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Boonrit N, Chaisawat K, Phueakong C, Nootong N, Ruanglertboon W. Exploring community pharmacists' attitudes in Thailand towards ChatGPT usage: A pilot qualitative investigation. Digit Health 2024; 10:20552076241283256. [PMID: 39314814 PMCID: PMC11418248 DOI: 10.1177/20552076241283256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Accepted: 08/28/2024] [Indexed: 09/25/2024] Open
Abstract
Background ChatGPT has recently emerged as a disruptive technology, potentially impacting various societal dimensions, including pharmacy practices. In Thailand, community pharmacists are navigating transitions as patients increasingly rely on digital tools for healthcare recommendations. This study explores the attitudes of community pharmacists in Hatyai, one of Thailand's most populated cities, towards the integration of ChatGPT in pharmacy services. Method ChatGPT-3.5 was used to generate responses to three questions concerning the use of medicine in special populations in the Thai language. These responses were then incorporated into a questionnaire and evaluated using a Likert scale from 1 to 5. Participants who consented were asked to rate the responses and participate in an in-depth interview. Results The majority of participants rated the responses favorably, with scores of 4 and 5 accounting for at least 60% of the ratings. Only a small proportion of responses received doubtful ratings (score of 3) or was in disagreement, ranging from 20% to 40%. Moreover, open opinions extracted from the interviews suggested that participants viewed ChatGPT as a capable assistant, as it provided fast yet reasonably accurate information in the Thai language. Conclusion The findings indicate that community pharmacists view ChatGPT as a capable assistant, albeit noting the need for further refinements. The study underscores the importance for pharmacists to proactively adapt to technological advancements, particularly those affecting patient safety, to enhance healthcare delivery and optimize treatment outcomes.
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Affiliation(s)
- Nuntapong Boonrit
- Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Prince of Songkla University, Hatyai, Songkhla, Thailand
| | - Kornchanok Chaisawat
- Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Prince of Songkla University, Hatyai, Songkhla, Thailand
| | - Chanakarn Phueakong
- Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Prince of Songkla University, Hatyai, Songkhla, Thailand
| | - Nantitha Nootong
- Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Prince of Songkla University, Hatyai, Songkhla, Thailand
| | - Warit Ruanglertboon
- Discipline of Pharmacology, Division of Health and Applied Sciences, Faculty of Science, Prince of Songkla University, Hatyai, Songkhla, Thailand
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Lim HM, Ng CJ, Abdullah A, Dunn AG. How do patients with high cardiovascular risk evaluate online health information? A qualitative study. BMC PRIMARY CARE 2023; 24:240. [PMID: 37964208 PMCID: PMC10647114 DOI: 10.1186/s12875-023-02182-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 10/13/2023] [Indexed: 11/16/2023]
Abstract
BACKGROUND People are exposed to variable health information from the Internet, potentially influencing their health decision-making and behaviour. It remains a challenge for people to discern between good- and poor-quality online health information (OHI). This study explored how patients evaluate and determine trust in statin-related OHI in patients with high cardiovascular risk. METHODS This qualitative study used vignettes and think-aloud methods. We recruited patients from a primary care clinic who were at least 18 years old, had high cardiovascular risk and had previously sought OHI. Participants were given two statin-related vignettes: Vignette 1 (low-quality information) and Vignette 2 (high-quality information). Participants voiced their thoughts aloud when reading the vignettes and determined the trust level for each vignette using a 5-point Likert scale. This was followed by a semi-structured interview which was audio-recorded and transcribed verbatim. The transcripts were coded and analysed using thematic analysis. RESULTS A total of 20 participants were recruited, with age ranging from 38-74 years. Among all the high cardiovascular-risk participants, eight had pre-existing cardiovascular diseases. For Vignette 1 (low-quality information), five participants trusted it while nine participants were unsure of their trust. 17 participants (85%) trusted Vignette 2 (high-quality information). Five themes emerged from the analysis of how patients evaluated OHI: (1) logical content, (2) neutral stance and tone of OHI content, (3) credibility of the information source, (4) consistent with prior knowledge and experience, and (5) corroboration with information from other sources. CONCLUSION Patients with high cardiovascular risks focused on the content, source credibility and information consistency when evaluating and determining their trust in statin-related OHI. Doctors should adopt a more personalised approach when discussing statin-related online misinformation with patients by considering their prior knowledge, beliefs and experience of statin use.
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Affiliation(s)
- Hooi Min Lim
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Chirk Jenn Ng
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia.
- Department of Research, SingHealth Polyclinics, 167 Jalan Bukit Merah Connection One (Tower 5)#15-10, Singapore, 150167, Singapore.
