Journal of evaluation in clinical practice最新文献

{"title":"Prognosticating global functional outcome in the recurrent ischemic stroke using baseline clinical and pre-clinical features: A machine learning study.","authors":"Tran Nhat Phong Dao, Hien Nguyen Thanh Dang, My Thi Kim Pham, Hien Thi Nguyen, Cuong Tran Chi, Minh Van Le","doi":"10.1111/jep.14100","DOIUrl":"10.1111/jep.14100","url":null,"abstract":"<p><strong>Background and purpose: </strong>Recurrent ischemic stroke (RIS) induces additional functional limitations in patients. Prognosticating globally functional outcome (GFO) in RIS patients is thereby important to plan a suitable rehabilitation programme. This study sought to investigate the ability of baseline features for classifying the patients with and without improving GFO (task 1) and identifying patients with poor GFO (task 2) at the third month after discharging from RIS.</p><p><strong>Methods: </strong>A total of 86 RIS patients were recruited and divided into the training set and testing set (50:50). The clinical and pre-clinical data were recorded. The outcome was the changes in Modified Rankin Scale (mRS) (task 1) and the mRS score at the third month (mRS 0-2: good GFO, mRS >2: poor GFO) (task 2). The permutation importance ranking method selected features. Four algorithms were trained on the training set with five-fold cross-validation. The best model was tested on the testing set.</p><p><strong>Results: </strong>In task 1, the support vector machine (SVM) model outperformed the other models, with the high performance matrix on the training set (sensitivity = 0.80; specificity = 1.00) and the testing set (sensitivity = 0.80; specificity = 0.95). In task 2, the SVM model with selected features also performed well on both datasets (training set: sensitivity = 0.76; specificity = 0.92; testing set: sensitivity = 0.72; specificity = 0.88).</p><p><strong>Conclusion: </strong>A machine learning model could be used to classify GFO responses to treatment and identify the third-month poor GFO in RIS patients, supporting physicians in clinical practice.</p>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":" ","pages":"e14100"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141731276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"To reveal the unseen low-hanging fruit: A multi-method study of Indonesian hospital pharmacist perception regarding the implementation of injection-to-oral conversion activity.","authors":"Tunggul Adi Purwonugroho, Laksmi Maharani, Nia Kurnia Sholihat","doi":"10.1111/jep.14104","DOIUrl":"10.1111/jep.14104","url":null,"abstract":"<p><strong>Introduction: </strong>Previous studies have demonstrated that the adoption of injection-to-oral conversion strategies in hospitalised patient yields both clinical and economic benefits. The objective of this study was to provide a comprehensive description of the current state of implementation and evaluate the perspectives of hospital pharmacists to guide future initiatives towards conversion implementation in Indonesia.</p><p><strong>Methods: </strong>A multi-method design was utilised. Quantitative approach used cross-sectional study design in which data were collected online using Google Form from August to October 2021. Qualitative analysis employed a phenomenological approach by performing in-depth interviews from July to August 2021. Each approach's data were compared to discover connections and discrepancies, and the final interpretation was done simultaneously.</p><p><strong>Results: </strong>A total of 204 pharmacists participated in the survey, with 64.2% of them reporting no previous experience in conversion. An in-depth interview included seven hospital pharmacists, with three themes were emerged: (1) strategic roles of the pharmacist; (2) key considerations; and (3) potential barriers and enablers of conversion implementation. Based on the elaboration of quantitative and qualitative data, the study found that pharmacist had strong perception regarding pharmacist role in conversion despite their little experience in implementing the activity. For future improvement, a platform that taking into account the pharmacist current conditions and insights should be created.</p><p><strong>Conclusions: </strong>Pharmacists appreciated conversion activity and grasped its concepts despite little clinical experience. Consider possible enabling and barrier factors and essential considerations before taking action. Local guidelines and instructional materials that emphasise application or implementation are encouraged. Furthermore, the implementation project must be piloted and evaluated for clinical and economic outcomes.</p>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":" ","pages":"e14104"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141748414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of a predictive score for diagnosing prostate cancer in primary care.","authors":"Francesco Lapi, Ettore Marconi, Iacopo Cricelli, Alberto Sobrero, Andrea Salvetti, Salvatore Campo, Claudio Cricelli","doi":"10.1111/jep.14111","DOIUrl":"10.1111/jep.14111","url":null,"abstract":"<p><strong>Background: </strong>Prostate cancer (PCa) represents the fifth cause of death in the male population worldwide. The prostate-specific antigen (PSA) test demonstrated poor accuracy to assess the presence of PCa. Thus, the PSA testing paradigm should be moved from the systematic screening approach to the early identification of men who are harbouring clinically significant disease. Accurate clinical-based tools to predict PCa should therefore be developed for general practice. We derived and validated a PCa predictive score using a primary care data source.