Medical Decision Making

How health professionals and patients make treatment decisions, and the barriers to, and facilitators of, effective decision making.

Opioid Prescribing After Surgery in the United States, Canada, and Sweden

Mark D. Neuman, MD
Sep. 4, 2019

Karim S. Ladha, Mark D. Neuman, Gabriella Broms, Jennifer Bethell, Brian T. Bateman, Duminda N. Wijeysundera, Max Bell, Linn Hallqvist, Tobias Svensson, Craig W. Newcomb, Colleen M. Brensinger, Lakisha J. Gaskins, Hannah Wunsch

Abstract [from journal]

Importance: Small studies and anecdotal evidence suggest marked differences in the use of opioids after surgery internationally; however, this has not been evaluated systematically across populations receiving similar procedures in different countries.

Objective: To determine whether there are differences in the frequency, amount, and type of opioids dispensed after surgery among the United States, Canada, and Sweden.

Design, Setting, and Participants: This cohort study included patients...

Impact of Public Reporting of Cardiovascular Outcomes on a Non-Reported Procedure

Apr. 26, 2019

Public reporting of cardiovascular outcomes remains controversial, 20 years after New York became the first state to mandate reporting of mortality data for percutaneous coronary intervention (PCI). It has been associated with a lower likelihood of performing potentially lifesaving procedures, perhaps reflecting an avoidance of intervening in high-risk cases.

Shared decision-making in the BREATHE asthma intervention trial: A research protocol

Marilyn Sommers, PhD, RN, FAAN
Apr. 1, 2019

Maureen George, Michael V. Pantalon, Marilyn (Lynn) S. Sommers, Karen Glanz, Haomiao Jia, Annie Chung, Allison A. Norful, Lusine Poghosyan, Danielle Coleman, Jean‐Marie Bruzzese
 

Abstract [from journal]

Aim: To evaluate the preliminary effectiveness of the BRief Evaluation of Asthma THerapy intervention, a 7-min primary care provider-delivered shared decision-making protocol that uses motivational interviewing to address erroneous asthma disease and medication beliefs.

Design: A multi-centre masked two-arm group-randomized clinical trial.

Methods: This 2-year pilot study is funded (September 2016) by the National Institute of Nursing Research. Eight providers will be randomized to one of two arms: the...

Rise of the Machines in Health Care?

Feb. 22, 2019

Artificial intelligence (AI) is moving fast and breaking things everywhere. It is built into multinational supply chains, web-based services, cars, and, slowly, health care. Although the adoption of AI in health care has been bumpy, it continues unabated. Last year, the U.S.

Measuring Emergency Care Survival: The Implications of Risk-Adjusting for Race and Poverty

Jun. 20, 2018

Kimon L.H. Ioannides, Avi Baehr, David N. Karp, Douglas J. Wiebe, Brendan G. Carr,...

ABSTRACT [FROM JOURNAL]

Objectives: We determined the impact of including race, ethnicity, and poverty in risk adjustment models for emergency care sensitive conditions mortality that could be used for hospital pay‐for‐performance initiatives. We hypothesized that adjusting for race, ethnicity, and poverty would bolster rankings for hospitals that cared for a disproportionate share of non‐white, Hispanic, or poor patients.

Methods: We performed a cross‐sectional analysis

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