scholarly journals Use of a Supportive Kidney Care Video Decision Aid in Older Patients: A Randomized Controlled Trial

2020 ◽  
Vol 51 (9) ◽  
pp. 736-744
Author(s):  
Nwamaka D. Eneanya ◽  
Shananssa G. Percy ◽  
Taylor L. Stallings ◽  
Wei Wang ◽  
David J.R. Steele ◽  
...  
Keyword(s):  
Older Patients ◽  
Decision Aid ◽  
Controlled Trial ◽  
Decision Aids ◽  
Future Research ◽  
High Satisfaction ◽  
Significant Difference ◽  
Surprise Question ◽  
To Receive ◽  
Video Education

Background: There are few studies of patient-facing decision aids that include supportive kidney care as an option. We tested the efficacy of a video decision aid on knowledge of supportive kidney care among older patients with advanced CKD. Methods: Participants (age ≥ 65 years with advanced CKD) were randomized to receive verbal or video education. Primary outcome was knowledge of supportive kidney care (score range 0–3). Secondary outcomes included preference for supportive kidney care, and satisfaction and acceptability of the video. Results: Among all participants (n = 100), knowledge of supportive kidney care increased significantly after receiving education (p < 0.01); however, there was no difference between study arms (p = 0.68). There was no difference in preference for supportive kidney care between study arms (p = 0.49). In adjusted analyses, total health literacy score (aOR 1.08 [95% CI: 1.003–1.165]) and nephrologists’ answer of “No” to the Surprise Question (aOR 4.87 [95% CI: 1.22–19.43]) were associated with preference for supportive kidney care. Most felt comfortable watching the video (96%), felt the content was helpful (96%), and would recommend the video to others (96%). Conclusions: Among older patients with advanced CKD, we did not detect a significant difference between an educational verbal script and a video decision aid in improving knowledge of supportive kidney care or preferences. However, patients who received video education reported high satisfaction and acceptability ratings. Future research will determine the effectiveness of a supportive kidney care video decision aid on real-world patient outcomes. Trial Registration: NCT02698722 (ClinicalTrials.gov).

A Pilot Randomized Trial of a Video Patient Decision Aid to Facilitate Early Intervention Referrals From Primary Care

2016 ◽  
Vol 56 (3) ◽  
pp. 268-277 ◽  
Author(s):  
Manuel E. Jimenez ◽  
Nathalie E. DuRivage ◽  
Orysia Bezpalko ◽  
Andrew Suh ◽  
Roy Wade ◽  
...  
Keyword(s):  
Early Intervention ◽  
Developmental Delay ◽  
Decision Aid ◽  
Controlled Trial ◽  
Decision Aids ◽  
Text Message ◽  
Text Messages ◽  
Urban Setting ◽  
Significant Difference ◽  
The Impact

Many young children identified with developmental concerns in pediatric settings do not receive early intervention (EI). We assessed the impact of a video decision aid and text message reminder on knowledge and attitudes regarding developmental delay and EI as well as referral completion. We conducted a pilot randomized controlled trial in an urban setting and enrolled 64 parent-child dyads referred to EI. Compared with controls, participants who received the intervention demonstrated increased knowledge regarding developmental delay and EI as well as more favorable attitudes in certain topics. Although we did not find a significant difference between arms in EI intake and evaluation, we found a pattern suggestive of increased intake and evaluation among participants with low health literacy in the intervention arm. Additional study is needed to identify strategies that improve the EI referral process for families and to understand the potential targeted role for decision aids and text messages.

A Pilot Randomized Controlled Trial Examining the Effects of Tai Chi and Electronic Tablet Use on Older Adults’ Cognition and Health

2018 ◽  
Vol 37 (2) ◽  
pp. 163-174 ◽  
Author(s):  
Beth Mastel-Smith ◽  
Gloria Duke ◽  
Zhaomin He
Keyword(s):  
Older Adults ◽  
Assisted Living ◽  
Tai Chi ◽  
Controlled Trial ◽  
Future Research ◽  
Institutional Review ◽  
Significant Difference ◽  
Before And After ◽  
Theory Of Aging ◽  
To Receive

