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Ooi SL, Micalos PS, Kim J, Pak SC. Rice bran arabinoxylan compound as a natural product for cancer treatment - an evidence-based assessment of the effects and mechanisms. PHARMACEUTICAL BIOLOGY 2024; 62:367-393. [PMID: 38745507 PMCID: PMC11097709 DOI: 10.1080/13880209.2024.2349042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 04/14/2024] [Indexed: 05/16/2024]
Abstract
CONTEXT Rice bran arabinoxylan compound (RBAC) is a natural immunomodulator with anticancer properties. OBJECTIVE This study critically evaluates the available evidence on the biological pathways of RBAC and its effects on cancer treatment. METHODS This secondary analysis of a scoping review includes studies evaluating the mechanisms of RBAC on healthy or malignant cells, animal models, or humans for cancer prevention or treatment. Data from randomized controlled trials on survival and quality of life outcomes were subjectd to meta analysis. RESULTS The evidence synthesis was based on 38 articles. RBAC exhibited antitumor properties by promoting apoptosis and restoring immune function in cancer patients to enhance inflammatory and cytotoxic responses to block tumorigenesis. RBAC works synergistically with chemotherapeutic agents by upregulating drug transport. In a clinical trial, combining RBAC with chemoembolization in treating liver cancer showed improved response, reduced recurrence rates, and prolonged survival. RBAC also augments the endogenous antioxidant system to prevent oxidative stress and protect against radiation side effects. In addition, RBAC has chemoprotective effects. Animals and humans have exhibited reduced toxicity and side effects from chemotherapy. Meta analysis indicates that RBAC treatment increases the survival odds by 4.02-times (95% CI: 1.67, 9.69) in the first year and 2.89-times (95% CI: 1.56, 5.35) in the second year. CONCLUSION RBAC is a natural product with immense potential in cancer treatment. Additional research is needed to characterize, quantify, and standardize the active ingredients in RBAC responsible for the anticancer effects. More well-designed, large-scale clinical trials are required to substantiate the treatment efficacies further.
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Affiliation(s)
- Soo Liang Ooi
- School of Dentistry and Medical Sciences, Charles Sturt University, Bathurst,Australia
| | - Peter S. Micalos
- School of Dentistry and Medical Sciences, Charles Sturt University, Port Macquarie, Australia
| | - Jeanman Kim
- STR Biotech Co. Ltd, Chuncheon-si, Gangwon-do, Republic of Korea
| | - Sok Cheon Pak
- School of Dentistry and Medical Sciences, Charles Sturt University, Bathurst,Australia
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Tomás E, Escoval A, Antunes ML. Cross-cultural adaptation of National Early Warning Score 2 to Angolan Portuguese. Afr J Emerg Med 2024; 14:145-149. [PMID: 38993947 PMCID: PMC11237354 DOI: 10.1016/j.afjem.2024.06.006] [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: 01/08/2024] [Revised: 06/12/2024] [Accepted: 06/13/2024] [Indexed: 07/13/2024] Open
Abstract
Objective To make a cross-cultural adaptation of the National Early Warning Score 2 (NEWS 2) from English to Angolan Portuguese. Methods A methodological research of cross-cultural adaptation was conducted, involving sequential stages of forward translation, translation synthesis, back-translation, and the application of the Delphi Panel methodology for analyzing semantic, idiomatic, experiential, and conceptual equivalence between the translated and the original versions. This process culminated in the development of a pre-final version, which subsequently underwent testing in a cohort of nurses (n = 37). The Intraclass Correlation Coefficient was calculated to assess inter-rater reliability of ratings. Cronbach's alpha was used for evaluating the internal consistency and reliability within the items of the NEWS 2 score. Results The cross-cultural adaptation process allowed us to prepare the final version of this tool. The data collected during the testing phase facilitated the examination of inter-rater reliability of ratings and the internal consistency and reliability within the items of the NEWS2 score. The Intraclass Correlation Coefficient observed at this step was 0.992. The Cronbach's alpha was 0.993. Conclusion The cross-cultural adaptation of the NEWS 2 scoring system to Angolan Portuguese was successful, providing healthcare professionals in Angola with the means to effectively use the tool.
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Affiliation(s)
- Esmael Tomás
- Faculty of Medicine of the University Agostinho Neto, Luanda, Angola
- NOVA National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal
| | - Ana Escoval
- NOVA National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal
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Rázuri EB, Yang Y, Tinius E, Knight DK. Adaptation of a trauma-informed intervention to prevent opioid use among youth in the legal system. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2024; 163:209294. [PMID: 38272116 DOI: 10.1016/j.josat.2024.209294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 10/24/2023] [Accepted: 01/11/2024] [Indexed: 01/27/2024]
Abstract
INTRODUCTION Youth in the legal system are at high risk for opioid and other substance use problems and exhibit high rates of trauma exposure. Trauma-focused therapeutic approaches to prevent substance use show promise, but few evidence-based interventions are designed with justice-involved youth in mind. Consequently, implementing trauma-informed, evidence-based interventions within juvenile justice systems is challenging. The current paper describes the systematic adaptation of Trust-Based Relational Intervention (TBRI) as a family-centered substance use prevention program for youth transitioning from secure residential facilities. METHODS The study utilized the ADAPT-ITT methodological framework to adapt TBRI Caregiver Training, an evidence-based, trauma-informed intervention designed to help caregivers support children and youth with histories of trauma. Phases of adaptation included (1) Assessment, (2) Decision, (3) Prototype Development, and (4) Testing and Integration. The adaptation process explored contextual factors (e.g., systems, facilities, and staff) and the needs of the new target population (i.e., youth in the legal system and their caregivers). Adaptations were made to both content (e.g., terminology and activities) and structure (e.g., session duration and delivery setting) with input from participants from the target population, key stakeholders, and content experts. RESULTS The systematic adaptation of the intervention model resulted in a two-phase, four-component intervention package that can be implemented in juvenile justice settings as part of youth reentry services. The primary intervention, delivered while youth are in residential facilities, includes the TBRI Caregiver Curriculum, TBRI Youth & Young Adult Curriculum, and TBRI Nurture Groups. The secondary intervention, delivered after youth transition home, includes the TBRI Family Coaching Curriculum. CONCLUSIONS Utilizing a systematic methodological framework to guide adaptation has implications for developing accessible, culturally relevant, and contextually appropriate interventions. Accounting for contextual factors and population needs can improve the fit of evidence-based interventions for youth in the legal system, facilitating uptake and ultimately improving outcomes for youth at risk for substance use problems. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04678960.
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Affiliation(s)
- Erin Becker Rázuri
- Karyn Purvis Institute of Child Development, Texas Christian University, United States.
| | - Yang Yang
- Institute of Behavioral Research, Texas Christian University, United States
| | - Elaine Tinius
- Institute of Behavioral Research, Texas Christian University, United States
| | - Danica Kalling Knight
- Karyn Purvis Institute of Child Development, Texas Christian University, United States; Institute of Behavioral Research, Texas Christian University, United States
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Paakkari O, Kulmala M, Lyyra N, Saaranen T, Lindfors P, Tyrväinen H. The core competencies of a health education teacher. Health Promot Int 2024; 39:daae078. [PMID: 38984688 PMCID: PMC11234200 DOI: 10.1093/heapro/daae078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2024] Open
Abstract
Teachers play a crucial role in students' learning and in the development of health literacy. Hence, the aim of this study was to identify the core competencies needed for teachers of health education in supporting student learning. A three-round Delphi study was carried out over an 8-week period, through consultation with 25 Finnish experts in health education. An open-ended question was used to identify the core competencies for school health educators. The data were analysed using inductive content analysis. In subsequent rounds, experts were asked to assess the importance of the identified competencies on a 7-point Likert scale, and finally to rank the most important competencies. In total, 52 competencies were identified and categorized into eight core competence domains. Thereafter, 40 competencies were assessed and selected for the third round, in which the experts ranked the 15 most important competencies, encompassing four core domains, i.e. pedagogic and subject-specific didactic, social and emotional, content knowledge and continuous professional development. Other domains of competence identified in the present study were ethical competence, competence in school health promotion, contextual competence and professional well-being competence. The study defines health education teacher core competencies and domains, and the information can be used in teacher education programmes, for developing teaching and for teachers' self-evaluation.
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Affiliation(s)
- Olli Paakkari
- Faculty of Sport and Health Sciences, Research Centre for Health Promotion, University of Jyväskylä, Keskussairaalantie 4, 40014, Finland
| | - Markus Kulmala
- Faculty of Sport and Health Sciences, Research Centre for Health Promotion, University of Jyväskylä, Keskussairaalantie 4, 40014, Finland
| | - Nelli Lyyra
- Faculty of Sport and Health Sciences, Research Centre for Health Promotion, University of Jyväskylä, Keskussairaalantie 4, 40014, Finland
| | - Terhi Saaranen
- Faculty of Health Sciences, Department of Nursing Science, University of Eastern Finland, Yliopistonrinne 3, 70211 Kuopio, Finland
| | - Pirjo Lindfors
- Faculty of Social Sciences, Unit of Health Sciences, Tampere University, Arvo Ylpön katu 34, 33014, Finland
| | - Heli Tyrväinen
- Health Sciences, Open University, University of Jyväskylä, Alvar Aallon katu 9, 40014, Finland
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5
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Holt G, Hughes D. Consensus study on UK weight management services' response to COVID-19: best practices in outpatient management, governance and digital solutions. J Hum Nutr Diet 2024. [PMID: 38990157 DOI: 10.1111/jhn.13346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 06/18/2024] [Accepted: 06/20/2024] [Indexed: 07/12/2024]
Abstract
BACKGROUND The COVID-19 pandemic put unprecedented pressure on weight management services. These services were required to adapt to continue to provide care for people living with obesity. This study sought to develop consensus recommendations on the best practice solutions adopted by weight management services in the United Kingdom during the COVID-19 pandemic. METHODS This study utilised a semi-structured interview and a modified Delphi methodology to develop a consensus of best practice recommendations identified by specialist weight management services during the pandemic. RESULTS Twenty-three healthcare professionals working in weight management service across the United Kingdom participated in the study. Analysis of interview transcripts identified four key thematic domains: outpatient, patient education and support, perioperative care and team working. Of the initial 43 unique recommendations, 30 reached consensus agreement. Outpatient recommendations focused on communication strategies, patient self-monitoring and remote patient tracking. Patient education and support recommendations addressed the development of online educational resources and support groups. Perioperative care recommendations emphasised case prioritisation, waiting list support and postoperative care. Team working recommendations targeted the use of digital collaboration tools and strategies for effective teamwork. CONCLUSION Developing consensus recommendations on best practice is a critical step for weight management and outpatient services to achieve higher standards of care. These recommendations provide a springboard for departmental discussions, paving the way for improved experiences for individuals living with obesity as they progress along their weight management journey.
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Affiliation(s)
- Guy Holt
- East Midlands Bariatric and Metabolic Institute, University Hospitals Derby and Burton NHS Trust, Derby, UK
| | - David Hughes
- East Midlands Bariatric and Metabolic Institute, University Hospitals Derby and Burton NHS Trust, Derby, UK
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Elghazaly H, Azim HA, Rugo HS, Cameron D, Swain SM, Curigliano G, Harbeck N, Tripathy D, Arun B, Aapro M, Piccart M, Cardoso F, Gligorov J, Elghazawy H, El Saghir NS, Penault-Llorca F, Perez EA, Poortmans P, Abdelaziz H, El-Zawahry HM, Kassem L, Sabry M, Viale G, Al-Sukhun S, Gado N, Leung JWT, Ezz Elarab L, Cardoso MJ, Abdel Karim K, Foheidi M, Elmaadawy MM, Conte P, Selim ASM, Kandil A, Kamal RM, Paltuev RM, Guarneri V, Abulkhair O, Zakaria O, Golshan M, Orecchia R, ElMahdy M, Abdel-Aziz AM, Eldin NB. Tailoring neo/adjuvant systemic therapy in breast cancer: "The advent of a personalized approach"-The Breast-Gynecological and Immuno-Oncology International Cancer Conference (BGICC) consensus and recommendations. Cancer 2024. [PMID: 38985794 DOI: 10.1002/cncr.35389] [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: 10/18/2023] [Revised: 02/19/2024] [Accepted: 03/13/2024] [Indexed: 07/12/2024]
Abstract
BACKGROUND The management of early breast cancer (BC) has witnessed an uprise in the use of neoadjuvant therapy and a remarkable reshaping of the systemic therapy postneoadjuvant treatment in the last few years, with the evolution of many controversial clinical situations that require consensus. METHODS During the 14th Breast-Gynecological and Immuno-Oncology International Cancer Conference held in Egypt in 2022, a panel of 44 BC experts from 13 countries voted on statements concerning debatable challenges in the neo/adjuvant treatment setting. The recommendations were subsequently updated based on the most recent data emerging. A modified Delphi approach was used to develop this consensus. A consensus was achieved when ≥75% of voters selected an answer. RESULTS AND CONCLUSIONS The consensus recommendations addressed different escalation and de-escalation strategies in the setting of neoadjuvant therapy for early BC. The recommendations recapitulate the available clinical evidence and expert opinion to individualize patient management and optimize therapy outcomes. Consensus was reached in 63% of the statements (52/83), and the rationale behind each statement was clarified.
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Affiliation(s)
- Hesham Elghazaly
- Department of Clinical Oncology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Hamdy A Azim
- Department of Clinical Oncology, Kasr Alainy School of Medicine, Cairo University, Giza, Egypt
| | - Hope S Rugo
- Department of Medicine, University of California San Francisco Comprehensive Cancer Center, San Francisco, California, USA
| | - David Cameron
- Edinburgh Cancer Research Centre, Institute of Genetics and Cancer, University of Edinburgh and National Health Service Lothian, Edinburgh, UK
| | - Sandra M Swain
- Georgetown Lombardi Comprehensive Cancer Center, MedStar Health, Washington, District of Columbia, USA
| | - Giuseppe Curigliano
- Department of Oncology and Hemato-Oncology, European Institute of Oncology, IRCCS, University of Milano, Milan, Italy
| | - Nadia Harbeck
- Department of Obstetrics and Gynecology and Comprehensive Cancer Center Munich, Breast Center, Ludwig Maximilian University Hospital, Munich, Germany
| | - Debu Tripathy
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Banu Arun
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Matti Aapro
- Breast Center, Clinique de Genolier, Genolier, Switzerland
| | - Martine Piccart
- Institut Jules Bordet and L'Université Libre de Bruxelles, Brussels, Belgium
| | - Fatima Cardoso
- Breast Unit, Champalimaud Clinical Center/Champalimaud Foundation, Lisbon, Portugal
| | - Joseph Gligorov
- Medical Oncology Department, L'Assistance Publique-Hôpitaux de Paris, Institute Universitaire de Cancérologie, Sorbonne Université, Paris, France
| | - Hagar Elghazawy
- Department of Clinical Oncology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Nagi S El Saghir
- Division of Hematology Oncology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Frederique Penault-Llorca
- National Institute of Health and Medical Research Unit 1240 "Molecular Imaging and Theranostic Strategies", Department of Pathology, Clermont Auvergne University, Center Jean Perrin, Clermont-Ferrand, France
| | - Edith A Perez
- Department of Hematology and Oncology, Mayo Clinic, Jacksonville, Florida, USA
| | - Philip Poortmans
- Iridium Network and Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk-Antwerp, Belgium
| | - Hany Abdelaziz
- Department of Clinical Oncology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Heba M El-Zawahry
- Department of Clinical Oncology, Kasr Alainy School of Medicine, Cairo University, Giza, Egypt
| | - Loay Kassem
- Department of Clinical Oncology, Kasr Alainy School of Medicine, Cairo University, Giza, Egypt
| | - Mohamed Sabry
- Department of Clinical Oncology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | | | | | - Neven Gado
- Department of Clinical Oncology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Jessica W T Leung
- Department of Breast Imaging, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Lobna Ezz Elarab
- Department of Clinical Oncology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Maria João Cardoso
- Breast Unit, Champalimaud Clinical Center, Champalimaud Foundation, Faculdade de Medicina, Lisbon, Portugal
| | - Khaled Abdel Karim
- Department of Clinical Oncology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Meteb Foheidi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Adult Medical Oncology, Princess Noorah Oncology Center, King Abdulaziz Medical City, Ministry of National Guard Health Affairs-Western Region, Jeddah, Saudi Arabia
| | - Merit M Elmaadawy
- Diagnostic Radiology Department, Mansoura University, Mansoura, Egypt
| | - Pierfranco Conte
- Department of Surgery, Oncology, and Gastroenterology, University of Padova, Padova, Italy
- Division of Oncology, Istituto Oncologico Veneto-IRCCS, Padova, Italy
| | - Ashraf S M Selim
- Diagnostic and Interventional Radiology Department, Cairo University, Giza, Egypt
| | - Alaa Kandil
- Department of Clinical Oncology, Alexandria School of Medicine, Alexandria, Egypt
| | - Rasha M Kamal
- Diagnostic and Interventional Radiology Department, Cairo University, Giza, Egypt
| | - Ruslan M Paltuev
- Department of Breast Tumours of Federal State Budgetary Institution "Petrov Research Institute of Oncology", Russian Association of Oncological Mammology, St Petersburg, Russia
| | - Valentina Guarneri
- Department of Surgery, Oncology, and Gastroenterology, University of Padova, Padova, Italy
- Division of Oncology, Istituto Oncologico Veneto-IRCCS, Padova, Italy
| | - Omalkhair Abulkhair
- Medical Oncology Department, Oncology Services, Alhabib Hospital, Riyad, Saudi Arabia
| | - Omar Zakaria
- Department of Surgery, Cairo University, Cairo, Egypt
| | - Mehra Golshan
- Department of Surgery, Yale Comprehensive Cancer Center, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Roberto Orecchia
- Scientific Directorate, IRCCS European Institute of Oncology, University of Milan, Milan, Italy
| | - Manal ElMahdy
- Department of Pathology, Ain Shams University, Cairo, Egypt
| | - Ahmed M Abdel-Aziz
- Department of Pathology, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Nermean Bahie Eldin
- Department of Clinical Oncology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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Wintermark M, Allen JW, Anzai Y, Das T, Flanders AE, Galanaud D, Gean A, Haller S, Lv H, Hirvonen J, Jordan JE, Lee R, Lui YW, Sundgren PC, Mukherjee P, Moen KG, Muto M, Ng K, Niogi SN, Rovira A, de Bruxellas NL, Smits M, Tsiouris AJ, Van Goethem J, Vyvere TV, Whitlow C, Wiesmann M, Yamada K, Zakharova N, Parizel PM. Standardized reporting for Head CT Scans in patients suspected of traumatic brain injury (TBI): An international expert endeavor. Neuroradiology 2024:10.1007/s00234-024-03410-2. [PMID: 38963424 DOI: 10.1007/s00234-024-03410-2] [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: 04/07/2024] [Accepted: 06/20/2024] [Indexed: 07/05/2024]
Abstract
BACKGROUND AND PURPOSE Traumatic brain injury (TBI) is a major source of health loss and disability worldwide. Accurate and timely diagnosis of TBI is critical for appropriate treatment and management of the condition. Neuroimaging plays a crucial role in the diagnosis and characterization of TBI. Computed tomography (CT) is the first-line diagnostic imaging modality typically utilized in patients with suspected acute mild, moderate and severe TBI. Radiology reports play a crucial role in the diagnostic process, providing critical information about the location and extent of brain injury, as well as factors that could prevent secondary injury. However, the complexity and variability of radiology reports can make it challenging for healthcare providers to extract the necessary information for diagnosis and treatment planning. METHODS/RESULTS/CONCLUSION In this article, we report the efforts of an international group of TBI imaging experts to develop a clinical radiology report template for CT scans obtained in patients suspected of TBI and consisting of fourteen different subdivisions (CT technique, mechanism of injury or clinical history, presence of scalp injuries, fractures, potential vascular injuries, potential injuries involving the extra-axial spaces, brain parenchymal injuries, potential injuries involving the cerebrospinal fluid spaces and the ventricular system, mass effect, secondary injuries, prior or coexisting pathology).
