This document discusses classification systems for psychiatric disorders. It describes the differences between syndromes, diseases, and disorders. Classification aims to facilitate communication, control of disorders through treatment and prevention, and comprehension of causes and processes. Psychiatric disorders are typically classified based on clinical syndromes rather than etiology due to limited biological understanding. The two main classification systems are the DSM-5 and ICD-11. The document outlines key aspects of these systems such as their history and constituents of a good classification system including reliability, validity, and utility. It also discusses categorical versus dimensional approaches to classification.
This document summarizes changes to diagnoses of somatic disorders in the DSM-5 and provides guidance on assessing and treating patients with somatic symptoms. It discusses how the DSM-5 consolidated somatoform disorders into the new category of somatic symptom and related disorders. Specifically, it replaced somatization disorder, undifferentiated somatoform disorder, and pain disorder with the new diagnosis of somatic symptom disorder. It also analyzes challenges with applying the new DSM-5 criteria in clinical practice based on a case example of a patient named Andrew experiencing chronic pain.
The feasibility and need for dimensional psychiatric diagnosesChloe Taracatac
This document discusses the feasibility and need for adding dimensional psychiatric diagnoses to complement traditional categorical diagnoses. It begins with an introduction on the terminology of categories vs dimensions. It then reviews literature supporting both the advantages of categorical and dimensional approaches. Specifically, categorical diagnoses improve reliability, communication and teaching, while dimensions better describe relationships between variables and clinical severity. The conclusion proposes preserving categorical definitions but adding dimensional criteria derived from the categories to incorporate both approaches into diagnostic systems.
The document provides an overview of psychiatric classification systems. It discusses the definition and advantages of classification, as well as key terms and historical approaches including etiological, descriptive, categorical, and dimensional.
It then describes the development of major classification systems including the DSM and ICD. The DSM is the diagnostic manual published by the American Psychiatric Association while the ICD is published by the World Health Organization. The document outlines the various editions of the DSM from DSM-I to the current DSM-5. It also discusses other classification systems and tools used in psychiatry such as the Chinese Classification of Mental Disorders and the Research Domain Criteria.
Epidemiology is defined as the study of the distribution and determinants of health-related states or events in populations and the application of this study to control health problems. It involves descriptive studies that ask questions about disease occurrence, magnitude, location, time period, and affected individuals. Analytical studies like case-control and cohort studies are used to test hypotheses about disease causes. Randomized controlled trials experimentally study interventions by applying or withdrawing suspected causes between study groups.
Classification in Psychiatry
The concept, reliability, validity, advantages and disadvantages of different classification systems, controversies in psychiatry classification
The document discusses psychiatric classification systems. It provides an overview of key concepts like nosology, syndrome, disease, and disorder. It describes the purposes of psychiatric classification as communication, control of disorders, and comprehension. It discusses important criteria for a good classification like reliability, validity, utility, and ease of use. Challenges in psychiatric classification are the reliance on subjective reports and lack of objective measures. The document contrasts categorical and dimensional models of classification and provides examples of disorders where a dimensional approach is favored. It provides a brief history of major classification systems and describes current systems like DSM-5 and ICD-11.
Essay plan for "To what extent can diagnosis be reliable and valid?"LauraSw
Yes, the title "To what extent can diagnosis be reliable and valid?" was referred to throughout the plan by discussing how diagnosis can only be reliable and valid to a limited extent.
The critical thinking was well integrated by discussing limitations and issues around reliability and validity of diagnosis and supporting the arguments with empirical evidence and examples.
Logical connectors like "therefore" were used to link ideas and build the argument. The plan laid out a logical argument supported by citing research studies and examples.
The conclusion directly answered the question by summarizing that diagnosis can only be reliable and valid to a limited extent given issues around classification systems, interpretation, bias, and cross-cultural differences.
So in summary, the critical thinking plan demonstrated
This document summarizes changes to diagnoses of somatic disorders in the DSM-5 and provides guidance on assessing and treating patients with somatic symptoms. It discusses how the DSM-5 consolidated somatoform disorders into the new category of somatic symptom and related disorders. Specifically, it replaced somatization disorder, undifferentiated somatoform disorder, and pain disorder with the new diagnosis of somatic symptom disorder. It also analyzes challenges with applying the new DSM-5 criteria in clinical practice based on a case example of a patient named Andrew experiencing chronic pain.
The feasibility and need for dimensional psychiatric diagnosesChloe Taracatac
This document discusses the feasibility and need for adding dimensional psychiatric diagnoses to complement traditional categorical diagnoses. It begins with an introduction on the terminology of categories vs dimensions. It then reviews literature supporting both the advantages of categorical and dimensional approaches. Specifically, categorical diagnoses improve reliability, communication and teaching, while dimensions better describe relationships between variables and clinical severity. The conclusion proposes preserving categorical definitions but adding dimensional criteria derived from the categories to incorporate both approaches into diagnostic systems.
The document provides an overview of psychiatric classification systems. It discusses the definition and advantages of classification, as well as key terms and historical approaches including etiological, descriptive, categorical, and dimensional.
