1
40
11
-
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
November 2022 List
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
November 2022 List
URL Address
<a href="http://doi.org/10.1097/cce.0000000000000764" target="_blank" rel="noreferrer noopener"> http://doi.org/10.1097/cce.0000000000000764</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Predicting Time to Death After Withdrawal of Life-Sustaining Treatment in Children
Publisher
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Critical Care Explorations
Date
A point or period of time associated with an event in the lifecycle of the resource
2022
Subject
The topic of the resource
Decision Support Techniques; Intensive Care Unit; Machine Learning; Pediatric; Terminal Care; Tissue and Organ Procurement
Creator
An entity primarily responsible for making the resource
Winter MC; Ledbetter DR
Description
An account of the resource
Accurately predicting time to death after withdrawal of life-sustaining treatment is valuable for family counseling and for identifying candidates for organ donation after cardiac death. This topic has been well studied in adults, but literature is scant in pediatrics. The purpose of this report is to assess the performance and clinical utility of the available tools for predicting time to death after treatment withdrawal in children. DATA SOURCES: Terms related to predicting time to death after treatment withdrawal were searched in PubMed and Embase from 1993 to November 2021. STUDY SELECTION: Studies endeavoring to predict time to death or describe factors related to time to death were included. Articles focusing on perceptions or practices of treatment withdrawal were excluded. DATA EXTRACTION: Titles, abstracts, and full text of articles were screened to determine eligibility. Data extraction was performed manually. Two-by-two tables were reconstructed with available data from each article to compare performance metrics head to head. DATA SYNTHESIS: Three hundred eighteen citations were identified from the initial search, resulting in 22 studies that were retained for full-text review. Among the pediatric studies, predictive models were developed using multiple logistic regression, Cox proportional hazards, and an advanced machine learning algorithm. In each of the original model derivation studies, the models demonstrated a classification accuracy ranging from 75% to 91% and positive predictive value ranging from 0.76 to 0.93. CONCLUSIONS: There are few tools to predict time to death after withdrawal of life-sustaining treatment in children. They are limited by small numbers and incomplete validation. Future work includes utilization of advanced machine learning models.
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1097/cce.0000000000000764" target="_blank" rel="noreferrer noopener">10.1097/cce.0000000000000764</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Terminal Care
2022
Critical Care Explorations
Decision Support Techniques
Intensive Care Unit
Ledbetter DR
machine learning
November 2022 List
Pediatric
Tissue and Organ Procurement
Winter MC
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.7326/M14-0644" target="_blank" rel="noreferrer">http://doi.org/10.7326/M14-0644</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Decision aids for advance care planning: an overview of the state of the science.
Publisher
An entity responsible for making the resource available
Annals Of Internal Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
2014
Subject
The topic of the resource
Humans; Terminally Ill; Prognosis; Internet; advance care planning; Decision Support Techniques
Creator
An entity primarily responsible for making the resource
Butler M; Ratner E; McCreedy E; Shippee N; Kane RL
Description
An account of the resource
Advance care planning honors patients' goals and preferences for future care by creating a plan for when illness or injury impedes the ability to think or communicate about health decisions. Fewer than 50% of severely or terminally ill patients have an advance directive in their medical record, and physicians are accurate only about 65% of the time when predicting patient preferences for intensive care. Decision aids can support the advance care planning process by providing a structured approach to informing patients about care options and prompting them to document and communicate their preferences. This review, commissioned as a technical brief by the Agency for Healthcare Research and Quality Effective Health Care Program, provides a broad overview of current use of and research related to decision aids for adult advance care planning. Using interviews of key informants and a search of the gray and published literature from January 1990 to May 2014, the authors found that many decision aids are widely available but are not assessed in the empirical literature. The 16 published studies testing decision aids as interventions for adult advance care planning found that most are proprietary or not publicly available. Some are constructed for the general population, whereas others address disease-specific conditions that have more predictable end-of-life scenarios and, therefore, more discrete choices. New decision aids should be designed that are responsive to diverse philosophical perspectives and flexible enough to change as patients gain experience with their personal illness courses. Future efforts should include further research, training of advance care planning facilitators, dissemination and access, and tapping potential opportunities in social media or other technologies.
