis Mak - Development and initial evaluation of a treatment decision dashboard. ( 0,848409766772503 )
J. Med. Internet Res. - Cool but counterproductive: interactive, Web-based risk communications can backfire. ( 0,842865257315297 )
Med Decis Making - Content coding for contextualization of care: evaluating physician performance at patient-centered decision making. ( 0,837953643900896 )
BMC Med Inform Decis Mak - Launching a virtual decision lab: development and field-testing of a web-based patient decision support research platform. ( 0,825029856020826 )
BMC Med Inform Decis Mak - Assessing the information desire of patients with advanced cancer by providing information with a decision aid, which is evaluated in a randomized trial: a study protocol. ( 0,821799987519576 )
AMIA Annu Symp Proc - Revisiting the EBM decision model to formalize non-compliance with computerized CPGs: results in the management of breast cancer with OncoDoc2. ( 0,82102385515825 )
BMC Med Inform Decis Mak - Genders of patients and clinicians and their effect on shared decision making: a participant-level meta-analysis. ( 0,815716614323889 )
Med Decis Making - Contributions of Second Opinions, Outcome Forecasts, and Testimonials to Patient Decisions about Knee Replacement Surgery. ( 0,815090038238163 )
Med Decis Making - When decisions should be shared: a study of social norms in medical decision making using a factorial survey approach. ( 0,808312255191894 )
AMIA Annu Symp Proc - Supporting shared decision making within the MobiGuide project. ( 0,806476179967475 )
Med Decis Making - What is known about parents' treatment decisions? A narrative review of pediatric decision making. ( 0,80507896821899 )
BMC Med Inform Decis Mak - Basing information on comprehensive, critically appraised, and up-to-date syntheses of the scientific evidence: a quality dimension of the International Patient Decision Aid Standards. ( 0,802956414819099 )
BMC Med Inform Decis Mak - Developing and user-testing Decision boxes to facilitate shared decision making in primary care--a study protocol. ( 0,802863177055724 )
Healthc (Amst) - Incentivizing shared decision making in the USA--where are we now? ( 0,796657783129582 )
BMC Med Inform Decis Mak - The design of a low literacy decision aid about rheumatoid arthritis medications developed in three languages for use during the clinical encounter. ( 0,796475130291864 )
Med Decis Making - Preferences and perceived involvement in treatment decision making among Chinese patients with chronic hepatitis. ( 0,79595987344168 )
BMC Med Inform Decis Mak - Visual AIDS for multimodal treatment options to support decision making of patients with colorectal cancer. ( 0,795693966730973 )
Int J Med Inform - Pharmacist-conducted medication reconciliation at hospital admission using information technology in Taiwan. ( 0,794613596786573 )
BMC Med Inform Decis Mak - Refining a brief decision aid in stable CAD: cognitive interviews. ( 0,794527376062106 )
Med Decis Making - Are medical outcomes fungible? A survey of voters, medical administrators, and physicians. ( 0,792380091923196 )
AMIA Annu Symp Proc - An information-centric framework for designing patient-centered medical decision aids and risk communication. ( 0,788027783612047 )
Med Decis Making - All stories are not alike: a purpose-, content-, and valence-based taxonomy of patient narratives in decision aids. ( 0,781055597822557 )
J Biomed Inform - Opportunistic decision making and complexity in emergency care. ( 0,779180241497111 )
BMC Med Inform Decis Mak - Barriers and facilitators to implementing Decision Boxes in primary healthcare teams to facilitate shared decisionmaking: a study protocol. ( 0,776124780513294 )
BMC Med Inform Decis Mak - Clarifying values: an updated review. ( 0,774325646140316 )
Med Decis Making - Factors Associated with Informed Decisions and Participation in Bowel Cancer Screening among Adults with Lower Education and Literacy. ( 0,758626353747778 )
BMC Med Inform Decis Mak - Congruence between patients' preferred and perceived participation in medical decision-making: a review of the literature. ( 0,756639058315686 )
Med Decis Making - The impact of a novel computer-based decision aid on shared decision making for colorectal cancer screening: a randomized trial. ( 0,752466701216821 )
Med Decis Making - Perceptions of shared decision making and decision aids among rural primary care clinicians. ( 0,746383330605207 )
Med Decis Making - Investing in deliberation: a definition and classification of decision support interventions for people facing difficult health decisions. ( 0,744432560539014 )
Med Decis Making - Breast cancer patients' treatment expectations after exposure to the decision aid program adjuvant online: the influence of numeracy. ( 0,742342170009107 )
Med Decis Making - The context of available options affects health care decisions: a generalization study. ( 0,730132852823985 )
Med Decis Making - Framing Options as Choice or Opportunity: Does the Frame Influence Decisions? ( 0,728905867375728 )
