clinical decision-making

A summary for primary care clinicians of the recently updated ENT guidelines for evaluation and management of sudden acute hearing loss. James W. Mold, MD, MPH

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The family physician's role in recognizing and managing sudden sensorineural hearing loss (SSNHL) is crucial. A recently updated otolaryngologic clinical practice guideline has been released for this emergency syndrome, but dissemination is limited to a specialty journal. As a result, the guidelines may not be widely available in the primary care setting where patients often present. We provide this focused review to clarify and disseminate SSNHL guidelines for the frontline family physician.

Author/s:

Prince, Andrew D.P., Stucken, Emily Z.

Twenty Common Mistakes Made in Daily Clinical Practice

John Bayhi — Thu, 02 Jan 2020 20:45:01 +0000

Date Added:

January 2, 2020

Journal/Publication:

The American Journal of Medicine

Publisher:

Elsevier Inc.

Publication Date:

January 1, 2020

Issue:

Volume:

133

Pages:

1-3

URL:

Twenty Common Mistakes Made in Daily Clinical Practice

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1016/j.amjmed.2019.06.045

Keywords

commentary

clinical decision-making

PMID (1):

31348895

Worth reviewing, especially #s 5, 12, 17, 18, and 19. James W. Mold. MD, MPH.

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The authors review twenty common mistakes in clinical practice and offer alternative treatment options for each case.

Author/s:

Frishman, WH, Alpert, JS

Testing of a Tool for Prostate Cancer Screening Discussions in Primary Care

John Bayhi — Thu, 26 Sep 2019 13:53:04 +0000

Date Added:

September 30, 2019

Journal/Publication:

Frontiers in Oncology

Publisher:

Frontiers Media S.A.

Publication Date:

June 28, 2018

Type:

Clinical Decision Aids

Format:

Article

DOI (1):

10.3389/fonc.2018.00238

Keywords

cancer screening

clinical decision-making

prostate cancer

prostate-specific antigen

shared decision-making

PMID (1):

30003062

MeSH

early detection of cancer

Surveys and Questionnaires

This tool was developed and tested in primary care settings as a way to facilitate discussions about prostate cancer screening. Both clinicians and patients seemed to like it. James W. Mold, MD, MPH

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The link to the study is available here: https://www.ncbi.nlm.nih.gov/pubmed/30003062

BACKGROUND:

As prostate cancer (PCa) screening decisions often occur in outpatient primary care, a brief tool to help the PCa screening conversation in busy clinic settings is needed.

METHODS:

A previously created 9-item tool to aid PCa screening discussions was tested in five diverse primary care clinics. Fifteen providers were recruited to use the tool for 4 weeks, and the tool was revised based upon feedback. The providers then used the tool with a convenience sample of patients during routine clinic visits. Pre- and post-visit surveys were administered to assess patients' knowledge of the option to be screened for PCa and of specific factors to consider in the decision. McNemar's and Stuart-Maxwell tests were used to compare pre-and post-survey responses.

RESULTS:

14 of 15 providers completed feedback surveys and had positive responses to the tool. All 15 providers then tested the tool on 95 men aged 40-69 at the five clinics with 2-10 patients each. The proportion of patients who strongly agreed that they had the option to choose to screen for PCa increased from 57 to 72% (p = 0.018) from the pre- to post-survey, that there are factors in the personal or family history that may affect PCa risk from 34 to 47% (p = 0.012), and that their opinions about possible side effects of treatment for PCa should be considered in the decision from 47 to 61% (p = 0.009).

CONCLUSION:

A brief conversation tool for the PCa screening discussion was well received in busy primary-care settings and improved patients' knowledge about the screening decision.

Author/s:

Misra-Hebert, AD, Hom, G, Klein, EA, Bauman, JA, Gupta, N, Ji, X, Stephenson, AJ, Jones, JS, Kattan, Kattan, MW

Diagnosis of Celiac Disease: Current State of the Evidence

Tracy Ashby — Tue, 23 Oct 2018 05:00:00 +0000

Date Added:

October 23, 2018

Journal/Publication:

AHRQ Comparative Effectiveness Reviews

Publisher:

Agency for Healthcare Research and Quality

Publication Date:

July 26, 2016

URL:

Diagnosis of Celiac Disease: Current State of the Evidence

Type:

Meta-analyses, Reviews, and Guidelines, Meta-analyses, Reviews, and Guidelines

Format:

Article

Keywords

celiac disease

sensitivity and specificity

clinical decision-making

PMID (1):

27583323

MeSH

celiac disease

sensitivity and specificity

clinical decision-making

This is a summary of the evidence regarding how to diagnose celiac disease.

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This is a summary of a systematic review evaluating the evidence regarding the comparative accuracy (the balance of sensitivity and specificity) and possible adverse consequences (both direct and indirect) of various methods used to diagnose celiac disease. The systematic review included 60 individual studies and 13 previous systematic reviews published from January 1990 through March 2015. The full report, listing all studies and reviews, is available at www.effectivehealthcare.ahrq.gov/celiac-disease. This summary is provided to assist in informed clinical decisionmaking. However, reviews of evidence should not be construed to represent clinical recommendations or guidelines.

Author/s:

John M. Eisenberg Center for Clinical Decisions and Communications Science