It then describes the development of major classification systems including the DSM and ICD. The DSM is the diagnostic manual published by the American Psychiatric Association while the ICD is published by the World Health Organization. The document outlines the various editions of the DSM from DSM-I to the current DSM-5. It also discusses other classification systems and tools used in psychiatry such as the Chinese Classification of Mental Disorders and the Research Domain Criteria.
Epidemiology is defined as the study of the distribution and determinants of health-related states or events in populations and the application of this study to control health problems. It involves descriptive studies that ask questions about disease occurrence, magnitude, location, time period, and affected individuals. Analytical studies like case-control and cohort studies are used to test hypotheses about disease causes. Randomized controlled trials experimentally study interventions by applying or withdrawing suspected causes between study groups.
Classification in Psychiatry
The concept, reliability, validity, advantages and disadvantages of different classification systems, controversies in psychiatry classification
The document discusses psychiatric classification systems. It provides an overview of key concepts like nosology, syndrome, disease, and disorder. It describes the purposes of psychiatric classification as communication, control of disorders, and comprehension. It discusses important criteria for a good classification like reliability, validity, utility, and ease of use. Challenges in psychiatric classification are the reliance on subjective reports and lack of objective measures. The document contrasts categorical and dimensional models of classification and provides examples of disorders where a dimensional approach is favored. It provides a brief history of major classification systems and describes current systems like DSM-5 and ICD-11.
Essay plan for "To what extent can diagnosis be reliable and valid?"LauraSw
Yes, the title "To what extent can diagnosis be reliable and valid?" was referred to throughout the plan by discussing how diagnosis can only be reliable and valid to a limited extent.
The critical thinking was well integrated by discussing limitations and issues around reliability and validity of diagnosis and supporting the arguments with empirical evidence and examples.
Logical connectors like "therefore" were used to link ideas and build the argument. The plan laid out a logical argument supported by citing research studies and examples.
The conclusion directly answered the question by summarizing that diagnosis can only be reliable and valid to a limited extent given issues around classification systems, interpretation, bias, and cross-cultural differences.
So in summary, the critical thinking plan demonstrated
The document discusses the nursing process and its introduction, definition, steps, and importance. It provides a brief history of the development of the nursing process from the 1950s to the present. The key steps discussed in detail include assessment, nursing diagnosis, planning, implementation, and evaluation. The nursing process is presented as a systematic, problem-solving approach that directs nursing activities and provides quality nursing care.
The document discusses diagnosis in psychiatry. It defines diagnosis as conclusions made about a client's problems and complaints that are used to plan care. Taxonomy involves classifying data into appropriate diagnostic categories. The DSM-IV-TR and ICD-10 are the main classification systems used internationally. They organize mental disorders into axes or chapters and provide diagnostic criteria. However, classification systems receive criticism for being overly broad and influenced by culture. Accurate diagnosis is still important for guiding treatment and care plans.
Term Case Competition.Group 2Kristina CharlesMelissa Herv.docxmehek4
Term Case Competition.
Group 2:
Kristina Charles
Melissa Hervas
Dayana Lewandowski
Marcella Ortega
Daylen Torres
Maridellis Utset
November 20th, 2016
Background:
C.W. Williams Healthcare Center was started by the first African American surgeon from Charlotte’s largest hospital in 1980. His passion for the health needs of the poor and wanting to make the world a better place for those less fortunate, was his ultimate concern.
In essence, the ACA, signed into law March 2010 by President Barack Obama will focus on …
the uninsured Americans granted health insurance
provide all screenings, and services as recommended by the U.S. Preventive Services Task Force.
establish lower healthcare costs
enhance system productivity
Major Ruling Beneficial to C.W. Williams
The ACA provides new options and incentives to help states rebalance their Medicaid long-term care programs in favor of community-based services and supports rather than institutional care (Paradise, 2015).
Accountable Care Organizations
Group of doctors, hospitals and other health care providers who come together voluntarily to give coordinated high quality care to their Medicare patients.
The goal of Accountable Care Organizations are to avoid unnecessary duplication of services and preventing medical errors. This ultimately results in savings for the Medicare program.
Goal of ACOs
C.W. Williams and ACOs
Currently one of C.W. Williams obstacles is the consortium being formed with the state to pay for Medicaid patients. If the state agrees to partake in this, all of C.W.’s patients, that require hospitalization, will no longer have the choice of which hospital they'd like to be admitted to.
CMC has expressed an interest in the patients of C.W. Williams
Older patients of C.W. Williams prefer CMC over Presbyterian.
It’ll be easier to form an ACO since the majority will be Medicare patients and there will only be one hospital affiliation.
Patient- Centered Medical Home (PCMH)
Patient-centered medical home is a model of care that aims to transform the delivery of comprehensive primary care to children, adolescents and adults. Through this model, practices seek to improve quality, effectiveness and efficiency of the care they deliver while responding to each patient’s unique needs and preferences.
Anti-Kickback & Stark Law Implications
Anti-Kickback Statute Prohibits:
Offering, paying, soliciting or receiving anything of value to induce or reward referrals to generate Federal health care program business.
