1.Clinical decision-making for immediate restoration of terminal dentition: determination and transfer of jaw relations.
Yiping GU ; Shengtao YANG ; Quan YUAN
West China Journal of Stomatology 2025;43(6):763-770
Immediate implant-supported fixed restoration in edentulous jaws demonstrates a success rate comparable to that of conventional implant restoration. However, this approach still presents a certain degree of technique sensitivity. In the field of immediate implant-supported fixed restoration in dentistry, a repeatable and stable jaw relation is the prerequisite for the design and fabrication of prostheses. It also reduces chairside denture placement and occlusal adjustment time and lowers the risk of occlusion-related complications. For patients with terminal dentition, the precise transfer of jaw relation following full-arch implantation serves as the fundamental basis for implant-supported occlusal reconstruction and functional restoration. This process is also a key research focus and challenge in the area of implant-supported occlusal rehabilitation. This review summarizes the procedures and methods for determining and transferring jaw relation in immediate implant-supported fixed restoration. It aims to serve as a basis for clinical decision making in implant-supported fixed restorations for terminal dentition patients.
Humans
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Dental Prosthesis, Implant-Supported
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Clinical Decision-Making
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Immediate Dental Implant Loading
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Jaw, Edentulous/surgery*
2.Artificial intelligence in andrology - fact or fiction: essential takeaway for busy clinicians.
Aldo E CALOGERO ; Andrea CRAFA ; Rossella CANNARELLA ; Ramadan SALEH ; Rupin SHAH ; Ashok AGARWAL
Asian Journal of Andrology 2024;26(6):600-604
Artificial intelligence (AI) is revolutionizing the current approach to medicine. AI uses machine learning algorithms to predict the success of therapeutic procedures or assist the clinician in the decision-making process. To date, machine learning studies in the andrological field have mainly focused on prostate cancer imaging and management. However, an increasing number of studies are documenting the use of AI to assist clinicians in decision-making and patient management in andrological diseases such as varicocele or sexual dysfunction. Additionally, machine learning applications are being employed to enhance success rates in assisted reproductive techniques (ARTs). This article offers the clinicians as well as the researchers with a brief overview of the current use of AI in andrology, highlighting the current state-of-the-art scientific evidence, the direction in which the research is going, and the strengths and limitations of this approach.
Humans
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Artificial Intelligence
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Andrology
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Machine Learning
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Male
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Clinical Decision-Making
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Reproductive Techniques, Assisted
3.Clinical decision making of implant guidance methods guided by new classification of surgical area mouth ope-ning.
Haiyang YU ; Jiacheng WU ; Nan HU
West China Journal of Stomatology 2023;41(2):134-139
When selecting implant guidance methods or judging whether the patient can be implanted, many doctors ignore or only use visual inspection to estimate a patient's mouth opening. This phenomenon often leads to failure to complete the implantation due to insufficient mouth opening or the deflection of the implant due to limited angle, resulting in the high incidence of corresponding complications. The main reason is that doctors lack accurate analysis and control of the overall geometric conditions of the intraoral surgical area, and three-dimensional position blocking of surgical instruments occurs during the operation. In the past, mouth opening was defined as the distance between the incisor edges of the upper and lower central incisors when the patient opens his mouth widely, and the implant area could be in any missing tooth position. When it is in the posterior tooth area, the specific measurement scheme of the mouth opening could not be simply equivalent to the previous measurement method in the anterior tooth area. However, how to measure quickly and conveniently the mouth opening of any surgical area to determine whether it could be implanted and meet the needs of the selected guidance method remains unclear. This paper introduces new concepts, establishes new classification and corresponding accurate measurement scheme of implant area, and establishes a decision tree of implant methods guided by the actually measured value. Results provide a quantitative basis for rational formulation and implementation of implant treatment.
Humans
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Mouth
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Dental Implantation, Endosseous/methods*
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Incisor
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Clinical Decision-Making
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Dental Implants
4.Identification and inner relation between gastrointestinal stromal tumor and intra-abdominal desmoid tumor.
Bo NI ; Lin Xi YANG ; Ming WANG ; Hui CAO
Chinese Journal of Gastrointestinal Surgery 2021;24(9):830-835
Intra-abdominal desmoid tumor (IADT) and gastrointestinal stromal tumor (GIST) are both mesenchymal tumors mostly found in gastrointestinal tracts and easily misdiagnosed, which would directly damage the survival prognosis and quality of life of patients. With the advent of the era of precision medicine, the understanding of the above two diseases is more in-depth, and the requirements for accurate diagnosis and individualized precision treatment are more stringent. Moreover, there seems to be some internal relationship between IADT and GIST, and the lack of systematic research and discussion makes clinical decision-making and patient management easy to fall into traps and misunderstandings. Therefore, this paper reviews the clinical characteristics, pathogenesis and treatments of the two, and explore their differences and internal relations, so as to provide research and practical reference for promoting more precise and individualized diagnosis and treatment regimens.
