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Book ; Online: Fast Facts : Early Breast Cancer

Vaidya, Jayant S. / Patkar, Vivek

(Fast facts)

2023

Abstract: Written for all members of the multidisciplinary breast cancer care team, and for everyone who wishes to know about breast cancer, this concise resource will aid understanding of the risk of developing breast cancer, the essentials of diagnosis and ... ...

Title variant	Fast Facts
Author's details	Jayant S. Vaidya, Vivek Patkar
Series title	Fast facts
Abstract	Written for all members of the multidisciplinary breast cancer care team, and for everyone who wishes to know about breast cancer, this concise resource will aid understanding of the risk of developing breast cancer, the essentials of diagnosis and preoperative assessment, and the current approach to treatment and follow-up, with a focus on how each mode of treatment can be optimized to match the individual patient's needs based on high-quality evidence. Table of Contents: • Etiopathophysiology and risk • Diagnosis • Staging and clinical status • Locoregional treatment • Adjuvant therapy • Survivorship.
Keywords	Breast/Cancer/Chemotherapy
Subject code	616.9
Language	English
Size	1 online resource (106 pages) :, illustrations.
Edition	2nd ed.
Publisher	S. Karger AG
Publishing place	Basel
Document type	Book ; Online
Note	Includes index.
ISBN	3-318-07002-5 ; 3-318-07021-1 ; 978-3-318-07002-6 ; 978-3-318-07021-7
Database	ZB MED Catalogue: Medicine, Health, Nutrition, Environment, Agriculture

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Article: Computer-interpretable guidelines: electronic tools to enhance the utility of thyroid nodule clinical practice guidelines and risk stratification tools.

Garber, Jeffrey R / Patkar, Vivek

Frontiers in endocrinology

2023 Volume 14, Page(s) 1228834

Abstract: Clinicians seeking guidance for evaluating and managing thyroid nodules currently have several resources. The principal ones are narrative clinical guidelines and clinical risk calculators. This paper will review the strengths and weaknesses of both. The ...

Abstract	Clinicians seeking guidance for evaluating and managing thyroid nodules currently have several resources. The principal ones are narrative clinical guidelines and clinical risk calculators. This paper will review the strengths and weaknesses of both. The paper will introduce a concept of computer interpretable guideline, a novel way of transforming narrative guidelines in to a clinical decision support tool that can provide patient specific recommendations at the point of care. The paper then describes an experience of developing an interactive web based computer interpretable guideline for thyroid nodule management, called Thyroid Nodule Management App (TNAPP). The advantages of this approach and the potential barriers for widespread adaptation are discussed.
MeSH term(s)	Humans ; Thyroid Nodule/diagnosis ; Thyroid Nodule/therapy ; Acclimatization ; Computers ; Electronics ; Risk Assessment
Language	English
Publishing date	2023-08-15
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2592084-4
ISSN	1664-2392
ISSN	1664-2392
DOI	10.3389/fendo.2023.1228834
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Editorial: Thyroid nodule evaluation: current, evolving, and emerging tools.

Garber, Jeffrey R / Frasoldati, Andrea / Patkar, Vivek / Papini, Enrico

Frontiers in endocrinology

2023 Volume 14, Page(s) 1276323

MeSH term(s)	Humans ; Thyroid Nodule/diagnosis
Language	English
Publishing date	2023-09-05
Publishing country	Switzerland
Document type	Editorial
ZDB-ID	2592084-4
ISSN	1664-2392
ISSN	1664-2392
DOI	10.3389/fendo.2023.1276323
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Article ; Online: American Association of Clinical Endocrinology And Associazione Medici Endocrinologi Thyroid Nodule Algorithmic Tool.

Garber, Jeffrey R / Papini, Enrico / Frasoldati, Andrea / Lupo, Mark A / Harrell, R Mack / Parangi, Sareh / Patkar, Vivek / Baloch, Zubair W / Pessah-Pollack, Rachel / Hegedus, Laszlo / Crescenzi, Anna / Lubitz, Carrie C / Paschke, Ralf / Randolph, Gregory W / Guglielmi, Rinaldo / Lombardi, Celestino P / Gharib, Hossein

Endocrine, metabolic & immune disorders drug targets

2022 Volume 21, Issue 11, Page(s) 2104–2115

Abstract: Objective: The first edition of the American Association of Clinical Endocrinology/American College of Endocrinology/Associazione Medici Endocrinologi Guidelines for the Diagnosis and Management of Thyroid Nodules was published in 2006 and updated in ... ...

