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Complementary therapy for endometriosis related pelvic pain. JOURNAL OF ENDOMETRIOSIS AND PELVIC PAIN DISORDERS 2023. [DOI: 10.1177/22840265231159704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023]
Abstract
In the setting of a global pandemic, it is vastly important now more than ever that patients have agency and control over pain management when living with a debilitating chronic pain disease such as endometriosis. We present a review of the available literature on the most popular and easily accessible complementary pain management therapies for endometriosis including Transcutaneous Electrical Nerve stimulator (TENS) units, diets, Cannabidiol (CBD), turmeric, meditation, yoga, and acupuncture. These are worthwhile recommendations; however, the data for each is limited and more research is needed to further support each of its use.
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Jacob C, Sezgin E, Sanchez-Vazquez A, Ivory C. Sociotechnical Factors Affecting Patients' Adoption of Mobile Health Tools: Systematic Literature Review and Narrative Synthesis. JMIR Mhealth Uhealth 2022; 10:e36284. [PMID: 35318189 PMCID: PMC9121221 DOI: 10.2196/36284] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 03/16/2022] [Accepted: 03/22/2022] [Indexed: 12/23/2022] Open
Abstract
Background Mobile health (mHealth) tools have emerged as a promising health care technology that may contribute to cost savings, better access to care, and enhanced clinical outcomes; however, it is important to ensure their acceptance and adoption to harness this potential. Patient adoption has been recognized as a key challenge that requires further exploration. Objective The aim of this review was to systematically investigate the literature to understand the factors affecting patients’ adoption of mHealth tools by considering sociotechnical factors (from technical, social, and health perspectives). Methods A structured search was completed following the participants, intervention, comparators, and outcomes framework. We searched the MEDLINE, PubMed, Cochrane Library, and SAGE databases for studies published between January 2011 and July 2021 in the English language, yielding 5873 results, of which 147 studies met the inclusion criteria. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and the Cochrane Handbook were followed to ensure a systematic process. Extracted data were analyzed using NVivo (QSR International), with thematic analysis and narrative synthesis of emergent themes. Results The technical factors affecting patients’ adoption of mHealth tools were categorized into six key themes, which in turn were divided into 20 subthemes: usefulness, ease of use, data-related, monetary factors, technical issues, and user experience. Health-related factors were categorized into six key themes: the disease or health condition, the care team’s role, health consciousness and literacy, health behavior, relation to other therapies, integration into patient journey, and the patients’ insurance status. Social and personal factors were divided into three key clusters: demographic factors, personal characteristics, and social and cultural aspects; these were divided into 19 subthemes, highlighting the importance of considering these factors when addressing potential barriers to mHealth adoption and how to overcome them. Conclusions This review builds on the growing body of research that investigates patients’ adoption of mHealth services and highlights the complexity of the factors affecting adoption, including personal, social, technical, organizational, and health care aspects. We recommend a more patient-centered approach by ensuring the tools’ fit into the overall patient journey and treatment plan, emphasizing inclusive design, and warranting comprehensive patient education and support. Moreover, empowering and mobilizing clinicians and care teams, addressing ethical data management issues, and focusing on health care policies may facilitate adoption.
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Affiliation(s)
- Christine Jacob
- University of Applied Sciences Northwestern Switzerland, Olten, Switzerland
| | - Emre Sezgin
- The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, United States.,NORC at the University of Chicago, Chicago, IL, United States
| | - Antonio Sanchez-Vazquez
- Innovative Management Practice Research Centre, Anglia Ruskin University, Cambridge, United Kingdom
| | - Chris Ivory
- Innovative Management Practice Research Centre, Anglia Ruskin University, Cambridge, United Kingdom
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Forbes L, Johnson SK. Online Mindfulness Intervention for Inflammatory Bowel Disease: Adherence and Efficacy. Front Psychol 2022; 12:709899. [PMID: 35401288 PMCID: PMC8987583 DOI: 10.3389/fpsyg.2021.709899] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 12/30/2021] [Indexed: 12/30/2022] Open
Abstract
The impact of stress and other psychological variables on Inflammatory Bowel Disease (IBD) prognosis, treatment response, and functional level is well-established; however, typical IBD treatment focuses on the physiological pathology of the disease and neglects complementary stress-reducing interventions. Recent pilot studies report the benefits of mindfulness-based interventions (MBIs) in people living with IBD, but are limited by small sample sizes. Recruitment challenges to in-person studies may be in part due to the difficulty IBD patients often have adhering to fixed schedules and travel as a result of IBD symptoms such as pain, fatigue, and incontinence. The current study aimed to address this barrier by offering participants access to online mindfulness training, allowing individuals to engage with intervention materials to fit their own schedule. Online mindfulness programs have gained popularity in recent years, as they increase access and flexibility and decrease cost to the user; however, the dropout rate tends to be high. The current study compared the rate of adherence and efficacy of mindfulness training as a function of level of support: self-guided versus supported. Analysis revealed no significant difference in the benefits received between participants in the two groups; however, a significant difference group (χ2 = 15.75; p = 0.000, r = 0.38) was found in terms of rate of completion, with 44.1% of the supportive group completing the protocol compared to 11.7% of the self-guided. Common challenges to meditation were measured, but did not significantly predict adherence to the intervention, and experience of these challenges did not significantly change (increase or decrease) over the duration of the study. Implications of the current research, future directions for the use of MBI for IBD patients, and a discussion of methodological considerations are provided.
