Computerized clinical decision support (CDS) will be essential to ensuring the safety and efficiency of new care delivery models, such as the patient-centered medical home. CDS will help empower non-physician team members, coordinate overall team efforts, and facilitate physician oversight. In this article, we discuss common clinical scenarios that could benefit from CDS optimized for team-based healthcare, including (1) low-acuity episodic illness, (2) diagnostic workup of new onset symptoms, (3) chronic care, (4) preventive care, and (5) care coordination. CDS that maximally supports teams may be one of biomedical informatics' best opportunities to decrease health care costs, improve quality, and increase clinical capacity.
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Pharmacoeconomics
January 2025
Belgian Health Care Knowledge Centre, Brussels, Belgium.
Background: Forecasting future public pharmaceutical expenditure is a challenge for healthcare payers, particularly owing to the unpredictability of new market introductions and their economic impact. No best-practice forecasting methods have been established so far. The literature distinguishes between the top-down approach, based on historical trends, and the bottom-up approach, using a combination of historical and horizon scanning data.
View Article and Find Full Text PDFArch Orthop Trauma Surg
January 2025
Department of Orthopaedic Surgery, Anam Hospital, Korea University College of Medicine, Seoul, South Korea.
Introduction: There is a lack of clinical evidence supporting the decision-making process between high tibial osteotomy (HTO) and unicomparmental knee arthroplasty (UKA) in gray zone indication, such as moderate medial osteoarthritis with moderate varus alignment. This study compared the outcomes between HTO and UKA in such cases and assessed the risk factor for not maintaining clinical improvements.
Materials And Methods: We retrospectively reviewed 65 opening-wedge HTOs and 55 UKAs with moderate medial osteoarthritis (Kellgren-Lawrence grade ≥ 3 and Ahlback grade < 3) and moderate varus alignment (5°< Hip-Knee-Ankle angle < 10°) over 3 years follow-up.
J Cancer Res Clin Oncol
January 2025
Institute for Community Medicine, Section Epidemiology of Health Care and Community Health, University Medicine Greifswald, 17489, Greifswald, Germany.
Introduction: The objective of this study is to compare the 5 year overall survival of patients with stage I-III colon cancer treated by laparoscopic colectomy versus open colectomy.
Methods: Using Mecklenburg-Western Pomerania Cancer Registry data from 2008 to 2018, we will emulate a phase III, multicenter, open-label, two-parallel-arm hypothetical target trial in adult patients with stage I-III colon cancer who received laparoscopic or open colectomy as an elective treatment. An inverse-probability weighted Royston‒Parmar parametric survival model (RPpsm) will be used to estimate the hazard ratio of laparoscopic versus open surgery after confounding factors are balanced between the two treatment arms.
Int Ophthalmol
January 2025
Department of Ophthalmology, Staedtisches Klinikum Dessau, Brandenburg Medical School Theodor Fontane, Dessau, Germany.
Purpose: Uveal melanoma (UM) is the most common primary ocular malignancy. The size and location of the tumor are decisive for brachytherapy with the β-emitting ruthenium-106 (Ru-106) plaque. The treatment of juxtapapillary and juxtafoveolar UM may be challenging because of the proximity or involvement of the macula and optic nerve and high recurrence rates.
View Article and Find Full Text PDFJACC Cardiovasc Imaging
January 2025
Department of Nuclear Medicine, Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Center for Rare Diseases Research, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Background: Cardiac involvement in amyloid light chain (AL) amyloidosis significantly influences prognosis, necessitating timely diagnosis and meticulous risk stratification.
Objectives: This prospective study aimed to delineate the molecular phenotypes of AL cardiac amyloidosis (AL-CA) by characterizing fibro-amyloid deposition using F-florbetapir and gallium-68-labeled fibroblast activation protein inhibitor-04 (Ga-FAPI-04) positron emission tomography (PET)/computed tomography (CT) imaging. The authors also proposed a novel molecular stratification methodology for prognosis.
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