Purpose: To evaluate the feasibility of Tai Chi (TC) and electronic tablet (ET) interventions on older adults’ cognition and health and to explore participants’ perceptions of intervention activities. Design: An emergent embedded experimental mixed methods design was used in which the qualitative strand helped explain intervention results. Method: Older adults who participate in TC classes will have improved cognition and health compared with older adults who participate in ET classes. Twenty-six participants from two assisted living residences were recruited and randomized to receive nine TC or ET classes. The Modified Mini Mental State Exam was used to measure cognition and the SF-12v2 assessed perceived health before and after the intervention. Participants were invited to share perceptions of the two interventions. Institutional review board approval was obtained and participants provided signed consent for both quantitative and qualitative strands. Findings: There was no significant difference within or between groups on cognition and health scores. Conclusions: TC and ET use are activities that can be delivered in the community and have the potential to promote compensatory scaffolding as described by the revised scaffolding theory of aging and cognition. Future research should involve larger samples and teaching methods that promote learning postures.

scholarly journals Basing Information on Comprehensive, Critically Appraised, and Up-to-Date Syntheses of the Scientific Evidence: An Update from the International Patient Decision Aid Standards

2021 ◽  
pp. 0272989X2199662
Author(s):  
Tammy C. Hoffmann ◽  
Mina Bakhit ◽  
Marie-Anne Durand ◽  
Lilisbeth Perestelo-Pérez ◽  
Catherine Saunders ◽  
...  
Keyword(s):  
Decision Aid ◽  
Scientific Evidence ◽  
Decision Aids ◽  
Future Research ◽  
Patient Decision Aid ◽  
Patient Decision Aids ◽  
Research Areas ◽  
Patient Decision ◽  
Evidence Quality ◽  
Emerging Issues

Background Patients and clinicians expect the information in patient decision aids to be based on the best available research evidence. The objectives of this International Patient Decision Aid Standards (IPDAS) review were to 1) check the currency of, and where needed, update evidence for the domain of “basing the information in decision aids on comprehensive, critically appraised, and up-to-date syntheses of the evidence”; 2) analyze the evidence characteristics of decision aids; and 3) propose updates to relevant IPDAS criteria. Methods We searched MEDLINE and PubMed to inform updates of this domain’s definitions, justifications, and components. We also searched 5 sources to identify all publicly available decision aids ( N = 471). Two assessors independently extracted each aid’s evidence characteristics. Results Minor updates to the definitions and theoretical justifications of this IPDAS domain are provided and changes to relevant IPDAS criteria proposed. Nearly all aids (97%) provided a year of creation/update, but most (81%) did not report an explicit update or expiration policy. No scientific references were cited in 33% of aids. Of the 314 that cited at least 1 reference, 39% cited at least 1 guideline, 44% cited at least 1 systematic review, and 23% cited at least 1 randomized trial. In 35%, it was unclear what statement in the aid the citations referred to. Only 14% reported any of the processes used to find and decide on evidence inclusion. Only 14% reported the evidence quality. Many emerging issues and future research areas were identified. Conclusions Although many emerging issues need to be addressed, this IPDAS domain is validated and criteria refined. High-quality patient decision aids should be based on comprehensive and up-to-date syntheses of critically appraised evidence.

A double-blind placebo-controlled trial of perioperative prophylactic antibiotics for elective neurosurgery

1988 ◽  
Vol 69 (5) ◽  
pp. 687-691 ◽  
Author(s):  
Ross Bullock ◽  
James R. van Dellen ◽  
William Ketelbey ◽  
S. Gustav Reinach
Keyword(s):  
Controlled Trial ◽  
Prophylactic Antibiotics ◽  
Risk Of Infection ◽  
Broad Spectrum Antibiotic ◽  
Wound Sepsis ◽  
Double Blind ◽  
Content Type ◽  
Exact Test ◽  
Significant Difference ◽  
To Receive

✓ In this study, 417 patients undergoing “clean” elective neurosurgical operative procedures were randomized to receive a broad-spectrum antibiotic (piperacillin) or placebo given as three perioperative doses, each 6 hours apart. Randomization was carried out by hospital pharmacists, and the investigators remained blinded until the end of the study. Twenty cases were excluded from analysis because either an unforeseen second operation was performed or antibiotic therapy was initiated within 30 days after surgery to treat infection or the risk of infection. Twelve of the 205 patients treated with placebo developed postoperative wound sepsis, and four of the 192 piperacillin-treated patients developed wound sepsis — a statistically significant difference (p < 0.05, Fisher's exact test). Piperacillin thus appeared to reduce the incidence of neurosurgical wound infection in this study.

