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Cornell S, Brander R, Peden A. Selfie-Related Incidents: Narrative Review and Media Content Analysis. J Med Internet Res 2023; 25:e47202. [PMID: 37756044 PMCID: PMC10568398 DOI: 10.2196/47202] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 07/31/2023] [Accepted: 08/23/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND Selfie-related injury has become a public health concern amid the near ubiquitous use of smartphones and social media apps. Of particular concern are selfie-related deaths at aquatic locations; areas often frequented because of their photogenic allure. Unfortunately, such places exhibit hazards inherent with their environment. OBJECTIVE This study aimed to ascertain current evidence regarding selfie-related injuries and recommended risk treatment measures in the academic literature as well as how selfie-related injuries and deaths were being reported by the media, allowing us to identify key challenges facing land managers and public health practitioners in mitigating selfie-related injuries and deaths. METHODS Between October and December 2022, we performed a narrative review of peer-reviewed literature published since January 2011. Literature was screened to identify causal factors implicated in selfie-related deaths and injuries, as well as risk treatments recommended. Furthermore, we used an environmental scan methodology to search for media reports of selfie-related injuries and deaths at aquatic locations in Australia and the United States. Individual cases of selfie-related aquatic injuries and deaths sourced from news reports were analyzed to assess epidemiological characteristics, and a thematic content analysis was conducted to identify key themes of news reporting on selfie-related deaths and injuries. RESULTS In total, 5 peer-reviewed studies were included. Four studies identified falls from height as the most common injury mechanism in selfie incidents. Drowning was the second most common cause of death. Recommended risk treatments were limited but included the adoption of "no selfie zones," physical barriers, signage, and provision of information on dangerous locations to social media users. In total, 12 cases were identified from media reports (4 injuries and 8 fatalities; 7 in Australia and 5 in the United States). The mean age of the reported victims was 22.1 (SD 6.93) years with victims more likely to be female tourists. Content analysis revealed 3 key themes from media reports: "blame," "warning," and "prevention and education." Few media reports (n=8) provided safety recommendations. CONCLUSIONS The selfie-related incident phenomenon should be viewed as a public health problem that requires a public health risk communication response. To date, little attention has been paid to averting selfie-related incidents through behavior change methodologies or direct messaging to users, including through social media apps. Although previous research has recommended "no selfie zones," barriers, and signage as ways to prevent selfie incidents, our results suggest this may not be enough, and it may be prudent to also engage in direct safety messaging to social media users. Media reporting of selfie incidents should focus on preventive messaging rather than blame or warning.
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Affiliation(s)
- Samuel Cornell
- School of Population Health, University of New South Wales, Sydney, Australia
- Beach Safety Research Group, University of New South Wales, Sydney, Australia
| | - Robert Brander
- Beach Safety Research Group, University of New South Wales, Sydney, Australia
- School of Environmental, Earth, and Biological Sciences, University of New South Wales, Sydney, Australia
| | - Amy Peden
- School of Population Health, University of New South Wales, Sydney, Australia
- Beach Safety Research Group, University of New South Wales, Sydney, Australia
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McKinn S, Batcup C, Cornell S, Freeman N, Doust J, Bell KJL, Figtree GA, Bonner C. Decision Support Tools for Coronary Artery Calcium Scoring in the Primary Prevention of Cardiovascular Disease Do Not Meet Health Literacy Needs: A Systematic Environmental Scan and Evaluation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11705. [PMID: 36141978 PMCID: PMC9517328 DOI: 10.3390/ijerph191811705] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/29/2022] [Accepted: 09/13/2022] [Indexed: 06/16/2023]
Abstract
A shared decision-making approach is considered optimal in primary cardiovascular disease (CVD) prevention. Evidence-based patient decision aids can facilitate this but do not always meet patients' health literacy needs. Coronary artery calcium (CAC) scans are increasingly used in addition to traditional cardiovascular risk scores, but the availability of high-quality decision aids to support shared decision-making is unknown. We used an environmental scan methodology to review decision support for CAC scans and assess their suitability for patients with varying health literacy. We systematically searched for freely available web-based decision support tools that included information about CAC scans for primary CVD prevention and were aimed at the public. Eligible materials were independently evaluated using validated tools to assess qualification as a decision aid, understandability, actionability, and readability. We identified 13 eligible materials. Of those, only one qualified as a decision aid, and one item presented quantitative information about the potential harms of CAC scans. None presented quantitative information about both benefits and harms of CAC scans. Mean understandability was 68%, and actionability was 48%. Mean readability (12.8) was much higher than the recommended grade 8 level. Terms used for CAC scans were highly variable. Current materials available to people considering a CAC scan do not meet the criteria to enable informed decision-making, nor do they meet the health literacy needs of the general population. Clinical guidelines, including CAC scans for primary prevention, must be supported by best practice decision aids to support decision-making.