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Affiliation(s)
- Max Wintermark
- Department of Neuroradiology, The University of Teas MD Anderson Center, Houston, TX, USA.
| | - Jason W Allen
- Department of Radiology, University of Indiana, Indianapolis, IN, USA
| | - Yoshimi Anzai
- Department of Radiology, University of Utah, Salt Lake City, UT, USA
| | - Tilak Das
- Department of Radiology, Cambridge University Hospitals, Cambridge, UK
| | - Adam E Flanders
- Department of Radiology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Damien Galanaud
- Department of Neuroradiology, Pitie Salpetrière Hospital & Sorbonne, Universite, Paris, France
| | - Alisa Gean
- Department of Radiology, University of California San Francisco, San Francisco, CA, USA
| | - Sven Haller
- Department of Imaging and Medical Informatics, University Hospitals of Geneva and Faculty of Medicine of the University of Geneva, Geneva, Switzerland
| | - Han Lv
- Department of Radiology, Capital Medical University Affiliated Beijing Friendship Hospital, Beijing, 100050, China
| | - Jussi Hirvonen
- Department of Radiology, Tampere University, Faculty of Medicine and Health Technology, and Tampere University Hospital, Tampere, Finland
| | - John E Jordan
- Providence Little Company of Mary Medical Center-Torrance, Torrance, CA, USA
| | - Roland Lee
- Radiology Department, San Diego VA Healthcare System, University of California San Diego, San Diego, CA, USA
| | - Yvonne W Lui
- FACR, Department of Radiology, NYU Langone Health / Grossman School of Medicine, New York, NY, USA
| | - Pia C Sundgren
- Diagnostic Radiology, Department of Clinical Sciences, Lund University, Lund, Sweden
- Department of Medcial Imaging and Physiology, Skåne University Hospital, Lund, Sweden
| | - Pratik Mukherjee
- Department of Veterans Affairs, San Francisco VA Health Care System, San Francisco, CA, U.S.A
- University of California, San Francisco, CA, USA
| | - Kent Gøran Moen
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | - Mario Muto
- Chief Diagnostic and Interventional Neuroradiology, Cardarelli Hospital Naples, Naples, Italy
| | - Karelys Ng
- Section of Neuroradiology, Department of Radiology, University Hospital Vall d'Hebron, Barcelona, Spain
| | - Sumit N Niogi
- Weill Cornell Medicine, Department of Radiology, New York, NY, USA
| | - Alex Rovira
- Section of Neuroradiology, Department of Radiology, University Hospital Vall d'Hebron, Barcelona, Spain
| | | | - Marion Smits
- Department of Radiology & Nuclear Medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
- Medical Delta, Delft, The Netherlands
| | - A John Tsiouris
- Associate Professor of Clinical RadiologyDirector of MRIDepartment of Radiology, Section Chief, Weill Cornell Medicine, NeuroradiologyNew York, NY, USA
| | - Johan Van Goethem
- Department of Medical and Molecular Imaging, University Hospital of Antwerp, Antwerp, Belgium
| | - Thijs Vande Vyvere
- Department of Rehabilitation Sciences and Physiotherapy, MOVANT, University of Antwerp, Antwerp, Belgium
- Pain in Motion International Research Group, Brussels, Belgium
- Department of Radiology, Antwerp University Hospital, Antwerp, Belgium
| | - Chris Whitlow
- Department of Radiology, Wake Forest University, Winston-Salem, USA
| | - Martin Wiesmann
- Department of Neuroradiology, University Hospital Aachen, Aachen, Germany
| | - Kei Yamada
- Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Natalia Zakharova
- N.N. Burdenko National Medical Research Center of Neurosurgery, Federal State Autonomous Institution, Moscow, Russian Federation
| | - Paul M Parizel
- FRANZCR Dept of Radiology, Royal Perth Hospital (RPH), Medical School, University of Western Australia (UWA), Perth, WA, Australia
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Rodríguez-Sánchez L, Reiter R, Rodríguez A, Emberton M, de Reijke T, Compérat EM, Bossi A, Sanchez-Salas R. The FocAL therapy CONsensus (FALCON): enhancing partial gland ablation for localised prostate cancer. BJU Int 2024; 134:50-53. [PMID: 38613454 DOI: 10.1111/bju.16360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/15/2024]
Affiliation(s)
| | - Robert Reiter
- Department of Urology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Alejandro Rodríguez
- Department of Urology, Atrium Health Wake Forest Baptist Medical Center, Winston Salem, North Carolina, USA
| | - Mark Emberton
- Division of Surgery and Interventional Science, University College London, London, UK
| | - Theo de Reijke
- Amsterdam UMC, department of Urology, University of Amsterdam, Amsterdam, The Netherlands
| | - Eva M Compérat
- Department of Pathology, Medical University of Vienna, General Hospital of Vienna, Vienna, Austria
| | - Alberto Bossi
- Genitourinary Oncology, Prostate Brachytherapy Unit, Gustave Roussy, Paris, France
| | - Rafael Sanchez-Salas
- Department of Surgery, Division of Urology, McGill University, Montreal, Quebec, Canada
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9
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Tyndall DA. A primer and overview of the role of artificial intelligence in oral and maxillofacial radiology. Oral Surg Oral Med Oral Pathol Oral Radiol 2024; 138:112-117. [PMID: 38538401 DOI: 10.1016/j.oooo.2024.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 02/10/2024] [Indexed: 06/23/2024]
Affiliation(s)
- Donald A Tyndall
- Department of Diagnostic Sciences, The University of North Carolina at Chapel Hill Adams School of Dentistry, Chapel Hill, NC.
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10
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Incze MA, Huebler S, Grant S, Gordon AJ. Using the Delphi Process to Prioritize an Agenda for Care Transition Research for Patients With Substance Use Disorders. SUBSTANCE USE & ADDICTION JOURNAL 2024; 45:523-528. [PMID: 38622904 DOI: 10.1177/29767342241246762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
Medical hospitalizations are increasingly recognized as important opportunities to engage individuals with substance use disorders (SUD) and offer treatment. While a growing number of hospitals have instituted interventions to support the provision of SUD care during medical admissions, post-hospitalization transitions of care remain a challenge for patients and clinicians and an understudied area of SUD care. Evidence is lacking on the most effective and feasible models of care to improve post-hospitalization care transitions for people with SUD. In the absence of strong empirical evidence to guide practice and policy, consensus-based research methods such as the Delphi process can play an important role in efficiently prioritizing existing models of care for future study and implementation. We conducted a Delphi study that convened a group of 25 national interdisciplinary experts with direct clinical experience facilitating post-hospitalization care transitions for people with SUD. Our panelists rated 10 existing care transition models according to anticipated effectiveness and facility of implementation based on the GRADE Evidence to Decision framework. Qualitative data on each care model were also gathered through comments and an online moderated discussion board. Our results help establish a hierarchy of SUD care transition models to inform future study and program development.
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Affiliation(s)
- Michael A Incze
- Division of General Internal Medicine, Department of Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
- Program of Addiction Research, Clinical Care, Knowledge, and Advocacy (PARCKA), Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Sophia Huebler
- Program of Addiction Research, Clinical Care, Knowledge, and Advocacy (PARCKA), Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
| | | | - Adam J Gordon
- Program of Addiction Research, Clinical Care, Knowledge, and Advocacy (PARCKA), Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
- Informatics, Decision-Enhancement, and Analytic Sciences (IDEAS) Center, VA Salt Lake City Health Care System, Salt Lake City, UT, USA
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Wang S, Zhang J, Wang L, Liang J, Wu X, Li X, Zhang L, Wang N. Development of an instrument to measure the competencies of health professionals in the process of evidence-based healthcare: A Delphi study. J Adv Nurs 2024. [PMID: 38949102 DOI: 10.1111/jan.16300] [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: 02/21/2024] [Revised: 06/03/2024] [Accepted: 06/09/2024] [Indexed: 07/02/2024]
Abstract
AIMS To identify and reach consensus on dimensions and criteria of a competence assessment instrument for health professionals in relation to the process of evidence-based healthcare. DESIGN A two-round Delphi survey was carried out from April to June 2023. METHODS Consensus was sought from an expert panel on the instrument preliminarily established based on the JBI Model of Evidence-Based Healthcare and a rapid review of systematic reviews of relevant literature. The level of consensus was reflected by the concentration and coordination of experts' opinions and percentage of agreement. The instrument was revised significantly based on the combination of data analysis, the experts' comments and research group discussions. RESULTS Sixteen national and three international experts were involved in the first-round Delphi survey and 17 experts participated in the second-round survey. In both rounds, full consensus was reached on the four dimensions of the instrument, namely evidence-generation, evidence-synthesis, evidence-transfer and evidence-implementation. In round-one, the instrument was revised from 77 to 61 items. In round-two, the instrument was further revised to have 57 items under the four dimensions in the final version. CONCLUSION The Delphi survey achieved consensus on the instrument. The validity and reliability of the instrument needs to be tested in future research internationally. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE Systematic assessment of nurses and other health professionals' competencies in different phases of evidence-based healthcare process based on this instrument provides implications for their professional development and multidisciplinary team collaboration in evidence-based practice and better care process and outcomes. IMPACT This study addresses a research gap of lacking an instrument to systematically assess interprofessional competencies in relation to the process of EBHC. The instrument covers the four phases of EBHC process with minimal criteria, highlighting essential aspects of ability to be developed. Identification of health professionals' level of competence in these aspects helps strengthen their capacity accordingly so as to promote virtuous EBHC ecosystem for the ending purpose of improving global healthcare outcomes. REPORTING METHOD This study was reported in line with the Conducting and REporting of DElphi studies (CREDES) guidance on Delphi studies. PATIENT AND PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Shuang Wang
- School of Nursing, Southern Medical University, Guangzhou, China
- Centre for General Practice, The Seventh Affiliated Hospital, Southern Medical University, Foshan, China
| | - Jiayi Zhang
- School of Nursing, Southern Medical University, Guangzhou, China
- Centre for General Practice, The Seventh Affiliated Hospital, Southern Medical University, Foshan, China
| | - Lijie Wang
- School of Nursing, Southern Medical University, Guangzhou, China
- Centre for General Practice, The Seventh Affiliated Hospital, Southern Medical University, Foshan, China
| | - Jin Liang
- School of Nursing, Southern Medical University, Guangzhou, China
- Centre for General Practice, The Seventh Affiliated Hospital, Southern Medical University, Foshan, China
| | - Xiaofen Wu
- Department of Nursing, Puning People's Hospital (Affiliated Puning People's Hospital, Southern Medical University), Puning, China
| | - Xiran Li
- Department of Nuclear Medicine, Third Military Medical University Southwest Hospital, Chongqing, China
| | - Lili Zhang
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Ning Wang
- Centre for General Practice, The Seventh Affiliated Hospital, Southern Medical University, Foshan, China
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Gebrye T, Mbada C, Hakimi Z, Fatoye F. Development of quality assessment tool for systematic reviews and meta-analyses of real-world studies: a Delphi consensus survey. Rheumatol Int 2024; 44:1275-1281. [PMID: 38683352 PMCID: PMC11178604 DOI: 10.1007/s00296-024-05595-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 04/08/2024] [Indexed: 05/01/2024]
Abstract
The increasing adoption of real-world studies in healthcare for decision making and planning has further necessitated the need for a specific quality assessment tool for evidence synthesis. This study aimed to develop a quality assessment tool for systematic reviews (SR) and meta-analysis (MA) involving real-world studies (QATSM-RWS) using a formal consensus method. Based on scoping review, the authors identified a list of items for possible inclusion in the quality assessment tool. A Delphi survey was formulated based on the identified items. A total of 89 experts, purposively recruited, with research experience in real-world data were invited to participate in the first round of Delphi survey. The participants who responded in the first Delphi round were invited to participate (n = 15) in the phrasing of the items. Strong level of agreement was found on the proposed list of items after the first round of Delphi. A rate of agreement ≥ 0.70 was used to define which items to keep in the tool. A list of 14 items emerged as suitable for QATSM-RWS. The items were structured under five domains: introduction, methods, results, discussions, and others. All participants agreed with the proposed phrasing of the items. This is the first study that has developed a specific tool that can be used to appraise the quality of SR and MA involving real-world studies. QATSM-RWS may be used by policymakers, clinicians, and practitioners when evaluating and generating real-world evidence. This tool is now undergoing validation process.
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Affiliation(s)
- Tadesse Gebrye
- Department of Health Professions, Faculty of Health, Psychology, and Social Care, Manchester Metropolitan University, Brooks Building, Birley Fields Campus, 53 Bonsall Street, Manchester, M15 6GX, UK.
| | - Chidozie Mbada
- Department of Health Professions, Faculty of Health, Psychology, and Social Care, Manchester Metropolitan University, Brooks Building, Birley Fields Campus, 53 Bonsall Street, Manchester, M15 6GX, UK
| | | | - Francis Fatoye
- Department of Health Professions, Faculty of Health, Psychology, and Social Care, Manchester Metropolitan University, Brooks Building, Birley Fields Campus, 53 Bonsall Street, Manchester, M15 6GX, UK
- Lifestyle Diseases, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
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Roca Ruiz LJ, Ruiz Ibán MÁ, Díaz Heredia J, López-Millán JM. Consensus on the preoperative management of patients with chronic moderate to severe shoulder pain to improve postoperative outcomes: Delphi results. J Shoulder Elbow Surg 2024; 33:e364-e376. [PMID: 38182020 DOI: 10.1016/j.jse.2023.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 11/08/2023] [Accepted: 11/14/2023] [Indexed: 01/07/2024]
Abstract
BACKGROUND Appropriate preoperative management of patients with chronic moderate to severe shoulder pain who are candidates for surgery owing to rotator cuff disease or glenohumeral osteoarthritis may improve surgery and patient outcomes, but published evidence in this regard is scarce. Therefore, the availability of recommendations on preoperative interventions based on expert consensus may serve as guidance. METHODS A Delphi study was conducted to develop a preoperative management algorithm based on a national expert consensus. A Delphi questionnaire was developed by a scientific committee following a systematic review of the relevant literature published during the past 10 years using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) criteria. It consisted of 48 statements divided into 5 blocks (block I, assessment and diagnosis of preoperative pain; block II, preoperative function and psychosocial aspects; block III, therapeutic objectives; block IV, treatment; and block V, follow-up and referral), and 28 experienced shoulder surgeons from across the country were invited to answer. RESULTS All participants responded to the Delphi questionnaire in the first round, and 25 responded in the second round (89.3% of those invited). Overall, 46 of 49 final statements reached a consensus, on the basis of which a final preoperative management algorithm was defined by the scientific committee. First, surgeons should assess shoulder pain intensity and characteristics, shoulder functionality, and psychosocial aspects using specific validated questionnaires. Preoperative therapeutic objectives should include shoulder pain control, depression and/or nocturnal sleep improvement, opioid consumption adjustment, and substance abuse cessation. Postoperative objectives regarding the degree of shoulder pain reduction or improvement in functionality and/or quality of life should be established in agreement with the patient. Treatment of preoperative chronic moderate to severe shoulder pain should comprise nonpharmacologic as well as pharmacologic interventions. Follow-up of the shoulder pain levels, treatment adherence, and mental health status of these patients may be carried out by the surgical team (surgeon and anesthesiologist) together with the primary care team. Patients with very intense shoulder pain levels may be referred to a pain unit following specific protocols. CONCLUSION A preoperative management algorithm for patients with chronic moderate to severe shoulder pain who are candidates for surgery owing to rotator cuff disease or glenohumeral osteoarthritis was defined based on a national expert consensus. Main points include comprehensive patient management starting with an objective assessment of shoulder pain and function, as well as quality of life; establishment of preoperative and postoperative therapeutic targets; prescription of individualized therapeutic interventions; and multidisciplinary patient follow-up. Implementation of these recommendations into clinical practice may result in better preoperative shoulder pain management and more successful surgical outcomes and patient satisfaction.
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Affiliation(s)
- Luis Javier Roca Ruiz
- Orthopedic Surgery and Traumatology Service, Virgen Macarena University Hospital, Seville, Spain; Department of Surgery, University of Seville, Spain
| | - Miguel Ángel Ruiz Ibán
- Department of Surgery, Health and Medical Sciences, University of Alcaláde Henares, Alcalá de Henares, Madrid, Spain; Area of Traumatology and Orthopedics, CEU San Pablo University, Madrid, Spain; Shoulder and Elbow Unit, Ramón y Cajal University Hospital, Madrid, Spain.
| | - Jorge Díaz Heredia
- Department of Surgery, Health and Medical Sciences, University of Alcaláde Henares, Alcalá de Henares, Madrid, Spain; Area of Traumatology and Orthopedics, CEU San Pablo University, Madrid, Spain
| | - José Manuel López-Millán
- Department of Surgery, University of Seville, Spain; Pain Unit, Anesthesiology and Reanimation Service, Virgen Macarena University Hospital, Seville, Spain
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Torné‐Ruiz A, Sanromà‐Ortiz M, Corral‐Nuñez A, Medel D, Roca J, García‐Expósito J. Management from a multidisciplinary perspective of phlebitis related to peripheral venous catheter insertion: An international Delphi study. Nurs Open 2024; 11:e2229. [PMID: 38957104 PMCID: PMC11220340 DOI: 10.1002/nop2.2229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 06/07/2024] [Accepted: 06/17/2024] [Indexed: 07/04/2024] Open
Abstract
AIM To determine the consensus and importance of care practices related to the management of peripheral venous catheter (PVC)-related phlebitis in hospitalized patients through the views of experts from different disciplines. BACKGROUND PVCs are commonly used in hospitals but are associated with complications such as phlebitis. Their management differs widely, and studies are heterogeneous. DESIGN Delphi method. METHODS Four stages: problem area (with Web of Science bibliometric review in July 2022), panel members, two Delphi rounds and closing criteria. In the Delphi survey, experts answered an online questionnaire based on assessment, treatment and follow-up dimensions (September 2022-February 2023). Statistical analyses were conducted of frequencies, percentages, measures of central tendency and levels of dispersion (QD). A space for comments was created, and a thematic analysis conducted of them. RESULTS Eighteen experts (nurses, doctors and pharmacists) participated in the Delphi rounds. Forty-five activities were identified: 19 in assessment, 15 in treatment and 11 in follow-up. A high consensus level (QD ≤ 0.6) was found in five activities (11.12%), moderate level (0.6 < QD < 1.0) in 19 (42.22%) and low level (QD > 1.0) in 21 (46.66%). Seven themes were determined (patient perspective, lack of consensus, low evidence-based practices, stage-based treatments, prevention activities, high variability in practice and specialist teams and interdisciplinary work). CONCLUSION The importance of systematic assessment scales is highlighted together with consensus on signs and symptoms (pain, redness, inflammation, palpable cord and induration). Treatment according to severity and daily visual recording and monitoring are emphasized along with the need for patient participation and healthcare literacy. A high level of consensus was obtained in 11% of the activities, showing the large variability of criteria and interventions for phlebitis management. Highlighted needs include working in a team, the use of specialist teams and promoting evidence- and prevention-based activities. RELEVANCE TO CLINICAL PRACTICE Clinical variability is noted and, therefore, the importance of consensus on standardized care for PVC phlebitis and evidence-based practice. REPORTING METHOD Delphi studies (CREDES). PATIENT OR PUBLIC CONTRIBUTION Experts contribution.