Stark Law Prohibits:
A physician from referring Medicare patients for designated health services to an entity with which the physician has a financial relationship unless an exception applies.
References
Centers for Medicare & Medicaid Services (2015). Accountable Care Organizations (ACO). Retreived November 11, 2016, from https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/ACO/index.html?redirect=/aco/
Harris, D.M. (2014). Contemporary Issues in H ...
This document discusses clinical staging as a new framework for understanding, preventing, and treating mental disorders like psychosis and mood disorders. Clinical staging aims to differentiate early, milder symptoms from those that accompany illness progression and chronicity. It allows clinicians to select treatments tailored to the early stages of illness and evaluate their effectiveness in preventing progression. For staging to be valid, early interventions need to be shown to be more effective and safer than later treatments. The staging framework could integrate biological, social, and psychological risk factors and move psychiatry towards a more clinicopathological model.
This document provides an introduction to medical surgical nursing. It defines medical surgical nursing as nursing care for patients whose conditions are treated medically or surgically. The objectives of the chapter are to define medical surgical nursing, explain the concepts of health and illness, and discuss the nursing process. The nursing process is presented as a systematic problem-solving approach used by nurses to meet patient needs through assessment, nursing diagnosis, planning, implementation, and evaluation. Health is defined in both negative and positive terms, and the concepts of illness, disease, impairment, disability, and handicap are explained. The document also covers health promotion, illness prevention, and the levels of nursing assessment.
This document outlines the course content for a 9th semester differential diagnosis and clinical decision making course. It discusses topics like intro to medical screening, differential diagnosis of various body systems, the process of differential diagnosis, screening and its purpose, reasons for medical disease screening, red and yellow flags, and the physical therapist's role in disease diagnosis, prevention, and clinical reasoning. Key terms like quicker, sicker, and signed prescription in relation to medical screening are also defined. A case example demonstrates recognition of red flags that warrant physician consultation.
This research article examines the ethical dilemmas faced by palliative care physicians through surveys and interviews with 30 palliative care specialists in Mexico.
The study identified 113 common dilemmas, most frequently regarding sedation, home administration of opioids, and institutional regulations. It was observed that truth-telling and bidirectional trust between patients and providers are core to palliative medicine ethics. The most prominent virtues among participants were justice and professional humility. Physicians in palliative care see themselves most importantly as educators and advisers who provide medical assistance.
The research aims to better understand the values that guide decision-making in palliative care in order to improve care for patients at the end of life. It finds rediscovering virtues in clinical practice can
Schemes for medical decision making a primer for traineesImad Hassan
An article on a practical road map for teaching trainees easy schemes for Clinical Decision Making. Due to appear soon on the journal "Perspectives on Medical Education"
Useful for Trainers and Trainees alike to complement and expand the PowerPoint presentation on the same subject.
The document provides guidelines from the American Psychiatric Association for the treatment of patients with schizophrenia. It discusses schizophrenia as a disorder with significant health, social, and economic burdens. The guidelines cover assessments for diagnosing schizophrenia and developing treatment plans, as well as recommendations for pharmacotherapy and psychosocial interventions. The guidelines are based on a systematic review of available evidence and are intended to enhance treatment and reduce the consequences of schizophrenia.
This document provides an overview of the nursing process. It begins by outlining the objectives of understanding the nursing process, its characteristics, benefits, and phases. It then defines the nursing process as a modified scientific method used to assess client needs and develop a care plan. The key phases are described as assessment, nursing diagnosis, planning, implementation, and evaluation. Assessment involves collecting client data, nursing diagnosis identifies responses to health issues, planning develops the care approach, implementation provides care, and evaluation assesses effectiveness. The document explains each phase in further detail.
1. The document discusses various types of medical research designs including observational and experimental studies.
2. Observational studies are divided into descriptive studies which aim to describe health problems without comparisons, and analytical studies which aim to identify associations between exposures and outcomes.
3. Experimental research designs involve assigning subjects to treatment or control groups randomly to evaluate new interventions while controlling for confounding factors. Randomized controlled trials are considered the gold standard for evaluating new treatments.
The document discusses clinical prediction rules, which are combinations of clinical findings that provide predictions about patient outcomes. It addresses how prediction rules are derived from study data and validated. Key points include how prediction rules should be developed using clearly defined samples and outcomes, and validated by comparing results to criterion measures while masking assessors, and ideally validating rules in new populations.
The document discusses the changing role of laboratories in diagnosis and diagnostic decision making. It notes that historically, diagnoses were labels placed on symptoms with little need for testing or effective treatment. Now, accurate diagnoses have serious consequences given more effective therapies. This has led to increased complexity and expectations in diagnostic medicine. The laboratory now plays a central role in the diagnostic process. Establishing acceptable risk for patients requires understanding how test validity, value, and clinical risk are determined. Factors like test purpose, reliability, and how results are used must be considered to optimize outcomes. Educating clinicians is important so medical decision points factor in test limitations and implications for patient risk.
