Download or read book Personalizing the Screening Decisions for Patients with Multiple Chronic Conditions written by Ali Hjaar and published by . This book was released on 2020 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Clinical practice guidelines do not sufficiently address the needs of patients with multiple chronic conditions (MCC) as these guidelines focus on single disease management and ignore unique patient-specific conditions. As a result, a nonpersonalized approach for the management of patients with MCC leads to adverse events and increases the financial burden on the health care system as over 150 million Americans experience MCC. Therefore, the focus of this dissertation is to develop methods to personalize the screening decisions for patients with MCC. Namely, we use simulation and optimization models to evaluate the impact of the national screening strategies and find the optimal screening policy for patients with MCC given their personal risk, life expectancy, and budget constraints. This dissertation is divided into 5 chapters. In Chapter 1, we review the impact of multiple chronic conditions on the health care system. In Chapter 2, we provide a literature review about completely and partially observable Markov decision processes and the use of simulation and mathematical models in improving screening guidelines. Moreover, we review the medical literature related to tailoring the clinical practice guidelines for patients with MCC. In Chapter 3, we investigate the breast cancer screening decision problem for women with Down syndrome as they have a lower breast cancer risk and significantly lower life expectancies than women without Down syndrome. Therefore, it is not clear whether mammography screening strategies used for women without Down syndrome would benefit women with Down syndrome in the same way. We use simulation modeling to estimate the potential harms and benefits of mammography screening for women with Down syndrome. We consider various mammography screening strategies that included annual, biennial, triennial, and one-time digital mammography screenings during the ages 40-74. We estimate numbers of mammograms, false-positives, benign biopsies, breast cancer deaths prevented, and life-years gained per 1000 screened women when compared with no screening. In average-risk women 50-74, biennial screening incurred 146 mammograms, 13 false-positive mammograms, and 1.9 benign biopsies per one life-year gained compared with no screening. In women with Down syndrome, the same screening strategy incurred 1,670 mammograms, 156 false-positive mammograms, and 22 benign biopsies per one life-year gained compared with no screening. The harm/benefit ratio varied for other screening strategies, and was most favorable for one-time screening at age 50, which incurred 1,230 mammograms, 112 false-positive mammograms, and 16 benign biopsies per one life-year gained compared with no screening. We find that the harm/benefit ratios for various mammography screening strategies in women with Down syndrome are not as favorable as those for average-risk women. That is, the benefit of screening mammography for women with Down syndrome is less pronounced due to lower breast cancer risk and shorter life expectancy. In Chapter 4, we focus on personalizing the screening decisions for patients with MCC. For this purpose, we develop a stochastic modeling framework and provide an exact solution algorithm. We consider the optimal management of screening decisions for an index disease (e.g., breast cancer, colorectal cancer, HIV, etc.) while accounting for the existence of a chronic condition (e.g., hypertension, diabetes, Alzheimer's disease, etc.). Our modeling framework is particularly useful for cases where the chronic condition affects the risk of the index disease. In a case study using real breast cancer epidemiology data, we demonstrate how our modeling framework can be used to personalize breast cancer screening for women with type 2 diabetes. In addition to providing a personalized breast cancer screening schedule for women with diabetes, we find some important policy insights that were not previously recognized by the medical community. More specifically, we find that compared to women with no diabetes, women with diabetes should be screened less aggressively, but screening should end at similar ages. We also find that adherence to the optimal screening policy is more crucial for women with diabetes compared to women with no diabetes. Our main insight on screening recommendations also has important resource implications as it leads to fewer screening mammograms. That is, compared to the current national breast cancer screening guidelines, the optimal breast cancer screening policy for women with diabetes could save the health care system approximately 2.6 million mammograms annually which translates to $405 million of annual cost savings. Due to the increasing cost of healthcare, financial and limited resources constraints ought to be considered. Hence, we extend our modeling framework in Chapter 5 to examine the impact of the costs related to breast cancer screening, diagnosis, and treatment on the optimal screening policy for women with no diabetes, women with pre-diabetes, and women with diabetes. We use willingness-to-pay (WTP) ratios to evaluate the costs related to screening, diagnosis, and treatment costs in terms of QALYs. Our numerical results show that the optimal screening policy is greatly affected by the WTP ratios.
