1
|
Occhigrossi F, Carpenedo R, Leoni MLG, Varrassi G, Chinè E, Cascella M. Delphi-Based Expert Consensus Statements for the Management of Percutaneous Radiofrequency Neurotomy in the Treatment of Lumbar Facet Joint Syndrome. Pain Ther 2023; 12:863-877. [PMID: 37103732 PMCID: PMC10199975 DOI: 10.1007/s40122-023-00512-2] [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: 02/12/2023] [Accepted: 03/31/2023] [Indexed: 04/28/2023] Open
Abstract
INTRODUCTION A modified Delphi strategy was implemented for obtaining recommendations that could be useful in the management of percutaneous radiofrequency treatment of lumbar facet joint syndrome, as the literature on the argument was poor in quality. METHODS An Italian research team conducted a comprehensive literature search, defined the investigation topics (diagnosis, treatment, and outcome evaluation), and developed an explorative semi-structured questionnaire. They also selected the members of the panel. After an online meeting with the participants, the board developed a structured questionnaire of 15 closed statements (round 1). A five-point Likert scale was used and the cut-off for consensus was established at a minimum of 70% of the number of respondents (level of agreement ≥ 4, agree or strongly agree). The statements without consensus were rephrased (round 2). RESULTS Forty-one clinicians were included in the panel and responded in both rounds. After the first round, consensus (≥ 70%) was obtained in 9 out of 15 statements. In the second round, only one out of six statements reached the threshold. The lack of consensus was observed for statements concerning the use of imaging for a diagnosis [54%, median 4, interquartile range (IQR) 3-5], number of diagnostic blocks (37%, median 4, IQR 2-4), bilateral denervation (59%, median 4, IQR 2-4), technique and number of lesions (66%, median 4, IQR 3-5), and strategy after denervation failure (68%, median 4, IQR 3-4). CONCLUSION Results of the Delphi investigations suggest that there is a need to define standardized protocols to address this clinical problem. This step is essential for designing high-quality studies and filling current gaps in scientific evidence.
Collapse
Affiliation(s)
| | | | - Matteo Luigi Giuseppe Leoni
- Unit of Interventional and Surgical Pain Management, Guglielmo da Saliceto Hospital, Via Taverna 49, 29121 Piacenza, Italy
| | | | - Elisabetta Chinè
- Unit of Pain Therapy, Polyclinic of Tor Vergata, 00133 Rome, Italy
| | - Marco Cascella
- Division of Anesthesia and Pain Medicine, Istituto Nazionale Tumori, IRCCS Fondazione G, Pascale, 80100 Naples, Italy
| |
Collapse
|
2
|
D’Souza RS, Pilitsis JG, Langford BJ, Orhurhu V, Hussain N, Hoffmann CM, Anitescu M, Vanterpool S, Ali R, Patel K, Moeschler SM. Speaker Gender Representation at the North American Neuromodulation Society Annual Meeting (2017-2021): Have We Made Progress in Closing the Gender Gap? J Pain Res 2022; 15:3423-3432. [PMID: 36320224 PMCID: PMC9618239 DOI: 10.2147/jpr.s380152] [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: 06/27/2022] [Accepted: 10/17/2022] [Indexed: 11/05/2022] Open
Abstract
Background Speaker gender representation at medical conferences is a significant site of gender disparity. Our primary objective was to quantify the proportion of female speakers and compare plenary session opportunities by gender at the North American Neuromodulation Society (NANS) Annual Conference. Methods Data from the 2017-2021 NANS Annual Conference presentations were abstracted. Primary outcomes included gender composition of speaker slots, gender composition of individual speakers, and comparison of plenary speaker slots by gender. Secondary outcomes included comparisons of session size, age, professional degree, and number of presentations per speaker based on gender. Results Gender composition of annual speaker slots was (% slots presented by women): 2017:14.6%; 2018:20.5%; 2019:23.5%; 2020:21.0%; 2021:41.4%. Annual gender composition of individual speakers was (% women): 2017:18.7%; 2018:20.6%; 2019:24.6%; 2020:24.9%; 2021:33.8%. Of all speaker slots, the percentage of plenary slots did not differ based on gender, with 11.4% presented by female speakers versus 11.2% presented by male speakers (OR 1.0, 95% CI 0.7-1.5, P=0.893). Compared to male speaker slots, there was an association of lower age (43.9±5.6 vs 50.8±8.9, P<0.001), lower odds of holding a single doctorate degree (OR 0.3, 95% CI 0.2-0.5, P<0.001), and lower odds of holding a dual MD/PhD or DO/PhD degree (OR 0.3, 95% CI 0.1-0.5, P<0.001) in female speaker slots. Compared to male speakers, there was an association of higher number of presentations per female speaker at the 2021 NANS Annual Meeting (2.48±1.60 vs 1.79±1.30, P=0.008). Conclusion Although the volume of female speaker slots and individual speakers trailed behind their male counterparts, female speaker representation steadily increased at each subsequent annual NANS meeting. We identified no difference in plenary session slots based on gender.
Collapse
Affiliation(s)
- Ryan S D’Souza
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic Hospital, Rochester, MN, USA,Correspondence: Ryan S D’Souza, Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA, Email
| | - Julie G Pilitsis
- Department of Clinical Neurosciences, Florida Atlantic University, Boca Raton, FL, USA
| | - Brendan J Langford
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic Hospital, Rochester, MN, USA
| | - Vwaire Orhurhu
- Department of Pain Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Nasir Hussain
- Department of Anesthesiology, Beth Israel Deaconess Medical Center, Boston, MA, USA,Department of Anesthesiology, The Ohio State University, Columbus, OH, USA
| | - Chelsey M Hoffmann
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic Hospital, Rochester, MN, USA
| | - Magdalena Anitescu
- Department of Anesthesia and Critical Care, University of Chicago, Chicago, IL, USA
| | | | - Rushna Ali
- Division of Neurosurgery, Spectrum Health, Grand Rapids, MI, USA
| | - Kiran Patel
- Department of Anesthesiology, New York University Langone Medical Center, New York City, NY, USA
| | - Susan M Moeschler
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic Hospital, Rochester, MN, USA
| |
Collapse
|