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Therapist perspectives on the clinical utility of hand performance information from at-home egocentric video in outpatient neurorehabilitation: a multi-methods evaluation study.

BACKGROUND: Restoring hand function is a primary focus of rehabilitation after neurological injuries, such as stroke and spinal cord injury. … ercentile). CONCLUSIONS: This study demonstrates the potential of using egocentric video to inform clinical decision-making in neurorehabilitation, particularly for hand function. The strong preference for video over metrics suggests clinical decision support systems should prioritize interpretable, observation-based information aligned with clinical reasoning processes. …

Screening 'Gum Disease or Problem' Status Using Molar Probing Depths: Model Development and Validation in NHANES Young to Middle-Aged Adults.

Background/Objectives: A parsimonious multivariable model was engineered and externally validated using dental electronic health records to screen for a clinician-evaluated "gum disease or related problem" status. Designed for seamless electronic integration, a positive screening result triggers a targeted referral-and the model is well-suited for dental hygienist use- while providing clinical decision support for dentists during definitive diagnoses. This automated support standardises workflows, maximises team efficiency, and supports data-driven clinical decision-making. Methods: This cross…

Pediatric head injury in the emergency department: balancing radiation risk, missed diagnoses, and decision-rule evolution.

BACKGROUND: Pediatric head injury is a frequent cause of emergency department neuroimaging worldwide and a major contributor to health care utilization. Although most children with minor head trauma do not sustain clinically important traumatic brain injury (ciTBI), the risk of acute complications necessitates accurate risk stratification. A central challenge is balancing the need to reliably exclude ciTBI against the potential harms of ionizing radiation. Despite high-sensitivity clinical decision rules, computed tomography (CT) remains the dominant imaging modality, with utilization rates ap

Clinical and Imaging Characteristics to Discriminate Between Complicated and Uncomplicated Acute Cholecystitis: A Regression Model and Decision Tree Analysis.

Background: Acute complicated cholecystitis (ACC) is associated with prolonged hospitalization, increased morbidity, and higher mortality. However, objective imaging-based criteria to guide early clinical decision-making remain limited. This study aimed to develop a predictive scoring system integrating clinical characteristics, laboratory biomarkers, and computed tomography (CT) findings to facilitate the early identification of ACC in the emergency department (ED). Methods: We conducted a retrospective study at an urban tertiary care center in Taiwan, screening 729 patients who presented to …

Development of clinical decision support for patients older than 65 years with fall-related TBI using artificial intelligence modeling.

BACKGROUND: Older persons comprise most traumatic brain injury (TBI)-related hospitalizations and deaths and are particularly susceptible to fall-induced TBIs. The combination of increased frailty and susceptibility to clinical decline creates a significant ongoing challenge in the management of geriatric TBI. As the population ages and co-existing medical conditions complexify, so does the need to improve the quality of care for this population. Utilizing early hospital admission variables, this study will create and validate a multinomial decision tree that predicts the discharge disposition

A framework to integrate equity in public health emergency response dashboards: Dashboard instrument to review equity (DIRE).

OBJECTIVES: COVID-19 created an urgent element of clinical and financial strain to the public health system, forcing it into rapid response mode. Key public health decisions were quickly made, with limited data and guidance to address decision trade-offs and community inequities. Gaps identified in the pandemic confirmed the need for a new tool, like this study's Dashboard Instrument to Review Equity (DIRE) Framework, to ensure decision-makers are given quick and equitable decision-making guidance. STUDY DESIGN: Scoping review and tool development. METHODS: The scoping review was conducted t

[Identification and management of palliative care needs in primary care. A practical proposal].

The heterogeneous and unique characteristics of advanced disease frequently compromise the emotional adjustment of patients and families, generating a high demand for care. These conditions often exceed approaches based on protocols and clinical guidelines, making an adequate, individualized and precise situational diagnosis essential, which facilitates an efficient shared decision-making and a quality patient-centered care. Palliative care, therefore, should be based on the degree of care complexity, determined by the needs of the patient-family unit and the problem-solving capacity of health

Secondary antibody deficiencies: what's around the corner?

Secondary antibody deficiencies (SADs) are characterized by impaired humoral immunity, which can cause recurrent and severe infections. Several factors may contribute to SAD development, making it difficult to establish a clear etiological classification. This heterogeneity also leads to clinical variability, further complicating patient management and treatment strategies. Various diagnostic and therapeutic algorithms are often adapted from those used in primary antibody deficiencies, potentially resulting in under- or over-treatment. Key points include the decision to initiate Immunoglobulin

When is it time to bid farewell to anticoagulation?

Decisions about antithrombotic therapy in cancer patients at the end of life can be challenging. This cohort study examined prescribing behaviour and outcomes relating to antithrombotic therapy in this patient group, finding that deprescribing was uncommon. Greater awareness of this neglected but high-risk aspect of patient care is required along with interventions to enable shared decision-making in this setting. Commentary on: Aldridge et al. Antithrombotic therapy in patients with cancer at the end of life and associated clinical outcomes: a cohort study using population-linked routinely co

A Qualitative Analysis of Factors Influencing Critical Care Trial Enrollment Among Surrogates.

BACKGROUND: We sought to identify factors that influence surrogate decision makers' decisions to enroll patients into a critical care randomized controlled trial. METHODS: We conducted a qualitative study embedded within a randomized controlled trial testing the effect of a behavioral nudge intervention for surrogate decision makers on enrollment rate in a sham ventilatory weaning trial among patients with acute respiratory failure. Participants were adult surrogate decision makers of patients receiving mechanical ventilation for acute respiratory failure. The study was conducted in 10 ICUs a

Machine Learning Diagnosis of Peritonsillar Abscess.