Download or read book Cancer Screening Decisions written by Ronald Adler and published by LWW. This book was released on 2017-11-09 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Patients are flooded with conflicting information about the value of cancer screening tests and deciding when, or if, they should have them has never been more difficult. Cancer Screening Decisions: A Patient-Centered Approach is a hands-on tool for clinicians to use with patients as they weigh the personal advantages and disadvantages of cancer screenings. Taking a uniquely visual approach, every page offers clear, colorful graphics to walk you and your patients through every step of the decision-making process for the four most common cancers: breast, colorectal, lung, and prostate. It's a vital resource for every clinician looking to personalize care and empower patients to make the best possible choices for their health. Cancer Screening Decisions: A Patient-Centered Approach is an exceptional, visual resource designed with a strong emphasis on a shared decision-making process. It is created with sturdy, coated pages spiral bound at the top so that patients can easily view information as the book stands vertically. Patient-facing pages are image-rich and easy to understand; while the provider-facing pages contain step-by-step talking points, easy to understand explanations of complex concepts, and effective communication strategies for each type of screening to guide your conversation. With this resource, you or other members of your care team are uniquely equipped to help guide patients through difficult decision making and inform them completely about the advantages and disadvantages of each screening and what is right for them. A primer on shared decision making, designed to be used by you or other members of your care team together with patients Pros and cons of each screening under discussion Simple, evidence-based infographics that make cancer screening data easy to understand Desktop flip design for dual use between patient and clinician Patient-facing pages that distill complex, yet essential information into helpful visuals and graphics Clinician-facing pages that serve as practical guides for facilitating challenging conversations An effective, patient-friendly way to personalize care that is also efficient for your busy practice, saving you time while providing the highest quality patient care Uniquely designed to improve patient-provider communication, increase patient participation in and knowledge of care options, and reduce decisional conflict as patients make choices that align with their personal values Large, colored tabs make navigation quick and simple -
Download or read book McLaughlin and Kaluzny s Continuous Quality Improvement In Health Care written by William Sollecito and published by Jones & Bartlett Publishers. This book was released on 2011-09-29 with total page 644 pages. Available in PDF, EPUB and Kindle. Book excerpt: Through a unique interdisciplinary perspective on quality management in health care, this text covers the subjects of operations management, organizational behavior, and health services research. With a particular focus on Total Quality Management and Continuous Quality Improvement, the challenges of implementation and institutionalization are addressed using examples from a variety of health care organizations, including primary care clinics, hospital laboratories, public health departments, and academic health centers. New to the Fourth Edition: - All chapters have been updated to reflect recent trends in healthcare including the more global focus of CQI. - New introductory chapters summarize the evolution of CQI and discuss the factors influencing the application and diffusion of CQI. - Several new chapters cover ‘hot’ topics such as the role of the patient in CQI, social marketing as an approach to CQI, assessing risk and harm in patient care, CQI in public health organizations, quality improvement in nursing, and quality improvement in resource-poor countries. - A new companion volume of case studies
Download or read book Crossing the Quality Chasm written by Institute of Medicine and published by National Academies Press. This book was released on 2001-07-19 with total page 359 pages. Available in PDF, EPUB and Kindle. Book excerpt: Second in a series of publications from the Institute of Medicine's Quality of Health Care in America project Today's health care providers have more research findings and more technology available to them than ever before. Yet recent reports have raised serious doubts about the quality of health care in America. Crossing the Quality Chasm makes an urgent call for fundamental change to close the quality gap. This book recommends a sweeping redesign of the American health care system and provides overarching principles for specific direction for policymakers, health care leaders, clinicians, regulators, purchasers, and others. In this comprehensive volume the committee offers: A set of performance expectations for the 21st century health care system. A set of 10 new rules to guide patient-clinician relationships. A suggested organizing framework to better align the incentives inherent in payment and accountability with improvements in quality. Key steps to promote evidence-based practice and strengthen clinical information systems. Analyzing health care organizations as complex systems, Crossing the Quality Chasm also documents the causes of the quality gap, identifies current practices that impede quality care, and explores how systems approaches can be used to implement change.
