1
|
Flintoft-Burt M, Stanier P, Planner A, Thahal H, Woods D. Recurrence of the frozen shoulder after hydrodilatation, what is the true incidence? Shoulder Elbow 2023; 15:610-618. [PMID: 37981967 PMCID: PMC10656972 DOI: 10.1177/17585732221124914] [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: 02/16/2022] [Revised: 06/05/2022] [Accepted: 08/23/2022] [Indexed: 11/21/2023]
Abstract
Purpose of the study To assess the outcome and recurrence rates of frozen shoulder treated by hydrodilatation in an independent hospital setting. Method Patients presenting to a shoulder clinic from August 2019 to July 2021 with a diagnosis of frozen shoulder were offered hydrodilatation. Data included primary or secondary frozen shoulder, length of symptoms, and diabetic status. An Oxford Shoulder Score was completed prior to hydrodilatation. Using ultrasound guidance, 40 mg Triamcinolone and local anaesthetic (10-25 mL depending on patient tolerance) were injected into the rotator interval. At a mean of 9 months, patients recorded their tolerance of the procedure, subsequent progress, the need for further treatment, and their current Oxford Shoulder Score. Results From 55 shoulders, six patients had a failure to improve and 10 patients had a transient improvement followed by recurrence (29%). 2/21 (9.5%) patients had 25 mL injected compared to 14/34 (41%) who had < = 20 mL (p = 0.012). 14/43 (33%) of primary frozen shoulder patients had a recurrence, compared with 2/12 (16%) secondary frozen shoulder patients, p = 0.019. Conclusion Further treatment was indicated in 14/34 (41%) of patients who underwent hydrodilatation in the frozen stage of frozen shoulder and could not tolerate more than 20 mL of injection, and was more commonly required in primary (33%) versus secondary (16%) frozen shoulder.
Collapse
Affiliation(s)
| | - Paul Stanier
- Trauma and Orthopaedics, Great Western Hospitals NHS Foundation Trust, Swindon, UK
| | - Andy Planner
- Radiology, BMI The Ridgeway Hospital, Swindon, UK
| | | | - David Woods
- Orthopaedics, BMI The Ridgeway Hospital, Swindon UK
| |
Collapse
|
2
|
Manobianco A, Seah S, Fraval A, Tran P. How the internet is accessed by and influences surgical patient's decision making. ANZ J Surg 2023; 93:2054-2055. [PMID: 37265079 DOI: 10.1111/ans.18554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 05/22/2023] [Indexed: 06/03/2023]
Affiliation(s)
- Alexander Manobianco
- Department of Orthopaedic Surgery, Western Health, Melbourne, Victoria, Australia
- Melbourne Clinical School, The University of Notre Dame, Werribee, Victoria, Australia
| | - Sebastian Seah
- Department of Orthopaedic Surgery, Western Health, Melbourne, Victoria, Australia
| | - Andrew Fraval
- Department of Orthopaedic Surgery, Western Health, Melbourne, Victoria, Australia
| | - Phong Tran
- Department of Orthopaedic Surgery, Western Health, Melbourne, Victoria, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, Melbourne, Victoria, Australia
| |
Collapse
|
3
|
Lans A, Kanbier LN, Bernstein DN, Groot OQ, Ogink PT, Tobert DG, Verlaan JJ, Schwab JH. Social determinants of health in prognostic machine learning models for orthopaedic outcomes: A systematic review. J Eval Clin Pract 2023; 29:292-299. [PMID: 36099267 DOI: 10.1111/jep.13765] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 08/22/2022] [Accepted: 08/27/2022] [Indexed: 11/26/2022]
Abstract
RATIONAL Social determinants of health (SDOH) are being considered more frequently when providing orthopaedic care due to their impact on treatment outcomes. Simultaneously, prognostic machine learning (ML) models that facilitate clinical decision making have become popular tools in the field of orthopaedic surgery. When ML-driven tools are developed, it is important that the perpetuation of potential disparities is minimized. One approach is to consider SDOH during model development. To date, it remains unclear whether and how existing prognostic ML models for orthopaedic outcomes consider SDOH variables. OBJECTIVE To investigate whether prognostic ML models for orthopaedic surgery outcomes account for SDOH, and to what extent SDOH variables are included in the final models. METHODS A systematic search was conducted in PubMed, Embase and Cochrane for studies published up to 17 November 2020. Two reviewers independently extracted SDOH features using the PROGRESS+ framework (place of residence, race/ethnicity, Occupation, gender/sex, religion, education, social capital, socioeconomic status, 'Plus+' age, disability, and