2014-09
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.7326/M14-0644" target="_blank" rel="noreferrer">10.7326/M14-0644</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
2014
Advance Care Planning
Annals Of Internal Medicine
Backlog
Butler M
Decision Support Techniques
Humans
Internet
Journal Article
Kane RL
McCreedy E
Prognosis
Ratner E
Shippee N
Terminally Ill
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1177/1049909106292167" target="_blank" rel="noreferrer">http://doi.org/10.1177/1049909106292167</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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Enteral and parenteral nutrition in terminally ill cancer patients: a review of the literature
Publisher
An entity responsible for making the resource available
The American Journal Of Hospice & Palliative Care
Date
A point or period of time associated with an event in the lifecycle of the resource
2006
Subject
The topic of the resource
Humans; Survival Rate; Terminally Ill; Practice Guidelines as Topic; Communication; Treatment Outcome; Decision Support Techniques; Research Design; Risk Factors; Patient Selection; Activities of Daily Living; Evidence-Based Medicine; Patient Education as Topic; quality of life; Nutritional Status; Nutrition Assessment; Enteral Nutrition/adverse effects/methods/utilization; Malnutrition/etiology/therapy; Neoplasms/complications/mortality/psychology; Parenteral Nutrition/adverse effects/methods/utilization; Terminal Care/methods/psychology/utilization
Creator
An entity primarily responsible for making the resource
Dy SM
Description
An account of the resource
Many terminally ill patients who are able to eat appear to be eating less than they should, losing weight, and becoming malnourished, and many others develop difficulties with eating. These symptoms and signs are usually a marker of advanced cancer, rather than the cause of decreasing functional status, and providing supplemental nutrition rarely changes the course of the disease. This article reviews evidence on issues relevant to enteral and parenteral nutrition in patients with advanced cancer, including benefits, risks, and discomforts; how these types of nutrition are used and perceived, and how decisions are made; and how decision-making might be improved.
2006
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1177/1049909106292167" target="_blank" rel="noreferrer">10.1177/1049909106292167</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
2006
Activities of Daily Living
Backlog
Communication
Decision Support Techniques
Dy SM
Enteral Nutrition/adverse effects/methods/utilization
Evidence-based Medicine
Humans
Journal Article
Malnutrition/etiology/therapy
Neoplasms/complications/mortality/psychology
Nutrition Assessment
Nutritional Status
Parenteral Nutrition/adverse effects/methods/utilization
Patient Education as Topic
Patient Selection
Practice Guidelines As Topic
Quality Of Life
Research Design
Risk Factors
Survival Rate
Terminal Care/methods/psychology/utilization
Terminally Ill
The American Journal of Hospice & Palliative Care
Treatment Outcome
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1542/peds.2004-2127" target="_blank" rel="noreferrer">http://doi.org/10.1542/peds.2004-2127</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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Quality-adjusted life-years lack quality in pediatric care: a critical review of published cost-utility studies in child health
Publisher
An entity responsible for making the resource available
Pediatrics
Date
A point or period of time associated with an event in the lifecycle of the resource
2005
Subject
The topic of the resource
Child; Humans; Pediatrics; Decision Support Techniques; Health Status; Quality-Adjusted Life Years; adolescent; infant; Cost-Benefit Analysis/standards; Costs and Cost Analysis/standards; Health Services Research/standards
Creator
An entity primarily responsible for making the resource
Griebsch I; Coast J; Brown J
Description
An account of the resource
