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Väyrynen KML, Chen A, Heinonen S, Tekay A, Torkki P. Roles of different organizations in implementing patient-reported measures in routine maternity care in Finland. J Patient Rep Outcomes 2024; 8:117. [PMID: 39361084 PMCID: PMC11450123 DOI: 10.1186/s41687-024-00793-x] [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: 06/10/2024] [Accepted: 09/25/2024] [Indexed: 10/05/2024] Open
Abstract
BACKGROUND The integration of patient-centered care (PCC) and value-based healthcare (VBHC) principles, emphasizing personalized, responsive care and cost efficiency, is crucial in modern healthcare. Despite advocation from the International Consortium for Health Outcomes Measurement (ICHOM) for the global adoption of these principles through patient-reported measures (PRMs), their implementation, especially the pregnancy and childbirth (PCB) set, remains limited in maternity care. This study focuses on understanding the optimal organizational entity for integrating standard ICHOM-PCB-PRMs into routine maternity care in Finland. It aims to clarify the distribution of tasks among stakeholders and gather Finnish maternity healthcare professionals' perspectives on organizational responsibility in PRM collection. The emphasis was on identifying the optimal organizational framework for managing PRMs in maternity care. RESULTS A total of 66 maternity healthcare professionals participated in the study, reaching a consensus that public maternity care centers in Finland should be the primary entity responsible for managing PRMs in the maternity sector. Key aspects such as confidence with the role as a mother, maternal confidence with breastfeeding, and satisfaction with the result of care were identified as crucial and should be inquired about in both public maternity care centers and hospital maternity wards. The findings highlight the importance of comprehensive and consistent attention to these PRMs across public maternity care centers and hospital maternity settings to ensure holistic and effective maternal care. CONCLUSIONS The study highlights the central role of public maternity care centers in the collection and management of PRMs within Finnish maternity care, as agreed upon by the professional consensus. It underscores the importance of a consistent and holistic approach to PRM inquiry across different care settings to enhance the quality and effectiveness of maternity care. This finding is crucial for policymakers and healthcare practitioners, suggesting that reinforcing the collaborative efforts between public maternity care centers and hospital maternity wards is vital for a patient-centric, efficient healthcare system. Aligning with PCC and VBHC principles, this approach aims to improve healthcare outcomes for pregnant and postpartum women in Finland, emphasizing the need for a unified strategy in managing maternity care.
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Affiliation(s)
- Kirsi Marja-Leena Väyrynen
- Wellbeing Services County of Central Finland/Hospital Nova of Central Finland, Hoitajantie 3, Jyvaskyla, FI-40620, Finland.
- Department of Public Health, Faculty of Medicine, University of Helsinki, Biomedicum 1, Haartmaninkatu 8 b, Helsinki, 00290, Finland.
| | - An Chen
- School of Public Health, Zhejiang Chinese Medical University, No. 548 Binwen Road, Binjiang District, Hangzhou, Zhejiang Province, 310053, China
- Department of Obstetrics and Gynaecology, Helsinki University Hospital and University of Helsinki, Haartmaninkatu 2, Helsinki, 00290, Finland
| | - Seppo Heinonen
- Department of Obstetrics and Gynaecology, Helsinki University Hospital and University of Helsinki, Haartmaninkatu 2, Helsinki, 00290, Finland
| | - Aydin Tekay
- Department of Obstetrics and Gynaecology, Helsinki University Hospital and University of Helsinki, Haartmaninkatu 2, Helsinki, 00290, Finland
| | - Paulus Torkki
- Department of Public Health, Faculty of Medicine, University of Helsinki, Biomedicum 1, Haartmaninkatu 8 b, Helsinki, 00290, Finland
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Wittich L, Tsatsaronis C, Kuklinski D, Schöner L, Steinbeck V, Busse R, Rombey T. Patient-Reported Outcome Measures as an Intervention: A Comprehensive Overview of Systematic Reviews on the Effects of Feedback. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2024; 27:1436-1453. [PMID: 38843978 DOI: 10.1016/j.jval.2024.05.013] [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: 10/11/2023] [Revised: 05/30/2024] [Accepted: 05/30/2024] [Indexed: 06/28/2024]
Abstract