sexual orientation). RESULTS The search yielded 7138 studies, of which 59 met the inclusion criteria. Across all studies, 96% (57/59) considered at least one PROGRESS+ factor during development. The most common factors were age (95%; 56/59) and gender/sex (96%; 57/59). Differential effect analyses, such as subgroup analysis, covariate adjustment, and baseline comparison, were rarely reported (10%; 6/59). The majority of models included age (92%; 54/59) and gender/sex (69%; 41/59) as final input variables. However, factors such as insurance status (7%; 4/59), marital status (7%; 4/59) and income (3%; 2/59) were seldom included. CONCLUSION The current level of reporting and consideration of SDOH during the development of prognostic ML models for orthopaedic outcomes is limited. Healthcare providers should be critical of the models they consider using and knowledgeable regarding the quality of model development, such as adherence to recognized methodological standards. Future efforts should aim to avoid bias and disparities when developing ML-driven applications for orthopaedics.
Collapse
Affiliation(s)
- Amanda Lans
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.,Department of Orthopaedic Surgery, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Laura N Kanbier
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - David N Bernstein
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Olivier Q Groot
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.,Department of Orthopaedic Surgery, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Paul T Ogink
- Department of Orthopaedic Surgery, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Daniel G Tobert
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Jorrit-Jan Verlaan
- Department of Orthopaedic Surgery, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Joseph H Schwab
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| |
Collapse
|
4
|
Binnie T, O'Sullivan P, Bunzli S, Campbell A, Ng L, Kent P, Smith A. How Do People With Knee Osteoarthritis Conceptualize Knee Confidence? A Qualitative Study. Phys Ther 2022; 102:6609082. [PMID: 35713515 DOI: 10.1093/ptj/pzac082] [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: 10/08/2021] [Revised: 03/16/2022] [Accepted: 05/31/2022] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Reduced knee confidence is common in people with knee osteoarthritis (OA) and is likely to influence how people with knee OA engage with movement and activities. However, there is conflicting evidence surrounding the association between confidence and function. This may be because knee confidence has been assessed via a single questionnaire item that was not developed for people with knee OA and thus may not provide an accurate or comprehensive assessment of confidence in this population. A better understanding of knee confidence could inform a more thorough assessment of the construct both in clinical and research contexts. Therefore, the aim of this study was to explore the meaning of knee confidence from the perspective of people with knee OA. METHODS Fifty-one people with a clinical diagnosis of knee OA took part in a one-to-one semistructured interview. Interviews explored how each participant conceptualized knee confidence. Reflexive thematic analysis was selected as a flexible approach for identifying patterns of meaning across cases through a combination of data-driven and theory-informed coding of the transcribed data. RESULTS People with knee OA conceptualized confidence with reference to 1 or more of 4 themes: (1) symptoms, (2) functional ability, (3) the internal structure of the knee, and (4) knowledge about knee OA and its management. Each conceptualization of confidence was associated with present and future concerns. CONCLUSION Because people with knee OA conceptualize knee confidence in different ways, a single-item measure is unlikely to capture all of the aspects of this construct in this population. This may explain the conflicting evidence around the association between reduced knee confidence and function in people with knee OA. IMPACT This study showed that a multi-item measure is needed to measure knee confidence in people with knee OA. Clinicians and researchers need to understand what knee confidence means to people with knee OA, because it is likely to influence how these individuals engage with movement and activities. Understanding this relationship can enable more targeted education and functional rehabilitation for people with knee OA.