Download or read book Improving the Quality of Health Care for Mental and Substance Use Conditions written by Institute of Medicine and published by National Academies Press. This book was released on 2006-03-29 with total page 528 pages. Available in PDF, EPUB and Kindle. Book excerpt: Each year, more than 33 million Americans receive health care for mental or substance-use conditions, or both. Together, mental and substance-use illnesses are the leading cause of death and disability for women, the highest for men ages 15-44, and the second highest for all men. Effective treatments exist, but services are frequently fragmented and, as with general health care, there are barriers that prevent many from receiving these treatments as designed or at all. The consequences of this are seriousâ€"for these individuals and their families; their employers and the workforce; for the nation's economy; as well as the education, welfare, and justice systems. Improving the Quality of Health Care for Mental and Substance-Use Conditions examines the distinctive characteristics of health care for mental and substance-use conditions, including payment, benefit coverage, and regulatory issues, as well as health care organization and delivery issues. This new volume in the Quality Chasm series puts forth an agenda for improving the quality of this care based on this analysis. Patients and their families, primary health care providers, specialty mental health and substance-use treatment providers, health care organizations, health plans, purchasers of group health care, and all involved in health care for mental and substanceâ€"use conditions will benefit from this guide to achieving better care.
Download or read book McLaughlin Kaluzny s Continuous Quality Improvement in Health Care written by Julie K. Johnson and published by Jones & Bartlett Learning. This book was released on 2018-10-01 with total page 373 pages. Available in PDF, EPUB and Kindle. Book excerpt: Through a unique interdisciplinary perspective on quality management in health care, this text covers the subjects of operations management, organizational behavior, and health services research. With a particular focus on Total Quality Management (TQM) and Continuous Quality Improvement (CQI), the challenges of implementation and institutionalization are addressed using examples from a variety of health care organizations, including primary care clinics, hospital laboratories, public health departments, and academic health centers. Significantly revised throughout, the Fifth Edition offers a greater focus on application techniques, and features 14 chapters in lieu of the prior edition's 20 chapters, making it an even more effective teaching tool. New chapters have been incorporated on Implementation Science (3), Lean Six Sigma (6), and Classification and the Reduction of Medical Errors (10).
Download or read book Registries for Evaluating Patient Outcomes written by Agency for Healthcare Research and Quality/AHRQ and published by Government Printing Office. This book was released on 2014-04-01 with total page 396 pages. Available in PDF, EPUB and Kindle. Book excerpt: This User’s Guide is intended to support the design, implementation, analysis, interpretation, and quality evaluation of registries created to increase understanding of patient outcomes. For the purposes of this guide, a patient registry is an organized system that uses observational study methods to collect uniform data (clinical and other) to evaluate specified outcomes for a population defined by a particular disease, condition, or exposure, and that serves one or more predetermined scientific, clinical, or policy purposes. A registry database is a file (or files) derived from the registry. Although registries can serve many purposes, this guide focuses on registries created for one or more of the following purposes: to describe the natural history of disease, to determine clinical effectiveness or cost-effectiveness of health care products and services, to measure or monitor safety and harm, and/or to measure quality of care. Registries are classified according to how their populations are defined. For example, product registries include patients who have been exposed to biopharmaceutical products or medical devices. Health services registries consist of patients who have had a common procedure, clinical encounter, or hospitalization. Disease or condition registries are defined by patients having the same diagnosis, such as cystic fibrosis or heart failure. The User’s Guide was created by researchers affiliated with AHRQ’s Effective Health Care Program, particularly those who participated in AHRQ’s DEcIDE (Developing Evidence to Inform Decisions About Effectiveness) program. Chapters were subject to multiple internal and external independent reviews.
Download or read book Varieties of Narrative Analysis written by James A. Holstein and published by SAGE. This book was released on 2012 with total page 329 pages. Available in PDF, EPUB and Kindle. Book excerpt: Offers practical illustrations from different disciplines and perspectives, showing how researchers from various backgrounds deal with narrative data.
