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Kurt A, Dinç F, Güneş Şan E, Uzun İB. Development and validation of the climate change health protection behaviors scale for adolescents: a methodological study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024; 34:3682-3695. [PMID: 39037213 DOI: 10.1080/09603123.2024.2382903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 07/16/2024] [Indexed: 07/23/2024]
Abstract
This study aimed to develop and validate the Climate Change Health Protection Behaviors Scale for adolescents. A total of 1036 adolescents were recruited from middle and high schools. The development of the assessment scale was carried out in three steps: item generation, content validity evaluation, and psychometric evaluation. Psychometric testing was conducted to determine the relationship between the resulting factors and the Healthy Lifestyle Belief Scale and Climate Change Awareness Scale. A 28-item scale was developed, consisting of four factors that account for 65.0% of the variance. The Cronbach's alpha value was 0.874. Additionally, a positive correlation was observed between the Climate Change Health Protection Behaviors Scale and both the Climate Change Awareness Scale and the Healthy Lifestyle Belief Scale for adolescents. These results suggest that the Climate Change Health Protection Behaviors Scale is a reliable and valid tool for evaluating health protection behaviors related to climate change in adolescents.
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Affiliation(s)
- Aylin Kurt
- Bartın University, Faculty of Health Sciences, Nursing Department, Pediatric Nursing, Bartın, Turkey
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Dahlmann-Noor AH, Ghorbani-Mojarrad N, Williams KM, Ghoneim A, Allen PM, Beach ML, Bruce G, Buckhurst HD, Buckhurst PJ, Cruickshank FE, Cufflin MP, Day MD, Doyle L, Evans BJW, Flitcroft DI, Gray LS, Grewal I, Guggenheim JA, Hammond CJ, Higginbotham JC, Jawaid I, Kearney S, Lawrenson JG, Logan NS, Loughman J, Mallen EAH, McCullough SJ, Nagra M, Saunders KJ, Seidel D, Shah T, Strang NC, Webber KJ, Wolffsohn JS, Young AL. 2024 UK and Ireland modified Delphi consensus on myopia management in children and young people. Ophthalmic Physiol Opt 2024. [PMID: 39295273 DOI: 10.1111/opo.13381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 07/19/2024] [Accepted: 08/09/2024] [Indexed: 09/21/2024]
Abstract
INTRODUCTION This work aimed to establish the largest UK and Ireland consensus on myopia management in children and young people (CYP). METHODS A modified Delphi consensus was conducted with a panel of 34 optometrists and ophthalmologists with expertise in myopia management. RESULTS Two rounds of voting took place and 131 statements were agreed, including that interventions should be discussed with parents/carers of all CYP who develop myopia before the age of 13 years, a recommendation for interventions to be publicly funded for those at risk of fast progression and high myopia, that intervention selection should take into account the CYP's hobbies and lifestyle and that additional training for eye care professionals should be available from non-commercial sources. Topics for which published evidence is limited or lacking were areas of weaker or no consensus. Modern myopia management contact and spectacles are suitable first-line treatments. The role and provision of low-concentration atropine needs to be reviewed once marketing authorisations and funding decisions are in place. There is some evidence that a combination of low-concentration atropine with an optical intervention can have an additive effect; further research is needed. Once an intervention is started, best practice is to monitor non-cycloplegic axial length 6 monthly. CONCLUSION Research is needed to identify those at risk of progression, the long-term effectiveness of individual and combined interventions, and when to discontinue treatment when myopia has stabilised. As further evidence continues to emerge, this consensus work will be repeated to ensure it remains relevant.
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Affiliation(s)
- Annegret H Dahlmann-Noor
- NIHR Moorfields Biomedical Research Centre, London, UK
- Moorfields Eye Hospital NHS Foundation Trust, London, UK
- University College London Institute of Ophthalmology, London, UK
- Myopia Consortium, UK
| | - Neema Ghorbani-Mojarrad
- Myopia Consortium, UK
- School of Optometry and Vision Science, University of Bradford, Bradford, UK
- Wolfson Centre for Applied Health Research, Bradford, UK
| | - Katie M Williams
- Moorfields Eye Hospital NHS Foundation Trust, London, UK
- University College London Institute of Ophthalmology, London, UK
- Myopia Consortium, UK
- King's College London, London, UK
| | - Ahmed Ghoneim
- Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Peter M Allen
- Myopia Consortium, UK
- Vision and Hearing Research Centre, Anglia Ruskin University, Cambridge, UK
| | | | | | - Hetal D Buckhurst
- Myopia Consortium, UK
- School of Health Professions, University of Plymouth, Plymouth, UK
| | - Phillip J Buckhurst
- Myopia Consortium, UK
- School of Health Professions, University of Plymouth, Plymouth, UK
| | | | - Matthew P Cufflin
- School of Optometry and Vision Science, University of Bradford, Bradford, UK
| | - Mhairi D Day
- Myopia Consortium, UK
- Department of Vision Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Lesley Doyle
- Myopia Consortium, UK
- Centre for Optometry and Vision Science, Ulster University, Coleraine, UK
- Northern Ireland Clinical Research Network, Belfast, UK
| | - Bruce J W Evans
- Department of Optometry and Visual Sciences, City St George's, University of London, London, UK
| | - Daniel Ian Flitcroft
- Children's Health Ireland (CHI) at Temple Street, Dublin, Ireland
- Centre for Eye Research Ireland, Technological University of Dublin, Dublin, Ireland
| | - Lyle S Gray
- Department of Vision Sciences, Glasgow Caledonian University, Glasgow, UK
| | | | - Jeremy A Guggenheim
- Myopia Consortium, UK
- School of Optometry & Vision Sciences, Cardiff University, Cardiff, UK
| | - Christopher J Hammond
- Myopia Consortium, UK
- King's College London, London, UK
- Guys and St Thomas' NHS Foundation Trust, London, UK
| | | | | | - Stephanie Kearney
- Myopia Consortium, UK
- Department of Vision Sciences, Glasgow Caledonian University, Glasgow, UK
| | - John G Lawrenson
- Department of Optometry and Visual Sciences, City St George's, University of London, London, UK
| | - Nicola S Logan
- Myopia Consortium, UK
- School of Optometry, College of Life and Health Sciences, Aston University, Birmingham, UK
| | - James Loughman
- Centre for Eye Research Ireland, Technological University of Dublin, Dublin, Ireland
| | - Edward A H Mallen
- School of Optometry and Vision Science, University of Bradford, Bradford, UK
| | - Sara J McCullough
- Myopia Consortium, UK
- Centre for Optometry and Vision Science, Ulster University, Coleraine, UK
| | - Manbir Nagra
- Vision and Eye Research Institute, Anglia Ruskin University, Cambridge, UK
| | - Kathryn J Saunders
- Myopia Consortium, UK
- Centre for Optometry and Vision Science, Ulster University, Coleraine, UK
| | - Dirk Seidel
- Department of Vision Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Tanvi Shah
- Moorfields Eye Hospital NHS Foundation Trust, London, UK
- Diopter Eye Clinic, London, UK
| | - Niall C Strang
- Myopia Consortium, UK
- Department of Vision Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Kathryn J Webber
- School of Optometry and Vision Science, University of Bradford, Bradford, UK
| | - James S Wolffsohn
- Myopia Consortium, UK
- School of Optometry, College of Life and Health Sciences, Aston University, Birmingham, UK
| | - Alexandra L Young
- Cameron Optometry, Edinburgh, UK
- Princess Alexandra Eye Pavilion, NHS Lothian, Edinburgh, UK
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Raab C, Gambashidze N, Brust L, Weigl M, Koch A. Motivation for patient engagement in patient safety: a multi-perspective, explorative survey. BMC Health Serv Res 2024; 24:1052. [PMID: 39261814 PMCID: PMC11391733 DOI: 10.1186/s12913-024-11495-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 08/27/2024] [Indexed: 09/13/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Despite increasing calls for more patient engagement in patient safety, limited knowledge remains on what actually motivates key stakeholders in healthcare to promote patient engagement. We therefore set out to survey key stakeholders of patient engagement in patient safety (i.e., patients, healthcare professionals, and managers). We aimed to identify and explore stakeholder's distinct and shared motives for patient engagement. METHODS A stepwise Delphi method was applied, utilizing semi-structured online interviews for determination of stakeholder motives for patient engagement in patient safety. In a subsequent online survey, statements were evaluated and identified. 34 subject-matter experts from all relevant stakeholder groups completed the online interviews and 33 the online survey. We used content analysis approaches for qualitative and descriptive analyses for quantitative measures. Further, we evaluated the consensus on distinct and shared motives across stakeholder groups. RESULTS Seven key motives for patient engagement in patient safety were identified. Major motives attributed to patients were: (1) To improve experiences and care outcomes for oneself, as well as (2) for future patients, (3) to express gratitude and appreciation, (4) to cope successfully with treatment-related emotions. A motive shared by patients and professionals was (5) to contribute actively to improved delivery of healthcare. To optimize patient safety, costs, and care processes (6) was shared by professionals and managers. Lastly, (7) to improve patient-provider relationships was jointly shared by all stakeholder groups. For four motives (1, 2, 6, 7) consensus was established. CONCLUSIONS In order to unlock the full potential of future interventions in patient engagement, a deeper understanding of stakeholder motives is essential. We identified a set of distinct and shared motives for patient engagement across relevant stakeholder groups. Our findings may inform future interventions in patient engagement that take account of the motivational foundations and aspirations of all stakeholders who are key for the success for collaborative patient safety and care improvements. TRIAL REGISTRATION ID DRKS00031837 (Date May 8, 2023).
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Affiliation(s)
- Caroline Raab
- Institute for Patient Safety (IfPS), University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
- Department of Psychology, University of Innsbruck, Innsbruck, Austria
| | - Nikoloz Gambashidze
- Institute for Patient Safety (IfPS), University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Larissa Brust
- Institute for Patient Safety (IfPS), University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Matthias Weigl
- Institute for Patient Safety (IfPS), University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany.
| | - Amelie Koch
- Institute for Patient Safety (IfPS), University Hospital Bonn, Venusberg-Campus 1, 53127, Bonn, Germany
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Koller D, Bödeker M, Dapp U, Grill E, Fuchs J, Maier W, Strobl R. A Framework for Measuring Neighborhood Walkability for Older Adults-A Delphi Consensus Study. J Urban Health 2024:10.1007/s11524-024-00910-7. [PMID: 39227524 DOI: 10.1007/s11524-024-00910-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/26/2024] [Indexed: 09/05/2024]
Abstract
While mobility in older age is of crucial importance for health and well-being, it is worth noting that currently, there is no German language framework for measuring walkability for older adults that also considers the functional status of a person. Therefore, we combined the results of an expert workshop, a literature review, and a Delphi consensus survey. Through this, we identified and rated indicators relevant for walkability for older adults, additionally focusing on their functional status. The expert workshop and the review led to an extensive list of potential indicators, which we hope will be useful in future research. Those indicators were then adapted and rated in a three-stage Delphi expert survey. A fourth additional Delphi round was conducted to assess the relevance of each indicator for the different frailty levels, namely "robust," "pre-frail," and "frail." Between 20 and 28 experts participated in each round of the Delphi survey. The Delphi process resulted in a list of 72 indicators deemed relevant for walkability in older age groups, grouped into three main categories: "Built environment and transport infrastructure," "Accessibility and meeting places," and "Attractiveness and sense of security." For 35 of those indicators, it was suggested that functional status should be additionally considered. This framework represents a significant step forward in comprehensively covering indicators for subjective and objective walkability in older age, while also incorporating aspects of functioning relevant to older adults. It would be beneficial to test and apply the indicator set in a community setting.
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Affiliation(s)
- Daniela Koller
- Institute of Medical Information Processing, Biometry, and Epidemiology, Faculty of Medicine, LMU Munich, Munich, Germany.
| | - Malte Bödeker
- Federal Centre for Health Education, Cologne, Germany
| | - Ulrike Dapp
- Geriatrics Centre, Scientific Department at the University of Hamburg, Albertinen-Haus, Hamburg, Germany
| | - Eva Grill
- Institute of Medical Information Processing, Biometry, and Epidemiology, Faculty of Medicine, LMU Munich, Munich, Germany
- German Center for Vertigo and Balance Disorders, LMU University Hospital, Munich, Germany
| | - Judith Fuchs
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Werner Maier
- Institute of Medical Information Processing, Biometry, and Epidemiology, Faculty of Medicine, LMU Munich, Munich, Germany
| | - Ralf Strobl
- Institute of Medical Information Processing, Biometry, and Epidemiology, Faculty of Medicine, LMU Munich, Munich, Germany
- German Center for Vertigo and Balance Disorders, LMU University Hospital, Munich, Germany
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Pereira S, Fassarella C, Ribeiro O. Development and Validation of the "Program to Promote Positive Nursing Practice Environments": Modified Delphi Study. Healthcare (Basel) 2024; 12:1748. [PMID: 39273772 PMCID: PMC11394860 DOI: 10.3390/healthcare12171748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2024] [Revised: 08/29/2024] [Accepted: 08/30/2024] [Indexed: 09/15/2024] Open
Abstract
Positive nursing practice environments benefit clients, professionals, and institutions, specifically for professionals, by improving professional visibility, recognition, retention intentions, well-being, commitment, job satisfaction, and reducing stress and burnout. Clients experience better quality care, safety, satisfaction, engagement, and fewer care omissions. Institutions favored reduced absenteeism and turnover, improved efficiency, lower costs, and better health outcomes. This study aimed to document the development of the "Program to Promote Positive Nursing Practice Environments" and analyze expert perceptions to reach a consensus. Using a two-round modified online Delphi technique with 22 experts, we examined perspectives on the program's goals, duration, organization, and content. Initial feedback showed agreement on the program's duration but mixed opinions on the number and length of sessions due to concerns about participant workload and fatigue. Adjustments led to a strong consensus and positive feedback on the program's coverage of essential nursing practice environment constructs. The program includes sessions on client, professional, and institutional dynamics, focusing on key attributes and outcomes for fostering positive nursing environments. By equipping nurses with knowledge and skills, the program aims to enhance work environments effectively. These findings provide a substantial advancement in the field, offering a robust framework for future initiatives.
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Affiliation(s)
- Soraia Pereira
- Abel Salazar Biomedical Sciences Institute, University of Porto, 4050-313 Porto, Portugal
- Northern Health School of the Portuguese Red Cross, 3720-126 Oliveira de Azeméis, Portugal
- CINTESIS@RISE, 4050-313 Porto, Portugal
| | - Cintia Fassarella
- Faculty of Nursing, University of Rio de Janeiro, Rio de Janeiro 20550-013, Brazil
| | - Olga Ribeiro
- CINTESIS@RISE, 4050-313 Porto, Portugal
- Nursing School of Porto, 4200-450 Porto, Portugal
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Niederberger M, Schifano J, Deckert S, Hirt J, Homberg A, Köberich S, Kuhn R, Rommel A, Sonnberger M. Delphi studies in social and health sciences-Recommendations for an interdisciplinary standardized reporting (DELPHISTAR). Results of a Delphi study. PLoS One 2024; 19:e0304651. [PMID: 39186713 PMCID: PMC11346927 DOI: 10.1371/journal.pone.0304651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 05/16/2024] [Indexed: 08/28/2024] Open
Abstract
BACKGROUND While different proposals exist for a guideline on reporting Delphi studies, none of them has yet established itself in the health and social sciences and across the range of Delphi variants. This seems critical because empirical studies demonstrate a diversity of modifications in the conduction of Delphi studies and sometimes even errors in the reporting. The aim of the present study is to close this gap and formulate a general reporting guideline. METHOD In an international Delphi procedure, Delphi experts were surveyed online in three rounds to find consensus on a reporting guideline for Delphi studies in the health and social sciences. The respondents were selected via publications of Delphi studies. The preliminary reporting guideline, containing 65 items on five topics and presented for evaluation, had been developed based on a systematic review of the practice of Delphi studies and a systematic review of existing reporting guidelines for Delphi studies. Starting in the second Delphi round, the experts received feedback in the form of mean values, measures of dispersion, a summary of the open-ended responses and their own response in the previous round. The final draft of the reporting guideline contains the items on which at least 75% of the respondents agreed by assigning scale points 6 and 7 on a 7-point Likert scale. RESULTS 1,072 experts were invited to participate. A total of 91 experts completed the first Delphi round, 69 experts the second round, and 56 experts the third round. Of the 65 items in the first draft of the reporting guideline, consensus was ultimately reached for 38 items addressing the five topics: Title and Abstract (n = 3), Context (n = 7), Method (n = 20), Results (n = 4) and Discussion (n = 4). Items focusing on theoretical research and on dissemination were either rejected or remained subjects of dissent. DISCUSSION We assume a high level of acceptance and interdisciplinary suitability regarding the reporting guideline presented here and referred to as the "Delphi studies in social and health sciences-recommendations for an interdisciplinary standardized reporting" (DELPHISTAR). Use of this reporting guideline can substantially improve the ability to compare and evaluate Delphi studies.
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Affiliation(s)
- Marlen Niederberger
- Department of Research Methods in Health Promotion and Prevention, Institute for Health Sciences, University of Education Schwäbisch Gmünd, Schwäbisch Gmünd, Germany
| | - Julia Schifano
- Department of Research Methods in Health Promotion and Prevention, Institute for Health Sciences, University of Education Schwäbisch Gmünd, Schwäbisch Gmünd, Germany
| | - Stefanie Deckert
- Center for Evidence-Based Healthcare, University Hospital and Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Julian Hirt
- Department of Health, Institute of Nursing Science, Eastern Switzerland University of Applied Sciences, St. Gallen, Switzerland
- Pragmatic Evidence Lab, Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel and University of Basel, Basel, Switzerland
| | - Angelika Homberg
- Department of Medical Education Research, Medical Faculty Mannheim at Heidelberg University, Mannheim, Germany
| | - Stefan Köberich
- Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Rainer Kuhn
- DIALOGIK Non-Profit Institute for Communication and Cooperation Research, Stuttgart, Germany
- Center for Interdisciplinary Risk and Innovation Studies (ZIRIUS), University of Stuttgart, Stuttgart, Germany
| | - Alexander Rommel
- Department 2, Epidemiology and Health Monitoring, Robert Koch-Institut, Berlin, Germany
| | - Marco Sonnberger
- Department of Sociology of Technology, Risk and Environment, University of Stuttgart, Stuttgart, Germany
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Morgan C, Donaldson C, Lancsar E, Petrou S, Andronis L. Considerations Around the Inclusion of Children and Young People's Time in Economic Evaluation: Findings from an International Delphi Study. PHARMACOECONOMICS 2024:10.1007/s40273-024-01411-w. [PMID: 39153138 DOI: 10.1007/s40273-024-01411-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/12/2024] [Indexed: 08/19/2024]
Abstract
BACKGROUND People's time is a finite resource and a valuable input that ought to be considered in economic evaluations taking a broad, societal perspective. Yet, evaluations of interventions focusing on children and young people (CYP) rarely account for the opportunity cost of time in this population. As a key reason for this, health economists have pointed to uncertainty around when it is appropriate to include CYP time-related costs in an economic evaluation and highlighted the lack of clear guidance on the topic. METHODS With this in mind, we carried out a Delphi study to establish a list of relevant considerations for researchers to utilise whilst making decisions about whether and when to include CYP time in their economic evaluations. Delphi panellists were asked to propose and rate a set of possible considerations and provide additional thoughts on their ratings. Ratings were summarised using descriptive statistics, and text comments were interrogated through thematic analysis. FINDINGS A total of 73 panellists across 16 countries completed both rounds of a two-round Delphi study. Panellists' ratings showed that, when thinking about whether to include displaced CYP time in an economic evaluation, it is very important to consider whether: (1) inclusion would be in line with specified perspective(s) (median score: 9), (2) CYP's time may already be accounted for in other parts of the evaluation (median score: 8), (3) the amount of forgone time is substantial, either in absolute or relative terms (median score: 7) and (4) inclusion of CYP's time costs would be of interest to decision-makers (median score: 7). Respondents thought that considerations such as (1) whether inclusion would be of interest to the research community (median score: 6), (2) whether CYP's time displaced by receiving treatment is 'school' or 'play' time (median score: 5), and (3) whether CYP's are old enough for their time to be considered valuable (median score: 5) are moderately important. A range of views was offered to support beliefs and ratings, many of which were underpinned by compelling normative questions.
