Predictors of Family Dissatisfaction with Support During Neurocritical Care Shared Decision-Making.

Background: There is a critical need to improve support for families making difficult shared decisions about patient care with clinicians in the neuroscience ICU (neuro-ICU). The aim of this study is to identify patient- and family-related factors associated with dissatisfaction with shared decision-making support among families of neuro-critically ill patients.

Methods: We conducted a retrospective observational cohort study using survey data that had been collected from a consecutive sample of family members of patients in the neuro-ICU (one family member per patient) at two US academic centers.

Deep Learning to Estimate RECIST in Patients with NSCLC Treated with PD-1 Blockade.

Real-world evidence (RWE), conclusions derived from analysis of patients not treated in clinical trials, is increasingly recognized as an opportunity for discovery, to reduce disparities, and to contribute to regulatory approval. Maximal value of RWE may be facilitated through machine-learning techniques to integrate and interrogate large and otherwise underutilized datasets. In cancer research, an ongoing challenge for RWE is the lack of reliable, reproducible, scalable assessment of treatment-specific outcomes.

State-Interaction Pair-Density Functional Theory Can Accurately Describe a Spiro Mixed Valence Compound.

Mixed-valence compounds with strong couplings between electronic states constitute one of the most challenging types of multireference systems for electronic structure theory. Previous work on a model mixed-valence compound, the 2,2',6,6'-tetrahydro-4 H,4' H-5,5'-spirobi[cyclopenta[ c]pyrrole] cation, showed that multireference perturbation theory (MRPT) can give a physical energy surface for the mixed-valence compound only by going to the third order or by using a scheme involving averaging orbital energies in a way specific to mixed-valence systems. In this study, we show that second-order MRPT methods (CASPT2, MS-CASPT2, and XMS-CASPT2) can give good results by calculating the Fock operator for the zeroth-order Hamiltonian using the state-averaged density matrix.

Primary Care Physician Involvement in Shared Decision Making for Critically Ill Patients and Family Satisfaction with Care.

Purpose: An intensive care unit (ICU) patient's primary care physician (PCP) may be able to assist family with certain ICU shared medical decisions. We explored whether families of patients in nonopen ICUs who nevertheless report involvement of a patient's PCP in medical decision making are more satisfied with ICU shared decision making than families who do not.

Methods: Between March 2013 and December 2015, we administered the Family Satisfaction in the ICU 24 survey to family members of adult neuroscience ICU patients.

Dedicated Afternoon Rounds for ICU Patients' Families and Family Satisfaction With Care.

Objective: It was hypothesized that adding dedicated afternoon rounds for patients' families to supplement standard family support would improve overall family satisfaction with care in a neuroscience ICU.

Design: Pre- and postimplementation (pre-I and post-I) design.

Setting: Single academic neuroscience ICU.