Collapse
Affiliation(s)
- Tara Binnie
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Peter O'Sullivan
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia.,Body Logic Physiotherapy, Perth, Western Australia, Australia
| | - Samantha Bunzli
- The University of Melbourne, Department of Surgery, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia
| | - Amity Campbell
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Leo Ng
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Peter Kent
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Anne Smith
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
| |
Collapse
|
5
|
Heath EL, Ackerman IN, Holder C, Lorimer MF, Graves SE, Harris IA. Between-hospital and between-surgeon variation in thresholds for hip and knee replacement. ANZ J Surg 2022; 92:2229-2234. [PMID: 35642256 DOI: 10.1111/ans.17811] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 04/14/2022] [Accepted: 05/09/2022] [Indexed: 01/12/2023]
Abstract
BACKGROUND Total hip replacement (THR) and total knee replacement (TKR) are cost-effective interventions to reduce pain and disability associated with osteoarthritis, however there is no clear guidelines available to determine appropriate patient selection and the timing of surgery. This prospective cohort study aimed to evaluate the hospital- and surgeon-level variation in the severity of patient-reported symptoms prior to THR and TKR. METHODS Patients undergoing primary THR (n = 4330) or TKR (n = 7054) for osteoarthritis who participated in a national registry-led Patient Reported Outcome Measures (PROMs) pilot program were included in the analysis. Pre-operative Oxford Hip Score (OHS) and Oxford Knee Score (OKS) (range 0-48; representing worst to best hip/knee pain and function) data were examined for variation between private and public hospitals and between surgeons using linear mixed models. RESULTS Pre-operative mean OHS was significantly higher (better) in patients whose surgery was performed in a private hospital compared to public hospitals; 21.39 versus 18.11 (mean difference 3.27, 95% CI 1.75, 4.79). For OKS, the difference between private hospital and public hospital scores was dependent on BMI and gender. Most of the variation in pre-operative OHS and OKS was not at the individual hospital- or surgeon-level, which explained only a negligible proportion of the model variance (⟨5%) for THR and TKR. CONCLUSION Apart from a difference between private and public hospitals, there was little between-hospital or between-surgeon symptom variation in joint-specific pain and function prior to THR or TKR. The findings suggest consistency in the surgical thresholds for patients being offered hip and knee joint replacement procedures.
Collapse
Affiliation(s)
- Emma L Heath
- South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia, Australia
| | - Ilana N Ackerman
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Carl Holder
- South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia, Australia
| | - Michelle F Lorimer
- South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia, Australia
| | - Stephen E Graves
- Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR), Adelaide, South Australia, Australia.,Clinical and Health Sciences, University of South Australia, Adelaide, South Australia, Australia
| | - Ian A Harris
- Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR), Adelaide, South Australia, Australia.,South Western Sydney Clinical School and Ingham Institute for Applied Medical Research, University of New South Wales, Sydney, New South Wales, Australia
| |
Collapse
|
6
|
Rohringer M, Fink C, Kellerer JD, Schulc E. Longitudinal observational study on health literacy and clinical outcomes in older adults with total knee arthroplasty in the context of inpatient and outpatient rehabilitation. JOURNAL OF ORTHOPAEDICS, TRAUMA AND REHABILITATION 2022. [DOI: 10.1177/22104917221092161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Purpose To assess health literacy (HL) of patients with total knee arthroplasty (TKA) and evaluate its impact on patient reported outcome measures (PROMs) as well as investigating outcome differences in inpatient and outpatient rehabilitation. Methods In this study, HL and PROMs of older patients were assessed preoperatively (T0) and after 3 (T1), 6 (T2), and 12 (T3) months. HL was assessed with the short form of the European HL Questionnaire; pain scores, functional restrictions, and activity levels with standardized PROMs. Results Limited HL was observed in 70.6% of patients at T0. HL improved from baseline to follow-ups (p < 0.001). There was no impact of HL on PROMs. Pain scores were higher in patients undergoing outpatient rehabilitation (p = 0.022). No differences were found between the rehabilitation settings for the other outcomes. Conclusion The study shows that limited HL is prevalent in patients with scheduled TKA. Rehabilitation seems to have a positive effect on increasing HL.
