Journal of general internal medicine
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Clinical decision support systems can improve medical diagnosis and reduce diagnostic errors. Older systems, however, were cumbersome to use and had limited success in identifying the correct diagnosis in complicated cases. ⋯ The Isabel clinical decision support system quickly suggested the correct diagnosis in almost all of these complex cases, particularly with key finding entry. The system performed well in this experimental setting and merits evaluation in more natural settings and clinical practice.
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To evaluate the impact of regulatory scenarios on the financial viability of medical device companies. ⋯ The environment in which the medical device industry operates is financially attractive. Furthermore, when compared with the alternative of applying the same evidence standards for pharmaceuticals to medical devices, the CSP policy offers improved financial incentives for medical device companies.
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As patients grow older, accurate communication with health care providers about cancer becomes increasingly important. However, little is known about the cancer communication experiences of older Asian immigrants. ⋯ Clinicians should be aware of and act upon specific cancer communication needs/challenges of their older immigrant patients. Moreover, health care systems need to be prepared to address the needs of an increasingly multiethnic and linguistically diverse patient population. Finally, community-level interventions should address baseline knowledge deficits while encouraging immigrant patients to engage their doctors in discussions about cancer screening.
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Comparative Study
Programmable infusion pumps in ICUs: an analysis of corresponding adverse drug events.
Patients in intensive care units (ICUs) frequently experience adverse drug events involving intravenous medications (IV-ADEs), which are often preventable. ⋯ The smart pumps we evaluated are unlikely to reduce preventable IV-ADEs in ICUs because they address only 4% of them. Expanding smart-pump capabilities might prevent more IV-ADEs.
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To understand potential barriers to physician-initiated discussions about Implantable Cardioverter Defibrillator (ICD) deactivation in patients with advanced illness. ⋯ Whereas some of the barriers to discussing ICD deactivation are common to all forms of advance care planning, ICDs have unique characteristics that make these conversations more difficult. Future educational interventions will need to be designed to teach physicians how to improve communication with patients about the management of ICDs at the end of life.