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Affiliation(s)
- Alba Torné‐Ruiz
- Department of Nursing and PhysiotherapyUniversity of LleidaLleidaSpain
- Xarxa Assistencial Universitària de ManresaBarcelonaSpain
| | | | | | - Daniel Medel
- Department of Nursing and PhysiotherapyUniversity of LleidaLleidaSpain
| | - Judith Roca
- Department of Nursing and PhysiotherapyUniversity of LleidaLleidaSpain
- Health Education, Nursing, Sustainability and Innovation Research Group (GREISI)LleidaSpain
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Andronic O, Lu V, Claydon-Mueller LS, Cubberley R, Khanduja V. Clinical Equipoise in the Management of Patients With Femoroacetabular Impingement Syndrome and Concomitant Tönnis Grade 2 Hip Osteoarthritis or Greater: An International Expert-Panel Delphi Study. Arthroscopy 2024; 40:2029-2038.e1. [PMID: 38158166 DOI: 10.1016/j.arthro.2023.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 12/17/2023] [Accepted: 12/19/2023] [Indexed: 01/03/2024]
Abstract
PURPOSE To gather global-expert opinion on the management of patients with femoroacetabular impingement syndrome (FAIS) and Tönnis grade 2 hip osteoarthritis (OA) or greater. METHODS An internet-based modified Delphi methodology was used via an online platform (Online Surveys) using the CREDES (Conducting and Reporting Delphi Studies) guidelines. The expert panel comprised 27 members from 18 countries: 21 orthopaedic surgeons (78%), 5 physiotherapists (18%), and 1 dual orthopaedic surgeon-sport and exercise medicine physician (4%). Comments and suggestions were collected during each round, and amendments were performed for the subsequent round. Between each pair of rounds, the steering panel provided the experts with a summary of results and amendments. Consensus was set a priori as minimum agreement of 80%. RESULTS Complete participation (100%) was achieved in all 4 rounds. A final list of 10 consensus statements was formulated. The experts agreed that there is no single superior management strategy for FAIS with Tönnis grade 2 OA and that Tönnis grade 3 OA and the presence of bilateral cartilage defects (acetabular and femoral) is a contraindication for hip preservation surgery. Nonoperative management should include activity modification and physiotherapy with hip-specific strengthening, lumbo-pelvic mobility training, and core strengthening. There was no consensus on the need for 3-dimensional imaging for initial quantification of joint degeneration. CONCLUSIONS There is clinical equipoise in terms of the best management strategy for patients with FAIS and Tönnis grade 2 OA, and therefore, there is an urgent need to perform a randomized controlled trial for this cohort of patients to ascertian the best management strategy. LEVEL OF EVIDENCE Level V, expert opinion.
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Affiliation(s)
- Octavian Andronic
- Department of Orthopaedics, Balgrist University Hospital, University of Zürich, Zürich, Switzerland; Medical Technology Research Centre, Anglia Ruskin University, Chelmsford, England; Department of Trauma and Orthopaedics, Young Adult Hip Service, Addenbrooke's-Cambridge University Hospital, Cambridge, England
| | - Victor Lu
- School of Clinical Medicine, University of Cambridge, Cambridge, England
| | | | - Rachael Cubberley
- Medical Technology Research Centre, Anglia Ruskin University, Chelmsford, England
| | - Vikas Khanduja
- Medical Technology Research Centre, Anglia Ruskin University, Chelmsford, England; Department of Trauma and Orthopaedics, Young Adult Hip Service, Addenbrooke's-Cambridge University Hospital, Cambridge, England.
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Hohmann E. Editorial Commentary: Hip Arthroscopy Benefits Patients With Tönnis Grade 0 or 1 Hip Arthritis and Is Not Recommended for Grade 3: Optimal Treatment of Femoroacetabular Impingement Syndrome for Grade 2 Arthritis May Be Determined by Age and Body Mass Index. Arthroscopy 2024; 40:2039-2041. [PMID: 38365123 DOI: 10.1016/j.arthro.2024.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Accepted: 02/07/2024] [Indexed: 02/18/2024]
Abstract
Femoroacetabular impingement syndrome (FAIS) is a possible cause of early osteoarthritis, and restoration of normal anatomy can potentially prevent future major cartilage damage. Symptomatic cam lesions can lead to debonding of articular cartilage, resulting in superolateral cartilage lesions in 93% of patients. Patients with pincer lesions often exhibit cartilage lesions in the anterior and superolateral glenoid rim. Whereas the efficacy of prophylactic surgery remains uncertain, surgical intervention appears to yield superior short-term clinical outcomes compared with conservative treatment. Yet, there is a relatively high prevalence of asymptomatic individuals in the general population with either cam (25%) or pincer (67%) deformities, so prophylactic treatment of asymptomatic patients cannot be recommended. Symptomatic FAIS patients with Tönnis grades 0 and 1 (minimal hip arthritis) benefit from hip arthroscopy. Patients with higher grades of osteoarthritis may be unsuitable hip arthroscopy candidates and face a higher risk of conversion to hip replacement. The existing evidence regarding the treatment of patients with FAIS and Tönnis grade 2 or higher remains inconclusive. Generally, surgery tends to have favorable outcomes for younger patients with a normal body mass index, whereas nonsurgical alternatives should be explored in cases with severe joint space narrowing, Tönnis grade 3, and bilateral cartilage lesions.
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Chen YH, Jones C, Bannatyne A, Horne M. Development of an Instrument to Assess Health and Social Care Professionals' Knowledge and Attitudes Towards Later-Life Intimacy and Sexuality (HSCP-KALLIS): A Delphi Study. Int J Older People Nurs 2024; 19:e12629. [PMID: 38978224 DOI: 10.1111/opn.12629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 05/29/2024] [Accepted: 06/10/2024] [Indexed: 07/10/2024]
Abstract
AIMS We aimed to ascertain the content validity of an instrument to assess health and social care professionals' knowledge and attitudes towards later-life intimacy and sexuality (HSCP-KALLIS). BACKGROUND For older adults, intimacy and sexuality are important in maintaining their quality of life and well-being. However, addressing these needs remains challenging for health and social care professionals, particularly for nursing staff providing 24-h direct care to older people with dementia or those identified as lesbian, gay, bisexual, transgender, intersex or queer/questioning individuals. Existing instruments assessing knowledge and attitudes towards later-life intimacy and sexuality are dated and fail to adequately address dementia and sexual diversity. DESIGN A two-round modified Delphi study was conducted. METHODS Initially, 79 knowledge and attitude items were generated through an integrative review. Panellists rated each item's clarity and importance using online questionnaires. The content validity index for the individual and overall items was calculated. The panellists' written feedback-along with their knowledge level of later-life intimacy and sexuality-was obtained. RESULTS Panellists included health and social care professionals (n = 9); healthcare-related educators (n = 2); researchers specialising in later-life intimacy, sexuality, dementia care and sexual diversity support (n = 7); and family carers of older people with dementia (n = 2). The instrument was revised based on the feedback received. The components of dementia, LGBTIQ+ and the provision of sex worker services in healthcare settings were highlighted by the panellists. Notably, 46 knowledge and 40 attitude items fulfilled the consensus criteria for clarity and importance. CONCLUSIONS Acceptable content validity was established for the knowledge and attitude items. Further research is required to establish the psychometric properties of the HSCP-KALLIS. This instrument has implications for clinical practice-specifically, in nursing care-by addressing issues to improve awareness regarding later-life intimacy and sexuality in healthcare settings. IMPLICATIONS FOR PRACTICE The HSCP-KALLIS has the potential to inform the educational needs regarding knowledge and attitudes towards later-life intimacy and sexuality for health and social care professionals, specifically nursing staff. The findings of the HSCP-KALLIS can be used for the development of competencies for later-life intimacy and sexuality, establishing policies and guidelines to support older adults' intimacy and sexuality needs in health care settings.
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Affiliation(s)
- Yung-Hui Chen
- Faculty of Health Sciences & Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Cindy Jones
- Faculty of Health Sciences & Medicine, Bond University, Gold Coast, Queensland, Australia
- Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
| | - Amy Bannatyne
- Faculty of Health Sciences & Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Maria Horne
- Faculty of Medicine & Health, School of Healthcare, University of Leeds, Leeds, UK
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Taylor C, Mitchell C, Kaneko H, Foley B, Shaw J. Review of the Australian nurse teacher professional practice standards: An e-Delphi study. Nurse Educ Pract 2024; 79:104045. [PMID: 38991261 DOI: 10.1016/j.nepr.2024.104045] [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: 03/15/2024] [Revised: 04/30/2024] [Accepted: 06/26/2024] [Indexed: 07/13/2024]
Abstract
AIM The aim of the study was to review the 2010 Australian nurse teacher professional practice standards ('the Standards') to see if they were still relevant to current nursing educator practice in any practice setting, such as academia or clinical settings. BACKGROUND It has been over 10 years since 'the Standards have been reviewed. Nurse education practice has met many challenges in the past decade, so it is timely to evaluate whether the Standards are still relevant to nursing educators today. DESIGN A modified Delphi technique was used for this study. METHODS Delphi surveys were used to obtain consensus on the relevance of the Standards' statements to any nursing educator. Links to two electronic surveys were sent to an expert panel of nursing educator leaders. Also, two online focus groups of nursing educators from any practice setting or level of experience were held. Results from the first survey and focus groups led to word changes and additional statements, which were included in the second Delphi survey. RESULTS Forty participants responded to the first survey and 38 to the second. Fifteen nursing educators attended the focus groups. There was ≥85 % agreement on all statements in the first survey. with similar high agreement responses in the second survey. Changes in the Standards included language used around culture, inclusion of 'sustainability of the program' and 'demonstrates knowledge and expertise in teaching and educational practice'. CONCLUSIONS The Australian nurse teacher professional practice standards remain highly relevant to nursing educators across all practice settings. In response to feedback from nursing educators some changes to language and additional standard statements were included in the revised standards.
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Affiliation(s)
- Christine Taylor
- School of Nursing and Midwifery, Western Sydney University, NSW, Australia; NSW Centre for Evidence-Based Health Care: A Joanna Briggs Institute Affiliated Centre, Rydalmere, NSW, Australia.
| | - Creina Mitchell
- School of Nursing and Midwifery, Griffith University, QLD, Australia
| | - Hellen Kaneko
- Queensland Digital Academy, Queensland Health, QLD, Australia
| | - Belinda Foley
- The Tweed Hospital, Northern NSW Local Health District, NSW, Australia
| | - Julie Shaw
- Department of Nursing and Allied Health, Swinburne University of Technology, VIC, Australia
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Morgagni P, Bencivenga M, Carneiro F, Cascinu S, Derks S, Di Bartolomeo M, Donohoe C, Eveno C, Gisbertz S, Grimminger P, Gockel I, Grabsch H, Kassab P, Langer R, Lonardi S, Maltoni M, Markar S, Moehler M, Marrelli D, Mazzei MA, Melisi D, Milandri C, Moenig PS, Mostert B, Mura G, Polkowski W, Reynolds J, Saragoni L, Van Berge Henegouwen MI, Van Hillegersberg R, Vieth M, Verlato G, Torroni L, Wijnhoven B, Tiberio GAM, Yang HK, Roviello F, de Manzoni G. International consensus on the management of metastatic gastric cancer: step by step in the foggy landscape : Bertinoro Workshop, November 2022. Gastric Cancer 2024; 27:649-671. [PMID: 38634954 PMCID: PMC11193703 DOI: 10.1007/s10120-024-01479-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 02/05/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND Many gastric cancer patients in Western countries are diagnosed as metastatic with a median overall survival of less than twelve months using standard chemotherapy. Innovative treatments, like targeted therapy or immunotherapy, have recently proved to ameliorate prognosis, but a general agreement on managing oligometastatic disease has yet to be achieved. An international multi-disciplinary workshop was held in Bertinoro, Italy, in November 2022 to verify whether achieving a consensus on at least some topics was possible. METHODS A two-round Delphi process was carried out, where participants were asked to answer 32 multiple-choice questions about CT, laparoscopic staging and biomarkers, systemic treatment for different localization, role and indication of palliative care. Consensus was established with at least a 67% agreement. RESULTS The assembly agreed to define oligometastases as a "dynamic" disease which either regresses or remains stable in response to systemic treatment. In addition, the definition of oligometastases was restricted to the following sites: para-aortic nodal stations, liver, lung, and peritoneum, excluding bones. In detail, the following conditions should be considered as oligometastases: involvement of para-aortic stations, in particular 16a2 or 16b1; up to three technically resectable liver metastases; three unilateral or two bilateral lung metastases; peritoneal carcinomatosis with PCI ≤ 6. No consensus was achieved on how to classify positive cytology, which was considered as oligometastatic by 55% of participants only if converted to negative after chemotherapy. CONCLUSION As assessed at the time of diagnosis, surgical treatment of oligometastases should aim at R0 curativity on the entire disease volume, including both the primary tumor and its metastases. Conversion surgery was defined as surgery on the residual volume of disease, which was initially not resectable for technical and/or oncological reasons but nevertheless responded to first-line treatment.
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Affiliation(s)
- Paolo Morgagni
- Department of General Surgery, Morgagni-Pierantoni Hospital, Forlì, Italy
| | - Maria Bencivenga
- General and Upper GI Surgery, Department of Surgery, University Hospital Verona, University of Verona, Verona, Italy.
| | - Fatima Carneiro
- Department of Pathology, Centro Hospitalar de São João, Institute of Molecular Pathology and Immunology of the University of Porto (Ipatimup), Porto, Portugal
| | - Stefano Cascinu
- Department of Medical Oncology, Comprehensive Cancer Center, Università Vita-Salute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Sarah Derks
- Department of Medical Oncology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Maria Di Bartolomeo
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Claire Donohoe
- Medicinal Chemistry, Trinity Translational Medicine Institute, Trinity Centre for Health Sciences, Trinity College Dublin, The University of Dublin, St. James's Hospital, Dublin 8, Ireland
| | - Clarisse Eveno
- Department of Digestive and Oncologic Surgery, Claude Huriez University Hospital, Centre Hospitalier Universitaire (CHU) Lille, Université de Lille, Lille, France
| | - Suzanne Gisbertz
- Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Peter Grimminger
- Department of General, Visceral and Transplant Surgery, University Medical Center, University of Mainz, Mainz, Germany
| | - Ines Gockel
- Department of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital of Leipzig, Leipzig, Germany
| | - Heike Grabsch
- Department of Pathology, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
- Pathology and Data Analytics, Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, United Kingdom
| | - Paulo Kassab
- Gastric Surgery Division, BP Gastric Surgery Department, Santa Casa Medical School, São Paulo, Brazil
| | - Rupert Langer
- Institute of Pathology and Microbiology, Johannes Kepler University Linz, Altenberger Strasse 69, 4040, Linz, Austria
| | - Sara Lonardi
- Istituto Oncologico Veneto IOV-IRCCS, Padua, Italy
| | - Marco Maltoni
- Unit of Palliative Care, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Forlì-Cesena, Italy
| | - Sheraz Markar
- Surgical Interventional Trials Unit, University of Oxford, Oxford, UK
| | - Markus Moehler
- Department of Medicine, Johannes-Gutenberg University Clinic, Mainz, Germany
| | - Daniele Marrelli
- Unit of General Surgery and Surgical Oncology, Department of Medicine Surgery and Neurosciences, University of Siena, 53100, Siena, Italy
| | - Maria Antonietta Mazzei
- Unit of Diagnostic Imaging, Department of Medical, Surgical and Neuro Sciences and of Radiological Sciences, Azienda Ospedaliero-Universitaria Senese, University of Siena, 53100, Siena, Italy
| | - Davide Melisi
- Medical Oncology at the Department of Medicine, University of Verona, Verona, Italy
| | - Carlo Milandri
- Department of Oncology, San Donato Hospital, 52100, Arezzo, Italy
| | | | - Bianca Mostert
- Department of Medical Oncology, Erasmus MC Cancer Institute, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
| | - Gianni Mura
- Department of Surgery, San Donato Hospital, Arezzo, Italy
| | - Wojciech Polkowski
- Department of Surgical Oncology, Medical University of Lublin, Radziwiłłowska 13 St, 20-080, Lublin, Poland
| | | | - Luca Saragoni
- Pathology Unit, Santa Maria delle Croci Ravenna Hospital, Ravenna, Italy
| | - Mark I Van Berge Henegouwen
- Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Michael Vieth
- Institute of Pathology, Klinikum Bayreuth, Bayreuth, Germany
| | - Giuseppe Verlato
- Department of Diagnostics and Public Health, Section of Epidemiology and Medical Statistics, University of Verona, Verona, Italy
| | - Lorena Torroni
- Department of Diagnostics and Public Health, Section of Epidemiology and Medical Statistics, University of Verona, Verona, Italy
| | - Bas Wijnhoven
- Department of Surgery, Erasmus MC-University Medical Centre Rotterdam, Rotterdam, Netherlands
| | | | - Han-Kwang Yang
- Surgical Department, SNUH National Cancer Center, Seoul, Korea
| | - Franco Roviello
- Unit of General Surgery and Surgical Oncology, Department of Medicine Surgery and Neurosciences, University of Siena, 53100, Siena, Italy
| | - Giovanni de Manzoni
- General and Upper GI Surgery, Department of Surgery, University Hospital Verona, University of Verona, Verona, Italy
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Noebauer-Huhmann IM, Vanhoenacker FM, Vilanova JC, Tagliafico AS, Weber MA, Lalam RK, Grieser T, Nikodinovska VV, de Rooy JWJ, Papakonstantinou O, Mccarthy C, Sconfienza LM, Verstraete K, Martel-Villagrán J, Szomolanyi P, Lecouvet FE, Afonso D, Albtoush OM, Aringhieri G, Arkun R, Aström G, Bazzocchi A, Botchu R, Breitenseher M, Chaudhary S, Dalili D, Davies M, de Jonge MC, Mete BD, Fritz J, Gielen JLMA, Hide G, Isaac A, Ivanoski S, Mansour RM, Muntaner-Gimbernat L, Navas A, O Donnell P, Örgüç Ş, Rennie W, Resano S, Robinson P, Sanal HT, Ter Horst SAJ, van Langevelde K, Wörtler K, Koelz M, Panotopoulos J, Windhager R, Bloem JL. Soft tissue tumor imaging in adults: European Society of Musculoskeletal Radiology-Guidelines 2023-overview, and primary local imaging: how and where? Eur Radiol 2024; 34:4427-4437. [PMID: 38062268 PMCID: PMC11213759 DOI: 10.1007/s00330-023-10425-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 09/08/2023] [Accepted: 09/26/2023] [Indexed: 06/29/2024]
Abstract
OBJECTIVES Early, accurate diagnosis is crucial for the prognosis of patients with soft tissue sarcomas. To this end, standardization of imaging algorithms, technical requirements, and reporting is therefore a prerequisite. Since the first European Society of Musculoskeletal Radiology (ESSR) consensus in 2015, technical achievements, further insights into specific entities, and the revised WHO-classification (2020) and AJCC staging system (2017) made an update necessary. The guidelines are intended to support radiologists in their decision-making and contribute to interdisciplinary tumor board discussions. MATERIALS AND METHODS A validated Delphi method based on peer-reviewed literature was used to derive consensus among a panel of 46 specialized musculoskeletal radiologists from 12 European countries. Statements were scored online by level of agreement (0 to 10) during two iterative rounds. Either "group consensus," "group agreement," or "lack of agreement" was achieved. RESULTS Eight sections were defined that finally contained 145 statements with comments. Overall, group consensus was reached in 95.9%, and group agreement in 4.1%. This communication contains the first part consisting of the imaging algorithm for suspected soft tissue tumors, methods for local imaging, and the role of tumor centers. CONCLUSION Ultrasound represents the initial triage imaging modality for accessible and small tumors. MRI is the modality of choice for the characterization and local staging of most soft tissue tumors. CT is indicated in special situations. In suspicious or likely malignant tumors, a specialist tumor center should be contacted for referral or teleradiologic second opinion. This should be done before performing a biopsy, without exception. CLINICAL RELEVANCE The updated ESSR soft tissue tumor imaging guidelines aim to provide best practice expert consensus for standardized imaging, to support radiologists in their decision-making, and to improve examination comparability both in individual patients and in future studies on individualized strategies. KEY POINTS • Ultrasound remains the best initial triage imaging modality for accessible and small suspected soft tissue tumors. • MRI is the modality of choice for the characterization and local staging of soft tissue tumors in most cases; CT is indicated in special situations. Suspicious or likely malignant tumors should undergo biopsy. • In patients with large, indeterminate or suspicious tumors, a tumor reference center should be contacted for referral or teleradiologic second opinion; this must be done before a biopsy.
