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Robillard JM, Masellis M, Martin SE, Khachaturian AS, Dixon RA. The Return of Biomarker Results in Research: Balancing Complexity, Precision, and Ethical Responsibility. J Alzheimers Dis 2024; 97:1083-1090. [PMID: 38306053 PMCID: PMC10836546 DOI: 10.3233/jad-230359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
Recent research aimed at the discovery, integration, and communication of health outcome measures (or "biomarkers") in Alzheimer's disease has raised challenging questions related to whether, how and when results from these investigations should be disclosed to research participants. Reflecting the apparent heterogeneity of many neurodegenerative diseases, biomarker or other risk factor results are often probabilistic, interactive, multi-modal, and selective. Such characteristics make it very complex to summarize and communicate to clinicians, researchers, and research participants. Whereas the format and content of academic literature is well-managed by the peer-review process, reporting individualized results to participants involves complex, sensitive, and ethical considerations. This paper describes three key factors to consider in decisions about the return of results to research participants: complexity, precision, and responsibility. The paper also presents six practical recommendations for implementing meaningful and ethical communication with research participants.
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Affiliation(s)
- Julie M Robillard
- Department of Medicine, Division of Neurology, University of British Columbia, Vancouver, BC, Canada
- BC Children's and Women's Hospital, Vancouver, BC, Canada
| | - Mario Masellis
- Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada
| | - Susanna E Martin
- Department of Medicine, Division of Neurology, University of British Columbia, Vancouver, BC, Canada
- BC Children's and Women's Hospital, Vancouver, BC, Canada
| | - Ara S Khachaturian
- The Campaign to Prevent Alzheimer's Disease 2020, Inc. Rockville, MD, USA
| | - Roger A Dixon
- Department of Psychology, Faculty of Science, University of Alberta, Edmonton, AB, Canada
- Neuroscience and Mental Health Institute, University of Alberta, Edmonton, AB, Canada
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Cariñanos-Ayala S, Zarandona J, Durán-Sáenz I, Arrue M. Identifying undergraduate nurses´ learning requirements and teaching strategies in dementia care education: A nominal group technique. Nurse Educ Pract 2023; 71:103711. [PMID: 37467601 DOI: 10.1016/j.nepr.2023.103711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 05/04/2023] [Accepted: 07/01/2023] [Indexed: 07/21/2023]
Abstract
AIM Identify priorities and reach a consensus on student nurses´ learning requirements and the best-suited teaching strategies in dementia care. BACKGROUND Dementia has become a global health priority. Nurses are primary service providers for people with dementia, but they may fall short on professional training. Nursing curricula still lacks a clear educational framework for dementia, meaning that nurse educators must make decisions amidst uncertainty. DESIGN Nominal group technique based on the conceptual framework proposed by Van de Ven and Delbecq (1972). METHODS A structured face-to-face meeting convened in November 2021 involved nine participants who were directly involved in dementia care. The steps in the technique were (a) idea generation, (b) round-robin recording, (c) discussion, (d) voting and ranking, (e) discussion on the vote and (f) re-ranking. Participants answered two nominal questions. Consent, anonymity, feedback and iteration were guaranteed throughout the process. RESULTS The nominal group prioritized theoretical understanding of dementia, communication, caregivers´ needs, comprehensive assessment and ethical practice as learning requirements for nursing students. The outstanding teaching strategy discussed included various approaches to experiential learning. CONCLUSIONS The nominal group technique process explored learning requirement priorities for student nurses within a specific context. Participants discussed experiential learning as the best-suited teaching strategy. Findings could support nurse educators to design and deliver better dementia education.
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Affiliation(s)
- Susana Cariñanos-Ayala
- Basque Nurse Education Research Group, Bioaraba Health Research Institute, c/ Isabel Orbe s/n, 01002 Vitoria-Gasteiz, Spain; Vitoria-Gasteiz Nursing School, Osakidetza-Basque Health Service, Jose Atxotegi s/n, 01009 Vitoria-Gasteiz, Spain.
