mHealth in clinical decision-making: A systematic literature review (Preprint)

2019 ◽  
Author(s):  
Amandeep Dhir
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Care Providers ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Future Research ◽  
Care Providers ◽  
Rigorous Approach ◽  
Almost All ◽  
Mhealth Apps

UNSTRUCTURED A large number of mHealth apps are available nowadays for patients and health care providers. Many of those apps are designed specifically for clinical decision making (CDM). Despite their proliferation, limited studies have examined the utilization and effectiveness of these apps. The current study undertakes a systematic review to organize and synthesize the extant literature on mHealth for CDM in all resource settings. A thorough search of databases resulted in a preliminary list of 1,313 titles and abstracts, of which 1,107 were excluded as they were either duplicates or irrelevant to the scope of the study. Thereafter, full-text screening of the remaining 206 articles was performed, and 175 were excluded on the basis of pre-specified inclusion/exclusion criteria. This rigorous approach resulted in the identification of 31 studies for inclusion in the review. The utilization of mHealth for CDM appears to have pervaded almost all health care settings, as demonstrated by the insights gleaned from the review of the prior studies in the domain. However, the evidence of effectiveness is still limited and unreliable, which underscores the existence of a paucity of accumulated knowledge that, in turn, invites interesting opportunities for future research.

Consent, Refusal, and Waivers in Patient-Centered Dysphagia Care: Using Law, Ethics, and Evidence to Guide Clinical Practice

2016 ◽  
Vol 25 (4) ◽  
pp. 453-469 ◽  
Author(s):  
Jennifer Horner ◽  
Maria Modayil ◽  
Laura Roche Chapman ◽  
An Dinh
Keyword(s):  
Health Care ◽  
Public Policy ◽  
Clinical Practice ◽  
Health Care Providers ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Care Providers ◽  
Patient Centered ◽  
Legal Advice ◽  
Medical Context

PurposeWhen patients refuse medical or rehabilitation procedures, waivers of liability have been used to bar future lawsuits. The purpose of this tutorial is to review the myriad issues surrounding consent, refusal, and waivers. The larger goal is to invigorate clinical practice by providing clinicians with knowledge of ethics and law. This tutorial is for educational purposes only and does not constitute legal advice.MethodThe authors use a hypothetical case of a “noncompliant” individual under the care of an interdisciplinary neurorehabilitation team to illuminate the ethical and legal features of the patient–practitioner relationship; the elements of clinical decision-making capacity; the duty of disclosure and the right of informed consent or informed refusal; and the relationship among noncompliance, defensive practices, and iatrogenic harm. We explore the legal question of whether waivers of liability in the medical context are enforceable or unenforceable as a matter of public policy.ConclusionsSpeech-language pathologists, among other health care providers, have fiduciary and other ethical and legal obligations to patients. Because waivers try to shift liability for substandard care from health care providers to patients, courts usually find waivers of liability in the medical context unenforceable as a matter of public policy.

The Role of Children and Adolescents in Decision Making About Life-Threatening Illness

2021 ◽  
pp. 104-117
Author(s):  
Victoria A. Miller ◽  
Melissa K. Cousino
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Children And Adolescents ◽  
Health Care Providers ◽  
Control Treatment ◽  
Future Research ◽  
Care Providers ◽  
Life Threatening Illness ◽  
Life Threatening ◽  
And Control

The concept of decision-making involvement (DMI) recognizes that children and adolescents can be involved in decision making in numerous ways and that parents and health care providers have an important role in supporting and guiding youth. Facilitating DMI may enhance youth decision-making skills, self-efficacy and control, treatment adherence, and satisfaction with care. Given the loss of control children and adolescents typically feel when diagnosed with a serious, life-threatening illness, DMI may be especially important. Parents and health care providers can facilitate child and adolescent involvement by seeking their opinions and concerns, soliciting questions, asking for information, and checking for understanding. Additional tools are available for facilitating youth involvement in decision making at the end of life. Future research is needed to develop and evaluate strategies to enhance different aspects of DMI in multiple settings and contexts across development.

scholarly journals Clinical decision-making approaches by health caregivers of patients with COVID-19

2020 ◽  
Vol 7 (10) ◽  
pp. 4056-4057
Author(s):  
Mohsen Taghadosi ◽  
Neda Mirbagher Ajorpaz ◽  
Mohammad Aghajani
Keyword(s):  
Decision Making ◽  
Health Care Providers ◽  
Clinical Decision Making ◽  
Quality Care ◽  
Healthcare Providers ◽  
Clinical Decision ◽  
World Health ◽  
Care Providers ◽  
Health Crisis ◽  
The World

The Coronavirus disease of 2019 COVID-19) is the current health crisis in the world- a new, complex phenomenon that has affected and hospitalized many people around the world. Health care providers deal with COVID-19 patients daily and care for the patients while there is no definitive cure for it. Clinical decision-making is an important task of health professionals that plays an essential role in preserving the patient's life and providing quality care. Therefore, understanding clinical decision-making approaches by healthcare providers, such as nurses and physicians, especially in crises such as COVID-19, is essential.

scholarly journals Real time location systems: Is it big brother or a big opportunity for professional practice?