This document outlines a plan for developing a needs assessment related to clinical pathways for ED admissions for intractable pain and social admissions. It includes reviewing strategies to overcome organizational barriers, identifying legal and ethical considerations, finalizing a theoretical needs assessment plan, and beginning an annotated bibliography with 6 sources related to the needs assessment topic.
This document discusses nursing diagnosis, including its definition, steps for formulating a nursing diagnosis, categories and types. It defines nursing diagnosis as a statement of a health problem or potential problem that a nurse can treat. The steps for formulation include establishing a database through various assessments, analyzing client responses, organizing the data, and confirming the diagnosis. Nursing diagnoses can be actual, risk, or potential complications. They should not merely restate a medical diagnosis but provide a basis for nursing interventions.
Epidemiology designs for clinical trials - PubricaPubrica
1. Clinical trial study design
2. Cohort Study design
3. Case-Control Studies
4. Cross-Sectional Studies
5. Ecological Studies
6. Randomized Clinical Trials
Continue Reading: https://bit.ly/3tDt6rH
Reference: https://pubrica.com/services/research-services/experimental-design/
Why Pubrica:
When you order our services, We promise you the following – Plagiarism free | always on Time | 24*7 customer support | Written to international Standard | Unlimited Revisions support | Medical writing Expert | Publication Support | Biostatistical experts | High-quality Subject Matter Experts.
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Blog: https://pubrica.com/academy/
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Lecture I-IV -for adult nursing care planssuser1af747
This document provides a course syllabus for an Advanced Nursing Health Assessment of Adult course. The 3-credit course is intended for first year adult health nursing students and will cover advanced health assessment techniques, history taking, physical examination skills, and clinical decision making. The course objectives are to enhance students' health assessment knowledge and skills to assess and care for adult clients. The course will be delivered through lectures, skills labs, hospital placements, and assignments. Students will be evaluated based on presentations, skills exams, and a final written exam.
The DSM-5 introduces an integrated approach to diagnosis and classification that combines dimensional and categorical models. It incorporates dimensional assessments of severity for select diagnoses to provide more clinical utility and better inform research. Several disorders are now conceptualized as existing on a spectrum, such as autism spectrum disorder and substance use disorder, to account for variations in symptoms between individuals. This integrated approach in DSM-5 aims to provide more detailed clinical information to improve diagnosis, treatment planning, and patient outcomes compared to the narrow categorical approach of previous DSM editions.
This document contains a list of 13 group members and their student IDs. It then provides a proposed question based on a clinical scenario using the PICO framework. The question is about a 60-year-old female diagnosed with peripheral arterial disease and type 2 diabetes. The document concludes with a critical appraisal of a study based on the Critical Appraisal tool, answering 12 questions about the study methodology, results, and applicability.
Jill Pizzola's Tenure as Senior Talent Acquisition Partner at THOMSON REUTERS...dsnow9802
Jill Pizzola's tenure as Senior Talent Acquisition Partner at THOMSON REUTERS in Marlton, New Jersey, from 2018 to 2023, was marked by innovation and excellence.
The document discusses the nursing process and its introduction, definition, steps, and importance. It provides a brief history of the development of the nursing process from the 1950s to the present. The key steps discussed in detail include assessment, nursing diagnosis, planning, implementation, and evaluation. The nursing process is presented as a systematic, problem-solving approach that directs nursing activities and provides quality nursing care.
The document discusses diagnosis in psychiatry. It defines diagnosis as conclusions made about a client's problems and complaints that are used to plan care. Taxonomy involves classifying data into appropriate diagnostic categories. The DSM-IV-TR and ICD-10 are the main classification systems used internationally. They organize mental disorders into axes or chapters and provide diagnostic criteria. However, classification systems receive criticism for being overly broad and influenced by culture. Accurate diagnosis is still important for guiding treatment and care plans.
Term Case Competition.Group 2Kristina CharlesMelissa Herv.docxmehek4
Term Case Competition.
Group 2:
Kristina Charles
Melissa Hervas
Dayana Lewandowski
Marcella Ortega
Daylen Torres
Maridellis Utset
November 20th, 2016
Background:
C.W. Williams Healthcare Center was started by the first African American surgeon from Charlotte’s largest hospital in 1980. His passion for the health needs of the poor and wanting to make the world a better place for those less fortunate, was his ultimate concern.
In essence, the ACA, signed into law March 2010 by President Barack Obama will focus on …
the uninsured Americans granted health insurance
provide all screenings, and services as recommended by the U.S. Preventive Services Task Force.
establish lower healthcare costs
enhance system productivity
Major Ruling Beneficial to C.W. Williams
The ACA provides new options and incentives to help states rebalance their Medicaid long-term care programs in favor of community-based services and supports rather than institutional care (Paradise, 2015).
Accountable Care Organizations
Group of doctors, hospitals and other health care providers who come together voluntarily to give coordinated high quality care to their Medicare patients.
The goal of Accountable Care Organizations are to avoid unnecessary duplication of services and preventing medical errors. This ultimately results in savings for the Medicare program.
Goal of ACOs
C.W. Williams and ACOs
Currently one of C.W. Williams obstacles is the consortium being formed with the state to pay for Medicaid patients. If the state agrees to partake in this, all of C.W.’s patients, that require hospitalization, will no longer have the choice of which hospital they'd like to be admitted to.