| | - Jagoba Zarandona
- Basque Nurse Education Research Group, Bioaraba Health Research Institute, c/ Isabel Orbe s/n, 01002 Vitoria-Gasteiz, Spain; Vitoria-Gasteiz Nursing School, Osakidetza-Basque Health Service, Jose Atxotegi s/n, 01009 Vitoria-Gasteiz, Spain
| | - Iván Durán-Sáenz
- Basque Nurse Education Research Group, Bioaraba Health Research Institute, c/ Isabel Orbe s/n, 01002 Vitoria-Gasteiz, Spain; Vitoria-Gasteiz Nursing School, Osakidetza-Basque Health Service, Jose Atxotegi s/n, 01009 Vitoria-Gasteiz, Spain
| | - Marta Arrue
- Department of Nursing II, Faculty of Medicine and Nursing, Department of Nursing, University of the Basque Country (UPV/EHU), Donostia-San Sebastián, Spain
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Howell M, Avidan AY, Foldvary-Schaefer N, Malkani RG, During EH, Roland JP, McCarter SJ, Zak RS, Carandang G, Kazmi U, Ramar K. Management of REM sleep behavior disorder: an American Academy of Sleep Medicine clinical practice guideline. J Clin Sleep Med 2023; 19:759-768. [PMID: 36515157 PMCID: PMC10071384 DOI: 10.5664/jcsm.10424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 12/09/2022] [Accepted: 12/09/2022] [Indexed: 12/14/2022]
Abstract
INTRODUCTION This guideline establishes clinical practice recommendations for the management of rapid eye movement sleep behavior disorder (RBD) in adults. METHODS The American Academy of Sleep Medicine (AASM) commissioned a task force of experts in sleep medicine to develop recommendations and assign strengths based on a systematic review of the literature and an assessment of the evidence using Grading of Recommendations, Assessment, Development and Evaluation methodology. The task force provided a summary of the relevant literature and the certainty of evidence, the balance of benefits and harms, patient values and preferences, and resource use considerations that support the recommendations. The AASM Board of Directors approved the final recommendations. GOOD PRACTICE STATEMENT The following good practice statement is based on expert consensus, and its implementation is necessary for the appropriate and effective management of patients with RBD: It is critically important to help patients maintain a safe sleeping environment to prevent potentially injurious nocturnal behaviors. In particular, the removal of bedside weapons, or objects that could inflict injury if thrown or wielded against a bed partner, is of paramount importance. Sharp furniture like nightstands should be moved away or their edges and headboard should be padded. To reduce the risk of injurious falls, a soft carpet, rug, or mat should be placed next to the bed. Patients with severe, uncontrolled RBD should be recommended to sleep separately from their partners, or at the minimum, to place a pillow between themselves and their partners. RECOMMENDATIONS The following recommendations, with medications listed in alphabetical order, are a guide for clinicians in choosing a specific treatment for RBD in adults. Each recommendation statement is assigned a strength ("strong" or "conditional"). A "strong" recommendation (ie, "We recommend…") is one that clinicians should follow under most circumstances. A "conditional" recommendation (ie, "We suggest…") is one that requires that the clinician use clinical knowledge and experience and strongly consider the patient's values and preferences to determine the best course of action. Adult patients with isolated RBD. 1. The AASM suggests that clinicians use clonazepam (vs no treatment) for the treatment of isolated RBD in adults. (CONDITIONAL). 2. * The AASM suggests that clinicians use immediate-release melatonin (vs no treatment) for the treatment of isolated RBD in adults. (CONDITIONAL). 3. * The AASM suggests that clinicians use pramipexole (vs no treatment) for the treatment of isolated RBD in adults. (CONDITIONAL). 4. The AASM suggests that clinicians use transdermal rivastigmine (vs no treatment) for the treatment of isolated RBD in adults with mild cognitive impairment. (CONDITIONAL). Adult patients with secondary RBD due to medical condition. 5. * The AASM suggests that clinicians use clonazepam (vs no treatment) for the treatment of secondary RBD due to medical condition in adults. (CONDITIONAL). 6. * The AASM suggests that clinicians use immediate-release melatonin (vs no treatment) for the treatment of secondary RBD due to medical condition in adults. (CONDITIONAL). 7. The AASM suggests that clinicians use transdermal rivastigmine (vs no treatment) for the treatment of secondary RBD due to medical condition (Parkinson disease) in adults. (CONDITIONAL). 8. * The AASM suggests that clinicians not use deep brain stimulation (DBS; vs no treatment) for the treatment of secondary RBD due to medical condition in adults. (CONDITIONAL). Adult patients with drug-induced RBD. 9. * The AASM suggests that clinicians use drug discontinuation (vs drug continuation) for the treatment of drug-induced RBD in adults. (CONDITIONAL). * The Recommendations section of this paper includes remarks that provide additional context to guide clinicians with implementation of this recommendation. CITATION Howell M, Avidan AY, Foldvary-Schaefer N, et al. Management of REM sleep behavior disorder: an American Academy of Sleep Medicine clinical practice guideline. J Clin Sleep Med. 2023;19(4):759-768.
