搜索结果：Terminology

Background/Objectives: Cancer-related terminology is not merely descriptive and plays a critical role in shaping emotional responses, personal identity, and communication across clinical, social, and public spheres. Despite growing interest in the psychosocial dimensions of illness language, few studies have centered the lived experiences of individuals navigating cancer through the lens of terminology. This study explores how people living with and beyond cancer perceive, interpret, and emotionally respond to cancer-related language, focusing on the way terminology influences identity, stigma, and communicative interaction. Methods: A sequential mixed-methods design was employed. The quantitative phase involved 146 participants with a cancer diagnosis completing a structured questionnaire on preferred terminology and emotional impact. The qualitative phase followed, using open-ended questionnaires with 11 participants to deepen understanding of linguistic experiences. Thematic content analysis was used to identify patterns across narratives. Results: These findings reveal that labels such as "cancer patient" evoke strong negative emotional reactions, associated with stigma, fear, and identity reduction. Person-first and context-sensitive language was perceived as more respectful and empowering. Emotional responses to language varied widely, from fear to neutrality, shaped by speaker role, context, and time since diagnosis. Media representations were often seen as dramatizing or moralizing, reinforcing the need for communicative clarity, empathy, and education in both clinical and public discourse. Conclusions: Cancer-related language is a powerful psychosocial force. It shapes how individuals are seen and see themselves and can either reinforce stigma or foster dignity and resilience. This study highlights the urgent need for person-centered, context-aware communication practices across healthcare, media, and society.

The NCCN Biomarkers Resource Committee (BRC) was established to provide molecular expertise and guidance related to key aspects of biomarker testing in NCCN publications. A key aim is to reduce inconsistencies and standardize biomarker testing terms and definitions for suggested use across all NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines). The key areas found to need terminology clarification and harmonization included those describing types of genomic events and testing approaches. For these areas, current professional society guidelines regarding terminology, utilization within current guidelines, and common parlance in practice were explored. Synonyms were also identified. Each area was discussed to nominate preferred (and, when applicable, nonpreferred) terminology with a rationale. The aims of this document are to define commonly used terms for clinical care providers and provide recommendations for the standardized use of this biomarker terminology within NCCN Guidelines and publications.

The objective of this study was to analyze current evidence-based pan-European standards of good clinical practice in the use of peripheral intravenous catheters (PIVCs) to determine if they meet clinicians' needs for unambiguous, standardized guidance for the prevention and management of PIVC-associated complications. Reference documents meeting agreed inclusion criteria were identified and analyzed. Documents were systematically searched for terms (selected based on expertise of the authors and supported by scientific literature) most likely to be associated with the prevention/management of complications associated with the use of PIVCs. A matrix was constructed to visualize the degree of consensus across guidelines regarding prevention and management terminology. Recommendations for optimizing clarity and standardization across Europe were proposed. Few European reference documents included PIVCs within their scope, and few were subject to a quality review. Adherence to the established GRADE framework of rating supporting evidence was missing from all reference documents. There was ambiguous terminology across documents and many instances of omission of terms rated important by the authors for the prevention and management of complications. An English-language European guideline for the prevention of complications associated with PIVCs is needed, featuring consensus terminology and a standardized, systematic, and transparent method for grading evidence.