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Affiliation(s)
- Cameron Morgan
- Centre for Health Economics at Warwick, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK
| | - Cam Donaldson
- Yunus Centre for Social Business and Health, Glasgow Caledonian University, Glasgow, UK
- Department of Health Services Research and Policy, Australian National University, Canberra, Australia
| | - Emily Lancsar
- Department of Health Services Research and Policy, Australian National University, Canberra, Australia
| | - Stavros Petrou
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Lazaros Andronis
- Centre for Health Economics at Warwick, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK.
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Carl J, Mazzoli E, Mouton A, Sum RKW, Singh A, Niederberger M, Martins J, Kriellaars D, Green N, Elsborg P, Dudley DA, Cairney J, Barratt J, Barnett LM. Development of a Global Physical Literacy (GloPL) Action Framework: Study protocol for a consensus process. PLoS One 2024; 19:e0307000. [PMID: 39133681 PMCID: PMC11318864 DOI: 10.1371/journal.pone.0307000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 06/26/2024] [Indexed: 08/15/2024] Open
Abstract
BACKGROUND The holistic concept of physical literacy (PL) has gained growing attention in recent research, policy, and practice. Many important policy documents of the physical activity and educational fields (e.g., Global Action Plan on Physical Activity 2018-2030 by the World Health Organization, UNESCO's Quality Physical Education guidelines for policymakers) have specified PL. However, a clear framework for action is needed, as most initiatives across the world are fragmented, lack a prospective orientation, can benefit from conceptual clarification, and are not linked to effective translation into practice. Therefore, we aim to consensually develop a Global Physical Literacy (GloPL) Action Framework to define goals and principles (asking what is needed) as well as actions and ways (asking how these can be achieved) to move PL forward. MATERIALS AND METHODS We apply a three-stage group Delphi technique involving three representation groups: (a) geographical representatives to achieve global coverage of perspectives; (b) representatives of special thematic interest reflecting prominent gaps of current PL activities; and (c) representatives of societies from the broad field of physical activity and health to facilitate dissemination. The process will begin with an individual pre-Delphi exercise, in which experts generate initial ideas for the framework, followed by a four-eye document analysis to derive themes for the discussion. Subsequently, the experts will meet face-to-face in three online rounds to discuss and prioritize the themes. Interspersed formal voting with pre-defined agreement thresholds (via descriptive statistics) will inform the inclusion of themes within the final framework. CONCLUSIONS A global consensus on goals, principles, actions, and ways for the development of PL has the potential to provide a largely accepted roadmap for future activities in research, policy, and practice. The co-production approach will help disseminate the GloPL Action Framework and benefit work in relevant application fields of physical activity and health worldwide.
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Affiliation(s)
- Johannes Carl
- Institute for Physical Activity and Nutrition (IPAN), School of Health and Social Development, Deakin University, Geelong, Victoria, Australia
| | - Emiliano Mazzoli
- Institute for Physical Activity and Nutrition (IPAN), School of Health and Social Development, Deakin University, Geelong, Victoria, Australia
| | - Alexandre Mouton
- Department of Physical Activity and Rehabilitation Sciences, University of Liège, Liège, Belgium
| | - Raymond Kim-Wai Sum
- Department of Sports Science and Physical Education, Chinese University of Hong Kong, Shatin, Hong Kong
| | - Amika Singh
- Mulier Instituut, Utrecht, The Netherlands
- Department of Movement, School & Sports, Windesheim University of Applied Sciences, Zwolle, The Netherlands
| | - Marlen Niederberger
- Department of Sports Science and Physical Education, University of Education, Schwäbisch Gmünd, Germany
| | - João Martins
- Centro de Estudos em Educação, Faculdade de Motricidade Humana e UIDEF, Universidade de Lisboa, Cruz Quebrada, Portugal
| | - Dean Kriellaars
- Department of Physical Therapy, University of Manitoba, Winnipeg, Canada
| | - Nigel Green
- International Physical Literacy Association, Wigan, England, United Kingdom
| | - Peter Elsborg
- Center for Clinical Research and Prevention, Copenhagen University Hospital – Bispebjerg and Frederiksberg, Frederiksberg, Denmark
| | - Dean A. Dudley
- Macquarie School of Education, Macquarie University, North Ryde, New South Wales, Australia
- School of Human Movement and Nutrition Sciences, University of Queensland, St. Lucia, Queensland, Australia
| | - John Cairney
- School of Human Movement and Nutrition Sciences, University of Queensland, St. Lucia, Queensland, Australia
| | - Jaime Barratt
- School of Human Movement and Nutrition Sciences, University of Queensland, St. Lucia, Queensland, Australia
- Department of Educational Studies, Brock University, St. Catharines, Ontario, Canada
| | - Lisa M. Barnett
- Institute for Physical Activity and Nutrition (IPAN), School of Health and Social Development, Deakin University, Geelong, Victoria, Australia
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Chaudhuri S, Gupta M, Phadke V, Chawla JK. Conceptual Framework of Upper Cross Syndrome: A Delphi Study. Cureus 2024; 16:e67873. [PMID: 39328683 PMCID: PMC11424749 DOI: 10.7759/cureus.67873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2024] [Indexed: 09/28/2024] Open
Abstract
BACKGROUND Upper cross syndrome (UCS) is one of the most common postural dysfunctions due to prolonged flexed attitude. Good posture plays an important role in maintaining musculoskeletal balance and protecting it from further injury. Conducting research on the conceptual framework will help clinicians to identify and plan treatment strategies for the correction of this syndrome and prevent secondary complications. Thus, the aim of this study was to develop a conceptual framework for UCS. METHODS AND MATERIAL The Delphi method was used to conduct the study and develop a conceptual framework. A total of 30 multidisciplinary experts participated in the study, and a list of 41 items was finalized after an extensive literature review. A cover letter along with all the items was mailed to the experts to obtain their input. Three rounds of Delphi were conducted until a consensus was reached. The following parameters were used to determine consensus: moderate Kendall's coefficient of concordance (Kendall's W), agreement greater than 51.0%, interquartile range (IQR) below 1.5, and standard deviation (SD) below 1. RESULTS By the end of the third round, 37 items were finalized. The conceptual framework consisted of four items in postural alignment, eight items in muscular imbalance, 20 items in functional limitation, and five items in the psychosocial domain. CONCLUSION We successfully developed a conceptual framework for UCS. Four domains, including postural alignment, muscular imbalance, functional limitation, and psychosocial, were identified. This will lead to a deeper comprehension of UCS, which will facilitate its early detection and treatment. The multidimensional approach of the study will provide a better scope for the clinicians to educate the patient about good posture, which not only will impact physical performance but also improve quality of life. The development of this framework will help to prevent, monitor the progress, and correct UCS.
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Affiliation(s)
| | - Meena Gupta
- Physiotherapy, Amity Institute of Health Allied Science, Noida, IND
| | - Vandana Phadke
- Clinical Research, Indian Spinal Injury Centre, New Delhi, IND
| | - Jasmine Kaur Chawla
- Physiotherapy, School of Allied Health Sciences, Manav Rachna International Institute of Research and Studies, Faridabad, IND
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Brillantino A, Renzi A, Talento P, Brusciano L, Marano L, Grillo M, Maglio MN, Foroni F, Palumbo A, Sotelo MLS, Vicenzo L, Lanza M, Frezza G, Antropoli M, Gambardella C, Monaco L, Ferrante I, Izzo D, Giordano A, Pinto M, Fantini C, Gasparrini M, Di Visconte MS, Milazzo F, Ferreri G, Braini A, Cocozza U, Pezzatini M, Gianfreda V, Di Leo A, Landolfi V, Favetta U, Agradi S, Marino G, Varriale M, Mongardini M, Pagano CEFA, Contul RB, Gallese N, Ucchino G, D'Ambra M, Rizzato R, Sarzo G, Masci B, Da Pozzo F, Ascanelli S, Liguori P, Pezzolla A, Iacobellis F, Boriani E, Cudazzo E, Babic F, Geremia C, Bussotti A, Cicconi M, Sarno AD, Mongardini FM, Brescia A, Lenisa L, Mistrangelo M, Zuin M, Mozzon M, Chiriatti AP, Bottino V, Ferronetti A, Rispoli C, Carbone L, Calabrò G, Tirrò A, de Vito D, Ioia G, Lamanna GL, Asciore L, Greco E, Bianchi P, D'Oriano G, Stazi A, Antonacci N, Renzo RMD, Poto GE, Ferulano GP, Longo A, Docimo L. The Italian Unitary Society of Colon-Proctology (Società Italiana Unitaria di Colonproctologia) guidelines for the management of acute and chronic hemorrhoidal disease. Ann Coloproctol 2024; 40:287-320. [PMID: 39228195 PMCID: PMC11375232 DOI: 10.3393/ac.2023.00871.0124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 02/23/2024] [Indexed: 09/05/2024] Open
Abstract
The aim of these evidence-based guidelines is to present a consensus position from members of the Italian Unitary Society of Colon-Proctology (Società Italiana Unitaria di Colon-Proctologia, SIUCP) on the diagnosis and management of hemorrhoidal disease, with the goal of guiding physicians in the choice of the best treatment option. A panel of experts was charged by the Board of the SIUCP to develop key questions on the main topics related to the management of hemorrhoidal disease and to perform an accurate and comprehensive literature search on each topic, in order to provide evidence-based answers to the questions and to summarize them in statements. All the clinical questions were discussed by the expert panel in multiple rounds through the Delphi approach and, for each statement, a consensus among the experts was reached. The questions were created according to PICO (patients, intervention, comparison, and outcomes) criteria, and the statements were developed adopting the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) methodology. In cases of grade 1 hemorrhoidal prolapse, outpatient procedures including hemorrhoidal laser procedure and sclerotherapy may be considered the preferred surgical options. For grade 2 prolapse, nonexcisional procedures including outpatient treatments, hemorrhoidal artery ligation and mucopexy, laser hemorrhoidoplasty, the Rafaelo procedure, and stapled hemorrhoidopexy may represent the first-line treatment options, whereas excisional surgery may be considered in selected cases. In cases of grades 3 and 4, stapled hemorrhoidopexy and hemorrhoidectomy may represent the most effective procedures, even if, in the expert panel opinion, stapled hemorrhoidopexy represents the gold-standard treatment for grade 3 hemorrhoidal prolapse.
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Affiliation(s)
| | - Adolfo Renzi
- Esophageal Diseases Center and GERD Unit, Buon Consiglio Hospital, Naples, Italy
| | - Pasquale Talento
- Department of Surgery, Pelvic Floor Center, AUSL-IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - Luigi Brusciano
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Luigi Marano
- Department of Medicine, Academy of Applied Medical and Social Sciences (Akademia Medycznych i Społecznych Nauk Stosowanych, AMiSNS), Elbląg, Poland
| | - Maurizio Grillo
- Deparment of Surgery, Antonio Cardarelli Hospital, Naples, Italy
| | | | - Fabrizio Foroni
- Deparment of Surgery, Antonio Cardarelli Hospital, Naples, Italy
| | - Alessio Palumbo
- Deparment of Surgery, Antonio Cardarelli Hospital, Naples, Italy
| | | | - Luciano Vicenzo
- Deparment of Surgery, Antonio Cardarelli Hospital, Naples, Italy
| | - Michele Lanza
- Deparment of Surgery, Antonio Cardarelli Hospital, Naples, Italy
| | - Giovanna Frezza
- Deparment of Surgery, Antonio Cardarelli Hospital, Naples, Italy
| | | | - Claudio Gambardella
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Luigi Monaco
- Department of General Surgery, Villa Esther Clinic, Pineta Grande Hospital, Avellino, Italy
| | - Ilaria Ferrante
- Department of General Surgery, Villa Esther Clinic, Pineta Grande Hospital, Avellino, Italy
| | - Domenico Izzo
- Department of General and Emergency Surgery, AORN dei Colli/C.T.O. Hospital, Naples, Italy
| | - Alfredo Giordano
- Department of General and Emergency Surgery, Hospital of Mercato San Severino, University of Salerno, Salerno, Italy
| | | | - Corrado Fantini
- Department of Surgery, Pellegrini Hospital, ASL Napoli 1, Naples, Italy
| | | | | | - Francesca Milazzo
- Department of Surgery, Pelvic Floor Center, AUSL-IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - Giovanni Ferreri
- Department of Surgery, Pelvic Floor Center, AUSL-IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - Andrea Braini
- Department of General Surgery, Azienda Sanitaria Friuli Occidentale (ASFO), Pordenone, Italy
| | - Umberto Cocozza
- Department of General Surgery, S. Maria degli Angeli Hospital, Bari, Italy
| | | | - Valeria Gianfreda
- Unit of Colonproctologic and Pelvic Surgery, M.G. Vannini Hospital, Rome, Italy
| | - Alberto Di Leo
- Department of General and Minimally Invasive Surgery, San Camillo Hospital, Trento, Italy
| | - Vincenzo Landolfi
- Department of General and Specialist Surgery, AORN S.G. Moscati, Avellino, Italy
| | - Umberto Favetta
- Unit of Proctology and Pelvic Surgery, Città di Pavia Clinic, Pavia, Italy
| | | | - Giovanni Marino
- Department of General Surgery, Santa Marta e Santa Venera Hospital of Acireale, Catania, Italy
| | - Massimiliano Varriale
- Department of General and Emergency Surgery, Sandro Pertini Hospital, ASL Roma 2, Rome, Italy
| | | | | | | | - Nando Gallese
- Unit of Proctologic Surgery, Sant'Antonio Clinic, Cagliari, Italy
| | | | - Michele D'Ambra
- Department of General and Oncologic Minimally Invasive Surgery, Federico II University, Naples, Italy
| | - Roberto Rizzato
- Department of General Surgery, Hospital Conegliano - AULSS 2 Marca Trevigiana, Treviso, Italy
| | - Giacomo Sarzo
- Department of General Surgery, Sant'Antonio Hospital, University of Padova, Padova, Italy
| | - Bruno Masci
- Department of Surgery, San Carlo di Nancy Hospital, Rome, Italy
| | - Francesca Da Pozzo
- Department of Surgery, Santa Maria dei Battuti Hospital, Pordenone, Italy
| | - Simona Ascanelli
- Department of Surgery, University Hospital of Ferrara, Ferrara, Italy
| | | | | | - Francesca Iacobellis
- Department of General and Emergency Radiology, Antonio Cardarelli Hospital, Naples, Italy
| | - Erika Boriani
- Department of Surgery, University of Parma, Parma, Italy
| | - Eugenio Cudazzo
- Department of Surgery, Pelvic Floor Center, AUSL-IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - Francesca Babic
- Department of Surgery, Cattinara Hospital ASUGI, Trieste, Italy
| | - Carmelo Geremia
- Unit of Proctology and Pelvic Surgery, Città di Pavia Clinic, Pavia, Italy
| | | | - Mario Cicconi
- Department of General Surgery, Sant'Omero-Val Vibrata Hospital, Teramo, Italy
| | - Antonia Di Sarno
- Esophageal Diseases Center and GERD Unit, Buon Consiglio Hospital, Naples, Italy
| | - Federico Maria Mongardini
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Antonio Brescia
- Department of Oncologic Colorectal Surgery, University Hospital S. Andrea, La Sapienza University, Rome, Italy
| | - Leonardo Lenisa
- Department of Surgery, Surgery Unit, Pelvic Floor Centre, Humanitas San Pio X, Milano, Italy
| | | | - Matteo Zuin
- Unit of General Surgery, Hospital of Cittadella - ULSS 6 Euganea, Padova, Italy
| | - Marta Mozzon
- Unit of General Surgery, S. Maria della Misericordia Hospital, Azienda Sanitaria Universitaria Friuli Centrale (ASU FC), Udine, Italy
| | | | | | | | - Corrado Rispoli
- Unit of General Surgery, AORN dei Colli/Monaldi Hospital, Naples, Italy
| | | | - Giuseppe Calabrò
- Unit of Colonproctology, Euromedica Scientific Institut, Milano, Italy
| | - Antonino Tirrò
- Unit of Surgery, Santa Marta e Santa Venera Hospital - ASP Catania, Catania, Italy
| | - Domenico de Vito
- Unit of Surgery, Sanatrix Clinic, Pineta Grande Hospital, Naples, Italy
| | - Giovanna Ioia
- Department of General and Onologic Surgery, Andrea Tortora Hospital, Pagani, ASL Salerno, Salerno, Italy
| | | | - Lorenzo Asciore
- Department of Surgery, Ave Gratia Plena Hospital, ALS CE, Caserta, Italy
| | - Ettore Greco
- Department of Surgery, P. Colombo Hospital, Rome, Italy
| | | | | | | | - Nicola Antonacci
- Week Surgery and Day Surgery Unit, AUSL Romagna Bufalini Hospital, Cesena, Italy
| | | | | | | | - Antonio Longo
- Department of Surgery, Madonna della Fiducia Clinic, Rome, Italy
| | - Ludovico Docimo
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
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Neville C, Beurskens C, Diels J, MacDowell S, Rankin S. Consensus Among International Facial Therapy Experts for the Management of Adults with Unilateral Facial Palsy: A Two-Stage Nominal Group and Delphi Study. Facial Plast Surg Aesthet Med 2024; 26:405-417. [PMID: 37922418 DOI: 10.1089/fpsam.2023.0101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2023] Open
Abstract
Background: Nonsurgical rehabilitation of unilateral peripheral facial palsy (FP) varies globally with controversy regarding best practice. Objective: To develop facial therapist consensus regarding what should be included or excluded in rehabilitation of adults with FP of any etiology. Three clinical presentations: flaccid, paretic and synkinetic, were separately considered. Methodology: A two-stage study was conducted: a nominal group technique (NGT) to develop a questionnaire plus Delphi study. Delphi participants were recruited worldwide, through an experience-based inclusion questionnaire. The final Delphi questionnaire included 166 items for each clinical presentation covering assessment, outcome measures, and interventions, for example, education, eye care, neuromuscular retraining, and electrical modalities. Inclusion/exclusion agreement was set at 80%, indicating participant consensus. Items reaching 70-79% were deemed "near-included/near-excluded." Results: Averaged across all presentations, 24.9% of the 166 items were included, (e.g., Sunnybrook Facial Grading System, patient education and neuromuscular retraining), 26.9% of the 166 items were excluded, (e.g., gross strengthening and electrical stimulation); 48.2% were neither included nor excluded. Conclusion: This study brings together the global community's expertise as a first step toward establishing best practice for specialist facial therapy. It is hoped this will guide clinical decision making, advance research, and optimize patient outcomes in this challenging field.
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Affiliation(s)
- Catriona Neville
- Facial Palsy MDT, Queen Victoria Hospital, East Grinstead, United Kingdom
- The Facial Rehabilitation Centre Ltd, United Kingdom
| | - Carien Beurskens
- Department of Physiotherapy, Formerly of Radboud University Medical Centre, Nijmegen, The Netherlands
| | | | - Sara MacDowell
- Franciscan Missionaries of Our Lady Health System, Our Lady of the Lake Regional Medical Centre, Centre for Facial Plastic Surgery, Baton Rouge, Louisiana, USA
| | - Susan Rankin
- Rankin Physiotherapy, Burnaby, British Columbia, Canada
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Kennedy MA, Wood KC, Campbell A, Potiaumpai M, Wilson CM, Schwartz AL, Gorzelitz J, Caru M, Schmitz KH. Identification of core competencies for exercise oncology professionals: A Delphi study of United States and Australian participants. Cancer Med 2024; 13:e70004. [PMID: 39046221 PMCID: PMC11267632 DOI: 10.1002/cam4.70004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 05/13/2024] [Accepted: 06/30/2024] [Indexed: 07/25/2024] Open
Abstract
INTRODUCTION Integration of exercise into standard oncology care requires a highly skilled workforce of exercise professionals; however, competency requirements have not kept pace with advancements in the field. Therefore, the aim of this study was to obtain consensus on core competencies required for an exercise professional to be qualified to work with adults undergoing active cancer treatment. MATERIALS AND METHODS A three-round modified electronic Delphi process was used. In Round 1, an international group of 64 exercise oncology stakeholders (i.e., exercise oncology professionals (n = 29), clinical referrers (n = 21), and people with lived experience (n = 14)) responded to open-ended prompts eliciting perspectives regarding competencies needed for an exercise oncology professional to work with adults receiving active cancer treatment. Subsequently, only exercise oncology professionals participated, ranking the importance of competencies. In Round 2, professionals received summary feedback, ranked new competencies generated from open-ended responses, and reranked competencies not reaching consensus. In the final round, professionals finalized consensus ranking and rated frequency and mastery level for each. RESULTS Consensus was reached on 103 core competencies required for exercise professionals to be qualified to deliver care to adults undergoing active cancer treatment. The core competencies represent 10 content areas and reflect the needs of clinical referrers and people with lived experience of receiving cancer treatment. CONCLUSIONS The core competencies identified reflect significant advancements in the field of exercise oncology. Results will underpin the development of education, certification, and employment requirements for exercise oncology professionals, providing a critical step toward achieving routine integration of exercise into standard oncology care.