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Affiliation(s)
- Shannon McKinn
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney 2006, Australia
| | - Carys Batcup
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney 2006, Australia
| | - Samuel Cornell
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney 2006, Australia
| | - Natasha Freeman
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney 2006, Australia
| | - Jenny Doust
- Australian Women and Girls’ Health Research Centre, School of Public Health, University of Queensland, Brisbane 4006, Australia
| | - Katy J. L. Bell
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney 2006, Australia
| | - Gemma A. Figtree
- Kolling Institute, University of Sydney, St Leonards 2065, Australia
| | - Carissa Bonner
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney 2006, Australia
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Deutsch JE, Gill-Body KM, Schenkman M. Updated Integrated Framework for Making Clinical Decisions Across the Lifespan and Health Conditions. Phys Ther 2022; 102:6497836. [PMID: 35079823 DOI: 10.1093/ptj/pzab281] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 09/16/2021] [Accepted: 10/26/2021] [Indexed: 11/13/2022]
Abstract
The updated Integrated Framework for Clinical Decision Making responds to changes in evidence, policy, and practice since the publication of the first version in 2008. The original framework was proposed for persons with neurological health conditions, whereas the revised framework applies to persons with any health condition across the lifespan. In addition, the revised framework (1) updates patient-centered concepts with shared clinical decision-making; (2) frames the episode of care around the patient's goals for participation; (3) explicitly describes the role of movement science; (4) reconciles movement science and International Classification of Function language, illustrating the importance of each perspective to patient care; (5) provides a process for movement analysis of tasks; and (6) integrates the movement system into patient management. Two cases are used to illustrate the application of the framework: (1) a 45-year-old male bus driver with low back pain whose goals for the episode of care are to return to work and recreational basketball; and (2) a 65-year-old female librarian with a fall history whose goals for the episode of care are to return to work and reduce future falls. The framework is proposed as a tool for physical therapist education and to guide clinical practice for all health conditions across the lifespan.
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Affiliation(s)
- Judith E Deutsch
- Rivers Lab, Department of Rehabilitation and Movement Science, School of Health Professions, Rutgers University, Newark, New Jersey, USA
| | | | - Margaret Schenkman
- Department of Physical Medicine and Rehabilitation, Physical Therapy Program, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
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Karunaratne S, Harris IA, Trevena L, Horsley M, Solomon M. Observing the use of knee arthroplasty appropriateness tools in clinical practice: do appropriateness criteria tools predict surgeon decision-making? Osteoarthritis Cartilage 2021; 29:1275-1281. [PMID: 34217825 DOI: 10.1016/j.joca.2021.06.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 06/09/2021] [Accepted: 06/22/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The primary aim of this study was to evaluate the agreement between surgeons and two validated total knee arthroplasty (TKA) appropriateness tools, and secondarily to compare Australian appropriateness rates to those reported internationally. METHODS A consecutive sample of patients from one public hospital arthroplasty clinic and a convenience sample from private rooms of surgeons in New South Wales, Australia (n = 11), referred for surgical opinion regarding TKA were enrolled over 1 year. Surgeons applied appropriateness tools created by Escobar et al. and the American Academy of Orthopaedic Surgeons (AAOS). Correlation between the appropriateness tools and surgeon's decisions were evaluated. RESULTS There were 368 patients enrolled, and contrasting rates of being "appropriate" for surgery were identified between the Escobar (n = 109, 29.6%) and AAOS (n = 292, 79.3%) tools. Surgeon agreement with the Escobar tool was substantial (ĸ = 0.61, 95%CI: 0.53-0.69) compared to slight with the AAOS tool (ĸ = 0.11, 95%CI: 0.06-0.16). Of those advised against TKA (n = 179, 48.6%), the AAOS tool suggested many patients (n = 111, 62.0%) were "appropriate" compared to the Escobar tool (n = 12, 6.7%). CONCLUSIONS Surgeons rated patients seeking opinion for TKA as appropriate over half the time, however the AAOS tool had low correlation with surgeons as opposed to the Escobar tool. This was illustrated by both tools rating a majority of patients to be operated on as appropriate, but only the AAOS tool considering most patients not chosen for surgery to be appropriate. When comparing previously published appropriateness rates, appropriateness in Australia, USA, Spain and Qatar was found to be similar.