Collapse
Affiliation(s)
- Matthias Rohringer
- Department of Nursing Science and Gerontology, Institute of Nursing Science, UMIT–Private University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
| | - Christian Fink
- Research Unit for Orthopaedic Sports Medicine and Injury Prevention, Institute for Sports Medicine, Alpine Medicine and Health Tourism, UMIT–Private University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
- Gelenkpunkt–Sports and Joint Surgery, Innsbruck, Austria
| | - Jan Daniel Kellerer
- Department of Nursing Science and Gerontology, Institute of Nursing Science, UMIT–Private University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
| | - Eva Schulc
- Department of Nursing Science and Gerontology, Division of Integrated Care, UMIT–Private University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
| |
Collapse
|
7
|
Characteristics and Injury Patterns of Road Traffic Injuries in Urban and Rural Uganda-A Retrospective Medical Record Review Study in Two Hospitals. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147663. [PMID: 34300111 PMCID: PMC8304504 DOI: 10.3390/ijerph18147663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 07/14/2021] [Accepted: 07/16/2021] [Indexed: 11/17/2022]
Abstract
In the ongoing Second Decade of Action for Road Safety, road traffic crashes pose a considerable threat especially in low-income countries. Uganda shows a vast burden of non-fatal injuries and resides at the top range of countries with the highest death rates due to unsafe roads. However, little is known about the differences in road traffic associated injuries between urban and rural areas and potential influence factors. Here, we used a cross-sectional study conducted by a retrospective medical record review from trauma cases admitted in 2016 to hospitals in rural and urban areas in Uganda. Injury severity scores were calculated and descriptive analysis was carried out while multivariate logistic regression was applied to assess significant covariates. According to the 1683 medical records reviewed, the mean age of trauma patients in the dataset under investigation was 30.8 years with 74% male. The trauma in-hospital mortality was 4% while prevalence of traumatic injuries is 56.4%. Motorcycle users (49.6%) and pedestrians (33.7%) were identified as the most vulnerable groups in both urban and rural setting while mild injuries of extremities (61.6%) and the head/neck-region (42.0%) were registered most. The frequency of road traffic injuries was homogenous in the urban and rural hospitals investigated in this study; interventions should therefore be intensified ubiquitously. The identification of significant differences in road traffic crash and injury characteristics provides the opportunity for specific programmes to decrease the socio-economic and health burden of unsafe roads. In addition to law enforcement and introduction of a Systems Thinking approach to road safety including infrastructural and educational concepts, the strengthening of trauma care and health resources is recommended.
Collapse
|
8
|
Health literacy and clinical outcomes in patients with total knee arthroplasty in different rehabilitation settings: An exploratory prospective observational study. Int J Orthop Trauma Nurs 2021; 42:100865. [PMID: 34090254 DOI: 10.1016/j.ijotn.2021.100865] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 04/14/2021] [Accepted: 04/23/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Limited health literacy is associated with negative clinical outcomes. Although research on health literacy has increased in recent years, there is still a lack of evidence for orthopaedic patients undergoing joint replacement and in the rehabilitation sector. OBJECTIVES The aims of this study were to assess health literacy of patients undergoing total knee arthroplasty (TKA) and to observe its course during rehabilitation. Furthermore, we aimed to investigate associations between health literacy and clinical outcomes as well as differences regarding rehabilitation settings. METHODS In this prospective observational study, data about (n = 92) patients' health literacy and clinical outcomes were collected. Baseline assessments were conducted preoperatively (T0) and followed-up after three (T1) and six (T2) months. Health literacy was assessed with the European Health Literacy Questionnaire, pain scores, functional restrictions and activity levels with standardised patient-reported outcome measures (PROMs). Subgroup analyses were conducted regarding inpatient and outpatient rehabilitation. RESULTS Out of 92 patients, 77 completed postoperative rehabilitation between T0 and T1. Health literacy improved from T0 to T1 (p < 0.001) and subsequently remained constant until T2. Although the study showed an average improvement in health literacy scores in post-discharge rehabilitation, subgroup analyses indicated that patients did not achieve higher levels of health literacy. Pain scores were higher in patients undergoing outpatient rehabilitation (p = 0.022). No differences were found in other outcomes regarding rehabilitation settings and health literacy. CONCLUSIONS Based on our results, there seems to be no association between health literacy and clinical outcomes. Furthermore, the results regarding health literacy over the rehabilitation period indicated a need for enhancement of educational strategies to strengthen health literacy in the context of inpatient and outpatient orthopaedic rehabilitation.