- Duke-NUS Medical School, Singapore, Singapore.
| | - Adina Abdullah
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Adam G Dunn
- Biomedical Informatics and Digital Health, School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
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Hu X, Pennington BRT, Avidan MS, Kheterpal S, deBourbon NG, Politi MC. Description of the Content and Quality of Publicly Available Information on the Internet About Inhaled Volatile Anesthesia and Total Intravenous Anesthesia: Descriptive Study. JMIR Perioper Med 2023; 6:e47714. [PMID: 37917148 PMCID: PMC10654911 DOI: 10.2196/47714] [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: 03/29/2023] [Revised: 08/29/2023] [Accepted: 09/19/2023] [Indexed: 11/03/2023] Open
Abstract
BACKGROUND More than 300 million patients undergo surgical procedures requiring anesthesia worldwide annually. There are 2 standard-of-care general anesthesia administration options: inhaled volatile anesthesia (INVA) and total intravenous anesthesia (TIVA). There is limited evidence comparing these methods and their impact on patient experiences and outcomes. Patients often seek this information from sources such as the internet. However, the majority of websites on anesthesia-related topics are not comprehensive, updated, and fully accurate. The quality and availability of web-based patient information about INVA and TIVA have not been sufficiently examined. OBJECTIVE This study aimed to (1) assess information on the internet about INVA and TIVA for availability, readability, accuracy, and quality and (2) identify high-quality websites that can be recommended to patients to assist in their anesthesia information-seeking and decision-making. METHODS Web-based searches were conducted using Google from April 2022 to November 2022. Websites were coded using a coding instrument developed based on the International Patient Decision Aids Standards criteria and adapted to be appropriate for assessing websites describing INVA and TIVA. Readability was calculated with the Flesch-Kincaid (F-K) grade level and the simple measure of Gobbledygook (SMOG) readability formula. RESULTS A total of 67 websites containing 201 individual web pages were included for coding and analysis. Most of the websites provided a basic definition of general anesthesia (unconsciousness, n=57, 85%; analgesia, n=47, 70%). Around half of the websites described common side effects of general anesthesia, while fewer described the rare but serious adverse events, such as intraoperative awareness (n=31, 46%), allergic reactions or anaphylaxis (n=29, 43%), and malignant hyperthermia (n=18, 27%). Of the 67 websites, the median F-K grade level was 11.3 (IQR 9.5-12.8) and the median SMOG score was 13.5 (IQR 12.2-14.4), both far above the American Medical Association (AMA) recommended reading level of sixth grade. A total of 51 (76%) websites distinguished INVA versus TIVA as general anesthesia options. A total of 12 of the 51 (24%) websites explicitly stated that there is a decision to be considered about receiving INVA versus TIVA for general anesthesia. Only 10 (20%) websites made any direct comparisons between INVA and TIVA, discussing their positive and negative features. A total of 12 (24%) websites addressed the concept of shared decision-making in planning anesthesia care, but none specifically asked patients to think about which features of INVA and TIVA matter the most to them. CONCLUSIONS While the majority of websites described INVA and TIVA, few provided comparisons. There is a need for high-quality patient education and decision support about the choice of INVA versus TIVA to provide accurate and more comprehensive information in a format conducive to patient understanding.
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Affiliation(s)
- Xinwen Hu
- Department of Anesthesiology, Washington University in St Louis School of Medicine, St Louis, MO, United States
| | - Bethany R Tellor Pennington
- Department of Anesthesiology, Washington University in St Louis School of Medicine, St Louis, MO, United States
| | - Michael S Avidan
- Department of Anesthesiology, Washington University in St Louis School of Medicine, St Louis, MO, United States
| | - Sachin Kheterpal
- Department of Anesthesiology, University of Michigan, Ann Arbor, MI, United States
| | | | - Mary C Politi
- Department of Surgery, Washington University in St Louis School of Medicine, St Louis, MO, United States
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Ahmadzadeh K, Bahrami M, Zare-Farashbandi F, Adibi P, Boroumand MA, Rahimi A. Patient education information material assessment criteria: A scoping review. Health Info Libr J 2023; 40:3-28. [PMID: 36637218 DOI: 10.1111/hir.12467] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 10/13/2022] [Accepted: 11/03/2022] [Indexed: 01/14/2023]
Abstract
BACKGROUND Patient education information material (PEIM) is an essential component of patient education programs in increasing patients' ability to cope with their diseases. Therefore, it is essential to consider the criteria that will be used to prepare and evaluate these resources. OBJECTIVE This paper aims to identify these criteria and recognize the tools or methods used to evaluate them. METHODS National and international databases and indexing banks, including PubMed, Scopus, Web of Science, ProQuest, the Cochrane Library, Magiran, SID and ISC, were searched for this review. Original or review articles, theses, short surveys, and conference papers published between January 1990 and June 2022 were included. RESULTS Overall, 4688 documents were retrieved, of which 298 documents met the inclusion criteria. The criteria were grouped into 24 overarching criteria. The most frequently used criteria were readability, quality, suitability, comprehensibility and understandability. CONCLUSION This review has provided empirical evidence to identify criteria, tools, techniques or methods for developing or evaluating a PEIM. The authors suggest that developing a comprehensive tool based on these findings is critical for evaluating the overall efficiency of PEIM using effective criteria.