BMC Med Inform Decis Mak - A randomized study of telephonic care support in populations at risk for musculoskeletal preference-sensitive surgeries. ( 0,728577858102075 )
BMC Med Inform Decis Mak - Applying the theory of planned behaviour to multiple sclerosis patients' decisions on disease modifying therapy--questionnaire concept and validation. ( 0,727555392051081 )
BMC Med Inform Decis Mak - Data mining of audiology patient records: factors influencing the choice of hearing aid type. ( 0,727437622032828 )
J Med Syst - The reliability of an epilepsy treatment clinical decision support system. ( 0,726636296694954 )
Med Decis Making - Why do patients derogate physicians who use a computer-based diagnostic support system? ( 0,724488158970451 )
Med Decis Making - Choice set size and decision making: the case of Medicare Part D prescription drug plans. ( 0,723698908441293 )
J. Med. Internet Res. - Supporting informed decision making online in 20 minutes: an observational web-log study of a PSA test decision aid. ( 0,723461099444957 )
Med Decis Making - The impact of explicit values clarification exercises in a patient decision aid emerges after the decision is actually made: evidence from a randomized controlled trial. ( 0,715331925697209 )
BMC Med Inform Decis Mak - Disclosing conflicts of interest in patient decision aids. ( 0,713648793334855 )
Comput Methods Programs Biomed - AngioLab--a software tool for morphological analysis and endovascular treatment planning of intracranial aneurysms. ( 0,712543896994253 )
J Am Med Inform Assoc - Imaging informatics for consumer health: towards a radiology patient portal. ( 0,710160717481136 )
BMC Med Inform Decis Mak - Risk assessment and decision making about in-labour transfer from rural maternity care: a social judgment and signal detection analysis. ( 0,70981885365818 )
Med Decis Making - The DECISIONS study: a nationwide survey of United States adults regarding 9 common medical decisions. ( 0,707021260972746 )
BMC Med Inform Decis Mak - Coaching and guidance with patient decision aids: A review of theoretical and empirical evidence. ( 0,703701064106178 )
Med Decis Making - Adherence and decision AIDS: a model and a narrative review. ( 0,70175327567101 )
BMC Med Inform Decis Mak - Presenting quantitative information about decision outcomes: a risk communication primer for patient decision aid developers. ( 0,700895679007733 )
BMC Med Inform Decis Mak - Development and pilot testing of a decision aid for drivers with dementia. ( 0,700430759443899 )
BMC Med Inform Decis Mak - A targeted decision aid for the elderly to decide whether to undergo colorectal cancer screening: development and results of an uncontrolled trial. ( 0,699366593545349 )
Med Decis Making - Theoretical foundation of patient v. population preferences in calculating QALYs. ( 0,698163172067387 )
BMC Med Inform Decis Mak - Delivering patient decision aids on the Internet: definitions, theories, current evidence, and emerging research areas. ( 0,697811057693497 )
J Med Syst - Comparison of AI techniques for prediction of liver fibrosis in hepatitis patients. ( 0,697609047801873 )
BMC Med Inform Decis Mak - The effect of a decision aid intervention on decision making about coronary heart disease risk reduction: secondary analyses of a randomized trial. ( 0,697494037097836 )
Med Decis Making - Cost-effectiveness on a local level: whether and when to adopt a new technology. ( 0,697299705589881 )
J. Med. Internet Res. - A web-based tool to support shared decision making for people with a psychotic disorder: randomized controlled trial and process evaluation. ( 0,696558753084576 )
BMC Med Inform Decis Mak - Diagnosis and management of people with venous thromboembolism and advanced cancer: how do doctors decide? A qualitative study. ( 0,694665859539008 )
BMC Med Inform Decis Mak - Arriba-lib: evaluation of an electronic library of decision aids in primary care physicians. ( 0,694468369431819 )
Med Decis Making - What makes a tumor diagnosis a call to action? On the preference for action versus inaction. ( 0,687616968659322 )
Med Decis Making - Decision coaching to prepare patients for making health decisions: a systematic review of decision coaching in trials of patient decision AIDS. ( 0,685452681932167 )
BMC Med Inform Decis Mak - Development and pilot testing of an online case-based approach to shared decision making skills training for clinicians. ( 0,683846483723869 )
BMC Med Inform Decis Mak - A new method for determining physician decision thresholds using empiric, uncertain recommendations. ( 0,68101558158989 )
Med Decis Making - Decision-making Processes among Prostate Cancer Survivors with Rising PSA Levels: Results from a Qualitative Analysis. ( 0,680519362440275 )
Med Decis Making - An emerging field of research: challenges in pediatric decision making. ( 0,679842081094807 )
BMC Med Inform Decis Mak - Development of a decision aid to inform patients' and families' renal replacement therapy selection decisions. ( 0,675652019030598 )