OBJECTIVES Patient-reported outcome measures (PROMs) have emerged as a promising approach to involve patients in their treatment process. Beyond serving as outcome measures, PROMs can be applied to provide feedback to healthcare providers and patients, thereby offering valuable insights that can improve health outcomes and care processes. This overview offers a comprehensive synthesis of the effects of PROM feedback, contributing to the evidence-based discussion on PROMs' potential to enhance patient care. METHODS Following Cochrane Collaboration recommendations, this overview included literature reviews across diverse treatment areas, investigating the impact of PROM feedback on patient health outcomes (including quality of life, symptoms, or survival) and care process outcomes (including communication, symptom identification, or clinical practice). The methodological quality of the evidence was assessed with a modified version of A Measurement Tool to Assess Systematic Reviews 2, and the potential overlap of primary studies was quantified. Results were narratively synthesized. RESULTS Forty reviews grouped into 4 categories of treatment areas were included. Overall, their methodological quality was low. The overall overlap of primary studies was 2.2%, reaching up to 15.7% within specific treatment areas. The results indicate that PROM feedback may enhance the quality-of-care processes, whereas its effects on patient health outcomes remained less conclusive. CONCLUSIONS PROM feedback positively influences the interaction between physicians and patients across the included treatment areas. Further research is needed to comprehend the trickle-down effects of PROM feedback and how to enhance its potential in yielding health benefits for patients.
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Affiliation(s)
- Laura Wittich
- Department of Health Care Management, School of Economics and Management, Technical University Berlin, Berlin, Germany.
| | - Chrissa Tsatsaronis
- Department of Health Care Management, School of Economics and Management, Technical University Berlin, Berlin, Germany
| | - David Kuklinski
- Department of Health Care Management, School of Medicine, University of St. Gallen, St. Gallen, Switzerland
| | - Lukas Schöner
- Department of Health Care Management, School of Economics and Management, Technical University Berlin, Berlin, Germany
| | - Viktoria Steinbeck
- Department of Health Care Management, School of Economics and Management, Technical University Berlin, Berlin, Germany
| | - Reinhard Busse
- Department of Health Care Management, School of Economics and Management, Technical University Berlin, Berlin, Germany
| | - Tanja Rombey
- Department of Health Care Management, School of Economics and Management, Technical University Berlin, Berlin, Germany
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Lokeesan L, Martin E, Miller YD. Establishing Methods to Assess Baby-Friendly Hospital Initiative Compliance Using the Global Standards and Women's Self-Reported Experiences. J Hum Lact 2024; 40:405-412. [PMID: 38785274 PMCID: PMC11340230 DOI: 10.1177/08903344241252644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 04/17/2024] [Indexed: 05/25/2024]
Abstract
The World Health Organization recommends assessing compliance with key clinical practices of the Baby-Friendly Hospital Initiative (BFHI; Steps 3-9) using birthing women's self-reports. Globally, compliance is mainly assessed using health staff reports, and the use of women's self-reports in selected countries has deviated from the Global Standards for the BFHI. Therefore, we aimed to provide insight into the appropriate method of incorporating women's self-reports in assessing compliance with Steps 3-9 of the BFHI. We developed questions and coding algorithms for assessing compliance with Steps 3-9 based on Global Standards for BFHI compliance, and implemented them via a cross-sectional survey of 302 women who gave birth to a live baby in Sri Lankan hospitals. Compliance with specific practices within each of Steps 3-9 and overall compliance with each step were described as percentages. Compliance with specific practices and each BFHI Step ranged from 15.9%-100% and 7.0%-100%, respectively. Our findings particularly emphasize the potentially enhanced usefulness and robustness of assessing all specific practices within BFHI key clinical steps and not focusing only on one practice within a step, to derive more useful health service guidance globally for capturing BFHI compliance and its impact on breastfeeding outcomes. This method could be translated across multiple settings globally. It would enable more specific identification of care advancements required by health services to improve the effectiveness of breastfeeding support and address the prevailing undervaluing and under-use of women's experiential data to evaluate and guide health service improvement.
