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Related Concept Videos

Decision Making01:20

Decision Making

Decision-making is a fundamental cognitive process that involves evaluating alternatives and selecting among them. This process can range from simple choices, such as deciding what to wear, to complex decisions, like choosing a major in college or a career path. The complexity of the decision often dictates the approach we use, which can be broadly categorized into two types: automatic and controlled decision-making.
Automatic decision-making is fast, intuitive, and relies on gut feelings...
Impact of Pharmacokinetic–Pharmacodynamic Models: Regulatory Decisions01:15

Impact of Pharmacokinetic–Pharmacodynamic Models: Regulatory Decisions

PK–PD modeling has significantly influenced FDA regulatory decisions, particularly drug approval, dosage optimization, and labeling. These models integrate pharmacokinetics (PK) and pharmacodynamics (PD) to predict drug behavior and effects, aiding in optimizing dosing regimens and enhancing the probability of clinical trial success.One notable example is Nesiritide (Natrecor®), a recombinant human brain natriuretic peptide for treating acute decompensated congestive heart failure (CHF).
Critical Thinking II01:25

Critical Thinking II

Critical thinking is a cognitive process with several attributes. The attributes of critical thinking include the following:
Pharmacovigilance01:19

Pharmacovigilance

Post-marketing surveillance is a critical component of pharmaceutical regulation, often uncovering unanticipated adverse drug reactions (ADRs) once a drug is widely used over an extended period.
This process, termed pharmacovigilance, aims to detect, evaluate, and minimize harmful effects related to medication use. The data collection for pharmacovigilance depends on spontaneous reporting systems, where healthcare professionals or patients voluntarily report suspected ADRs.
In some cases, there...
Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches01:23

Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches

Biopharmaceutical studies constitute a vital field aiming to enhance drug delivery methods and refine therapeutic approaches, drawing upon diverse interdisciplinary knowledge. In research methodologies, the choice between controlled and non-controlled studies significantly influences the study's reliability and accuracy.
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast, controlled...
Nursing Diagnosis01:22

Nursing Diagnosis

Following assessment, a nursing diagnosis is the next step in the nursing process. It begins after the nurse has collected and recorded the patient data. The purpose of diagnosing is to identify how the client responds to actual or potential health processes, identify factors that bestow or that cause health problems, the etiologies, and identify resources or strengths the individual, group, or community can draw on to prevent or resolve problems.
The nursing diagnosis focuses on evidence-based...

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Related Experiment Videos

Clinical judgment versus decision analysis for managing device advisories.

Mitesh S Amin1, Mark A Wood, Richard K Shepard

  • 1Division of Cardiology, Department of Internal Medicine, Virginia Commonwealth University Medical Center, Richmond, Virginia 23298-0053, USA.

Pacing and Clinical Electrophysiology : PACE
|September 25, 2008
PubMed
Summary

Device advisories for pacemakers (PM) and implantable cardioverter-defibrillators (ICD) show varied management. A decision analysis model can guide clinicians to avoid unnecessary procedures.

Related Experiment Videos

Area of Science:

  • Cardiology
  • Medical Device Technology
  • Clinical Practice Management

Background:

  • Implantable cardioverter-defibrillator (ICD) and pacemaker (PM) advisories significantly impact patient management.
  • Clinical practice surveys reveal substantial variability in managing patients post-device advisory.
  • This study compares a single university practice's management of device advisories against a decision analysis model's predictions.

Purpose of the Study:

  • To compare actual clinical management of device advisories with a predictive decision analysis model.
  • To identify variability in patient management following ICD and PM advisories.
  • To assess the utility of decision analysis in optimizing device advisory management.

Main Methods:

  • Retrospective review of patients with implanted devices affected by advisories between March 2005 and May 2006.
  • Comparison of the medical center's actual patient management strategy with a decision analysis model's predicted strategy.
  • Analysis of management decisions based on advisory type, manufacturer recommendations, device dependency, and patient/physician preferences.

Main Results:

  • Over 14 months, 11 advisories affected 436 patients; 385 were managed.
  • Management strategies included device replacement (15.2%), reprogramming/magnets (11.7%), and increased follow-up (71.3%).
  • Decision analysis model concordance was 57.1%; 25 devices were replaced against model preference, highlighting potential for unnecessary procedures.

Conclusions:

  • Despite a conservative approach, more devices were replaced than predicted by the decision analysis model.
  • Formal decision analysis can foster a systematic, evidence-based approach to device advisories.
  • Implementing decision analysis may help avoid unnecessary device replacement procedures.