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Patient perspective: Is intensive screening of women at high risk of breast cancer evidence-based medicine or ?
Womens Health (Lond)
January 2025
Department of Pharmacy Practice, Midwestern University College of Pharmacy, Glendale Campus, Glendale, AZ, USA.
In 2023, a breast cancer risk assessment and a subsequent positive test for the BRCA-2 genetic mutation brought me to the uncomfortable intersection of a longstanding career as an advocate for high-quality medical evidence to support shared patient-provider decision making and a new role as a high-risk patient. My search for studies of available risk-management options revealed that the most commonly recommended approach for women with a ⩾20% lifetime breast cancer risk, intensive screening including annual mammography and/or magnetic resonance imaging beginning at age 25-40 years, was supported only by cancer-detection statistics, with almost no evidence on patient-centered outcomes-mortality, physical and psychological morbidity, or quality of life-compared with standard screening or a surgical alternative, bilateral risk-reducing mastectomy. In this commentary, I explore parallels between the use of the intensive screening protocol and another longstanding women's health recommendation based on limited evidence, the use of hormone therapy (HT) for postmenopausal chronic disease prevention, which was sharply curtailed after the publication of the groundbreaking Women's Health Initiative trial in 2002.
View Article and Find Full Text PDFArtificial intelligence in clinical settings: a systematic review of its role in language translation and interpretation.
Ann Transl Med
December 2024
Division of Advanced Gastrointestinal and Bariatric Surgery, Mayo Clinic, Jacksonville, FL, USA.
Background: Addressing language barriers through accurate interpretation is crucial for providing quality care and establishing trust. While the ability of artificial intelligence (AI) to translate medical documentation has been studied, its role for patient-provider communication is less explored. This review evaluates AI's effectiveness in clinical translation by assessing accuracy, usability, satisfaction, and feedback on its use.
View Article and Find Full Text PDFEpidemiology of diagnostic errors in pediatric emergency departments using electronic triggers.
Acad Emerg Med
January 2025
Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, Texas, USA.
Objectives: We applied three electronic triggers to study frequency and contributory factors of missed opportunities for improving diagnosis (MOIDs) in pediatric emergency departments (EDs): return visits within 10 days resulting in admission (Trigger 1), care escalation within 24 h of ED presentation (Trigger 2), and death within 24 h of ED visit (Trigger 3).
Methods: We created an electronic query and reporting template for the triggers and applied them to electronic health record systems of five pediatric EDs for visits from 2019. Clinician reviewers manually screened identified charts and initially categorized them as "unlikely for MOIDs" or "unable to rule out MOIDs" without a detailed chart review.
Adapting self-measured blood pressure monitoring to reduce health disparities (ASPIRE): a pilot hybrid effectiveness‑implementation study protocol.
Pilot Feasibility Stud
January 2025
Advocate Christ Medical Center, Advocate Health, Oak Lawn, IL, USA.
Background: Hypertension is the leading risk factor for cardiovascular disease (CVD). Despite advances in blood pressure management, significant racial and ethnic disparities persist, resulting in higher risks of stroke, heart disease, and mortality among non-White populations. Self-measured blood pressure (SMBP) monitoring, also known as home blood pressure monitoring, has shown promise in improving blood pressure control, especially when combined with feedback from healthcare providers.
View Article and Find Full Text PDFThe Influence of Patient Provider Educational Interactions and Associated Preoperative Variables on Outcomes in the Hip Dysplasia Population.
Iowa Orthop J
January 2025
Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.
Background: Patient provider interactions influence patient treatment adherence, clinical outcomes, patient satisfaction, and an overall patient's engagement in healthcare decisions. The purpose of this study was to examine the effectiveness of patient provider educational interactions and associated variables on patient reported outcomes in the hip dysplasia population.
Methods: A secondary data analysis was completed with 6-month postoperative survey data from participants, who had undergone periacetabular osteotomy.
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