This timely guide to communication in patient-centered medicine argues for greater clarity in explaining health risks versus benefits of an array of screening tests, procedures, and drug regimens. It reviews the growing trend toward patients' involvement in their own care, particularly in terms of chronic conditions, and details approaches physicians can use to prepare patients (and themselves) for collaborative decision-making based on informed choices and clear, meaningful knowledge. Chapters apply this lens to a wide range of common interventions as contentious as estrogen replacement therapy and antibiotics, and as widely prescribed as the daily aspirin and the annual physical. With this goal in mind, the authors also introduce an innovative decision-making tool that translates risks and benefits into a clear graphic format for fewer chances of miscommunication or misunderstanding. Among the topics covered: Involving the patient in decision making. Towards a universal decision aid. BRCT: the Benefit/Risk Characterization Theater. Breast Cancer Screening—Mammograms. Prostate Cancer Screening. Colon cancer screening with colonoscopy. Screening for and treating dementia. Statins, cholesterol, and coronary heart disease. Physicians in family and internal medicine will find Interpreting Health Benefits and Risks: A Practical Guide to Facilitate Doctor- Patient Communication a valuable resource for communicating with patients and new possibilities for working toward their better health and health education. This book considers several common and important situations where faulty decision-making makes overtreatment a serious risk. Clear, fair, referenced, and useful information is provided. And a powerful intuitive technique is introduced which allows patient and doctor to talk as equals as they work together in the exam room. The authors emphasize that some patients who have been fully educated will still accept high risks of harm for a small chance of avoiding premature death. But as this book is accepted and its ideas and technique are extended, I feel sure that net harm to patients will be curtailed. And what is more, the integrity of the decision-making process will be improved. —Thomas Finucane, MD, Professor of Medicine, Division of Gerontology and Geriatric Medicine, The Johns Hopkins University School of Medicine

In recent decades, advances in biomedical research have helped save or lengthen the lives of children around the world. With improved therapies, child and adolescent mortality rates have decreased significantly in the last half century. Despite these advances, pediatricians and others argue that children have not shared equally with adults in biomedical advances. Even though we want children to benefit from the dramatic and accelerating rate of progress in medical care that has been fueled by scientific research, we do not want to place children at risk of being harmed by participating in clinical studies. Ethical Conduct of Clinical Research Involving Children considers the necessities and challenges of this type of research and reviews the ethical and legal standards for conducting it. It also considers problems with the interpretation and application of these standards and conduct, concluding that while children should not be excluded from potentially beneficial clinical studies, some research that is ethically permissible for adults is not acceptable for children, who usually do not have the legal capacity or maturity to make informed decisions about research participation. The book looks at the need for appropriate pediatric expertise at all stages of the design, review, and conduct of a research project to effectively implement policies to protect children. It argues persuasively that a robust system for protecting human research participants in general is a necessary foundation for protecting child research participants in particular.

Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. The committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001), finds that diagnosis-and, in particular, the occurrence of diagnostic errorsâ€"has been largely unappreciated in efforts to improve the quality and safety of health care. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers. The recommendations of Improving Diagnosis in Health Care contribute to the growing momentum for change in this crucial area of health care quality and safety.

This book demonstrates how a novel decision-aid, called a Benefit-Risk Characterization Theater (BRCT), can be used to: · Significantly improve accurate communication of health risks from exposure to COVID-19; and · Assess how to best contain and control COVID-19. To date, there have been far-reaching ramifications based on ineffective risk communication when clarifying these health endpoints. A BRCT is a familiar, theatrical chart representation of 1,000 people, with the risks and benefits shown by blackened seats. Since health outcomes can easily be put into such a chart, we show how BRCTs can be used objectively by professionals, the media and lay people. It allows characterization and communication of health benefits and risks of COVID-19 treatment and containment in an undemanding and straightforward way. BRCTs have been successfully used to assist patients in determining: · Their level of acceptable risk of various medical interventions; · If the benefits of intervention outweigh the risks; · Who should make the final decision regarding medical intervention; and · Whether the decision is evidence-based. Written by experts in the field, this book fills in a gap in communication between the medical community, the public and patients. It also provides an area of expertise in communication that is beneficial for medical providers and medical students.