Electronic health records (EHRs) have been widely adopted, but most nursing records remain in unstructured free-text format, which limits the secondary use of nursing data. Standardized terminologies improve semantic interoperability; however, manual annotation is labor intensive and yields inconsistent results. Advances in large language models (LLMs) and retrieval-augmented generation (RAG) have created new possibilities for automating the mapping of nursing records to standardized terminologies, thereby enhancing the utility of nursing data. This study aimed to develop and evaluate Clinical Care Classification nursing terminology with retrieval-augmented mapping (CNTRAM), a 2-stage RAG framework incorporating an LLM, for the automated mapping of nursing diagnoses and interventions from free-text intensive care unit nursing records to standardized Clinical Care Classification (CCC) terms. CNTRAM is a 2-stage retrieval-augmented framework that integrates dense embedding retrieval, retrieval-enhanced prompting, and few-shot LLM guidance to map free-text nursing records to standardized CCC terminology. Free-text records and their segments were embedded as subqueries to retrieve the most relevant CCC reference entries and annotated examples, which were merged to construct context windows. Each subquery was combined with its retrieved context using a predefined RAG prompt template that enforces CCC coding rules and a structured JSON schema and was then processed by an LLM to generate CCC outputs. A gold standard dataset of 100 intensive care unit nursing records was annotated by 3 senior nurses and finalized via consensus, with interrater reliability quantified using the Fleiss κ. Model performance was compared with traditional baselines (term frequency-inverse document frequency, Bidirectional Encoder Representations from Transformer, and fine-tuned Bidirectional Encoder Representations from Transformers model) and 4 LLMs (Mistral-7B, Qwen3-14B, Llama3.3-70B, and DeepSeek-R1) across no-RAG, zero-shot, and few-shot settings, using precision, recall, F1-score, and intersection over union (IoU) as metrics. Interrater agreement was substantial, with Fleiss κ=0.6449 for diagnoses and κ=0.6180 for interventions. CNTRAM achieved substantial performance gains over all baseline approaches. For nursing diagnoses, DeepSeek-R1 with RAG+few-shot prompting achieved the best performance, with a precision of 0.7909, a recall of 0.7901, an F1-score of 0.7836, and an IoU of 0.7614. These results were significantly higher than those of traditional baselines (F1-score 0.0268-0.2027), no-RAG LLMs (F1-score 0.0299-0.0588), and RAG+zero-shot LLMs (F1-score 0.0716-0.2160). For nursing interventions, the same configuration achieved a precision of 0.8453, a recall of 0.8504, an F1-score of 0.8413, and an IoU of 0.8097, outperforming traditional baselines (F1-score 0.1200-0.2323), no-RAG LLMs (F1-score 0.0077-0.0189), and RAG+zero-shot LLMs (F1-score 0.2744-0.4461). This study developed CNTRAM, an LLM-based 2-stage RAG framework that combines dense embedding retrieval and few-shot prompting for CCC terminology mapping. Using DeepSeek-R1, CNTRAM outperformed baseline models, improved mapping accuracy, and provided a feasible solution for standardizing unstructured nursing data.

Biomimetics in dental restorative materials has gradually shifted from simply copying the appearance of natural teeth to better understanding how those tissues actually behave. Instead of focusing only on aesthetics, there is now more attention on how enamel and dentin function in real conditions, how they respond to stress, interact with their surroundings, and change over time. Because of this, newer materials are no longer just passive fillers; they are being designed to reflect aspects of natural tooth structure, composition, and behavior within the oral environment. This review brings together key ideas in this area, recent developments, and the challenges that remain. One issue that often comes up is how terms like bioinspired, biomimetic, and bioactive are used. They are sometimes treated as if they mean the same thing, but in practice, they point to different goals or levels of complexity in material design. For instance, some studies focus on creating more organized composite structures or mimicking natural mineralization processes, while others focus on antibacterial surfaces or peptide-based approaches that may support remineralization. There is also growing interest in materials that respond to environmental changes, such as shifts in pH or the early stages of wear. Even with promising laboratory results, these materials are not yet widely used in everyday clinical practice. Several issues continue to slow their adoption, including unclear terminology, limited availability of testing models that reflect real oral conditions, and a lack of long-term clinical data. Part of the challenge lies in the lack of consistent terminology, which can make it harder to compare findings across studies. Manufacturing challenges also remain, particularly when scaling up more complex systems. Moving forward, progress will depend on closer collaboration across disciplines, including materials science, oral biology, microbiology, and digital manufacturing. Such efforts will be important for developing restorative materials that behave more like natural tissues and perform reliably over time inside the mouth.