Collapse
|
9
|
Davaris MT, Bunzli S, Dowsey MM, Choong PF. Gamifying health literacy: how can digital technology optimize patient outcomes in surgery? ANZ J Surg 2021; 91:2008-2013. [PMID: 33825300 DOI: 10.1111/ans.16753] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 02/22/2021] [Accepted: 03/07/2021] [Indexed: 01/22/2023]
Abstract
The digital age is entrenched in our society, with constant innovation driving change in the way clinicians and patients manage their health concerns. Health literacy is emerging as an important modifiable factor that can affect clinical and patient outcomes, yet traditional forms of patient education have shown mixed results. Digital media and technologies, the concept of gamification as a means to improve patient health literacy, and its potential for misuse will be explored in this review, in the context of a digital, gamified tool that could support patients along their surgical journey.
Collapse
Affiliation(s)
- Myles T Davaris
- Department of Surgery, University of Melbourne, St Vincent's Hospital, Fitzroy, Victoria, Australia
| | - Samantha Bunzli
- Department of Surgery, University of Melbourne, St Vincent's Hospital, Fitzroy, Victoria, Australia
| | - Michelle M Dowsey
- Department of Surgery, University of Melbourne, St Vincent's Hospital, Fitzroy, Victoria, Australia
| | - Peter F Choong
- Department of Surgery, University of Melbourne, St Vincent's Hospital, Fitzroy, Victoria, Australia
| |
Collapse
|
10
|
I R de Oliveira B, Smith AJ, O'Sullivan PPB, Haebich S, Fick D, Khan R, Bunzli S. 'My hip is damaged': a qualitative investigation of people seeking care for persistent hip pain. Br J Sports Med 2020; 54:858-865. [PMID: 31980419 DOI: 10.1136/bjsports-2019-101281] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2020] [Indexed: 12/30/2022]
Abstract
OBJECTIVES Clinicians who use the biopsychosocial approach to manage musculoskeletal pain disorders aim to understand how patients make sense of their symptoms. Treatment includes targeting the negative beliefs and coping responses that can lead to progressive pain and disability. We aimed to explore how people seeking care for persistent hip pain and disability make sense of their symptoms. METHODS Cross-sectional qualitative study. People were eligible if they were aged ≥18 years, were consulting an orthopaedic surgeon for persistent hip pain and offered a non-surgical intervention. Data were collected through interviews that explored patients' beliefs about the identity (diagnosis), causes, consequences, timeline and controllability of their symptoms, their strategies to cope with pain and their experiences in seeking healthcare. Transcribed interview data were analysed thematically using a framework approach. RESULTS Sixteen people (median age=51, range=33-73 years; median duration hip pain=3 years, range=3 months-20 years) participated. Most participants (10/16) believed their pain was caused by an exercise-related injury. Because of the results of imaging and interactions with healthcare professionals, all participants believed they had damaged hip structures. All described ineffective strategies to manage their pain and multiple failed treatments. For many (7/16), a lack of control over symptoms threatened their physical and mental health. CONCLUSIONS The way participants with persistent hip pain and disability made sense of their symptoms contributed to them avoiding physical activity, and it impaired their sleep, emotional well-being and physical health.
Collapse
Affiliation(s)
- Beatriz I R de Oliveira
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
| | - Anne Julia Smith
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
| | - Peter P B O'Sullivan
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
| | - Samantha Haebich
- Hollywood Medical Centre, Hollywood Private Hospital, Nedlands, Western Australia, Australia
| | - Daniel Fick
- Hollywood Medical Centre, Hollywood Private Hospital, Nedlands, Western Australia, Australia.,Faculty of Science and Engineering, Curtin University, Perth, Western Australia, Australia
| | - Riaz Khan
- Faculty of Science and Engineering, Curtin University, Perth, Western Australia, Australia.,School of Medicine, The University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - Samantha Bunzli
- Department of Surgery, St Vincent's Hospital, The University of Melbourne, Melbourne, Victoria, Australia
| |
Collapse
|