Andy Lazris, MD, is a practicing primary care physician who experiences the effects of Medicare policy on a daily basis. As a result, he believes that the way we care for our elderly has taken a wrong turn and that Medicare is complicit in creating the very problems it seeks to solve. Aging is not a disease to be cured; it is a life stage to be lived. Lazris argues that aggressive treatments cannot change that fact but only get in the way and decrease quality of life. Unfortunately, Medicare’s payment structure and rules deprive the elderly of the chance to pursue less aggressive care, which often yields the most humane and effective results. Medicare encourages and will pay more readily for hospitalization than for palliative and home care. It encourages and pays for high-tech assaults on disease rather than for the primary care that can make a real difference in the lives of the elderly. Lazris offers straightforward solutions to ensure Medicare’s solvency through sensible cost-effective plans that do not restrict patient choice or negate the doctor-patient relationship. Using both data and personal stories, he shows how Medicare needs to change in structure and purpose as the population ages, the physician pool becomes more specialized, and new medical technology becomes available. Curing Medicare demonstrates which medical interventions (medicines, tests, procedures) work and which can be harmful in many common conditions in the elderly; the harms and benefits of hospitalization; the current culture of long-term care; and how Medicare often promotes care that is ineffective, expensive, and contrary to what many elderly patients and their families really want.

Every day we make decisions about our health - some big and some small. What we eat, how we live and even where we live can affect our health. But how can we be sure that the advice we are given about these important matters is right for us? This book will provide you with the right tools for assessing health advice.

This book provides an understanding and appreciation of the risk assessment process and the ability to objectively interpret health risk values. Included is an explanation of the uncertainty inherent in the assessment of risks as well as an explanation of how the communication and characterization of risks can dramatically alter the perception of those risks. Case studies illustrate the strengths and limitations of characterizing certain risks. Using the accepted risk assessment paradigm proposed by the National Research Council, these case studies illustrate which risk values have merit and why other assessments fail to meet basic criteria.

The Internet serves as an essential tool in promoting health awareness through the circulation of important research among the medical professional community. While digital tools and technologies have greatly improved healthcare, challenges are still prevalent among diverse populations worldwide. The Handbook of Research on Advancing Health Education through Technology presents a comprehensive discussion of health knowledge equity and the importance of the digital age in providing life-saving data for diagnosis and treatment of diverse populations with limited resources. Featuring timely, research-based chapters across a broad spectrum of topic areas including, but not limited to, online health information resources, data management and analysis, and knowledge accessibility, this publication is an essential reference source for researchers, academicians, medical professionals, and upper level students interested in the advancement and dissemination of medical knowledge.

Evaluating the strength or persuasiveness of epidemiologic evidence is inherently challenging, both for those new to the field and for experienced researchers. There are a myriad of potential biases to consider, but little guidance about how to asses the likely impact on study results. This book offers a strategy for assessing epidemiologic research findings, explicitly describing the goals and products of epidemiologic research in order to better evaluate it successes and limitations. The focus throughout is on practical tools for making optimal use of available data to assess whether hypothesized biases are operative and to anticipate concerns at the point of study design in order to ensure that needed information is generated. Specific tools for assessing the presence and impact of selection bias in both cohort and case-control studies, bias from non-response, confounding, exposure measurement error, disease measurement error, and random error are identified and evaluated. The potential value of each approach as well as its limitations are discussed, using examples from the published literature. Such information should help those who generate and interpret epidemiologic research to apply methodological principles more effectively to substantive issues, leading to a more accurate appraisal of the current evidence and greater clarity about research needs.

Canadian Maternity and Pediatric Nursing prepares your students for safe and effective maternity and pediatric nursing practice. The content provides the student with essential information to care for women and their families, to assist them to make the right choices safely, intelligently, and with confidence.