Clinical Decision-Making
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Fibromatosis, Aggressive/diagnosis*
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Gastrointestinal Stromal Tumors/diagnosis*
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Humans
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Prognosis
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Quality of Life
5.Performance and Impact of Prostate Specific Membrane Antigen-Based Diagnostics in the Management of Men with Biochemical Recurrence of Prostate Cancer and its Role in Salvage Lymph Node Dissection
Marieke J KRIMPHOVE ; Lena H THEISSEN ; Alexander P COLE ; Felix PREISSER ; Philipp C MANDEL ; Felix K H CHUN
The World Journal of Men's Health 2020;38(1):32-47
clinical decision making. Furthermore, we compare different image-fusion techniques such as PSMA-PET vs. F-/C-Choline-PET scans vs. PSMA-single photon emission computed tomography/CT. Finally, we touch upon the contemporary role of radio-guided-PSMA salvage lymphadenectomy.]]>
Clinical Decision-Making
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Humans
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Lymph Node Excision
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Lymph Nodes
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Magnetic Resonance Imaging
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Male
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Membranes
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Neoplasm Metastasis
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Positron-Emission Tomography
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Prostate
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Prostate-Specific Antigen
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Prostatic Neoplasms
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Recurrence
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Salvage Therapy
6.Reliability and Validity of Korean Version of Nursing Students' Anxiety and Self-Confidence with Clinical Decision Making Scale
Mi YU ; Young EUN ; KA WHITE ; KyungJa KANG
Journal of Korean Academy of Nursing 2019;49(4):411-422
PURPOSE: The purpose of this study was to adapt, modify, and validate the Nursing Anxiety and Self-Confidence with Clinical Decision-Making Scale (NASC-CDM©) for Korean nursing students. METHODS: Participants were 183 nursing students with clinical practice experience in two nursing colleges. The construct validity and reliability of the final Korean version of the NASC-CDM© were examined using exploratory and confirmatory factor analyses and testing of internal consistency reliability. For adaptation and modification, the instrument was translated from English to Korean. Expert review and a cross-sectional survey were used to test the instrument's validity. RESULTS: The Korean version of the NASC-CDM© (KNASC-CDM) was composed of 23 items divided into four dimensions: (i) Listening fully and using resources to gather information; (ii) Using information to see the big picture; (iii) Knowing and acting; and (iv) Seeking information from clinical instructors. The instrument explained 60.1% of the total variance for self-confidence and 63.1% of the variance for anxiety; Cronbach's α was .93 for self-confidence and .95 for anxiety. CONCLUSION: The KNASC-CDM can be used to identify anxiety and self-confidence in nursing students' clinical decision-making in Korea. However, further research should be done to test this instrument, as it is classified differently from the original NASC-CDM© version.
Anxiety
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Clinical Decision-Making
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Cross-Sectional Studies
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Humans
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Korea
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Nursing
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Reproducibility of Results
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Students, Nursing
7.Structural Equation Modeling on Clinical Decision Making Ability of Nurses
Min Kyoung PARK ; Soukyoung KIM
Journal of Korean Academy of Nursing 2019;49(5):601-612
PURPOSE: The purpose of this study was to construct and test a hypothetical model of clinical decision-making ability of nurses based on the Decision Making Process model and the Cognitive Continuum theory. METHODS: The data were collected from nurses working at 11 hospitals in Busan, Daejeon, and South Gyeongsang Province from June 30 to August 1, 2017. Finally, the data from 323 nurses were analyzed. RESULTS: The goodness-of-fit of the final model was at a good level (χ²/df=2.46, GFI=.87, AGFI=.84, IFI=.90, CFI=.90, SRMR=.07, RMSEA=.07) and 6 out of 10 paths of the model were supported. The clinical decision-making ability was both directly and indirectly affected by task complexity and indirectly affected by experiences, autonomy, and work environment. Specifically, it was strongly directly affected by analytical competency but was insignificantly affected by intuitive competency. These variables accounted for 66.0% of clinical decision-making ability. CONCLUSION: The nurses' clinical decision-making ability can be improved by improving their analytical competency. Therefore, it is necessary to organize nursing work, create a supportive work environment, and develop and implement various education programs.
Busan
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Clinical Competence
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Clinical Decision-Making
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Decision Making
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Education
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Intuition
;
Nursing
8.Factors Affecting Admission Type in Patients with Schizophrenia Spectrum
Young Joo PARK ; Min Soo KO ; Ka Eul KIM ; Kyeng Hyeng JHO ; Hee Jung NAM
Journal of Korean Neuropsychiatric Association 2019;58(3):238-244
OBJECTIVES: This study examined the admission type and its related factors among patients with psychotic disorders defined based on the revised mental health welfare law. METHODS: This study was conducted on a total of 100 patients diagnosed on the schizophrenia spectrum and other psychotic disorders. The admission type and sociodemographic characteristics were examined. Social support, psychopathology, excitement, insight, and social functioning were evaluated using the Social Support Scale, Positive and Negative Syndrome Scale (PANSS), PANSS excitement component, Brief Psychiatric Rating Scale, Global Assessment Functioning Scale, Strauss-Carpenter scale, Korean version of the Scale to Assess Unawareness of Mental Disorder, and Korean version of Beck Cognitive Insight Scale. RESULTS: The severity of psychotic symptoms, excitement, social functioning, and insight were significantly different between involuntary and voluntary admissions (p<0.05). Excitement and insight were found to be factors affecting the admission type (p<0.05). CONCLUSION: Excitement and insight were factors mainly accounting for the admission type in patients with psychotic disorder. This study could be helpful in improving clinical decision-making and community mental health care.