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Affiliation(s)
- Iris-Melanie Noebauer-Huhmann
- Department of Biomedical Imaging and Image Guided Therapy, Division of Neuroradiology and Musculoskeletal Radiology, Medical University of Vienna, Vienna, Austria.
| | - Filip M Vanhoenacker
- Department of Radiology AZ Sint Maarten Mechelen, University Hospital Antwerp, Antwerp, Belgium
- Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium
| | - Joan C Vilanova
- Department of Radiology, Clínica Girona, Institute of Diagnostic Imaging (IDI) Girona, University of Girona, Girona, Spain
| | - Alberto S Tagliafico
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
- Department of Radiology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Marc-André Weber
- Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, University Medical Center Rostock, Rostock, Germany
| | - Radhesh K Lalam
- Department of Radiology, Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, UK
| | - Thomas Grieser
- Dept. for Diagnostic and Interventional, Radiology University Hospital Augsburg, Augsburg, Germany
| | - Violeta Vasilevska Nikodinovska
- Medical Faculty, Ss. Cyril and Methodius University, Skopje, Macedonia
- Department of Radiology, University Surgical Clinic "St. Naum Ohridski" Skopje, Skopje, Macedonia
| | - Jacky W J de Rooy
- Department of Imaging, Radiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Olympia Papakonstantinou
- 2Nd Department of Radiology, Attikon Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Catherine Mccarthy
- Oxford Musculoskeletal Radiology and Oxford University Hospitals, Oxford, UK
| | - Luca Maria Sconfienza
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
- Dipartimento Di Scienze Biomediche Per La Salute, Università Degli Studi Di Milano, Milan, Italy
| | | | | | - Pavol Szomolanyi
- High Field MR Center, Department of Biomedical Imaging and Image-Guided Therapy, Medical University Vienna, Vienna, Austria
- Department of Imaging Methods, Institute of Measurement Science, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Frédéric E Lecouvet
- Department of Radiology and Medical Imaging, Cliniques Universitaires Saint Luc, Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain (UCLouvain), Brussels, Belgium
| | - Diana Afonso
- Hospital Particular da Madeira, and Hospital da Luz Lisboa, Lisbon, Portugal
| | - Omar M Albtoush
- Department of Radiology, University of Jordan, Ammam, Jordan
| | - Giacomo Aringhieri
- Academic Radiology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Remide Arkun
- Ege University Medical School Izmir, Izmir, Turkey Star Imaging Center Izmir, Izmir, Turkey
| | - Gunnar Aström
- Department of Immunology, Genetics and Pathology (Oncology) and Department of Surgical Sciences (Radiology), Uppsala University, Uppsala, Sweden
| | - Alberto Bazzocchi
- Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Rajesh Botchu
- Department of Musculoskeletal Radiology, Royal Orthopedic Hospital, Birmingham, UK
| | | | | | - Danoob Dalili
- Academic Surgical Unit, South West London Elective Orthopaedic Centre (SWLEOC), London, UK
| | - Mark Davies
- Department of Musculoskeletal Radiology, Royal Orthopedic Hospital, Birmingham, UK
| | - Milko C de Jonge
- Department of Radiology, St. Antonius Hospital, Utrecht, The Netherlands
| | - Berna D Mete
- Department of Radiology School of Medicine, Izmir Demokrasi University, Izmir, Turkey
| | - Jan Fritz
- Department of Radiology, NYU Grossman School of Medicine, New York, USA
- Diagnostic and Interventional Radiology, Eberhard Karls University Tuebingen, University Hospital Tuebingen, Tübingen, Germany
| | - Jan L M A Gielen
- Department of Radiology and Medical Imaging, University Hospital Antwerp, Edegem, Belgium
| | - Geoff Hide
- Department of Radiology, Freeman Hospital, Newcastle Upon Tyne, UK
| | - Amanda Isaac
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Slavcho Ivanoski
- St. Erasmo Hospital for Orthopaedic Surgery and Traumatology Ohrid, Ohrid, Macedonia
| | | | | | - Ana Navas
- Department of Radiology, Division of Musculoskeletal Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | | | | | - Winston Rennie
- Clinical MSK Radiology, Loughborough University, Leicester Royal Infirmary, Leicester, UK
| | | | - Philip Robinson
- Musculoskeletal Radiology Department Chapel Allerton Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK
- NIHR Leeds Biomedical Research Centre, Leeds, UK
| | - Hatice T Sanal
- Radiology Department, University of Health Sciences, Gülhane Training and Research Hospital, Istanbul, Turkey
| | - Simone A J Ter Horst
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands Department of Radiology and Nuclear Medicine, University Medical Centre Utrecht, Utrecht, The Netherlands
| | | | - Klaus Wörtler
- Musculoskeletal Radiology Section, Klinikum Rechts der Isar, Technical University of Munich - TUM School of Medicine, Munich, Germany
| | - Marita Koelz
- Clinical Institute of Pathology, Medical University of Vienna, Vienna, Austria
| | - Joannis Panotopoulos
- Departement of Orthopaedics and Traumatology, Division of Orthopaedics, Medical University of Vienna, Vienna, Austria
| | - Reinhard Windhager
- Departement of Orthopaedics and Traumatology, Medical University of Vienna, Vienna, Austria
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Fletcher DJ, Boller M, Burkitt-Creedon JM, Fausak E, Van Noord MG, Mears K, Hopper K, Epstein SE. 2024 RECOVER Guidelines: Methods, evidence identification, evaluation, and consensus process for development of treatment recommendations. J Vet Emerg Crit Care (San Antonio) 2024; 34 Suppl 1:3-15. [PMID: 38924655 DOI: 10.1111/vec.13388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 04/25/2024] [Indexed: 06/28/2024]
Abstract
OBJECTIVE To describe the methodology used by the Reassessment Campaign on Veterinary Resuscitation (RECOVER) to re-evaluate the scientific evidence relevant to CPR in small and large animals, to newborn resuscitation, and to first aid and to formulate the respective consensus-based clinical guidelines. DESIGN This report describes the evidence-to-guidelines process employed by RECOVER that is based on the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach and includes Information Specialist-driven systematic literature search, evidence evaluation conducted by more than 200 veterinary professionals, and provision of clinical guidelines in the domains of Preparedness and Prevention, Basic Life Support, Advanced Life Support, Post-cardiac Arrest Care, Newborn Resuscitation, First Aid, and Large Animal CPR. SETTING Transdisciplinary, international collaboration in academia, referral practice, and general practice. RESULTS For this update to the RECOVER 2012 CPR guidelines, we answered 135 Population, Intervention, Comparator, and Outcome (PICO) questions with the help of a team of Domain Chairs, Information Specialists, and more than 200 Evidence Evaluators. Most primary contributors were veterinary specialists or veterinary technician specialists. The RECOVER 2024 Guidelines represent the first veterinary application of the GRADE approach to clinical guideline development. We employed an iterative process that follows a predefined sequence of steps designed to reduce bias of Evidence Evaluators and to increase the repeatability of the quality of evidence assessments and ultimately the treatment recommendations. The process also allowed numerous important knowledge gaps to emerge that form the foundation for prioritizing research efforts in veterinary resuscitation science. CONCLUSIONS Large collaborative, volunteer-based development of evidence- and consensus-based clinical guidelines is challenging and complex but feasible. The experience gained will help refine the process for future veterinary guidelines initiatives.
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Affiliation(s)
- Daniel J Fletcher
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA
| | - Manuel Boller
- VCA Canada Central Victoria Veterinary Hospital, Victoria, British Columbia, Canada
- Faculty of Veterinary Medicine, Department of Veterinary Clinical and Diagnostic Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Jamie M Burkitt-Creedon
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, California, USA
| | - Erik Fausak
- University Library, University of California, Davis, Davis, California, USA
| | - Megan G Van Noord
- University Library, University of California, Davis, Davis, California, USA
| | - Kim Mears
- Robertson Library, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
| | - Kate Hopper
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, California, USA
| | - Steven E Epstein
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, California, USA
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22
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Muchadeyi MT, Hernandez-Villafuerte K, Di Tanna GL, Eckford RD, Feng Y, Meregaglia M, Peasgood T, Petrou S, Ubels J, Schlander M. Quality Appraisal in Systematic Literature Reviews of Studies Eliciting Health State Utility Values: Conceptual Considerations. PHARMACOECONOMICS 2024; 42:767-782. [PMID: 38551803 PMCID: PMC11180162 DOI: 10.1007/s40273-024-01365-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/22/2024] [Indexed: 06/16/2024]
Abstract
BACKGROUND The increasing number of studies that generate health state utility values (HSUVs) and the impact of HSUVs on cost-utility analyses make a robust tailored quality appraisal (QA) tool for systematic reviews of these studies necessary. OBJECTIVE This study aimed to address conceptual issues regarding QA in systematic reviews of studies eliciting HSUVs by establishing a consensus on the definitions, dimensions and scope of a QA tool specific to this context. METHODS A modified Delphi method was used in this study. An international multidisciplinary panel of seven experts was purposively assembled. The experts engaged in two anonymous online survey rounds. After each round, the experts received structured and controlled feedback on the previous phase. Controlled feedback allowed the experts to re-evaluate and adjust their positions based on collective insights. Following these surveys, a virtual face-to-face meeting was held to resolve outstanding issues. Consensus was defined a priori at all stages of the modified Delphi process. RESULTS The response rates to the first-round and second-round questionnaires and the virtual consensus meeting were 100%, 86% and 71%, respectively. The entire process culminated in a consensus on the definitions of scientific quality, QA, the three QA dimensions-reporting, relevance and methodological quality-and the scope of a QA tool specific to studies that elicit HSUVs. CONCLUSIONS Achieving this consensus marks a pivotal step towards developing a QA tool specific to systematic reviews of studies eliciting HSUVs. Future research will build on this foundation, identify QA items, signalling questions and response options, and develop a QA tool specific to studies eliciting HSUVs.
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Affiliation(s)
- Muchandifunga Trust Muchadeyi
- Division of Health Economics, German Cancer Research Centre (DKFZ) Foundation under Public Law, Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
- Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Karla Hernandez-Villafuerte
- Division of Health Economics, German Cancer Research Centre (DKFZ) Foundation under Public Law, Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
| | - Gian Luca Di Tanna
- Department of Business Economics, Health and Social Care (DEASS), University of Applied Sciences and Arts of Southern Switzerland, Manno, Lugano, Switzerland
- The George Institute for Global Health, University of New South Wales (UNSW Sydney), Sydney, NSW, Australia
| | - Rachel D Eckford
- Division of Health Economics, German Cancer Research Centre (DKFZ) Foundation under Public Law, Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
| | - Yan Feng
- Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | - Michela Meregaglia
- Centre for Research on Health and Social Care Management (CERGAS), SDA Bocconi School of Management, Milan, Italy
| | - Tessa Peasgood
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
- Sheffield Centre for Health and Related Research, University of Sheffield, Sheffield, UK
| | - Stavros Petrou
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Jasper Ubels
- Division of Health Economics, German Cancer Research Centre (DKFZ) Foundation under Public Law, Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
- Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Michael Schlander
- Division of Health Economics, German Cancer Research Centre (DKFZ) Foundation under Public Law, Im Neuenheimer Feld 280, 69120, Heidelberg, Germany.
- Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.
- Alfred Weber Institute for Economics (AWI), University of Heidelberg, Heidelberg, Germany.
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de Barros GAM, Pos AM, Sousa ÂM, Pereira CL, Nobre CDDA, Palmeira CCDA, Caruy CAA, Munhoz DC, Kraychete DC, Avelar ECQ, Fukushima FB, Garcia JBS, Torres JNL, Rodrigues KDA, Palladini M, Neto ODHC, Carmona MJC. Cannabinoid products for pain management: recommendations from the São Paulo State Society of Anesthesiology. BRAZILIAN JOURNAL OF ANESTHESIOLOGY (ELSEVIER) 2024; 74:844513. [PMID: 38740135 PMCID: PMC11167254 DOI: 10.1016/j.bjane.2024.844513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 03/12/2024] [Accepted: 04/24/2024] [Indexed: 05/16/2024]
Abstract
There is growing interest in using cannabinoids across various clinical scenarios, including pain medicine, leading to the disregard of regulatory protocols in some countries. Legislation has been implemented in Brazil, specifically in the state of São Paulo, permitting the distribution of cannabinoid products by health authorities for clinical purposes, free of charge for patients, upon professional prescription. Thus, it is imperative to assess the existing evidence regarding the efficacy and safety of these products in pain management. In light of this, the São Paulo State Society of Anesthesiology (SAESP) established a task force to conduct a narrative review on the topic using the Delphi method, requiring a minimum agreement of 60% among panelists. The study concluded that cannabinoid products could potentially serve as adjuncts in pain management but stressed the importance of judicious prescription. Nevertheless, this review advises against their use for acute pain and cancer-related pain. In other clinical scenarios, established treatments should take precedence, particularly when clinical protocols are available, such as in neuropathic pain. Only patients exhibiting poor therapeutic responses to established protocols or demonstrating intolerance to recommended management may be considered as potential candidates for cannabinoids, which should be prescribed by physicians experienced in handling these substances. Special attention should be given to individual patient characteristics and the likelihood of drug interactions.
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Affiliation(s)
| | | | - Ângela Maria Sousa
- Universidade de São Paulo (USP), Instituto do Câncer do Estado de São Paulo, São Paulo, SP, Brazil
| | | | - Cecília Daniele de Azevedo Nobre
- Casa de Saúde São José (Rede Santa Catarina), Rio de Janeiro, RJ, Brazil; Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
| | | | | | - Derli Conceição Munhoz
- Faculdade de Medicina da Universidade Estadual de Campinas (Unicamp), Campinas, SP, Brazil
| | | | | | - Fernanda Bono Fukushima
- Universidade Estadual Paulista (Unesp), Faculdade de Medicina de Botucatu, Botucatu, SP, Brazil
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Schemberg M, Ender J, Bence J, van der Maaten J, Kunstd G, Mukherjee C, Meineri M. Intraoperative and Intraprocedural Use of 3-Dimensional Transesophageal Echocardiography: An International European Association of Cardiothoracic Anesthesia and Intensive Care Survey of Cardiac Surgical Centers. J Cardiothorac Vasc Anesth 2024; 38:1467-1476. [PMID: 38627172 DOI: 10.1053/j.jvca.2024.02.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 02/28/2024] [Indexed: 06/15/2024]
Abstract
OBJECTIVE To assess the intraoperative use of 3-dimensional transesophageal echocardiography (3D TEE) in cardiac surgical centers, the authors created a survey aimed at evaluating the availability of equipment and the use of 3D TEE for specific surgical and interventional procedures and single-image modalities. The respondents were asked to identify the perceived impact on patient management and current limitations to its routine use. DESIGN A multiple choice 25-question online survey submitted to the members of the European Association of Cardiothoracic Anesthesia and Intensive Care (EACTAIC) on December 6, 2021, and closed on January 31, 2022. SETTING An online survey. PARTICIPANTS Registered EACTAIC members in 2021. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS A total of 239 respondents from 44 different countries took part in the survey (27% of the total 903 EACTAIC members). Most respondents (59%) were TEE-certified by the National Board of Echocardiography, European Association of Cardiovascular Imaging (EACVI/EACTAIC), or had a national certificate. Of the respondents, 68% had no formal 3D TEE training. Eight percent of respondents had no 3D machines, whereas 40% had one for each operating room, and 33% had only one for the entire operating room block. 3D TEE was performed most frequently in more than 67% of cases for mitral valve surgery, and in more than 54% of cases for mitral and tricuspid clips, aortic valve, tricuspid valve, and aortic surgery. CONCLUSION Current guidelines suggest integrating 3D TEE into all comprehensive examinations. The authors' survey reported that intraoperative 3D TEE was used in the majority of mitral valve surgery and only one-half of the other valve surgeries and transcatheter procedures. Its use may be explained by the availability of 3D machines, trained personnel, and limited time to perform TEE in the operating room. Educational initiatives for training in 3D TEE may further increase its routine use.
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Affiliation(s)
- Mathias Schemberg
- Department of Anesthesiology and Intensive Care Medicine, Herzzentrum Leipzig, Leipzig, Germany
| | - Joerg Ender
- Department of Anesthesiology and Intensive Care Medicine, Herzzentrum Leipzig, Leipzig, Germany
| | - Johan Bence
- Department of Anaesthesiology and Intensive Care, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - Joost van der Maaten
- Department of Anesthesiology, Cardiothoracic Anesthesia, University Medical Center Groningen, Groningen, the Netherlands
| | - Gudrun Kunstd
- Department of Anesthesiology, King's College, London, United Kingdom
| | - Chirojit Mukherjee
- Department of Anesthesiology and Intensive Care, Herzzentrum Karlsruhe, Karlsruhe, Germany
| | - Massimiliano Meineri
- Department of Anesthesiology and Intensive Care Medicine, Herzzentrum Leipzig, Leipzig, Germany.