scholarly journals P033 Randomised controlled trial on the efficacy of Audio-visual Health Educational materials on CPAP ADherence: The AHEAD trial

2021 ◽  
Vol 2 (Supplement_1) ◽  
pp. A32-A32
Author(s):  
C Ellender ◽  
C Samaranayake ◽  
B Duce ◽  
M Boyde ◽  
S Winter ◽  
...  
Keyword(s):  
Health Literacy ◽  
Low Cost ◽  
Controlled Trial ◽  
Standard Of Care ◽  
Eligibility Criteria ◽  
Cpap Adherence ◽  
Low Health Literacy ◽  
Significant Difference ◽  
Educational Videos ◽  
Video Education

Abstract OSA is a prevalent chronic disease with significant health implications, for which achieving &gt;4 hours/night on continuous positive airway pressure (CPAP) is essential for effective treatment. Educational videos to improve CPAP adherence are of interest as a low-cost intervention, however trials have shown mixed results. This study aimed to compare CPAP usage following standard of care education (SOCE), with the usage following the addition of educational videos, customised to incorporate low health literacy communication, motivational and self-efficacy techniques. Methods Adults with OSA recommended treatment with CPAP, were recruited and randomised in a single blinded method, to watch short educational videos following their in laboratory CPAP study or SOCE. The primary outcome was CPAP usage at 2mths and secondary outcomes were usage at 12mth and proportion of patients with adequate usage &gt;4hrs/night. Results 195 patients met the eligibility criteria and were randomised to video education (n = 96) or to SOCE (n = 99). There was no significant difference in compliance at 2mths (median usage 1.7hrs IQR 0–6.2 SOCE, 4.4hrs IQR 0–6.7 video education p = 0.1), however at 12mths there was increased usage in the video education arm (median 0hrs IQR 0–5.4 standard of care, 3.8hrs IQR 0–6.87 p = 0.05). The proportion with adequate CPAP usage &gt;4hrs/night at 12mths was higher in the video education group (33, 33% versus 48, 50% p = 0.01). Conclusions Long-term adherence to CPAP is enhanced by the addition of educational videos that incorporate low health literacy communication and motivational techniques, compared to SOCE.

scholarly journals EMDR Individual Protocol for Paraprofessional Use: A Randomized Controlled Trial With First Responders

2013 ◽  
Vol 7 (2) ◽  
pp. 55-64 ◽  
Author(s):  
Ignacio Jarero ◽  
Carolina Amaya ◽  
Martha Givaudan ◽  
Alaide Miranda
Keyword(s):  
Controlled Trial ◽  
First Responders ◽  
Global Improvement ◽  
Randomized Controlled ◽  
Posttraumatic Symptoms ◽  
Significant Difference ◽  
To Receive ◽  
Nonsignificant Decrease ◽  
Supportive Counseling

The eye movement desensitization and reprocessing (EMDR) individual protocol for paraprofessional use in acute trauma situations (EMDR-PROPARA) is part of a project developed at the initiative of Dr. Francine Shapiro. This randomized clinical trial examined the effectiveness of the protocol administered by experienced EMDR therapists. There were 39 traumatized first responders on active duty randomly assigned to receive two 90-min sessions of either EMDR-PROPARA or of supportive counseling. Participants in the EMDR-PROPARA group showed benefits immediately after treatment, with their scores on the Short PTSD Rating Interview (SPRINT) showing further decreases at 3-month follow-up. In comparison, supportive counseling participants experienced a nonsignificant decrease after treatment and an increase in the SPRINT scores at the second follow-up. The significant difference between the two treatments provides preliminary support for EMDR-PROPARA’s effectiveness in reducing severity of posttraumatic symptoms and subjective global improvement. More controlled research is recommended to evaluate further the efficacy of this intervention.