OBJECTIVES: Cost-utility analysis in which health benefits are quantified in terms of quality-adjusted life-years (QALYs) has now become the standard type of cost-effectiveness analysis. These studies are potentially influential in determining the extent of funding for particular pediatric interventions, and so their methodologic quality is extremely important. The objective of this study was twofold: first, to critically appraise published cost-utility analyses of interventions in child and adolescent health care in terms of the methods used to derive QALYs and, second, to discuss unresolved methodologic issues that are pertinent to the measurement of QALYs in pediatric populations. METHODS: A comprehensive search using computerized databases (including Medline, Embase, Econlit, and databases specific to economic evaluation), Web searches, and citation tracking was undertaken to identify cost-utility studies of interventions that were aimed at those who were younger than 16 years and published before April 2004. The methods of individual studies were compared with the recognized published guidelines of the US Panel on Cost-Effectiveness in Health and Medicine and the National Institute for Clinical Excellence in England and Wales, which recommend the use of a generic health state classification system (eg, Health Utility Index, EuroQol-5D), a choice-based valuation method (eg, standard gamble or time trade-off) and preferences of the general public in estimating QALYs. Studies therefore were categorized and evaluated according to the methods used to describe the health state, the valuation technique, and source of preferences. RESULTS: Fifty-four studies were reviewed, 34 (63%) of which were published in the past 5 years. A generic health status classification instrument was used in 22 (35%) cases; the remainder developed study-specific health state descriptions or elicited preferences directly from patients or proxies. In 3 (5%) cases, sources were unclear. Preference weights were elicited using choice-based techniques in 28 (42%) cases, either as tariffs for health status classification instruments (17 cases) or by directly valuing health state descriptions or patient health (11 cases). Preferences of the general public were used in only 23 (37%) cases. Four studies aggregated QALYs for mother/child or parents/child pairs without giving any theoretical justification. Although there was an increasing tendency for studies to use generic health status classification instruments, choice-based methods, and preferences of the general public, the majority of studies still did not adhere to these standard recommendations even in the period between January 2000 and March 2004. Despite increasing standardization in the methods advocated for economic evaluation over the past 10 years, there remains extensive variation in the actual methods used by researchers to calculate QALYs for children and adolescents. It is unclear whether these results suggest poor practice or a set of positive (or reactive) choices made by analysts in a methodologically uncertain area in which specific guidance is lacking regarding how to address the complexities of pediatric outcomes within the QALY framework. Many aspects of QALY measurement in children are not yet fully developed. In particular, there is (1) a lack of appropriate health state classification instruments that take account of the dynamics of child development, (2) a lack of health state classification instruments for use in children and infants who are younger than 5 years, and (3) the need to understand fully the role of proxies for measuring and valuing child health. Additional research efforts are also required to develop methods that account for the health benefits of parents or caregivers of the child and to consider the implications of combining different forms of utility measurement in childhood and adulthood. CONCLUSIONS: Although variations from standard recommendations may be attributable to poor practice among researchers who are either unaware of these recommendations or choose not to follow them, they could equally be the result of attempts to make research more rigorous and more defensible than it might be if the standard recommendations were followed. There are 4 potential approaches to conducting cost-utility analysis in pediatric populations: (1) the explicit development of a generic instrument designed to be applicable across both child and adult populations (likely to be difficult in practice), (2) insistence on use of a generic instrument developed for adults, (3) the use of generic instruments specifically developed for children without being concerned about comparability with interventions aimed at adults, and (4) abandoning attempts to use single outcome measures that combine mortality with quality weights. In the absence of a clear way forward, it is suggested that an expert panel be convened to debate and further consider these potential solutions and recommendations for best practice and future research. In the interim, comparisons of the relative cost-effectiveness reported as cost per QALY gained across interventions for different diseases and populations should be treated with extreme caution.