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Affiliation(s)
- Khadijeh Ahmadzadeh
- Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.,Student Research Commitee, Sirjan School of Medical Sciences, Sirjan, Iran
| | - Masoud Bahrami
- Department of Adult Health Nursing, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Firoozeh Zare-Farashbandi
- Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Payman Adibi
- Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Ali Boroumand
- Department of Medical Library and Information Sciences, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Alireza Rahimi
- Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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5
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Narvaez-Rojas A, Arnaout MM, Hoz SS, Agrawal A, Lee A, Moscote-Salazar LR, Deora H. Info-pollution: a word of caution for the neurosurgical community. EGYPTIAN JOURNAL OF NEUROSURGERY 2022. [DOI: 10.1186/s41984-022-00179-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
AbstractThe medical-patient relationship is facing pollution of information all over the internet, for physician and patients is becoming tougher to keep updated with the highest quality of information. During the last 20 years multiple evaluation tools have been developed trying to find the best tool to assess high-quality information, to date DISCERN tool represents the most widely spread. Information can be found on the surface internet and in the deep web, constituting the biggest chunk of the internet, informing and controlling the quality of information is a formidable task. PubMed and Google Scholar are the most important tools for a physician to find information, although multiple others are available; awareness must be raised over improving current strategies for data mining high-quality information for the patients and the healthcare community.
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Nytun KL, Moldestad IO, Snibsøer AK, Espehaug B. The effect of web-based preoperative information on parents of children who are going through elective ambulatory surgery: A systematic review and meta-analysis. PATIENT EDUCATION AND COUNSELING 2022; 105:3389-3397. [PMID: 36182646 DOI: 10.1016/j.pec.2022.09.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 09/08/2022] [Accepted: 09/09/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE To evaluate the effect of preoperative web-based information to parents of children undergoing elective ambulatory surgery performed with anesthesia. Outcome measures were parental anxiety, knowledge, and satisfaction. METHOD The review followed the PRISMA statement. A systematic search of six databases was conducted. Randomized controlled trials, cluster-randomized trials and quasi-randomized controlled trials were eligible for inclusion. RESULT Eight studies were included. An effect in favour of web-based information compared to standard information was observed for parental anxiety measured before separation from child (SMD=-0.66, 95% CI=-0.92 to -0.40) and after surgery (SMD=-0.55, 95% CI=-0.95 to -0.16), for parental knowledge measured in-hospital (SMD=1.10, Cl 95%=0.37-1.82), and parental satisfaction after discharge (SMD=1.03, 95% Cl=0.41-1.65). No effect was observed for anxiety at separation, and for satisfaction in-hospital. The certainty of the evidence varied from very low to moderate. CONCLUSION Depending on the timing of assessment, web-based information before pediatric surgery may reduce the level of parental anxiety and increase the level of parental knowledge and satisfaction more than standard care. PRACTICE IMPLICATIONS Web-based routines can be used to convey pre-operative information to parents before paediatric ambulatory surgery. Still, standardized research that enables further comparison across studies is needed.
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Affiliation(s)
- Kari Louise Nytun
- Section for Evidence-Based Practice, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Postbox 7030, Bergen 5020, Norway; Department of Communication, Haukeland University Hospital, Postbox 1400, 5021 Bergen, Norway.
| | - Irene Ohlen Moldestad
- Section for Evidence-Based Practice, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Postbox 7030, Bergen 5020, Norway; Biomatlab, Department of Orthopaedic Surgery, Haukeland University Hospital, Postbox 1400, 5021 Bergen, Norway.
| | - Anne Kristin Snibsøer
- Section for Evidence-Based Practice, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Postbox 7030, Bergen 5020, Norway; Department of Health and Caring Sciences, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Postbox 7030, Bergen 5020, Norway.
| | - Birgitte Espehaug
- Section for Evidence-Based Practice, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Postbox 7030, Bergen 5020, Norway.
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Sun ZJ, Sun X, Huo Y, Mi M, Peng GL, Zhang CL, Jiang Y, Zhou Y, Zhao X, Li T, Wu XB. Abbreviated perioperative fasting management for elective fresh fracture surgery: guideline adherence analysis. BMC Musculoskelet Disord 2022; 23:688. [PMID: 35858882 PMCID: PMC9297612 DOI: 10.1186/s12891-022-05574-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 06/10/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Long-term fasting for elective surgery has been proven unnecessary based on established guidelines. Instead, preoperative carbohydrate loading 2 h before surgery and recommencing oral nutrition intake as soon as possible after surgery is recommended. This study was performed to analyze the compliance with and effect of abbreviated perioperative fasting management in patients undergoing surgical repair of fresh fractures based on current guidelines. METHODS Patients with fresh fractures were retrospectively analyzed from the prospectively collected database about perioperative managements based on enhanced recovery of surgery (ERAS) from May 2019 to July 2019 at our hospital. A carbohydrate-enriched beverage was recommended up to 2 h before surgery for all surgical patients except those with contraindications. Postoperatively, oral clear liquids were allowed once the patients had regained full consciousness, and solid food was allowed 1 to 2 h later according to the patients' willingness. The perioperative fasting time was recorded and the patients' subjective comfort with respect to thirst and hunger was assessed using an interview-assisted questionnaire. RESULTS In total, 306 patients were enrolled in this study. The compliance rate of preoperative carbohydrate loading was 71.6%, and 93.5% of patients began ingestion of oral liquids within 2 h after surgery. The median (interquartile range) preoperative fasting time for liquids and solids was 8 (5.2-12.9) and 19 (15.7-22) hours, respectively. The median postoperative fasting time for liquids and solids was 1 (0.5-1.9) and 2.8 (2.2-3.5) hours, respectively. A total of 70.3% and 74.2% of patients reported no thirst and hunger during the perioperative period, respectively. Logistic regression analysis showed that the preoperative fasting time for liquids was an independent risk factor for perioperative hunger. No risk factor was identified for perioperative thirst. No adverse events such as aspiration pneumonia or gastroesophageal reflux were observed. CONCLUSIONS In this study of a real clinical practice setting, abbreviated perioperative fasting management was carried out with high compliance in patients with fresh fractures. The preoperative fasting time should be further shortened to further improve patients' subjective comfort.