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Affiliation(s)
- Mary A. Kennedy
- Nutrition and Health Innovation Research Institute, School of Medical and Health SciencesEdith Cowan UniversityJoondalupWestern AustraliaAustralia
| | | | - Anna Campbell
- School of Applied SciencesEdinburgh Napier UniversityEdinburghUK
| | - Melanie Potiaumpai
- Division of Hematology and OncologyUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Christopher M. Wilson
- Physical Therapy Program, School of Health SciencesOakland UniversityRochesterMichiganUSA
- Founding Residency Program DirectorBeaumont Health Oncology ResidencyTroyMichiganUSA
| | - Anna L. Schwartz
- College of Nursing, University of Nebraska Medical CenterOmahaNebraskaUSA
| | - Jessica Gorzelitz
- Department of Health and Human PhysiologyUniversity of IowaIowa CityIowaUSA
| | - Maxime Caru
- Department of Pediatrics, Division of Hematology and OncologyPennsylvania State Health Children's HospitalHersheyPennsylvaniaUSA
| | - Kathryn H. Schmitz
- Division of Hematology and OncologyUniversity of PittsburghPittsburghPennsylvaniaUSA
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13
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Noebauer-Huhmann IM, Vanhoenacker FM, Vilanova JC, Tagliafico AS, Weber MA, Lalam RK, Grieser T, Nikodinovska VV, de Rooy JWJ, Papakonstantinou O, Mccarthy C, Sconfienza LM, Verstraete K, Martel-Villagrán J, Szomolanyi P, Lecouvet FE, Afonso D, Albtoush OM, Aringhieri G, Arkun R, Aström G, Bazzocchi A, Botchu R, Breitenseher M, Chaudhary S, Dalili D, Davies M, de Jonge MC, Mete BD, Fritz J, Gielen JLMA, Hide G, Isaac A, Ivanoski S, Mansour RM, Muntaner-Gimbernat L, Navas A, O Donnell P, Örgüç Ş, Rennie W, Resano S, Robinson P, Sanal HT, Ter Horst SAJ, van Langevelde K, Wörtler K, Koelz M, Panotopoulos J, Windhager R, Bloem JL. Soft tissue tumor imaging in adults: European Society of Musculoskeletal Radiology-Guidelines 2023-overview, and primary local imaging: how and where? Eur Radiol 2024; 34:4427-4437. [PMID: 38062268 PMCID: PMC11213759 DOI: 10.1007/s00330-023-10425-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 09/08/2023] [Accepted: 09/26/2023] [Indexed: 06/29/2024]
Abstract
OBJECTIVES Early, accurate diagnosis is crucial for the prognosis of patients with soft tissue sarcomas. To this end, standardization of imaging algorithms, technical requirements, and reporting is therefore a prerequisite. Since the first European Society of Musculoskeletal Radiology (ESSR) consensus in 2015, technical achievements, further insights into specific entities, and the revised WHO-classification (2020) and AJCC staging system (2017) made an update necessary. The guidelines are intended to support radiologists in their decision-making and contribute to interdisciplinary tumor board discussions. MATERIALS AND METHODS A validated Delphi method based on peer-reviewed literature was used to derive consensus among a panel of 46 specialized musculoskeletal radiologists from 12 European countries. Statements were scored online by level of agreement (0 to 10) during two iterative rounds. Either "group consensus," "group agreement," or "lack of agreement" was achieved. RESULTS Eight sections were defined that finally contained 145 statements with comments. Overall, group consensus was reached in 95.9%, and group agreement in 4.1%. This communication contains the first part consisting of the imaging algorithm for suspected soft tissue tumors, methods for local imaging, and the role of tumor centers. CONCLUSION Ultrasound represents the initial triage imaging modality for accessible and small tumors. MRI is the modality of choice for the characterization and local staging of most soft tissue tumors. CT is indicated in special situations. In suspicious or likely malignant tumors, a specialist tumor center should be contacted for referral or teleradiologic second opinion. This should be done before performing a biopsy, without exception. CLINICAL RELEVANCE The updated ESSR soft tissue tumor imaging guidelines aim to provide best practice expert consensus for standardized imaging, to support radiologists in their decision-making, and to improve examination comparability both in individual patients and in future studies on individualized strategies. KEY POINTS • Ultrasound remains the best initial triage imaging modality for accessible and small suspected soft tissue tumors. • MRI is the modality of choice for the characterization and local staging of soft tissue tumors in most cases; CT is indicated in special situations. Suspicious or likely malignant tumors should undergo biopsy. • In patients with large, indeterminate or suspicious tumors, a tumor reference center should be contacted for referral or teleradiologic second opinion; this must be done before a biopsy.
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Affiliation(s)
- Iris-Melanie Noebauer-Huhmann
- Department of Biomedical Imaging and Image Guided Therapy, Division of Neuroradiology and Musculoskeletal Radiology, Medical University of Vienna, Vienna, Austria.
| | - Filip M Vanhoenacker
- Department of Radiology AZ Sint Maarten Mechelen, University Hospital Antwerp, Antwerp, Belgium
- Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium
| | - Joan C Vilanova
- Department of Radiology, Clínica Girona, Institute of Diagnostic Imaging (IDI) Girona, University of Girona, Girona, Spain
| | - Alberto S Tagliafico
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
- Department of Radiology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Marc-André Weber
- Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Center Rostock, Rostock, Germany
| | - Radhesh K Lalam
- Department of Radiology, Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, UK
| | - Thomas Grieser
- Dept. for Diagnostic and Interventional, Radiology University Hospital Augsburg, Augsburg, Germany
| | - Violeta Vasilevska Nikodinovska
- Medical Faculty, Ss. Cyril and Methodius University, Skopje, Macedonia
- Department of Radiology, University Surgical Clinic "St. Naum Ohridski" Skopje, Skopje, Macedonia
| | - Jacky W J de Rooy
- Department of Imaging, Radiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Olympia Papakonstantinou
- 2Nd Department of Radiology, Attikon Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Catherine Mccarthy
- Oxford Musculoskeletal Radiology and Oxford University Hospitals, Oxford, UK
| | - Luca Maria Sconfienza
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
- Dipartimento Di Scienze Biomediche Per La Salute, Università Degli Studi Di Milano, Milan, Italy
| | | | | | - Pavol Szomolanyi
- High Field MR Center, Department of Biomedical Imaging and Image-Guided Therapy, Medical University Vienna, Vienna, Austria
- Department of Imaging Methods, Institute of Measurement Science, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Frédéric E Lecouvet
- Department of Radiology and Medical Imaging, Cliniques Universitaires Saint Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain (UCLouvain), Brussels, Belgium
| | - Diana Afonso
- Hospital Particular da Madeira, and Hospital da Luz Lisboa, Lisbon, Portugal
| | - Omar M Albtoush
- Department of Radiology, University of Jordan, Ammam, Jordan
| | - Giacomo Aringhieri
- Academic Radiology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Remide Arkun
- Ege University Medical School Izmir, Izmir, Turkey Star Imaging Center Izmir, Izmir, Turkey
| | - Gunnar Aström
- Department of Immunology, Genetics and Pathology (Oncology) and Department of Surgical Sciences (Radiology), Uppsala University, Uppsala, Sweden
| | - Alberto Bazzocchi
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Rajesh Botchu
- Department of Musculoskeletal Radiology, Royal Orthopedic Hospital, Birmingham, UK
| | | | | | - Danoob Dalili
- Academic Surgical Unit, South West London Elective Orthopaedic Centre (SWLEOC), London, UK
| | - Mark Davies
- Department of Musculoskeletal Radiology, Royal Orthopedic Hospital, Birmingham, UK
| | - Milko C de Jonge
- Department of Radiology, St. Antonius Hospital, Utrecht, The Netherlands
| | - Berna D Mete
- Department of Radiology School of Medicine, Izmir Demokrasi University, Izmir, Turkey
| | - Jan Fritz
- Department of Radiology, NYU Grossman School of Medicine, New York, USA
- Diagnostic and Interventional Radiology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, Tübingen, Germany
| | - Jan L M A Gielen
- Department of Radiology and Medical Imaging, University Hospital Antwerp, Edegem, Belgium
| | - Geoff Hide
- Department of Radiology, Freeman Hospital, Newcastle Upon Tyne, UK
| | - Amanda Isaac
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Slavcho Ivanoski
- St. Erasmo Hospital for Orthopaedic Surgery and Traumatology Ohrid, Ohrid, Macedonia
| | | | | | - Ana Navas
- Department of Radiology, Division of Musculoskeletal Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | | | | | - Winston Rennie
- Clinical MSK Radiology, Loughborough University, Leicester Royal Infirmary, Leicester, UK
| | | | - Philip Robinson
- Musculoskeletal Radiology Department Chapel Allerton Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK
- NIHR Leeds Biomedical Research Centre, Leeds, UK
| | - Hatice T Sanal
- Radiology Department, University of Health Sciences, Gülhane Training and Research Hospital, Istanbul, Turkey
| | - Simone A J Ter Horst
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands Department of Radiology and Nuclear Medicine, University Medical Centre Utrecht, Utrecht, The Netherlands
| | | | - Klaus Wörtler
- Musculoskeletal Radiology Section, Klinikum Rechts der Isar, Technical University of Munich - TUM School of Medicine, Munich, Germany
| | - Marita Koelz
- Clinical Institute of Pathology, Medical University of Vienna, Vienna, Austria
| | - Joannis Panotopoulos
- Departement of Orthopaedics and Traumatology, Division of Orthopaedics, Medical University of Vienna, Vienna, Austria
| | - Reinhard Windhager
- Departement of Orthopaedics and Traumatology, Medical University of Vienna, Vienna, Austria
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Jeon H, Shin H, Muratbekova M, Zhamankulova M. Policy suggestions for improving nursing education in a low- and middle-income country: A modified Delphi study. Nurs Outlook 2024; 72:102222. [PMID: 38908293 DOI: 10.1016/j.outlook.2024.102222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 05/12/2024] [Accepted: 05/21/2024] [Indexed: 06/24/2024]
Abstract
BACKGROUND Health policy critically influences a national healthcare system and nurse's roles, working conditions, and professional development opportunities, especially in low- and middle-income countries. PURPOSE To explore and prioritize the major challenges and solution, and establish policy directions for improving nursing education in the Kyrgyz Republic. METHODS The key stakeholders of nursing practice, education, policymaking, and regulation were involved in this modified Delphi study. Following two rounds of exploring priority issues and potential strategies, the participants of the final round assembled for consensual discussions on the establishment of policy directions. DISCUSSION Innovations in nursing education systems, building educational capacity, and ensuring educational outcomes were suggested and agreed upon for the sequential improvement of nursing education. Timely enactment of these policies will enable the Kyrgyz Republic to mitigate nursing shortages, improve the quality of healthcare services, and enhance overall public health outcomes. CONCLUSION The policy suggestions derived from this study, including the improvement of nursing education quality and the assurance of nurses' competencies, have great potential for improving quality healthcare practice and sustaining an effective healthcare system.
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Affiliation(s)
- Hyejin Jeon
- College of Nursing Science, Kyung Hee University, Seoul, Republic of Korea
| | - Hyunsook Shin
- College of Nursing Science, Kyung Hee University, Seoul, Republic of Korea.
| | - Medina Muratbekova
- College of Nursing Science, Kyung Hee University, Seoul, Republic of Korea
| | - Madina Zhamankulova
- Department of Nursing, I. K. Akhunbaev Kyrgyz State Medical Academy, Bishkek, Kyrgyz Republic
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Boncheva P, Dokova K. Cultural adaptation of a self-review tool for health promoting universities in Bulgaria. Front Public Health 2024; 12:1399793. [PMID: 38962785 PMCID: PMC11220526 DOI: 10.3389/fpubh.2024.1399793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 06/04/2024] [Indexed: 07/05/2024] Open
Abstract
Introduction The Health Promoting University initiative is unknown in Bulgaria, and the health promotion potential of Bulgarian universities has not been studied. In order to examine it, a suitable instrument is needed. The UK Healthy Universities Network provides an accessible Self-Review-Tool (SRT). Aim: To present the process of cultural adaptation of the SRT in Bulgarian language. Methods The standardized WHO methodology for cultural adaptation of instruments was followed in four stages: (1) Two language translations of the instrument into Bulgarian were made; (2) An expert Delphi discussion reached a consensus on specific health promoting (HP) terms, followed by a backward translation; (3) Pilot testing of the tool among university community representatives was conducted through a survey among a small sample, with independent responses to the SRT questionnaire followed by cognitive interviews; (4) Final revision of the instrument. Results Ten public health experts reached a consensus on the name of the initiative and various HP terms. Ten other respondents pre-tested the tool. Difficulties in responding the SRT concerned the meaning of some HP terms, complex words, the system of answers, limited applicability of some statements. Changes were made to 61 of the total 68 elements in the SRT. Conclusion All stages of the cultural adaptation were important for the final result. The adapted Bulgarian version of the SRT would be useful to Bulgarian universities that want to make a clear commitment to improving the health of their university community and the wider society.
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Nielsen MS, Steinsbekk A, Nøst TH. Development of Recommendations for the Digital Sharing of Notes With Adolescents in Mental Health Care: Delphi Study. JMIR Ment Health 2024; 11:e57965. [PMID: 38860592 PMCID: PMC11185290 DOI: 10.2196/57965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 04/18/2024] [Accepted: 04/24/2024] [Indexed: 06/12/2024] Open
Abstract
Background In many countries, health care professionals are legally obliged to share information from electronic health records with patients. However, concerns have been raised regarding the sharing of notes with adolescents in mental health care, and health care professionals have called for recommendations to guide this practice. Objective The aim was to reach a consensus among authors of scientific papers on recommendations for health care professionals' digital sharing of notes with adolescents in mental health care and to investigate whether staff at child and adolescent specialist mental health care clinics agreed with the recommendations. Methods A Delphi study was conducted with authors of scientific papers to reach a consensus on recommendations. The process of making the recommendations involved three steps. First, scientific papers meeting the eligibility criteria were identified through a PubMed search where the references were screened. Second, the results from the included papers were coded and transformed into recommendations in an iterative process. Third, the authors of the included papers were asked to provide feedback and consider their agreement with each of the suggested recommendations in two rounds. After the Delphi process, a cross-sectional study was conducted among staff at specialist child and adolescent mental health care clinics to assess whether they agreed with the recommendations that reached a consensus. Results Of the 84 invited authors, 27 responded. A consensus was reached on 17 recommendations on areas related to digital sharing of notes with adolescents in mental health care. The recommendations considered how to introduce digital access to notes, write notes, and support health care professionals, and when to withhold notes. Of the 41 staff members at child and adolescent specialist mental health care clinics, 60% or more agreed with the 17 recommendations. No consensus was reached regarding the age at which adolescents should receive digital access to their notes and the timing of digitally sharing notes with parents. Conclusions A total of 17 recommendations related to key aspects of health care professionals' digital sharing of notes with adolescents in mental health care achieved consensus. Health care professionals can use these recommendations to guide their practice of sharing notes with adolescents in mental health care. However, the effects and experiences of following these recommendations should be tested in clinical practice.
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Affiliation(s)
- Martine Stecher Nielsen
- Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Aslak Steinsbekk
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Norwegian Centre for E-health Research, Tromsø, Norway
| | - Torunn Hatlen Nøst
- Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Clinic of Anaesthesia and Intensive Care, Clinical Research Facility, St. Olavs hospital, Trondheim, Norway
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Grant S, Smart R. ROMPER: The RAND/USC OPTIC Method for Policy Expert Ratings. MethodsX 2024; 12:102751. [PMID: 38799036 PMCID: PMC11127521 DOI: 10.1016/j.mex.2024.102751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 05/07/2024] [Indexed: 05/29/2024] Open
Abstract
We developed an expert panel approach for identifying expert views on the effectiveness and implementability of population-level policy interventions. ROMPER-the RAND/USC OPTIC Method for Policy Expert Ratings-involves an online, three-round, modified-Delphi process:•Experts rate and comment on policies according to domains of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) Evidence-to-Decision framework.•To identify consensus on policy effectiveness and implementability, expert ratings are analyzed using the Inter-Percentile Range Adjusted for Symmetry (IPRAS) technique from the RAND/UCLA Appropriateness Method and visualized using a forest plot. To explain consensus, expert comments are analyzed using reflexive thematic analysis and reported following the Standards for Reporting Qualitative Research.•To provide actionable information for decisionmakers, each policy is summarized in a "Policy Profile" adapted from GRADEPro Evidence-to-Decision tables.We validated ROMPER in two studies that successfully recruited the targeted sample size, retained experts through all three rounds, and examined consensus on which policies are (not) effective and implementable. ROMPER protocols, materials, data, and code are openly available on the Open Science Framework with Creative Commons licensing for replication and reuse. ROMPER provides a validated, replicable, open access approach for eliciting expert views on both policy effectiveness and implementability-and for summarizing (lack of) consensus specifically for policymakers.
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Affiliation(s)
- Sean Grant
- RAND Corporation, 1776 Main St, Santa Monica, CA 90401, USA
- HEDCO Institute for Evidence-Based Educational Practice, College of Education, University of Oregon, 1215 University of Oregon, Eugene, OR 97403-1215, USA
| | - Rosanna Smart
- RAND Corporation, 1776 Main St, Santa Monica, CA 90401, USA
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Ou C, Daly Z, Carter M, Hall WA, Zusman EZ, Russolillo A, Duffy S, Jenkins E. Developing consensus to enhance perinatal mental health through a model of integrated care: Delphi study. PLoS One 2024; 19:e0303012. [PMID: 38722862 PMCID: PMC11081323 DOI: 10.1371/journal.pone.0303012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 04/17/2024] [Indexed: 05/13/2024] Open
Abstract
Perinatal mental illness is an important public health issue, with one in five birthing persons experiencing clinically significant symptoms of anxiety and/or depression during pregnancy or the postpartum period. The purpose of this study was to develop a consensus-based model of integrated perinatal mental health care to enhance service delivery and improve parent and family outcomes. We conducted a three-round Delphi study using online surveys to reach consensus (≥75% agreement) on key domains and indicators of integrated perinatal mental health care. We invited modifications to indicators and domains during each round and shared a summary of results with participants following rounds one and two. Descriptive statistics were generated for quantitative data and a thematic analysis of qualitative data was undertaken. Study participants included professional experts in perinatal mental health (e.g., clinicians, researchers) (n = 36) and people with lived experience of perinatal mental illness within the past 5 years from across Canada (e.g., patients, family members) (n = 11). Consensus was reached and all nine domains of the proposed model for integrated perinatal mental health care were retained. Qualitative results informed the modification of indicators and development of an additional domain and indicators capturing the need for antiracist, culturally safe care. The development of an integrated model of perinatal mental health benefitted from diverse expertise to guide the focus of included domains and indicators. Engaging in a consensus-building process helps to create the conditions for change within health services.