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Affiliation(s)
- Michael Howell
- Department of Neurology, University of Minnesota, Minneapolis, Minnesota
| | - Alon Y. Avidan
- David Geffen School of Medicine at UCLA, Los Angeles, California
| | | | - Roneil G. Malkani
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
- Jesse Brown Veterans Affairs Medical Center, Chicago, Illinois
| | - Emmanuel H. During
- Department of Neurology, Division of Movement Disorders, Icahn School of Medicine at Mount Sinai, New York, New York
- Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Joshua P. Roland
- Thirty Madison, New York, New York
- Department of Pulmonology, Critical Care, and Sleep Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Stuart J. McCarter
- Department of Neurology, Mayo Clinic College of Medicine, Rochester, Minnesota
| | - Rochelle S. Zak
- Sleep Disorders Center, University of California, San Francisco, San Francisco, California
| | | | - Uzma Kazmi
- American Academy of Sleep Medicine, Darien, Illinois
| | - Kannan Ramar
- Division of Pulmonary and Critical Care Medicine, Center for Sleep Medicine, Mayo Clinic, Rochester, Minnesota
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Ohanesian N. Caregiver Burden and the Impact of Diagnostic Disclosure of Dementia: Why Primary Care Physicians Have a Moral Responsibility to Disclose. J Clin Ethics 2023; 34:128-137. [PMID: 37229740 DOI: 10.1086/724230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
AbstractCurrently, the number of individuals affected by Alzheimer's disease is rapidly increasing, expected to reach 14 million in the United States within 30 years. In spite of this impending crisis, less than 50 percent of primary care physicians disclose the diagnosis of dementia to their patients. This failure negatively impacts not only patients but also caregivers, whom dementia patients require to help them meet their needs and who often serve as important decision makers, either as surrogates or as designated healthcare agents for the patient. If caregivers are not informed about and prepared to deal with the challenges they face, their health, both emotional and physical, is put at risk. We will argue that both patient and caregiver have the right to be informed of the diagnosis, as their interests are intertwined, especially as the disease progresses and the caregiver becomes the primary advocate for the patient. The caregiver of an individual with dementia therefore becomes intimately connected to the patient's autonomy in a way few caregivers of other diseases do. In this article, we will show that a timely and thorough disclosure of the diagnosis is morally obligated by the core principles of medical ethics. As the population ages, primary care physicians must see themselves in a triadic relationship with both the dementia patient and caregiver, recognizing that the interests of both are deeply interdependent.
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Li K, Rashid T, Li J, Honnorat N, Nirmala AB, Fadaee E, Wang D, Charisis S, Liu H, Franklin C, Maybrier M, Katragadda H, Abazid L, Ganapathy V, Valaparla VL, Badugu P, Vasquez E, Solano L, Clarke G, Maestre G, Richardson T, Walker J, Fox PT, Bieniek K, Seshadri S, Habes M. Postmortem Brain Imaging in Alzheimer's Disease and Related Dementias: The South Texas Alzheimer's Disease Research Center Repository. J Alzheimers Dis 2023; 96:1267-1283. [PMID: 37955086 PMCID: PMC10693476 DOI: 10.3233/jad-230389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND Neuroimaging bears the promise of providing new biomarkers that could refine the diagnosis of dementia. Still, obtaining the pathology data required to validate the relationship between neuroimaging markers and neurological changes is challenging. Existing data repositories are focused on a single pathology, are too small, or do not precisely match neuroimaging and pathology findings. OBJECTIVE The new data repository introduced in this work, the South Texas Alzheimer's Disease research center repository, was designed to address these limitations. Our repository covers a broad diversity of dementias, spans a wide age range, and was specifically designed to draw exact correspondences between neuroimaging and pathology data. METHODS Using four different MRI sequences, we are reaching a sample size that allows for validating multimodal neuroimaging biomarkers and studying comorbid conditions. Our imaging protocol was designed to capture markers of cerebrovascular disease and related lesions. Quantification of these lesions is currently underway with MRI-guided histopathological examination. RESULTS A total of 139 postmortem brains (70 females) with mean age of 77.9 years were collected, with 71 brains fully analyzed. Of these, only 3% showed evidence of AD-only pathology and 76% had high prevalence of multiple pathologies contributing to clinical diagnosis. CONCLUSION This repository has a significant (and increasing) sample size consisting of a wide range of neurodegenerative disorders and employs advanced imaging protocols and MRI-guided histopathological analysis to help disentangle the effects of comorbid disorders to refine diagnosis, prognosis and better understand neurodegenerative disorders.