Abstract	Objective: The first edition of the American Association of Clinical Endocrinology/American College of Endocrinology/Associazione Medici Endocrinologi Guidelines for the Diagnosis and Management of Thyroid Nodules was published in 2006 and updated in 2010 and 2016. The American Association of Clinical Endocrinology/American College of Endocrinology/Associazione Medici Endocrinologi multidisciplinary thyroid nodules task force was charged with developing a novel interactive electronic algorithmic tool to evaluate thyroid nodules. Methods: The Thyroid Nodule App (termed TNAPP) was based on the updated 2016 clinical practice guideline recommendations while incorporating recent scientific evidence and avoiding unnecessary diagnostic procedures and surgical overtreatment. This manuscript describes the algorithmic tool development, its data requirements, and its basis for decision making. It provides links to the web-based algorithmic tool and a tutorial. Results: TNAPP and TI-RADS were cross-checked on 95 thyroid nodules with histology-proven diagnoses. Conclusion: TNAPP is a novel interactive web-based tool that uses clinical, imaging, cytologic, and molecular marker data to guide clinical decision making to evaluate and manage thyroid nodules. It may be used as a heuristic tool for evaluating and managing patients with thyroid nodules. It can be adapted to create registries for solo practices, large multispecialty delivery systems, regional and national databases, and research consortiums. Prospective studies are underway to validate TNAPP to determine how it compares with other ultrasound-based classification systems and whether it can improve the care of patients with clinically significant thyroid nodules while reducing the substantial burden incurred by those who do not benefit from further evaluation and treatment.
MeSH term(s)	Biopsy, Fine-Needle ; Endocrinology ; Humans ; Prospective Studies ; Retrospective Studies ; Thyroid Neoplasms/diagnosis ; Thyroid Nodule/diagnostic imaging ; Ultrasonography ; United States
Language	English
Publishing date	2022-01-14
Publishing country	United Arab Emirates
Document type	Journal Article
ZDB-ID	2228325-0
ISSN	2212-3873 ; 1871-5303
ISSN (online)	2212-3873
ISSN	1871-5303
DOI	10.2174/187153032111211230225617
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Article: Clinical guidelines and care pathways: a case study applying PROforma decision support technology to the breast cancer care pathway.

Patkar, Vivek / Fox, John

Studies in health technology and informatics

2008 Volume 139, Page(s) 233–242

Abstract: PROforma is a formal language for modeling clinical processes that was developed by the Advanced Computation Laboratory of Cancer Research UK in 1996, together with associated tools, for creating decision support, care planning, clinical workflow ... ...

Abstract	PROforma is a formal language for modeling clinical processes that was developed by the Advanced Computation Laboratory of Cancer Research UK in 1996, together with associated tools, for creating decision support, care planning, clinical workflow management and other applications. The technology has been used to develop and evaluate a number of decision support applications in range of clinical settings. Clinical trials have been carried out and published for seven of these applications, all suggesting major positive benefits on a variety of outcome measures. The most recent and ongoing project called CREDO is an ambitious attempt to address the challenges in deploying sophisticated decision support systems in the intricate and convoluted management of chronic diseases, taking breast cancer as an example. In this chapter we describe the implementation of evidence based clinical guidelines within a complex care-pathway for patients with breast symptoms and analyse in detail the results of an evaluation study. Some important lessons learned during the process are shared and future directions are discussed.
MeSH term(s)	Breast Neoplasms/therapy ; Clinical Protocols ; Decision Support Systems, Clinical ; Female ; Humans ; United Kingdom ; User-Computer Interface
Language	English
Publishing date	2008
Publishing country	Netherlands
Document type	Journal Article
ISSN	0926-9630
ISSN	0926-9630
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: American Association of Clinical Endocrinology And Associazione Medici Endocrinologi Thyroid Nodule Algorithmic Tool.

Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists

2021 Volume 27, Issue 7, Page(s) 649–660

Abstract	Objective: The first edition of the American Association of Clinical Endocrinology/American College of Endocrinology/Associazione Medici Endocrinologi Guidelines for the Diagnosis and Management of Thyroid Nodules was published in 2006 and updated in 2010 and 2016. The American Association of Clinical Endocrinology/American College of Endocrinology/Associazione Medici Endocrinologi multidisciplinary thyroid nodules task force was charged with developing a novel interactive electronic algorithmic tool to evaluate thyroid nodules. Methods: The Thyroid Nodule App (termed TNAPP) was based on the updated 2016 clinical practice guideline recommendations while incorporating recent scientific evidence and avoiding unnecessary diagnostic procedures and surgical overtreatment. This manuscript describes the algorithmic tool development, its data requirements, and its basis for decision making. It provides links to the web-based algorithmic tool and a tutorial. Results: TNAPP and TI-RADS were cross-checked on 95 thyroid nodules with histology-proven diagnoses. Conclusion: TNAPP is a novel interactive web-based tool that uses clinical, imaging, cytologic, and molecular marker data to guide clinical decision making to evaluate and manage thyroid nodules. It may be used as a heuristic tool for evaluating and managing patients with thyroid nodules. It can be adapted to create registries for solo practices, large multispecialty delivery systems, regional and national databases, and research consortiums. Prospective studies are underway to validate TNAPP to determine how it compares with other ultrasound-based classification systems and whether it can improve the care of patients with clinically significant thyroid nodules while reducing the substantial burden incurred by those who do not benefit from further evaluation and treatment.
Language	English
Publishing date	2021-06-03
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1473503-9
ISSN	1530-891X
ISSN	1530-891X
DOI	10.1016/j.eprac.2021.04.007
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Article ; Online: From practice guidelines to clinical decision support: closing the loop.

Fox, John / Patkar, Vivek / Chronakis, Ioannis / Begent, Richard

Journal of the Royal Society of Medicine

2009 Volume 102, Issue 11, Page(s) 464–473

MeSH term(s)	Decision Support Techniques ; Health Services/standards ; Health Services Accessibility ; Point-of-Care Systems ; Practice Guidelines as Topic ; Quality of Health Care
Language	English
Publishing date	2009-10-29
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	6731-3
ISSN	1758-1095 ; 0141-0768 ; 0035-9157
ISSN (online)	1758-1095
ISSN	0141-0768 ; 0035-9157
DOI	10.1258/jrsm.2009.090010
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Article ; Online: Using computerised decision support to improve compliance of cancer multidisciplinary meetings with evidence-based guidance.

Patkar, Vivek / Acosta, Dionisio / Davidson, Tim / Jones, Alison / Fox, John / Keshtgar, Mohammed

BMJ open

2012 Volume 2, Issue 3

Abstract: Objectives: The cancer multidisciplinary team (MDT) meeting (MDM) is regarded as the best platform to reduce unwarranted variation in cancer care through evidence-compliant management. However, MDMs are often overburdened with many different agendas and ...

Abstract	Objectives: The cancer multidisciplinary team (MDT) meeting (MDM) is regarded as the best platform to reduce unwarranted variation in cancer care through evidence-compliant management. However, MDMs are often overburdened with many different agendas and hence struggle to achieve their full potential. The authors developed an interactive clinical decision support system called MATE (Multidisciplinary meeting Assistant and Treatment sElector) to facilitate explicit evidence-based decision making in the breast MDMs. Design: Audit study and a questionnaire survey. Setting: Breast multidisciplinary unit in a large secondary care teaching hospital. Participants: All members of the breast MDT at the Royal Free Hospital, London, were consulted during the process of MATE development and implementation. The emphasis was on acknowledging the clinical needs and practical constraints of the MDT and fitting the system around the team's workflow rather than the other way around. Delegates, who attended MATE workshop at the England Cancer Networks' Development Programme conference in March 2010, participated in the questionnaire survey. Outcome measures: The measures included evidence-compliant care, measured by adherence to clinical practice guidelines, and promoting research, measured by the patient identification rate for ongoing clinical trials. Results: MATE identified 61% more patients who were potentially eligible for recruitment into clinical trials than the MDT, and MATE recommendations demonstrated better concordance with clinical practice guideline than MDT recommendations (97% of MATE vs 93.2% of MDT; N=984). MATE is in routine use in breast MDMs at the Royal Free Hospital, London, and wider evaluations are being considered. Conclusions: Sophisticated decision support systems can enhance the conduct of MDMs in a way that is acceptable to and valued by the clinical team. Further rigorous evaluations are required to examine cost-effectiveness and measure the impact on patient outcomes. The decision support technology used in MATE is generic and if found useful can be applied across medicine.
Language	English
Publishing date	2012-06-25
Publishing country	England
Document type	Journal Article
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2011-000439
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Decision support for health care: the PROforma evidence base.