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25
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Clark S, Cohen A, Welch SB, Bate A, Anderson AT, Chomilo N, Dougé J, Durkee M, Iruka IU, Jindal M, Jones SC, Li A, Arshad A, Heard-Garris N. Guidance on Conversations About Race and Racism in Pediatric Clinical Settings. Pediatrics 2024; 154:e2023063767. [PMID: 38903051 PMCID: PMC11211695 DOI: 10.1542/peds.2023-063767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 04/22/2024] [Accepted: 04/23/2024] [Indexed: 06/22/2024] Open
Abstract
OBJECTIVE To develop guidance for pediatric clinicians on how to discuss race and racism in pediatric clinical settings. METHODS We conducted a modified Delphi study from 2021 to 2022 with a panel of pediatric clinicians, psychologists, parents, and adolescents with expertise in racism and child health through scholarship or lived experience. Panelists responded to an initial survey with open-ended questions about how to talk to youth about race and racism. We coded the responses using qualitative methods and presented them back to the panelists. In iterative surveys, panelists reached a consensus on which themes were most important for the conversation. RESULTS A total of 29 of 33 panelists completed the surveys and a consensus was reached about the concepts pediatric clinicians should consider before, during, and after conversations about race and racism and impediments clinicians may face while having these discussions. Panelists agreed that it was within the pediatric clinician's role to have these conversations. An overarching theme was the importance of having background knowledge about the systemic nature of racism. Panelists agreed that being active listeners, learning from patients, and addressing intersectionality were important for pediatric clinicians during conversations. Panelists also agreed that short- and long-term benefits may result from these conversations; however, harm could be done if pediatric clinicians do not have adequate training to conduct the conversations. CONCLUSIONS These principles can help guide conversations about race and racism in the pediatric clinical setting, equipping clinicians with tools to offer care that acknowledges and addresses the racism many of their patients face.
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Affiliation(s)
- Shawnese Clark
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
- Mary Ann & J. Milburn Smith Child Health Outcomes, Research and Evaluation Center, Stanley Manne Children’s Research Institute, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois
- ARISE Health Lab, Ann & Robert H. Lurie Children's Hospital, Chicago, Illinois
| | - Alyssa Cohen
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
- Mary Ann & J. Milburn Smith Child Health Outcomes, Research and Evaluation Center, Stanley Manne Children’s Research Institute, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois
- ARISE Health Lab, Ann & Robert H. Lurie Children's Hospital, Chicago, Illinois
- Division of Advanced General Pediatrics and Primary Care, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois
| | - Sarah B. Welch
- Buehler Center for Health Policy and Economics, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Aleha Bate
- Department of Clinical Psychology, Adler University, Chicago, Illinois
| | - Ashaunta T. Anderson
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, California
- Division of General Pediatrics, Children’s Hospital Los Angeles, Los Angeles, California
| | - Nathan Chomilo
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota
- Park Nicollet Health Services, St Louis Park, Minnesota
| | | | - Myles Durkee
- Department of Psychology, University of Michigan, Ann Arbor, Michigan
| | - Iheoma U. Iruka
- Department of Public Policy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Monique Jindal
- Department of Medicine, University of Illinois Chicago School of Medicine, Chicago, Illinois
| | - Shawn C.T. Jones
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia
| | - Angie Li
- Weinberg College of Arts and Sciences, Northwestern University, Evanston, Illinois
| | | | - Nia Heard-Garris
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
- Mary Ann & J. Milburn Smith Child Health Outcomes, Research and Evaluation Center, Stanley Manne Children’s Research Institute, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois
- ARISE Health Lab, Ann & Robert H. Lurie Children's Hospital, Chicago, Illinois
- Division of Advanced General Pediatrics and Primary Care, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois
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Gauvreau CL, Schreyer L, Gibson PJ, Koo A, Ungar WJ, Regier D, Chan K, Hayeems R, Gibson J, Palmer A, Peacock S, Denburg AE. Development of a Value Assessment Framework for Pediatric Health Technologies Using Multicriteria Decision Analysis: Expanding the Value Lens for Funding Decision Making. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2024; 27:879-888. [PMID: 38548179 DOI: 10.1016/j.jval.2024.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 03/07/2024] [Accepted: 03/19/2024] [Indexed: 04/20/2024]
Abstract
OBJECTIVES A health technology assessment (HTA) does not systematically account for the circumstances and needs of children and youth. To supplement HTA processes, we aimed to develop a child-tailored value assessment framework using a multicriteria decision analysis approach. METHODS We constructed a multicriteria-decision-analysis-based model in multiple phases to create the Comprehensive Assessment of Technologies for Child Health (CATCH) framework. Using a modified Delphi process with stakeholders having broad disciplinary and geographic variation (N = 23), we refined previously generated criteria and developed rank-based weights. We established a criterion-pertinent scoring rubric for assessing incremental benefits of new drugs. Three clinicians independently assessed comprehension by pilotscoring 9 drugs. We then validated CATCH for 2 childhood cancer therapies through structured deliberation with an expert panel (N = 10), obtaining individual scores, consensus scores, and verbal feedback. Analyses included descriptive statistics, thematic analysis, exploratory disagreement indices, and sensitivity analysis. RESULTS The modified Delphi process yielded 10 criteria, based on absolute importance/relevance and agreed importance (median disagreement indices = 0.34): Effectiveness, Child-specific Health-related Quality of Life, Disease Severity, Unmet Need, Therapeutic Safety, Equity, Family Impacts, Life-course Development, Rarity, and Fair Share of Life. Pilot scoring resulted in adjusted criteria definitions and more precise score-scaling guidelines. Validation panelists endorsed the framework's key modifiers of value. Modes of their individual prescores aligned closely with deliberative consensus scores. CONCLUSIONS We iteratively developed a value assessment framework that captures dimensions of child-specific health and nonhealth gains. CATCH could improve the richness and relevance of HTA decision making for children in Canada and comparable health systems.
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Affiliation(s)
- Cindy L Gauvreau
- Child Health Evaluative Sciences, The Hospital for Sick Children (SickKids) Research Institute, Toronto, ON, Canada
| | - Leighton Schreyer
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Paul J Gibson
- McMaster Children's Hospital, Hamilton, ON, Canada; Pediatric Oncology Group of Ontario, Toronto, ON, Canada
| | - Alicia Koo
- Department of Pharmacy, The Hospital for Sick Children, Toronto, ON, Canada
| | - Wendy J Ungar
- Child Health Evaluative Sciences, The Hospital for Sick Children (SickKids) Research Institute, Toronto, ON, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Dean Regier
- BC Cancer Research Institute, Vancouver, BC, Canada
| | - Kelvin Chan
- Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Robin Hayeems
- Child Health Evaluative Sciences, The Hospital for Sick Children (SickKids) Research Institute, Toronto, ON, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Jennifer Gibson
- Joint Centre for Bioethics, University of Toronto, Toronto, ON, Canada
| | - Antonia Palmer
- Ac4orn: Advocacy for Canadian Childhood Cancer Research Network, Toronto, ON, Canada
| | - Stuart Peacock
- Faculty of Health Sciences, Simon Fraser University, Vancouver, BC, Canada; Cancer Control Research, BC Cancer, Vancouver, BC, Canada
| | - Avram E Denburg
- Child Health Evaluative Sciences, The Hospital for Sick Children (SickKids) Research Institute, Toronto, ON, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada; Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, ON, Canada.
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Kellams A, Kair L, Broomfield-Massey K, Harper KD, Bugg K, Stuebe A. Setting the Agenda for Patient-Centered Research in Infant and Young-Child Feeding: Results from the Academy of Breastfeeding Medicine and Reaching Our Sisters Everywhere. Breastfeed Med 2024. [PMID: 38938202 DOI: 10.1089/bfm.2023.0297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/29/2024]
Abstract
Background: Breastfeeding is critically important for optimal health of both birthing people and their infants. Shared, patient-centered goals of how health care team members, community groups, and families can help facilitate breastfeeding success are needed, as are ways to define and measure what breastfeeding success looks like from the patient's perspective. Methods: The Academy of Breastfeeding Medicine and Reaching Our Sisters Everywhere's collaborated in a multi-methods approach to identify breastfeeding priorities most important to parents. Results: We identified (1) Key components of a successful breastfeeding journey defined by parents and families, (2) Research priorities that will enable families to achieve breastfeeding. Conclusion: Dissemination of these findings can foster research efforts that are codesigned with birthing parents and families and reflect their priorities.
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Affiliation(s)
- Ann Kellams
- Department of Pediatrics, University of Virginia Health System, Charlottesville, Virginia, USA
| | - Laura Kair
- Department of Pediatrics, University of California Davis of medicine, Sacramento, California, USA
| | | | - Kimberly D Harper
- Collaborative for Maternal and Infant Health, The University of North Carolina, Chapel Hill, North Carolina, USA
| | - Kimarie Bugg
- Reaching Our Sisters Everywhere (ROSE), Lithonia, Georgia, USA
| | - Alison Stuebe
- Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, North Carolina, USA
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Santos PAFD, Rabiais ICM, Frade JM, Coutinho VRD, Baptista RCN. General nurse competencies in disaster: A delphi study. Nurse Educ Pract 2024; 79:104037. [PMID: 38968822 DOI: 10.1016/j.nepr.2024.104037] [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: 03/03/2024] [Revised: 06/08/2024] [Accepted: 06/18/2024] [Indexed: 07/07/2024]
Abstract
AIM The aim of this study is to understand the significance of a disaster-related competence framework for Portuguese general nurses and identify from ICN - Core Competencies in Disaster Nursing version 2.0 core competencies description, those that are considered crucial for a competent preparedness and response in disaster scenarios. BACKGROUND Research suggests that the occurrence of disasters will be more recurrent, requiring that nurses, pillars of any health system, have knowledge, skills and preparedness to face these events. DESIGN An exploratory, cross-sectional qualitative study was carried out. Delphi method was used for data collection. METHODS The study group consisted of technical-scientific council's presidents or coordinators/directors of nursing courses, nurses integrated in the Portuguese Council of Nurses and National Nursing Specialty Colleges and nurses with experience in the field of disasters. RESULTS Findings revealed that there is consensus on sixteen competencies, considered relevant for developing general nurse knowledge and competence, both at a national or international level, in the field of disasters. CONCLUSIONS The development of these competencies which establishes practice standards, building nurses skills and knowledge and ultimately, influencing nursing level-entry curricula's, conferring professional autonomy and self-regulation, in the field of disaster are fundamental. Furthermore, this study may serve as a reference for future alignment of competency frameworks between European Union countries or others.
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Gilmore LE, Chou ST, Ghavam S, Thom CS. Consensus transfusion guidelines for a large neonatal intensive care network. Transfusion 2024. [PMID: 38884350 DOI: 10.1111/trf.17914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 04/30/2024] [Accepted: 05/22/2024] [Indexed: 06/18/2024]
Affiliation(s)
- Lindsay E Gilmore
- Division of Neonatology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Stella T Chou
- Division of Hematology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Sarvin Ghavam
- Division of Neonatology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Christopher S Thom
- Division of Neonatology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
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Karam SG, Zhang Y, Pardo-Hernandez H, Siebert U, Koopman L, Noyes J, Tarride JE, Stevens AL, Welch V, Saz-Parkinson Z, Ens B, Devji T, Xie F, Hazlewood G, Mbuagbaw L, Alonso-Coello P, Brozek JL, Schünemann HJ. ROBVALU: a tool for assessing risk of bias in studies about people's values, utilities, or importance of health outcomes. BMJ 2024; 385:e079890. [PMID: 38866410 PMCID: PMC11167527 DOI: 10.1136/bmj-2024-079890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/09/2024] [Indexed: 06/14/2024]
Affiliation(s)
- Samer G Karam
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
- Michael G DeGroote Cochrane Canada and McMaster GRADE Centres, McMaster University, Hamilton, ON, Canada
| | - Yuan Zhang
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
- Michael G DeGroote Cochrane Canada and McMaster GRADE Centres, McMaster University, Hamilton, ON, Canada
| | - Hector Pardo-Hernandez
- Iberoamerican Cochrane Centre, Sant Antoni Maria Claret, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Uwe Siebert
- Department of Public Health, Health Services Research and Health Technology Assessment, Institute of Public Health, Medical Decision Making and Health Technology Assessment, UMIT TIROL-University for Health Sciences and Technology, Hall in Tirol, Austria
- Center for Health Decision Science and Departments of Epidemiology and Health Policy and Management, Harvard T H Chan School of Public Health, Boston, MA, USA
- Institute for Technology Assessment and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Laura Koopman
- Department of Specialist Medical Care, National Health Care Institute, Diemen, Netherlands
| | - Jane Noyes
- School of Medical and Health Sciences, Bangor University, Wales, UK
| | - Jean-Eric Tarride
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
- Centre for Health Economics and Policy Analysis, McMaster University Faculty of Health Sciences, Hamilton, ON, Canada
- Programs for Assessment of Technologies in Health, St Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - Adrienne L Stevens
- Centre for Immunisation Programmes, Public Health Agency of Canada, ON, Canada
| | - Vivian Welch
- Bruyère Research Institute and, School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | | | - Brendalynn Ens
- Implementation Support and Knowledge Mobilisation, Canadian Agency for Drugs and Technologies in Health, Ottawa, ON, Canada
| | - Tahira Devji
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Feng Xie
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
- Centre for Health Economics and Policy Analysis, McMaster University Faculty of Health Sciences, Hamilton, ON, Canada
| | - Glen Hazlewood
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Lawrence Mbuagbaw
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
- Department of Anaesthesia, McMaster University, Hamilton, ON, Canada
- Department of Paediatrics, McMaster University, Hamilton, ON, Canada
- Biostatistics Unit, Father Sean O'Sullivan Research Centre, St Joseph's Healthcare, Hamilton, ON, Canada
- Centre for Development of Best Practices in Health, Yaoundé Central Hospital, Yaoundé, Cameroon
- Division of Epidemiology and Biostatistics, Department of Global Health, Stellenbosch University, Cape Town, South Africa
| | - Pablo Alonso-Coello
- Iberoamerican Cochrane Centre, Sant Antoni Maria Claret, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Institut de Recerca Sant Pau (IR SANT PAU), Sant Quintí, Barcelona, Spain
| | - Jan L Brozek
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
- Michael G DeGroote Cochrane Canada and McMaster GRADE Centres, McMaster University, Hamilton, ON, Canada
| | - Holger J Schünemann
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
- Clinical Epidemiology and Research Centre (CERC), Humanitas Universityand Humanitas Research Hospital, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele, Milan, Italy
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Mistry A, Leslie A, Ojha S, Sharkey D. Identifying neonatal transport research priorities: a modified Delphi consensus. Arch Dis Child Fetal Neonatal Ed 2024:fetalneonatal-2024-327213. [PMID: 38857987 DOI: 10.1136/archdischild-2024-327213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Accepted: 05/15/2024] [Indexed: 06/12/2024]
Abstract
OBJECTIVES With increasing advances in neonatal transport, a focused research strategy is required to increase the evidence base towards providing optimal care. We aimed to identify the most important neonatal transport research questions as prioritised by parents and healthcare professionals (HCPs). DESIGN Key stakeholders participated in a modified three-stage Delphi consensus process. Research questions were identified and submitted through two survey stages before the final priority setting workshop. PARTICIPANTS Parents of babies who received neonatal care, neonatal HCPs and stakeholders. OUTCOME Identify the top 10 research priorities for neonatal transport. RESULTS Overall, 269 survey responses from HCPs/stakeholders (n=161) and parents (n=108) were analysed from two survey rounds. Consensus was reached on 22 of 43 research priorities for the final priority setting workshop. The agreed top research priorities covered the domains of: (1) Pain assessment and management, (2) Long-term neurological outcomes, (3) Impact of transfer on birth-related brain injury, (4) Investigating risk of transport, (5) Safety restraints for infants, (6) Optimal temperature management, (7) Respiratory management and outcomes, (8) Benchmarking of important of transport measures, (9) Understanding transport environmental exposures, (10) Mental health and burden of transfer on families. CONCLUSION We have identified the top research questions for neonatal transport through an extensive process actively engaging parents, HCPs and key stakeholders. Targeted funding and research resources, directed towards addressing these prioritised research areas, will inform evidence-based practices and international frameworks specific to neonatal transport, helping minimise research waste and ultimately improve outcomes for these high-risk infants and their families.
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Affiliation(s)
- Aarti Mistry
- Centre for Perinatal Research (CePR), School of Medicine, University of Nottingham, Nottingham, UK
| | - Andrew Leslie
- Centre for Perinatal Research (CePR), School of Medicine, University of Nottingham, Nottingham, UK
- UK-Neonatal Transport Research Collaborative (UK-NTRC), UK-Neonatal Transport Group, Nottingham, UK
| | - Shalini Ojha
- Centre for Perinatal Research (CePR), School of Medicine, University of Nottingham, Nottingham, UK
| | - Don Sharkey
- Centre for Perinatal Research (CePR), School of Medicine, University of Nottingham, Nottingham, UK
- UK-Neonatal Transport Research Collaborative (UK-NTRC), UK-Neonatal Transport Group, Nottingham, UK
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Leston M, Ordóñez-Mena J, Joy M, de Lusignan S, Hobbs R, McInnes I, Lee L. Defining and Risk-Stratifying Immunosuppression (the DESTINIES Study): Protocol for an Electronic Delphi Study. JMIR Res Protoc 2024; 13:e56271. [PMID: 38842925 PMCID: PMC11190617 DOI: 10.2196/56271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 04/29/2024] [Accepted: 04/29/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND Globally, there are marked inconsistencies in how immunosuppression is characterized and subdivided into clinical risk groups. This is detrimental to the precision and comparability of disease surveillance efforts-which has negative implications for the care of those who are immunosuppressed and their health outcomes. This was particularly apparent during the COVID-19 pandemic; despite collective motivation to protect these patients, conflicting clinical definitions created international rifts in how those who were immunosuppressed were monitored and managed during this period. We propose that international clinical consensus be built around the conditions that lead to immunosuppression and their gradations of severity concerning COVID-19. Such information can then be formalized into a digital phenotype to enhance disease surveillance and provide much-needed intelligence on risk-prioritizing these patients. OBJECTIVE We aim to demonstrate how electronic Delphi objectives, methodology, and statistical approaches will help address this lack of consensus internationally and deliver a COVID-19 risk-stratified phenotype for "adult immunosuppression." METHODS Leveraging existing evidence for heterogeneous COVID-19 outcomes in adults who are immunosuppressed, this work will recruit over 50 world-leading clinical, research, or policy experts in the area of immunology or clinical risk prioritization. After 2 rounds of clinical consensus building and 1 round of concluding debate, these panelists will confirm the medical conditions that should be classed as immunosuppressed and their differential vulnerability to COVID-19. Consensus statements on the time and dose dependencies of these risks will also be presented. This work will be conducted iteratively, with opportunities for panelists to ask clarifying questions between rounds and provide ongoing feedback to improve questionnaire items. Statistical analysis will focus on levels of agreement between responses. RESULTS This protocol outlines a robust method for improving consensus on the definition and meaningful subdivision of adult immunosuppression concerning COVID-19. Panelist recruitment took place between April and May of 2024; the target set for over 50 panelists was achieved. The study launched at the end of May and data collection is projected to end in July 2024. CONCLUSIONS This protocol, if fully implemented, will deliver a universally acceptable, clinically relevant, and electronic health record-compatible phenotype for adult immunosuppression. As well as having immediate value for COVID-19 resource prioritization, this exercise and its output hold prospective value for clinical decision-making across all diseases that disproportionately affect those who are immunosuppressed. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/56271.