CMC has expressed an interest in the patients of C.W. Williams
Older patients of C.W. Williams prefer CMC over Presbyterian.
It’ll be easier to form an ACO since the majority will be Medicare patients and there will only be one hospital affiliation.
Patient- Centered Medical Home (PCMH)
Patient-centered medical home is a model of care that aims to transform the delivery of comprehensive primary care to children, adolescents and adults. Through this model, practices seek to improve quality, effectiveness and efficiency of the care they deliver while responding to each patient’s unique needs and preferences.
Anti-Kickback & Stark Law Implications
Anti-Kickback Statute Prohibits:
Offering, paying, soliciting or receiving anything of value to induce or reward referrals to generate Federal health care program business.
Stark Law Prohibits:
A physician from referring Medicare patients for designated health services to an entity with which the physician has a financial relationship unless an exception applies.
References
Centers for Medicare & Medicaid Services (2015). Accountable Care Organizations (ACO). Retreived November 11, 2016, from https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/ACO/index.html?redirect=/aco/
Harris, D.M. (2014). Contemporary Issues in H ...
This document discusses clinical staging as a new framework for understanding, preventing, and treating mental disorders like psychosis and mood disorders. Clinical staging aims to differentiate early, milder symptoms from those that accompany illness progression and chronicity. It allows clinicians to select treatments tailored to the early stages of illness and evaluate their effectiveness in preventing progression. For staging to be valid, early interventions need to be shown to be more effective and safer than later treatments. The staging framework could integrate biological, social, and psychological risk factors and move psychiatry towards a more clinicopathological model.
This document provides an introduction to medical surgical nursing. It defines medical surgical nursing as nursing care for patients whose conditions are treated medically or surgically. The objectives of the chapter are to define medical surgical nursing, explain the concepts of health and illness, and discuss the nursing process. The nursing process is presented as a systematic problem-solving approach used by nurses to meet patient needs through assessment, nursing diagnosis, planning, implementation, and evaluation. Health is defined in both negative and positive terms, and the concepts of illness, disease, impairment, disability, and handicap are explained. The document also covers health promotion, illness prevention, and the levels of nursing assessment.
This document outlines the course content for a 9th semester differential diagnosis and clinical decision making course. It discusses topics like intro to medical screening, differential diagnosis of various body systems, the process of differential diagnosis, screening and its purpose, reasons for medical disease screening, red and yellow flags, and the physical therapist's role in disease diagnosis, prevention, and clinical reasoning. Key terms like quicker, sicker, and signed prescription in relation to medical screening are also defined. A case example demonstrates recognition of red flags that warrant physician consultation.
This research article examines the ethical dilemmas faced by palliative care physicians through surveys and interviews with 30 palliative care specialists in Mexico.
The study identified 113 common dilemmas, most frequently regarding sedation, home administration of opioids, and institutional regulations. It was observed that truth-telling and bidirectional trust between patients and providers are core to palliative medicine ethics. The most prominent virtues among participants were justice and professional humility. Physicians in palliative care see themselves most importantly as educators and advisers who provide medical assistance.
The research aims to better understand the values that guide decision-making in palliative care in order to improve care for patients at the end of life. It finds rediscovering virtues in clinical practice can
Schemes for medical decision making a primer for traineesImad Hassan
An article on a practical road map for teaching trainees easy schemes for Clinical Decision Making. Due to appear soon on the journal "Perspectives on Medical Education"
Useful for Trainers and Trainees alike to complement and expand the PowerPoint presentation on the same subject.
The document provides guidelines from the American Psychiatric Association for the treatment of patients with schizophrenia. It discusses schizophrenia as a disorder with significant health, social, and economic burdens. The guidelines cover assessments for diagnosing schizophrenia and developing treatment plans, as well as recommendations for pharmacotherapy and psychosocial interventions. The guidelines are based on a systematic review of available evidence and are intended to enhance treatment and reduce the consequences of schizophrenia.
This document provides an overview of the nursing process. It begins by outlining the objectives of understanding the nursing process, its characteristics, benefits, and phases. It then defines the nursing process as a modified scientific method used to assess client needs and develop a care plan. The key phases are described as assessment, nursing diagnosis, planning, implementation, and evaluation. Assessment involves collecting client data, nursing diagnosis identifies responses to health issues, planning develops the care approach, implementation provides care, and evaluation assesses effectiveness. The document explains each phase in further detail.
1. The document discusses various types of medical research designs including observational and experimental studies.
2. Observational studies are divided into descriptive studies which aim to describe health problems without comparisons, and analytical studies which aim to identify associations between exposures and outcomes.
3. Experimental research designs involve assigning subjects to treatment or control groups randomly to evaluate new interventions while controlling for confounding factors. Randomized controlled trials are considered the gold standard for evaluating new treatments.
The document discusses clinical prediction rules, which are combinations of clinical findings that provide predictions about patient outcomes. It addresses how prediction rules are derived from study data and validated. Key points include how prediction rules should be developed using clearly defined samples and outcomes, and validated by comparing results to criterion measures while masking assessors, and ideally validating rules in new populations.
