Factors influencing patient decision‐making concerning treatment escalation in Raynaud’s phenomenon secondary to systemic sclerosis

2021 ◽  
Author(s):  
Michael Hughes ◽  
Suiyuan Huang ◽  
John D Pauling ◽  
Maya Sabbagh ◽  
Dinesh Khanna
Keyword(s):  
Decision Making ◽  
Systemic Sclerosis ◽  
Raynaud’S Phenomenon ◽  
Raynaud's Phenomenon ◽  
Patient Decision Making ◽  
Factors Influencing ◽  
Patient Decision ◽  
Treatment Escalation

scholarly journals Willingness to trade-off: An intermediate factor in patient decision-making regarding escalating care

2018 ◽  
Vol 5 (1) ◽  
pp. 205510291876771
Author(s):  
Elizabeth K Seng ◽  
Amy S Grinberg ◽  
Liana Fraenkel
Keyword(s):  
Decision Making ◽  
Disease Risk ◽  
Patient Decision Making ◽  
Trade Off ◽  
Trade Offs ◽  
Patient Decision ◽  
Treatment Escalation ◽  
High Treatment ◽  
Willingness To Engage

This study aimed to evaluate treatment necessity, treatment concern, and willingness to engage in decisional trade-offs in the context of treatment escalation decision-making. Participants ( n = 147) recruited online were randomized to read a vignette about escalating care in psoriasis in a 2 (high treatment concern vs moderate treatment concern) × 2 (high perceived treatment necessity vs moderate perceived treatment necessity) design. High treatment concern was associated with choosing to defer treatment escalation and being unwilling to engage in decisional trade-offs if disease risk changed. Results highlight the importance of treatment concern and willingness trade-off in treatment escalation decision-making.

scholarly journals Factors influencing patient decision-making between simple mastectomy and surgical alternatives

BJS Open ◽  
2018 ◽  
Vol 3 (1) ◽  
pp. 31-37 ◽  
Author(s):  
W. Q. Lee ◽  
V. K. M. Tan ◽  
H. M. C. Choo ◽  
J. Ong ◽  
R. Krishnapriya ◽  
...  
Keyword(s):  
Decision Making ◽  
Patient Decision Making ◽  
Factors Influencing ◽  
Patient Decision ◽  
Simple Mastectomy

Ascorbic Acid does not Improve Endothelium-Dependent Flow-mediated Dilatation of the Brachial Artery in Patients with Raynaud’s Phenomenon Secondary to Systemic Sclerosis

2003 ◽  
Vol 73 (1) ◽  
pp. 3-7 ◽  
Author(s):  
M. E. Mavrikakis ◽  
J. P. Lekakis ◽  
M. Papamichael ◽  
K. S. Stamatelopoulos ◽  
Ch. C. Kostopoulos ◽  
...  
Keyword(s):  
Ascorbic Acid ◽  
Smooth Muscle ◽  
Systemic Sclerosis ◽  
Endothelial Dysfunction ◽  
Brachial Artery ◽  
Raynaud’S Phenomenon ◽  
Raynaud's Phenomenon ◽  
Water Soluble ◽  
Placebo Administration ◽  
Flow Mediated Dilatation

Previous studies have shown that patients with Raynaud’s phenomenon secondary to systemic sclerosis present abnormal endothelial function; the mechanisms responsible for the endothelial dysfunction are unknown but increased vascular oxidative stress could be a possible cause. The hypothesis that a potent water-soluble antioxidant can reverse endothelial dysfunction in these patients was tested in the present study. We examined 11 female patients with Raynaud’s phenomenon secondary to systemic sclerosis and ten healthy control women by ultrasound imaging of the brachial artery to assess flow-mediated (endothelium-dependent) and nitrate-induced (endothelium-independent) vasodilatation. Flow-mediated dilatation and nitrate-induced dilatation were significantly reduced in patients with Raynaud’s phenomenon, indicating abnormal endothelial and smooth muscle cell function. Patients with Raynaud’s phenomenon entered a double-blind, randomized, crossover placebo-controlled trial and received orally 2 g of ascorbic acid or placebo; vascular studies were repeated two hours after ascorbic acid or placebo administration. Flow-mediated dilatation did not improve after ascorbic acid (1.6 ± 2.2% to 2.2 ± 2.5%, ns) or placebo administration (1.2 ± 1,9% to 1.7 ± 1.4%, ns); also nitrate-induced dilatation was similar after ascorbic acid or placebo (16 ± 7.4% vs 17 ± 8%, ns), suggesting no effect of ascorbic acid on endothelial and vascular smooth muscle function. In conclusion, ascorbic acid does not reverse endothelial vasomotor dysfunction in the brachial circulation of patients with Raynaud’s phenomenon secondary to systemic sclerosis. The use of different antioxidants or different dosing of ascorbic acid may be required to show a beneficial effect on endothelial vasodilator function.

An economic theory of patient decision-making

2005 ◽  
Vol 2 (3) ◽  
pp. 153-164 ◽  
Author(s):  
Douglas O. Stewart ◽  
Joseph P. DeMarco
Keyword(s):  
Decision Making ◽  
Economic Theory ◽  
Patient Decision Making ◽  
Patient Decision
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