Comparative Effectiveness of Induction Treatment Regimens in NDMM: Results of an SLR to Inform Clinical Decision-Making in the US

2019 ◽  
Vol 19 (10) ◽  
pp. e204
Author(s):  
Anna Forsythe ◽  
Ed Kim ◽  
Kejal Parikh ◽  
Ronda Copher
Keyword(s):  
Decision Making ◽  
Comparative Effectiveness ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Induction Treatment ◽  
Treatment Regimens ◽  
The Us

scholarly journals Are Aortic Surgery Device Technology Providers Valid or Valued Assets?

2021 ◽  
Author(s):  
Cian Tan ◽  
Mohammed Idhrees ◽  
Mohamad Bashir
Keyword(s):  
Decision Making ◽  
Conflict Of Interest ◽  
Medical Technology ◽  
Best Practice ◽  
Clinical Decision Making ◽  
Aortic Surgery ◽  
Surgical Care ◽  
Clinical Decision ◽  
The Us ◽  
Device Technology

ABSTRACT The involvement of Medical Technology (MedTech) corporations in the provision of surgical care remains a topic of debate. This relationship is especially relevant in cardiac and aortic surgery as the use of grafts, stents, prostheses, and other devices is an integral component of most procedures. Many argue that the involvement of device representatives in cardiac surgical cases is valuable – they are often experts on their product and are able to contribute their expertise in challenging cases. Yet, the potential for MedTech corporations to influence surgeons’ clinical decision-making introduces a conflict-of-interest and calls into question what the ‘best practice’ for sales reps should be. The influence of MedTech corporations over policymaking bodies in the US, UK, and Europe also represents a major issue for transparency and is equally deserving of evaluation.

scholarly journals US-Guided Fine-Needle Aspiration Cytology of Para-Aortic Lymph Nods Metastasis in Uterine Cervical Cancer: Accuracy and Impact on Clinical Decision Making

2021 ◽  
Author(s):  
Junping Liu ◽  
Xin Liu ◽  
Zhengying Guo ◽  
Xiaojuan Lv ◽  
Weimin Mao ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Decision Making ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Needle Aspiration ◽  
Uterine Cervical Cancer ◽  
Aspiration Cytology ◽  
Diagnosis Group ◽  
The Us ◽  
Needle Aspiration Cytology

Abstract Objective: To investigate whether ultrasound guided fine-needle aspiration cytology(US-FNAC) is an effective technique for diagnosing para-aortic lymph nodes(PALNs) metastasis in uterine cervical cancer and access the impact on clinical therapeutic decision. Methods: We retrospectively reviewed the clinical data of 92 patients with PALN enlargement in cervical cancer between 2010 and 2018. The US-FNAC cytological results were classified by the same experienced cellular pathologists. The diagnostic indicators were calculated according to biopsy , imaging and clinical follow-up results. Univariate and multivariate analysis was used to analyze the differences of influencing factors. The effect of US-FNAC on clinical decision making was evaluated. Results: The results of cytological diagnosis by US-FNAC were categorized as malignancy(n=62;67.4%), suspicious malignancy(n=11;12.0%), undetermined(n=5;5.4%), benign (n=10;10.9%), and inadequacy(n=4;4.3%). The satisfactory biopsy samples were obtained from 95.7% of PLANs (88/92). The sensitivity, specificity, PPV, NPV and accuracy of FNAC in distinguishing benign from malignant were 90.1%(95%CI:0.809-0.953), 100%(95%CI:0.561-1), 100%(95%CI:0.938-1), 46.7%(95%CI:0.223-0.726) and 90.9%(95%CI:0.848-0.970) respectively. Univariate analysis indicated that experience of the puncture physicians(radiologists) was significant differences between the correct diagnosis group and wrong diagnosis group (P<0.05); the experience was confirmed as independent predictor of diagnostic accuracy by multivariate analysis (p=0.031,OR=0.077,95%CI:0.354-0.919). All patients tolerated the US-FNAC procedure well and only nine patients presented slight abdominal discomfort. Through US-FNAC technique, the therapeutic methods of 74 patients (80.4%) were subjected to affect.Conclusions: US-FNAC is a relatively safe and effective examination technique for enlarged para-aortic lymph nodes, which can be considered as a routine examination before treatment of cervical cancer to guide clinical decision-making.

Debates in Dysphagia Management: How Do You Use Evidence-Based Practice in Your Dysphagia Patient Care?

2011 ◽  
Vol 20 (4) ◽  
pp. 121-123
Author(s):  
Jeri A. Logemann
Keyword(s):  
Decision Making ◽  
Patient Care ◽  
Clinical Outcomes ◽  
Clinical Judgment ◽  
Clinical Decision Making ◽  
Evidence Based Practice ◽  
Clinical Decision ◽  
Evidence Based ◽  
Clinical Method ◽  
Do So

Evidence-based practice requires astute clinicians to blend our best clinical judgment with the best available external evidence and the patient's own values and expectations. Sometimes, we value one more than another during clinical decision-making, though it is never wise to do so, and sometimes other factors that we are unaware of produce unanticipated clinical outcomes. Sometimes, we feel very strongly about one clinical method or another, and hopefully that belief is founded in evidence. Some beliefs, however, are not founded in evidence. The sound use of evidence is the best way to navigate the debates within our field of practice.

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