Journal of pain and symptom management
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J Pain Symptom Manage · Nov 2020
Multicenter StudyMinimal clinically important differences and feasibility of Dyspnea-12 and the Multidimensional Dyspnea Profile in cardiorespiratory disease.
Breathlessness is a cardinal symptom in cardiorespiratory disease and consists of multiple dimensions that can be measured using the instruments Dyspnea-12 (D12) and the Multidimensional Dyspnea Profile (MDP). ⋯ D12 and MDP are responsive to change and feasible for use for assessing multidimensional breathlessness in outpatients with cardiorespiratory disease. MCIDs were determined for use as endpoints in clinical trials.
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J Pain Symptom Manage · Nov 2020
Deep natural language processing to identify symptom documentation in clinical notes for patients with heart failure undergoing cardiac resynchronization therapy.
Clinicians lack reliable methods to predict which patients with congestive heart failure (CHF) will benefit from cardiac resynchronization therapy (CRT). Symptom burden may help to predict response, but this information is buried in free-text clinical notes. Natural language processing (NLP) may identify symptoms recorded in the electronic health record and thereby enable this information to inform clinical decisions about the appropriateness of CRT. ⋯ A deep NLP algorithm can be trained to capture symptoms in patients with CHF who received CRT with promising precision and recall.
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J Pain Symptom Manage · Nov 2020
The Experience of Emergency Department Providers with Embedded Palliative Care during COVID.
Although the importance of palliative care (PC) integration in the emergency department (ED) has long been recognized, few formalized programs have been reported, and none have evaluated the experience of ED clinicians with embedded PC. ⋯ ED clinicians' perception of embedded PC was overall positive, with an emphasis on the impact related to task management, enrichment of PC skills, providing support for the team, and improved care for ED patients.
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J Pain Symptom Manage · Nov 2020
Long-term prognosis of older adults who survive emergency mechanical ventilation.
Emergent mechanical ventilation represents an important inflection point in seriously ill older adults' illness trajectories. Data are lacking on the long-term prognosis after surviving mechanical ventilation to inform shared decision making in serious illness conversations. ⋯ This study demonstrated the long-term prognosis of older adults who underwent emergent mechanical ventilation. These data could be used to inform shared decision making in serious illness conversations.