Fox, John / Patkar, Vivek / Thomson, Richard

Informatics in primary care

2006 Volume 14, Issue 1, Page(s) 49–54

Abstract: Cancer Research UK has developed PROforma, a formal language for modelling clinical processes, along with associated tools for creating decision support, care planning, clinical workflow management and other applications. The PROforma method has been ... ...

Abstract	Cancer Research UK has developed PROforma, a formal language for modelling clinical processes, along with associated tools for creating decision support, care planning, clinical workflow management and other applications. The PROforma method has been evaluated in a variety of settings: in primary health care (prescribing, referral of suspected cancer patients, genetic risk assessment) and in specialist care of patients with breast cancer, leukaemia, HIV infection and other conditions. About nine years of experience have been gained with PROforma technologies. Seven trials of decision support applications have been published or are in preparation. Each of these has shown significant positive effects on a variety of measures of quality and/or outcomes of care. This paper reviews the evidence base for the clinical effectiveness of these PROforma applications, and previews the CREDO project -- a multi-centre trial of a complex PROforma application for supporting integrated breast cancer care across primary and secondary care settings.
MeSH term(s)	Breast Neoplasms/therapy ; Decision Support Systems, Clinical ; Female ; Genetic Predisposition to Disease ; Humans ; Neoplasms/therapy ; Practice Guidelines as Topic ; Risk Assessment ; United Kingdom
Language	English
Publishing date	2006-07-17
Publishing country	England
Document type	Journal Article
ZDB-ID	2258410-9
ISSN	1475-9985 ; 1476-0320
ISSN (online)	1475-9985
ISSN	1476-0320
DOI	10.14236/jhi.v14i1.616
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Article ; Online: Cancer multidisciplinary team meetings: evidence, challenges, and the role of clinical decision support technology.

Patkar, Vivek / Acosta, Dionisio / Davidson, Tim / Jones, Alison / Fox, John / Keshtgar, Mohammad

International journal of breast cancer

2011 Volume 2011, Page(s) 831605

Abstract: Multidisciplinary team (MDT) model in cancer care was introduced and endorsed to ensure that care delivery is consistent with the best available evidence. Over the last few years, regular MDT meetings have become a standard practice in oncology and ... ...

Abstract	Multidisciplinary team (MDT) model in cancer care was introduced and endorsed to ensure that care delivery is consistent with the best available evidence. Over the last few years, regular MDT meetings have become a standard practice in oncology and gained the status of the key decision-making forum for patient management. Despite the fact that cancer MDT meetings are well accepted by clinicians, concerns are raised over the paucity of good-quality evidence on their overall impact. There are also concerns over lack of the appropriate support for this important but overburdened decision-making platform. The growing acceptance by clinical community of the health information technology in recent years has created new opportunities and possibilities of using advanced clinical decision support (CDS) systems to realise full potential of cancer MDT meetings. In this paper, we present targeted summary of the available evidence on the impact of cancer MDT meetings, discuss the reported challenges, and explore the role that a CDS technology could play in addressing some of these challenges.
Language	English
Publishing date	2011-07-17
Publishing country	Egypt
Document type	Journal Article
ZDB-ID	2603566-2
ISSN	2090-3189 ; 2090-3170
ISSN (online)	2090-3189
ISSN	2090-3170
DOI	10.4061/2011/831605
Database	MEDical Literature Analysis and Retrieval System OnLINE

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