American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Aug 2014
ReviewA Universal Decision Support System: Addressing the Decision Making Needs of Patients, Families, and Clinicians in the Setting of Critical Illness.
In the setting of a complex critical illness, preference-sensitive decision making-choosing between two or more reasonable treatment options-can be difficult for patients, families, and clinicians alike. A common challenge to making high-quality decisions in this setting is a lack of critical information access and sharing among participants. Decision aids-brochures, web applications, and videos-are a major focus of current research because mounting evidence suggests they can improve decision-making quality and enhance collaborative shared decision making. ⋯ The format and content of the system could be adapted to decisional participants' unique characteristics, abilities, and needs. Universal decision support can better standardize a decisional approach and also allow a unique degree of personalization within a framework of shared decision making. We also discuss potential criticisms of this approach as well as strategies that can overcome them in a critical illness setting.
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Am. J. Respir. Crit. Care Med. · Aug 2014
Integrative 'Omic Analysis of Experimental Bacteremia Identifies a Metabolic Signature that Distinguishes Human Sepsis from SIRS.
Sepsis is a leading cause of morbidity and mortality. Currently, early diagnosis and the progression of the disease are difficult to make. The integration of metabolomic and transcriptomic data in a primate model of sepsis may provide a novel molecular signature of clinical sepsis. ⋯ A model of sepsis based on reciprocal metabolomic and transcriptomic data was developed in primates and validated in two human patient cohorts. It is anticipated that the identified parameters will facilitate early diagnosis and management of sepsis.