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Affiliation(s)
- Christine Ou
- School of Nursing, University of Victoria, Victoria, Canada
| | - Zachary Daly
- School of Nursing, University of British Columbia, Vancouver, Canada
- Wellstream: The Canadian Centre for Innovation in Child and Youth Mental Health and Substance Use, Vancouver, Canada
| | - Michelle Carter
- School of Nursing, University of British Columbia, Vancouver, Canada
- Wellstream: The Canadian Centre for Innovation in Child and Youth Mental Health and Substance Use, Vancouver, Canada
- St. Paul’s Hospital, Providence Healthcare, Vancouver, Canada
| | - Wendy A. Hall
- School of Nursing, University of British Columbia, Vancouver, Canada
| | - Enav Z. Zusman
- Department of Obstetrics & Gynaecology, University of British Columbia, Vancouver, BC, Canada
| | - Angela Russolillo
- St. Paul’s Hospital, Providence Healthcare, Vancouver, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Sheila Duffy
- Pacific Post Partum Support Society, Burnaby, BC, Canada
| | - Emily Jenkins
- School of Nursing, University of British Columbia, Vancouver, Canada
- Wellstream: The Canadian Centre for Innovation in Child and Youth Mental Health and Substance Use, Vancouver, Canada
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Marvaso G, Jereczek-Fossa BA, Zaffaroni M, Vincini MG, Corrao G, Andratschke N, Balagamwala EH, Bedke J, Blanck O, Capitanio U, Correa RJM, De Meerleer G, Franzese C, Gaeta A, Gandini S, Garibaldi C, Gerszten PC, Gillessen S, Grubb WR, Guckenberger M, Hannan R, Jhaveri PM, Josipovic M, Kerkmeijer LGW, Lehrer EJ, Lindskog M, Louie AV, Nguyen QN, Ost P, Palma DA, Procopio G, Rossi M, Staehler M, Tree AC, Tsang YM, Van As N, Zaorsky NG, Zilli T, Pasquier D, Siva S. Delphi consensus on stereotactic ablative radiotherapy for oligometastatic and oligoprogressive renal cell carcinoma-a European Society for Radiotherapy and Oncology study endorsed by the European Association of Urology. Lancet Oncol 2024; 25:e193-e204. [PMID: 38697165 DOI: 10.1016/s1470-2045(24)00023-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 01/09/2024] [Accepted: 01/11/2024] [Indexed: 05/04/2024]
Abstract
The purpose of this European Society for Radiotherapy and Oncology (ESTRO) project, endorsed by the European Association of Urology, is to explore expert opinion on the management of patients with oligometastatic and oligoprogressive renal cell carcinoma by means of stereotactic ablative radiotherapy (SABR) on extracranial metastases, with the aim of developing consensus recommendations for patient selection, treatment doses, and concurrent systemic therapy. A questionnaire on SABR in oligometastatic renal cell carcinoma was prepared by a core group and reviewed by a panel of ten prominent experts in the field. The Delphi consensus methodology was applied, sending three rounds of questionnaires to clinicians identified as key opinion leaders in the field. At the end of the third round, participants were able to find consensus on eight of the 37 questions. Specifically, panellists agreed to apply no restrictions regarding age (25 [100%) of 25) and primary renal cell carcinoma histology (23 [92%] of 25) for SABR candidates, on the upper threshold of three lesions to offer ablative treatment in patients with oligoprogression, and on the concomitant administration of immune checkpoint inhibitor. SABR was indicated as the treatment modality of choice for renal cell carcinoma bone oligometatasis (20 [80%] of 25) and for adrenal oligometastases 22 (88%). No consensus or major agreement was reached regarding the appropriate schedule, but the majority of the poll (54%-58%) retained the every-other-day schedule as the optimal choice for all the investigated sites. The current ESTRO Delphi consensus might provide useful direction for the application of SABR in oligometastatic renal cell carcinoma and highlight the key areas of ongoing debate, perhaps directing future research efforts to close knowledge gaps.
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Affiliation(s)
- Giulia Marvaso
- Division of Radiation Oncology, European Institute of Oncology, IRCCS, Milan, Italy; Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
| | - Barbara Alicja Jereczek-Fossa
- Division of Radiation Oncology, European Institute of Oncology, IRCCS, Milan, Italy; Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
| | - Mattia Zaffaroni
- Division of Radiation Oncology, European Institute of Oncology, IRCCS, Milan, Italy.
| | - Maria Giulia Vincini
- Division of Radiation Oncology, European Institute of Oncology, IRCCS, Milan, Italy
| | - Giulia Corrao
- Division of Radiation Oncology, European Institute of Oncology, IRCCS, Milan, Italy
| | - Nicolaus Andratschke
- Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Ehsan H Balagamwala
- Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Jens Bedke
- Department of Urology and Transplantation surgery, Klinikum Stuttgart, Stuttgart, Germany
| | - Oliver Blanck
- Department of Radiation Oncology, University Medical Center Schleswig Holstein, Kiel, Germany
| | - Umberto Capitanio
- IRCCS San Raffaele Scientific Institute, Milan, Italy; University Vita-Salute San Raffaele, Milan, Italy
| | - Rohann J M Correa
- Department of Radiation Oncology, London Health Sciences Centre, London, ON, Canada
| | - Gert De Meerleer
- Department of Radiation Oncology, Leuven University Hospitals, Leuven, Belgium
| | - Ciro Franzese
- Department of Radiotherapy and Radiosurgery, IRCCS Humanitas Research Hospital, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Aurora Gaeta
- Department of Experimental Oncology, European Institute of Oncology, IRCCS, Milan, Italy
| | - Sara Gandini
- Department of Experimental Oncology, European Institute of Oncology, IRCCS, Milan, Italy
| | - Cristina Garibaldi
- Unit of Radiation Research, European Institute of Oncology, IRCCS, Milan, Italy
| | - Peter C Gerszten
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, USA
| | - Silke Gillessen
- Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland; Università della Svizzera Italiana, Lugano, Switzerland
| | - William R Grubb
- Department of Radiation Oncology, Augusta University Medical Center, Augusta, GA, USA
| | - Matthias Guckenberger
- Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Raquibul Hannan
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Pavan M Jhaveri
- Department of Radiation Oncology, Baylor College of Medicine, Houston, TX, USA
| | - Mirjana Josipovic
- Section of Radiotherapy, Department of Oncology, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, Copenhagen University Hospital, Copenhagen, Denmark
| | - Linda G W Kerkmeijer
- Department of Radiation Oncology, Radboud University Medical Centre, Nijmegen, Netherlands
| | - Eric J Lehrer
- Department of Radiation Oncology, Mayo Clinic, Rochester, MN, USA
| | - Magnus Lindskog
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden; Department of Pelvic Cancer, Section of Genitourinary Oncology, Karolinska University Hospital, Stockholm, Sweden
| | - Alexander V Louie
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Quynh-Nhu Nguyen
- Departments of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Piet Ost
- Department of Human Structure and Repair, Ghent University, Ghent, Belgium and Department of Radiation Oncology, Iridium Network, Antwerp, Belgium
| | - David A Palma
- Department of Radiation Oncology, London Health Sciences Centre, London, ON, Canada
| | - Giuseppe Procopio
- Dipartimento Di Oncologia Medica, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Maddalena Rossi
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Michael Staehler
- Interdisciplinary Centre on Renal Tumours, University of Munich, Munich, Germany
| | - Alison C Tree
- Department of Urology, The Institute of Cancer Research, London, UK; The Royal Marsden NHS Foundation Trust, Sutton, Surrey, UK
| | - Yat Man Tsang
- Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Nicholas Van As
- Department of Urology, The Institute of Cancer Research, London, UK; The Royal Marsden NHS Foundation Trust, Sutton, Surrey, UK; The Institute of Cancer Research, London, UK
| | - Nicholas G Zaorsky
- University Hospitals Seidman Cancer Center and Case Western Reserve University, Cleveland, OH, USA
| | - Thomas Zilli
- Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland; Università della Svizzera Italiana, Lugano, Switzerland
| | - David Pasquier
- Academic Department of Radiation Oncology, Centre O Lambret, Lille, France; University of Lille, Centrale Lille, CNRS, UMR 9189-CRIStAL, Lille, France
| | - Shankar Siva
- Peter MacCallum Cancer Centre, Department of Radiation Oncology, University of Melbourne, Parkville, VIC, Australia; Faculty of Medicine, University of Melbourne, Parkville, VIC, Australia
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Oto B, Baeten R, Chen L, Dalal P, Dancel R, Fox S, Lange IV CW, Baston C, Bornemann P, Dugar S, Goldsmith A, Herbst MK, Kirkpatrick JN, Koratala A, Lanspa MJ, Lobo V, Nomura JT, Pustavoitau A, Senussi MH, Sorrell VL, West FM, Sarwal A. Best Practices for Point of Care Ultrasound: An Interdisciplinary Expert Consensus. POCUS JOURNAL 2024; 9:95-108. [PMID: 38681157 PMCID: PMC11044939 DOI: 10.24908/pocus.v9i1.17240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
Despite the growing use of point of care ultrasound (POCUS) in contemporary medical practice and the existence of clinical guidelines addressing its specific applications, there remains a lack of standardization and agreement on optimal practices for several areas of POCUS use. The Society of Point of Care Ultrasound (SPOCUS) formed a working group in 2022 to establish a set of recommended best practices for POCUS, applicable to clinicians regardless of their training, specialty, resource setting, or scope of practice. Using a three-round modified Delphi process, a multi-disciplinary panel of 22 POCUS experts based in the United States reached consensus on 57 statements in domains including: (1) The definition and clinical role of POCUS; (2) Training pathways; (3) Credentialing; (4) Cleaning and maintenance of POCUS devices; (5) Consent and education; (6) Security, storage, and sharing of POCUS studies; (7) Uploading, archiving, and reviewing POCUS studies; and (8) Documenting POCUS studies. The consensus statements are provided here. While not intended to establish a standard of care or supersede more targeted guidelines, this document may serve as a useful baseline to guide clinicians, leaders, and systems considering initiation or enhancement of POCUS programs.
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Affiliation(s)
- Brandon Oto
- Bridgeport Hospital, Yale New Haven HealthBridgeport, CTUSA
| | | | - Leon Chen
- Memorial Sloan Kettering Cancer CenterNew York, NYUSA
| | | | - Ria Dancel
- University of North Carolina at Chapel HillChapel Hill, NCUSA
| | - Steven Fox
- University of Alabama at BirminghamBirmingham, ALUSA
| | | | | | | | | | | | | | | | | | - Michael J Lanspa
- Intermountain Medical Center and the University of UtahMurray , UTUSA
| | - Viveta Lobo
- Stanford University School of MedicineStanford, CAUSA
| | | | | | | | - Vincent L. Sorrell
- Gill Heart and Vascular Institute, University of KentuckyLexington, KYUSA
| | | | - Aarti Sarwal
- Wake Forest University School of MedicineWinston-Salem, NCUSA
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Bautista C, Vyas MB, Daniels L, Guanci M, Rhudy L. Essential Components of a Neuroscience Nursing Orientation: A Delphi Study. J Neurosci Nurs 2024; 56:49-53. [PMID: 38416414 DOI: 10.1097/jnn.0000000000000748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
ABSTRACT BACKGROUND: The essential components of an effective neuroscience nurse orientation program for those caring for the adult general care population have not been well defined or standardized. METHODS : Using a 2-round, modified Delphi methodology, electronic surveys were distributed to 53 experts in neuroscience nursing orientation to gain consensus on the essential components of orientation for the neuroscience nurse. Survey data included demographics of the expert, literature-based components of neuroscience nurse orientation, and an opportunity to agree/disagree or write in additional components. RESULTS : Round 1 of the consensus survey elicited a response rate of 55% (29/53), and round 2 had a 51% (27/53) response rate. On the basis of round 1 expert responses, 4 new orientation components were added, and 36 components of a neuroscience nursing orientation were revised to include only the elements with ≥75% agreement. Twenty-two elements in round 2 met the criteria of ≥75% very important and important to include as components of a neuroscience nursing orientation. CONCLUSION : An expert consensus was reached on the necessary components of a neuroscience nursing orientation. The identified neuroscience nursing orientation components concentrated on improving nursing practice and provision of care to adult neuroscience patients. This study demonstrates priority components within a standardized orientation program for neuroscience nurses based on literature and expert consensus. A comprehensive neuroscience nursing orientation is a vital step in sustaining high-quality care for patients and improving neurological outcomes.
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Djurtoft C, Bruun MK, Riel H, Hoegh MS, Darlow B, Rathleff MS. How do we explain painful non-traumatic knee conditions to adolescents? A multiple-method study to develop credible explanations. Eur J Pain 2024; 28:659-672. [PMID: 37987218 DOI: 10.1002/ejp.2210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 09/19/2023] [Accepted: 11/07/2023] [Indexed: 11/22/2023]
Abstract
BACKGROUND Perceived diagnostic uncertainty can leave adolescents confused about their condition and impede their ability to understand "what's wrong with me". Our aim is to develop credible explanations about the condition for adolescents suffering from non-traumatic knee pain. METHODS This multiple-method study integrated findings from two systematic literature searches of qualitative and quantitative studies, an Argumentative Delphi with international experts (n = 16) and think-aloud interviews with adolescents (n = 16). Experts provided feedback with arguments on how to communicate credible explanations to meet adolescents' needs; we analysed feedback using thematic analysis. The explanations were tailored based on the adolescent end-users' input. RESULTS We screened 3239 titles/abstracts and included 16 papers exploring diagnostic uncertainty from adolescents' and parents' perspectives. Five themes were generated: (1) understanding causes and contributors to the pain experience, (2) feeling stigmatized for having an invisible condition, (3) having a name for pain, (4) controllability of pain, and (5) worried about something being missed. The Argumentative Delphi identified the following themes: (1) multidimensional perspective, (2) tailored to adolescents, (3) validation and reassurance, and (4) careful wording. Merging findings from the systematic search and the Delphi developed three essential domains to address in credible explanations: "What is non-traumatic knee pain and what does it mean?", "What is causing my knee pain?" and "How do I manage my knee pain?" CONCLUSIONS Six credible explanations for the six most common diagnoses of non-traumatic knee pain were developed. We identified three domains to consider when tailoring credible explanations to adolescents experiencing non-traumatic knee pain. SIGNIFICANCE This study provides credible explanations for the six most common diagnoses of non-traumatic knee pain. Additionally, we identified three key domains that may need to be addressed to reduce diagnostic uncertainty in adolescents suffering from pain complaints. Based on our findings, we believe that clinicians will benefit from exploring adolescents' own perceptions of why they experience pain and perceived management strategies, as this information might capture important clinical information when managing these young individuals.
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Affiliation(s)
- C Djurtoft
- Center for General Practice at Aalborg University, Aalborg, Denmark
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - M K Bruun
- Center for General Practice at Aalborg University, Aalborg, Denmark
| | - H Riel
- Center for General Practice at Aalborg University, Aalborg, Denmark
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
- Department of Physiotherapy, University College of Northern Denmark, Aalborg, Denmark
| | - M S Hoegh
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - B Darlow
- Department of Primary Health Care and General Practice, University of Otago, Wellington, New Zealand
| | - M S Rathleff
- Center for General Practice at Aalborg University, Aalborg, Denmark
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark
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Jung A, Braun T, Armijo-Olivo S, Challoumas D, Luedtke K. Consensus on the definition and assessment of external validity of randomized controlled trials: A Delphi study. Res Synth Methods 2024; 15:288-302. [PMID: 38146072 DOI: 10.1002/jrsm.1688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 08/25/2023] [Accepted: 11/20/2023] [Indexed: 12/27/2023]
Abstract
External validity is an important parameter that needs to be considered for decision making in health research, but no widely accepted measurement tool for the assessment of external validity of randomized controlled trials (RCTs) exists. One of the most limiting factors for creating such a tool is probably the substantial heterogeneity and lack of consensus in this field. The objective of this study was to reach consensus on a definition of external validity and on criteria to assess the external validity of RCTs included in systematic reviews. A three-round online Delphi study was conducted. The development of the Delphi survey was based on findings from a previous systematic review. Potential panelists were identified through a comprehensive web search. Consensus was reached when at least 67% of the panelists agreed to a proposal. Eighty-four panelists from different countries and various disciplines participated in at least one round of this study. Consensus was reached on the definition of external validity ("External validity is the extent to which results of trials provide an acceptable basis for generalization to other circumstances such as variations in populations, settings, interventions, outcomes, or other relevant contextual factors"), and on 14 criteria to assess the external validity of RCTs in systematic reviews. The results of this Delphi study provide a consensus-based reference standard for future tool development. Future research should focus on adapting, pilot testing, and validating these criteria to develop measurement tools for the assessment of external validity.
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Affiliation(s)
- Andres Jung
- Department of Physiotherapy, Pain and Exercise Research Luebeck (P.E.R.L), Institute of Health Sciences, Universität zu Lübeck, Lübeck, Germany
- Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Tobias Braun
- Department of Applied Health Sciences, Division of Physiotherapy, Hochschule für Gesundheit (University of Applied Sciences), Bochum, Germany
- Department of Health, HSD Hochschule Döpfer (University of Applied Sciences), Cologne, Germany
| | - Susan Armijo-Olivo
- Faculty of Business and Social Sciences, Hochschule Osnabrück-University of Applied Sciences, Osnabrück, Germany
- Faculty of Rehabilitation Medicine, Department of Physical Therapy, Rehabilitation Research Center, University of Alberta, Edmonton, Alberta, Canada
| | - Dimitris Challoumas
- Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK
| | - Kerstin Luedtke
- Department of Physiotherapy, Pain and Exercise Research Luebeck (P.E.R.L), Institute of Health Sciences, Universität zu Lübeck, Lübeck, Germany
- Center of Brain, Behavior and Metabolism (CBBM), Universität zu Lübeck, Lübeck, Germany
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Islam F, Heeren P, Yang K, Milisen K, Sabbe M. Identifying key items to be addressed by non-clinical operators to manage out-of-hours telephone triage services for older adults seeking non-urgent unplanned care in Belgium: an e-Delphi study. BMC Health Serv Res 2024; 24:189. [PMID: 38341533 PMCID: PMC10858535 DOI: 10.1186/s12913-024-10657-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 01/30/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND This study aimed to achieve expert consensus regarding key items to be addressed by non-clinical operators using computer-software integrated medical dispatch protocols to manage out-of-hours telephone triage (OOH-TT) services for calls involving older adults seeking non-urgent unplanned care across Belgium. METHODS A three-part classic e-Delphi study was conducted. A purposive sample of experts specialized in out-of-hours unplanned care and/or older persons across Belgium were recruited as panelists. Eligibility criteria included experts with at least 2 years of relevant experience. Level of consensus was defined to be reached when at least 70% of the panelists agreed or disagreed regarding the value of each item proposed within a survey for the top 10 most frequently used protocols for triaging older adults. Responses were analyzed over several rounds until expert consensus was found. Descriptive and thematic analyses were used to aggregate responses. RESULTS N = 12 panelists agreed that several important missing protocol topics were not covered by the existing OOH-TT service. They also agreed about the nature of use (for the top 10 most frequently used protocols) but justified that some modifications should be made to keywords, interrogation questions, degree of urgency and/or flowcharts used for the algorithms to help operators gain better comprehensive understanding patient profiles, medical habits and history, level of support from informal caregivers, known comorbidities and frailty status. Furthermore, panelists also stressed the importance of considering feasibility in implementing protocols within the real-world setting and prioritizing the right type of training for operators which can facilitate the delivery of high-quality triage. Overall, consensus was found for nine of the top 10 most frequently used protocols for triaging older adults with no consensus found for the protocol on triaging patients unwell for no apparent reason. CONCLUSION Our findings show that overall, a combination of patient related factors must be addressed to provide high quality triage for adults seeking non-urgent unplanned care over the telephone (in addition to age). However, further elements such as appropriate operator training and feasibility of implementing more population-specific protocols must also be considered. This study presents a useful step towards identifying key items which must be targeted within the larger scope of providing non-urgent out-of-hours telephone triage services for older adults seeking non-urgent unplanned care.
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Affiliation(s)
- Farah Islam
- Department of Public Health and Primary Care, KU Leuven Kapucijnenvoer 35, 3000, Leuven, Belgium
| | - Pieter Heeren
- Department of Public Health and Primary Care, KU Leuven Kapucijnenvoer 35, 3000, Leuven, Belgium
- Department of Geriatric Medicine, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Kelu Yang
- Department of Public Health and Primary Care, KU Leuven Kapucijnenvoer 35, 3000, Leuven, Belgium
| | - Koen Milisen
- Department of Public Health and Primary Care, KU Leuven Kapucijnenvoer 35, 3000, Leuven, Belgium.