Recognizing the crucial role of medicine in everyday life, it is unsurprising that medical literature in the Croatian language has been produced and studied for several centuries. To date, numerous studies have provided an overview of the history of Croatian medical literature, primarily focusing on lexicographical works, encyclopedias, and publications. Nevertheless, Croatian medical textbooks and manuals from the 19th century have been less systematically examined as a distinct corpus. This period is particularly significant in the history of Croatian scientific and cultural production: it was marked by intensified efforts to standardize the Croatian language, the development of scientific terminology, and Enlightenment-inspired initiatives aimed at making scientific knowledge accessible to the Croatian public in their native language. Works produced during this period bear witness to the development of medicine in the Croatian context and represent a valuable source for studying the history of Croatian scientific and professional terminology, as well as scientific style. The aim of this study is to provide an overview of selected Croatian medical textbooks and manuals from the 19th century, listing them and briefly describing their structure, content, and intended use. By doing so, the study seeks to supplement existing overviews of older Croatian medical literature and to highlight the significance of these works for interdisciplinary research, encompassing medical history, linguistic studies, and the broader cultural context of 19th-century Croatia. S obzirom na nužnost i važnost medicine u svakodnevnome životu, nije čudno što medicinsku literaturu na hrvatskome jeziku pratimo već nekoliko stoljeća. Do danas je većim brojem radova dan pregled povijesti medicinske literature na hrvatskome jeziku, mahom leksikografskih radova, enciklopedistike i publicistike. Unatoč tomu, hrvatska medicinska udžbenička i priručnička literatura 19. stoljeća rjeđe je sustavno proučavana kao zasebna cjelina. Devetnaesto je stoljeće u povijesti hrvatske znanstvene i kulturne produkcije iznimno važno: obilježeno je intenziviranjem rada na standardizaciji hrvatskoga jezika, jačanjem znanstvene terminologije te prosvjetiteljskim idejama da se znanost na hrvatskome jeziku približi javnosti. Djela nastala u tom razdoblju svjedoče o razvoju medicine na hrvatskome prostoru i vrijedan su izvor za proučavanje povijesti hrvatskoga znanstvenog i stručnog nazivlja, kao i znanstvenoga stila. Cilj je ovoga rada dati pregled odabranih hrvatskih medicinskih udžbenika i priručnika nastalih u 19. stoljeću, popisati ih te ukratko opisati njihovu strukturu, sadržaj i namjenu. Takvim se pristupom nastoji pridonijeti dopunjavanju postojećih pregleda starije hrvatske medicinske literature i ukazati na važnost tih djela za interdisciplinarna istraživanja.

Immigrant women face unique challenges accessing appropriate gynaecological health care. This study investigates how Arabic-speaking women perceive and respond to pelvic pain while navigating Norwegian health care. Interpretative Phenomenological Analysis (IPA) was employed to examine the lived experiences of nine Arab women through interviews conducted in Arabic, facilitating both in-depth individual case analysis and cross-case comparative examination. Four themes emerged: (1) Symptom Dismissal and Erosion of Trust in Healthcare; (2) Cultural Stereotyping and Communication Challenges; (3) The Intersection of Pain, Identity, and Daily Life; and (4) Navigating Healthcare Systems and Treatment. These themes reveal challenges in provider relationships, impacts on daily functioning, and complexities of cross-cultural health care experiences. Findings highlight the need for improved cultural competency and better recognition of immigrant women's health concerns. Health care providers should consider cultural backgrounds and previous health care experiences when treating Arab immigrant women, ensuring more effective and culturally sensitive care delivery. Immigrant women with pelvic pain struggle to receive appropriate health care in NorwayPelvic pain affects one in five women globally, significantly impacting daily life. This study examined how Arab women in Norway experience and manage pelvic pain within the Norwegian health care system. We interviewed nine Arab women living in Norway for 7 to 20 years, conducting interviews in Arabic for comfort. Our findings highlighted four main challenges. First, seven of nine women reported health care providers dismissing their pain as normal or inadequately investigating symptoms, eroding trust and discouraging future care-seeking. One doctor even suggested a woman was imagining her problems. Second, cultural stereotyping and communication barriers were prevalent. Despite interpreter services, medical terminology was confusing, and some doctors made inappropriate ethnic assumptions. Women with Arabic-speaking doctors had better experiences. Third, pelvic pain severely affected daily life, hindering childcare, employment, and relationships, leading to isolation for some. Fourth, women faced long waiting times and struggled with the Norwegian health care system’s emphasis on patient autonomy, contrasting with the directive approach in their home countries. These findings indicate that the Norwegian health care system inadequately serves immigrant women with pelvic pain. Health care providers need enhanced cultural competency training to avoid stereotypes and respect diverse backgrounds. Crucially, providers must believe women’s pain reports and conduct thorough investigations. Taking immigrant women’s concerns seriously and providing culturally sensitive care will enable access to appropriate treatment, maintain trust, and support Norway’s goal of equal health care for all.