The document discusses the changing role of laboratories in diagnosis and diagnostic decision making. It notes that historically, diagnoses were labels placed on symptoms with little need for testing or effective treatment. Now, accurate diagnoses have serious consequences given more effective therapies. This has led to increased complexity and expectations in diagnostic medicine. The laboratory now plays a central role in the diagnostic process. Establishing acceptable risk for patients requires understanding how test validity, value, and clinical risk are determined. Factors like test purpose, reliability, and how results are used must be considered to optimize outcomes. Educating clinicians is important so medical decision points factor in test limitations and implications for patient risk.
This document outlines a plan for developing a needs assessment related to clinical pathways for ED admissions for intractable pain and social admissions. It includes reviewing strategies to overcome organizational barriers, identifying legal and ethical considerations, finalizing a theoretical needs assessment plan, and beginning an annotated bibliography with 6 sources related to the needs assessment topic.
This document discusses nursing diagnosis, including its definition, steps for formulating a nursing diagnosis, categories and types. It defines nursing diagnosis as a statement of a health problem or potential problem that a nurse can treat. The steps for formulation include establishing a database through various assessments, analyzing client responses, organizing the data, and confirming the diagnosis. Nursing diagnoses can be actual, risk, or potential complications. They should not merely restate a medical diagnosis but provide a basis for nursing interventions.
Epidemiology designs for clinical trials - PubricaPubrica
1. Clinical trial study design
2. Cohort Study design
3. Case-Control Studies
4. Cross-Sectional Studies
5. Ecological Studies
6. Randomized Clinical Trials
Continue Reading: https://bit.ly/3tDt6rH
Reference: https://pubrica.com/services/research-services/experimental-design/
Why Pubrica:
When you order our services, We promise you the following – Plagiarism free | always on Time | 24*7 customer support | Written to international Standard | Unlimited Revisions support | Medical writing Expert | Publication Support | Biostatistical experts | High-quality Subject Matter Experts.
Contact us:
Web: https://pubrica.com/
Blog: https://pubrica.com/academy/
Email: sales@pubrica.com
WhatsApp : +91 9884350006
United Kingdom: +44- 74248 10299
Lecture I-IV -for adult nursing care planssuser1af747
This document provides a course syllabus for an Advanced Nursing Health Assessment of Adult course. The 3-credit course is intended for first year adult health nursing students and will cover advanced health assessment techniques, history taking, physical examination skills, and clinical decision making. The course objectives are to enhance students' health assessment knowledge and skills to assess and care for adult clients. The course will be delivered through lectures, skills labs, hospital placements, and assignments. Students will be evaluated based on presentations, skills exams, and a final written exam.
The DSM-5 introduces an integrated approach to diagnosis and classification that combines dimensional and categorical models. It incorporates dimensional assessments of severity for select diagnoses to provide more clinical utility and better inform research. Several disorders are now conceptualized as existing on a spectrum, such as autism spectrum disorder and substance use disorder, to account for variations in symptoms between individuals. This integrated approach in DSM-5 aims to provide more detailed clinical information to improve diagnosis, treatment planning, and patient outcomes compared to the narrow categorical approach of previous DSM editions.
This document contains a list of 13 group members and their student IDs. It then provides a proposed question based on a clinical scenario using the PICO framework. The question is about a 60-year-old female diagnosed with peripheral arterial disease and type 2 diabetes. The document concludes with a critical appraisal of a study based on the Critical Appraisal tool, answering 12 questions about the study methodology, results, and applicability.
Jill Pizzola's Tenure as Senior Talent Acquisition Partner at THOMSON REUTERS...dsnow9802
Jill Pizzola's tenure as Senior Talent Acquisition Partner at THOMSON REUTERS in Marlton, New Jersey, from 2018 to 2023, was marked by innovation and excellence.
Job Finding Apps Everything You Need to Know in 2024SnapJob
SnapJob is revolutionizing the way people connect with work opportunities and find talented professionals for their projects. Find your dream job with ease using the best job finding apps. Discover top-rated apps that connect you with employers, provide personalized job recommendations, and streamline the application process. Explore features, ratings, and reviews to find the app that suits your needs and helps you land your next opportunity.
A Guide to a Winning Interview June 2024Bruce Bennett
This webinar is an in-depth review of the interview process. Preparation is a key element to acing an interview. Learn the best approaches from the initial phone screen to the face-to-face meeting with the hiring manager. You will hear great answers to several standard questions, including the dreaded “Tell Me About Yourself”.
Resumes, Cover Letters, and Applying OnlineBruce Bennett
This webinar showcases resume styles and the elements that go into building your resume. Every job application requires unique skills, and this session will show you how to improve your resume to match the jobs to which you are applying. Additionally, we will discuss cover letters and learn about ideas to include. Every job application requires unique skills so learn ways to give you the best chance of success when applying for a new position. Learn how to take advantage of all the features when uploading a job application to a company’s applicant tracking system.