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Affiliation(s)
- Karl Li
- Glenn Biggs Institute for Neurodegenerative Disorders, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Tanweer Rashid
- Glenn Biggs Institute for Neurodegenerative Disorders, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Jinqi Li
- Research Imaging Institute, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Nicolas Honnorat
- Glenn Biggs Institute for Neurodegenerative Disorders, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Anoop Benet Nirmala
- Glenn Biggs Institute for Neurodegenerative Disorders, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Elyas Fadaee
- Glenn Biggs Institute for Neurodegenerative Disorders, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Di Wang
- Glenn Biggs Institute for Neurodegenerative Disorders, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Sokratis Charisis
- Glenn Biggs Institute for Neurodegenerative Disorders, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Hangfan Liu
- Glenn Biggs Institute for Neurodegenerative Disorders, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Crystal Franklin
- Research Imaging Institute, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Mallory Maybrier
- Glenn Biggs Institute for Neurodegenerative Disorders, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Haritha Katragadda
- Glenn Biggs Institute for Neurodegenerative Disorders, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Leen Abazid
- Research Imaging Institute, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Vinutha Ganapathy
- Department of Neurology, University of Texas Health Science Center, San Antonio, TX, USA
| | | | - Pradeepthi Badugu
- Glenn Biggs Institute for Neurodegenerative Disorders, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Eliana Vasquez
- Glenn Biggs Institute for Neurodegenerative Disorders, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Leigh Solano
- Glenn Biggs Institute for Neurodegenerative Disorders, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Geoffrey Clarke
- Research Imaging Institute, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Gladys Maestre
- Department of Neuroscience, School of Medicine, University of Texas Rio Grande Valley, Harlingen, TX, USA
- Department of Human Genetics, School of Medicine, University of Texas Rio Grande Valley, Brownsville, TX, USA
| | - Tim Richardson
- Glenn Biggs Institute for Neurodegenerative Disorders, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jamie Walker
- Glenn Biggs Institute for Neurodegenerative Disorders, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Peter T. Fox
- Research Imaging Institute, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Kevin Bieniek
- Glenn Biggs Institute for Neurodegenerative Disorders, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- Department of Pathology, University of Texas Health Science Center, San Antonio, TX, USA
| | - Sudha Seshadri
- Glenn Biggs Institute for Neurodegenerative Disorders, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Mohamad Habes
- Glenn Biggs Institute for Neurodegenerative Disorders, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- Research Imaging Institute, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
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Harrison KL, Garrett SB, Halim M, Sideman AB, Allison TA, Dohan D, Naasan G, Miller BL, Smith AK, Ritchie CS. “I Didn’t Sign Up for This”: Perspectives from Persons Living with Dementia and Care Partners on Challenges, Supports, and Opportunities to Add Geriatric Neuropalliative Care to Dementia Specialty Care. J Alzheimers Dis 2022; 90:1301-1320. [DOI: 10.3233/jad-220536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: In the United States, dementia specialty centers affiliated with centers of excellence for research hold promise as locations to develop innovative, holistic care in care systems otherwise siloed by discipline or payer. Objective: We conducted foundational research to inform development of patient-and family-centered palliative care interventions for dementia specialty centers. Methods: We interviewed persons living with dementia (PLWD), current, and former care partners (CP) recruited from a specialty dementia clinic and purposively selected for variation across disease syndrome and stage. A framework method of thematic analysis included coding, analytic matrices, and pattern mapping. Results: 40 participants included 9 PLWD, 16 current CPs, and 15 former CPs of decedents; 48% impacted by Alzheimer’s disease dementia. While help from family, support groups and adult day centers, paid caregiving, and sensitive clinical care were invaluable to PLWD, CPs, or both, these supports were insufficient to navigate the extensive challenges. Disease-oriented sources of distress included symptoms, functional impairment and falls, uncertainty and loss, and inaccessible care. Social and relational challenges included constrained personal and professional opportunities. The obligation and toll of giving or receiving caregiving were challenging. Clinical care challenges for PLWD and/or CPs included care fragmentation, insufficient guidance to inform planning and need for expert interdisciplinary clinical care at home. Conclusion: Findings highlight the breadth and gravity of gaps, which surpass the disciplinary focus of either behavioral neurology or palliative care alone. Results can inform the development of novel interventions to add principles of geriatrics and neuropalliative care to dementia care.