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Affiliation(s)
- Leila Forbes
- BASE Cognitive Behavioral, Charlotte, NC, United States
| | - Susan K. Johnson
- Department of Psychological Science, University of North Carolina at Charlotte, Charlotte, NC, United States
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4
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If virtual gynecology clinics are here to stay, we need to include everyone. AJOG GLOBAL REPORTS 2021; 2:100043. [PMID: 34909705 PMCID: PMC8660131 DOI: 10.1016/j.xagr.2021.100043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 12/01/2021] [Accepted: 12/07/2021] [Indexed: 11/25/2022] Open
Abstract
Before the COVID-19 pandemic virtual clinics in gynecology were not commonplace in the United Kingdom or most other countries. Owing to the need to reconfigure health provision to caring for COVID-19 patients, reducing footfall in hospitals and restricted movement, telemedicine was rapidly introduced at scale in hospitals thought the United Kingdom. This happened without much consultation with service users and healthcare professionals. It is anticipated that after the pandemic, telemedicine will remain to some extent. The authors report how their hospital how their place of work, a large London teaching hospital, adopted virtual phone consultations in gynecology, along with a countrywide survey of 200 service users and healthcare professionals. Now it is important carry out a robust evaluation of outcomes (both clinician and patient experience) and also to take care that service users from disadvantaged backgrounds do not lose out.
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Teepe GW, Da Fonseca A, Kleim B, Jacobson NC, Salamanca Sanabria A, Tudor Car L, Fleisch E, Kowatsch T. Just-in-Time Adaptive Mechanisms of Popular Mobile Apps for Individuals With Depression: Systematic App Search and Literature Review. J Med Internet Res 2021; 23:e29412. [PMID: 34309569 PMCID: PMC8512178 DOI: 10.2196/29412] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 07/06/2021] [Accepted: 07/26/2021] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND The number of smartphone apps that focus on the prevention, diagnosis, and treatment of depression is increasing. A promising approach to increase the effectiveness of the apps while reducing the individual's burden is the use of just-in-time adaptive intervention (JITAI) mechanisms. JITAIs are designed to improve the effectiveness of the intervention and reduce the burden on the person using the intervention by providing the right type of support at the right time. The right type of support and the right time are determined by measuring the state of vulnerability and the state of receptivity, respectively. OBJECTIVE The aim of this study is to systematically assess the use of JITAI mechanisms in popular apps for individuals with depression. METHODS We systematically searched for apps addressing depression in the Apple App Store and Google Play Store, as well as in curated lists from the Anxiety and Depression Association of America, the United Kingdom National Health Service, and the American Psychological Association in August 2020. The relevant apps were ranked according to the number of reviews (Apple App Store) or downloads (Google Play Store). For each app, 2 authors separately reviewed all publications concerning the app found within scientific databases (PubMed, Cochrane Register of Controlled Trials, PsycINFO, Google Scholar, IEEE Xplore, Web of Science, ACM Portal, and Science Direct), publications cited on the app's website, information on the app's website, and the app itself. All types of measurements (eg, open questions, closed questions, and device analytics) found in the apps were recorded and reviewed. RESULTS None of the 28 reviewed apps used JITAI mechanisms to tailor content to situations, states, or individuals. Of the 28 apps, 3 (11%) did not use any measurements, 20 (71%) exclusively used self-reports that were insufficient to leverage the full potential of the JITAIs, and the 5 (18%) apps using self-reports and passive measurements used them as progress or task indicators only. Although 34% (23/68) of the reviewed publications investigated the effectiveness of the apps and 21% (14/68) investigated their efficacy, no publication mentioned or evaluated JITAI mechanisms. CONCLUSIONS Promising JITAI mechanisms have not yet been translated into mainstream depression apps. Although the wide range of passive measurements available from smartphones were rarely used, self-reported outcomes were used by 71% (20/28) of the apps. However, in both cases, the measured outcomes were not used to tailor content and timing along a state of vulnerability or receptivity. Owing to this lack of tailoring to individual, state, or situation, we argue that the apps cannot be considered JITAIs. The lack of publications investigating whether JITAI mechanisms lead to an increase in the effectiveness or efficacy of the apps highlights the need for further research, especially in real-world apps.