- Department of Geriatric Medicine, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium.
| | - Marc Sabbe
- Department of Public Health and Primary Care, KU Leuven Kapucijnenvoer 35, 3000, Leuven, Belgium
- Department of Emergency Medicine, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
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Wollesen B, Herden M, Lamberti N, Giannaki CD. Defining and reporting exercise intensity in interventions for older adults: a modified Delphi process. Eur Rev Aging Phys Act 2024; 21:3. [PMID: 38302886 PMCID: PMC10835929 DOI: 10.1186/s11556-024-00337-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 01/14/2024] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND Many exercise studies, including older adults, do not report all relevant exercise characteristics. Especially the description of exercise intensity is missing and mostly not controlled. This leads to difficulties in interpreting study results and summarizing the evidence in systematic reviews or meta-analyses. Therefore, the aim of the present Delphi study was to gain recommendations about the categorization of exercise intensity and for the conducting and reporting of characteristics in future intervention studies with older adults by experts in exercise science and physiology. METHODS Two hundred ninety-seven international interdisciplinary participants from an EU COST action were invited to participate in three rounds of online questionnaires in April/May 2023. Up to N = 93 experts participated in each round. Round 1 included open-ended questions to solicit possible recommendations and categorizations for light, moderate, vigorous, and high intensity. In round 2, the experts rated their agreement using Likert scales (1-10) on the revealed categories and recommendations. Clusters with a higher average rating of M = 8.0 were summarized into round 3. In the final round, the results were presented for a final rating of agreement (based on a simple majority > 50%). RESULTS In round 1 a total of 416 qualitative statements were provided from thirteen questions. From round 1 to round 3, a total of 38 items were excluded, with 205 items retained for the final consensus. In round three 37 participants completed the whole questionnaire. The experts showed overall agreement on the final categorizations with 6.7 to 8.8 out of 10 points on the Likert scale. They also showed broad consensus on the relevance of reporting exercise intensity and the recommendations for future conducting and reporting of study results. However, exercise types such as yoga, balance, and coordination training led to conflicting results for categorization into light or moderate. DISCUSSION AND IMPLICATIONS The results of the current survey can be used to classify the intensity of exercise and suggest a practical approach that can be adopted by the scientific community and applied when conducting systematic reviews and meta-analysis articles when vital and objective information regarding exercise intensity is lacking from the original article.
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Affiliation(s)
- Bettina Wollesen
- Institute of Human Movement Science, University of Hamburg, Hamburg, Germany.
| | - Mona Herden
- Institute of Human Movement Science, University of Hamburg, Hamburg, Germany
| | - Nicola Lamberti
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Christoforos D Giannaki
- Department of Life Sciences, School of Life and Health Sciences, University of Nicosia, Nicosia, Cyprus
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Aslan T, Gozum S. Development of family health nursing certificate program for Turkey: Delphi study. NURSE EDUCATION TODAY 2024; 133:106045. [PMID: 38029693 DOI: 10.1016/j.nedt.2023.106045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 11/10/2023] [Accepted: 11/13/2023] [Indexed: 12/01/2023]
Abstract
BACKGROUND There are 26,252 family medicine units and the same number of family health workers in Türkiye. However, the educational standards and professional identities of these employees differ from international definitions. OBJECTIVES The aim of the study was to create a draft Family Health Nursing Certificate Program using the Delphi consensus technique. METHODS The study was conducted both online and face to face from 15 March to 25 May 2022. The research encompassed academic nurses working in the field of family health nursing and family health workers working in family health centres in Türkiye. Two rounds of the Delphi survey were undertaken. The first was completed by 38 experts and the second by 35 experts. Definition, title, education level, duties, and responsibilities of the family health nurse, along with consensus regarding the necessary certification, screening, follow-up and practices among family health nurses, were evaluated for the draft Family Health Nursing Certificate Program. The criteria for consensus on Likert-type questions were a width value of 1.50 and a percentage agreement of 75 %. RESULTS Consensus was reached at rates of 84.5 % and 62.2 % on the items in the first and second rounds, respectively, with rates of 89.2 % and 45 % on the Likert-type questions. At the end of the survey rounds, an 85.6 % consensus was reached on all topics and an 85.9 % consensus was reached on the Likert-type questions. CONCLUSIONS The Family Health Nursing Certificate Program drafted by consensus can be used for nurses working in family health centers in Türkiye, to guide educational proficiency and standardization. It may also be used as a comprehensive guide in countries other than Türkiye.
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Affiliation(s)
- Tugba Aslan
- Department of Public Health, Nursing Faculty, Akdeniz University, Dumlupınar Boulevard, 07070 Antalya, Turkey.
| | - Sebahat Gozum
- Department of Public Health, Nursing Faculty, Akdeniz University, Dumlupınar Boulevard, 07070 Antalya, Turkey.
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Torné-Ruiz A, Reguant M, Sanromà-Ortiz M, Piriz M, Roca J, García-Expósito J. Assessment, Treatment, and Follow-Up of Phlebitis Related to Peripheral Venous Catheterisation: A Delphi Study in Spain. Healthcare (Basel) 2024; 12:378. [PMID: 38338263 PMCID: PMC10855708 DOI: 10.3390/healthcare12030378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 01/27/2024] [Accepted: 01/30/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Phlebitis related to peripheral venous catheters (PVCs) is a common complication in patients who require these devices and can have important consequences for the patients and the healthcare system. The management and control of the PVC-associated complications is related to nursing competency. The present study aims to determine, at the national level in Spain, the consensus on the assessment, treatment, and follow-up of PVC-related phlebitis and the importance of the actions taken. METHOD A three-round Delphi technique was used with clinical care nurses who are experts in the field of in-hospital intravenous treatment in Spain. For this, an online questionnaire was developed with three open-ended questions on the dimensions of phlebitis assessment, treatment, and follow-up. For the statistical analysis of the results, frequencies and percentages were used to determine consensus, and the measures of central tendency (mean, standard deviation, and the coefficient of variation) were used to rank importance. The coefficient of variation was set as acceptable at ≤30%. RESULTS The final sample was 27 expert nurses. At the conclusion of round 3, actions were ranked according to their importance, with six items included in the PVC-related phlebitis assessment (symptomatology/observation, redness, the Maddox scale, induration, temperature, and pain), two in treatment (catheter removal, pentosan polysulphate sodium ointment + application of cold), and just one in follow-up (general monitoring + temperature control). CONCLUSIONS There is a major disparity in relation to the PVC-related phlebitis assessment, treatment, and follow-up actions. More clinical studies are therefore needed to minimise the complications associated with the use of PVCs, given their impact on the quality of care and patient safety and their economic cost.
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Affiliation(s)
- Alba Torné-Ruiz
- Department of Nursing and Physiotherapy, University of Lleida, 25199 Lleida, Spain; (A.T.-R.); (M.S.-O.); (J.G.-E.)
- Hospital Fundació Althaia, Xarxa Assistencial Universitària de Manresa, 08243 Manresa, Spain
| | - Mercedes Reguant
- Department of Research Methods and Diagnosis in Education, University of Barcelona, 08035 Barcelona, Spain;
| | - Montserrat Sanromà-Ortiz
- Department of Nursing and Physiotherapy, University of Lleida, 25199 Lleida, Spain; (A.T.-R.); (M.S.-O.); (J.G.-E.)
- Blanquerna School of Health Science, Ramon Llull University, 08025 Barcelona, Spain
| | - Marta Piriz
- Infectious Diseases Division, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain;
- Institut de Recerca de l’Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain
| | - Judith Roca
- Department of Nursing and Physiotherapy, University of Lleida, 25199 Lleida, Spain; (A.T.-R.); (M.S.-O.); (J.G.-E.)
- Health Care Research Group (GRECS), Biomedical Research Institute of Lleida, 25198 Lleida, Spain
- Health Education, Nursing, Sustainability and Innovation Research Group (GREISI), 25199 Lleida, Spain
| | - Judith García-Expósito
- Department of Nursing and Physiotherapy, University of Lleida, 25199 Lleida, Spain; (A.T.-R.); (M.S.-O.); (J.G.-E.)
- Group Preving, 03003 Alicante, Spain
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Goldman JG, Volpe D, Ellis TD, Hirsch MA, Johnson J, Wood J, Aragon A, Biundo R, Di Rocco A, Kasman GS, Iansek R, Miyasaki J, McConvey VM, Munneke M, Pinto S, St. Clair KA, Toledo S, York MK, Todaro R, Yarab N, Wallock K. Delivering Multidisciplinary Rehabilitation Care in Parkinson's Disease: An International Consensus Statement. JOURNAL OF PARKINSON'S DISEASE 2024; 14:135-166. [PMID: 38277303 PMCID: PMC10836578 DOI: 10.3233/jpd-230117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2024]
Abstract
BACKGROUND Parkinson's disease (PD) is a complex neurodegenerative disorder impacting everyday function and quality of life. Rehabilitation plays a crucial role in improving symptoms, function, and quality of life and reducing disability, particularly given the lack of disease-modifying agents and limitations of medications and surgical therapies. However, rehabilitative care is under-recognized and under-utilized in PD and often only utilized in later disease stages, despite research and guidelines demonstrating its positive effects. Currently, there is a lack of consensus regarding fundamental topics related to rehabilitative services in PD. OBJECTIVE The goal of the international Parkinson's Foundation Rehabilitation Medicine Task Force was to develop a consensus statement regarding the incorporation of rehabilitation in PD care. METHODS The Task Force, comprised of international multidisciplinary experts in PD and rehabilitation and people directly affected by PD, met virtually to discuss topics such as rehabilitative services, existing therapy guidelines and rehabilitation literature in PD, and gaps and needs. A systematic, interactive, and iterative process was used to develop consensus-based statements on core components of PD rehabilitation and discipline-specific interventions. RESULTS The expert-based consensus statement outlines key tenets of rehabilitative care including its multidisciplinary approach and discipline-specific guidance for occupational therapy, physical therapy, speech language pathology/therapy, and psychology/neuropsychology across all PD stages. CONCLUSIONS Rehabilitative interventions should be an essential component in the comprehensive treatment of PD, from diagnosis to advanced disease. Greater education and awareness of the benefits of rehabilitative services for people with PD and their care partners, and further evidence-based and scientific study are encouraged.
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Affiliation(s)
- Jennifer G. Goldman
- JPG Enterprises LLC, Medical Division, Chicago, IL, USA
- ^Shirley Ryan AbilityLab, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Daniele Volpe
- Fresco Parkinson Institute, Fiesole, Italy
- Fresco Parkinson Center Villa Margherita, S. Stefano Riabilitazione, Vicenza, Italy
- NYU Grossman School of Medicine, New York, NY, USA
| | - Terry D. Ellis
- Boston University Sargent College of Health and Rehabilitation Sciences, Boston, MA, USA
| | - Mark A. Hirsch
- Wake Forest School of Medicine, Winston-Salem, NC, USA
- Department of Physical Medicine and Rehabilitation, Carolinas Rehabilitation, Charlotte, NC, USA
| | - Julia Johnson
- Kings College Hospital NHS Foundation Trust, London, UK
| | - Julia Wood
- Lewy Body Dementia Association, Lilburn, GA, USA
| | - Ana Aragon
- Independent Consultant Occupational Therapist, Bath, UK
| | | | | | | | | | | | | | - Marten Munneke
- Radboudumc Center of Expertise for Movement Disorders, Nijmegen, Netherlands
| | - Serge Pinto
- The French National Centre for Scientific Research, Aix-Marseille University, Aix-en-Provence, France
| | | | - Santiago Toledo
- ^Shirley Ryan AbilityLab, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | - Ronnie Todaro
- Voz Advisors, New York, NY, USA
- ^Parkinson’s Foundation, New York, NY, USA
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Huettemann R, Sevov B, Meister S, Fehring L. How to establish digital health ecosystems from the perspective of health service-organizations: A taxonomy developed based on expert interviews conducted as modified Delphi approach. Digit Health 2024; 10:20552076241271890. [PMID: 39130523 PMCID: PMC11311194 DOI: 10.1177/20552076241271890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 07/04/2024] [Indexed: 08/13/2024] Open
Abstract
Objective Digital health ecosystems may be the next revolution in improving citizens' well-being, health delivery, data management, and health system processes, but solutions have not yet been broadly established. Reasons could be that health service-organizations have misaligned interests or lack capabilities. This study investigates reasons from a multi-health-service-organization perspective, differentiating between payers, insurers, healthcare providers, and innovators, detailing the expected value-adds, preferred participation roles, and required capabilities including a rating assessment. Methods Findings are based on a taxonomy development methodology, which combines a literature review with semi-structured qualitative expert interviews, conducted using a modified Delphi approach. Interviews were thematically analysed. Results In total, 21 experts across the four health service-organization groups were interviewed. The capability taxonomy includes a total of 16 capabilities, categorized in three themes: 'Health market', 'organizational', and 'technology and informatic'. Providers expect a value-add from strengthening their health process economics through efficiency gains but reveal the largest capability gaps, especially in 'interoperability' and 'platform'. Innovators' 'technology and informatic' capabilities complement well with those of payers for the 'health market'. Conclusions We present a health service-organization-specific three-stage approach for establishing digital health ecosystems. Payers and insurers should address their 'technology and informatic' capability gaps, using technical enablers or forming new entities to reduce dependencies from legacy information technology systems. Innovators should clarify their monetization models and create positive awareness for their services, possibly entering the market directly. Providers must address interoperability issues and may require incentives to encourage their participation. Findings suggest governmental policymakers to prioritize three health policy initiatives.
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Affiliation(s)
- Robin Huettemann
- Faculty of Health, School of Medicine, Witten/Herdecke University, Witten, Germany
| | - Benedict Sevov
- Faculty of Health, School of Medicine, Witten/Herdecke University, Witten, Germany
| | - Sven Meister
- Healthcare Informatics, Faculty of Health, School of Medicine, Witten/Herdecke University, Witten, Germany
- Department Healthcare, Fraunhofer Institute for Software and Systems Engineering ISST, Dortmund, Germany
| | - Leonard Fehring
- Faculty of Health, School of Medicine, Witten/Herdecke University, Witten, Germany
- Gastroenterology, HELIOS University Hospital Wuppertal, Witten/Herdecke University, Wuppertal, Germany
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Morales-Mancillas NR, Velazquez-Valenzuela F, Kinoshita S, Suzuki T, Dahlmann-Noor AH, Dart JKG, Hingorani M, Ali A, Fung S, Akova YA, Doan S, Gupta N, Hammersmith KM, Tan DTH, Paez-Garza JH, Rodriguez-Garcia A. Definition and Diagnostic Criteria for Pediatric Blepharokeratoconjunctivitis. JAMA Ophthalmol 2024; 142:39-47. [PMID: 38127333 PMCID: PMC10797454 DOI: 10.1001/jamaophthalmol.2023.5750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 10/24/2023] [Indexed: 12/23/2023]
Abstract
Importance Pediatric blepharokeratoconjunctivitis (PBKC) is a chronic, sight-threatening inflammatory ocular surface disease. Due to the lack of unified terminology and diagnostic criteria, nonspecific symptoms and signs, and the challenge of differentiation from similar ocular surface disorders, PBKC may be frequently unrecognized or diagnosed late. Objective To establish a consensus on the nomenclature, definition, and diagnostic criteria of PBKC. Design, Setting, and Participants This quality improvement study used expert panel and agreement applying the non-RAND modified Delphi method and open discussions to identify unified nomenclature, definition, and definitive diagnostic criteria for PBKC. The study was conducted between September 1, 2021, and August 14, 2022. Consensus activities were carried out through electronic surveys via email and online virtual meetings. Results Of 16 expert international panelists (pediatric ophthalmologists or cornea and external diseases specialists) chosen by specific inclusion criteria, including their contribution to scientific leadership and research in PBKC, 14 (87.5%) participated in the consensus. The name proposed was "pediatric blepharokeratoconjunctivitis," and the agreed-on definition was "Pediatric blepharokeratoconjunctivitis is a frequently underdiagnosed, sight-threatening, chronic, and recurrent inflammatory eyelid margin disease associated with ocular surface involvement affecting children and adolescents. Its clinical spectrum includes chronic blepharitis, meibomitis, conjunctivitis, and corneal involvement ranging from superficial punctate keratitis to corneal infiltrates with vascularization and scarring." The diagnostic criteria included 1 or more suggestive symptoms accompanied by clinical signs from 3 anatomical regions: the eyelid margin, conjunctiva, and cornea. For PBKC suspect, the same criteria were included except for corneal involvement. Conclusions and Relevance The agreements on the name, definition, and proposed diagnostic criteria of PBKC may help ophthalmologists avoid diagnostic confusion and recognize the disease early to establish adequate therapy and avoid sight-threatening complications. The diagnostic criteria rely on published evidence, analysis of simulated clinical cases, and the expert panel's clinical experience, requiring further validation with real patient data analysis.
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Affiliation(s)
- Nallely R Morales-Mancillas
- Tecnologico de Monterrey, School of Medicine and Health Sciences, Institute of Ophthalmology and Visual Sciences, Pediatric and Strabismus Service, Monterrey, Mexico
| | - Fabiola Velazquez-Valenzuela
- Tecnologico de Monterrey, School of Medicine and Health Sciences, Institute of Ophthalmology and Visual Sciences, Cornea, External Disease and Ocular Immunology Service, Monterrey, Mexico
| | - Shigeru Kinoshita
- Department of Frontier Medical Science and Technology for Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Tomo Suzuki
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
- Department of Ophthalmology, Kyoto City Hospital Organization, Kyoto, Japan
| | - Annegret H Dahlmann-Noor
- National Institute of Health Research's Biomedical Research Centre at Moorfields Eye Hospital and the UCL Institute of Ophthalmology, London, United Kingdom
- Children's Service, Moorfields Eye Hospital National Health Service Foundation Trust, London, United Kingdom
| | - John K G Dart
- Corneal Service, Moorfields Eye Hospital National Health Service Foundation Trust, London, United Kingdom
| | - Melanie Hingorani
- Children's Service, Moorfields Eye Hospital National Health Service Foundation Trust, London, United Kingdom
- Corneal Service, Moorfields Eye Hospital National Health Service Foundation Trust, London, United Kingdom
| | - Asim Ali
- Department of Ophthalmology & Vision Sciences, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Simon Fung
- Department of Ophthalmology, University of California, Los Angeles
| | - Yonca A Akova
- Department of Ophthalmology, Bayındır Hospital, Ankara, Turkey
| | - Serge Doan
- Department of Ophthalmology, Fondation Ophtalmolologique A. de Rothschild, Paris, France
| | - Noopur Gupta
- Cornea, Cataract & Refractive Surgery Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | | | - Donald T H Tan
- Eye & Cornea Surgeons, Eye & Retina Surgeons, Camden Medical and Mount Elizabeth Novena Specialist Centre, Singapore
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
- Department of Ophthalmology and Visual Science, Duke-NUS Graduate Medical School, Singapore
| | - J Homar Paez-Garza
- Tecnologico de Monterrey, School of Medicine and Health Sciences, Institute of Ophthalmology and Visual Sciences, Pediatric and Strabismus Service, Monterrey, Mexico
| | - Alejandro Rodriguez-Garcia
- Tecnologico de Monterrey, School of Medicine and Health Sciences, Institute of Ophthalmology and Visual Sciences, Cornea, External Disease and Ocular Immunology Service, Monterrey, Mexico
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Romero-Ibarguengoitia ME, López-Zamarrón KY, Hernández-Treviño MG, Gutierrez-González D, González-Cantú A, González Peña OI, Garza-Silva A. Development, validation and measurement of patient satisfaction questionnaire in Spanish in drive thru services adapted to hospital pharmacies during COVID-19 pandemic. Saudi Pharm J 2024; 32:101838. [PMID: 38162710 PMCID: PMC10757251 DOI: 10.1016/j.jsps.2023.101838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 10/19/2023] [Indexed: 01/03/2024] Open
Abstract
Background There are no validation studies on patient satisfaction surveys in Spanish that can evaluate a hospital pharmacy drive-thru service. Objective To develop and apply a pharmacy drive-thru satisfaction survey in Spanish during the COVID-19 pandemic with an analysis of the instrument validation. Methods This was a qualitative study for developing, validating, and measuring patient satisfaction who used the drive-thru pharmacy during the COVID-19 pandemic. Content validity was obtained by a two-round Delphi and patient interview for apparent validity. The questionnaire was administered to 110 patients. The researchers made an item reduction by inter-item and item-total correlation analysis, stability validation by a test-retest, a test of reliability by Cronbach's alpha, and extraction of factors by an exploratory factorial analysis. Likewise, confirmatory factor analysis was developed to obtain a structural equation model based on generating an instrument of two sub-models of latent factors (service and place) with ten observed variables (items). Results A questionnaire was developed that relates six observable variables to the latent factor service and four observable variables to the latent factor place which are ten items based on a Likert scale from 1 to 5, obtaining a Cronbach's alpha = 0.901. The mean population satisfaction score was 4.523. The model presented a Root Mean Square Error of Approximation (RMSEA) of 0.026 (0.000-0.098), and standardized beta values greater than 0.2 according to the confirmatory factor analysis. Therefore, the goodness-of-fit of our model is consistent and the instrument of patient satisfaction with the use of drive-thru has been validated. Patient satisfaction had a mean of 4.9 points. Conclusions This study developed and validated a reliable scale that evaluates satisfaction in a hospital pharmacy drive-thru service during COVID-19 pandemic that can be applied in other Spanish speaking countries. A great percentage of the patients that were evaluated had good satisfaction.