Peritonsillar abscess (PTA) is a difficult diagnosis to make clinically, with clinical examination of even otolaryngologists showing poor sensitivity and specificity. Machine learning is a form of artificial intelligence that "learns" from data to make predictions. We developed a machine learning classifier to predict the diagnosis of PTA based on patient symptoms. We retrospectively collected clinical data and symptomatology from 916 patients who underwent attempted needle aspiration for PTA. Machine learning classifiers were trained on a subset of the data to predict the presence or absence

A prediction nomogram for residual after negative pressure aspiration for endogenic cesarean scar ectopic pregnancy: a retrospective study.

BACKGROUND: We aimed to establish a predictive nomogram to evaluate the incidence of residual tissue in patients with endogenic cesarean sca … t, and external validation confirmed its reliability. CONCLUSIONS: The model may aid in individual clinical decision-making, allowing clinicians to perform immediate postoperative assessments for patients with endogenous ectopic pregnancy in cesarean section scars treated with negative pressure suction, identify high-risk subpopulations, and select appropriate supplement …

Machine-learning based prediction of appendicitis for patients presenting with acute abdominal pain at the emergency department.

BACKGROUND: Acute abdominal pain (AAP) constitutes 5-10% of all emergency department (ED) visits, with appendicitis being a prevalent AAP et … flows for AAP or are specifically designed to diagnose appendicitis as early as possible within the clinical decision-making process. To mimic daily clinical practice, this proof-of-concept study aims to develop ML models that support decision-making using comprehensive clinical data up to key decision points in the ED workflow to detect appendicitis in patients presentin …

Treatment of intramedullary spinal cord tumors: a modified Delphi technique of the North American Spine Society Section of Spine Oncology.

OBJECTIVE: Intramedullary spinal cord tumors (IMSCTs) are rare tumors with heterogeneous presentations and natural histories that complicate … ement regarding surgical management of IMSCTs. Although not intended as a substitute for individual clinical decision-making, the results can help guide care of these patients. Additionally, areas of controversy meriting further investigation are highlighted.

Indications for haematopoietic cell transplantation and CAR-T for haematological diseases, solid tumours and immune disorders: 2025 EBMT practice recommendations.

For over two decades, the EBMT has updated recommendations on indications for haematopoietic cell transplantation (HCT) practice based on clinical and scientific developments in the field. This is the ninth special EBMT report on indications for HCT for haematological diseases, solid tumours and immune disorders. Our aim is to provide guidance on HCT indications according to prevailing clinical practice in EBMT countries and centres. In order to inform patient decisions, these recommendations must be considered with the risk of the disease, risk of HCT procedure and non-HCT strategies, includi

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… Since the last update, innovative cellular therapies and gene therapies have entered in activity across indications affecting clinical decision making. … The increasing application of CAR-T and other genetically modified cell therapies will require ongoing consideration in clinical decision-making in HCT across the indications. Supplementary information Supplementary Table 1. …

Large Language Model Decision Support for Cranial CT in Pediatric Head Trauma.

Background: Pediatric head trauma is a common reason for emergency department presentation. Although most children have minor injuries, a small proportion harbor clinically important traumatic brain injuries requiring urgent intervention. Artificial intelligence (AI) may offer structured support in computed tomography (CT) decision making, but evidence regarding the performance of general-purpose large language models in pediatric head trauma remains limited. Objective: To evaluate the association between AI-based cranial CT recommendations and clinically meaningful outcomes in pediatric patie

Rethinking Head Computed Tomography (CT) in the Emergency Department: From Reflex Imaging to Reasoned Care.

Head computed tomography (CT) is among the most frequently ordered tests in emergency care, yet its use for mild traumatic brain injury (mTBI) remains highly variable. Contemporary practice patterns reflect this: head CT is obtained in >80% of emergency department (ED) evaluations for suspected mTBI, and in older adults presenting after a fall, approximately half undergo cranial CT in routine practice (49% in a UK ED cohort aged ≥65 years). Ageing societies bring more older fallers to the ED, often with incomplete histories and widespread use of anticoagulants or antiplatelets. These realities

Genetic counselling and ethical issues with chromosome microarray analysis in prenatal testing.

Molecular karyotyping using chromosome microarray analysis (CMA) detects more pathogenic chromosomal anomalies than classical karyotyping, making CMA likely to become a first tier test for prenatal diagnosis. Detecting copy number variants of uncertain clinical significance raises ethical considerations. We consider the risk of harm to a woman or her fetus following the detection of a copy number variant of uncertain significance, whether it is ethically justifiable to withhold any test result information from a woman, what constitutes an 'informed choice' when women are offered CMA in pregnan

Ethical considerations in the management of Ebola virus disease.

Is it ethically appropriate in some circumstances for HCWs to decline to care for patients with EVD? How should treatment decisions be made regarding limitation of therapy for patients with EVD? There are two main ethical questions regarding the critical care of patients with EVD in an Australian setting: Is it ethically appropriate in some circumstances for HCWs to decline to care for patients with EVD? How should treatment decisions be made regarding limitation of therapy for patients with EVD? The key concern is ensuring that no patient is denied therapy that should be provided, while preve

Clinical reasoning and hypothesis generation in expert clinical swallowing examinations.

BACKGROUND: A clinical swallow examination (CSE) provides integral information that informs the diagnostic decision-making process within dysphagia management. However, multiple studies have highlighted a high degree of reported variability within the CSE process. It has been hypothesized that such variability may be the result of the clinical reasoning process rather than poor practices. AIMS: To elucidate the nature of expert, speech-language therapists' (SLTs) clinical reasoning during an initial bedside assessment of patients referred for suspected dysphagia in the acute care environment.