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Affiliation(s)
- Zhi-Jian Sun
- Department of Orthopedic Trauma, Beijing Jishuitan Hospital, Beijing, 100035, China
| | - Xu Sun
- Department of Orthopedic Trauma, Beijing Jishuitan Hospital, Beijing, 100035, China
| | - Yan Huo
- Department of Orthopedic Trauma, Beijing Jishuitan Hospital, Beijing, 100035, China
| | - Meng Mi
- Department of Orthopedic Trauma, Beijing Jishuitan Hospital, Beijing, 100035, China
| | - Gui-Ling Peng
- Department of Orthopedic Trauma, Beijing Jishuitan Hospital, Beijing, 100035, China
| | - Chun-Ling Zhang
- Department of Orthopedic Trauma, Beijing Jishuitan Hospital, Beijing, 100035, China
| | - Yao Jiang
- Department of Orthopedic Trauma, Beijing Jishuitan Hospital, Beijing, 100035, China
| | - Yan Zhou
- Department of Anesthesiology, Beijing Jishuitan Hospital, Beijing, 100035, China
| | - Xia Zhao
- Department of Nutriology, Beijing Jishuitan Hospital, Beijing, 100035, China
| | - Ting Li
- Department of Orthopedic Trauma, Beijing Jishuitan Hospital, Beijing, 100035, China.
| | - Xin-Bao Wu
- Department of Orthopedic Trauma, Beijing Jishuitan Hospital, Beijing, 100035, China
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Doubleday AR, Novin S, Long KL, Schneider DF, Sippel RS, Pitt SC. Online Information for Treatment for Low-Risk Thyroid Cancer: Assessment of Timeliness, Content, Quality, and Readability. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2021; 36:850-857. [PMID: 32108292 PMCID: PMC11014722 DOI: 10.1007/s13187-020-01713-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The Internet is a key source of health information, yet little is known about resources for low-risk thyroid cancer treatment. We examined the timeliness, content, quality, readability, and reference to the 2015 American Thyroid Association (ATA) guidelines in websites about thyroid cancer treatment. We identified the top 60 websites using Google, Bing, and Yahoo for "thyroid cancer." Timeliness and content analysis identified updates in the ATA guidelines (n = 6) and engaged a group of stakeholders to develop essential items (n = 29) for making treatment decisions. Website quality and readability analysis used 4 validated measures: DISCERN; Journal of the American Medical Association (JAMA) benchmark criteria; Health on the Net Foundation certification (HONcode); and the Suitability Assessment of Materials (SAM) method. Of the 60 websites, 22 were unique and investigated. Content analysis revealed zero websites contained all updates from the ATA guidelines and rarely (18.2%) referenced them. Only 31.8% discussed all 3 treatment options: total thyroidectomy, lobectomy, and active surveillance. Websites discussed 28.2% of the 29 essential items for making treatment decisions. Quality analysis with DISCERN showed "fair" scores overall. Only 29.9% of the JAMA benchmarks were satisfied, and 40.9% were HONcode certified. Readability analysis with the SAM method found adequate readability, yet 90.9% scored unsuitable in literacy demand. The overall timeliness, content, quality, and readability of websites about low-risk thyroid cancer treatment is fair and needs improvement. Most websites lack updates from the 2015 ATA guidelines and information about treatment options that are necessary to make informed decisions.
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Affiliation(s)
- Amanda R Doubleday
- Department of Surgery, Division of Endocrine Surgery, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison, WI, 53792, USA.