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Affiliation(s)
- Krista L. Harrison
- Division of Geriatrics, University of California, San Francisco, San Francisco, CA, USA
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, CA, USA
- Global Brain Health Institute, University of California, San Francisco, CA, USA
| | - Sarah B. Garrett
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, CA, USA
| | - Madina Halim
- Division of Geriatrics, University of California, San Francisco, San Francisco, CA, USA
| | - Alissa Bernstein Sideman
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, CA, USA
- Global Brain Health Institute, University of California, San Francisco, CA, USA
- Department of Humanities and Social Sciences, University of California San Francisco, San Francisco, CA, USA
| | - Theresa A. Allison
- Division of Geriatrics, University of California, San Francisco, San Francisco, CA, USA
- San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA
- Department of Family & Community Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Daniel Dohan
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, CA, USA
- Department of Humanities and Social Sciences, University of California San Francisco, San Francisco, CA, USA
| | - Georges Naasan
- The Barbara and Maurice Deane Center for Wellness and Cognitive Health, Department of Neurology, Mount Sinai Hospitals, Icahn School of Medicine, New York, NY, USA
| | - Bruce L. Miller
- Global Brain Health Institute, University of California, San Francisco, CA, USA
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Alexander K. Smith
- Division of Geriatrics, University of California, San Francisco, San Francisco, CA, USA
- San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA
| | - Christine S. Ritchie
- Division of Geriatrics, University of California, San Francisco, San Francisco, CA, USA
- The Mongan Institute and the Division of Palliative Care and Geriatric Medicine, Massachusetts General Hospital, Boston, MA, USA
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Taylor LP, Besbris JM, Graf WD, Rubin MA, Cruz-Flores S, Epstein LG. Clinical Guidance in Neuropalliative Care: An AAN Position Statement. Neurology 2022; 98:409-416. [PMID: 35256519 DOI: 10.1212/wnl.0000000000200063] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 01/03/2022] [Indexed: 11/15/2022] Open
Affiliation(s)
- Lynne P Taylor
- From the Department of Neurology (L.P.T.), University of Washington, Seattle; Department of Supportive Care Medicine and Neurology (J.M.B.), Cedars-Sinai Medical Center, Los Angeles, CA; Department of Pediatrics (Division of Neurology) (W.D.G.), Connecticut Children's, University of Connecticut, Farmington; Department of Neurology (M.A.R.), University of Texas Southwestern Medical Center, Dallas; Department of Neurology (S.C.C.-F.), Texas Tech University Center, El Paso; and Department of Pediatrics and Neurology (L.G.E.), Northwestern University School of Medicine, Chicago, IL.
