Articles: outcome-assessment-health-care.
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Acute kidney injury (AKI) is a highly prevalent clinical syndrome that substantially impacts patient outcomes. It is accepted by the clinical communities that the management of AKI is time-sensitive. Unfortunately, despite growing proof of its preventability, AKI management remains suboptimal in community, acute care, and postacute care settings. Digital health solutions comprise various tools and models to improve care processes and patient outcomes in multiple medical fields. AKI development, progression, recovery, or lack thereof, offers tremendous opportunities for developing, validating, and implementing digital health solutions in multiple settings. This article will review the definitions and components of digital health, the characteristics of AKI that allow digital health solutions to be considered, and the opportunities and threats in implementing these solutions. ⋯ Careful needs assessment, selection of the correct digital health solution, and appropriate clinical validation of the benefits while avoiding additional health disparities are moral, professional, and ethical obligations for all individuals using these healthcare tools, including clinicians, data scientists, and administrators.
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Pediatric emergency care · Dec 2023
Assessment of the Interval to Diagnosis in Pediatric Bone Sarcoma.
The timely diagnosis of primary bone malignancies in pediatric patients is critical to clinical outcomes. The purpose of this study is to investigate the initial presentation of pediatric bone sarcoma patients to an academic health care system and assess the current interval to diagnosis. ⋯ We found pediatric patients with primary bone sarcoma present with an average interval to diagnosis of 20 days. Twenty percent of patients had a significantly prolonged interval to diagnosis of 54 days. Clinical features suggest night pain is not a sensitive indicator. In patients of appropriate age with persistent unilateral pain in suspicious locations, early advanced imaging with magnetic resonance imaging should be considered.
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Support for Complicated Grief in Military Primary Care: Associations, Challenges, and Opportunities.
This study examined whether service members and their families engage in communication with their primary care managers (PCMs) regarding their losses and to what extent PCMs provide counseling or referrals for grief-related concerns. Additionally, the study explored the potential associations between ethnicity, age, military status (dependent, service member, or veteran), gender, patients' disclosure of loss to their PCM, receipt of referrals for grief-related services, and treatment seeking. ⋯ The study's findings have implications for primary care and highlight opportunities for improved outcomes, including the development of appropriate assessment protocols, interventions, and educational initiatives to address grief-related concerns within the military healthcare system. Future research should further investigate the specific needs and preferences of military personnel and their families to enhance the delivery of targeted and effective healthcare services.
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Randomized Controlled Trial Multicenter Study
Effects of the Million Hearts Model on Myocardial Infarctions, Strokes, and Medicare Spending: A Randomized Clinical Trial.
The Million Hearts Model paid health care organizations to assess and reduce cardiovascular disease (CVD) risk. Model effects on long-term outcomes are unknown. ⋯ The Million Hearts Model, which encouraged and paid for CVD risk assessment and reduction, reduced first-time MIs and strokes. Results support guidelines to use risk scores for CVD primary prevention.
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Palliative medicine · Oct 2023
ReviewWhat outcomes do studies use to measure the impact of prognostication on people with advanced cancer? Findings from a systematic review of quantitative and qualitative studies.
Studies evaluating the impact of prognostication in advanced cancer patients vary in the outcomes they measure, and there is a lack of consensus about which outcomes are most important. ⋯ Outcome reporting and measurement varied markedly across the studies. A standardised approach to outcome reporting in studies of prognosis is necessary to enhance data synthesis, improve clinical practice and better align with stakeholders' priorities.