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Affiliation(s)
- Meredith Leston
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - José Ordóñez-Mena
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Mark Joy
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Simon de Lusignan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Richard Hobbs
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Iain McInnes
- Wolfson Medical School Building, University of Glasgow, Glasgow, United Kingdom
| | - Lennard Lee
- Department of Oncology, University of Oxford, Oxford, United Kingdom
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Liu C, Wong T, Leung D, Park HYL, Aung T, Aihara M, Makornwattana M, Fang SK, Park KH, Leung C. Clinical Staging of Prostaglandin-Associated Periorbitopathy Syndrome in Glaucoma: A Review from Asia. Semin Ophthalmol 2024:1-5. [PMID: 38842062 DOI: 10.1080/08820538.2024.2361001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 05/21/2024] [Indexed: 06/07/2024]
Abstract
PURPOSE Topical prostaglandin analogues are commonly used to treat patients with glaucoma, but may cause periocular and periorbital complications known as prostaglandin-associated periorbitopathy syndrome (PAPS). METHODS A literature review was conducted on PAPS. Given the lack of consensus on grading PAPS, glaucoma specialists from Asia convened to evaluate current PAPS grading systems and propose additional considerations in grading PAPS. RESULTS Existing grading systems are limited by the lack of specificity in defining grades and consideration for patients' subjective perception of symptoms. Patient-reported symptoms (e.g., via a self-assessment tool) and additional clinical assessments (e.g., exophthalmometry, lid laxity, differences between tonometry results, baseline measurements, and external ocular photographs) would be beneficial for grading PAPS systematically. CONCLUSIONS Effective management of PAPS could be facilitated by a common clinical grading system to consistently and accurately diagnose and characterise symptoms. Further research is required to validate specific recommendations and approaches to stage and monitor PAPS.
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Affiliation(s)
- Catherine Liu
- School of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan
- Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Tina Wong
- Singapore National Eye Centre, Singapore
- Duke-NUS Medical School, Singapore
| | - Dexter Leung
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong
| | | | - Tin Aung
- Singapore National Eye Centre, Singapore
- Duke-NUS Medical School, Singapore
| | - Makoto Aihara
- Department of Ophthalmology, University of Tokyo, Tokyo, Japan
| | | | | | - Ki Ho Park
- Seoul National University College of Medicine, Seoul, Korea
| | - Christopher Leung
- School of Clinical Medicine, Department of Ophthalmology, The University of Hong Kong, Hong Kong
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Taher R, Bhanushali P, Allan S, Alvarez-Jimenez M, Bolton H, Dennison L, Wallace BE, Hadjistavropoulos HD, Hall CL, Hardy A, Henry AL, Lane S, Maguire T, Moreton A, Moukhtarian TR, Vallejos EP, Shergill S, Stahl D, Thew GR, Timulak L, van den Berg D, Viganò N, Stock BW, Young KS, Yiend J. Bridging the gap from medical to psychological safety assessment: consensus study in a digital mental health context. BJPsych Open 2024; 10:e126. [PMID: 38828683 DOI: 10.1192/bjo.2024.713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/05/2024] Open
Abstract
BACKGROUND Digital Mental Health Interventions (DMHIs) that meet the definition of a medical device are regulated by the Medicines and Healthcare products Regulatory Agency (MHRA) in the UK. The MHRA uses procedures that were originally developed for pharmaceuticals to assess the safety of DMHIs. There is recognition that this may not be ideal, as is evident by an ongoing consultation for reform led by the MHRA and the National Institute for Health and Care Excellence. AIMS The aim of this study was to generate an experts' consensus on how the medical regulatory method used for assessing safety could best be adapted for DMHIs. METHOD An online Delphi study containing three rounds was conducted with an international panel of 20 experts with experience/knowledge in the field of UK digital mental health. RESULTS Sixty-four items were generated, of which 41 achieved consensus (64%). Consensus emerged around ten recommendations, falling into five main themes: Enhancing the quality of adverse events data in DMHIs; Re-defining serious adverse events for DMHIs; Reassessing short-term symptom deterioration in psychological interventions as a therapeutic risk; Maximising the benefit of the Yellow Card Scheme; and Developing a harmonised approach for assessing the safety of psychological interventions in general. CONCLUSION The implementation of the recommendations provided by this consensus could improve the assessment of safety of DMHIs, making them more effective in detecting and mitigating risk.
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Affiliation(s)
- Rayan Taher
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Palak Bhanushali
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Stephanie Allan
- Institute of Health and Wellbeing, University of Glasgow, UK
| | - Mario Alvarez-Jimenez
- Centre for Youth Mental Health, University of Melbourne, Australia
- Orygen, Parkville, Australia
| | | | | | | | | | - Charlotte L Hall
- NIHR MindTech-MedTech Co-operative, NIHR Nottingham Biomedical Research Centre, School of Medicine, Institute of Mental Health, University of Nottingham, UK
| | - Amy Hardy
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | | | - Sam Lane
- SilverCloud by Amwell, Boston, USA
| | - Tess Maguire
- School of Psychology, University of Southampton, UK
| | | | - Talar R Moukhtarian
- Mental Health and Wellbeing Unit, Warwick Medical School, University of Warwick, UK
| | - Elvira Perez Vallejos
- NIHR MindTech-MedTech Co-operative, NIHR Nottingham Biomedical Research Centre, School of Medicine, Institute of Mental Health, University of Nottingham, UK
| | - Sukhi Shergill
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
- Kent and Medway Medical School, Canterbury, UK
| | - Daniel Stahl
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Graham R Thew
- Department of Experimental Psychology, University of Oxford, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
| | | | - David van den Berg
- Department of Clinical Psychology, VU University and Amsterdam Public Health Research, Amsterdam, Netherlands
| | | | - Ben Wensley Stock
- University of Oxford Medical Sciences Division, University of Oxford, UK
| | - Katherine S Young
- SilverCloud by Amwell, Boston, USA
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Jenny Yiend
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
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Schönenberger N, Blanc AL, Hug BL, Haschke M, Goetschi AN, Wernli U, Meyer-Massetti C. Developing indicators for medication-related readmissions based on a Delphi consensus study. Res Social Adm Pharm 2024; 20:92-101. [PMID: 38433064 DOI: 10.1016/j.sapharm.2024.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 02/14/2024] [Accepted: 02/18/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND Medication-related readmissions challenge healthcare systems by burdening patients, increasing costs and straining resources. However, to date, there has been no consensus study on indicators for medication-related readmissions. OBJECTIVES This Delphi study aimed to develop a consensus-based set of indicators for detecting patients at risk of medication-related readmission. METHODS An expert panel of clinical pharmacists, physicians and nursing experts participated in a two-round Delphi study. In round 1, 31 indicators taken from the literature were rated for relevance on a scale from 1 to 9, with a median rating of 7 or higher suggesting relevance. The RAND/UCLA method was used to determine consensus. In round 2, indicators lacking consensus were re-rated together with a series of new indicators generated by the experts. Additional details were sought for some indicators. The main outcomes were the relevance of, consensus on, and completeness of the proposed indicators for identifying risks of 30-day medication-related readmission. RESULTS Thirty-eight experts participated in round 1. Consensus was found for all the indicators, with 25 included and 6 excluded. Thirty-four experts participated in round 2. Consensus was found for all 5 newly suggested indicators, and 4 were included. The expert panel prioritized the following indicators: (1) insufficient communication between different healthcare providers, (2) polypharmacy (≥7 medications), (3) low rates of medication adherence (twice-weekly mistakes or missing administration), (4) complex medication regimens (≥3 doses, ≥2 dosage forms and ≥2 administration routes per day), and (5) multimorbidity (≥3 chronic conditions). The final set comprised 29 indicators. CONCLUSIONS The indicator set developed for flagging potential medication-related readmissions could guide priorities for clinical pharmacy services at hospital discharge, improving patient outcomes and resource use. A validation study of these indicators is planned.
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Affiliation(s)
- Nicole Schönenberger
- Clinical Pharmacology and Toxicology, Department of General Internal Medicine, Inselspital, Bern University Hospital, 3010, Bern, Switzerland; Graduate School for Health Sciences, University of Bern, 3012, Bern, Switzerland.
| | - Anne-Laure Blanc
- Pharmacy of the Eastern Vaud Hospitals, 1847, Rennaz, Switzerland; Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, 1205, Geneva, Switzerland
| | - Balthasar L Hug
- Department of Internal Medicine, Lucerne Cantonal Hospital, 6000, Lucerne, Switzerland; University of Lucerne, Faculty of Health Sciences and Medicine, 6005, Lucerne, Switzerland
| | - Manuel Haschke
- Clinical Pharmacology and Toxicology, Department of General Internal Medicine, Inselspital, Bern University Hospital, 3010, Bern, Switzerland
| | - Aljoscha N Goetschi
- Clinical Pharmacology and Toxicology, Department of General Internal Medicine, Inselspital, Bern University Hospital, 3010, Bern, Switzerland; Graduate School for Health Sciences, University of Bern, 3012, Bern, Switzerland
| | - Ursina Wernli
- Clinical Pharmacology and Toxicology, Department of General Internal Medicine, Inselspital, Bern University Hospital, 3010, Bern, Switzerland; Graduate School for Health Sciences, University of Bern, 3012, Bern, Switzerland
| | - Carla Meyer-Massetti
- Clinical Pharmacology and Toxicology, Department of General Internal Medicine, Inselspital, Bern University Hospital, 3010, Bern, Switzerland; Institute of Primary Healthcare (BIHAM), University of Bern, 3012, Bern, Switzerland
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Greenfield K, Schoth DE, Hain R, Bailey S, Mott C, Rajapakse D, Harrop E, Renton K, Anderson AK, Carter B, Johnson M, Liossi C. A rapid systematic review of breakthrough pain definitions and descriptions. Br J Pain 2024; 18:215-226. [PMID: 38751563 PMCID: PMC11092936 DOI: 10.1177/20494637231208093] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2024] Open
Abstract
Background Breakthrough pain is common in life-limiting conditions and at end-of-life. Despite over 30 years of study, there is little consensus regarding the definition and characteristics of breakthrough pain. Objective This study aims to update and expand a 2010 systematic review by Haugen and colleagues to identify (1) all definitions of breakthrough pain and (2) all descriptions and classifications of breakthrough pain reported by patients, caregivers, clinicians, and experts. Design This rapid systematic review followed the Cochrane Rapid Review Methods Group guidelines. A protocol is published on PROSPERO (CRD42019155583). Data sources CINAHL, MEDLINE, PsycINFO, and the Web of Science were searched for breakthrough pain terms from the inception dates of each database to 26th August 2022. Results We identified 65 studies that included data on breakthrough pain definitions, descriptions, or classifications from patients (n = 30), clinicians (n = 6), and experts (n = 29), but none with data from caregivers. Most experts proposed that breakthrough pain was a sudden, severe, brief pain occurring in patients with adequately controlled mild-moderate background pain. However, definitions varied and there was no consensus. Pain characteristics were broadly similar across studies though temporal factors varied widely. Experts classified breakthrough pain into nociceptive, neuropathic, visceral, somatic, or mixed types. Patients with breakthrough pain commonly experienced depression, anxiety, and interference with daily life. Conclusions Despite ongoing efforts, there is still no consensus on the definition of breakthrough pain. A compromise is needed on breakthrough pain nomenclature to collect reliable incidence and prevalence data and to inform further refinement of the construct.
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Affiliation(s)
| | - Daniel E Schoth
- School of Psychology, University of Southampton, Highfield, UK
| | - Richard Hain
- Paediatric Palliative Medicine, Noah’s Ark Children’s Hospital for Wales, Cardiff, UK
| | - Simon Bailey
- Sir James Spence Institute,Royal Victoria Infirmary, Newcastle upon Tyne,UK
| | - Christine Mott
- Acorns Children’s Hospice, Birmingham,UK
- Birmingham Children’s Hospital, Birmingham,UK
| | - Dilini Rajapakse
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Emily Harrop
- Helen & Douglas House Hospices, Oxford, UK
- Oxford University Hospitals NHS Trust,John Radcliffe Hospital, Oxford, UK
| | - Kate Renton
- University Hospital Southampton NHS Trust, Southampton General Hospital, Southampton, UK
- Naomi House & Jacksplace, Winchester, UK
| | | | - Bernie Carter
- Faculty of Health, Social Care and Medicine,Edge Hill University, Ormskirk, UK
| | | | - Christina Liossi
- School of Psychology, University of Southampton, Highfield, UK
- Psychological Services Department, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
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Rashid R, Sohrabi C, Kerwan A, Franchi T, Mathew G, Nicola M, Agha RA. The STROCSS 2024 guideline: strengthening the reporting of cohort, cross-sectional, and case-control studies in surgery. Int J Surg 2024; 110:3151-3165. [PMID: 38445501 PMCID: PMC11175759 DOI: 10.1097/js9.0000000000001268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 02/21/2024] [Indexed: 03/07/2024]
Abstract
INTRODUCTION First released in 2017, the STROCSS guidelines have become integral for promoting high-quality reporting of observational research in surgery. However, regular updates are essential to ensure they remain relevant and of value to surgeons. Building on the 2021 updates, the authors have developed the STROCSS 2024 guidelines. This timely revision aims to address residual reporting gaps, assimilate recent advances, and further strengthen observational study quality across all surgical disciplines. METHODS A core steering committee compiled proposed changes to update the STROCSS 2021 guidelines based on identified gaps in prior iterations. An expert panel of surgical research leaders then evaluated the proposed changes for inclusion. A Delphi consensus exercise was used. Proposals that scored between 7-9 on a nine-point Likert agreement scale, by ≥70% of Delphi participants, were integrated into the STROCSS 2024 checklist. RESULTS In total, 46 of 56 invited participants (82%) completed the Delphi survey and hence participated in the development of STROCSS 2024. All suggested amendments met the criteria for inclusion, indicating a high level of agreement among the Delphi group. All proposed items were therefore integrated into the final revised checklist. CONCLUSION The authors present the updated STROCSS 2024 guidelines, which have been developed through expert consensus to further enhance the transparency and reporting quality of observational research in surgery.
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Affiliation(s)
| | | | | | - Thomas Franchi
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | | | - Maria Nicola
- Imperial College Healthcare NHS Trust, London, UK
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Gurland BH, Olson CH, McCarthy MS, Bordeianou LG. Core Descriptor Sets for Rectal Prolapse Outcomes Research Using a Modified Delphi Consensus. Dis Colon Rectum 2024; 67:841-849. [PMID: 38231033 DOI: 10.1097/dcr.0000000000003187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
BACKGROUND There is wide variation in prolapse care. OBJECTIVE To determine core descriptor sets for rectal prolapse to enhance outcomes research. DESIGN Descriptors for patients undergoing rectal prolapse surgery were generated through a systematic review and expert opinion. Stakeholders were recruited internationally via listserv and social media. Experts were encouraged to consider the minimum descriptors that could be considered during clinical care, and descriptors were grouped into core descriptor sets. Consensus was defined as greater than 70% agreement. SETTING A 3-round Delphi process using a 9-point Likert scale based on expert results was distributed via survey. The final interactive meeting used a polling platform. PARTICIPANTS The Pelvic Floor Disorders Consortium interdisciplinary group convened to advance the clinical care of pelvic floor disorders. MAIN OUTCOME MEASURES To achieve expert consensus for core descriptor sets for rectal prolapse using a modified Delphi method. RESULTS A total of 206 providers participated, with survey response rates of 82% and 88%, respectively. Responders were from North America (56%), Europe (29%), and Latin America, Asia, Australia, New Zealand, and Africa (15%). Ninety-one percent of participants identified as colorectal surgeons and 80% reported >5 years of experience (35% reported >15 years). Fifty-seven attendees participated in the final meeting and voted on core descriptor sets. Ninety-three percent of participants agreed that descriptors such as age, BMI, frailty, nutrition, and the American Society of Anesthesiology score correlated to physiologic status. One hundred percent of participants agreed to include baseline bowel function. One hundred percent of participants reported willingness to complete a synoptic operative report. Follow-up intervals 1, 3, and 5 years after surgery (76%) with a collection of recurrence and functional outcomes at those time periods reached an agreement. LIMITATIONS Individual bias, self-identification of experts, and paucity of knowledge related to rectal prolapse. CONCLUSIONS This represents the first steps toward international consensus to unify language and data collection processes for rectal prolapse. See Video Abstract . CONJUNTOS DE DESCRIPTORES BSICOS PARA LA INVESTIGACIN DE RESULTADOS DE PROLAPSO RECTAL MEDIANTE UN CONSENSO DELPHI MODIFICADO ANTECEDENTES:Existe una amplia variación en la atención del prolapso.OBJETIVO:Determinar conjuntos de descriptores básicos para el prolapso rectal para mejorar los resultados de la investigación.DISEÑO:Los descriptores para pacientes sometidos a cirugía de prolapso rectal se generaron a través de una revisión sistemática y la opinión de expertos. Las partes interesadas fueron reclutadas internacionalmente a través de listas de servicio y redes sociales. Se animó a los expertos a considerar los descriptores mínimos que podrían considerarse durante la atención clínica, y los descriptores se agruparon en conjuntos de descriptores básicos. El consenso se definió como > 70% de acuerdo.AJUSTE:Se distribuyó mediante encuesta un proceso Delphi de tres rondas que utiliza una escala Likert de 9 puntos basada en resultados de expertos. La reunión interactiva final utilizó una plataforma de votación.PARTICIPANTES:El grupo interdisciplinario del Consorcio de Trastornos del Suelo Pélvico se reunió para avanzar en la atención clínica de los trastornos del suelo pélvico.MEDIDAS PRINCIPALES DE RESULTADOS:Lograr el consenso de expertos para los conjuntos de descriptores básicos para el prolapso rectal utilizando un método Delphi modificado.RESULTADOS:Participaron 206 proveedores con tasas de respuesta a la encuesta del 82% y 88% respectivamente. Los encuestados procedían de América del Norte (56%), Europa (29%) y América Latina, Asia, Australia, Nueva Zelanda y África (15%). El noventa y uno por ciento se identificó como cirujanos colorrectales y el 80% reportó más de 5 años de experiencia (35% > 15 años). Cincuenta y siete asistentes participaron en la reunión final y votaron sobre conjuntos de descriptores básicos. El noventa y tres por ciento estuvo de acuerdo en que descriptores como edad, índice de masa corporal, fragilidad, nutrición y puntuación de la Sociedad Estadounidense de Anestesiología se correlacionaban con el estado fisiológico. El cien por ciento estuvo de acuerdo en incluir la función intestinal inicial. El 100% refirió disposición para realizar un informe operativo sinóptico. Los intervalos de seguimiento 1,3,5 años después de la cirugía (76%) con un conjunto de recurrencias y los resultados funcionales en esos períodos de tiempo coincidieron.LIMITACIONES:Sesgo individual, autoidentificación de los expertos y escasez de conocimientos relacionados con el prolapso rectal.CONCLUSIONES:Esto representa los primeros pasos hacia un consenso internacional para unificar el lenguaje y los procesos de recolección de datos para el prolapso rectal. (Traducción-Yesenia Rojas-Khalil ).