</p><p><strong>Methods: </strong>Using the Italian Health Search Database, we formed a cohort of men aged 45-90 years in the period between 2002 and 2015. These patients were followed up until 31 December 2022. Those with less than a 5-year follow-up were excluded. The cohort was randomly divided into 'derivation' and 'validation' samples in a 1:1 ratio. Along with the demographic and clinical determinants forming the score, we investigated the role of PSA kinetics in the prediction accuracy.</p><p><strong>Results: </strong>In a cohort of 529,082 men aged 45+ years, we identified 14,524 cases of PCa (incidence rate = 2.71 per 1000 person-years; 95% confidence interval = 2.67-2.80). The prediction accuracy of the PCa-HScore featured an explained variation of 12% and a discrimination power of 70%. The calibration slope was almost equal to 1 (p = 0.951, tested for equivalence against the 'perfect' slope) and the PSA kinetics did not improve the prediction accuracy.</p><p><strong>Conclusions: </strong>The PCa-HScore might guide the prescription of PSA and/or other clinical strategies in those men reporting certain levels of risk. A related decision support system could therefore be implemented in primary care.</p>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":" ","pages":"e14111"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141759140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perspectives of paediatric providers on antibiotic stewardship in a high-prescribing rural region.","authors":"Bethany A Wattles, Kyle B Brothers, Carla A Rich, Lesa Ryan, Michael J Smith","doi":"10.1111/jep.14108","DOIUrl":"10.1111/jep.14108","url":null,"abstract":"<p><strong>Purpose: </strong>Understanding drivers of antibiotic use is key to limiting the development of antimicrobial resistance. Outpatient antibiotic prescribing rates vary substantially across and within states. Kentucky is one of the highest prescribing states, and the southeastern region has rates that are drastically higher than the national average and urban areas of the state. We sought to examine provider perceptions of antibiotic use in this rural area to more effectively guide future interventions and policy.</p><p><strong>Methods: </strong>This study utilized Medicaid prescription claims to identify providers who frequently prescribe antibiotics to children in southeastern Kentucky. Semistructured qualitative interviews were conducted to elicit provider perspectives on antibiotic overuse.</p><p><strong>Findings: </strong>Individual, in-person interviews were conducted with 25 providers from a variety of practices and training backgrounds (private, nonprofit, retail, physician, advanced practice registered nurses, etc.). The following themes emerged as issues that prescribers consider to contribute to antibiotic overuse: (1) caregiver pressure, especially from grandparents or families who desire a 'quick fix'; (2) business concerns and competition and (3) cultural factors related to poverty and rural locations. Interviewed providers were supportive of public education and had mixed views on the effectiveness of delayed fill or provider feedback initiatives.</p><p><strong>Conclusions: </strong>This study highlights unique challenges associated with antibiotic prescribing in rural areas. Findings will guide future interventions through adaptation of existing strategies to better serve this vulnerable population.</p>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":" ","pages":"e14108"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141788333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of music on pain, anxiety and satisfaction during nonstress testing.","authors":"Handan Özcan, Suna Oral, Şehma Kuruay, Banu Müşerref Yilmaz","doi":"10.1111/jep.14106","DOIUrl":"10.1111/jep.14106","url":null,"abstract":"<p><strong>Objective: </strong>To determine the effect of instrumental music played during Nonstress Test (NST) on pain, anxiety and satisfaction.</p><p><strong>Methods: </strong>This research was planned as randomised controlled. The sample of the study consists of 64 pregnant women. In data collection, a survey form containing socio-demographic characteristics, State-Trait Anxiety Scale, Visual Analog Scale (VAS) and Evgeny Grinko-Valse piece were used as music.</p><p><strong>Results: </strong>Among the groups where music was applied, satisfaction with the procedure was significantly high (X₂: 12.666, p: 0.049). No significant difference was detected between anxiety and pain conditions (p > 0.05). The scale scores of the groups before and after the procedure were evaluated; Before the procedure, significant differences were detected between the groups in terms of trait anxiety and fear of pain. As a result of the evaluation made after the procedure, there are significant differences between state anxiety and fear of pain (p < 0.05). It was determined that music played during the NST procedure reduced state and trait anxiety. Satisfaction levels are also higher among the group that is listened to music.</p><p><strong>Conclusion: </strong>A successful pregnancy is important for the health of mother and baby. Reducing anxiety and stress, especially during the examinations, ensures that the process continues successfully. It is recommended that music played during pregnancy examinations and screening tests be used in clinics and during the procedure to increase satisfaction and reduce anxiety.</p>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":" ","pages":"e14106"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11664491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141748413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A many-facet Rasch measurement model approach to investigating objective structured clinical examination item parameter drift.","authors":"Karen Coetzee, Sandra Monteiro, Luxshi Amirthalingam","doi":"10.1111/jep.14114","DOIUrl":"10.1111/jep.14114","url":null,"abstract":"<p><strong>Rationale: </strong>Objective Structured Clinical Examinations (OSCEs) are widely used for assessing clinical competence, especially in high-stakes environments such as medical licensure. However, the reuse of OSCE cases across multiple administrations raises concerns about parameter stability, known as item parameter drift (IPD). AIMS & OBJECTIVES: This study aims to investigate IPD in reused OSCE cases while accounting for examiner scoring effects using a Many-facet Rasch Measurement (MFRM) model.