Download or read book P5 eHealth An Agenda for the Health Technologies of the Future written by Gabriella Pravettoni and published by Springer Nature. This book was released on 2019-11-29 with total page 191 pages. Available in PDF, EPUB and Kindle. Book excerpt: This open access volume focuses on the development of a P5 eHealth, or better, a methodological resource for developing the health technologies of the future, based on patients’ personal characteristics and needs as the fundamental guidelines for design. It provides practical guidelines and evidence based examples on how to design, implement, use and elevate new technologies for healthcare to support the management of incurable, chronic conditions. The volume further discusses the criticalities of eHealth, why it is difficult to employ eHealth from an organizational point of view or why patients do not always accept the technology, and how eHealth interventions can be improved in the future. By dealing with the state-of-the-art in eHealth technologies, this volume is of great interest to researchers in the field of physical and mental healthcare, psychologists, stakeholders and policymakers as well as technology developers working in the healthcare sector.
Download or read book Jekel s Epidemiology Biostatistics and Preventive Medicine E Book written by Joann G. Elmore and published by Elsevier Health Sciences. This book was released on 2020-01-15 with total page 496 pages. Available in PDF, EPUB and Kindle. Book excerpt: Written by renowned epidemiologists and public health experts, this unique text provides complete, concise coverage of epidemiology, biostatistics, preventive medicine, and public health in clear, easy-to-understand terms. One convenient volume delivers must-know content in four complex areas—information that’s sure to be covered in today’s classrooms and on USMLE exams—presented with a clinical focus and real-life medical examples throughout. Depth of coverage, concise writing style, outstanding online review questions, a clinical emphasis ... these features and more make Jekel's your go-to resource for learning, study, and review. Focuses on clinical problem solving and decision making using epidemiologic concepts and examples. Contains more clinical cases throughout, including global examples. Offers expanded coverage of the impact of big data and precision medicine, as well as an updated and reorganized biostatistics section. Features quick-reference boxes that showcase key concepts and calculations, and dynamic illustrations that facilitate learning using a highly visual approach. Provides almost 300 multiple-choice chapter review questions and answers in print, with additional questions and more online at Student Consult. Aligns content to board blueprints for the USMLE as well as the three specialties certified by the American Board of Preventive Medicine: Occupational Medicine, and Public Health & General Preventive Medicine—and is recommended by the ABPM as a top review source for its core specialty examination. Enhanced eBook version included with purchase. Your enhanced eBook allows you to access all the text, figures, and references from the book on a variety of devices. Evolve Instructor site, with an image and table bank as well as chapter overviews as PowerPoints, is available to instructors through their Elsevier sales rep or via request at: https://evolve.elsevier.com.
Download or read book Artificial Intelligence in Healthcare written by Adam Bohr and published by Academic Press. This book was released on 2020-06-21 with total page 385 pages. Available in PDF, EPUB and Kindle. Book excerpt: Artificial Intelligence (AI) in Healthcare is more than a comprehensive introduction to artificial intelligence as a tool in the generation and analysis of healthcare data. The book is split into two sections where the first section describes the current healthcare challenges and the rise of AI in this arena. The ten following chapters are written by specialists in each area, covering the whole healthcare ecosystem. First, the AI applications in drug design and drug development are presented followed by its applications in the field of cancer diagnostics, treatment and medical imaging. Subsequently, the application of AI in medical devices and surgery are covered as well as remote patient monitoring. Finally, the book dives into the topics of security, privacy, information sharing, health insurances and legal aspects of AI in healthcare. Highlights different data techniques in healthcare data analysis, including machine learning and data mining Illustrates different applications and challenges across the design, implementation and management of intelligent systems and healthcare data networks Includes applications and case studies across all areas of AI in healthcare data