2005
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1542/peds.2004-2127" target="_blank" rel="noreferrer">10.1542/peds.2004-2127</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
2005
Adolescent
Backlog
Brown J
Child
Coast J
Cost-Benefit Analysis/standards
Costs and Cost Analysis/standards
Decision Support Techniques
Griebsch I
Health Services Research/standards
Health Status
Humans
Infant
Journal Article
Pediatrics
Quality-Adjusted Life Years
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1542/peds.2005-0094" target="_blank" rel="noreferrer">http://doi.org/10.1542/peds.2005-0094</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
A clinical decision rule to identify children at low risk for appendicitis
Publisher
An entity responsible for making the resource available
Pediatrics
Date
A point or period of time associated with an event in the lifecycle of the resource
2005
Subject
The topic of the resource
Child; Female; Humans; Male; Cohort Studies; Decision Support Techniques; Risk Factors; Sensitivity and Specificity; adolescent; Abdominal Pain/etiology; ROC Curve; Appendicitis/diagnosis/radiography/surgery/ultrasonography
Creator
An entity primarily responsible for making the resource
Kharbanda AB; Taylor GA; Fishman SJ; Bachur RG
Description
An account of the resource
OBJECTIVE: Computed tomography (CT) has gained widespread acceptance in the evaluation of children with suspected appendicitis. Concern has been raised regarding the long-term effects of ionizing radiation. Other means of diagnosing appendicitis, such as clinical scores, are lacking in children. We sought to develop a clinical decision rule to predict which children with acute abdominal pain do not have appendicitis. METHODS: Prospective cohort study was conducted of children and adolescents who aged 3 to 18 years, had signs and symptoms suspicious for appendicitis, and presented to the emergency department between April 2003 and July 2004. Standardized data-collection forms were completed on eligible patients. Two low-risk clinical decision rules were created and validated using logistic regression and recursive partitioning. The sensitivity, negative predictive value (NPV), and negative likelihood ratio of each clinical rule were compared. RESULTS: A total of 601 patients were enrolled. Using logistic regression, we created a 6-part score that consisted of nausea (2 points), history of focal right lower quadrant pain (2 points), migration of pain (1 point), difficulty walking (1 point), rebound tenderness/pain with percussion (2 points), and absolute neutrophil count of >6.75 x 10(3)/microL (6 points). A score < or =5 had a sensitivity of 96.3% (95% confidence interval [CI]: 87.5-99.0), NPV of 95.6% (95% CI: 90.8-99.0), and negative likelihood ratio of .102 (95% CI: 0.026-0.405) in the validation set. Using recursive partitioning, a second low-risk decision rule was developed consisting of absolute neutrophil count of <6.75 x 10(3)/microL, absence of nausea, and absence of maximal tenderness in the right lower quadrant. This rule had a sensitivity of 98.1% (95% CI: 90.1-99.9), NPV of 97.5% (95% CI: 86.8-99.9), and negative likelihood ratio of 0.058 (95% CI: 0.008-0.411) in the validation set. Theoretical application of the low-risk rules would have resulted in a 20% reduction in CT. CONCLUSIONS: Our low-risk decision rules can predict accurately which children are at low risk for appendicitis and could be treated safely with careful observation rather than CT examination.
