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Factors impacting physicians’ decisions to prevent variceal hemorrhage

Published on Dec 1, 2015in BMC Gastroenterology2.252
· DOI :10.1186/s12876-015-0287-1
Kathleen Yan2
Estimated H-index: 2
(Yale University),
John F. P. Bridges29
Estimated H-index: 29
(Johns Hopkins University)
+ 3 AuthorsLiana Fraenkel32
Estimated H-index: 32
(Yale University)
Abstract
Background Reasons underlying the variability of physicians’ preferences for non-selective beta-blockers (BBs) and endoscopic variceal ligation (EVL) to prevent a first variceal bleed have not been empirically studied. Our aims were to examine whether 1) gastroenterologists can be classified into distinct subgroups based on how they prioritize specific treatment attributes and 2) physician characteristics are associated with treatment preference.
  • References (25)
  • Citations (7)
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References25
Newest
#1Ming Bai (Fourth Military Medical University)H-Index: 20
#2Xingshun Qi (Fourth Military Medical University)H-Index: 22
Last. Dai-MingFan (Fourth Military Medical University)H-Index: 55
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Background and Aim The effect of combined therapies (among non-selected beta-blockers [NSBB], endoscopic therapy, and other treatments) on the first variceal bleeding has been evaluated in several randomized controlled trials previously, and the results were controversial. We performed this meta-analysis to assess the effect of combined therapies in patients with high-risk varices without previous variceal bleeding. Methods The Cochrane Library, The Cochrane Hepato-Biliary Group Controlled Trial...
6 CitationsSource
#1John F. P. Bridges (Johns Hopkins University)H-Index: 29
#2Susan M. Joy (Johns Hopkins University)H-Index: 8
Last. Timothy M. Pawlik (Johns Hopkins University)H-Index: 82
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Abstract In 2006, the European Parliament designated hepatocellular carcinoma (HCC) a serious public health problem, recognizing it as both a complex and deadly cancer. The authors conducted the first comparative needs assessment for HCC across five European countries. One hundred HCC experts assessed ten dimensions of HCC control. Common needs exist for lifestyle risk factor management (p < 0.001), political awareness (p < 0.001) and public awareness (p < 0.001). Discordances were found on fund...
8 CitationsSource
#1Lise Lotte GluudH-Index: 36
#2Aleksander Krag (Copenhagen University Hospital)H-Index: 26
Background Non-selective beta-blockers are used as a first-line treatment for primary prevention in patients with medium- to high-risk oesophageal varices. The effect of non-selective beta-blockers on mortality is debated and many patients experience adverse events. Trials on banding ligation versus non-selective beta-blockers for patients with oesophageal varices and no history of bleeding have reached equivocal results. Objectives To compare the benefits and harms of banding ligation versus no...
71 CitationsSource
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#2Terry N. Flynn (UTS: University of Technology, Sydney)H-Index: 31
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This study provides preliminary indications that there may be potentially important and systematic differences in the valuations attached to identical health states by adolescents in comparison with adult population groups. The study findings lend support to the potential future application of profile case BWS DCE methods to undertake large-scale health state valuation studies directly with young adolescent population samples and provide support for the feasibility and acceptability of a web-bas...
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There is a growing need for efficient procedures for identification of emerging technologies by horizon scanning systems. We demonstrate the value of best-worst scaling (BWS) in exploring clinicians' views on emerging technologies that will impact outcomes in hepatocellular carcinoma (HCC) in the next 5 to 10 years.
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Barriers to integrating personalized medicine into clinical practice: a best–worst scaling choice experiment
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SUMMARY Background In patients with oesophageal varices, the combination of endoscopic variceal ligation (EVL) and medical therapy is recommended as standard of care for prevention of rebleeding. The results of previous meta-analyses on this topic are equivocal. Aim To assess the effects of EVL plus medical therapy vs. monotherapy (EVL or medical therapy alone) for secondary prevention in oesophageal varices. Methods Electronic and manual searches were combined. The primary outcome measures were...