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Affiliation(s)
- S Karunaratne
- Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Sydney, Australia; Institute of Academic Surgery, Royal Prince Alfred Hospital, Sydney, Australia; Department of Orthopaedic Surgery, Royal Prince Alfred Hospital, Sydney, Australia.
| | - I A Harris
- Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Sydney, Australia; Department of Orthopaedic Surgery, Royal Prince Alfred Hospital, Sydney, Australia; Institute for Musculoskeletal Health, Faculty of Medicine and Health, The University of Sydney, Australia; Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - L Trevena
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - M Horsley
- Department of Orthopaedic Surgery, Royal Prince Alfred Hospital, Sydney, Australia
| | - M Solomon
- Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Sydney, Australia; Institute of Academic Surgery, Royal Prince Alfred Hospital, Sydney, Australia
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Karunaratne S, Harris IA, Trevena L, Horsley M, Fajardo M, Solomon M. Online Decision Aids for Knee Arthroplasty: An Environmental Scan. JBJS Rev 2021; 9:01874474-202104000-00006. [PMID: 33830958 DOI: 10.2106/jbjs.rvw.20.00088] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Knee arthroplasty is a high-risk, resource-intensive procedure that should be reserved for patients in whom the benefit will outweigh the risks. The provision of high-quality, publicly available decision aids can help patients to balance the benefits against the harms of treatments and to assist informed decision-making. The aim of this study was to identify and evaluate the content and readability of freely available knee arthroplasty decision aids. METHODS A systematic search using an environmental scan methodology of publicly available online materials was performed in December 2018. Included materials were assessed for quality using the International Patient Decision Aid Standards instrument (IPDASi), understandability and actionability from a patient's perspective using the Patient Education Materials Assessment Tool (PEMAT), and readability grade level using the Flesch-Kincaid Grade Level and the Gunning Fog Index. RESULTS Of 761 online materials screened, 26 decision aids were identified. Only 18 (69%) may be considered to meet criteria to be defined as a decision aid and 4 (15%) met criteria suggesting that the material did not introduce potential harmful bias according to the IPDASi. The mean score (and standard deviation) for all decision aids was 74% ± 12% for understandability and 44% ± 19% for actionability using the PEMAT. Readability indices indicated a mean minimum reading level of Grade 10 (10.8 ± 2.5). No decision aid included a wait-and-see option. CONCLUSIONS Few high-quality decision aids exist for patients considering knee arthroplasty and none include a wait-and-see option. Many do not provide actionable options and are pitched at above-average reading levels. Developers need to address these issues to encourage high-quality decision-making, especially for those with low health literacy.
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Affiliation(s)
- Sascha Karunaratne
- Surgical Outcomes Research Centre (SOuRCe) (S.K., I.A.H., and M.S.), Institute of Academic Surgery (S.K., I.A.H., and M.S.), and Department of Orthopaedic Surgery (S.K., I.A.H., and M.H.), Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Ian A Harris
- Surgical Outcomes Research Centre (SOuRCe) (S.K., I.A.H., and M.S.), Institute of Academic Surgery (S.K., I.A.H., and M.S.), and Department of Orthopaedic Surgery (S.K., I.A.H., and M.H.), Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.,Institute for Musculoskeletal Health (I.A.H.) and Sydney School of Public Health (L.T. and M.F.), Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Lyndal Trevena
- Institute for Musculoskeletal Health (I.A.H.) and Sydney School of Public Health (L.T. and M.F.), Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Mark Horsley
- Surgical Outcomes Research Centre (SOuRCe) (S.K., I.A.H., and M.S.), Institute of Academic Surgery (S.K., I.A.H., and M.S.), and Department of Orthopaedic Surgery (S.K., I.A.H., and M.H.), Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Michael Fajardo
- Institute for Musculoskeletal Health (I.A.H.) and Sydney School of Public Health (L.T. and M.F.), Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Michael Solomon
- Surgical Outcomes Research Centre (SOuRCe) (S.K., I.A.H., and M.S.), Institute of Academic Surgery (S.K., I.A.H., and M.S.), and Department of Orthopaedic Surgery (S.K., I.A.H., and M.H.), Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