A video decision aid to improve acute myeloid leukemia patients’ illness understanding: Results of a pilot trial.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 7040-7040
Author(s):  
Thomas William LeBlanc ◽  
Susan C. Locke ◽  
Kris Herring ◽  
Debra M. Davis ◽  
Jesse D Troy ◽  
...  
Keyword(s):  
Acute Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Decision Aid ◽  
Short Form ◽  
Decision Aids ◽  
Decisional Conflict ◽  
School Level ◽  
High Satisfaction ◽  
Post Test ◽  
Acute Myeloid

7040 Background: Many acute myeloid leukemia (AML) patients harbor misunderstandings about their illness, overestimating both their likelihood of cure and risks of intensive therapies. Decision aids (DA) can improve illness understanding and reduce decisional conflict, but are not routinely used in AML. Methods: We developed an AML DA with input from patients, caregivers, clinicians, and laypersons, via the International Patient Decision Aids Standards (IPDAS) process. It includes 10 short animated videos with voiceovers, covering AML basics, etiology, outcomes, treatment paradigms, and risks/benefits of various treatment approaches. We enrolled 20 patients in a pilot feasibility and efficacy trial, with pre/post survey assessments of AML knowledge via an 18-item questionnaire, decisional conflict (Decisional Conflict Scale; DCS), anxiety (State Trait Anxiety Inventory, Short Form; STAI-6), and measures of DA usability and satisfaction. Results: Participants were a mean of 62.4 years old, 12 (60%) were male, 17 (85%) white, and 15 (75%) had newly-diagnosed disease. Mean time since AML diagnosis was 145 days (median 31; range 2-1092). 16 (80%) exhibited high-school-level understanding of medical terms per the REALM-SF, and participants on average exhibited moderate numeracy (mean score of 4.1 on the Subjective Numeracy Scale). All participants completed the study, exceeding our pre-determined feasibility threshold. AML knowledge scores generally improved, from a mean of 11.8 correct items on pre-test, to 15.2 on post-test assessment (p < 0.0001), with 80% of participants achieving improved scores. Struggles remained regarding patients’ understanding of the role that genetic tests play in AML care. There was no increase in anxiety after watching the videos, but decisional conflict was significantly reduced, from a mean of 28.5 at baseline to 22 in the post-test (p = .019). Participants reported high satisfaction and usability scores for the DA. Conclusions: Our AML decision aid exhibits favorable performance characteristics, with high satisfaction and usability, a marked increase in patient knowledge, and reduced decisional conflict. Further testing is warranted in a randomized trial. Clinical trial information: NCT03442452.

Educational Video Intervention Effects on Periprocedural Anxiety Levels Among Cardiac Catheterization Patients: A Randomized Clinical Trial

2016 ◽  
Vol 30 (1) ◽  
pp. 70-84 ◽  
Author(s):  
Shahnaz Mohammed Ayasrah ◽  
Muayyad M. Ahmad
Keyword(s):  
Cardiac Catheterization ◽  
Controlled Trial ◽  
Test Procedure ◽  
Group Versus ◽  
Educational Video ◽  
Video Intervention ◽  
Significant Difference ◽  
Anxiety Levels ◽  
Experimental Group ◽  
Video Education

Purpose: To explore the effectiveness of an educational video intervention in lowering periprocedural anxiety among Jordanian patients hospitalized for cardiac catheterization (CATH). There are many potential reasons of anxiety related to CATH including involvement of the heart and the actual test procedure. Methods: A randomized controlled trial took place in a specialized heart institute in Jordan. The sample size was 186 patients who had undergone CATH procedure. Patients anxiety levels were measured by physiological parameters of anxiety (blood pressure, heart rate, and respiratory rate) and by the Spielberger State Anxiety Inventory (SAI). Results: After video education, there was a significant difference in periprocedural perceived anxiety between the groups: preprocedural anxiety levels (M = 39.03, SD = 5.70) for the experimental group versus (M = 49.34, SD = 6.00) for the control, p < .001, and postprocedural perceived anxiety for the experimental group (M = 29.18, SD = 5.42) versus (M = 41.73, SD = 5.41) for the control. Conclusion: Providing an educational video intervention about CATH may effectively decrease periprocedural anxiety levels.

scholarly journals Impact of Artificial Intelligence, With and Without Information, on Pathologists’ Decisions: An Experiment

2021 ◽  
Author(s):  
Julien Meyer ◽  
April Khademi ◽  
Bernard Têtu ◽  
Wencui Han ◽  
Pria Nippak ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Decision Aid ◽  
Online Survey ◽  
Decision Aids ◽  
Survey Study ◽  
Gleason Grade ◽  
Accuracy Rate ◽  
Significant Difference ◽  
The Difference ◽  
The Individual

