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Measurement challenges in shared decision making: putting the ‘patient’ in patient‐reported measures 下载免费PDF全文
Paul J. Barr PhD MSc PH BSc Psych Glyn Elwyn BA MB BCh MSc PhD 《Health expectations》2016,19(5):993-1001
Measuring clinicians' shared decision‐making (SDM) performance is a key requirement given the intensity of policy interest in many developed countries – yet it remains one of the most difficult methodological challenges, which is a concern for many stakeholders. In this Viewpoint Article, we investigate the development of existing patient‐reported measures (PRMs) of SDM identified in a recent review. We find that patients were involved in the development of only four of the 13 measures. This lack of patient involvement in PRM development is associated with two major threats to content validity, common to all 13 PRMs of SDM: (i) an assumption of patient awareness of ‘decision points’ and (ii) an assumption that there is only one decision point in each healthcare consultation. We provide detailed examples of these threats and their impact on accurate assessment of SDM processes and outcomes, which may hamper efforts to introduce incentives for SDM implementation. We propose cognitive interviewing as a recommended method of involving patients in the design of PRMs in the field of SDM and provide a practical example of this approach. 相似文献
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He Li BCh Hongmei Zeng PhD Rongshou Zheng MPH Xiaonong Zou MD Maomao Cao BCh Dianqin Sun BCh Jinyi Zhou MPH Pengfei Luo MPH Shangchun Jia BCh Zhenqiu Zha PhD Jialin Wang BCh Hengmin Ma MPH Xibin Sun BCh Xiaoqin Cao PhD Shixian Feng BCh Lei Fan MPH Jufang Shi PhD Wanqing Chen PhD 《Cancer》2020,126(20):4563-4571
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Meredith Achey BM Jason L. Aldred MD Noha Aljehani MD Bastiaan R. Bloem MD PhD Kevin M. Biglan MD MPH Piu Chan MD PhD Esther Cubo MD PhD E. Ray Dorsey MD MBA Christopher G. Goetz MD Mark Guttman MD Anhar Hassan MB BCh FRACP Suketu M. Khandhar MD Zoltan Mari MD Meredith Spindler MD Caroline M. Tanner MD PhD Pieter van den Haak MSc Richard Walker MD Jayne R. Wilkinson MD 《Movement disorders》2014,29(7):871-883
Travel distance, growing disability, and uneven distribution of doctors limit access to care for most Parkinson's disease (PD) patients worldwide. Telemedicine, the use of telecommunications technology to deliver care at a distance, can help overcome these barriers. In this report, we describe the past, present, and likely future applications of telemedicine to PD. Historically, telemedicine has relied on expensive equipment to connect single patients to a specialist in pilot programs in wealthy nations. As the cost of video conferencing has plummeted, these efforts have expanded in scale and scope, now reaching larger parts of the world and extending the focus from care to training of remote providers. Policy, especially limited reimbursement, currently hinders the growth and adoption of these new care models. As these policies change and technology advances and spreads, the following will likely develop: integrated care networks that connect patients to a wide range of providers; education programs that support patients and health care providers; and new research applications that include remote monitoring and remote visits. Together, these developments will enable more individuals with PD to connect to care, increase access to expertise for patients and providers, and allow more‐extensive, less‐expensive participation in research. © 2014 International Parkinson and Movement Disorder Society 相似文献
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Cillian Clancy MB BCh MRCSI John P. Burke PhD MRCSI Mitchel Barry MD FRCSI Matthew F. Kalady MD FASCRS J. Calvin Coffey PhD FRCSI 《Annals of surgical oncology》2014,21(12):3900-3908
Background
Approximately 20 % of patients diagnosed with colorectal cancer will have distant metastases at first presentation (stage IV disease). The effect of removing the primary tumor on survival for patients with stage IV disease with unresectable metastases remains unclear. To address this a meta-analysis of all studies comparing primary tumor resection with chemotherapy alone in cases of stage IV colorectal cancer with unresectable metastases was performed.Methods
A comprehensive search for published studies examining the effect of primary tumor resection in the setting of colorectal cancer with unresectable metastases was performed. Each study was reviewed and data extracted. Random-effects methods were used to combine data.Results
There were 21 studies including a total of 44,226 patients that met the inclusion criteria. Resection of the primary tumor in patients with unresectable metastases compared with chemotherapy alone was associated with a lower mortality risk (OR 0.28; 95 % CI 0.165–0.474; P < 0.001), translating into a difference in mean survival of 6.4 months in favor of resection (95 % CI 5.025–7.858, P < 0.001). Patients who underwent resection of the primary tumor were more likely to have liver metastasis only (OR 1.551; 95 % CI 1.247–1.929; P < 0.001), were less likely to have ≥2 metastasis (OR 0.653; 95 % CI 0.508–0.839; P = 0.001), and were less likely to have rectal cancer (OR 0.495; 95 % CI 0.390–0.629; P < 0.001). There was significant cross-study heterogeneity.Conclusions
Resection of the primary tumor may confer a survival advantage in stage IV colorectal cancer with unresectable metastases but significant selection bias exists in current studies. Randomized controlled trials are essential to validate these findings. 相似文献8.
The significance of receptor status discordance between breast cancer primary and brain metastasis 下载免费PDF全文
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Sanskriti Sasikumar MD Melanie Cohn PhD Irene E. Harmsen BSc Aaron Loh MB BCh BAO Sang Soo Cho PhD Michel Sáenz-Farret MD MSc Ricardo Maciel MD MSc Derrick Soh MD Alexandre Boutet MD PhD Jürgen Germann PhD Gavin Elias BA Ariana Youm MA Katherine Duncan PhD Nathan C. Rowland MD PhD Antonio P. Strafella MD PhD Suneil K. Kalia MD PhD Andres M. Lozano MD PhD Alfonso Fasano MD PhD 《Movement disorders》2022,37(3):635-640