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Trevena LJ, Bonner C, Okan Y, Peters E, Gaissmaier W, Han PKJ, Ozanne E, Timmermans D, Zikmund-Fisher BJ. Current Challenges When Using Numbers in Patient Decision Aids: Advanced Concepts. Med Decis Making 2021; 41:834-847. [PMID: 33660535 DOI: 10.1177/0272989x21996342] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND Decision aid developers have to convey complex task-specific numeric information in a way that minimizes bias and promotes understanding of the options available within a particular decision. Whereas our companion paper summarizes fundamental issues, this article focuses on more complex, task-specific aspects of presenting numeric information in patient decision aids. METHODS As part of the International Patient Decision Aids Standards third evidence update, we gathered an expert panel of 9 international experts who revised and expanded the topics covered in the 2013 review working in groups of 2 to 3 to update the evidence, based on their expertise and targeted searches of the literature. The full panel then reviewed and provided additional revisions, reaching consensus on the final version. RESULTS Five of the 10 topics addressed more complex task-specific issues. We found strong evidence for using independent event rates and/or incremental absolute risk differences for the effect size of test and screening outcomes. Simple visual formats can help to reduce common judgment biases and enhance comprehension but can be misleading if not well designed. Graph literacy can moderate the effectiveness of visual formats and hence should be considered in tool design. There is less evidence supporting the inclusion of personalized and interactive risk estimates. DISCUSSION More complex numeric information. such as the size of the benefits and harms for decision options, can be better understood by using incremental absolute risk differences alongside well-designed visual formats that consider the graph literacy of the intended audience. More research is needed into when and how to use personalized and/or interactive risk estimates because their complexity and accessibility may affect their feasibility in clinical practice.
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Affiliation(s)
- Lyndal J Trevena
- Faculty of Medicine and Health, School of Public Health, The University of Sydney, Sydney, NSW, Australia.,Ask Share Know NHMRC Centre for Research Excellence, The University of Sydney, Australia
| | - Carissa Bonner
- Faculty of Medicine and Health, School of Public Health, The University of Sydney, Sydney, NSW, Australia.,Ask Share Know NHMRC Centre for Research Excellence, The University of Sydney, Australia
| | - Yasmina Okan
- Centre for Decision Research, University of Leeds, Leeds, UK
| | | | | | - Paul K J Han
- Center for Outcomes Research and Evaluation, Maine Medical Center Research Institute, Portland, ME, USA.,School of Medicine, Tufts University, Medford, MA, USA
| | | | - Danielle Timmermans
- Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, North Holland, The Netherlands
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Zadro JR, Traeger AC, Décary S, O'Keeffe M. Problem with patient decision aids. BMJ Evid Based Med 2020; 26:bmjebm-2020-111371. [PMID: 32439722 DOI: 10.1136/bmjebm-2020-111371] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/01/2020] [Indexed: 11/04/2022]
Abstract
Patient decision aids are evidence-based tools designed to help patients make specific and deliberated choices among healthcare options. Research shows that patient decision aids increase knowledge, accuracy of risk perceptions, alignment of care with patient values and preferences, and patient involvement in decision making. Some patient decision aids can reduce the use of invasive and potentially low-value procedures. On this basis, clinical practice guidelines and international organisations have begun to recommend the use of patient decision aids and shared decision making as a strategy to reduce medical overuse. Although patient decision aids hold promise for improving healthcare, there are fundamental issues with patient decision aids that need to be addressed before further progress can be made. The problems with patient decision aids are: (1) Guidelines for developing patient decision aids may not be sufficient to ensure developers select the best available evidence and present it appropriately; (2) Biased presentation of low-certainty evidence is common and (3) Biased presentation of low-certainty evidence is misleading, and could inadvertently support, low-value care. We explore these issues in the article and present a case study of online patient decision aids for musculoskeletal pain. We suggest ways to ensure patient decision aids help patients understand the evidence and, where possible, support high-quality care.
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Affiliation(s)
- Joshua R Zadro
- Institute for Musculoskeletal Health, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Adrian C Traeger
- Institute for Musculoskeletal Health, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Simon Décary
- Tier 1 Canada Research Chair in Shared Decision Making and Knowledge Translation, Centre de recherche sur les soins et les services de première ligne, de l'Université Laval, Quebec City, Quebec, Canada
| | - Mary O'Keeffe
- Institute for Musculoskeletal Health, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- School of Allied Health, Faculty of Education & Health Sciences, University of Limerick, Limeric, Ireland
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