2020 ◽  
Vol 10 (11) ◽  
pp. 67
Author(s):  
Jacqueline Limoges ◽  
Sara Lankshear ◽  
Joseph Church
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Real Time ◽  
Professional Practice ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Care Providers ◽  
Location Systems

Purpose: Real Time Location Systems (RTLS) is an emerging health care technology with the potential to capture data that can be used to improve professional practice and patient outcomes. However, there is a paucity of literature in this area to guide health professionals and leaders in both the implementation and use of RTLS data. To address this gap in the literature, this qualitative study was designed to explore how staff perceive and experience RTLS, and how health care providers anticipate using RTLS data for professional practice and clinical decision making.Results: Interviews and focus groups were conducted with 31 health care professionals who work in a community hospital in Canada. There was variation between the participants in terms of the experience of being monitored, the intensity of emotions related to RTLS and being monitored, the degree to which RTLS influenced clinical decision making and reflection, and the perceptions of usefulness of RTLS data for  professional practice. Three key themes emerged from the data: (1) the experience of being monitored, (2) anticipating using the data and (3) claiming the data for professional practice.Conclusions: Supports are vital to the successful adoption of RTLS and to enable health care professionals to claim and use RTLS data for professional practice and clinical decision making. During the implementation and use of RTLS data, it is crucial to recognize that RTLS data only represent the time spent in a location, and not the professional or knowledge-based practice of health professionals. Further research is required to understand the leadership strategies to guide the use of RTLS data.

Alternative Medicine and Multiple Sclerosis: An Objective Review from an American Perspective

2000 ◽  
Vol 2 (3) ◽  
pp. 15-28 ◽  
Author(s):  
Allen C. Bowling ◽  
Ragaa Ibrahim ◽  
Thomas M. Stewart
Keyword(s):  
Multiple Sclerosis ◽  
Health Care ◽  
Alternative Medicine ◽  
Health Care Providers ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
The United States ◽  
Care Providers ◽  
American Perspective ◽  
Conventional Medical Therapy

Abstract The use of complementary and alternative medicine (CAM), or unconventional medicine, may be challenging for health care providers in the United States. There are several definitions of CAM, and therapies that are considered alternative in one country may be conventional in other countries. Unconventional medical practices may be used instead of, or in addition to, conventional medical therapy. It may be difficult for people with multiple sclerosis (MS) to obtain reliable MS-relevant CAM information, and there may be conflicts between the values of patients and those of health care providers. These issues may create problems in the clinical decision-making process. The relevance to MS of some commonly used CAM therapies is discussed: herbal medicine, vitamins and minerals, marijuana, and a histamine and caffeine transdermal gel patch. Current information about the efficacy and safety of CAM therapies is extremely variable. Some therapies appear promising, others are unsafe or ineffective, and nearly all need to be studied further.

scholarly journals MORE ENABLING APPROACH: A CHALLENGE FOR THE PRACTITIONERS- A CRITICAL REVIEW

2016 ◽  
Vol 5 (1) ◽  
pp. 4-10
Author(s):  
Amna Aamir Khan ◽  
Sumaira Imran Farooqui
Keyword(s):  
Decision Making ◽  
Health Care Providers ◽  
Clinical Decision Making ◽  
Evidence Based Practice ◽  
Clinical Decision ◽  
Activity Limitation ◽  
Multidisciplinary Teams ◽  
Evidence Based ◽  
Care Providers ◽  
Participation Restriction

The multidisciplinary teams of today are working in-collaboration and as one unit to assess, set goals, evaluate and provide reliable interventions to the patients/client. The essence of conceptual framework of ICF provides an opportunity to achieve the common goals of activity limitation and participation restriction by adapting a holistic model of rehabilitation encompassing the psychological, physical and the emotional needs with the advent of new techniques and modernized technologies. The new enabling approach is challenge faced by the health care providers where patient preferences, empowerment and health related quality of life are most essential. The review will provide a critical analysis on the barriers faced by the practitioner especially during clinical decision making. Psychosocial perspectives of the client that is the most ignored area is also emphasized in the review and also motivational aspects of the patients in promoting the evidence based practice and clinical decision making and ultimately focusing on the enablement of the disabled. KEYWORDS Enabling Approach, Evidence Based Practice, HRQoL, Clinical Decision Making, Psychological, Disability, Activity Limitation, Participation Restriction

scholarly journals Invited Commentary: Opportunities That Come With Studying the Co-Occurrence of Multiple Outcomes

2020 ◽  
Vol 189 (9) ◽  
pp. 982-984 ◽  
Author(s):  
Sebastien Haneuse ◽  
Deborah Schrag ◽  
Daniel Nevo
Keyword(s):  
Health Care Providers ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Evidence Base ◽  
Clinical Settings ◽  
Care Providers ◽  
Additional Information ◽  
Potential Benefits ◽  
Almost All

Abstract In almost all clinical settings, patients are at risk for multiple potential events and, in consultation with health-care providers, must weigh the potential benefits and harms across these events when making decisions. As researchers seek to build an evidence base to inform these decisions, they must contend with a choice as to how they will handle the different events. One approach, arguably the standard approach in the literature, is to consider the events individually by conducting analyses and publishing results for each one at a time. Doing so, however, fails to acknowledge or exploit the inherent multivariate nature of the data, represents a lost opportunity, and results in an evidence base that is not aligned with how clinical decision-making is actually performed. The article by Prentice et al. (Am J Epidemiol. 2020;189(9):972–981) in this issue of the Journal moves beyond this standard by illustrating recently developed methods that directly take advantage of information on the co-occurrence of multiple events. Moreover, their article highlights the role of modern methods in deriving additional information and insight from studies of multiple clinical outcomes by making full use of multivariate data, with the goal being to complement, not replace, existing methods.

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