Medical decision making : an international journal of the Society for Medical Decision Making
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Review
What is known about parents' treatment decisions? A narrative review of pediatric decision making.
With the increasing complexity of decisions in pediatric medicine, there is a growing need to understand the pediatric decision-making process. ⋯ Current research demonstrates a diversity of influences on parent decision making and parent decision preferences; however, little is known about decision outcomes or interventions to improve outcomes. Further investigation, using prospective methods, is needed in order to understand how to support parents through the difficult treatment decisions.
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Review Comparative Study
Systematic review and empirical comparison of contemporaneous EQ-5D and SF-6D group mean scores.
Group mean estimates and their underlying distributions are the focus of assessment for cost and outcome variables in economic evaluation. Research focusing on the comparability of alternative preference-based measures of health-related quality of life has typically focused on analysis of individual-level data within specific clinical specialties or community-based samples. ⋯ These findings show that group mean EQ-5D and SF-6D scores are not directly comparable. This raises serious concerns about the cross-study comparability of economic evaluations that differ in the choice of preference-based measures, although the review focuses on 2 of the available instruments only. Further work is needed to address the practical implications of noninterchangeable utility estimates for cost-per-QALY estimates and decision making.
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Processes of communication that guide decision making among clinicians collaboratively caring for complex patients are poorly understood and vary based on local contexts. In this paper, the authors characterize these processes and propose a wiki-style communication model to improve coordination of decision making among clinicians using an integrated electronic health record (EHR). ⋯ EHR-based wiki-style applications may have the potential to improve communication and care coordination among clinicians caring for complex patients. This could lead to improved quality and safety within multidisciplinary disease management programs.
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Diabetes self-management presents a series of challenging tasks, and primary care, where the majority of cases of adult diabetes are treated, is hard-pressed to address these issues given competing demands. This article discusses how interactive media (IM) can be used to support diabetes self-management. ⋯ . Key opportunities for IM to support diabetes self-management include assessment of information for shared decision making, assistance with problem-solving self-management challenges, and provision of follow-up support. A key current challenge is the linkage of IM supports to the rest of the patient's care, and collection of cost-effectiveness data is a key need for future research.
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Health-state utilities are essential for cost-utility analysis. Few estimates exist for liver disease in the literature. The authors' aim was to conduct a systematic review of health-state utilities in liver disease, to look at the variation of study designs used, and to pool utilities for some liver disease states. ⋯ The authors have created a valuable liver disease- based utility resource from which researchers and policy makers can easily view all available utility estimates from the literature. They have also estimated health-state utilities for major states of hepatitis C.