</p><p><strong>Method: </strong>Data from 12 OSCE cases, reused over seven administrations of the Internationally Educated Nurse Competency Assessment Program (IENCAP), were analyzed using the MFRM model. Each case was treated as an item, and examiner scoring effects were accounted for in the analysis.</p><p><strong>Results: </strong>The results indicated that despite accounting for examiner effects, all cases exhibited some level of IPD, with an average absolute IPD of 0.21 logits. Three cases showed positive directional trends. IPD significantly affected score decisions in 1.19% of estimates, at an invariance violation of 0.58 logits.</p><p><strong>Conclusion: </strong>These findings suggest that while OSCE cases demonstrate sufficient stability for reuse, continuous monitoring is essential to ensure the accuracy of score interpretations and decisions. The study provides an objective threshold for detecting concerning levels of IPD and underscores the importance of addressing examiner scoring effects in OSCE assessments. The MFRM model offers a robust framework for tracking and mitigating IPD, contributing to the validity and reliability of OSCEs in evaluating clinical competence.</p>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":" ","pages":"e14114"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11664641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141788332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of limited English proficiency on oncological outcomes in the United States: A systematic review.","authors":"Kierstyn M Smith, Camille R Rogers, Olawale O Akinola, Natalie A Holbert, Heather B Blunt, Renata W Yen","doi":"10.1111/jep.14112","DOIUrl":"10.1111/jep.14112","url":null,"abstract":"<p><strong>Background: </strong>The increasing number of immigrants in the United States (U.S.) has resulted in more patients with limited English proficiency (LEP). LEP contributes to patient-provider language discordance, which may impact oncologic health outcomes.</p><p><strong>Objectives: </strong>To assess the effects of LEP compared to English proficiency (EP) for oncological outcomes in adult cancer patients in the United States.</p><p><strong>Search methods: </strong>We searched MEDLINE (Ovid), the Cochrane Library (Cochrane Database of Systematic Reviews and the Cochrane Central Register of Controlled Trials), PsycINFO, CINAHL and Scopus from data inception to 26 January 2023. We also searched the reference lists and cited lists of included studies. Studies were limited to the United States and the English language.</p><p><strong>Selection criteria: </strong>We included retrospective and cross-sectional studies that analyzed one or more clinical outcomes (survival, readmission, length of stay, complications and discharge disposition) in LEP and EP cancer patients. Studies were eligible if they assessed cancer patients in the United States who were 18 years and older.</p><p><strong>Data collection and analysis: </strong>Using a piloted, standardized data collection form, two non-blinded, independent reviewers extracted data in duplicate from studies meeting our inclusion criteria. Reviewers resolved discrepancies through discussion. We then performed a qualitative assessment of the findings.</p><p><strong>Main results: </strong>We retrieved 2425 records from the database searches. We screened 1496 records by title and abstract and reviewed the full text of eight records. We retrieved 347 records from additional search methods and reviewed the full text of six records. We included 14 papers in total for analysis. The studies included 55,141 total patients and assessed outcomes in brain, oesophageal, head and neck, pancreatic and skin cancer. Our qualitative assessment demonstrated limited information on whether LEP impacted survival, complications and discharge disposition. We found no significant association between LEP and readmission or length of stay.</p><p><strong>Conclusions: </strong>Studies assessing the impact of LEP and EP on the health outcomes of cancer patients are sparse and inconsistent in the measurements of outcomes and data reporting. The inconclusiveness of our study indicates that further standardized research is needed to assess the impact of LEP on the outcomes of cancer patients in the United States.</p>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":" ","pages":"e14112"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141788280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of forearm and intra-arterial blood pressure measurements according to body and arm positions in obese patients.","authors":"Elif Günay Ismailoğlu, Hakan Aygün, Seda Şahan, Eda Ergin, Eliz Geçtan","doi":"10.1111/jep.14093","DOIUrl":"10.1111/jep.14093","url":null,"abstract":"<p><strong>Rationale: </strong>Noninvasive blood pressure (BP) monitoring is very important also difficult for accurate diagnosis and monitor of obese patients.</p><p><strong>Aims: </strong>The study aimed to assess the agreement between forearm arm BP and intra-arterial BP values in a different body and arm positions in obese patients.