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Affiliation(s)
- Gisbert W Teepe
- Centre for Digital Health Interventions, Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland
| | - Ashish Da Fonseca
- Centre for Digital Health Interventions, Institute of Technology Management, University of St. Gallen, St. Gallen, Switzerland
| | - Birgit Kleim
- Experimental Psychopathology and Psychotherapy, Department of Psychology, University of Zurich, Zurich, Switzerland
- Department of Psychiatry, Psychotherapy and Psychosomatics, University of Zurich, Zurich, Switzerland
| | - Nicholas C Jacobson
- Center for Technology and Behavioral Health, Departments of Biomedical Data Science and Psychiatry, Geisel School of Medicine, Dartmouth College, Hanover, NH, United States
| | - Alicia Salamanca Sanabria
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence And Technological Enterprise, Singapore, Singapore
| | - Lorainne Tudor Car
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom
| | - Elgar Fleisch
- Centre for Digital Health Interventions, Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland
- Centre for Digital Health Interventions, Institute of Technology Management, University of St. Gallen, St. Gallen, Switzerland
| | - Tobias Kowatsch
- Centre for Digital Health Interventions, Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland
- Centre for Digital Health Interventions, Institute of Technology Management, University of St. Gallen, St. Gallen, Switzerland
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence And Technological Enterprise, Singapore, Singapore
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Ball E, Rivas C. Health Apps Require Co-development to Be Acceptable and Effective. Front Psychol 2021; 12:714453. [PMID: 34335428 PMCID: PMC8322940 DOI: 10.3389/fpsyg.2021.714453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 06/15/2021] [Indexed: 11/30/2022] Open
Affiliation(s)
- Elizabeth Ball
- Department of Obstetrics and Gynaecology, Barts Health NHS Trust, London, United Kingdom.,Women's Health Research Unit, Yvonne Carter Building, Queen Mary University of London, London, United Kingdom.,Centre for Maternal and Child Health Research, School of Health Sciences, City University of London, London, United Kingdom
| | - Carol Rivas
- Social Research Institute, University College London, London, United Kingdom
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Ball E, Willmott F, Rivas C, Talati C. COVID-19 in Women's health: Pre-operative gynaecological assessment and shared decision making. Best Pract Res Clin Obstet Gynaecol 2021; 73:12-21. [PMID: 33865717 PMCID: PMC7970420 DOI: 10.1016/j.bpobgyn.2021.03.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 03/09/2021] [Indexed: 12/16/2022]
Abstract
The National Health Service (NHS) response to the coronavirus disease 2019 (COVID-19) pandemic brought about rapid and innovative changes to surgical care in gynaecology, shared decision making around operative procedures and pre-operative gynaecological pathways. Short-term changes are linked to the redeployment of resources away from elective gynaecology and long-term changes relate to accelerating the streamlining of treatments, telemedicine and education in patient self-management. The speed and recency of the response does not yet permit the creation of a large evidence base for effective and acceptable interventions, apart from anecdotal observations of 'what works well'' good practice and guidance from the Royal Colleges and the National Institute for Health and Care Excellence (NICE).