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Dice JL, Brismée JM, Froment FP, Henricksen J, Sherwin R, Pool J, Milne N, Clewley D, Basson A, Olson KA, Gross AR. Spinal manipulation and mobilisation among infants, children, and adolescents: an international Delphi survey of expert physiotherapists. J Man Manip Ther 2024; 32:284-294. [PMID: 38484120 PMCID: PMC11216234 DOI: 10.1080/10669817.2024.2327782] [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: 11/15/2023] [Accepted: 03/04/2024] [Indexed: 06/29/2024] Open
Abstract
OBJECTIVE The aim of this study was to establish international consensus regarding the use of spinal manipulation and mobilisation among infants, children, and adolescents among expert international physiotherapists. METHODS Twenty-six international expert physiotherapists in manual therapy and paediatrics voluntarily participated in a 3-Round Delphi survey to reach a consensus via direct electronic mail solicitation using Qualtrics®. Consensus was defined a-priori as ≥75% agreement on all items with the same ranking of agreement or disagreement. Round 1 identified impairments and conditions where spinal mobilisation and manipulation might be utilised. In Rounds 2 and 3, panelists agreed or disagreed using a 4-point Likert scale. RESULTS Eleven physiotherapists from seven countries representing five continents completed all three Delphi rounds. Consensus regarding spinal mobilisation or manipulation included:Manipulation is not recommended: (1) for infants across all conditions, impairments, and spinal levels; and (2) for children and adolescents across most conditions and spinal levels.Manipulation may be recommended for adolescents to treat spinal region-specific joint hypomobility (thoracic, lumbar), and pain (thoracic).Mobilisation may be recommended for children and adolescents with hypomobility, joint pain, muscle/myofascial pain, or stiffness at all spinal levels. CONCLUSION Consensus revealed spinal manipulation should not be performed on infants regardless of condition, impairment, or spinal level. Additionally, the panel agreed that manipulation may be recommended only for adolescents to treat joint pain and joint hypomobility (limited to thoracic and/or lumbar levels). Spinal mobilisation may be recommended for joint hypomobility, joint pain, muscle/myofascial pain, and muscle/myofascial stiffness at all spinal levels among children and adolescents.
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Affiliation(s)
- Jenifer L. Dice
- Center for Rehabilitation Research, School of Health Professions, Texas Tech University Health Sciences Center, Lubbock, TX, USA
- School of Physical Therapy, Texas Woman’s University, Houston, TX, USA
| | - Jean-Michel Brismée
- Center for Rehabilitation Research, School of Health Professions, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Frédéric P. Froment
- Center for Rehabilitation Research, School of Health Professions, Texas Tech University Health Sciences Center, Lubbock, TX, USA
- President, International Academy of Musculoskeletal Physiotherapy, Paris, France
| | - Janis Henricksen
- School of Physical Therapy, University of St. Augustine, Dallas, TX, USA
| | - Rebecca Sherwin
- Physical Therapy Department, NELA Rehabilitation, West Monroe, Louisiana, USA
- Doctor of Physical Therapy Program, Hauser School of Physical Therapy, University of the Cumberlands, Williamsburg, KY, USA
| | - Jan Pool
- Institute of Movement Studies, University of Applied Sciences, Utrecht, The Netherlands
| | - Nikki Milne
- THINK Paediatrics Research Group, Faculty of Health Sciences and Medicine, Bond University, Robina, Queensland, Australia
| | - Derek Clewley
- Doctor of Physical Therapy Division, Duke University, Durham, NC, USA
| | - Annalie Basson
- Faculty of Health Sciences, Physiotherapy Department, University of the Witwatersrand, Johannesburg, South Africa
| | - Kenneth A. Olson
- Private Practitioner, Northern Rehab Physical Therapy Specialists, DeKalb, IL, USA
| | - Anita R. Gross
- Rehabilitation Sciences, McMaster University, Hamilton, Canada
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Dahir KM, Rush ET, Diaz-Mendoza S, Kishnani PS. A Delphi panel to build consensus on assessing disease severity and disease progression in adult patients with hypophosphatasia in the United States. J Endocrinol Invest 2024; 47:1487-1497. [PMID: 38236379 PMCID: PMC11142979 DOI: 10.1007/s40618-023-02256-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 11/21/2023] [Indexed: 01/19/2024]
Abstract
BACKGROUND Hypophosphatasia (HPP) is an inborn error of metabolism with a variable presentation. We conducted a modified Delphi panel to obtain expert consensus on knowledge gaps regarding disease severity and progression in adult patients with HPP. METHODS Healthcare professionals (HCPs) with experience managing adult patients with HPP were recruited to participate in a 3-round Delphi panel (round 1: paper survey and 1:1 interview; rounds 2-3: email survey). Panelists rated the extent of their agreement with statements about disease severity and progression in adult patients with HPP. Consensus was defined as ≥ 80% agreement. RESULTS Ten HCPs completed round 1; nine completed rounds 2 and 3. Consensus was reached on 46/120 statements derived from steering committee input. Disease severity markers in adult patients with HPP can be bone-related (recurrent/poorly healing fractures, pseudo-fractures, metatarsal fractures, osteomalacia) or involve dentition or physiologic/functional manifestations (use of mobility devices/home modifications, abnormal gait, pain). Disease progression markers can include recurrent/poorly healing low-trauma fractures, development of ectopic calcifications, and/or impairment of functional activity. Panelists supported the development of a tool to help assess disease severity in the clinic and track changes in severity over time. Panelists also highlighted the role of a multidisciplinary team, centers with expertise, and the need to refer patients when disease severity is not clear. CONCLUSIONS These statements regarding disease severity, progression, and assessment methods address some knowledge gaps in adult patients with HPP and may be helpful for treating HCPs, although the small sample size affects the ability to generalize the healthcare provider experience.
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Affiliation(s)
- K M Dahir
- Division of Endocrinology and Metabolism, Vanderbilt University Medical Center, 1215 21st Ave S Suite 8210, Nashville, TN, 37232, USA.
| | - E T Rush
- Division of Clinical Genetics, Children's Mercy Kansas City, 2401 Gillham Rd, Kansas City, MO, 64108, USA.
- Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA.
- Department of Internal Medicine, University of Kansas School of Medicine, Kansas City, KS, USA.
| | | | - P S Kishnani
- Division of Medical Genetics, Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA
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Perowne R, Rowe S, Gutman LM. Understanding and Defining Young People's Involvement and Under-Representation in Mental Health Research: A Delphi Study. Health Expect 2024; 27:e14102. [PMID: 38872473 PMCID: PMC11176595 DOI: 10.1111/hex.14102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 05/22/2024] [Accepted: 05/23/2024] [Indexed: 06/15/2024] Open
Abstract
INTRODUCTION The mental health of young people (aged 16-25 years) is a growing public health concern in the United Kingdom due to the increasing numbers of young people experiencing mental health difficulties, with many not in contact with mental health services. To design services that meet the needs of all young people, a diversity of young people must be involved in mental health research, beyond being participants. This Delphi study aimed to identify different types of 'involvement' and to define and describe 'under-representation' in young people's involvement in mental health research. METHODS Twenty-seven experts in young people's mental health research completed a series of online questionnaires. The experts were academic researchers, patient and public involvement (PPI) professionals and young 'experts by experience'. Round 1 generated panellists' views on 'involvement' and 'under-representation'. Round 2 summarised panellists' responses from Round 1 and sought consensus (minimum 70% agreement) in nine question areas. Round 3 validated the findings of the previous rounds. RESULTS Consensus was achieved in eight out of nine areas, resulting in a matrix (with definitions) of the different types of young people's involvement in mental health research, from being advisors to involvement ambassadors. The findings generated an agreed-upon definition of under-representation, an identification of when in the research process there is under-representation and the characteristics of the young people who are under-represented. Experts further agreed on demographic data that should be collected to improve reporting on involvement. CONCLUSIONS This study adds to our understanding of involvement and under-representation in the context of young people's mental health research through expert consensus. It provides a practical resource for researchers considering involving young people in the research process and suggests the data that should be collected to improve reporting on the diversity of the young people involved. PATIENT AND PUBLIC CONTRIBUTION A research oversight group of five young people advised on this study. They contributed throughout the project-from endorsing the research question to commenting on the findings and dissemination. Two of the group reviewed all participant materials and piloted the initial questionnaire.
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Affiliation(s)
- Rachel Perowne
- UCL Centre for Behaviour Change, Division of Psychology and Language Sciences, University College London, London, UK
| | - Sarah Rowe
- Division of Psychiatry, University College London, London, UK
| | - Leslie Morrison Gutman
- UCL Centre for Behaviour Change, Division of Psychology and Language Sciences, University College London, London, UK
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Brady K, Cleary R, O'Gorman E, McDonough S, Kerr C, Kiernan D, McConkey E, Ryan J, Malone A. Identifying the top 10 priorities of adolescents with a physical disability regarding participation in physical activity: A Delphi study. Dev Med Child Neurol 2024. [PMID: 38815177 DOI: 10.1111/dmcn.15986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 05/03/2024] [Accepted: 05/10/2024] [Indexed: 06/01/2024]
Abstract
AIM To establish consensus among adolescents with a physical disability regarding their priorities for enhancing participation in physical activity and help inform the design of future interventions for participation in physical activity. METHOD We conducted a national multi-round Delphi study involving adolescents with a physical disability aged 13 to 17 years. Round 1 of the initial survey consisted of open-ended questions. Free-text responses were then analysed thematically, creating items categorized according to the family of participation-related constructs (fPRC). In round 2, participants rated the perceived importance of these items using a 5-point Likert scale. The top 10 priorities were constructed from the highest-ranked items. RESULTS One hundred and sixteen participants (mean age = 14 years 7 months, range = 13-17 years; 66 males; 58 with cerebral palsy; 43 wheelchair users) completed round 1; 108 items were included in round 2. Fifty-eight items were rated as either 'important' or 'really important' by 70% of participants. The top 10 priorities were rated as important or really important by 82% to 94% of participants with a mean Likert score of 4.40 (range = 4.25-4.63). Seven of the top 10 priorities were related to the environmental context of the fPRC. The other three were related to involvement and the related concept of preference. INTERPRETATION The priorities identified will help inform future physical activity interventions for adolescents with a physical disability.
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Affiliation(s)
- Karen Brady
- Central Remedial Clinic, Dublin, Ireland
- CP-Life Research Centre, School of Physiotherapy, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
| | - Ronan Cleary
- School of Physiotherapy, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
| | | | - Suzanne McDonough
- School of Physiotherapy, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
| | - Claire Kerr
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | | | | | - Jennifer Ryan
- CP-Life Research Centre, School of Physiotherapy, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
| | - Ailish Malone
- CP-Life Research Centre, School of Physiotherapy, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
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Haladay D, Morris Z, Tilson J, Fitzgerald C, Applebaum D, Flom-Meland C, DeWaay D, Manal TJ, Gravano T, Anderson S, Miro R, Russ D, Klein A. Development of a Novel Evidence-Based Practice-Specific Competency for Doctor of Physical Therapy Students in Clinical Education: A Modified Delphi Approach. JOURNAL, PHYSICAL THERAPY EDUCATION 2024:00001416-990000000-00112. [PMID: 38814571 DOI: 10.1097/jte.0000000000000350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 03/04/2024] [Indexed: 05/31/2024]
Abstract
INTRODUCTION Evidence-based practice (EBP) results in high-quality care and decreases unwarranted variation in practice. REVIEW OF THE LITERATURE Few performance criteria related to EBP are included in physical therapy clinical education (CE) performance measures, despite EBP requirements in Doctor of Physical Therapy education. The purpose of this study was to develop EBP-specific competencies that may be used for Doctor of Physical Therapy students for use throughout CE. SUBJECTS Thirteen subject matter experts (SME) participated in this study. METHODS Subject matter experts were asked to rank each core EBP competency, from a previously described framework, using a 3-point Likert scale, which included "Not Essential," "Essential," and "Not Sure." A consensus of 70% or greater for the "Essential" rating advanced the competency to the final Delphi round, whereas a consensus of 70% or greater for the "Not Essential" rating was required for competency elimination. Subject matter experts voted to either "Accept" or "Modify" the competencies that had reached the inclusion consensus threshold. All competencies that reached consensus for inclusion after all 3 rounds were included in the final EBP Domain of Competence. RESULTS Consensus was achieved in round one for 38% (n = 26) of items. In round 2, a consensus was achieved for 20% (n = 8) of items. Of the items remaining after rounds 1 and 2, 6 overarching competencies were identified, and all remaining items served as descriptions and specifications in the final EBP Domain of Competence. DISCUSSION AND CONCLUSIONS The 6 competencies developed from this study constitute the EBP Domain of Competence and may be used throughout CE to assess students' EBP competency in clinical practice.
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Affiliation(s)
- Douglas Haladay
- Douglas Haladay is an emeritus board-certified specialist in Orthopaedic Physical Therapy and professor and director for the School of Physical Therapy & Rehabilitation Sciences within the Morsani College of Medicine at the University of South Florida, 12901 North Bruce B. Downs Blvd., MDC 077, Tampa, FL 33612-4766 . Please address all correspondence to Douglas Haladay
- Zoe Morris is a research coordinator for the School of Physical Therapy & Rehabilitation Sciences at the University of South Florida
- Julie Tilson is a board-certified specialist in Neurologic Physical Therapy and DPT Program director and professor of Clinical Physical Therapy at the University of Southern California
- Caitlin Fitzgerald is the associate director of clinical education and assistant professor in the Department of Physical Therapy in the School of Health and Rehabilitation Sciences at MGH Institute of Health Professions
- Donna Applebaum is assistant professor and the director of clinical education at the Department of Physical Therapy in the School of Health and Rehabilitation Sciences at MGH Institute of Health Professions
- Cindy Flom-Meland is a board-certified specialist in Neurologic Physical Therapy and professor and chair for the Department of Physical Therapy at the University of North Dakota
- Deborah DeWaay is a board-certified in Internal Medicine and serves as the associate dean and professor for Undergraduate Medical Education at the University of South Florida
- Tara Jo Manal is the senior vice president of scientific affairs with the American Physical Therapy Association
- Tamara Gravano is a board-certified specialist in Geriatric Physical Therapy and an associate professor and assistant director for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- Stephanie Anderson is a board-certified in Orthopaedic Physical Therapy and assistance clinical professor at Graceland University
- Rebecca Miro is a research administrator for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- David Russ is an associate professor and assistant director of research for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- Aimee Klein is a board-certified specialist in Orthopaedic Physical Therapy and professor and assistant school director for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
| | - Zoe Morris
- Douglas Haladay is an emeritus board-certified specialist in Orthopaedic Physical Therapy and professor and director for the School of Physical Therapy & Rehabilitation Sciences within the Morsani College of Medicine at the University of South Florida, 12901 North Bruce B. Downs Blvd., MDC 077, Tampa, FL 33612-4766 . Please address all correspondence to Douglas Haladay
- Zoe Morris is a research coordinator for the School of Physical Therapy & Rehabilitation Sciences at the University of South Florida
- Julie Tilson is a board-certified specialist in Neurologic Physical Therapy and DPT Program director and professor of Clinical Physical Therapy at the University of Southern California
- Caitlin Fitzgerald is the associate director of clinical education and assistant professor in the Department of Physical Therapy in the School of Health and Rehabilitation Sciences at MGH Institute of Health Professions
- Donna Applebaum is assistant professor and the director of clinical education at the Department of Physical Therapy in the School of Health and Rehabilitation Sciences at MGH Institute of Health Professions
- Cindy Flom-Meland is a board-certified specialist in Neurologic Physical Therapy and professor and chair for the Department of Physical Therapy at the University of North Dakota
- Deborah DeWaay is a board-certified in Internal Medicine and serves as the associate dean and professor for Undergraduate Medical Education at the University of South Florida
- Tara Jo Manal is the senior vice president of scientific affairs with the American Physical Therapy Association
- Tamara Gravano is a board-certified specialist in Geriatric Physical Therapy and an associate professor and assistant director for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- Stephanie Anderson is a board-certified in Orthopaedic Physical Therapy and assistance clinical professor at Graceland University
- Rebecca Miro is a research administrator for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- David Russ is an associate professor and assistant director of research for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- Aimee Klein is a board-certified specialist in Orthopaedic Physical Therapy and professor and assistant school director for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
| | - Julie Tilson
- Douglas Haladay is an emeritus board-certified specialist in Orthopaedic Physical Therapy and professor and director for the School of Physical Therapy & Rehabilitation Sciences within the Morsani College of Medicine at the University of South Florida, 12901 North Bruce B. Downs Blvd., MDC 077, Tampa, FL 33612-4766 . Please address all correspondence to Douglas Haladay
- Zoe Morris is a research coordinator for the School of Physical Therapy & Rehabilitation Sciences at the University of South Florida
- Julie Tilson is a board-certified specialist in Neurologic Physical Therapy and DPT Program director and professor of Clinical Physical Therapy at the University of Southern California
- Caitlin Fitzgerald is the associate director of clinical education and assistant professor in the Department of Physical Therapy in the School of Health and Rehabilitation Sciences at MGH Institute of Health Professions
- Donna Applebaum is assistant professor and the director of clinical education at the Department of Physical Therapy in the School of Health and Rehabilitation Sciences at MGH Institute of Health Professions
- Cindy Flom-Meland is a board-certified specialist in Neurologic Physical Therapy and professor and chair for the Department of Physical Therapy at the University of North Dakota
- Deborah DeWaay is a board-certified in Internal Medicine and serves as the associate dean and professor for Undergraduate Medical Education at the University of South Florida
- Tara Jo Manal is the senior vice president of scientific affairs with the American Physical Therapy Association
- Tamara Gravano is a board-certified specialist in Geriatric Physical Therapy and an associate professor and assistant director for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- Stephanie Anderson is a board-certified in Orthopaedic Physical Therapy and assistance clinical professor at Graceland University
- Rebecca Miro is a research administrator for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- David Russ is an associate professor and assistant director of research for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- Aimee Klein is a board-certified specialist in Orthopaedic Physical Therapy and professor and assistant school director for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
| | - Caitlin Fitzgerald
- Douglas Haladay is an emeritus board-certified specialist in Orthopaedic Physical Therapy and professor and director for the School of Physical Therapy & Rehabilitation Sciences within the Morsani College of Medicine at the University of South Florida, 12901 North Bruce B. Downs Blvd., MDC 077, Tampa, FL 33612-4766 . Please address all correspondence to Douglas Haladay
- Zoe Morris is a research coordinator for the School of Physical Therapy & Rehabilitation Sciences at the University of South Florida
- Julie Tilson is a board-certified specialist in Neurologic Physical Therapy and DPT Program director and professor of Clinical Physical Therapy at the University of Southern California
- Caitlin Fitzgerald is the associate director of clinical education and assistant professor in the Department of Physical Therapy in the School of Health and Rehabilitation Sciences at MGH Institute of Health Professions
- Donna Applebaum is assistant professor and the director of clinical education at the Department of Physical Therapy in the School of Health and Rehabilitation Sciences at MGH Institute of Health Professions
- Cindy Flom-Meland is a board-certified specialist in Neurologic Physical Therapy and professor and chair for the Department of Physical Therapy at the University of North Dakota
- Deborah DeWaay is a board-certified in Internal Medicine and serves as the associate dean and professor for Undergraduate Medical Education at the University of South Florida
- Tara Jo Manal is the senior vice president of scientific affairs with the American Physical Therapy Association
- Tamara Gravano is a board-certified specialist in Geriatric Physical Therapy and an associate professor and assistant director for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- Stephanie Anderson is a board-certified in Orthopaedic Physical Therapy and assistance clinical professor at Graceland University
- Rebecca Miro is a research administrator for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- David Russ is an associate professor and assistant director of research for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- Aimee Klein is a board-certified specialist in Orthopaedic Physical Therapy and professor and assistant school director for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
| | - Donna Applebaum
- Douglas Haladay is an emeritus board-certified specialist in Orthopaedic Physical Therapy and professor and director for the School of Physical Therapy & Rehabilitation Sciences within the Morsani College of Medicine at the University of South Florida, 12901 North Bruce B. Downs Blvd., MDC 077, Tampa, FL 33612-4766 . Please address all correspondence to Douglas Haladay