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#1M. Lugtenberg (Tilburg University)H-Index: 10
#2Jako S. Burgers (Radboud University Nijmegen Medical Centre)H-Index: 37
Last. Gert P. Westert (Tilburg University)H-Index: 38
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Background: Despite considerable efforts to promote and support guideline use, adherence is often suboptimal. Barriers to adherence vary not only across guidelines but also across recommendations within guidelines. The aim of this study was to assess the perceived barriers to guideline adherence among GPs by focusing on key recommendations within guidelines. Methods: We conducted a cross-sectional electronic survey among 703 GPs in the Netherlands. Sixteen key recommendations were derived from f...
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#1Jordan J. Louviere (UTS: University of Technology, Sydney)H-Index: 83
#2Terry N. Flynn (UTS: University of Technology, Sydney)H-Index: 31
Background: One of the greatest difficulties in evaluating healthcare system reform in any country is that governments often do not clearly articulate what it is they are attempting to do. In Australia, a recent inquiry set out 15 principles to guide the reform process, but it remains unclear how the Australian public values the principles, how such values vary across the country, and, more fundamentally, if Australians understand the principles.
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BACKGROUND Colorectal cancer (CRC) screening can be administered through tests with varied characteristics and is a preference-sensitive decision.
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#1Lei Zhang (HUST: Huazhong University of Science and Technology)
#2Hong-Ping Luo (HUST: Huazhong University of Science and Technology)
Last. Wan-GuangZhang (HUST: Huazhong University of Science and Technology)H-Index: 10
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Purpose. This study was conducted to introduce a novel modified surgical technique for laparoscopic splenectomy and esophagogastric devascularization (LSED) and its safety and efficiency. Methods. From June 2016 to November 2017, 86 patients were diagnosed with portal hypertension and serious gastroesophageal varices in our center. Of them, 32 patients underwent LSED and 54 received the modified LSED. Results and outcomes were compared retrospectively. Results. There were no significant differen...
Source
#1Ilene L. Hollin (SC: University of Southern California)H-Index: 10
#2Holly L. Peay (RTI International)H-Index: 15
Last. John F. P. Bridges (Johns Hopkins University)H-Index: 29
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Purpose Patient preference information (PPI) have an increasing role in regulatory decision-making, especially in benefit–risk assessment. PPI can also facilitate prioritization of symptoms to treat and inform meaningful selection of clinical trial endpoints. We engaged patients and caregivers to prioritize symptoms of Duchenne and Becker muscular dystrophy (DBMD) and explored preference heterogeneity.
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#1Mo Zhou (Johns Hopkins University)H-Index: 6
#2Winter Maxwell Thayer (Johns Hopkins University)H-Index: 3
Last. John F. P. Bridges (Johns Hopkins University)H-Index: 29
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Background Latent class analysis (LCA) has been increasingly used to explore preference heterogeneity, but the literature has not been systematically explored and hence best practices are not understood.
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Last. Jaime Bosch (University of Bern)H-Index: 7
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#2Hugo Perazzo (NIH: National Institutes of Health)H-Index: 12
Last. Renata M. PerezH-Index: 16
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#1Kei Long Cheung (UM: Maastricht University)H-Index: 6
#2Ben F. M. Wijnen (UM: Maastricht University)H-Index: 7
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Introduction Best–worst scaling (BWS) is becoming increasingly popular to elicit preferences in health care. However, little is known about current practice and trends in the use of BWS in health care. This study aimed to identify, review and critically appraise BWS in health care, and to identify trends over time in key aspects of BWS.
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Best-worst scaling (BWS), also known as maximum-difference scaling, is a multiattribute approach to measuring preferences. BWS aims at the analysis of preferences regarding a set of attributes, their levels or alternatives. It is a stated-preference method based on the assumption that respondents are capable of making judgments regarding the best and the worst (or the most and least important, respectively) out of three or more elements of a choice-set. As is true of discrete choice experiments ...
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