5 Common Mistakes to Avoid During the Job Application Process.pdfAlliance Jobs
The journey toward landing your dream job can be both exhilarating and nerve-wracking. As you navigate through the intricate web of job applications, interviews, and follow-ups, it’s crucial to steer clear of common pitfalls that could hinder your chances. Let’s delve into some of the most frequent mistakes applicants make during the job application process and explore how you can sidestep them. Plus, we’ll highlight how Alliance Job Search can enhance your local job hunt.
2. Diseases have existed as time immemorial and it is our
understanding of the diseases that has changed over
the time with advances
This evolution of our knowledge is reflected in our
classification systems.
27-06-2023 2
3. Syndrome Disease Disorder
Syndrome- is a constellation of symptoms that are
unique as a group.
May contain some symptoms that occur in other syndromes.
It is the particular combination of symptoms that makes the
syndrome specific
Etiology variable
Disease - is a condition with specific etio-
pathogenesis and has biomedical connotation.
Disorder- is term midway b/w the above two in
means of significance, consistency and correlates.
Cource , outcome and prognosis known.
27-06-2023 3
4. Concept of Classification
Every patient has three kind of characteristic:-
Universal, shared with all others
Shared with some but not others
Unique, shared with no others
Classification depends on B relative to A & C
It is the process by which the complexity of phenomenon is
reduced by arranging them into categories according to
some established criteria for certain purposes.
(kendel RE, criteria for assessing a classification in psychiatry ..west sussex, psychiatric
diagnosis and classification 2002)
27-06-2023 4
5. Purpose of Classification
Communication:- about the disorder, summarizing it
Control :- refers to treatment and prevention, ultimate
purpose of any classification.
Comprehension :- cause of disorder, process in their
development and maintenance. Desired as leads to more
effective control.
Comprehension is not served in the present systems due to
limitation of the understandings of the psychiatric
disorders.
27-06-2023 5
6. Importance of clearly defining a psychiatric
disorder
Influences the estimates of the psychiatric morbidity
burden on the community
Legal implication in criminal cases and disability
benefits
Lack of clarity leads to abuse of the diagnosis
Lack of clear definition leads to reduce confidence in
the discipline of psychiatry
27-06-2023 6
7. Ideally classification be based on knowledge of
etiology or path physiology – improves T/t and
prevention efforts.
Psychiatry – defined and classified mostly on the basis
of their clinical syndromes.
27-06-2023 7
8. Constituents for good classification
Reliability :- shows how far errors of measurement
have been excluded from assessment
Improved by- operational diagnostic criteria, structured
interviews
It establishes ceiling for validity
Validity :- how far a test measures actually, what it is
supposed to measure
Utility :- assessed by its impact on three domains :
use, decision making and clinical outcome.
Ease of use
Applicability across settings and cultures.
Meets need for various users : Clinicians, researchers
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9. Categorical v/s Dimensional
Psychiatric disorders traditionally classified categorically
Patients may not fit neatly into the available categories
Problem of comorbidities
Dimensional system solves problem assoc with boundaries
and comorbidity
But these not of great value in clinical practice, in terms of
decision for t/t and disorder meriting t/t
Pluralistic view- eg categorical for eating disorders etc
and dimensional for GAD, PTSD. (haslam et al, categorical v/s
dimensional model, 2003- Aust NZ J Psy)
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12. History
ICD - WHO
Used -Europe, Africa and Asia
1948 - ICD 6
ICD 7 1955
ICD 8 1965
ICD 9 1975
ICD 10 1992
ICD-11 2022
New Oxford Textbook of Psychiatry. Third Edition, Oxford University Press; 2020.
DSM-I by APA- 1952
DSM-II
1968
DSM-III
1980
DSM-IV
1994
DSM-IV TR
2000
DSM-5
2013
13. ICD 11
• 2007- International advisory
group
• 2015 - Beta draft available
publicly
• May 2019- 72nd WHA
• Implemented from 01 Jan 2022
• Chapter 06 Mental, Behavioural
or Neurodevelopmental
Disorders (MBND)
Gaebel W, Stricker J, Kerst A. Changes from ICD-10 to ICD-11 and future directions in
psychiatric classification Dialogues Clin Neurosci. 2020;22(1):7-15.
are unlikely to find single gene underpinnings for most mental disorders, which are
more likely to have polygenetic vulnerabilities interacting with epigenetic factors (that
switch genes on and off ) and environmental exposures to produce disorders.
Biological or social mark that sets a person apart from others, is discrediting and disrupts interactions with others
It is clear that a hierarchy was present that tended to suppress
the significance of lower-order symptoms in the syndrome definitions in order to
achieve such pure types. This hierarchical arrangement of disorders was implicit in the
Kraepelinean classification tradition of ranking organic mental disorders, nuclear
schizophrenia, manic-depressive illness, and neurotic illnesses from higher- to lowerorder
conditions (16). It was followed by an explicit statement of Jaspers: “The principle
of medical diagnosis is that all the disease-phenomena should be characterized within
a single diagnosis…in any one person”
we now have a plethora
of comorbidity—because patients do not usually have only mood, somatic, or anxiety
symptoms but tend to come with a mix from multiple symptom groups. Hence, we have
heterogeneous conditions within single diagnostic groups, a remarkably high rate in
specialty mental health settings of “not otherwise specified” (NOS) diagnoses that do
not quite fit the existing criteria, as well as high rates of “subsyndromal” mixed anxietymood-
somatic disorders in primary care settings
Korsakoff’s
syndrome illustrates the progression from symptom to syndrome to disease.