Brief Psychiatric Rating Scale
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Clinical Decision-Making
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Humans
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Jurisprudence
;
Mental Disorders
;
Mental Health
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Patient Admission
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Psychopathology
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Psychotic Disorders
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Schizophrenia Spectrum and Other Psychotic Disorders
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Schizophrenia
9.The Potential Role of Biomarkers Associated with ASCVD Risk: Risk-Enhancing Biomarkers
Journal of Lipid and Atherosclerosis 2019;8(2):173-182
Serum cholesterol is major risk factor and contributor to atherosclerotic cardiovascular disease (ASCVD). Therapeutic cholesterol-lowering drugs, especially statin, revealed that reduction in low-density lipoprotein cholesterol (LDL-C) produces marked reduction of ASCVD events. In the preventive scope, lower LDL-C is generally accepted as better in proven ASCVD patients and high-risk patient groups. However, in patients with low to intermediate risk without ASCVD, risk assessment is clinically guided by traditional major risk factors. In this group, the complement approach to detailed risk assessment about traditional major risk factors is needed. These non-traditional risk factors include ankle-brachial index (ABI), high-sensitivity C-reactive protein (hsCRP) level, lipoprotein(a) (Lp[a]), apolipoprotein B (apoB), or coronary artery calcium (CAC) score. CAC measurements have an additive role in the decision to use statin therapy in non-diabetic patients 40–75 years old with intermediate risk in primary prevention. This review comprises ASCVD lipid/biomarkers other than CAC. The 2013 and 2018 American College of Cardiology/American Heart Association (ACC/AHA) guidelines suggest these factors as risk-enhancing factors to help health care providers better determine individualized risk and treatment options especially regarding abnormal biomarkers. The recent 2018 Korean guidelines for management of dyslipidemia did not include these biomarkers in clinical decision making. The current review describes the current roles of hsCRP, ABI, LP(a), and apoB in personal modulation and management of health based on the 2018 ACC/AHA guideline on the management of blood cholesterol.
Ankle Brachial Index
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Apolipoproteins
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Apolipoproteins B
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Biomarkers
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C-Reactive Protein
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Calcium
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Cardiovascular Diseases
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Cholesterol
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Clinical Decision-Making
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Complement System Proteins
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Coronary Vessels
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Dyslipidemias
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Health Personnel
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Heart
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Humans
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Hydroxymethylglutaryl-CoA Reductase Inhibitors
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Lipoprotein(a)
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Lipoproteins
;
Primary Prevention
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Risk Assessment
;
Risk Factors
10.Formulation of the Scope and Key Questions of the Guideline Recommendations for Immunosuppressive Treatment in Kidney Transplantation
Seungyeon HUH ; Nayoung HAN ; Minji SOHN ; Junghwa RYU ; Jaeseok YANG ; Jung Mi OH
Korean Journal of Clinical Pharmacy 2019;29(1):18-24
BACKGROUND: Although a growing number of guidelines and clinical researches are available for immunosuppressive treatment of post-transplantation, there is no clinical practice guideline for the care of kidney transplant recipients in Korea. Selection of a researchable question is the most important step in conducting qualified guideline development. Thus, we aimed to formulate key questions for Korean guideline to aid clinical decision-making for immunosuppressive treatment. METHODS: Based on previous published guidelines review, a first survey was constructed with 29 questions in the range of immunosuppressive treatments. The experts were asked to rate the clinical importance of the question using a 5-point Likert scale. The questions reached 60% or more from the first survey and additional new questions were included in the second survey. In analyzing the responses to items rated on the 9-point scale, consensus agreement on each question was defined as 75% or more of experts rating 7 to 9. RESULTS: In the first survey, 50 experts were included. Among the 29 questions, 27 were derived to get 60% or more importance and 3 new questions were additionally identified. Through the second survey, 9 questions were selected that experts reached consensus on 75% and over of the options. Finally, we developed key questions using PICO (patient, intervention, comparison, and outcome) methodology. CONCLUSION: The experts reached a high level of consensus on many of key questions in the survey. Final key questions provide direction for developing clinical practice guideline in the immunosuppressive treatment of transplantation.
Clinical Decision-Making
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Consensus
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Kidney Transplantation
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Kidney
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Korea
;
Transplant Recipients

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