| | - Sherwin Novin
- Department of Surgery, Division of Endocrine Surgery, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison, WI, 53792, USA
| | - Kristin L Long
- Department of Surgery, Division of Endocrine Surgery, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison, WI, 53792, USA
| | - David F Schneider
- Department of Surgery, Division of Endocrine Surgery, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison, WI, 53792, USA
| | - Rebecca S Sippel
- Department of Surgery, Division of Endocrine Surgery, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison, WI, 53792, USA
| | - Susan C Pitt
- Department of Surgery, Division of Endocrine Surgery, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison, WI, 53792, USA
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Lim HM, Dunn AG, Muhammad Firdaus Ooi S, Teo CH, Abdullah A, Woo WJ, Ng CJ. mHealth adoption among primary care physicians in Malaysia and its associated factors: a cross-sectional study. Fam Pract 2021; 38:210-217. [PMID: 32968795 DOI: 10.1093/fampra/cmaa103] [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] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND mHealth apps potentially improve health care delivery and patient outcomes, but the uptake of mHealth in primary care is challenging, especially in low-middle-income countries. OBJECTIVE To measure factors associated with mHealth adoption among primary care physicians (PCPs) in Malaysia. METHODS A cross-sectional study using a self-administered questionnaire was conducted among PCPs. The usage of mHealth apps by the PCPs has divided into the use of mHealth apps to support PCPs' clinical work and recommendation of mHealth apps for patient's use. Factors associated with mHealth adoption were analysed using multivariable logistic regression. RESULTS Among 217 PCPs in the study, 77.0% used mHealth apps frequently for medical references, 78.3% medical calculation and 30.9% interacting with electronic health records (EHRs). Only 22.1% of PCPs frequently recommended mHealth apps to patients for tracking health information, 22.1% patient education and 14.3% use as a medical device. Performance expectancy and facilitating conditions were associated with mHealth use for medical references. Family medicine trainees, working in a government practice and performance expectancy were the facilitators for the use of mHealth apps for medical calculation. Internet connectivity, performance expectancy and use by colleagues were associated with the use of mHealth with EHR. Performance expectancy was associated with mHealth apps' recommendation to patients to track health information and provide patient education. CONCLUSIONS PCPs often used mHealth apps to support their clinical work but seldom recommended mHealth apps to their patients. Training for PCPs is needed on the appraisal and knowledge of the mHealth apps for patient use.
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Affiliation(s)
- Hooi Min Lim
- Department of Primary Care Medicine, University of Malaya Medical Centre, Kuala Lumpur, Malaysia.,University of Malaya eHealth Initiative (UMeHI), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Adam G Dunn
- University of Malaya eHealth Initiative (UMeHI), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.,Discipline of Biomedical Informatics and Digital Health, School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | | | - Chin Hai Teo
- University of Malaya eHealth Initiative (UMeHI), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.,Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Adina Abdullah
- University of Malaya eHealth Initiative (UMeHI), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.,Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Wing Jun Woo
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Chirk Jenn Ng
- University of Malaya eHealth Initiative (UMeHI), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.,Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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10
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Zuidema WP, Graumans MJ, Oosterhuis JWA, van der Steeg AFW, van Heurn E. The Quality of Web Sites' Health Information on Minimal Invasive Repair of Pectus Excavatum Using the DISCERN Instrument. Eur J Pediatr Surg 2021; 31:157-163. [PMID: 32396941 DOI: 10.1055/s-0040-1710026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
INTRODUCTION The Internet is a frequently used tool for patients with pectus excavatum (PE) to get information about symptoms and treatment options. In addition, it is used by both health care providers as a marketing tool and support group systems. The Internet health information varies in precision, quality, and reliability. The study purpose was to determine the quality of information on the PE Web sites using the DISCERN instrument, including information about operation and potential complications after a Nuss bar procedure. MATERIALS AND METHODS Four search engines, Google, Yahoo, Ask, and Bing, were used to explore seven key terms concerning PE. Search language was English. The DISCERN quality instrument was used to evaluate the Web sites. Also, information on possible complications was scored per Web site. RESULTS A total of 560 Web sites were assessed in March 2019. Excluded were 139 Web sites. There were 333 duplicates, leaving 88 unique Web sites. Of these, 58.1% were hospital-related information Web sites, 28.4% medical information Web sites, and 3.4% patient forum sites. Interactive multimedia was used on 21.6% of the sites. Pain postoperatively was mentioned on 64.8% of the sites, while only 9.1% mentioned the mortality risk of the surgical correction of PE for Nuss bar placement. The quality of the unique Web sites showed a mean DISCERN score of 42.5 (standard deviation 12.2). Medical information Web sites, encyclopedia, and government-sponsored sites had higher DISCERN scores. Hospital-related information sites, medical companies, and lay persons' sites, had lower total scores. CONCLUSION The overall quality of PE Web sites is low to moderate, with serious shortcomings.