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Affiliation(s)
- Elizabeth Ball
- Department of Obstetrics and Gynaecology, Barts Health NHS Trust, United Kingdom; Department of Women's and Child Health, City University London, United Kingdom.
| | - Fredric Willmott
- Department of Obstetrics and Gynaecology, Barts Health NHS Trust, United Kingdom
| | - Carol Rivas
- University College London Social Research Institute, University College London (UCL) London, United Kingdom
| | - Chiraag Talati
- Department of Anaesthesia, Homerton University Hospital NHS Trust, United Kingdom
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Mueller S, Soriano D, Boscor A, Saville NM, Arjyal A, Baral S, Fordham M, Hearn G, Kayastha R, Kostkova P. MANTRA: Improving Knowledge of Maternal Health, Neonatal Health, and Geohazards in Women in Rural Nepal Using a Mobile Serious Game. Front Public Health 2020; 8:584375. [PMID: 33363082 PMCID: PMC7759478 DOI: 10.3389/fpubh.2020.584375] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 11/19/2020] [Indexed: 11/13/2022] Open
Abstract
Serious games, conveying educational knowledge rather than merely entertainment, are a rapidly expanding research domain for cutting-edge educational technology. Digital interventions like serious games are great opportunities to overcome challenges in low-and-middle-income countries that limit access to health information, such as social barriers like low-literacy and gender. MANTRA: Increasing maternal and child health resilience before, during and after disasters using mobile technology in Nepal takes on these challenges with a novel digital health intervention; a serious mobile game aimed at vulnerable low-literacy female audiences in rural Nepal. The serious game teaches 28 learning objectives of danger signs in geohazards, maternal, and neonatal health to improve knowledge and self-assessment of common conditions and risks to inform healthcare-seeking behavior. Evaluations consisted of recruiting 35 end users to participate in a pre-test assessment, playing the game, post-test assessment, and focus groups to elicit qualitative feedback. Assessments analyzed knowledge gain in two ways; by learning objective with McNemar tests for each learning objective, and by participant scores with paired t-tests of overall scores and by module. Results of assessments of knowledge gain by learning objective (McNemar tests) indicate participants had sufficient prior knowledge to correctly interpret and respond to 26% of pictograms (coded AA), which is a desirable result although without the possibility of improvement through the intervention. The geohazard module had greatest impact as 16% of responses showed knowledge gain (coded BA). The two most successful learning objectives showing statistically significant positive change were evidence of rockfalls and small cracks in the ground (p = < 0.05). Assessment of knowledge gain by participant scores (paired t-tests) showed the 35 participants averaged a 7.7 point improvement (p < 0.001) in the assessment (28 learning objectives). Average change in knowledge of subdivided module scores (each module normalized to 100 points for comparison) was greatest in the geohazard module (9.5 points, p < 0.001), then maternal health (7.4 points, p = 0.0067), and neonatal health (6.0 points, p = 0.013). This evaluation demonstrated that carefully designed digital health interventions with pictograms co-authored by experts and users can teach complex health and geohazard situations. Significant knowledge gain was demonstrated for several learning objectives while those with non-significant or negative change will be re-designed to effectively convey information.
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Affiliation(s)
- Sonja Mueller
- Institute for Risk and Disaster Reduction, University College London, London, United Kingdom.,Institute for Risk and Disaster Reduction Centre for Digital Public Health in Emergencies (dPHE), University College London, London, United Kingdom
| | - Delphine Soriano
- Institute for Risk and Disaster Reduction, University College London, London, United Kingdom.,Institute for Risk and Disaster Reduction Centre for Digital Public Health in Emergencies (dPHE), University College London, London, United Kingdom
| | - Andrei Boscor
- Institute for Risk and Disaster Reduction, University College London, London, United Kingdom.,Institute for Risk and Disaster Reduction Centre for Digital Public Health in Emergencies (dPHE), University College London, London, United Kingdom
| | - Naomi M Saville
- Institute for Global Health, University College London, London, United Kingdom
| | - Abriti Arjyal
- Health Research and Social Development Forum, Kathmandu, Nepal
| | - Sushil Baral
- Health Research and Social Development Forum, Kathmandu, Nepal
| | - Maureen Fordham
- Institute for Risk and Disaster Reduction, University College London, London, United Kingdom.,Institute for Risk and Disaster Reduction Centre for Gender and Disaster, University College London, London, United Kingdom
| | | | - Rachya Kayastha