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Affiliation(s)
- Laavanya Lokeesan
- Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
- Department of Nursing, Faculty of Health Sciences, Open University of Sri Lanka, Nawala, Nugegoda, Sri Lanka
| | - Elizabeth Martin
- Mater Research Institute – University of Queensland, South Brisbane, QLD, Australia
- Wesley Research Institute, Auchenflower, Brisbane, QLD, Australia
| | - Yvette D. Miller
- Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
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MacEwan SR, Olvera RG, Jonnalagadda P, Fareed N, McAlearney AS. Patient and Provider Perspectives About the Use of Patient-Generated Health Data During Pregnancy: Qualitative Exploratory Study. JMIR Form Res 2024; 8:e52397. [PMID: 38718395 PMCID: PMC11112476 DOI: 10.2196/52397] [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: 09/01/2023] [Revised: 12/22/2023] [Accepted: 03/27/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND There is increasing interest in using patient-generated health data (PGHD) to improve patient-centered care during pregnancy. However, little research has examined the perspectives of patients and providers as they report, collect, and use PGHD to inform obstetric care. OBJECTIVE This study aims to explore the perspectives of patients and providers about the use of PGHD during pregnancy, including the benefits and challenges of reporting, collecting, and using these data, as well as considerations for expanding the use of PGHD to improve obstetric care. METHODS We conducted one-on-one interviews with 30 pregnant or postpartum patients and 14 health care providers from 2 obstetrics clinics associated with an academic medical center. Semistructured interview guides included questions for patients about their experience and preferences for sharing PGHD and questions for providers about current processes for collecting PGHD, opportunities to improve or expand the collection of PGHD, and challenges faced when collecting and using this information. Interviews were conducted by phone or videoconference and were audio recorded, transcribed verbatim, and deidentified. Interview transcripts were analyzed deductively and inductively to characterize and explore themes in the data. RESULTS Patients and providers described how PGHD, including physiologic measurements and experience of symptoms, were currently collected during and between in-person clinic visits for obstetric care. Both patients and providers reported positive perceptions about the collection and use of PGHD during pregnancy. Reported benefits of collecting PGHD included the potential to use data to directly inform patient care (eg, identify issues and adjust medication) and to encourage ongoing patient involvement in their care (eg, increase patient attention to their health). Patients and providers had suggestions for expanding the collection and use of PGHD during pregnancy, and providers also shared considerations about strategies that could be used to expand PGHD collection and use. These strategies included considering the roles of both patients and providers in reporting and interpreting PGHD. Providers also noted the need to consider the unintended consequences of using PGHD that should be anticipated and addressed. CONCLUSIONS Acknowledging the challenges, suggestions, and considerations voiced by patients and providers can inform the development and implementation of strategies to effectively collect and use PGHD to support patient-centered care during pregnancy.
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Affiliation(s)
- Sarah R MacEwan
- Division of General Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, United States
- Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research, College of Medicine, The Ohio State University, Columbus, OH, United States
| | - Ramona G Olvera
- Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research, College of Medicine, The Ohio State University, Columbus, OH, United States
| | - Pallavi Jonnalagadda
- Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research, College of Medicine, The Ohio State University, Columbus, OH, United States
| | - Naleef Fareed
- Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research, College of Medicine, The Ohio State University, Columbus, OH, United States
- Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, OH, United States
| | - Ann Scheck McAlearney
- Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research, College of Medicine, The Ohio State University, Columbus, OH, United States
- Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, OH, United States
- Department of Family and Community Medicine, College of Medicine, The Ohio State University, Columbus, OH, United States
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Luce A, Turner G, Kennedy L, Bush-Evans RD. "Quite simply they don't communicate": a case study of a National Health Service response to staff suicide. MEDICAL HUMANITIES 2024; 50:116-124. [PMID: 38195242 DOI: 10.1136/medhum-2023-012722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/26/2023] [Indexed: 01/11/2024]
Abstract
Workplace suicide can have significant knock-on effects within an organisation, yet research has shown within the healthcare profession, not all staff receive suicide prevention training, and few employers take the time to reflect on the need to change workplace policies or practices following the death of a staff member to suicide. How staff suicide is communicated across an organisation and to family members is important. Effective crisis communication is critical for effective management for a timely and sensitive response to a staff suicide within an organisation. By doing so, workplaces can help to reduce the significant emotional trauma suicide can have on an employee, and support good mental health across its workforce. This study aimed to explore and understand the communication processes around staff suicide across a National Health Service (NHS) Trust and to provide recommendations based on these findings. Semi-structured interviews were conducted with 29 participants, each lasting approximately 90 min. The Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines were followed. Thematic analysis was used to analyse the data, resulting in seven themes being identified based on communication. Findings indicated that the Trust had no clear communication strategy in place for tackling staff suicide. Each suicide was handled differently, training across staff roles was lacking and operational procedures were deemed insensitive. This paper aimed to provide insight into the communication strategies used in the aftermath of a staff suicide. These findings highlight the inconsistency of the communication, lack of clear policy and guidance and the negative impact this had on staff. Further research is needed across NHS Trusts nationwide to gain insight into the current communication strategies in place to develop a national approach to clear communication following the death of an NHS worker to suicide. Tweetable abstract: Effective communication is critical in the aftermath of an NHS staff suicide. By doing so, NHS Trusts can help to reduce the trauma suicide can have on an employee and support good mental health across its workforce @stann2.