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Affiliation(s)
- Wietse P Zuidema
- Department of Pediatric Surgery, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | - Maarten J Graumans
- Department of Pediatric Surgery, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | - Jan W A Oosterhuis
- Department of Thoracic Surgery, Medical Centre Haaglanden, Den Haag, The Netherlands
| | | | - Ernest van Heurn
- Department of Pediatric Surgery, Amsterdam University Medical Centre, Amsterdam, The Netherlands
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11
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Sharif F, Rahman A, Tonner E, Ahmed H, Haq I, Abbass R, Asinger S, Sbai M. Can technology optimise the pre-operative pathway for elective hip and knee replacement surgery: a qualitative study. Perioper Med (Lond) 2020; 9:33. [PMID: 33292556 PMCID: PMC7667783 DOI: 10.1186/s13741-020-00166-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 11/03/2020] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND An ageing population has resulted in a rise in the number of hip and knee replacement surgeries in the UK. The pre-operative pathway is plagued with issues causing long delays and cancellations. Virtual healthcare technologies have a growing evidence base to help solve these issues. One problem of implementing these technologies is the resistance to change mentality from healthcare professionals. By getting their opinions on the place of these technologies within the pre-operative pathway, a united front can be formed to help deliver change. METHODS Sixteen semi-structured interviews were conducted with key stakeholders within the orthopaedic pre-operative pathway at Imperial College Healthcare NHS Trust. General topics included the different technologies that could be used within the pathway, their uses and associated benefits and problems. Interviews were audio-recorded, before being manually transcribed and then analysed to form categories and themes. RESULTS Various uses, benefits and problems were identified by healthcare professionals for each modality of technology. E-forms were seen as a high reward, low-risk intervention. Remote patient monitoring and teleconsultations had their bonuses, but feasibility was a primary concern. Web-based interventions were seen as an intervention of the past, whereas virtual reality was seen as perhaps being ahead of its time. M-health was very positively viewed due to its all-encompassing nature. Digital illiteracy emerged as a consistent problem for most technologies. CONCLUSIONS Current literature, the results from this study and technology trends within society highlight both M-health and E-forms as the 2 most promising virtual healthcare technologies for use in the pre-operative pathway for orthopaedics. Areas such as pre-operative assessment, triaging and prehabilitation are prime candidates for virtual intervention. Future research should also consider including patient opinions on any proposed interventions, as well as taking into account barriers to implementation.
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Affiliation(s)
- Faraz Sharif
- Imperial College London, Faculty of Medicine, South Kensington, London, SW7 2BU UK
| | - Ammar Rahman
- Imperial College London, Faculty of Medicine, South Kensington, London, SW7 2BU UK
| | | | | | - Iqraa Haq
- Imperial College London, Faculty of Medicine, South Kensington, London, SW7 2BU UK
| | - Rami Abbass
- Imperial College London, Faculty of Medicine, South Kensington, London, SW7 2BU UK
| | - Shad Asinger
- Imperial College London, Faculty of Medicine, South Kensington, London, SW7 2BU UK
| | - Magda Sbai
- Guy’s and St Thomas NHS Trust, London, UK
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Whitley JA, Kieran K. Accuracy and comprehensiveness of publicly-available online data about bedwetting: An actionable opportunity to improve parent and caregiver self-education. J Pediatr Urol 2020; 16:661.e1-661.e8. [PMID: 32753282 DOI: 10.1016/j.jpurol.2020.07.013] [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] [Received: 12/05/2019] [Revised: 06/23/2020] [Accepted: 07/11/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Monosymptomatic nocturnal enuresis (MNE) is one of the most common reasons for referral to pediatric urologists. Prior to subspecialist visits, many parents seek electronically available information online to gather information about this condition and potential treatment options. Previous publications suggest that electronically available information on medical conditions do not always align with evidence-based or expert recommendations. We wondered if the same was true for MNE. OBJECTIVE To describe the content and accessibility of electronically available information on MNE, and its alignment with recommendations from the International Children's Continence Society (ICCS-MNE). STUDY DESIGN We simulated a layperson's electronic search using 10 pertinent search terms associated with bedwetting. We evaluated the first five pages (50 results) for each search. We evaluated all publicly-available (non-paywalled) sites for concordance with ICCS-MNE in eight domains (increasing fluid intake, limiting bladder irritants, optimizing bowel habits, utilizing timed voiding, pelvic floor relaxation, endorsing alarm use, avoiding medications as standard first-line therapies, and pediatrician referral), as well as statements discouraging blaming or punishing the child. Sites were classified as layperson-derived (blogs, communities/forums) or commercially-derived (medical institutions, commercial medical sites, corporations, government). Reading level was assessed by readable.io (compound scoring algorithms). RESULTS Of 500 pages, 410 (82%) met inclusion criteria. Of these, 49.3% were layperson-derived and 47.8% were commercially-derived. Publication year ranged from 1999 to 2017. A median three (range 0-8) therapeutic domains were mentioned per site. Only one site discussed all eight therapeutic domains. Commercial sites discussed more ICCS-MNE domains than blogs and communities/forums (median 4.1 vs. 2.4, p < 0.0001; Figure). Blogs and forums were less likely to recommend subspecialist evaluation (53.0% vs. 81.1%, p < 0.0001), but more likely to recommend alternative medicine therapies (57.9% vs. 28.6%, p < 0.0001). The overall median readability grade level was lower for blogs/communities than for commercial sites (7.9 vs. 8.6, p < 0.0001). DISCUSSION Our findings show that the vast majority of electronically available information on MNE is not congruent with or does not include all ICCS-MNE recommendations. About half of websites are blogs and forums; these not only are more likely to recommend alternative medicine therapies and less likely to recommend subspecialist evaluation, but have lower reading levels and thus may be accessible to more laypersons. CONCLUSION Neither commercially-derived nor layperson-derived websites are comprehensive with regard to ICCS-MNE recommendations. Our findings underscore the need to ensure that electronically published data are accurate, and to understand what data patients may have acquired before visiting with clinicians.