- Institute for Risk and Disaster Reduction, University College London, London, United Kingdom.,Institute for Global Health, University College London, London, United Kingdom
| | - Patty Kostkova
- Institute for Risk and Disaster Reduction, University College London, London, United Kingdom.,Institute for Risk and Disaster Reduction Centre for Digital Public Health in Emergencies (dPHE), University College London, London, United Kingdom
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Grimes CL, Balk EM, Dieter AA, Singh R, Wieslander CK, Jeppson PC, Aschkenazi SO, Kim JH, Truong MD, Gupta AS, Keltz JG, Hobson DT, Sheyn D, Petruska SE, Adam G, Meriwether KV. Guidance for gynecologists utilizing telemedicine during COVID‐19 pandemic based on expert consensus and rapid literature reviews. Int J Gynaecol Obstet 2020. [PMCID: PMC9087699 DOI: 10.1002/ijgo.13276] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Background COVID‐19 has impacted delivery of outpatient gynecology and shifted care toward use of telemedicine. Objective To rapidly review literature and society guidelines and create expert consensus to provide guidance regarding management of outpatient gynecology scenarios via telemedicine. Search strategy Searches were conducted in Medline and Cochrane databases from inception through April 15, 2020. Selection criteria Literature searches were conducted for articles on telemedicine and abnormal uterine bleeding, chronic pelvic pain, endometriosis, vaginitis, and postoperative care. Searches were restricted to available English language publications. Data collection and analysis Expedited literature review methodology was followed and 10 943 citations were single‐screened. Full‐text articles and relevant guidelines were reviewed and narrative summaries developed. Main results Fifty‐one studies on the use of telemedicine in gynecology were found. Findings were reported for these studies and combined with society guidelines and expert consensus on four topics (abnormal uterine bleeding, chronic pelvic pain and endometriosis, vaginal discharge, and postoperative care). Conclusions Guidance for treating gynecological conditions via telemedicine based on expedited literature review, review of society recommendations, and expert consensus is presented. Due to minimal evidence surrounding telemedicine and gynecology, a final consensus document is presented here that can be efficiently used in a clinical setting. Guidance for gynecologists using telemedicine during COVID‐19 based on rapid literature review, review of society recommendations, and expert consensus in accessible format.
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Affiliation(s)
- Cara L. Grimes
- Division of Female Pelvic Medicine and Reconstructive Surgery Departments of Obstetrics and Gynecology and Urology New York Medical College Valhalla NY USA
| | - Ethan M. Balk
- Center for Evidence Synthesis in Health Brown School of Public Health Brown University Providence RI USA
| | - Alexis A. Dieter
- Division of Urogynecology and Reconstructive Pelvic Surgery Department of Obstetrics and Gynecology University of North Carolina at Chapel Hill Chapel Hill NC USA
| | - Ruchira Singh
- Division of Female Pelvic Medicine and Reconstructive Surgery Department of Obstetrics and Gynecology University of Florida Jacksonville FL USA
| | - Cecilia K. Wieslander
- Division of Female Pelvic Medicine and Reconstructive Surgery Department of Obstetrics and Gynecology David Geffen School of Medicine at UCLA Los Angeles CA USA
| | - Peter C. Jeppson
- Division of Female Pelvic Medicine and Reconstructive Surgery Department of Obstetrics and Gynecology University of New Mexico Albuquerque NM USA
| | - Sarit O. Aschkenazi
- Prohealth Women Services Division of Urogynecology Department of Obstetrics and Gynecology Waukesha Memorial Hospital Medical College of Wisconsin Waukesha WI USA
| | - Jin Hee Kim
- Division of Gynecologic Specialty Surgery Department of Obstetrics and Gynecology Columbia University Medical Center New York NY USA
| | - Mireille D. Truong
- Division of Minimally Invasive Gynecologic Surgery Department of Obstetrics and Gynecology Cedars‐Sinai Medical Center Los Angeles CA USA
| | - Ankita S. Gupta
- Department of Obstetrics & Gynecology University of Louisville Louisville KY USA
| | - Julia G. Keltz
- Department of Obstetrics and Gynecology New York Medical College Valhalla NY USA
| | - Deslyn T.G. Hobson
- Department of Obstetrics and Gynecology Wayne State University School of Medicine Detroit MI USA
| | - David Sheyn
- Division of Female Pelvic Medicine and Reconstructive Surgery Department of Obstetrics and Gynecology MetroHealth Medical Center Cleveland OH USA
| | - Sara E. Petruska
- Department of Obstetrics & Gynecology University of Louisville Louisville KY USA
| | - Gaelen Adam
- Center for Evidence Synthesis in Health Brown School of Public Health Brown University Providence RI USA
| | - Kate V. Meriwether
- Division of Female Pelvic Medicine and Reconstructive Surgery Department of Obstetrics and Gynecology University of New Mexico Albuquerque NM USA
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