IEEE J Biomed Health Inform - Leveraging social supports for improving personal expertise on ACL reconstruction and rehabilitation. ( 0,673562447371464 )
AMIA Annu Symp Proc - Sharing my health data: a survey of data sharing preferences of healthy individuals. ( 0,673468909094568 )
Int J Health Geogr - Mass casualty modelling: a spatial tool to support triage decision making. ( 0,672401033460876 )
AMIA Annu Symp Proc - Role of physicians' reactance in e-iatrogenesis: a case study with ASTI guiding mode on the management of hypertension. ( 0,671161666047386 )
BMC Med Inform Decis Mak - A genetic fuzzy system for unstable angina risk assessment. ( 0,670513729371717 )
Med Decis Making - Looking at patients' choices through the lens of expected utility: a critique and research agenda. ( 0,670248493097371 )
BMC Med Inform Decis Mak - Measuring decision quality: psychometric evaluation of a new instrument for breast cancer chemotherapy. ( 0,666715882813992 )
AMIA Annu Symp Proc - Patient clinical profiles associated with physician non-compliance despite the use of a guideline-based decision support system: a case study with OncoDoc2 using data mining techniques. ( 0,666419290056614 )
IEEE Trans Vis Comput Graph - Empirical Studies in Information Visualization: Seven Scenarios. ( 0,66594538926229 )
BMC Med Inform Decis Mak - Event-based knowledge elicitation of operating room management decision-making using scenarios adapted from information systems data. ( 0,661375671319291 )
J. Med. Internet Res. - Development and evaluation of the personal patient profile-prostate (P3P), a Web-based decision support system for men newly diagnosed with localized prostate cancer. ( 0,66080356489737 )
J Med Syst - VIKOR method with enhanced accuracy for multiple criteria decision making in healthcare management. ( 0,660441918842237 )
Med Decis Making - Expected net present value of sample information: from burden to investment. ( 0,659923330186069 )
J Am Med Inform Assoc - Workshop on using natural language processing applications for enhancing clinical decision making: an executive summary. ( 0,658384750434413 )
Med Decis Making - Can Streamlined Multicriteria Decision Analysis Be Used to Implement Shared Decision Making for Colorectal Cancer Screening? ( 0,654355752683608 )
BMC Med Inform Decis Mak - Values clarification in a decision aid about fertility preservation: does it add to information provision? ( 0,653882274036355 )
BMC Med Inform Decis Mak - Shared decision-making and health for First Nations, M?tis and Inuit women: a study protocol. ( 0,648547650675475 )
J Telemed Telecare - Approaches to economic evaluation in telemedicine. ( 0,647157754964808 )
BMC Med Inform Decis Mak - Do personal stories make patient decision aids more effective? A critical review of theory and evidence. ( 0,647100327405828 )
Med Decis Making - Germs are germs, and why not take a risk? Patients' expectations for prescribing antibiotics in an inner-city emergency department. ( 0,646913730507457 )
BMC Med Inform Decis Mak - A regret theory approach to decision curve analysis: a novel method for eliciting decision makers' preferences and decision-making. ( 0,646250886171372 )
Med Decis Making - Participation of very old adults in health care decisions. ( 0,64295278576052 )
Med Decis Making - Interpreting patient decisional conflict scores: behavior and emotions in decisions about treatment. ( 0,640532036652441 )
BMC Med Inform Decis Mak - Incorporating patient and family preferences into evidence-based medicine. ( 0,640175294109562 )
J Med Syst - Development of a decision support engine to assist patients with hospital selection. ( 0,638790593046809 )
Med Decis Making - A model to support shared decision making in electronic health records systems. ( 0,638571014736935 )
BMC Med Inform Decis Mak - A preliminary exploration of the feasibility of offering men information about potential prostate cancer treatment options before they know their biopsy results. ( 0,638032353099818 )
J. Med. Internet Res. - The effect of patient narratives on information search in a web-based breast cancer decision aid: an eye-tracking study. ( 0,636724286343836 )
BMC Med Inform Decis Mak - The SAKK cancer-specific geriatric assessment (C-SGA): a pilot study of a brief tool for clinical decision-making in older cancer patients. ( 0,634070049928153 )
Neural Comput - Dynamics of multiple-choice decision making. ( 0,633271711957484 )
Artif Intell Med - From decision to shared-decision: Introducing patients' preferences into clinical decision analysis. ( 0,629296838403964 )
Appl Clin Inform - A retrospective analysis of interruptive versus non-interruptive clinical decision support for identification of patients needing contact isolation. ( 0,627150703613038 )
J Biomed Inform - Towards actionable risk stratification: a bilinear approach. ( 0,620011739978415 )
BMC Med Inform Decis Mak - Dual processing model of medical decision-making. ( 0,619303541959139 )