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Affiliation(s)
- Jorge A Whitley
- Seattle Children's Hospital, Division of Urology, Seattle, WA, USA
| | - Kathleen Kieran
- Seattle Children's Hospital, Division of Urology, Seattle, WA, USA; University of Washington Department of Urology, Seattle, WA, USA.
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Merchant RN, Chima N, Ljungqvist O, Kok JNJ. Preoperative Fasting Practices Across Three Anesthesia Societies: Survey of Practitioners. JMIR Perioper Med 2020; 3:e15905. [PMID: 33393934 PMCID: PMC7709845 DOI: 10.2196/15905] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 11/03/2019] [Accepted: 12/14/2019] [Indexed: 12/24/2022] Open
Abstract
Background Pulmonary aspiration of gastric contents is recognized as a complication of anesthesia. To minimize that risk, anesthesiologists advised fasting for solid foods and liquids for an often prolonged period of time. However, 30 years ago, evidence was promulgated that fasting for clear liquids was unnecessary to ensure an empty stomach. Despite a strong evidence base and the knowledge that fasting may be physiologically harmful and unpleasant for patients, the adoption of society guidelines recommending short fasting periods for clear fluids into clinical practice is uncertain. Objective This study aimed to determine the current practices of anesthetists with respect to fasting guidelines. Methods An electronic internet survey was distributed to anesthetists in Canada (CAN), Australia and New Zealand (ANZ), and Europe (EUR) during April 2014 to February 2015. The anesthetists were asked about fasting guidelines, their recommendations to patients for the consumption of clear fluids and solid foods, and the reasons and consequences if these guidelines were not followed. Results A total of 971 anesthetists completed the survey (CAN, n=679; ANZ, n=185; and EUR, n=107). Although 85.0% (818/962) of these participants claimed that their advice to patients followed current society guidelines, approximately 50.4% (476/945) enforced strict fasting and did not allow clear fluids after midnight. The primary reasons given were with regard to problems with a variable operating room schedule (255/476, 53.6%) and safety issues surrounding the implementation of clear fluid drinking guidelines (182/476, 38.2%). Conclusions Many anesthetists continue to follow outdated practices. The current interest in further liberalizing preoperative fluid intake will require more change in anesthesia culture.
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Affiliation(s)
- Richard Neville Merchant
- Department of Anesthesiology and Perioperative Medicine, Royal Columbian Hospital, Fraser Health Authority, University of British Columbia, New Westminster, BC, Canada
| | - Navraj Chima
- Vancouver Coastal Health Authority, University of British Columbia, Vancouver, BC, Canada
| | - Olle Ljungqvist
- Department of Surgery, Faculty of Medicine and Health, Orebro University, Orebro, Sweden
| | - Juliana Nai Jia Kok
- Department of Anaesthesia and Pain Management, Royal Melbourne Hospital, Melbourne, Australia
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Garson LM, Vakharia S, Edwards AF, Maze M. "A Time of Opportunity": Patient Safety and the Perioperative Surgical Home. Anesth Analg 2019; 123:1348-1350. [PMID: 27644056 DOI: 10.1213/ane.0000000000001598] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Leslie M Garson
- From the *Department of Anesthesiology and Perioperative Care, University of California, Irvine, Orange, California; †Department of Anesthesiology, Wake Forest University School of Medicine, Winston-Salem, North Carolina; and ‡Department of Anesthesia and Perioperative Care, UCSF, San Francisco, California
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Mercier FJ, Benhamou D. Obstetric anaesthesia: Dynamic and multidirectional research approaches to ultimately improve parturient management. Anaesth Crit Care Pain Med 2018; 37:405-407. [PMID: 30236474 DOI: 10.1016/j.accpm.2018.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Frédéric J Mercier
- Department of anaesthesia, hôpital Antoine Béclère, hôpitaux universitaires Paris-Sud, Assistance publique-Hôpitaux de Paris (AP-HP), université Paris-Sud, 92141 Clamart cedex, France.