As radiopharmaceutical therapy (RPT) expands beyond neuroendocrine tumors and prostate cancer, it is important to understand the U.S. Food and Drug Administration (FDA) approval process and to establish a shared vocabulary for effective communication. The 505(b)(2) New Drug Application is a well-established mechanism for FDA approval of nuclear medicine products. It is an application for drugs that are similar to an approved product, supported by published literature and studies conducted on similar drugs, and bridging studies demonstrating the scientific relevance of the data to the product. This streamlined approval pathway can encourage development of more treatment options, facilitating greater patient access and improved resilience to supply chain disruptions. The evolving RPT landscape necessitates new nomenclature. "Radioligand equivalent" refers to an RPT approved through the 505(b)(2) pathway, distinct from a generic RPT approved through an Abbreviated New Drug Application. Establishing shared terminology supports clear multidisciplinary communication and fosters informed treatment selection.

Revision total hip arthroplasty (rTHA) is a complex and resource-intensive procedure. However, physician and hospital compensations have not evolved to reflect such complexity. Therefore, we sought to describe trends in (1) physician, (2) 90-day episode-of-care, and (3) procedure type reimbursements during a 12-year period. Using a national claims database, we identified patients who underwent aseptic or septic rTHA between 2010 and 2022 using current-procedural-terminology (CPT) and international-classification-of-diseases (ICD) 9/10 codes. Debridement-antibiotics-and-implant-retention (DAIR) procedures were excluded. A total of 57,821 aseptic and 17,379 septic procedures were identified. The mean dollar reimbursement was calculated each year and adjusted for inflation. Patients were grouped by insurance type: (1) Commercial, (2) Medicare-Advantage (MCR-A), and (3) Medicare (MCR). A subgroup analysis compared septic revisions based on procedure types. Commercially insured septic procedures showed the highest increase in physician (mean difference change of $1,525.3, P < 0.001) and 90-day episode-of-care (mean difference change of $529.9, P < 0.001) reimbursements during the 12-year period. Although compared to 2010, physician reimbursement in 2022 had a slight increase in the MCR and MCR-A groups, 90-day episode-of-care reimbursement was significantly decreased (MCR mean difference change of $-2,889.3, P < 0.001; MCR-A mean difference change of $-1,601.3, P < 0.001). Regarding procedure types, single-stage and explantation had a constant slight increase in reimbursement, but aseptic revisions' and reimplantation procedures' reimbursement remained stagnant throughout the 12-year period. Reimbursement for rTHA has remained stagnant over the past 12 years and fails to reflect increasing procedural complexity. Medicare-based plans consistently underperform compared to commercial payers, and the lack of growth in payments for aseptic and septic reimplantations threatens the sustainability of care for these patients. Urgent policy reform is needed to align reimbursement with clinical resource demands, ensure equitable compensation, and preserve patient access to this essential surgical service.