2005
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1542/peds.2005-0094" target="_blank" rel="noreferrer">10.1542/peds.2005-0094</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
2005
Abdominal Pain/etiology
Adolescent
Appendicitis/diagnosis/radiography/surgery/ultrasonography
Bachur RG
Backlog
Child
Cohort Studies
Decision Support Techniques
Female
Fishman SJ
Humans
Journal Article
Kharbanda AB
Male
Pediatrics
Risk Factors
ROC Curve
Sensitivity and Specificity
Taylor GA
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1067/mpd.2002.127502" target="_blank" rel="noreferrer">http://doi.org/10.1067/mpd.2002.127502</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Evaluation of heart murmurs in children: cost-effectiveness and practical implications
Publisher
An entity responsible for making the resource available
The Journal Of Pediatrics
Date
A point or period of time associated with an event in the lifecycle of the resource
2002
Subject
The topic of the resource
Child; Humans; infant; Prevalence; Decision Support Techniques; Sensitivity and Specificity; Infant Welfare; adolescent; Preschool; Non-U.S. Gov't; Research Support; infant; Comparative Study; Newborn; Child welfare; Radiography; Cardiology/economics; Cost-Benefit Analysis/economics; Echocardiography/economics; Electrocardiography/economics; Heart Murmurs/diagnosis/economics/epidemiology; Pediatrics/economics; Referral and Consultation/economics; Thoracic/economics
Creator
An entity primarily responsible for making the resource
Yi MS; Kimball TR; Tsevat J; Mrus JM; Kotagal UR
Description
An account of the resource
OBJECTIVE: To assess the cost-effectiveness of various strategies to evaluate heart murmurs in children. METHODS: We modeled 6 strategies to follow the initial examination by the pediatrician: (1) refer suspected pathologic murmurs to a cardiologist, (2) obtain a chest radiograph (CXR) and electrocardiogram (ECG) and refer suspected pathologic murmurs to a cardiologist, (3) refer suspected pathologic murmurs for an echocardiogram (ECHO), (4) obtain a CXR and ECG and refer suspected pathologic murmurs for an ECHO, (5) refer all patients with murmurs to a cardiologist, or (6) refer all patients with murmurs for an ECHO. RESULTS: The least effective was strategy 1, which detects 82% of pathologic murmurs at $72 per patient evaluated. Strategy 5 detects 95% of pathologic murmurs at $38,000 per additional case detected over strategy 1. The most effective, strategy 6, detects 100% of pathologic murmurs at $158,000 per additional case detected over strategy 5. Strategies 2, 3, and 4 were not cost-effective. The results were sensitive to the costs of cardiology referral and ECHO. CONCLUSIONS: Adding a CXR and ECG to the pediatrician's evaluation, or selectively referring directly to ECHO increases costs with little gain in accuracy. Given the current cost constraints present in health care, whether the optimal strategy involves referring to a cardiologist or obtaining an ECHO for all patients with murmurs depends on how much society should allocate to diagnose pathologic murmurs.
2002
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1067/mpd.2002.127502" target="_blank" rel="noreferrer">10.1067/mpd.2002.127502</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
2002
Adolescent
Backlog
Cardiology/economics
Child
Child welfare
Comparative Study
Cost-Benefit Analysis/economics
Decision Support Techniques
Echocardiography/economics
Electrocardiography/economics
Heart Murmurs/diagnosis/economics/epidemiology
Humans
Infant
Infant Welfare
Journal Article
Kimball TR
Kotagal UR
Mrus JM
Newborn
Non-U.S. Gov't
Pediatrics/economics
Preschool
Prevalence
Radiography
Referral and Consultation/economics
Research Support
Sensitivity and Specificity
The Journal Of Pediatrics
Thoracic/economics
Tsevat J
Yi MS
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1067/mpd.2002.128657" target="_blank" rel="noreferrer">http://doi.org/10.1067/mpd.2002.128657</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Sorting through the haystack--decision analysis and the search for heart disease among children with murmur
Publisher
An entity responsible for making the resource available
The Journal Of Pediatrics
Date
A point or period of time associated with an event in the lifecycle of the resource
2002
Subject
The topic of the resource
Child; Humans; infant; Adult; Decision Support Techniques; Sensitivity and Specificity; Infant Welfare; adolescent; Preschool; infant; Newborn; Child welfare; Cost-Benefit Analysis/economics; Heart Diseases/diagnosis/economics
Creator
An entity primarily responsible for making the resource
Danford DA
