A paradigm shift in the medical treatment of acromegaly: from a ‘trial and error’ to a personalized therapeutic decision-making process

2015 ◽  
Vol 83 (1) ◽  
pp. 1-2 ◽  
Author(s):  
Mônica R. Gadelha
Keyword(s):  
Decision Making ◽  
Medical Treatment ◽  
Paradigm Shift ◽  
Decision Making Process ◽  
Trial And Error ◽  
Therapeutic Decision ◽  
Therapeutic Decision Making

scholarly journals Therapeutic decision making in autoimmune and inflammatory disorders of the central nervous system in children

2016 ◽  
Author(s):  
Russell Clive Dale
Keyword(s):  
Decision Making ◽  
Central Nervous System ◽  
Nervous System ◽  
Fatal Outcome ◽  
Decision Making Process ◽  
Therapeutic Decision ◽  
Inflammatory Disorders ◽  
Sydenham Chorea ◽  
The Central Nervous System ◽  
Therapeutic Decision Making

Autoimmune and inflammatory disorders of the central nervous system can result in significant morbidity and mortality. Through the recognition of syndromes using diagnostic biomarkers, the clinician is now able to use immune suppressive therapies to improve outcomes. However, the therapeutic decision-making process is complex. The clinician has to balance the risk of disease, with the risk of treatment side effects. To achieve this balance, it is important to understand the natural history of disease, the risk of residual disability, the risk of relapse, and risk of a fatal outcome. It is also important to have some understanding of the pathological processes, as some of the entities have more reversible processes, whereas others have destructive processes. This review will assess the dynamic nature of this decision-making process, and compare some of the more severe diseases such as neuromyelitis optica, anti-N-methyl-D-aspartate receptor encephalitis and opsoclonus myoclonus ataxia syndrome, with disorders with more favourable outcomes such as Sydenham chorea and post-infectious cerebellar ataxia. 

scholarly journals Empowering Patients in the Therapeutic Decision-Making Process: A Glance Into Behçet's Syndrome

2021 ◽  
Vol 8 ◽  
Author(s):  
Diana Marinello ◽  
Federica Di Cianni ◽  
Alessandra Del Bianco ◽  
Irene Mattioli ◽  
Jurgen Sota ◽  
...  
Keyword(s):  
Decision Making ◽  
Psychological Status ◽  
Care Process ◽  
Decision Making Process ◽  
Behçet’S Syndrome ◽  
Therapeutic Decision ◽  
Behçet's Syndrome ◽  
Behcet’S Syndrome ◽  
Therapeutic Decision Making ◽  
Behcet's Syndrome

Behçet's syndrome (BS) represents a challenging condition, characterized by a variable spectrum of disease profile and associated with a significant limitation of the daily activities as well as a potential negative impact on relationships and psychological status. Considering also the complexity of the therapeutic management of BS, that often includes biological off-label treatments, the participation in the therapeutic decision-making process of the BS patients is essential to ensure the integration of the care process into the life of the patient. For this reason, the empowerment of BS patients represents a crucial need and the present work is aimed at fully exploring all the potential variables implicated in the BS patient empowerment, also highlighting major points to consider and concrete actions to be planned in the immediate future in order to implement a pragmatic facilitation of the patients' empowerment.

scholarly journals Health emergencies and interoceptive sensibility modulate the perception of non-evidence-based drug use: Findings from the COVID-19 outbreak

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0256806
Author(s):  
Gerardo Salvato ◽  
Daniela Ovadia ◽  
Alessandro Messina ◽  
Gabriella Bottini
Keyword(s):  
Decision Making ◽  
Individual Characteristics ◽  
Decision Making Process ◽  
Evidence Based ◽  
Care Providers ◽  
Therapeutic Decision ◽  
Therapeutic Approaches ◽  
Experimental Drugs ◽  
Therapeutic Decisions ◽  
Therapeutic Decision Making