In the time since the last Clinical Practice Committee review of treatment of women with endometrial cancer in 2021, the field of gynecologic oncology has seen significant changes in endometrial cancer from understanding risk factors, addition of molecular staging, and expanded use of maintenance and targeted therapies. Despite these advances, the incidence of endometrial cancer as well as the deaths attributable to the disease continued to rise. Fortunately, since then, there has been progress in the treatment of patients with endometrial cancer, including increased utilization of molecular pathology, greater understanding of genetic predisposition, enhanced methods for lymph node assessment, a broader understanding of the efficacy of radiation and chemotherapy, and a more efficient approach to survivorship and surveillance. The purpose of this document is to present a comprehensive review of this progress. The authors reviewed the available evidence, contributed to the development of this manuscript, provided critical review of the guidelines, and finalized the manuscript recommendations. The review was also presented to and approved by the Society of Gynecologic Oncology (SGO) Clinical Practice Committee, Document Review Panel, and the Board of Directors prior to submission for publication. The recommendations for this manuscript were developed by a panel of gynecologic oncologists who were members of the SGO Clinical Practice Committee and subject matter experts. Panelists reviewed and considered evidence from current uterine cancer literature. The terminology used in these guidelines was adopted from the ASCCP management guidelines [1] using a two-part rating system to grade the strength of recommendation and quality of evidence (Table 1). The rating for each recommendation is given in parentheses.

This study aimed to quantify the economic impact of missed billing opportunities for tobacco cessation counseling at an academic medical center to identify what may be a systematic defect in the administration of tobacco cessation services and to highlight opportunities to improve patient outcomes and revenue. Patient surveys show that evidence-based tobacco cessation interventions are provided at low rates despite guidelines supporting the use of these services at every eligible encounter. Retrospective cohort study. The study analyzed deidentified patient health data from electronic health records at an academic medical center, focusing on primary care encounters from January 1, 2020, to December 31, 2023, involving patients 18 years and older with a history of current tobacco use. Billing data for tobacco cessation counseling ( Current Procedural Terminology codes 99406 or 99407) were examined to estimate revenue loss from unbilled eligible encounters. Of 1,068,875 primary care visits, 16.8% (179,304) involved tobacco users. However, only 1.0% of these encounters were billed for cessation services, representing an estimated potential revenue loss of $3.2&#xa0;million over 4 years. These findings identify a significant discrepancy between the billing of tobacco cessation services and the opportunities to do so. Better provision and billing of tobacco cessation counseling can improve patient health outcomes, advance value-based care goals, and enhance financial sustainability.

A substantial proportion of persons with inflammatory bowel disease (IBD) in remission continue to experience abdominal pain, altered bowel habits, and bloating that resemble irritable bowel syndrome (IBS). Lack of standardized definitions and evidence-based management strategies leads to diagnostic ambiguity and potentially unnecessary escalation of IBD therapy. A joint Rome Foundation/International Organization for the Study of Inflammatory Bowel Disease Working Team developed consensus recommendations on nomenclature, evaluation, and treatment of IBD with IBS-like symptoms. A multidisciplinary international panel applied a modified RAND/UCLA Appropriateness Method. Systematic literature reviews informed statement generation across multiple domains: nomenclature, diagnostic and symptom assessment, dietary therapies, drugs, and brain-gut behavioral therapies. Panelists rated the appropriateness of candidate statements independently on a 9-point Likert scale, followed by anonymized feedback, discussion, and re-voting across two iterative rounds. Thirteen panelists reviewed 133 initial statements; 105 proceeded to final scoring. Of these, 86 were rated appropriate, 16 uncertain, and 3 inappropriate. The preferred term was "IBD with IBS-like symptoms," defined as abdominal pain, bowel habit change, and/or bloating not explained by active inflammation or structural disease. For clinical care, diagnosis should combine Rome clinical criteria with objective exclusion of inflammation. For research, candidate thresholds for endoscopic, histologic, biomarker, and imaging remission were endorsed. Appropriate therapies included psyllium (if no stricture), a short-term low FODMAP diet, targeted drugs, and brain-gut behavioral therapies. This first joint consensus provides standardized terminology, evaluation strategies, and treatment recommendations for IBD with IBS-like symptoms, supporting improved clinical management and guiding future mechanistic and therapeutic research.