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Affiliation(s)
- Ann Luce
- Department of Communication and Journalism, Bournemouth University, Poole, UK
| | - Georgia Turner
- Department of Communication and Journalism, Bournemouth University, Poole, UK
| | - Lauren Kennedy
- Department of Communication and Journalism, Bournemouth University, Poole, UK
| | - Reece D Bush-Evans
- Department of Communication and Journalism, Bournemouth University, Poole, UK
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Nagineviciute M, Bartuseviciene E, Blazeviciene A. Woman-Centered Care: Standardized Outcomes Measure. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1537. [PMID: 37763656 PMCID: PMC10533153 DOI: 10.3390/medicina59091537] [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: 07/27/2023] [Revised: 08/23/2023] [Accepted: 08/24/2023] [Indexed: 09/29/2023]
Abstract
Background and Objectives: Patient- or woman-centered care, prioritizing women's perspectives, needs, and preferences, is a widely recommended approach to enhance the quality of maternity care services. It aligns with the broader principles of patient-centered care, emphasizing the importance of a collaborative and respectful relationship between healthcare providers and women. This study evaluates low-risk pregnancies managed by midwives and obstetrician-gynecologists in Lithuania using patient-reported outcome measures and patient-reported experience measures. Materials and Methods: A prospective cohort study was conducted between September 2022 and April 2023. Data were collected through patient-reported questionnaires. Results: A total of 153 pregnant women who had singleton, low-risk pregnancies participated in the study, of whom 24.8% had their pregnancies supervised by a midwife, and 75.2% of the participants had their pregnancies supervised by an obstetrician-gynecologist. The study found no statistically significant differences in assessed patient-reported outcome measures and patient-reported experience measures between both models of care. Conclusions: Adopting patient-centered approaches enables healthcare systems to understand and address women's specific needs and preferences, fostering high-quality and woman-centered care. This research adds to the growing evidence supporting midwife-led care and emphasizes the importance of personalized, woman-centered approaches in maternity care, ultimately enhancing maternal health outcomes and promoting positive experiences for low-risk pregnant women. The quality of care provided by midwives remains uncompromised and equivalently proficient compared to the care provided by collaborative teams.