</p><p><strong>Methods: </strong>The descriptive study was carried out on 60 intensive care patients with a body mass index above 30 kg/m² who were monitored with invasive radial BP in the general and surgical intensive care units. BP values obtained from the upper arm and forearm with different arm and body positions were compared with intra-arterial BP results. Bland-Altman analysis and correlation coefficient were used for the accuracy of upper and forearm noninvasive BP reading in different positions.</p><p><strong>Results: </strong>The best agreement was found between the forearm systolic BP in the supine and half-sitting position with the arm down and intra-arterial BP values. Also, the best agreement in diastolic BP was found between the half-sitting and half-sitting position with the arm down and intra-arterial BP.</p><p><strong>Conclusions: </strong>Forearm systolic BP measurement, especially in the supine and half-sitting position with the arm below the heart level position, was best agreement with intra-arterial measurement, regarded as the gold standard. For this reason, it is more appropriate to use forearm BP measurement in obese patients monitored in intensive care to obtain accurate results.</p>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":" ","pages":"e14093"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141748410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of childhood trauma history on premenstrual syndrome in women of reproductive age: A cross-sectional study.","authors":"Havva Yesildere Saglam, Elif Gürsoy, Ayşenur Karakuş","doi":"10.1111/jep.14172","DOIUrl":"10.1111/jep.14172","url":null,"abstract":"<p><strong>Aim: </strong>Premenstrual syndrome is a women's health problem affecting women of reproductive age. Early traumas may have negative effects on women's health. Childhood traumas are thought to be an important risk factor for the emergence of premenstrual syndrome. The aim of this study was to investigate the relationship between premenstrual syndrome and childhood traumas in women.</p><p><strong>Method: </strong>This is a cross-sectional study. This study was conducted online between September 2023 and January 2024. The sample of the study consisted of 437 women of reproductive age, between the ages of 18-49, who did not have any obstacles to participating in the study. Personal Information Form, Premenstrual Syndrome Scale and Childhood Trauma Scale were used to collect the data. SPSS statistical program was used to analyze the data. [Correction added on 28 December 2024, after first online publication: In the preceding sentence, 'SPPS' has been corrected to SPSS.] RESULTS: The prevalence of premenstrual syndrome was 55.6%. Emotional neglect, physical abuse, emotional abuse and sexual abuse levels were found to be higher in women with premenstrual syndrome (p < 0.05). It was determined that childhood traumas increased the level of premenstrual syndrome in women (ß = 0.266). Childhood trauma explained 6.8% of the total change in premenstrual syndrome level (R² = 0.068). Emotional neglect (ß = 0.163) and physical abuse (ß = 0.121) increased the level of premenstrual syndrome.</p><p><strong>Conclusion: </strong>Childhood traumas were found to be an important factor affecting the occurrence of premenstrual syndrome and exacerbating its symptoms. Early detection of childhood traumas may prevent long-term problems that may occur in individuals.</p>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":" ","pages":"e14172"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11713844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142467461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"End-of-life care for the devout Jewish patient.","authors":"Jennifer Eitingon, Danielle Doberman, Zackary Berger, Corey Xavier Tapper","doi":"10.1111/jep.14109","DOIUrl":"10.1111/jep.14109","url":null,"abstract":"<p><strong>Rationale: </strong>The Joint Commission emphasizes the importance of cultural competence and effective communication in quality medical care, particularly during end-of-life (EOL), when decisions are influenced by diverse cultural and religious backgrounds. For Orthodox Jewish patients, the philosophical framework used for EOL decision-making may conflict with that used in traditional Western medical ethics. In this paper, we explore the complexities of EOL decision-making for devout Jewish patients and highlight how approaches may differ from a Western ethical framework.</p><p><strong>Aims and objectives: </strong>This paper aims to familiarize clinicians with EOL preferences of Orthodox Jewish patients, organized into an ethical framework called 'casuistic deontology'. Leading with an open-minded approach emphasizing cultural humility, we explore ways in which integrating this perspective can allow for culturally appropriate and compassionate EOL care.</p><p><strong>Method: </strong>Using a case study methodology, we focus on a 79-year-old Orthodox Jewish male hospitalized with severe injuries. The patient's medical course is analyzed, highlighting how the decisions made by his family in consultation with their Rabbi may differ from the decisions made with a philosophy of a Western ethical framework.</p><p><strong>Results and conclusion: </strong>This case illustrates the ethical tensions that may arise when Western medical practices intersect with Orthodox Jewish beliefs, particularly regarding brain death, resuscitation, and artificial nutrition. We underscore the need for cultural sensitivity when approaching EOL decision-making, allowing for compassionate and comprehensive care that respects religious perspectives. This paper helps provide a structure for clinicians to navigate the complex EOL care needs for the devout Jewish patient in a manner consistent with their cultural and religious identity.</p>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":" ","pages":"e14109"},"PeriodicalIF":2.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141897615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}