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Affiliation(s)
- Maria Elena Romero-Ibarguengoitia
- Research and Education Department, Hospital Clinica Nova, Avenida del Bosque #139 Cuauhtemoc San Nicolás de los Garza, Nuevo León 66450, Mexico
- Universidad de Monterrey, Escuela de medicina, Vicerrectoría de Ciencias de la Salud, Av. Ignacio Morones Prieto 4500-Pte, Zona Valle Poniente, San Pedro Garza García, Nuevo León 66238, Mexico
| | - Katia Yackelyne López-Zamarrón
- Universidad de Monterrey, Escuela de medicina, Vicerrectoría de Ciencias de la Salud, Av. Ignacio Morones Prieto 4500-Pte, Zona Valle Poniente, San Pedro Garza García, Nuevo León 66238, Mexico
| | - Mariana Georgina Hernández-Treviño
- Universidad de Monterrey, Escuela de medicina, Vicerrectoría de Ciencias de la Salud, Av. Ignacio Morones Prieto 4500-Pte, Zona Valle Poniente, San Pedro Garza García, Nuevo León 66238, Mexico
| | - Dalia Gutierrez-González
- Research and Education Department, Hospital Clinica Nova, Avenida del Bosque #139 Cuauhtemoc San Nicolás de los Garza, Nuevo León 66450, Mexico
- Universidad de Monterrey, Escuela de medicina, Vicerrectoría de Ciencias de la Salud, Av. Ignacio Morones Prieto 4500-Pte, Zona Valle Poniente, San Pedro Garza García, Nuevo León 66238, Mexico
| | - Arnulfo González-Cantú
- Research and Education Department, Hospital Clinica Nova, Avenida del Bosque #139 Cuauhtemoc San Nicolás de los Garza, Nuevo León 66450, Mexico
- Universidad de Monterrey, Escuela de medicina, Vicerrectoría de Ciencias de la Salud, Av. Ignacio Morones Prieto 4500-Pte, Zona Valle Poniente, San Pedro Garza García, Nuevo León 66238, Mexico
| | - Omar Israel González Peña
- Research and Education Department, Hospital Clinica Nova, Avenida del Bosque #139 Cuauhtemoc San Nicolás de los Garza, Nuevo León 66450, Mexico
- Evidence-Based Medicine Research Unit, Children’s Hospital of Mexico Federico Gómez, National Institute of Health, Dr. Márquez 162, Col. Doctores, Del. Cuauhtémoc, Mexico City 06720, Mexico
- Universidad Internacional de La Rioja (UNIR), Avenida de la Paz, 137, 26006 Logroño, La Rioja, Spain
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Gattrell WT, Logullo P, van Zuuren EJ, Price A, Hughes EL, Blazey P, Winchester CC, Tovey D, Goldman K, Hungin AP, Harrison N. ACCORD (ACcurate COnsensus Reporting Document): A reporting guideline for consensus methods in biomedicine developed via a modified Delphi. PLoS Med 2024; 21:e1004326. [PMID: 38261576 PMCID: PMC10805282 DOI: 10.1371/journal.pmed.1004326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND In biomedical research, it is often desirable to seek consensus among individuals who have differing perspectives and experience. This is important when evidence is emerging, inconsistent, limited, or absent. Even when research evidence is abundant, clinical recommendations, policy decisions, and priority-setting may still require agreement from multiple, sometimes ideologically opposed parties. Despite their prominence and influence on key decisions, consensus methods are often poorly reported. Our aim was to develop the first reporting guideline dedicated to and applicable to all consensus methods used in biomedical research regardless of the objective of the consensus process, called ACCORD (ACcurate COnsensus Reporting Document). METHODS AND FINDINGS We followed methodology recommended by the EQUATOR Network for the development of reporting guidelines: a systematic review was followed by a Delphi process and meetings to finalize the ACCORD checklist. The preliminary checklist was drawn from the systematic review of existing literature on the quality of reporting of consensus methods and suggestions from the Steering Committee. A Delphi panel (n = 72) was recruited with representation from 6 continents and a broad range of experience, including clinical, research, policy, and patient perspectives. The 3 rounds of the Delphi process were completed by 58, 54, and 51 panelists. The preliminary checklist of 56 items was refined to a final checklist of 35 items relating to the article title (n = 1), introduction (n = 3), methods (n = 21), results (n = 5), discussion (n = 2), and other information (n = 3). CONCLUSIONS The ACCORD checklist is the first reporting guideline applicable to all consensus-based studies. It will support authors in writing accurate, detailed manuscripts, thereby improving the completeness and transparency of reporting and providing readers with clarity regarding the methods used to reach agreement. Furthermore, the checklist will make the rigor of the consensus methods used to guide the recommendations clear for readers. Reporting consensus studies with greater clarity and transparency may enhance trust in the recommendations made by consensus panels.
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Affiliation(s)
| | - Patricia Logullo
- Centre for Statistics in Medicine, University of Oxford, and EQUATOR Network UK Centre, Oxford, United Kingdom
| | | | - Amy Price
- Stanford Anesthesia, Informatics and Media Lab, Stanford University School of Medicine, Stanford, California, United States of America
| | | | - Paul Blazey
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Christopher C. Winchester
- Oxford PharmaGenesis, Oxford, United Kingdom
- Green Templeton College, University of Oxford, Oxford, United Kingdom
| | - David Tovey
- Journal of Clinical Epidemiology, London, United Kingdom
| | - Keith Goldman
- Global Medical Affairs, AbbVie, North Chicago, Illinois, United States of America
| | - Amrit Pali Hungin
- Faculty of Medical Sciences, Newcastle University, Newcastle, United Kingdom
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Meldrum K, Wallace V, Webb T, Ridgway L, Quigley R, Strivens E, Russell S. Developing an appropriate depression and anxiety screening tool for use with Australian First Nations peoples living in the Torres Strait and Northern Peninsula Area of Australia: Protocol for a Delphi study. PLoS One 2023; 18:e0292162. [PMID: 38060486 PMCID: PMC10703283 DOI: 10.1371/journal.pone.0292162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 09/13/2023] [Indexed: 12/18/2023] Open
Abstract
Tools that screen for depression and anxiety developed using the Western biomedical paradigm are still used with First Nations peoples globally, despite calls for cross-cultural adaption. Recent work by the research team found that tools used to screen for depression and anxiety were not appropriate for use with Australian First Nations peoples living in the Torres Strait and Northern Peninsula Area (NPA). of Australia. Consequently, the objective of this Delphi study is to gain consensus from an expert mental health panel to inform the development of an appropriate depression and anxiety screening tool(s). A Delphi study with Australian expert panellists will be used to reach consensus about whether an existing screening tool should be used or whether adaption or new tool development should take place. Three sequential rounds of anonymous online surveys will be used to reach consensus. The first round will seek consensus about the tool(s). Subsequent rounds will seek consensus on the development of the tool(s) identified in round one. Panellists will be identified using a combination of authorship of related publications, established national clinical or research profile in First Nations mental health, and/or by peer referral. Consensus will be reached when 75% of the panel agree. When agreement is not reached suggestions will be taken to the next round. If agreement is not achieved by the third round, the Steering Committee will make any outstanding decisions. Dissemination of the findings through continuing community engagement, conference presentations and publications will be led by Torres Strait Islander members of the research team.
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Affiliation(s)
- Kathryn Meldrum
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
| | - Valda Wallace
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
| | - Torres Webb
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
| | - Lynne Ridgway
- North Coast Neuropsychology, East Ballina, New South Wales, Australia
| | - Rachel Quigley
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
| | - Edward Strivens
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
- Cairns and Hinterland Hospital and Health Service, Cairns, Queensland, Australia
| | - Sarah Russell
- College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia
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Chen CC, Tsai CF, Chen SC. Consensus and agreements on the sonographic definitions of pediatric tenosynovitis: comment on the article by Collado et al. Arthritis Care Res (Hoboken) 2023; 75:2544-2545. [PMID: 37382037 DOI: 10.1002/acr.25185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 06/21/2023] [Indexed: 06/30/2023]
Affiliation(s)
- Chun-Chieh Chen
- Chung Shan Medical University School of Medicine and Chung Shan Medical University Hospital Health Management Center, Taichung, Taiwan
| | - Chin-Feng Tsai
- Chung Shan Medical University School of Medicine and Chung Shan Medical University Hospital Health Management Center, Taichung, Taiwan
| | - Shiuan-Chih Chen
- Chung Shan Medical University School of Medicine and Chung Shan Medical University Hospital Health Management Center, Taichung, Taiwan
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Shang J, Dong W, Huang P, Sun Y, He Y, Li H, Liao S, Li M. Development of a nutritional screening and assessment indicator system for patients with esophageal cancer in China: Findings from the Delphi method. Cancer Med 2023; 12:21240-21255. [PMID: 37990781 PMCID: PMC10726821 DOI: 10.1002/cam4.6703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 10/14/2023] [Accepted: 10/24/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND In China, individuals diagnosed with esophageal cancer are confronted with an elevated risk of nutritional inadequacy or malnutrition throughout the course of their disease, a condition that contributes to various adverse clinical outcomes. A vast corpus of data are burgeoning at an unprecedented rate, primarily due to the revolutionary growth of digitalization technologies and artificial intelligence, notably within the domains of health care and medicine. The purpose of this investigation is to initiate the development of a nutritional screening and assessment indicator framework for patients with esophageal cancer within the Chinese context. We seek to furnish an instrumental reference to facilitate preparations for the forthcoming era of advanced, "deep," evidence-based medicine. METHODS An integrative methodology was employed to forge the preliminary draft of the nutritional screening and assessment indicator system for preoperative patients with esophageal cancer. This encompassed a rigorous literature survey, in-depth clinical practice investigation, and the facilitation of expert panel discussions. Thereafter, two iterative consultation phases were conducted using the Delphi method in China. The analytic hierarchy process was deployed to ascertain the weighting of each index within the definitive evaluation indicator system. RESULTS The effective response rates for the dual rounds of expert consultation were 91.7% and 86.4%, with commensurate authority coefficients of 0.97 and 0.91. The Kendall harmony coefficients were ascertained to be 0.19 and 0.14 (p < 0.01), respectively. The culminating nutritional screening and assessment indicator system for patients with esophageal cancer comprised 5 primary-level indicators and 38 secondary-level indicators. CONCLUSIONS The nutritional screening and assessment indicator system contrived for patients with esophageal cancer is underpinned by cogent theoretical principles, leverages an astute research methodology, and manifests dependable outcomes. This system may be appositely utilized as a meaningful reference for the nutritional screening and assessment process in patients afflicted with esophageal cancer.
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Affiliation(s)
- Jingjing Shang
- Department of Thoracic SurgerySouthern Medical University Nanfang HospitalGuangzhouChina
- School of NursingSouthern Medical UniversityGuangzhouChina
| | - Wen Dong
- Department of Thoracic SurgerySouthern Medical University Nanfang HospitalGuangzhouChina
| | - Peipei Huang
- Department of Thoracic SurgerySouthern Medical University Nanfang HospitalGuangzhouChina
- School of NursingSouthern Medical UniversityGuangzhouChina
| | - Yidan Sun
- Department of Thoracic SurgerySouthern Medical University Nanfang HospitalGuangzhouChina
- School of NursingSouthern Medical UniversityGuangzhouChina
| | - Yuxin He
- Department of Thoracic SurgerySouthern Medical University Nanfang HospitalGuangzhouChina
- School of NursingSouthern Medical UniversityGuangzhouChina
| | - Hui Li
- Department of Thoracic SurgerySouthern Medical University Nanfang HospitalGuangzhouChina
- School of NursingSouthern Medical UniversityGuangzhouChina
| | - Shengwu Liao
- Department of Health ManagementSouthern Medical University Nanfang HospitalGuangzhouChina
| | - Mei Li
- Department of Thoracic SurgerySouthern Medical University Nanfang HospitalGuangzhouChina
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Dieudonné J, Jantzen L, Sanwald M, Trompke M, Pieper D, Stegbauer C, Willms G, Buchberger B, Brian Büchter R, Bühn S, Fischer F, Klein K, Kuhn J, Messer M, Wegewitz U, Niederberger M. [What is a public health intervention? Results of a Delphi process in German-speaking countries]. ZEITSCHRIFT FUR EVIDENZ, FORTBILDUNG UND QUALITAT IM GESUNDHEITSWESEN 2023; 182-183:89-97. [PMID: 37625924 DOI: 10.1016/j.zefq.2023.05.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 05/16/2023] [Accepted: 05/27/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND Internationally, a variety of definitions for public health interventions (PHI) exist. In the German-speaking countries, however, a definition is still outstanding. Therefore, the aim of this study was to derive consensus criteria for the definition of PHI from the expert perspective of science and practice. METHODS A Delphi survey with two online rounds was conducted from December 2022 to February 2023. Six criteria were formulated by a working group and posed for consensus: 1) the intention of the intervention, 2) potential conflicts of interest of the initiators of the intervention, 3) primary vs. secondary/tertiary prevention, 4) costs, 5) targeting, and 6) the reach of the intervention. In both Delphi rounds, experts from academia and practice were recruited through relevant networks and associations throughout the German-speaking world. The judgments were asked about standardized rating scales with the possibility of open justification. RESULTS In the first Delphi round, n = 52 and in the second round n = 43 experts from research, care and administration/management in health care participated. Consensus was reached on four of the six criteria after the second Delphi round: the intention of the intervention, possible conflicts of interest of the initiators of the intervention, primary vs. secondary/tertiary prevention, and the scope of the intervention. From the perspective of the experts interviewed, these are the criteria that distinguish PHI. DISCUSSION AND CONCLUSION Based on the consensus criteria, PHI can be defined more concretely. Thus, the results contribute to a better inter- and transdisciplinary understanding. Ideally, the criteria will make it easier to assign interventions to the public health sector in the future, even if a precise examination will be necessary in individual cases, among other things because the experts disagreed on the criteria of costs and how to address the target group.
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Affiliation(s)
- Jessica Dieudonné
- Forschungsmethoden in der Gesundheitsförderung und Prävention, PH Schwäbisch Gmünd, Schwäbisch Gmünd, Deutschland
| | - Lisa Jantzen
- Forschungsmethoden in der Gesundheitsförderung und Prävention, PH Schwäbisch Gmünd, Schwäbisch Gmünd, Deutschland
| | - Michelle Sanwald
- Forschungsmethoden in der Gesundheitsförderung und Prävention, PH Schwäbisch Gmünd, Schwäbisch Gmünd, Deutschland
| | - Michaela Trompke
- Forschungsmethoden in der Gesundheitsförderung und Prävention, PH Schwäbisch Gmünd, Schwäbisch Gmünd, Deutschland
| | - Dawid Pieper
- IVGF - Institut für Versorgungs- und Gesundheitssystemforschung, Fakultät für Gesundheitswissenschaften, Medizinische Hochschule Brandenburg; Zentrum für Versorgungsforschung Brandenburg, Medizinische Hochschule Brandenburg, Neuruppin, Deutschland
| | - Constance Stegbauer
- aQua - Institut für angewandte Qualitätsförderung und Forschung im Gesundheitswesen GmbH, Göttingen, Deutschland
| | - Gerald Willms
- aQua - Institut für angewandte Qualitätsförderung und Forschung im Gesundheitswesen GmbH, Göttingen, Deutschland
| | | | - Roland Brian Büchter
- Institut für Forschung in der Operativen Medizin (IFOM), Fakultät für Gesundheit, Department für Humanmedizin, Universität Witten/Herdecke, Witten, Deutschland
| | - Stefanie Bühn
- Deutsche Allianz Klimawandel und Gesundheit e.V. (KLUG), Berlin, Deutschland
| | - Florian Fischer
- Bayerisches Zentrum Pflege Digital, Hochschule für angewandte Wissenschaften Kempten, Kempten, Deutschland
| | - Katharina Klein
- Charité-Universitätsmedizin Berlin, Geschlechterforschung in der Medizin; Deutsche Krebsgesellschaft e.V., Berlin, Deutschland
| | - Joseph Kuhn
- Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit, Erlangen, Deutschland
| | - Melanie Messer
- Abteilung Pflegewissenschaft II, Universität Trier, Trier, Deutschland
| | - Uta Wegewitz
- Bundesanstalt für Arbeitsschutz und Arbeitsmedizin, Aalen, Deutschland
| | - Marlen Niederberger
- Forschungsmethoden in der Gesundheitsförderung und Prävention, PH Schwäbisch Gmünd, Schwäbisch Gmünd, Deutschland.
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Padovani A, Antonini A, Barone P, Bellelli G, Fagiolini A, Ferini Strambi L, Sorbi S, Stocchi F. Exploring depression in Alzheimer's disease: an Italian Delphi Consensus on phenomenology, diagnosis, and management. Neurol Sci 2023; 44:4323-4332. [PMID: 37402937 PMCID: PMC10641046 DOI: 10.1007/s10072-023-06891-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 06/05/2023] [Indexed: 07/06/2023]
Abstract
BACKGROUND In Alzheimer's disease (AD), the progressive cognitive impairment is often combined with a variety of neuropsychiatric symptoms, firstly depression. Nevertheless, its diagnosis and management is difficult, since specific diagnostic criteria and guidelines for treatment are still lacking. The aim of this Delphi study is to reach a shared point of view among different Italian specialists on depression in AD. METHODS An online Delphi survey with 30 questions regarding epidemiology, diagnosis, clinical features, and treatment of depression in AD was administered anonymously to a panel of 53 expert clinicians. RESULTS Consensus was achieved in most cases (86%). In the 80% of statements, a positive consensus was reached, while in 6% a negative consensus was achieved. No consensus was obtained in 14%. Among the most relevant findings, the link between depression and AD is believed to be strong and concerns etiopathogenesis and phenomenology. Further, depression in AD seems to have specific features compared to major depressive disorder (MDD). Regarding diagnosis, the DSM 5 diagnostic criteria for MDD seems to be not able to detect the specific aspects of depression in AD. Concerning treatment, antidepressant drugs are generally considered the main option for depression in dementia, according to previous guidelines. In order to limit side effects, multimodal and SSRI antidepressant are preferred by clinicians. In particular, the procognitive effect of vortioxetine seems to be appealing for the treatment of depression in AD. CONCLUSIONS This study highlights some crucial aspects of depression in AD, but more investigations and specific recommendations are needed.