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Affiliation(s)
- Milda Nagineviciute
- Department of Nursing, Faculty of Nursing, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania;
| | - Egle Bartuseviciene
- Department of Obstetrics and Gynecology, Faculty of Medicine, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania;
| | - Aurelija Blazeviciene
- Department of Nursing, Faculty of Nursing, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania;
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Chen A, Väyrynen K, Leskelä R, Torkki P, Heinonen S, Tekay A, Acharya G. The acceptability of implementing patient-reported measures in routine maternity care: A systematic review. Acta Obstet Gynecol Scand 2023; 102:406-419. [PMID: 36647292 PMCID: PMC10008272 DOI: 10.1111/aogs.14506] [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: 09/30/2022] [Revised: 12/10/2022] [Accepted: 12/18/2022] [Indexed: 01/18/2023]
Abstract
INTRODUCTION Patient-reported measures (PRMs) are becoming popular as they might influence clinical decisions, help to deliver patient-centered care, and improve health care quality. However, the limited knowledge and consensus about the acceptability of implementing PRMs in maternity care hinder their widespread use in clinical practice, and evidence-based recommendations are lacking. This systematic review aims to synthesize available evidence on the acceptability of implementing PRMs in routine maternity care. MATERIAL AND METHODS Literature on the implementation of PRMs in maternity care was electronically searched in six databases (PsycARTICLES, PubMed, Scopus, Web of Science, Cochrane Database of Systematic Reviews, and CINAHL), screened and selected for the topic of "acceptability". Theoretical Framework of Acceptability was used as the basic framework guiding data analysis and synthesis. Evidence was thematically analyzed and synthesized. Mixed Method Appraisal Tool and GRADE-CERQual approach were used to assess the quality of studies and evaluate the confidence in the review findings. RESULTS Overall, 4971 articles were screened. From 24 studies, we identified five themes regarding the acceptability of implementing PRMs in routine maternity care: (1) user's action and behavior, (2) stakeholders' attitudes, (3) perceived benefits, (4) perceived challenges and risks, and (5) stakeholders' preferences and suggestions on implementation. While pregnant and postpartum women, health professionals and other stakeholders involved in maternity care were generally positive about the implementation of PRMs in routine care and recognized the potential benefits (eg health improvement, women empowerment, care and services improvement and healthcare system advancement), they pointed out possible challenges and risks in answering PRMs questions, responding to answers, and setting up integrated information systems as well as suggested solutions in the aspects of PRMs data collection, follow-up care, and system-level management. The confidence in the review findings was moderate due to methodological limitations of included studies. CONCLUSIONS Available empirical evidence suggested that the use of PRMs in routine maternity care is acceptable among stakeholders involved in maternity care and the potential benefits of its integration in routine clinical practice to healthcare improvement has been recognized. However, possible challenges in data collection, follow-up care arrangement and system-level integration should be appropriately addressed.
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Affiliation(s)
- An Chen
- Institute of Healthcare Engineering, Management and Architecture (HEMA), Department of Industrial Engineering and ManagementAalto UniversityEspooFinland
- Department of Obstetrics and GynecologyHelsinki University Hospital and University of HelsinkiHelsinkiFinland
- Nordic Healthcare Group OyHelsinkiFinland
| | - Kirsi Väyrynen
- Department of Obstetrics and GynecologyCentral Finland Central HospitaJyväskyläFinland
| | | | - Paulus Torkki
- Institute of Healthcare Engineering, Management and Architecture (HEMA), Department of Industrial Engineering and ManagementAalto UniversityEspooFinland
- Nordic Healthcare Group OyHelsinkiFinland
- Department of Public Health, Faculty of MedicineHelsinki UniversityHelsinkiFinland
| | - Seppo Heinonen
- Department of Obstetrics and GynecologyHelsinki University Hospital and University of HelsinkiHelsinkiFinland
| | - Aydin Tekay
- Department of Obstetrics and GynecologyHelsinki University Hospital and University of HelsinkiHelsinkiFinland
| | - Ganesh Acharya
- Division of Obstetrics & Gynecology, Department of Clinical Science, Intervention and Technology (CLINTEC)Karolinska InstitutetStockholmSweden
- Women`s Health and Perinatology Research grroup, Department of Clinical MedicineUiT The Arctic University of NorwayTromsøNorway
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Feenstra MM, Kidholm K, Rudnicki M. Use of patient reported outcome measures in daily clinical practice - A way to optimize treatment of patients? Acta Obstet Gynecol Scand 2023; 102:404-405. [PMID: 36906816 PMCID: PMC10008266 DOI: 10.1111/aogs.14501] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 12/02/2022] [Accepted: 12/12/2022] [Indexed: 03/13/2023]
Affiliation(s)
- Maria Monberg Feenstra
- Department of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark.,Faculty of Health Science, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Kristian Kidholm
- Centre of Innovative Medical Technology (CIMT), Odense University Hospital, Odense, Denmark
| | - Martin Rudnicki
- Department of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark.,Faculty of Health Science, Department of Clinical Research, Odense University Hospital, Odense, Denmark
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