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1067/mpd.2002.128657" target="_blank" rel="noreferrer">10.1067/mpd.2002.128657</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
Description
An account of the resource
2002
2002
Adolescent
Adult
Backlog
Child
Child welfare
Cost-Benefit Analysis/economics
Danford DA
Decision Support Techniques
Heart Diseases/diagnosis/economics
Humans
Infant
Infant Welfare
Journal Article
Newborn
Preschool
Sensitivity and Specificity
The Journal Of Pediatrics
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1097/01.pec.0000081238.98249.40" target="_blank" rel="noreferrer">http://doi.org/10.1097/01.pec.0000081238.98249.40</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Validation of a decision rule identifying febrile young girls at high risk for urinary tract infection
Publisher
An entity responsible for making the resource available
Pediatric Emergency Care
Date
A point or period of time associated with an event in the lifecycle of the resource
2003
Subject
The topic of the resource
Child; Female; Humans; Decision Support Techniques; Risk Factors; European Continental Ancestry Group; Sensitivity and Specificity; Hospitals; Case-Control Studies; Emergency Service; Preschool; P.H.S.; Research Support; U.S. Gov't; infant; retrospective studies; Pediatric/statistics & numerical data; Pennsylvania/epidemiology; ROC Curve; Area Under Curve; Bacteriuria/diagnosis/microbiology; Colony Count; False Positive Reactions; Fever/etiology; Hospital/statistics & numerical data; Microbial; Urinary Tract Infections/diagnosis/epidemiology
Creator
An entity primarily responsible for making the resource
Gorelick MH; Hoberman A; Kearney D; Wald E; Shaw KN
Description
An account of the resource
OBJECTIVE: To validate a previously published clinical decision rule to predict risk of urinary tract infection in febrile young girls. METHODS: We performed a retrospective case-control study at a children's hospital emergency department in a different city than that in which the original derivation study took place. Girls younger than 2 years in whom urinalysis and urine culture were performed for evaluation of fever were eligible. Cases consisted of all patients with a positive urine culture result, defined as 50,000 or more colony-forming units per milliliter of a urinary tract pathogen (n = 98). A random sample of patients with a negative urine culture result (n = 114) was also selected as controls. The clinical prediction rule included five risk factors: age younger than 12 months, white race, temperature of 39.0 degrees C or higher, absence of any other potential source of fever, and fever for 2 days or more. The sensitivity and false-positive rate of this rule were calculated at different cutoff values. RESULTS: The overall discriminative ability of the rule, as indicated by the area under the receiver-operator characteristic curve (AUC), was similar in this validation sample (AUC = 0.72) to that in the original study (AUC = 0.76). However, in the validation sample, the presence of three or more risk factors (rather than two or more as in the original study) appeared to be the optimum cutoff to define a positive rule, which results in an indication for obtaining further diagnostic testing (sensitivity, 88% [95% CI, 79-94%]; false-positive rate, 70% [95% CI, 61-79%]). CONCLUSION: A simple clinical decision rule previously developed to predict urinary tract infection based on five risk factors performs similarly in a different patient population.
2003
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1097/01.pec.0000081238.98249.40" target="_blank" rel="noreferrer">10.1097/01.pec.0000081238.98249.40</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
2003
Area Under Curve
Backlog
Bacteriuria/diagnosis/microbiology
Case-Control Studies
Child
Colony Count
Decision Support Techniques
Emergency Service
European Continental Ancestry Group
False Positive Reactions
Female
Fever/etiology
Gorelick MH
Hoberman A
Hospital/statistics & numerical data
Hospitals
Humans
Infant
Journal Article
Kearney D
Microbial
P.H.S.
Pediatric Emergency Care
Pediatric/statistics & Numerical Data
Pennsylvania/epidemiology
Preschool
Research Support
Retrospective Studies
Risk Factors
ROC Curve
Sensitivity and Specificity
Shaw KN
U.S. Gov't
Urinary Tract Infections/diagnosis/epidemiology
Wald E
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
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URL Address
<a href="http://doi.org/10.1177/0272989x9001000109" target="_blank" rel="noreferrer">http://doi.org/10.1177/0272989x9001000109</a>
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The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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Whose utilities for decision analysis?