Abstract Background: Artificial intelligence (AI) is rapidly gaining attention in medicine and in pathology in particular. While much progress has been made in refining the accuracy of algorithms, thereby increasing their potential use, we need to better understand how these algorithms will be used by pathologists, who will remain for the foreseeable future the decision-makers. The objective of this paper is to determine the propensity of pathologists to rely on AI decision aids and to investigate whether providing information on the algorithm impacts this reliance.Methods: To test our hypotheses, we conducted an experiment with within-subjects design using an online survey study. 116 respondent pathologists and pathology students participated in the experiment. Each participant was tasked with assessing the Gleason grade for a series of 12 prostate cancer samples under three conditions: without advice, with advice from an AI decision aid, and with advice from an AI decision aid with information provided on the algorithm, namely the algorithm accuracy rate and the algorithm model. Scores were computed by comparing the respondents’ scores with the “true” score at the individual-question level. A mixed effects logistic regression was used to analyze the difference in scores between the different conditions, controlling for the random effects of participants and images and to assess the interactions with Experience, Gender and beliefs towards AI.Results: Participant responses to the questions with AI decision aids were significantly more accurate than the control condition without aid. However, no significant difference was found when subjects were provided with additional accuracy rate and model information on the AI advice. Moreover, the propensity to rely on AI was found to relate to general beliefs on AI but not with particular assessments of the AI tool offered. Males also performed better in the No-aid condition but not in the AI-aid condition.Conclusions: AI can significantly influence pathologists and the general beliefs in AI could be major predictors of future reliance on AI by pathologists.

scholarly journals Quality of Care Perceived by Older Patients and Caregivers in Integrated Care Pathways With Interviewing Assistance From a Social Robot: Noninferiority Randomized Controlled Trial (Preprint)

2020 ◽  
Author(s):  
Roel Boumans ◽  
Fokke van Meulen ◽  
William van Aalst ◽  
Joyce Albers ◽  
Marèse Janssen ◽  
...  
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Older Patients ◽  
Care Pathway ◽  
Controlled Trial ◽  
Social Robot ◽  
Control Group ◽  
Robot Assisted ◽  
Significant Difference

BACKGROUND Society is facing a global shortage of 17 million health care workers, along with increasing health care demands from a growing number of older adults. Social robots are being considered as solutions to part of this problem. OBJECTIVE Our objective is to evaluate the quality of care perceived by patients and caregivers for an integrated care pathway in an outpatient clinic using a social robot for patient-reported outcome measure (PROM) interviews versus the currently used professional interviews. METHODS A multicenter, two-parallel-group, nonblinded, randomized controlled trial was used to test for noninferiority of the quality of care delivered through robot-assisted care. The randomization was performed using a computer-generated table. The setting consisted of two outpatient clinics, and the study took place from July to December 2019. Of 419 patients who visited the participating outpatient clinics, 110 older patients met the criteria for recruitment. Inclusion criteria were the ability to speak and read Dutch and being assisted by a participating health care professional. Exclusion criteria were serious hearing or vision problems, serious cognitive problems, and paranoia or similar psychiatric problems. The intervention consisted of a social robot conducting a 36-item PROM. As the main outcome measure, the customized Consumer Quality Index (CQI) was used, as reported by patients and caregivers for the outpatient pathway of care. RESULTS In total, 75 intermediately frail older patients were included in the study, randomly assigned to the intervention and control groups, and processed: 36 female (48%) and 39 male (52%); mean age 77.4 years (SD 7.3), range 60-91 years. There was no significant difference in the total patient CQI scores between the patients included in the robot-assisted care pathway (mean 9.27, SD 0.65, n=37) and those in the control group (mean 9.00, SD 0.70, n=38): <i>P</i>=.08, 95% CI –0.04 to 0.58. There was no significant difference in the total CQI scores between caregivers in the intervention group (mean 9.21, SD 0.76, n=30) and those in the control group (mean 9.09, SD 0.60, n=35): <i>P</i>=.47, 95% CI –0.21 to 0.46. No harm or unintended effects occurred. CONCLUSIONS Geriatric patients and their informal caregivers valued robot-assisted and nonrobot-assisted care pathways equally. CLINICALTRIAL ClinicalTrials.gov NCT03857789; https://clinicaltrials.gov/ct2/show/NCT03857789

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