Download or read book Decision Analytics and Optimization in Disease Prevention and Treatment written by Nan Kong and published by John Wiley & Sons. This book was released on 2018-02-02 with total page 487 pages. Available in PDF, EPUB and Kindle. Book excerpt: A systematic review of the most current decision models and techniques for disease prevention and treatment Decision Analytics and Optimization in Disease Prevention and Treatment offers a comprehensive resource of the most current decision models and techniques for disease prevention and treatment. With contributions from leading experts in the field, this important resource presents information on the optimization of chronic disease prevention, infectious disease control and prevention, and disease treatment and treatment technology. Designed to be accessible, in each chapter the text presents one decision problem with the related methodology to showcase the vast applicability of operations research tools and techniques in advancing medical decision making. This vital resource features the most recent and effective approaches to the quickly growing field of healthcare decision analytics, which involves cost-effectiveness analysis, stochastic modeling, and computer simulation. Throughout the book, the contributors discuss clinical applications of modeling and optimization techniques to assist medical decision making within complex environments. Accessible and authoritative, Decision Analytics and Optimization in Disease Prevention and Treatment: Presents summaries of the state-of-the-art research that has successfully utilized both decision analytics and optimization tools within healthcare operations research Highlights the optimization of chronic disease prevention, infectious disease control and prevention, and disease treatment and treatment technology Includes contributions by well-known experts from operations researchers to clinical researchers, and from data scientists to public health administrators Offers clarification on common misunderstandings and misnomers while shedding light on new approaches in this growing area Designed for use by academics, practitioners, and researchers, Decision Analytics and Optimization in Disease Prevention and Treatment offers a comprehensive resource for accessing the power of decision analytics and optimization tools within healthcare operations research.
Download or read book Clinical Reasoning in the Health Professions E Book written by Joy Higgs and published by Elsevier Health Sciences. This book was released on 2018-10-15 with total page 532 pages. Available in PDF, EPUB and Kindle. Book excerpt: Clinical reasoning lies at the core of health care practice and education. Clinical Reasoning in the Health Professions, therefore, occupies a central place in the education of health professionals, the enhancement of professional decision making of individuals and groups of practitioners with their clients, and research into optimal practice reasoning. All chapters updated and 20 new chapters added Concrete examples, cases and vignettes were added to bring discussions to life for the reader Reflection points strategically placed to assist readers to extend their insights and build learning from their own practical experiences and theoretical knowledge Devices of particular value to reflective practitioners and educators All chapters updated and 20 new chapters added Concrete examples, cases and vignettes were added to bring discussions to life for the reader Reflection points strategically placed to assist readers to extend their insights and build learning from their own practical experiences and theoretical knowledge Devices of particular value to reflective practitioners and educators.
Download or read book Advancing the Science of Cancer in Latinos written by Amelie G. Ramirez and published by Springer Nature. This book was released on 2023 with total page 284 pages. Available in PDF, EPUB and Kindle. Book excerpt: This open access book is a collection of articles based on presentations from the 2020 Advancing the Science of Cancer in Latinos conference that gives an overview of conference outcomes. The vision of the conference has been to unite researchers, scientists, physicians and other healthcare professionals, patient advocates and students from across the world to discuss research advancements, identify gaps, and develop actionable goals to translate basic research findings into clinical best practices, effective community interventions, and professional training programs to decrease cancer risks and eliminate cancer disparities for Latinos. This conference comes at an especially important time when Latinos the largest and youngest minority group in the U.S. are expected to face a 142% rise in cancer cases in the coming years. Disparities continue to impact this population in critical areas: access to preventive and clinical care, changeable risk behaviors, quality of life, and mortality. Each chapter summarizes the presentation and includes current knowledge in the specific topic areas, identified gaps, and opportunities for future research. Topics explored include: Applying an Exposome-Wide (ExWAS) Approach to Latino Cancer Disparities Supportive Care Needs and Coping Strategies Used by Latino Men Cancer Survivors Optimizing Engagement of the Latino Community in Cancer Research Latino Population Growth and the Changing Demography of Cancer Implementation Science to Enhance the Value of Cancer Research in Latinos A Strength-Based Approach to Cancer Prevention in Latinxs Overcoming Clinical Research Disparities by Advancing Inclusive Research Advancing the Science of Cancer in Latinos: Building Collaboration for Action will appeal to a wide readership due to its comprehensive coverage of topics ranging from basic science and community prevention research to clinical practice to policy. The book is an essential resource for physicians and other medical professionals, researchers, scientists, academicians, patient advocates, and students. It also will appeal to policy-makers, NCI-designated cancer centers, academic centers, state health departments, and community organizations.