Publisher
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Medical Decision Making
Date
A point or period of time associated with an event in the lifecycle of the resource
1990
Subject
The topic of the resource
Humans; Attitude to Health; Attitude of Health Personnel; Prognosis; Choice Behavior; Decision Support Techniques; Multivariate Analysis; Non-U.S. Gov't; Research Support; Life Expectancy; Physicians/psychology; Patients/psychology; Patient Participation/psychology; Colostomy/psychology; Game Theory
Creator
An entity primarily responsible for making the resource
Boyd NF; Sutherland HJ; Heasman KZ; Tritchler DL; Cummings BJ
Description
An account of the resource
The goal of this study was to examine sources of variation in the utilities assigned to health states. The authors selected a common clinical problem, carcinoma of the rectum, and examined the utilities assigned to colostomy, a common outcome of treatment for that disease. After preparing and validating a description of colostomy and its effects on patients' lives, utilities for the state were obtained from five groups of individuals. These comprised two groups of patients who received treatment for rectal cancer, a group of physicians and surgeons specializing in the treatment of this disease, and two groups of healthy subjects, none of whom were health professionals. Of the patients who had been treated for rectal cancer, one group had been treated surgically with the formation of colostomies and the other had been treated with radiotherapy and none had a colostomy. Utilities for colostomy were elicited using the standard gamble, category rating, and a treatment choice questionnaire. The groups differed substantially in the utilities assigned to colostomy. In general, patients with colostomies and physicians assigned significantly higher utilities than did patients who did not themselves have a colostomy. The clinical significance of these differences was examined in a simplified clinical decision problem that compared surgery (with colostomy) and radiotherapy (without colostomy) as primary treatment. The expected clinical value of these treatment alternatives was substantially influenced by the differences observed in utilities for colostomy. These results emphasize the importance of patient utilities in clinical decision making and the need to gain greater understanding of the factors that influence the utilities that patients assign to health states.
1990
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1177/0272989x9001000109" target="_blank" rel="noreferrer">10.1177/0272989x9001000109</a>
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Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
1990
Attitude Of Health Personnel
Attitude To Health
Backlog
Boyd NF
Choice Behavior
Colostomy/psychology
Cummings BJ
Decision Support Techniques
Game Theory
Heasman KZ
Humans
Journal Article
Life Expectancy
Medical Decision Making
Multivariate Analysis
Non-U.S. Gov't
Patient Participation/psychology
Patients/psychology
Physicians/psychology
Prognosis
Research Support
Sutherland HJ
Tritchler DL
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Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1016/0277-9536(93)90179-8" target="_blank" rel="noreferrer">http://doi.org/10.1016/0277-9536(93)90179-8</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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Physician uncertainty and the art of persuasion
Publisher
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Social Science & Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
1993
Subject
The topic of the resource
Humans; Clinical Competence; Decision Support Techniques; decision making; Persuasive Communication; Physicians/psychology
Creator
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Rizzo JA
Description
An account of the resource
Incomplete information is a chronic feature of medica markets. Much attention has focused on information asymmetries between physicians and their patients. In contrast, physician uncertainty has received far less attention. This is a significant omission. Physician uncertainty may be an even more important reason than consumer uncertainty for the high cost of health care. This paper reviews and evaluates major approaches for managing physician uncertainty. We argue that quantitative approaches alone, such as scientific advancement and the application of decision analysis to clinical reasoning, are insufficient for dealing with uncertainty. Qualitative approaches, such as forging consensus through expert panels, and teaching physicians to accept and cope with uncertainty, will play a valuable role in promoting more effective clinical decision-making under conditions of uncertainty. The current tensions between those who would eradicate physician uncertainty through quantitative approaches and those who favor qualitative methods has parallels in many other fields, including