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Affiliation(s)
- Alessandro Padovani
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, DSCS-c/o U.O. Neurologia 2, Spedali Civili 1, 25121, Brescia, Italy.
| | - Angelo Antonini
- Parkinson and Movement Disorders Unit, Center for Neurodegenerative Diseases (CENSE), Department of Neuroscience, University of Padua, Padua, Italy
| | - Paolo Barone
- Center for Neurodegenerative Diseases (CEMAND), Neuroscience Section, University of Salerno, Salerno, Italy
| | - Giuseppe Bellelli
- School of Medicine and Surgery, University of Milano-Bicocca, 20126, Milan, Italy
- Acute Geriatric Unit, IRCCS San Gerardo, 20900, Monza, Italy
| | - Andrea Fagiolini
- Department of Molecular and Developmental Medicine, University of Siena School of Medicine, Siena, Italy
| | - Luigi Ferini Strambi
- IRCCS San Raffaele Scientific Institute, Department of Clinical Neurosciences, Neurology-Sleep Disorders Centre, Milan, Italy
- "Vita-Salute" San Raffaele University, Milan, Italy
| | - Sandro Sorbi
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Largo Brambilla, 3, 50134, Florence, Italy
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
| | - Fabrizio Stocchi
- University and Institute for Research and Medical Care, IRCCS San Raffaele, Rome, Italy
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Lüke C, Kauschke C, Dohmen A, Haid A, Leitinger C, Männel C, Penz T, Sachse S, Scharff Rethfeldt W, Spranger J, Vogt S, Niederberger M, Neumann K. Definition and terminology of developmental language disorders-Interdisciplinary consensus across German-speaking countries. PLoS One 2023; 18:e0293736. [PMID: 37943803 PMCID: PMC10635531 DOI: 10.1371/journal.pone.0293736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 10/18/2023] [Indexed: 11/12/2023] Open
Abstract
In recent years, there have been intense international discussions about the definition and terminology of language disorders in childhood, such as those sparked by the publications of the CATALISE consortium. To address this ongoing debate, a Delphi study was conducted in German-speaking countries. This study consisted of three survey waves and involved over 400 experts from relevant disciplines. As a result, a far-reaching consensus was achieved on essential definition criteria and terminology, presented in 23 statements. The German term 'Sprachentwicklungsstörung' was endorsed to refer to children with significant deviations from typical language development that can negatively impact social interactions, educational progress, and/or social participation and do not occur together with a potentially contributing impairment. A significant deviation from typical language development was defined as a child's scores in standardized test procedures being ≥ 1.5 SD below the mean for children of the same age. The results of this Delphi study provide a proposal for a uniform use of terminology for language disorders in childhood in German-speaking countries.
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Affiliation(s)
- Carina Lüke
- Faculty of Human Sciences, Department of Special Education and Therapy in Language and Communication Disorders, University of Würzburg, Würzburg, Germany
| | - Christina Kauschke
- Department of German Linguistics, University of Marburg, Marburg, Germany
| | - Andrea Dohmen
- Department of Applied Health Sciences, Speech and Language Therapy, University of Applied Health Sciences (HS Gesundheit), Bochum, Germany
| | - Andrea Haid
- Swiss University of Speech and Language Sciences SHLR, Rorschach, Switzerland
| | - Christina Leitinger
- Logopädieaustria, Professional Association of Austrian Speech-Language Therapists, Vienna, Austria
| | - Claudia Männel
- Department of Audiology and Phoniatrics, Charité –Universitätsmedizin Berlin, Berlin, Germany
- Department of Neuropsychology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Tanja Penz
- University Hospital for Hearing, Voice and Language Disorders, Innsbruck, Austria
| | - Steffi Sachse
- Institute of Psychology, University of Education Heidelberg, Heidelberg, Germany
| | | | - Julia Spranger
- Department of Research Methods in Health Promotion and Prevention, Institute for Health Sciences, University of Education Schwäbisch Gmünd, Schwäbisch Gmünd, Germany
| | - Susanne Vogt
- Department of Health & Social Affairs, University of Applied Sciences Fresenius Frankfurt, Frankfurt, Germany
| | - Marlen Niederberger
- Department of Research Methods in Health Promotion and Prevention, Institute for Health Sciences, University of Education Schwäbisch Gmünd, Schwäbisch Gmünd, Germany
| | - Katrin Neumann
- Department of Phoniatrics and Pedaudiology, University Hospital Münster, Münster, Germany
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Torres M, Serra-Sutton V, Soriano JB, Ferrer M, Trejo A, Benavides FG, Lumbreras B, Pérez-Gómez B, Pijoan JI, Monguet JM, Barbé F, Pollán M, Alonso J, Espallargues M, Serrano-Blanco A. Consensus on post COVID in the Spanish national health system: Results of the CIBERPOSTCOVID eDelphi study. J Infect Public Health 2023; 16:1784-1792. [PMID: 37741013 DOI: 10.1016/j.jiph.2023.08.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 06/28/2023] [Accepted: 08/27/2023] [Indexed: 09/25/2023] Open
Abstract
BACKGROUND In 2021, the Spanish Ministry of Health launched the CIBERPOSTCOVID project to establish what post COVID was. The present study reports the level of agreement among stakeholders on post COVID and its clinical and diagnostic characteristics in the Spanish health system. METHODS The agreement on post COVID among clinicians, public health managers, researchers and patients' representatives was explored in a real-time, asynchronous online Delphi. In a two-wave consensus, respondents rated from 1 (total disagreement) to 6 (total agreement) 67 statements related to terminology, duration, etiology, symptoms, impact on quality of life, severity, elements to facilitate diagnosis, applicability in the pediatric population, and risk factors. Consensus was reached when 70 % of ratings for a statement were 5 or 6, with an interquartile range equal or less than 1. FINDINGS A total of 333 professionals and patients participated in this eDelphi study. There was agreement that post COVID was "a set of multi-organic symptoms that persist or fluctuate after acute COVID-19 infection and are not attributable to other causes" with a minimum duration of 3 months. The highest levels of agreement were found in the most frequent symptoms and its impacts on everyday activities. Aspects related to the diagnostic process and the measurement of its severity reached a lower level of consensus. There was agreement on the need to rule out previous health problems and assess severity using validated functional scales. However, no agreement was reached on the risk factors or specific features in the pediatric population. INTERPRETATION This policy-based consensus study has allowed the characterization of post COVID generating collective intelligence and has contributed to an operational definition applicable in clinical practice, health services management and useful for research purposes in Spain and abroad. Agreements are consistent with existing evidence and reference institutions at European and international level.
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Affiliation(s)
- Marta Torres
- Agency for Health Quality and Assessment of Catalonia (AQuAS), Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Vicky Serra-Sutton
- Agency for Health Quality and Assessment of Catalonia (AQuAS), Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
| | - Joan B Soriano
- Hospital Universitario de la Princesa - Universidad Autónoma de Madrid (UAM), Madrid, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Montse Ferrer
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Alex Trejo
- Universitat Politècnica de Catalunya (UPC), Barcelona, Spain; Onsanity Solutions SL, Barcelona, Spain
| | - Fernando G Benavides
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Blanca Lumbreras
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Universidad Miguel Hernández (UMH), Alicante, Spain
| | - Beatriz Pérez-Gómez
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; National Centre for Epidemiology (CNE), Instituto de Salud Carlos III, Madrid, Spain
| | - José I Pijoan
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Hospital Universitario Cruces Biocruces, Bizkaia, Spain
| | - Josep M Monguet
- Universitat Politècnica de Catalunya (UPC), Barcelona, Spain
| | - Ferran Barbé
- CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain; Hospital Universitari Arnau de Vilanova de Lleida - Universitat de Lleida, Lleida, Spain
| | - Marina Pollán
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; National Centre for Epidemiology (CNE), Instituto de Salud Carlos III, Madrid, Spain
| | - Jordi Alonso
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Mireia Espallargues
- Agency for Health Quality and Assessment of Catalonia (AQuAS), Barcelona, Spain; Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Barcelona, Spain
| | - Antoni Serrano-Blanco
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
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Blok GCGH, Berger MY, Ahmeti AB, Holtman GA. What is important to the GP in recognizing acute appendicitis in children: a delphi study. BMC PRIMARY CARE 2023; 24:217. [PMID: 37872491 PMCID: PMC10591392 DOI: 10.1186/s12875-023-02167-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 09/30/2023] [Indexed: 10/25/2023]
Abstract
BACKGROUND For diagnostic research on appendicitis in registration data, insight is needed in the way GPs generate medical records. We aimed to reach a consensus on the features that GPs consider important in the consultation and medical records when evaluating a child with suspected appendicitis. METHODS We performed a three-round Delphi study among Dutch GPs selected by purposive sampling. An initial feature list was created based on a literature search and features in the relevant Dutch guideline. Finally, using a vignette describing a child who needed later reassessment, we asked participants to complete an online questionnaire about which consultation features should be addressed and recorded. RESULTS A literature review and Dutch guideline yielded 95 consultation features. All three rounds were completed by 22 GPs, with the final consensus list containing 26 symptoms, 29 physical assessments and signs, 2 additional tests, and 8 further actions (including safety-netting, i.e., informing the patient about when to contact the GP again). Of these, participants reached consensus that 37 should be actively addressed and that 20 need to be recorded if findings are negative. CONCLUSIONS GPs agreed that negative findings do not need to be recorded for most features and that records should include the prognostic and safety-netting advice given. The results have implications in three main domains: for research, that negative findings are likely to be missing; for medicolegal purposes, that documentation cannot be expected to be complete; and for clinical practice, that safety-netting advice should be given and documented.
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Affiliation(s)
- Guus C G H Blok
- Department of General Practice and Elderly Care Medicine, University Medical Center Groningen, University of Groningen, PO Box 196, Groningen, 9700 AD, The Netherlands
| | - Marjolein Y Berger
- Department of General Practice and Elderly Care Medicine, University Medical Center Groningen, University of Groningen, PO Box 196, Groningen, 9700 AD, The Netherlands
| | - Arjan B Ahmeti
- Department of General Practice and Elderly Care Medicine, University Medical Center Groningen, University of Groningen, PO Box 196, Groningen, 9700 AD, The Netherlands
| | - Gea A Holtman
- Department of General Practice and Elderly Care Medicine, University Medical Center Groningen, University of Groningen, PO Box 196, Groningen, 9700 AD, The Netherlands.
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Brillantino A, Renzi A, Talento P, Iacobellis F, Brusciano L, Monaco L, Izzo D, Giordano A, Pinto M, Fantini C, Gasparrini M, Schiano Di Visconte M, Milazzo F, Ferreri G, Braini A, Cocozza U, Pezzatini M, Gianfreda V, Di Leo A, Landolfi V, Favetta U, Agradi S, Marino G, Varriale M, Mongardini M, Pagano CEFA, Contul RB, Gallese N, Ucchino G, D'Ambra M, Rizzato R, Sarzo G, Masci B, Da Pozzo F, Ascanelli S, Foroni F, Palumbo A, Liguori P, Pezzolla A, Marano L, Capomagi A, Cudazzo E, Babic F, Geremia C, Bussotti A, Cicconi M, Di Sarno A, Mongardini FM, Brescia A, Lenisa L, Mistrangelo M, Sotelo MLS, Vicenzo L, Longo A, Docimo L. The Italian Unitary Society of Colon-proctology (SIUCP: Società Italiana Unitaria di Colonproctologia) guidelines for the management of anal fissure. BMC Surg 2023; 23:311. [PMID: 37833715 PMCID: PMC10576345 DOI: 10.1186/s12893-023-02223-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 10/06/2023] [Indexed: 10/15/2023] Open
Abstract
INTRODUCTION The aim of these evidence-based guidelines is to present a consensus position from members of the Italian Unitary Society of Colon-Proctology (SIUCP: Società Italiana Unitaria di Colon-Proctologia) on the diagnosis and management of anal fissure, with the purpose to guide every physician in the choice of the best treatment option, according with the available literature. METHODS A panel of experts was designed and charged by the Board of the SIUCP to develop key-questions on the main topics covering the management of anal fissure and to performe an accurate search on each topic in different databanks, in order to provide evidence-based answers to the questions and to summarize them in statements. All the clinical questions were discussed by the expert panel in different rounds through the Delphi approach and, for each statement, a consensus among the experts was reached. The questions were created according to the PICO criteria, and the statements developed adopting the GRADE methodology. CONCLUSIONS In patients with acute anal fissure the medical therapy with dietary and behavioral norms is indicated. In the chronic phase of disease, the conservative treatment with topical 0.3% nifedipine plus 1.5% lidocaine or nitrates may represent the first-line therapy, eventually associated with ointments with film-forming, anti-inflammatory and healing properties such as Propionibacterium extract gel. In case of first-line treatment failure, the surgical strategy (internal sphincterotomy or fissurectomy with flap), may be guided by the clinical findings, eventually supported by endoanal ultrasound and anal manometry.
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Affiliation(s)
- Antonio Brillantino
- Deparment of Surgery, "A. Cardarelli" Hospital, Via A. Cardarelli 9, Naples, 80131, Italy.
| | - Adolfo Renzi
- "Buonconsiglio-Fatebenefratelli" Hospital, Naples, Italy
| | - Pasquale Talento
- Department of Surgery, Pelvic Floor Center, AUSL-IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - Francesca Iacobellis
- Department of General and Emergency Radiology, "A. Cardarelli" Hospital, Naples, Italy
| | - Luigi Brusciano
- Department of Advanced Medical and Surgical Sciences, University of Campania "L. Vanvitelli", Naples, Italy
| | - Luigi Monaco
- "Pineta Grande" Hospital, "Villa Esther" Clinic, Avellino, Italy
| | - Domenico Izzo
- Department of General and Emergency Surgery, AORN dei Colli Monaldi-Cotugno-CTO, CTO Hospital, Naples, Italy
| | - Alfredo Giordano
- Department of General and Emergency Surgery, University of Salerno, Hospital of Mercato San Severino, Salerno, Italy
| | | | - Corrado Fantini
- Department of Surgery, "Dei Pellegrini" Hospital, ASL Napoli 1, Naples, Italy
| | | | - Michele Schiano Di Visconte
- Department of General Surgery, Colorectal and Pelvic Floor Diseases Center, "Santa Maria Dei Battuti" Hospital, Conegliano, TV, Italy
| | - Francesca Milazzo
- Department of Surgery, Pelvic Floor Center, AUSL-IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - Giovanni Ferreri
- Department of Surgery, Pelvic Floor Center, AUSL-IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - Andrea Braini
- Department of General Surgery, Azienda Sanitaria Friuli Occidentale (ASFO), Pordenone, Italy
| | - Umberto Cocozza
- Department of General Surgery, "S. Maria Degli Angeli" Hospital, Putignano (Bari), Italy
| | | | - Valeria Gianfreda
- Unit of Colonproctologic and Pelvic Surgery, "M.G. Vannini" Hospital, Rome, Italy
| | - Alberto Di Leo
- Department of General and Minivasive Surgery, "San Camillo" Hospital, Trento, Italy
| | - Vincenzo Landolfi
- Department of General and Specalist Surgery, AORN "S.G. Moscati", Avellino, Italy
| | - Umberto Favetta
- Unit of Proctology and Pelvic Surgery, "Città di Pavia" Clinic, Pavia, Italy
| | - Sergio Agradi
- Humanitas Gavazzeni/Castelli Bergamo, Bergamo, Italy
| | - Giovanni Marino
- Department of General Surgery, "Santa Marta e Santa Venera" Hospital of Acireale, Catania, Italy
| | - Massimilano Varriale
- Department of General and Emergency Surgery, "Sandro Pertini" Hospital, Asl Roma 2, Rome, Italy
| | | | | | | | - Nando Gallese
- Unit of Proctologic Surgery, "Sant'Antonio" Clinic, Cagliari, Italy
| | | | - Michele D'Ambra
- Department of General and Oncologic-Minivasive Surgery, "Federico II" University, Naples, Italy
| | - Roberto Rizzato
- Department of General Surgery, Hospital of Conegliano AULSS 2, Marca Trevigiana, Treviso, Italy
| | - Giacomo Sarzo
- Department of General Surgery, University of Padova, "Sant'Antonio" Hospital, Padova, Italy
| | | | - Francesca Da Pozzo
- Department of Surgery, "Santa Maria dei battuti" Hospital, San Vito al Tagliamento, Pordenone, Italy
| | - Simona Ascanelli
- Department of Surgery, University Hospital of Ferrara, Ferrara, Italy
| | - Fabrizio Foroni
- Deparment of Surgery, "A. Cardarelli" Hospital, Via A. Cardarelli 9, Naples, 80131, Italy
| | - Alessio Palumbo
- Deparment of Surgery, "A. Cardarelli" Hospital, Via A. Cardarelli 9, Naples, 80131, Italy
| | | | | | - Luigi Marano
- Academy of Applied Medical and Social Sciences - AMiSNS: Akademia Medycznych i Spolecznych Nauk Stosowanych, Elbląg, Poland
| | | | - Eugenio Cudazzo
- Department of Surgery, Pelvic Floor Center, AUSL-IRCCS Reggio Emilia, Reggio Emilia, Italy
| | - Francesca Babic
- Department of Surgery, Hospital of Cattinara, ASUGI Trieste, Trieste, Italy
| | - Carmelo Geremia
- Unit of Proctology and Pelvic Surgery, "Città di Pavia" Clinic, Pavia, Italy
| | | | - Mario Cicconi
- Department of General Surgery, "Sant'Omero-Val Vibrata" Hospital, Teramo, Italy
| | | | - Federico Maria Mongardini
- Department of Advanced Medical and Surgical Sciences, University of Campania "L. Vanvitelli", Naples, Italy
| | - Antonio Brescia
- Department of Oncologic Colorectal Surgery, University Hospital S. Andrea, "La Sapienza" University, Rome, Italy
| | - Leonardo Lenisa
- Department of Surgery, Humanitas San Pio X, Surgery Unit, Pelvic Floor Centre, Milano, Italy
| | | | | | - Luciano Vicenzo
- Deparment of Surgery, "A. Cardarelli" Hospital, Via A. Cardarelli 9, Naples, 80131, Italy
| | | | - Ludovico Docimo
- Department of Advanced Medical and Surgical Sciences, University of Campania "L. Vanvitelli", Naples, Italy
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Au ML, Li YY, Tong LK, Wang SC, Ng WI. Chinese version of Yoon Critical Thinking Disposition Instrument: validation using classical test theory and Rasch analysis. BMC Nurs 2023; 22:362. [PMID: 37803354 PMCID: PMC10559418 DOI: 10.1186/s12912-023-01519-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 09/18/2023] [Indexed: 10/08/2023] Open
Abstract
BACKGROUND Despite the availability of a wide range of critical thinking instruments, there was no original design for nurses that has been translated into Chinese. However, only instruments designed specifically for the nursing discipline would be reliable. This study aimed to translate, culturally adapt, and validate the Yoon Critical Thinking Disposition Instrument in the Chinese context. METHODS A four-step translation process was implemented according to Word Health Organization guidelines, which included forward translation, expert panel review, backward translation, and pre-testing. Experts and nursing students participated in testing the validity and reliability of the Chinese version. RESULTS The translation of the instrument went smoothly. According to a confirmatory factor analysis, there was an acceptable fit for the seven-factor model. Content validity indices ranged from 0.6 to 1 at item level, and 0.94 at scale level. In addition, there was extremely high internal consistency and test-retest reliability in the translated instrument. There was a good fit for the items with both person and item reliabilities greater than 0.6 and a separation index of 2.19, respectively. The item location was identified from the wright map as not covering person ability, but the scale did not have a gender-related differential item functioning. CONCLUSIONS In this study, a critical thinking disposition instrument for nursing students was translated into Chinese for the first time. This translated instrument is a reliable tool with satisfactory validity and reliability. It could provide opportunities for building a cross-cultural understanding of critical thinking disposition.
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Affiliation(s)
- Mio Leng Au
- Kiang Wu Nursing College of Macau, Macau SAR, China
| | - Yue Yi Li
- Kiang Wu Nursing College of Macau, Macau SAR, China
| | - Lai Kun Tong
- Kiang Wu Nursing College of Macau, Macau SAR, China.
| | - Si Chen Wang
- Kiang Wu Nursing College of Macau, Macau SAR, China
| | - Wai I Ng
- Kiang Wu Nursing College of Macau, Macau SAR, China
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Studart-Pereira LM, Bianchini EMG, Assis M, Bussi MT, Corrêa CDC, Cunha TCA, Drager LF, Ieto V, Lorenzi-Filho G, de Luccas GR, Brasil EL, Sovinski SRP, Zancanella E, Pires GN. Brazilian Consensus on Sleep-Focused Speech-Language-Hearing Sciences - 2023 Brazilian Sleep Association. Sleep Sci 2023; 16:489-506. [PMID: 38370880 PMCID: PMC10869236 DOI: 10.1055/s-0043-1776109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 09/21/2023] [Indexed: 02/20/2024] Open
Abstract
Introduction This consensus aimed to develop a structured document presenting the role of sleep-focused Speech-Language-Hearing (SPH) Sciences (SPHS). The recommendations were based on the expertise of specialists and on evidence in the literature, aiming to guide the coverage of this area and the consequent improvement in the quality of the professionals' approach. Methods A Delphi method was conducted with 49 SLH pathologists (SLHP), four sleep physicians, one dentist, one physical therapist, and one methodologist. Four Delphi panel rounds were conducted in Google Forms. The items were analyzed based on the panelists' percentage of agreement; consensuses were reached when ⅔ (66.6%) of valid responses were on a same on a same answer (either "agree" or "disagree"). Results Participants voted on 102 items. The mean consensus rate was 89.9% ± 10.9%. The essential topics were the importance of professional training, the SLH diagnosis, and the SLH treatment of sleep disorders. It was verified that all fields of the SLHS are related to the area of sleep; that sleep-focused SLH pathologists (SLHP) are the responsible for assessing, indicating, and conducting specific orofacial myofunctional therapy for sleep-disordered breathing alone or in combination with other treatments; that SLHP are included in interdisciplinary teams in the area of sleep in public and private services. Discussion The Brazilian consensus on sleep-focused SLHS is a landmark in this area. This consensus described the scope of action of sleep-focused SLHP and systematized recommendations being useful as a reference for the professional practice in the area of sleep.
