Impact of a Machine Learning-Based Decision Support System for Urinary Tract Infections: Prospective Observational Study in 36 Primary Care Practices.

Background: There is increasing attention on machine learning (ML)-based clinical decision support systems (CDSS), but their added value and pitfalls are very rarely evaluated in clinical practice. We implemented a CDSS to aid general practitioners (GPs) in treating patients with urinary tract infections (UTIs), which are a significant health burden worldwide.

Objective: This study aims to prospectively assess the impact of this CDSS on treatment success and change in antibiotic prescription behavior of the physician.

Relationship between trust and patient involvement in medical decision-making: A cross-sectional study.

Introduction: Patients vary in their preferences regarding involvement in medical decision-making. Current research does not provide complete explanation for this observed variation. Patient involvement in medical decision-making has been found to be influenced by various mechanisms, one of which could be patients' trust in physicians.

Guideline Adherence in Antibiotic Prescribing to Patients with Respiratory Diseases in Primary Care: Prevalence and Practice Variation.

Respiratory tract infections (RTIs) account for a large part of antibiotic prescriptions in primary care. However, guidelines advise restrictive antibiotic prescribing for RTIs. Only in certain circumstances, depending on, e.

Does shared decision-making reduce antibiotic prescribing in primary care?

Background: Increasing antibiotic resistance is recognized as a major threat to global health and is related to antibiotic prescription rates in primary care. Shared decision-making (SDM), the process in which patients and doctors participate together in making decisions, is argued to possibly promote more appropriate use of antibiotics and reduce prescribing. However, it is unknown whether in practice fewer antibiotics are prescribed where more SDM takes place.

Is there a conflict between general practitioners applying guidelines for antibiotic prescribing and including their patients' preferences?

Objectives: One perceived barrier to guideline adherence is the existence of conflicting patient preferences. We examined whether patient preferences influence the prescription of antibiotics in general practice, and how this affects guideline adherence. We hypothesized that preferences play a larger role in prescribing antibiotics if the guideline allows for preferences to be taken into account, ie, if prescribing antibiotics is an option which can be considered rather than a clear recommendation to prescribe or not.

Reconstructing spectral cues for sound localization from responses to rippled noise stimuli.

Human sound localization in the mid-saggital plane (elevation) relies on an analysis of the idiosyncratic spectral shape cues provided by the head and pinnae. However, because the actual free-field stimulus spectrum is a-priori unknown to the auditory system, the problem of extracting the elevation angle from the sensory spectrum is ill-posed. Here we test different spectral localization models by eliciting head movements toward broad-band noise stimuli with randomly shaped, rippled amplitude spectra emanating from a speaker at a fixed location, while varying the ripple bandwidth between 1.

Increased cost sharing and changes in noncompliance with specialty referrals in The Netherlands.

Introduction: The compulsory deductible, a form of patient cost-sharing in the Netherlands, has more than doubled during the past years. There are indications that as a result, refraining from medical care has increased. We studied the relation between patient cost-sharing and refraining from medical care by evaluating noncompliance with referrals to medical specialists over several years.

Measuring Temporal Resolution (Release of Masking) with a Hughson-Westlake Up-Down Instead of a Békèsy-Tracking Procedure.

Background: A temporal resolution test in addition to the pure-tone audiogram may be of great clinical interest because of its relevance in speech perception and expected relevance in hearing aid fitting. Larsby and Arlinger developed an appropriate clinical test, but this test uses a Békèsy-tracking procedure for estimating masked thresholds in stationary and interrupted noise to assess release of masking (RoM) for temporal resolution. Generally the Hughson-Westlake up-down procedure is used in the clinic to measure the pure-tone thresholds in quiet.

Evaluation of the preliminary auditory profile test battery in an international multi-centre study.

Objective: This paper describes the composition and international multi-centre evaluation of a battery of tests termed the preliminary auditory profile. It includes measures of loudness perception, listening effort, speech perception, spectral and temporal resolution, spatial hearing, self-reported disability and handicap, and cognition. Clinical applicability and comparability across different centres are investigated.

Measuring spectral and temporal resolution simultaneously: a comparison between two tests.

Objective: Spectral- and temporal-resolution tests are seldom used in clinical practice despite their proven relevance for patients' speech understanding in noise and expected importance for hearing-aid fitting. The aim here was to investigate and compare two clinically applicable tests ('tone test' and 'sweep test') that measure both spectral and temporal resolution simultaneously.

Design: Experiments were conducted monaurally via headphones.

Improved horizontal directional hearing in bone conduction device users with acquired unilateral conductive hearing loss.

We examined horizontal directional hearing in patients with acquired severe unilateral conductive hearing loss (UCHL). All patients (n = 12) had been fitted with a bone conduction device (BCD) to restore bilateral hearing. The patients were tested in the unaided (monaural) and aided (binaural) hearing condition.