Informed Consent and Shared Decision-Making in Modern Medicine: Case-Based Approach, Current Gaps and Practical Proposal.

Advances in personalized medicine and Systems Biology have introduced probabilistic models and error discovery to cardiovascular care, aiding disease prevention and procedural planning. However, clinical application faces cultural, technical, and methodological hurdles. Patient autonomy remains essential, with shared decision-making (SDM) gaining importance in managing complex cardiovascular treatment options.

Perpetuating sub-optimal care: CMS, QIPs, and the hemoglobin myth.

As the new Centers for Medicare & Medicaid Services' Quality Incentive Program takes effect, the implications are enormous for dialysis patients. Contrary to its intention, the Quality Incentive Program, with its upper hemoglobin limit, may well stifle innovative practice-based research and practical approaches to anemia management. An opportunity to move away from an excessive preoccupation with ESAs to substantially improve patient outcomes, and to do so at a much lower cost, may well be lost to patients, providers, and CMS as a result.