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Affiliation(s)
- Luciana Moraes Studart-Pereira
- Brazilian Sleep Association, São Paulo Brazil.
- Department of Speech-Language-Hearing Science, Federal University of Pernambuco, Recife Brazil.
| | | | - Márcia Assis
- Brazilian Sleep Association, São Paulo Brazil.
- Clínica do Sono de Curitiba, Hospital São Lucas, Curitibá, Brazil.
| | - Marieli Timpani Bussi
- Institute of Otorhinolaryngology & Head and Neck Surgery at UNICAMP, IOU, São Paulo Brazil.
| | | | - Thays Crosara Abrahão Cunha
- Brazilian Association of Sleep Dentistry, São Paulo Brazil.
- Núcleo de Ensino, Odontologia do Sono, São Paulo, Brazil.
| | - Luciano Ferreira Drager
- Brazilian Sleep Association, São Paulo Brazil.
- Hypertension Units, Institute of the Heart (InCor), and Course on Nephrology, University of São Paulo, São Paulo Brazil.
| | - Vanessa Ieto
- Speech-Language-Hearing Council, Brazilian Sleep Association, São Paulo Brazil.
| | | | - Gabriele Ramos de Luccas
- Department of Speech-Language Pathology and Audiology, Bauru School of Dentistry, University of São Paulo, Bauru Brazil.
| | - Evelyn Lucien Brasil
- Brazilian Sleep Association, São Paulo Brazil.
- Department of Critical Care Medicina, Hospital Israelita Albert Einstein, São Paulo Brazil.
| | | | - Edilson Zancanella
- Brazilian Association of Sleep Medicine, São Paulo Brazil.
- State University of Campinas, Campinas, São Paulo Brazil.
| | - Gabriel Natan Pires
- Departamento de Psicobiologia, Universidade Federal de São Paulo – São Paulo Brazil.
- Sleep Institute, São Paulo Brazil.
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Henry JC, Wong LY, Reyes AM, Jin JZ, Ferguson MK, Yip CH, Hill A. Achieving global surgical excellence: an evidence-based framework to guide surgical quality improvement programs in low and middle income countries. FRONTIERS IN HEALTH SERVICES 2023; 3:1096144. [PMID: 37609518 PMCID: PMC10441221 DOI: 10.3389/frhs.2023.1096144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 07/24/2023] [Indexed: 08/24/2023]
Abstract
Objectives There is a lack of evidence-based guidelines for enhancing global surgical care delivery. We propose a set of recommendations to serve as a framework to guide surgical quality improvement and scale-up initiatives in low and middle income countries (LMICs). Methods From January-December 2019, we reviewed the available literature and their application toward LMIC settings. The first initiative was the establishment of Best Practices Recommendations intended to summarize best-level evidence around quality improvement processes that have shown to decrease morbidity and mortality in LMICs. The GRADE level of evidence and strength of the recommendation were assigned in accordance with the WHO handbook for guidelines development. The second initiative was the scale-up of principles and practices by establishing international expert consensus on the optimal organization of surgical services in LMICs using a modified Delphi methodology. Results Recommendations for three topic areas were established: reducing surgical site infections, improving quality of trauma systems, and interventions to reduce maternal and perinatal mortality. 27 studies were included in a quantitative synthesis and meta-analysis for interventions reducing surgical site infections, 27 studies for interventions improving the quality of trauma systems, and 14 studies for interventions reducing maternal and perinatal mortality. Using Delphi methodology, an international expert panel established consensus that district hospitals should place the highest priority on developing surgical services for low complexity, high volume conditions. At the national level, emergency and essential surgical care should be integrated within national Universal Health Coverage frameworks. Conclusions This project fills a critical cap in the rapidly developing field of global surgery: gathering evidence-based, practical, and cost-effective solutions that will serve as a guide for the efficient planning and allocation of resources necessary to promote quality and safe essential surgical services in LMICs.
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Affiliation(s)
- Jaymie Claire Henry
- Department of Cardiothoracic Surgery, Baylor College of Medicine, Houston, TX, United States
| | - Lye-Yeng Wong
- Department of Cardiothoracic Surgery, Stanford University, Palo Alto, CA, United States
| | - Ana M. Reyes
- Department of Surgery, University of Miami/Jackson Health System, Miami, FL, United States
| | - James Z. Jin
- Department of Surgery, The University of Auckland, Middlemore Hospital, Auckland, New Zealand
| | - Mark K. Ferguson
- Department of Cardiothoracic Surgery, University of Chicago, Chicago, IL, United States
| | - Cheng Har Yip
- Department of Surgery, University of Malaya, Kuala Lumpur, Malaysia
| | - Andrew Hill
- Department of Surgery, University of Miami/Jackson Health System, Miami, FL, United States
- Department of Surgery, The University of Auckland, Middlemore Hospital, Auckland, New Zealand
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Shelygin YA, Achkasov SI, Reshetov IV, Mayev IV, Drapkina OM, Belousova EA, Vardanyan AV, Nanaeva BA, Abdulganieva DI, Adamyan LV, Namazova-Baranova LS, Razumovsky AY, Revishvili AS, Khatkov IE, Shabunin AV, Livzan MA, Sazhin AV, Timerbulatov VM, Khlynova OV, Yatsyk SP, Abdulkhakov RA, Alekseeva OP, Alekseenko SA, Bakulin IG, Barysheva OY, Blagovestnov DA, Bolikhov KV, Veselov VV, Vinogradov YA, Golovenko OV, Gubonina IV, Gulyaev AA, Dolgushina AI, Dyakonova EY, Zhigalova TN, Karpukhin OY, Knyazev OV, Kostenko NV, Loranskaya ID, Moskalev AI, Odintsova AH, Omelyanovsky VV, Osipenko MF, Pavlenko VV, Poluektova EA, Popov DE, Rodoman GV, Segal AM, Sitkin SI, Skalinskaya MI, Surkov AN, Tarasova LV, Uspenskaya YB, Frolov SA, Chashkova EY, Shapovalyants SG, Shifrin OS, Shcherbakova OV, Shchukina OB, Shkurko TV, Nazarov IV, Mingazov AF. Consensus on controversial issues of the surgery for Crohn’s disease by Delphi method. KOLOPROKTOLOGIA 2023; 22:172-183. [DOI: 10.33878/2073-7556-2023-22-2-172-183] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/17/2024]
Abstract
AIM: to establish the consensus on controversial issues of the surgery for Сrohn’s disease by Delphi method.METHODS: a cross-sectional study was conducted by the Delphi method. 62 experts voted intramural and anonymous (31.03.23). 5 statements from the current edition of clinical guidelines were selected for correction by working group and further voting [2]. Based on the practical experience of the working group and literature data, 3 new statements were created also. Statements that do not reach the required level of agreement (80% or more) will be subjected to Round 2 of the Delphi method.RESULTS: all experts took part in the anonymous voting. The panel of experts is represented by 8 different areas of practical medicine and the median of the professional experience of the respondents was 30 (12–49) years. Of the 8 statements submitted for voting, consensus (80% or more) was reached on 6 out of 8. 2 statements have been revised by working group for the distance 2nd round of the Delphi study. Consensus (more than 80%) was reached on both.CONCLUSION: a cross-sectional study by the Delphi method provided the opinions of a panel of experts on controversial issues in the surgical treatment of Crohn’s disease. Statements that reach consensus will be included by the working group in a new edition of clinical guidelines of Crohn’s disease.
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Derendorf L, Stock S, Simic D, Lemmen C. Developing quality indicators for cross-sectoral psycho-oncology in Germany: combining the RAND/UCLA appropriateness method with a Delphi technique. BMC Health Serv Res 2023; 23:599. [PMID: 37291536 DOI: 10.1186/s12913-023-09604-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 05/25/2023] [Indexed: 06/10/2023] Open
Abstract
BACKGROUND Internationally, the need for appropriately structured, high-quality care in psycho-oncology is more and more recognized and quality-oriented care is to be established. Quality indicators are becoming increasingly important for a systematic development and improvement of the quality of care. The aim of this study was to develop a set of quality indicators for a new form of care, a cross-sectoral psycho-oncological care program in the German health care system. METHODS The widely established RAND/UCLA Appropriateness Method was combined with a modified Delphi technique. A systematic literature review was conducted to identify existing indicators. All identified indicators were evaluated and rated in a two-round Delphi process. Expert panels embedded in the Delphi process assessed the indicators in terms of relevance, data availability and feasibility. An indicator was accepted by consensus if at least 75% of the ratings corresponded to category 4 or 5 on a five-point Likert scale. RESULTS Of the 88 potential indicators derived from a systematic literature review and other sources, 29 were deemed relevant in the first Delphi round. After the first expert panel, 28 of the dissented indicators were re-rated and added. Of these 57 indicators, 45 were found to be feasible in terms of data availability by the second round of expert panel. In total, 22 indicators were transferred into a quality report, implemented and tested within the care networks for participatory quality improvement. In the second Delphi round, the embedded indicators were tested for their practicability. The final set includes 16 indicators that were operationalized in care practice and rated by the expert panel as relevant, comprehensible, and suitable for care practice. CONCLUSION The developed set of quality indicators has proven in practical testing to be a valid quality assurance tool for internal and external quality management. The study findings could contribute to traceable high quality in cross-sectoral psycho-oncology by providing a valid and comprehensive set of quality indicators. TRIAL REGISTRATION "Entwicklung eines Qualitätsmanagementsystems in der integrierten, sektorenübergreifenden Psychoonkologie-AP "Qualitätsmanagement und Versorgungsmanagement" zur Studie "integrierte, sektorenübergreifende Psychoonkologie (isPO)" a sub-project of the "integrierte, sektorenübergreifende Psychoonkologie (isPO)", was registered in the German Clinical Trials Register (DRKS) (DRKS-ID: DRKS00021515) on 3rd September 2020. The main project was registered on 30th October 2018 (DRKS-ID: DRKS00015326).
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Affiliation(s)
- Lisa Derendorf
- Institute for Health Economics and Clinical Epidemiology (IGKE), University of Cologne, Faculty of Medicine and University Hospital Cologne, Gleueler Str. 176-178, 50935, Cologne, Germany.
| | - Stephanie Stock
- Institute for Health Economics and Clinical Epidemiology (IGKE), University of Cologne, Faculty of Medicine and University Hospital Cologne, Gleueler Str. 176-178, 50935, Cologne, Germany
| | - Dusan Simic
- Institute for Health Economics and Clinical Epidemiology (IGKE), University of Cologne, Faculty of Medicine and University Hospital Cologne, Gleueler Str. 176-178, 50935, Cologne, Germany
| | - Clarissa Lemmen
- Institute for Health Economics and Clinical Epidemiology (IGKE), University of Cologne, Faculty of Medicine and University Hospital Cologne, Gleueler Str. 176-178, 50935, Cologne, Germany
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Adje M, Steinhäuser J, Stevenson K, Mbada C, Alonge V, Karstens S. Developing tailored intervention strategies for implementation of stratified care to low back pain with physiotherapists in Nigeria: a Delphi study. BMC Health Serv Res 2023; 23:134. [PMID: 36759830 PMCID: PMC9909884 DOI: 10.1186/s12913-023-09123-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 01/30/2023] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND Stratified care approach involving use of the STarT-Back tool to optimise care for patients with low back pain is gaining widespread attention in western countries. However, adoption and implementation of this approach in low-and-middle-income countries will be restricted by context-specific factors that need to be addressed. This study aimed to develop with physiotherapists, tailored intervention strategies for the implementation of stratified care for patients with low back pain. METHODS A two-round web-based Delphi survey was conducted among purposively sampled physiotherapists with a minimum of three years of clinical experience, with post-graduation certification or specialists. Thirty statements on barriers and enablers for implementation were extracted from the qualitative phase. Statements were rated by a Delphi panel with additional open-ended feedback. After each Delphi round, participants received feedback which informed their subsequent responses. Additional qualitative feedback were analysed using qualitative content analysis. The criteria for consensus and stability were pre-determined using percentage agreement (≥ 75%), median value (≥ 4), Inter-quartile range (≤ 1), and Wilcoxon matched-pairs test respectively. RESULTS Participants in the first round were 139 and 125 of them completed the study, yielding a response rate of 90%. Participants were aged 35.2 (SD6.6) years, and 55 (39.6%) were female. Consensus was achieved in 25/30 statements. Wilcoxon's test showed stability in responses after the 5 statements failed to reach consensus: 'translate the STarT-Back Tool to pidgin language' 71% (p = 0.76), 'begin implementation with government hospitals' 63% (p = 0.11), 'share knowledge with traditional bone setters' 35% (p = 0.67), 'get second opinion on clinician's advice' 63% (p = 0.24) and 'carry out online consultations' 65% (p = 0.41). Four statements strengthened by additional qualitative data achieved the highest consensus: 'patient education' (96%), 'quality improvement appraisals' (96%), 'undergraduate training on psychosocial care' (96%) and 'patient-clinician communication' (95%). CONCLUSION There was concordance of opinion that patients should be educated to correct misplaced expectations and proper time for communication is vital to implementation. This communication should be learned at undergraduate level, and for already qualified clinicians, quality improvement appraisals are key to sustained and effective care. These recommendations provide a framework for future research on monitored implementation of stratified care in middle-income countries.
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Affiliation(s)
- Mishael Adje
- Therapeutic Sciences, Trier University of Applied Sciences, Trier, Germany. .,Institute of Family Medicine, University of Luebeck, Luebeck, Germany.
| | - Jost Steinhäuser
- grid.4562.50000 0001 0057 2672Institute of Family Medicine, University of Luebeck, Luebeck, Germany
| | - Kay Stevenson
- grid.9757.c0000 0004 0415 6205The Impact Accelerator Unit, The Medical School Keele University, Keele, United Kingdom
| | - Chidozie Mbada
- grid.25627.340000 0001 0790 5329Department of Health Professions, Manchester Metropolitan University, Manchester, United Kingdom
| | - Victor Alonge
- Department of Physiotherapy, Exercise and Sports, LUNEX International University of Health, Differdange, Luxembourg
| | - Sven Karstens
- grid.434099.30000 0001 0475 0480Therapeutic Sciences, Department of Computer Science, Trier University of Applied Sciences, Trier, Germany
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Taylor-Swanson L, Levett K. Leveraging Interprofessional Collaboration to Collect Agreed Common Outcomes in Everyday Clinical Practice. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2022; 28:911-915. [PMID: 36269344 DOI: 10.1089/jicm.2022.0733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Lisa Taylor-Swanson
- College of Nursing, University of Utah, Salt Lake City, UT, USA.,Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Kate Levett
- National School of Medicine, The University of Notre Dame Australia, Darlinghurst, Australia, USA.,NICM Health Research Institute, THRI, University of Western Sydney, Sydney, Australia.,Centre for Midwifery, Child and Family Health, University of Technology Sydney, Sydney, Australia
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Occurrence and Definitions of Intra and Postoperative Complications Related to Laparoscopy in Equids: A Scoping Review. Vet Sci 2022; 9:vetsci9100577. [PMID: 36288190 PMCID: PMC9609183 DOI: 10.3390/vetsci9100577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 10/11/2022] [Accepted: 10/11/2022] [Indexed: 11/06/2022] Open
Abstract
Simple Summary Laparoscopy and laparoscopic-assisted procedures in equines are nowadays common procedures with several advantages compared to laparotomy. However, despite the numerous benefits of minimally invasive surgery, there can be surgical complications which could have important welfare and economic consequences. Nevertheless, standard definitions of intra and postoperative complications are rarely reported and there is a lack of standard criteria to define and classify complications, limiting comparison of complication rates between studies. Thus, there is a need for implementation of rigorous criteria for defining complications and for greater numbers of research study with high quality of evidence. Adoption of classification systems and standard definitions would help surgeons to have a complete picture of the efficacy of a procedure or treatment and it is also essential to allow comparisons between studies, centers or time periods. Abstract Laparoscopy is a common approach in equine surgery and has the advantage of improved visibility and diagnostic accuracy, decreased morbidity and hospitalization time. However, despite the numerous benefits, there can be intraoperative and postoperative complications which could have important welfare and economic consequences. The aim of this study was to perform a scoping review to identify current evidence on the occurrence, definition and classification of intra and postoperative complications in equine laparoscopy. A scoping review was conducted in scientific databases. Peer-reviewed scientific articles in the English language on laparoscopy in equids between 1992 and 2022 were included. Data on the study method, sample size, surgical procedure, intra and postoperative complications were extracted and charted. One hundred sixty-four articles met the final inclusion criteria. A definition of “intraoperative complication” was given in one study. Difference between “minor” or “major” intraoperative complications were reported in 12 articles and between “minor” or “major” postoperative complications in 22 articles. A total of 22 intraoperative and 34 postoperative complications were described. The most reported intraoperative complication was hemorrhage from ovary or mesovary (12.7%), while the most reported postoperative complications were incisional complications (64.2%) and postoperative pain (32.7%). There is a need for implementation of criteria for defining complications. The adoption of classification systems and standard definitions would help surgeons to make decisions about the most appropriate treatment, and it is also essential to allow comparisons between research results.
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van Zuuren EJ, Logullo P, Price A, Fedorowicz Z, Hughes EL, Gattrell WT. Existing guidance on reporting of consensus methodology: a systematic review to inform ACCORD guideline development. BMJ Open 2022; 12:e065154. [PMID: 36201247 PMCID: PMC9462098 DOI: 10.1136/bmjopen-2022-065154] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 08/16/2022] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To identify evidence on the reporting quality of consensus methodology and to select potential checklist items for the ACcurate COnsensus Reporting Document (ACCORD) project to develop a consensus reporting guideline. DESIGN Systematic review. DATA SOURCES Embase, MEDLINE, Web of Science, PubMed, Cochrane Library, Emcare, Academic Search Premier and PsycINFO from inception until 7 January 2022. ELIGIBILITY CRITERIA Studies, reviews and published guidance addressing the reporting quality of consensus methodology for improvement of health outcomes in biomedicine or clinical practice. Reports of studies using or describing consensus methods but not commenting on their reporting quality were excluded. No language restrictions were applied. DATA EXTRACTION AND SYNTHESIS Screening and data extraction of eligible studies were carried out independently by two authors. Reporting quality items addressed by the studies were synthesised narratively. RESULTS Eighteen studies were included: five systematic reviews, four narrative reviews, three research papers, three conference abstracts, two research guidance papers and one protocol. The majority of studies indicated that the quality of reporting of consensus methodology could be improved. Commonly addressed items were: consensus panel composition; definition of consensus and the threshold for achieving consensus. Items least addressed were: public patient involvement (PPI); the role of the steering committee, chair, cochair; conflict of interest of panellists and funding. Data extracted from included studies revealed additional items that were not captured in the data extraction form such as justification of deviation from the protocol or incentives to encourage panellist response. CONCLUSION The results of this systematic review confirmed the need for a reporting checklist for consensus methodology and provided a range of potential checklist items to report. The next step in the ACCORD project builds on this systematic review and focuses on reaching consensus on these items to develop the reporting guideline. PROTOCOL REGISTRATION https://osf.io/2rzm9.
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Affiliation(s)
- Esther J van Zuuren
- Department of Dermatology, Leiden University Medical Center, Leiden, Zuid-Holland, Netherlands
| | - Patricia Logullo
- Nuffield Department of Orthopaedics, Rheumatology and Muskuloskeletal Sciences, Centre for Statistics in Medicine, University of Oxford and EQUATOR Network UK Centre, Oxford, Oxfordshire, UK
| | - Amy Price
- Stanford Anesthesia, Informatics and Media Lab, Stanford University School of Medicine, Stanford, California, USA
- The BMJ, London, UK
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