The use of oral anti-neoplastic therapies has accelerated in recent years. Non-supervised administration of oncological therapies introduces uncertainty in regard to adherence. This review and meta-analysis reports on available literature relating to adherence, adherence measuring methods, interventions to improve adherence and estimates patient adherence to common oral anti-neoplastic therapies. A literature search was conducted in the PubMed database up to January 29, 2024 using relevant terminology for oral anti-neoplastic agents. Titles and abstracts of retrieved articles were screened, and full-text articles deemed of interest were reviewed. Studies suitable for meta-analysis and consistent with the analytical approach were selected based on adherence measurement methods and definitions. Random effects meta-analysis was conducted using the R package metafor and visualized with forest plots for cumulative adherence and lower-bound adherence separately. We identified eight reviews and 75 original studies on adherence to non-endocrine oral anti-neoplastic agents, spanning the years from 1987 to 2023, with the vast majority published from 2010 onward. This review estimates the cumulative adherence to oral anti-neoplastic agents to be 84% (95% CI 78-89) and lower-bound adherence as 71% (95% CI 63-78). The definition of non-adherence and the measurement methods used across studies vary, rendering the comprehensive understanding of the subject challenging. This review identifies an adherence rate that deviates from full compliance across a wide variety of treatment regimens and tumor types, which could provide valuable insights for healthcare professionals in optimizing patient management.

Periprosthetic joint infection (PJI) following total knee arthroplasty (TKA) causes significant morbidity and incurs a substantial economic burden on the healthcare system. Recent studies have demonstrated that intraosseous vancomycin (IOV) can reduce the rate of PJI in both primary and aseptic revision TKA when compared to intravenous vancomycin (IVV). This study evaluated the economic impact associated with IOV and IVV administration during primary and aseptic revision TKA. Published institutional hospitalization cost data for PJI following TKA utilizing the Nationwide Inpatient Sample were adjusted to 2024 inflation rates to estimate the treatment cost of one knee PJI. Institutional costs for IOV and IVV were calculated using Medicare rates for current procedural terminology code 36680 as well as the costs of instrumentation, medications, and additional operating room time. Published PJI rates with (primary 0.54%, aseptic revision 1.86%) and without (primary 1.08%, aseptic revision 4.89%) IOV were used to calculate the number needed to treat to prevent one PJI. The cost per case was $177.04 for IOV and $3.90 for IVV. The inflation-adjusted cost per PJI treatment was $33,295.70. The number needed to treat to prevent one PJI for primary TKA was 185.2 and 33.0 for aseptic revision TKA. For primary TKA, utilizing IOV resulted in a cost savings of $1230.17 to prevent one PJI. For aseptic revision TKA, utilizing IOV resulted in a cost savings of $27,582.08. Utilizing IOV during both primary and aseptic revision TKA was shown to be cost-effective. The economic impact of PJI may be greater if additional costs, such as specialist visits, postoperative rehabilitation, and quality of life factors, are factored in.

Lifestyle counselling is part of healthcare professionals' work, but when focused on individual lifestyle counselling, its effects are often limited or context-dependent, highlighting the need for a person-centered approach where motivation, readiness for change, and relational aspects are key. The SELC scale measures self-efficacy, relevant to care professionals' engagement, but interpretation needs further study. The aim of this study was to explore how participants understood and evaluated items in the SELC scale and to identify potential issues related to clarity, relevance, and response options through qualitative pre-testing interviews. Qualitative pre-testing interviews with eight strategically selected participants explored how SELC items were understood and evaluated, using a structured guide with probing, and were analyzed with deductive qualitative content analysis. Participants found most items clear and easy to understand, although some terms were perceived as ambiguous. Items were generally perceived as relevant and consistently structured. Response alternatives were regarded as easy to distinguish, and the instructions were clear and straightforward. However, the open-ended item was unclear, and comments suggested that item order and the expert-driven perspective reduced the instrument's practical usefulness. In the revised SELC 20&#x2009;+&#x2009;20, terminology was clarified, items neutrally phrased, sequence aligned with real-life conversations, and visual and structural consistency improved. Pre-testing interviews identified strengths and improvement areas in the SELC scale and guided its refinement. Combined with previously published psychometric testing, results suggest the SELC scale has potential for assessing self-efficacy among healthcare professionals and in educational settings, although further validation is needed.