economics and mathematics. These tensions are unfortunate, since the most promising initiative to promote better clinical decision-making will likely need to draw upon both approaches. The recent initiative to implement medical practice guidelines is one example of a broad-based approach to improve clinical decision-making. Guidelines draw upon available scientific evidence, but typically involve consensus-building as well. They seek to persuade and educate physicians about appropriate treatments, without mandating changes in physician treatment patterns. Given the persistent uncertainties physicians will undoubtedly confront regarding appropriate clinical decision-making, this flexible approach may be the best way to mitigate market failures resulting from inappropriate clinical decisions.(ABSTRACT TRUNCATED AT 250 WORDS)
1993
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1016/0277-9536(93)90179-8" target="_blank" rel="noreferrer">10.1016/0277-9536(93)90179-8</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
1993
Backlog
Clinical Competence
Decision Making
Decision Support Techniques
Humans
Journal Article
Persuasive Communication
Physicians/psychology
Rizzo JA
Social science & medicine
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Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1177/0272989x9801800302" target="_blank" rel="noreferrer">http://doi.org/10.1177/0272989x9801800302</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Using a treatment-tradeoff method to elicit preferences for the treatment of locally advanced non-small-cell lung cancer
Publisher
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Medical Decision Making
Date
A point or period of time associated with an event in the lifecycle of the resource
1998
Subject
The topic of the resource
Female; Humans; Male; Attitude to Health; Aged; Treatment Outcome; Choice Behavior; Decision Support Techniques; Survival Analysis; Feasibility Studies; Reproducibility of Results; Non-U.S. Gov't; Research Support; Comparative Study; Adjuvant; Chemotherapy; Carcinoma; Questionnaires/standards; Antineoplastic Agents/adverse effects/therapeutic use; Lung Neoplasms/psychology/radiotherapy; Non-Small-Cell Lung/psychology/radiotherapy; Prostatic Neoplasms/psychology/radiotherapy; Radiotherapy/adverse effects/methods
Creator
An entity primarily responsible for making the resource
Brundage MD; Davidson JR; Mackillop WJ; Feldman-Stewart D; Groome P
Description
An account of the resource
The study was designed to evaluate a treatment-tradeoff method for its potential in helping lung cancer patients make treatment decisions. A treatment-tradeoff interview was conducted to determine how patients weighed potential survival benefits against the potential toxicities of different treatment options: 1) low-dose versus high-dose radiotherapy, and 2) high-dose radiotherapy versus combination chemo-radiotherapy. Fifty-six patients who had experienced cancer and 20 clinic staff participated; twenty of these participants repeated the interview in an assessment of response consistency. The treatment-tradeoff method proved feasible: all staff and 53 of the 56 patients were able to complete the process. A wide range of threshold scores across participants was observed for both tradeoffs. Sixty percent of the patients would accept the more toxic combination therapy over high-dose radiotherapy if the former offered a 10% absolute improvement in three-year survival. The method also proved reliable: test-retest correlations were high (tau ranged from 0.7 to 0.87 and r from 0.82 to 0.94) and test-retest mean score differences were low (1.3-4.2). The most clinically useful measure of consistency was a "preference consistency" index, which revealed that most patients declared the same treatment preference at test and retest. The authors conclude that, while there is great interindividual variability in willingness to accept aggressive treatments for lung cancer, patients' values can be consistently elicited with the tradeoff method. The method has potential for clinical application in decision making and for health-care policy development.
1998
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1177/0272989x9801800302" target="_blank" rel="noreferrer">10.1177/0272989x9801800302</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
1998
Adjuvant
Aged
Antineoplastic Agents/adverse effects/therapeutic use
Attitude To Health
Backlog
Brundage MD
Carcinoma
Chemotherapy
Choice Behavior
Comparative Study
Davidson JR
Decision Support Techniques
Feasibility Studies
Feldman-Stewart D
Female
Groome P
Humans
Journal Article
Lung Neoplasms/psychology/radiotherapy
Mackillop WJ
Male
Medical Decision Making
Non-Small-Cell Lung/psychology/radiotherapy
Non-U.S. Gov't
Prostatic Neoplasms/psychology/radiotherapy
Questionnaires/standards
Radiotherapy/adverse effects/methods
Reproducibility of Results
Research Support
Survival Analysis
Treatment Outcome