Download or read book Delivering High Quality Cancer Care written by Committee on Improving the Quality of Cancer Care: Addressing the Challenges of an Aging Population and published by National Academies Press. This book was released on 2014-01-10 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: In the United States, approximately 14 million people have had cancer and more than 1.6 million new cases are diagnosed each year. However, more than a decade after the Institute of Medicine (IOM) first studied the quality of cancer care, the barriers to achieving excellent care for all cancer patients remain daunting. Care often is not patient-centered, many patients do not receive palliative care to manage their symptoms and side effects from treatment, and decisions about care often are not based on the latest scientific evidence. The cost of cancer care also is rising faster than many sectors of medicine--having increased to $125 billion in 2010 from $72 billion in 2004--and is projected to reach $173 billion by 2020. Rising costs are making cancer care less affordable for patients and their families and are creating disparities in patients' access to high-quality cancer care. There also are growing shortages of health professionals skilled in providing cancer care, and the number of adults age 65 and older--the group most susceptible to cancer--is expected to double by 2030, contributing to a 45 percent increase in the number of people developing cancer. The current care delivery system is poorly prepared to address the care needs of this population, which are complex due to altered physiology, functional and cognitive impairment, multiple coexisting diseases, increased side effects from treatment, and greater need for social support. Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis presents a conceptual framework for improving the quality of cancer care. This study proposes improvements to six interconnected components of care: (1) engaged patients; (2) an adequately staffed, trained, and coordinated workforce; (3) evidence-based care; (4) learning health care information technology (IT); (5) translation of evidence into clinical practice, quality measurement and performance improvement; and (6) accessible and affordable care. This report recommends changes across the board in these areas to improve the quality of care. Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis provides information for cancer care teams, patients and their families, researchers, quality metrics developers, and payers, as well as HHS, other federal agencies, and industry to reevaluate their current roles and responsibilities in cancer care and work together to develop a higher quality care delivery system. By working toward this shared goal, the cancer care community can improve the quality of life and outcomes for people facing a cancer diagnosis.
Download or read book Health Professions Education written by Institute of Medicine and published by National Academies Press. This book was released on 2003-07-01 with total page 191 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Institute of Medicine study Crossing the Quality Chasm (2001) recommended that an interdisciplinary summit be held to further reform of health professions education in order to enhance quality and patient safety. Health Professions Education: A Bridge to Quality is the follow up to that summit, held in June 2002, where 150 participants across disciplines and occupations developed ideas about how to integrate a core set of competencies into health professions education. These core competencies include patient-centered care, interdisciplinary teams, evidence-based practice, quality improvement, and informatics. This book recommends a mix of approaches to health education improvement, including those related to oversight processes, the training environment, research, public reporting, and leadership. Educators, administrators, and health professionals can use this book to help achieve an approach to education that better prepares clinicians to meet both the needs of patients and the requirements of a changing health care system.
Download or read book COPD written by Sang-Do Lee and published by Springer. This book was released on 2017-10-10 with total page 359 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book explains how analysis of the heterogeneity of chronic obstructive pulmonary disease (COPD) enhances understanding of the condition and leads to improved, personalized treatment. State of the art knowledge is presented on a range of issues related to the heterogeneity of COPD, such as phenotypes (clinical, physiologic, radiologic, etc.), genotypes, and the tools to be used for dissecting heterogeneity (CT, MRI, biomarkers, etc.). Especially modern radiologic imaging holds promise in this context, and its role is described in detail with the aid of numerous illustrations. The implications of the heterogeneity for personalized treatment are clearly identified, with description of an appropriate tailored treatment strategy for each subgroup of patients. Information is provided on both current and emerging strategies, including bronchoscopic lung volume reduction and approaches to the management of pulmonary hypertension and comorbidities. This book will be a great asset in clinical practice and research for all who have an interest in COPD, a leading cause of morbidity and mortality worldwide.