Initially, confabulation and impressibility among alcoholics were recognised
by Korsakoff as significant symptoms. Later the presence of disorientation
for time and place, euphoria, difficulty in registration, confabulation and
‘tram-line’ thinking were identified as key features of this syndrome. Finally,
the discovery that in the alcoholic amnestic syndrome there was always
severe damage to the mammillary bodies confirmed that Korsakoff ’s
psychosis (syndrome) is a true disease with a neuropathological basis.
Taxonomy is the metatheory of classification including systematic study of carious strategies of classification.
Classification is pointless in A and in C it is iimpossible.
Classical taxonomic strategy: Monothetic approach -The candidate must meet exactly the set of necessary and sufficient criteria that define a given class (e.g., periodic table of elements).
Numerical taxonomy: Polythetic approach - The candidate must meet a certain number of criteria to qualify for a diagnosis (e.g., diagnosis of schizophrenia in ICD-10 and DSM-IV).
Prototype matching procedure: Polythetic approach - Diagnosis is made according to how close a candidate meets a prototype.
Reliability- consistency of a set of measurements or of a measuring instrument, often used to describe a test. test retest, interrater
Internal consistency reliability, assesses the consistency of results across items within a test.
reliability is analogous to precision, while validity is analogous to accuracy.
Validity (well-founded and applicable; sound and to the point; against which no objection can fairly be brought)
Diagnostic validity is a complex multifaceted construct that has historically been adapted from the field of psychological testing and includes a number of different types of validity. These include the following:
1. Face validity
whether the description of a category and its diagnostic criteria seem to accurately describe the disorder.
2. Descriptive validity
whether the features of a category are unique to that category relative to other mental disorders.
3. Predictive validity
The extent to which having a diagnosis predicts future clinical course, complications, and treatment response.
4. External or construct validity
The extent to which the diagnosis correlates with expected external vali-dators, such as family history and neurobiological markers.
Robins and Guze (1970) were 1st to advance formal methods of determining validity of a diagnosis.
Clinical descriptions
Laboratory studies
Specification of exclusion criteria
Follow up studies
Family studies
Utility if it provides nontrivial information about prognosis and likely treatment outcomes, and/or testable propositions about biological and social correlates
Categorical- clear boundaries b/w entities or b/w disorder and the absence of them; widespread acceptance in psychiatry and other fields, and have generally been found to have improved inter-rater reliability
Dimensional – lack of clear demarcation. dimensions are better suited to the portrayal of variation in populations than day-to-day decisions about the treatment of individuals. difference in the discriminative power may be rather small.
Taxometric analysis -0 statistical method of examining wether the interrelationship among the defining feature of a disorder better fit a dim/catego model
Classifcatory systems in 18th and 19th century were mainly for fatal diseases and mortality statistics
Need was felt for morbidity statistics…assigned to WHO
Post world war 2, WHO was established as specialized agency of UN in health . All members agreed collecting mortality statistics on causes of death and morbidity statistics of known medical and mental disorders to develop comparable national and international health statistics- ICD 6 : mental disorders subsection
- Comprehensive classification of all “diseases and related health problems”
Although APA contributed in icd 6 mental disorders sub section, it published a separate DSM I based on views mental disorders as psychobiological reactions to critical life and dev events.
ICD 8 - 1965 : few-sentence descriptions, organic-functional dichotomy, psychotic-neurotic
While publishing ICD 8 WHO noted disparity btw diff national nomenclatures and lists of mental disorders throughout the world and appointed a british psychiatrist Erwin Stengel to look into it
His proposal of “operationalized definitions “ basd on observation tht could be reliably reported was not accepted in publishing ICD 8 nor DSM II in 1968 (based on psychoanalitical approach/theories of etiology)
But this was later considered in publication of DSM III in 1980
DSM III-
marked a paradigm shift from the psychoanalytical approach
Explicit diagnostic criteria based on descriptive approach
Introduced multi axial system
DSM IV-TR (text revision) -to make the diagnostic codes consistent with the ICD
Need was felt to bring greater international agreement on definitions and opeartionalised criteria fro mental disorders and this was implemented for ICD 10
WHA world Health Assembly
Advisory group- reviewed avlb evidence and proposed changes
Beta draft avlbl for review and comments
Additionally feedback from mental health professionals was obtained via field formative studies (global survey of psychiatrists attitude towards mental disorders classification- 4887 psychiatrists)
Changes from ICD-10 to ICD-11 include the introduction of new diagnoses, the refinement of diagnostic criteria of existing diagnoses, and notable steps in the direction of dimensionality for some diagnoses.
A classification therefore has only provisional value.
It is a fiction which will discharge its function if it proves to be the most apt for the time