Scientific evidence plays an important role in the therapeutic decision-making process. What happens when physicians are forced to make therapeutic decisions under uncertainty? The absence of scientific guidelines at the beginning of a pandemic due to an unknown virus, such as COVID-19, could influence the perceived legitimacy of the application of non-evidence-based therapeutic approaches. This paper reports on a test of this hypothesis, in which we administered an ad hoc questionnaire to a sample of 64 Italian physicians during the first wave of the COVID-19 pandemic in Italy (April 2020). The questionnaire statements regarding the legitimacy of off-label or experimental drugs were framed according to three different scenarios (Normality, Emergency and COVID-19). Furthermore, as the perception of internal bodily sensations (i.e., interoception) modulates the decision-making process, we tested participants’ interoceptive sensibility using the Multidimensional Assessment of Interoceptive Awareness (MAIA). The results showed that participants were more inclined to legitimate non-evidence-based therapeutic approaches in the COVID-19 and Emergency scenarios than the Normality scenario. We also found that scores on the MAIA Trusting subscale positively predicted this difference. Our findings demonstrate that uncertain medical scenarios, involving a dramatic increase in patient volume and acuity, can increase risk-taking in therapeutic decision-making. Furthermore, individual characteristics of health care providers, such as interoceptive ability, should be taken into account when constructing models to prevent the breakdown of healthcare systems in cases of severe emergency.

scholarly journals Patients’ demographic and socioeconomic characteristics influence the therapeutic decision-making process in psoriasis

PLoS ONE ◽  
2020 ◽  
Vol 15 (8) ◽  
pp. e0237267 ◽  
Author(s):  
Emanuele Scala ◽  
Matteo Megna ◽  
Paolo Amerio ◽  
Giuseppe Argenziano ◽  
Graziella Babino ◽  
...  
Keyword(s):  
Decision Making ◽  
Decision Making Process ◽  
Therapeutic Decision ◽  
Socioeconomic Characteristics ◽  
Therapeutic Decision Making

scholarly journals Spinal arteriovenous malformation

2018 ◽  
Vol 21 (3) ◽  
pp. 172-174
Author(s):  
Elton Gomes Da Silva ◽  
Vinícius Teixeira Ribeiro ◽  
Juliana ' Rebechi Zuiani ◽  
Ronie Leo Piske ◽  
Helder Tedeschi
Keyword(s):  
Decision Making ◽  
Arteriovenous Malformation ◽  
Decision Making Process ◽  
Therapeutic Decision ◽  
Spinal Arteriovenous Malformation ◽  
Therapeutic Decision Making ◽  
Complex Lesions

Spinal AVMs are complex lesions that can present as a nidus or more often as fistulae. Diagnosis is usually made by angiography and the treatment of election in most cases is embolization being surgery reserved for selected cases. In this report the classification of such lesions and their treatment are discussed. We also present a case that was submitted to surgery. Although usually managed by embolization, surgery of spinal AVMs also has a role in the treatment, bringing to evidence the necessity for a multidisciplinary discussion in the therapeutic decision making process.

Impact of liquid-biopsy in the therapeutic decision making process in a Peruvian institution.

2018 ◽  
Vol 36 (15_suppl) ◽  
pp. e18761-e18761
Author(s):  
Luis Schwarz ◽  
Henry Leonidas Gomez ◽  
Paola Catherine Montenegro ◽  
Claudio J. Flores ◽  
María Requena ◽  
...  
Keyword(s):  
Decision Making ◽  
Liquid Biopsy ◽  
Decision Making Process ◽  
Therapeutic Decision ◽  
Therapeutic Decision Making

Decision Tables for Planning Drug Therapy

1979 ◽  
Vol 13 (2) ◽  
pp. 100-104 ◽  
Author(s):  
Joseph Wartak ◽  
T. Bryce Miller
Keyword(s):  
Decision Making ◽  
Drug Therapy ◽  
Data Processing ◽  
Scientific Data ◽  
New Method ◽  
Decision Making Process ◽  
Therapeutic Decision ◽  
Hypertensive Disease ◽  
Therapeutic Decision Making ◽  
Decision Tables

A new method of planning drug therapy is described. The method employs so-called decision tables, which have been used effectively in commercial and scientific data processing for over a decade. The decision tables seem to provide a simpler, clearer and more concise means of expressing the complexity and logic of the therapeutic decision making process. The use of decision tables is illustrated by an example involving therapeutic regimens in hypertensive disease.

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