| | - Dan Benhamou
- Department of anaesthesia and intensive care, hôpital Bicêtre, hôpitaux universitaires Paris-Sud, Assistance publique-Hôpitaux de Paris (AP-HP), université Paris-Sud, 94275 le Kremlin-Bicêtre cedex, France
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Ghai V, Pergialiotis V, Jan H, Duffy JMN, Doumouchtsis SK. Obstetric anal sphincter injury: a systematic review of information available on the internet. Int Urogynecol J 2018; 30:713-723. [DOI: 10.1007/s00192-018-3753-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 08/08/2018] [Indexed: 11/25/2022]
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Kaveh-Yazdy F, Zareh-Bidoki AM. Search engines, news wires and digital epidemiology: Presumptions and facts. Int J Med Inform 2018; 115:53-63. [PMID: 29779720 DOI: 10.1016/j.ijmedinf.2018.03.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 03/30/2018] [Accepted: 03/31/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND Digital epidemiology tries to identify diseases dynamics and spread behaviors using digital traces collected via search engines logs and social media posts. However, the impacts of news on information-seeking behaviors have been remained unknown. METHODS Data employed in this research provided from two sources, (1) Parsijoo search engine query logs of 48 months, and (2) a set of documents of 28 months of Parsijoo's news service. Two classes of topics, i.e. macro-topics and micro-topics were selected to be tracked in query logs and news. Keywords of the macro-topics were automatically generated using web provided resources and exceeded 10k. Keyword set of micro-topics were limited to a numerable list including terms related to diseases and health-related activities. The tests are established in the form of three studies. Study A includes temporal analyses of 7 macro-topics in query logs. Study B considers analyzing seasonality of searching patterns of 9 micro-topics, and Study C assesses the impact of news media coverage on users' health-related information-seeking behaviors. RESULTS Study A showed that the hourly distribution of various macro-topics followed the changes in social activity level. Conversely, the interestingness of macro-topics did not follow the regulation of topic distributions. Among macro-topics, "Pharmacotherapy" has highest interestingness level and wider time-window of popularity. In Study B, seasonality of a limited number of diseases and health-related activities were analyzed. Trends of infectious diseases, such as flu, mumps and chicken pox were seasonal. Due to seasonality of most of diseases covered in national vaccination plans, the trend belonging to "Immunization and Vaccination" was seasonal, as well. Cancer awareness events caused peaks in search trends of "Cancer" and "Screening" micro-topics in specific days of each year that mimic repeated patterns which may mistakenly be identified as seasonality. In study C, we assessed the co-integration and correlation between news and query trends. Our results demonstrated that micro-topics sparsely covered in news media had lowest level of impressiveness and, subsequently, the lowest impact on users' intents. CONCLUSION Our results can reveal public reaction to social events, diseases and prevention procedures. Furthermore, we found that news trends are co-integrated with search queries and are able to reveal health-related events; however, they cannot be used interchangeably. It is recommended that the user-generated contents and news documents are analyzed mutually and interactively.
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Quality and readability of internet-based information on halitosis. Oral Surg Oral Med Oral Pathol Oral Radiol 2017; 125:215-222. [PMID: 29325852 DOI: 10.1016/j.oooo.2017.12.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 11/10/2017] [Accepted: 12/01/2017] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To evaluate quality and readability of Internet-based information on halitosis. STUDY DESIGN An Internet search through 3 engines (Google, Yahoo, and Bing) was done with the terms ("bad breath," "halitosis," "oral malodor," "foul breath," "mouth malodor," "breath malodor," "fetor ex ore," "fetor oris," "ozostomia," and "stomatodysodia"). The first 50 websites from each engine resulting from each search term were screened. Included websites were evaluated using Health on the Net (HON) criteria, Journal of American Medical Association (JAMA) benchmarks, DISCERN, Ensuring Quality Information for Patients (EQIP), Flesch Reading Ease (FRE) score, and Flesch-Kincaid Grade level. RESULTS A total of 101 websites were included. HON, DISCERN, EQIP, and FRE score were 42.9%, 37.6%, 37.4%, and 51.9% of the maximum score, respectively. Fewer than 50% of sites displayed attribution, disclosure, and currency according to JAMA benchmarks. HON score, DISCERN score, and EQIP score had significant correlation with each other and were significantly higher in sites displaying the HON seal. CONCLUSION The current quality and readability of informative websites on halitosis are generally low and poorly organized. Clinicians should be able to assess the Internet-based information on halitosis, as well as give accurate advice and guide patients concerning this issue.
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Sarin A, Chen LL, Wick EC. Enhanced recovery after surgery-Preoperative fasting and glucose loading-A review. J Surg Oncol 2017; 116:578-582. [PMID: 28846137 DOI: 10.1002/jso.24810] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 06/19/2017] [Indexed: 02/04/2023]
Abstract
In this review, we explore the rationale and history behind the practice of preoperative fasting in elective surgery including the gradual move toward longer fasting and the more recent change in direction of practice. Gastric emptying physiology and the metabolic effects of prolonged fasting and carbohydrate loading are examined. Most recent guidelines related to these topics are discussed and practical recommendations for implementing these guidelines are suggested.
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Affiliation(s)
- Ankit Sarin
- Department of Surgery, University of California-San Francisco, San Francisco, California
| | - Lee-Lynn Chen
- Department of Anesthesia and Perioperative Care, University of California-San Francisco, San Francisco, California
| | - Elizabeth C Wick
- Department of Surgery, University of California-San Francisco, San Francisco, California
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Van Zundert AA, Gatt SP, Mahajan RP. Open Access, Crowd-Sourced Repository of Anesthesia Information (Wiki-Anesthesia) as Antidote to Inaccurate Internet-Based Resources. Anesth Analg 2017; 124:1741-1742. [DOI: 10.1213/ane.0000000000002036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Flexman AM, Roughead T, Fisher JH, Sewell D, Ryerson CJ. In Response. Anesth Analg 2017; 124:1742-1743. [DOI: 10.1213/ane.0000000000002035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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