| | - Jessica M Besbris
- From the Department of Neurology (L.P.T.), University of Washington, Seattle; Department of Supportive Care Medicine and Neurology (J.M.B.), Cedars-Sinai Medical Center, Los Angeles, CA; Department of Pediatrics (Division of Neurology) (W.D.G.), Connecticut Children's, University of Connecticut, Farmington; Department of Neurology (M.A.R.), University of Texas Southwestern Medical Center, Dallas; Department of Neurology (S.C.C.-F.), Texas Tech University Center, El Paso; and Department of Pediatrics and Neurology (L.G.E.), Northwestern University School of Medicine, Chicago, IL
| | - William D Graf
- From the Department of Neurology (L.P.T.), University of Washington, Seattle; Department of Supportive Care Medicine and Neurology (J.M.B.), Cedars-Sinai Medical Center, Los Angeles, CA; Department of Pediatrics (Division of Neurology) (W.D.G.), Connecticut Children's, University of Connecticut, Farmington; Department of Neurology (M.A.R.), University of Texas Southwestern Medical Center, Dallas; Department of Neurology (S.C.C.-F.), Texas Tech University Center, El Paso; and Department of Pediatrics and Neurology (L.G.E.), Northwestern University School of Medicine, Chicago, IL
| | - Michael A Rubin
- From the Department of Neurology (L.P.T.), University of Washington, Seattle; Department of Supportive Care Medicine and Neurology (J.M.B.), Cedars-Sinai Medical Center, Los Angeles, CA; Department of Pediatrics (Division of Neurology) (W.D.G.), Connecticut Children's, University of Connecticut, Farmington; Department of Neurology (M.A.R.), University of Texas Southwestern Medical Center, Dallas; Department of Neurology (S.C.C.-F.), Texas Tech University Center, El Paso; and Department of Pediatrics and Neurology (L.G.E.), Northwestern University School of Medicine, Chicago, IL
| | - Salvador Cruz-Flores
- From the Department of Neurology (L.P.T.), University of Washington, Seattle; Department of Supportive Care Medicine and Neurology (J.M.B.), Cedars-Sinai Medical Center, Los Angeles, CA; Department of Pediatrics (Division of Neurology) (W.D.G.), Connecticut Children's, University of Connecticut, Farmington; Department of Neurology (M.A.R.), University of Texas Southwestern Medical Center, Dallas; Department of Neurology (S.C.C.-F.), Texas Tech University Center, El Paso; and Department of Pediatrics and Neurology (L.G.E.), Northwestern University School of Medicine, Chicago, IL
| | - Leon G Epstein
- From the Department of Neurology (L.P.T.), University of Washington, Seattle; Department of Supportive Care Medicine and Neurology (J.M.B.), Cedars-Sinai Medical Center, Los Angeles, CA; Department of Pediatrics (Division of Neurology) (W.D.G.), Connecticut Children's, University of Connecticut, Farmington; Department of Neurology (M.A.R.), University of Texas Southwestern Medical Center, Dallas; Department of Neurology (S.C.C.-F.), Texas Tech University Center, El Paso; and Department of Pediatrics and Neurology (L.G.E.), Northwestern University School of Medicine, Chicago, IL
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Chiong W, Tolchin BD, Bonnie RJ, Busl K, Cruz-Flores S, Epstein LG, Greene EP, Illes J, Kirschen M, Larriviere DG, Mantri S, Rubin MA, Stern BJ, Taylor LP. Decisions With Patients and Families Regarding Aducanumab in Alzheimer Disease, With Recommendations for Consent: AAN Position Statement. Neurology 2022; 98:154-159. [PMID: 34789544 DOI: 10.1212/wnl.0000000000013053] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 11/02/2021] [Indexed: 11/15/2022] Open
Affiliation(s)
- Winston Chiong
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| | | | | | - Katharina Busl
- Department of Neurology, University of Florida, Gainesville, FL, USA
| | - Salvador Cruz-Flores
- Department of Neurology, Paul L. Foster School of Medicine Texas Tech University Health Sciences Center, El Paso, TX, USA
| | - Leon G Epstein
- Departments of Neurology and Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Ericka P Greene
- Department of Neurology, Houston Methodist Hospital, Houston, TX, USA
| | - Judy Illes
- Neuroethics Canada and Division of Neurology, University of British Columbia, Vancouver, BC, Canada
| | - Matthew Kirschen
- Departments of Anesthesia & Critical Care, Pediatrics and Neurology, Children's Hospital of Pennsylvania, Philadelphia, PA, USA
| | | | - Sneha Mantri
- Department of Neurology, Duke University, Durham, NC, USA
| | - Michael A Rubin
- Departments of Neurology & Neurotherapeutics and Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Barney J Stern
- Department of Neurology, Johns Hopkins University, Baltimore, MD, USA
| | - Lynne P Taylor
- Departments of Neurology and Neurosurgery, University of Washington, Seattle, WA, USA
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Affiliation(s)
- Laura S Boylan
- From the New York University Grossman School of Medicine and Bellevue Hospital, New York City; and Essentia Health, Duluth, MN.
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