Annals of internal medicine
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Patient care for the practicing physician increasingly relies on medical devices. The U. ⋯ In addition to playing a role in the clinical use of devices, physicians may also participate in their design, production, use, and safety by expressing their need for certain products, by providing practical input and feedback into product design, by participating in device-related research, and by reporting device-related adverse events. Physicians should understand the rules that govern the approved and unapproved use of medical devices as well as device premarket evaluation and approval processes and device postmarket surveillance.
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Review Meta Analysis
The accuracy of the Ottawa knee rule to rule out knee fractures: a systematic review.
The Ottawa knee rule is a clinical decision aid that helps rule out fractures and avoid unnecessary radiography. ⋯ A negative result on an Ottawa knee rule test accurately excluded knee fractures after acute knee injury. However, because the rule is calibrated toward 100% sensitivity and actual fracture prevalences are usually low, large-scale, multicentered studies are still needed to establish the cost-effectiveness of routinely implementing the rule.
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Review Meta Analysis
The accuracy of the Ottawa knee rule to rule out knee fractures: a systematic review.
The Ottawa knee rule is a clinical decision aid that helps rule out fractures and avoid unnecessary radiography. ⋯ A negative result on an Ottawa knee rule test accurately excluded knee fractures after acute knee injury. However, because the rule is calibrated toward 100% sensitivity and actual fracture prevalences are usually low, large-scale, multicentered studies are still needed to establish the cost-effectiveness of routinely implementing the rule.
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Enhancing patient choice is a central theme of medical ethics and law. Informed consent is the legal process used to promote patient autonomy; shared decision making is a widely promoted ethical approach. These processes may most usefully be seen as distinct in clinically and ethically important respects. ⋯ For decisions of lower risk, consent should still be present, but it can be simple rather than informed. Clinicians may use this analysis as a guide to their own interactions with patients. In the continuing effort to provide patients with appropriate decisional authority over their own medical choices, shared decision making, informed consent, and simple consent each has a distinct role to play.
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Review Meta Analysis Comparative Study
Test performance of positron emission tomography and computed tomography for mediastinal staging in patients with non-small-cell lung cancer: a meta-analysis.
To compare the diagnostic accuracy of computed tomography (CT) and positron emission tomography (PET) with 18-fluorodeoxyglucose (FDG) for mediastinal staging in patients with non-small-cell lung cancer and to determine whether test results are conditionally dependent (the sensitivity and specificity of FDG-PET depend on the presence or absence of enlarged mediastinal lymph nodes on CT). ⋯ Positron emission tomography with 18-fluorodeoxyglucose is more accurate than CT for mediastinal staging. Positron emission tomography with 18-fluorodeoxyglucose is more sensitive but less specific when CT shows enlarged mediastinal lymph nodes.