- Zoe Morris is a research coordinator for the School of Physical Therapy & Rehabilitation Sciences at the University of South Florida
- Julie Tilson is a board-certified specialist in Neurologic Physical Therapy and DPT Program director and professor of Clinical Physical Therapy at the University of Southern California
- Caitlin Fitzgerald is the associate director of clinical education and assistant professor in the Department of Physical Therapy in the School of Health and Rehabilitation Sciences at MGH Institute of Health Professions
- Donna Applebaum is assistant professor and the director of clinical education at the Department of Physical Therapy in the School of Health and Rehabilitation Sciences at MGH Institute of Health Professions
- Cindy Flom-Meland is a board-certified specialist in Neurologic Physical Therapy and professor and chair for the Department of Physical Therapy at the University of North Dakota
- Deborah DeWaay is a board-certified in Internal Medicine and serves as the associate dean and professor for Undergraduate Medical Education at the University of South Florida
- Tara Jo Manal is the senior vice president of scientific affairs with the American Physical Therapy Association
- Tamara Gravano is a board-certified specialist in Geriatric Physical Therapy and an associate professor and assistant director for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- Stephanie Anderson is a board-certified in Orthopaedic Physical Therapy and assistance clinical professor at Graceland University
- Rebecca Miro is a research administrator for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- David Russ is an associate professor and assistant director of research for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- Aimee Klein is a board-certified specialist in Orthopaedic Physical Therapy and professor and assistant school director for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
| | - Cindy Flom-Meland
- Douglas Haladay is an emeritus board-certified specialist in Orthopaedic Physical Therapy and professor and director for the School of Physical Therapy & Rehabilitation Sciences within the Morsani College of Medicine at the University of South Florida, 12901 North Bruce B. Downs Blvd., MDC 077, Tampa, FL 33612-4766 . Please address all correspondence to Douglas Haladay
- Zoe Morris is a research coordinator for the School of Physical Therapy & Rehabilitation Sciences at the University of South Florida
- Julie Tilson is a board-certified specialist in Neurologic Physical Therapy and DPT Program director and professor of Clinical Physical Therapy at the University of Southern California
- Caitlin Fitzgerald is the associate director of clinical education and assistant professor in the Department of Physical Therapy in the School of Health and Rehabilitation Sciences at MGH Institute of Health Professions
- Donna Applebaum is assistant professor and the director of clinical education at the Department of Physical Therapy in the School of Health and Rehabilitation Sciences at MGH Institute of Health Professions
- Cindy Flom-Meland is a board-certified specialist in Neurologic Physical Therapy and professor and chair for the Department of Physical Therapy at the University of North Dakota
- Deborah DeWaay is a board-certified in Internal Medicine and serves as the associate dean and professor for Undergraduate Medical Education at the University of South Florida
- Tara Jo Manal is the senior vice president of scientific affairs with the American Physical Therapy Association
- Tamara Gravano is a board-certified specialist in Geriatric Physical Therapy and an associate professor and assistant director for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- Stephanie Anderson is a board-certified in Orthopaedic Physical Therapy and assistance clinical professor at Graceland University
- Rebecca Miro is a research administrator for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- David Russ is an associate professor and assistant director of research for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- Aimee Klein is a board-certified specialist in Orthopaedic Physical Therapy and professor and assistant school director for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
| | - Deborah DeWaay
- Douglas Haladay is an emeritus board-certified specialist in Orthopaedic Physical Therapy and professor and director for the School of Physical Therapy & Rehabilitation Sciences within the Morsani College of Medicine at the University of South Florida, 12901 North Bruce B. Downs Blvd., MDC 077, Tampa, FL 33612-4766 . Please address all correspondence to Douglas Haladay
- Zoe Morris is a research coordinator for the School of Physical Therapy & Rehabilitation Sciences at the University of South Florida
- Julie Tilson is a board-certified specialist in Neurologic Physical Therapy and DPT Program director and professor of Clinical Physical Therapy at the University of Southern California
- Caitlin Fitzgerald is the associate director of clinical education and assistant professor in the Department of Physical Therapy in the School of Health and Rehabilitation Sciences at MGH Institute of Health Professions
- Donna Applebaum is assistant professor and the director of clinical education at the Department of Physical Therapy in the School of Health and Rehabilitation Sciences at MGH Institute of Health Professions
- Cindy Flom-Meland is a board-certified specialist in Neurologic Physical Therapy and professor and chair for the Department of Physical Therapy at the University of North Dakota
- Deborah DeWaay is a board-certified in Internal Medicine and serves as the associate dean and professor for Undergraduate Medical Education at the University of South Florida
- Tara Jo Manal is the senior vice president of scientific affairs with the American Physical Therapy Association
- Tamara Gravano is a board-certified specialist in Geriatric Physical Therapy and an associate professor and assistant director for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- Stephanie Anderson is a board-certified in Orthopaedic Physical Therapy and assistance clinical professor at Graceland University
- Rebecca Miro is a research administrator for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- David Russ is an associate professor and assistant director of research for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- Aimee Klein is a board-certified specialist in Orthopaedic Physical Therapy and professor and assistant school director for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
| | - Tara Jo Manal
- Douglas Haladay is an emeritus board-certified specialist in Orthopaedic Physical Therapy and professor and director for the School of Physical Therapy & Rehabilitation Sciences within the Morsani College of Medicine at the University of South Florida, 12901 North Bruce B. Downs Blvd., MDC 077, Tampa, FL 33612-4766 . Please address all correspondence to Douglas Haladay
- Zoe Morris is a research coordinator for the School of Physical Therapy & Rehabilitation Sciences at the University of South Florida
- Julie Tilson is a board-certified specialist in Neurologic Physical Therapy and DPT Program director and professor of Clinical Physical Therapy at the University of Southern California
- Caitlin Fitzgerald is the associate director of clinical education and assistant professor in the Department of Physical Therapy in the School of Health and Rehabilitation Sciences at MGH Institute of Health Professions
- Donna Applebaum is assistant professor and the director of clinical education at the Department of Physical Therapy in the School of Health and Rehabilitation Sciences at MGH Institute of Health Professions
- Cindy Flom-Meland is a board-certified specialist in Neurologic Physical Therapy and professor and chair for the Department of Physical Therapy at the University of North Dakota
- Deborah DeWaay is a board-certified in Internal Medicine and serves as the associate dean and professor for Undergraduate Medical Education at the University of South Florida
- Tara Jo Manal is the senior vice president of scientific affairs with the American Physical Therapy Association
- Tamara Gravano is a board-certified specialist in Geriatric Physical Therapy and an associate professor and assistant director for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- Stephanie Anderson is a board-certified in Orthopaedic Physical Therapy and assistance clinical professor at Graceland University
- Rebecca Miro is a research administrator for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- David Russ is an associate professor and assistant director of research for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- Aimee Klein is a board-certified specialist in Orthopaedic Physical Therapy and professor and assistant school director for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
| | - Tamara Gravano
- Douglas Haladay is an emeritus board-certified specialist in Orthopaedic Physical Therapy and professor and director for the School of Physical Therapy & Rehabilitation Sciences within the Morsani College of Medicine at the University of South Florida, 12901 North Bruce B. Downs Blvd., MDC 077, Tampa, FL 33612-4766 . Please address all correspondence to Douglas Haladay
- Zoe Morris is a research coordinator for the School of Physical Therapy & Rehabilitation Sciences at the University of South Florida
- Julie Tilson is a board-certified specialist in Neurologic Physical Therapy and DPT Program director and professor of Clinical Physical Therapy at the University of Southern California
- Caitlin Fitzgerald is the associate director of clinical education and assistant professor in the Department of Physical Therapy in the School of Health and Rehabilitation Sciences at MGH Institute of Health Professions
- Donna Applebaum is assistant professor and the director of clinical education at the Department of Physical Therapy in the School of Health and Rehabilitation Sciences at MGH Institute of Health Professions
- Cindy Flom-Meland is a board-certified specialist in Neurologic Physical Therapy and professor and chair for the Department of Physical Therapy at the University of North Dakota
- Deborah DeWaay is a board-certified in Internal Medicine and serves as the associate dean and professor for Undergraduate Medical Education at the University of South Florida
- Tara Jo Manal is the senior vice president of scientific affairs with the American Physical Therapy Association
- Tamara Gravano is a board-certified specialist in Geriatric Physical Therapy and an associate professor and assistant director for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- Stephanie Anderson is a board-certified in Orthopaedic Physical Therapy and assistance clinical professor at Graceland University
- Rebecca Miro is a research administrator for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- David Russ is an associate professor and assistant director of research for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- Aimee Klein is a board-certified specialist in Orthopaedic Physical Therapy and professor and assistant school director for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
| | - Stephanie Anderson
- Douglas Haladay is an emeritus board-certified specialist in Orthopaedic Physical Therapy and professor and director for the School of Physical Therapy & Rehabilitation Sciences within the Morsani College of Medicine at the University of South Florida, 12901 North Bruce B. Downs Blvd., MDC 077, Tampa, FL 33612-4766 . Please address all correspondence to Douglas Haladay
- Zoe Morris is a research coordinator for the School of Physical Therapy & Rehabilitation Sciences at the University of South Florida
- Julie Tilson is a board-certified specialist in Neurologic Physical Therapy and DPT Program director and professor of Clinical Physical Therapy at the University of Southern California
- Caitlin Fitzgerald is the associate director of clinical education and assistant professor in the Department of Physical Therapy in the School of Health and Rehabilitation Sciences at MGH Institute of Health Professions
- Donna Applebaum is assistant professor and the director of clinical education at the Department of Physical Therapy in the School of Health and Rehabilitation Sciences at MGH Institute of Health Professions
- Cindy Flom-Meland is a board-certified specialist in Neurologic Physical Therapy and professor and chair for the Department of Physical Therapy at the University of North Dakota
- Deborah DeWaay is a board-certified in Internal Medicine and serves as the associate dean and professor for Undergraduate Medical Education at the University of South Florida
- Tara Jo Manal is the senior vice president of scientific affairs with the American Physical Therapy Association
- Tamara Gravano is a board-certified specialist in Geriatric Physical Therapy and an associate professor and assistant director for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- Stephanie Anderson is a board-certified in Orthopaedic Physical Therapy and assistance clinical professor at Graceland University
- Rebecca Miro is a research administrator for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- David Russ is an associate professor and assistant director of research for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- Aimee Klein is a board-certified specialist in Orthopaedic Physical Therapy and professor and assistant school director for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
| | - Rebecca Miro
- Douglas Haladay is an emeritus board-certified specialist in Orthopaedic Physical Therapy and professor and director for the School of Physical Therapy & Rehabilitation Sciences within the Morsani College of Medicine at the University of South Florida, 12901 North Bruce B. Downs Blvd., MDC 077, Tampa, FL 33612-4766 . Please address all correspondence to Douglas Haladay
- Zoe Morris is a research coordinator for the School of Physical Therapy & Rehabilitation Sciences at the University of South Florida
- Julie Tilson is a board-certified specialist in Neurologic Physical Therapy and DPT Program director and professor of Clinical Physical Therapy at the University of Southern California
- Caitlin Fitzgerald is the associate director of clinical education and assistant professor in the Department of Physical Therapy in the School of Health and Rehabilitation Sciences at MGH Institute of Health Professions
- Donna Applebaum is assistant professor and the director of clinical education at the Department of Physical Therapy in the School of Health and Rehabilitation Sciences at MGH Institute of Health Professions
- Cindy Flom-Meland is a board-certified specialist in Neurologic Physical Therapy and professor and chair for the Department of Physical Therapy at the University of North Dakota
- Deborah DeWaay is a board-certified in Internal Medicine and serves as the associate dean and professor for Undergraduate Medical Education at the University of South Florida
- Tara Jo Manal is the senior vice president of scientific affairs with the American Physical Therapy Association
- Tamara Gravano is a board-certified specialist in Geriatric Physical Therapy and an associate professor and assistant director for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- Stephanie Anderson is a board-certified in Orthopaedic Physical Therapy and assistance clinical professor at Graceland University
- Rebecca Miro is a research administrator for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- David Russ is an associate professor and assistant director of research for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- Aimee Klein is a board-certified specialist in Orthopaedic Physical Therapy and professor and assistant school director for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
| | - David Russ
- Douglas Haladay is an emeritus board-certified specialist in Orthopaedic Physical Therapy and professor and director for the School of Physical Therapy & Rehabilitation Sciences within the Morsani College of Medicine at the University of South Florida, 12901 North Bruce B. Downs Blvd., MDC 077, Tampa, FL 33612-4766 . Please address all correspondence to Douglas Haladay
- Zoe Morris is a research coordinator for the School of Physical Therapy & Rehabilitation Sciences at the University of South Florida
- Julie Tilson is a board-certified specialist in Neurologic Physical Therapy and DPT Program director and professor of Clinical Physical Therapy at the University of Southern California
- Caitlin Fitzgerald is the associate director of clinical education and assistant professor in the Department of Physical Therapy in the School of Health and Rehabilitation Sciences at MGH Institute of Health Professions
- Donna Applebaum is assistant professor and the director of clinical education at the Department of Physical Therapy in the School of Health and Rehabilitation Sciences at MGH Institute of Health Professions
- Cindy Flom-Meland is a board-certified specialist in Neurologic Physical Therapy and professor and chair for the Department of Physical Therapy at the University of North Dakota
- Deborah DeWaay is a board-certified in Internal Medicine and serves as the associate dean and professor for Undergraduate Medical Education at the University of South Florida
- Tara Jo Manal is the senior vice president of scientific affairs with the American Physical Therapy Association
- Tamara Gravano is a board-certified specialist in Geriatric Physical Therapy and an associate professor and assistant director for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- Stephanie Anderson is a board-certified in Orthopaedic Physical Therapy and assistance clinical professor at Graceland University
- Rebecca Miro is a research administrator for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- David Russ is an associate professor and assistant director of research for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- Aimee Klein is a board-certified specialist in Orthopaedic Physical Therapy and professor and assistant school director for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
| | - Aimee Klein
- Douglas Haladay is an emeritus board-certified specialist in Orthopaedic Physical Therapy and professor and director for the School of Physical Therapy & Rehabilitation Sciences within the Morsani College of Medicine at the University of South Florida, 12901 North Bruce B. Downs Blvd., MDC 077, Tampa, FL 33612-4766 . Please address all correspondence to Douglas Haladay
- Zoe Morris is a research coordinator for the School of Physical Therapy & Rehabilitation Sciences at the University of South Florida
- Julie Tilson is a board-certified specialist in Neurologic Physical Therapy and DPT Program director and professor of Clinical Physical Therapy at the University of Southern California
- Caitlin Fitzgerald is the associate director of clinical education and assistant professor in the Department of Physical Therapy in the School of Health and Rehabilitation Sciences at MGH Institute of Health Professions
- Donna Applebaum is assistant professor and the director of clinical education at the Department of Physical Therapy in the School of Health and Rehabilitation Sciences at MGH Institute of Health Professions
- Cindy Flom-Meland is a board-certified specialist in Neurologic Physical Therapy and professor and chair for the Department of Physical Therapy at the University of North Dakota
- Deborah DeWaay is a board-certified in Internal Medicine and serves as the associate dean and professor for Undergraduate Medical Education at the University of South Florida
- Tara Jo Manal is the senior vice president of scientific affairs with the American Physical Therapy Association
- Tamara Gravano is a board-certified specialist in Geriatric Physical Therapy and an associate professor and assistant director for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- Stephanie Anderson is a board-certified in Orthopaedic Physical Therapy and assistance clinical professor at Graceland University
- Rebecca Miro is a research administrator for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- David Russ is an associate professor and assistant director of research for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
- Aimee Klein is a board-certified specialist in Orthopaedic Physical Therapy and professor and assistant school director for the School of Physical Therapy and Rehabilitation Sciences at the University of South Florida
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Querevalú-Pancorbo I, Rojas-Cama LF, Soncco-Llulluy F, Li J, Rosales-Rimache J. Abnormal uterine bleeding and associated factors: a cross-sectional study in high-performance Peruvian athletes. BMJ Open Sport Exerc Med 2024; 10:e001820. [PMID: 38818354 PMCID: PMC11138278 DOI: 10.1136/bmjsem-2023-001820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2024] [Indexed: 06/01/2024] Open
Abstract
Background Abnormal uterine bleeding (AUB) is a problem that affects women and can cause outcomes such as anaemia, affecting women's quality of life. In high-performance athletes, this problem can be further exacerbated by intense physical activity, strict nutritional regimens and physical stress. Hypothesis There are factors that increase the risk of occurrence of AUB in high-performance Peruvian athletes. Study design Cross-sectional study. Level of evidence Level 4. Methods We applied an online questionnaire with questions to identify AUB according to the International Federation of Gynecology and Obstetrics criteria, demographic characteristics, sport practised and evaluation of the risk of an eating disorder using the Eating Attitudes Test questionnaire. We used a generalised linear model to identify factors associated with AUB. Results We evaluated 101 participants whose mean age was 22.3±4.3 years. The body mass index had a mean of 22.6±2.4 kg/m2. From the total of athletes, 68.3% (95% CI 58.6% to 76.7%) presented AUB. The bivariate analysis showed that the type of sport and the duration of the sporting activity were associated (p<0.05) with AUB, with AUB frequencies of 76.5% observed in athletes who practised anaerobic sports. The multivariate analysis did not report factors significantly associated with AUB. Conclusion We found a high frequency of AUB in high-performance Peruvian athletes, especially in those who practice anaerobic and resistance sports. Clinical relevance High-performance female athletes health must be evaluated periodically, and immediate actions are taken to control and treat AUB.
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Affiliation(s)
| | | | | | - Jair Li
- Escuela de Posgrado, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Jaime Rosales-Rimache
- Facultad de Ciencias de la Salud, Escuela de Tecnología Médica, Universidad Continental, Huancayo, Peru
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Grottoli S, Maffei P, Tresoldi AS, Granato S, Benedan L, Mariani P, Giustina A. Insights from an Italian Delphi panel: exploring resistance to first-generation somatostatin receptor ligands and guiding second-line medical therapies in acromegaly management. J Endocrinol Invest 2024:10.1007/s40618-024-02386-3. [PMID: 38809458 DOI: 10.1007/s40618-024-02386-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 04/25/2024] [Indexed: 05/30/2024]
Abstract
PURPOSE First-line medical therapy for acromegaly management includes first-generation somatostatin receptor ligands (fgSRLs), but resistance limits their use. Despite international guidelines, the choice of second-line therapy is debated. METHODS We aim to discuss resistance to fgSRLs, identify second-line therapy determinants and assess glycemia's impact to provide valuable insights for acromegaly management in clinical practice. A group of Italian endocrinologists expert in the pituitary field participated in a two-round Delphi panel between July and September 2023. The Delphi questionnaire encompassed a total of 75 statements categorized into three sections: resistance to fgSRLs therapy and predictors of response; determinants for the selection of second-line therapy; the role of glycemia in the therapeutic management. The statements were rated on a 6-point Likert scale. RESULTS Fifty-nine (79%) statements reached a consensus. IGF-1 levels resulted central for evaluating resistance to fgSRLs, that should be defined considering also symptomatic clinical response, degree of tumor shrinkage and complications, using clinician- and patient-reported outcome tools available. Factors to be evaluated for the choice of second-line medical therapy are hyperglycemia-that should be managed as in non-acromegalic patients-tumor remnant, resistant headache and compliance. Costs do not represent a main determinant in the choice of second-line medical treatment. CONCLUSION The experts agreed on a holistic management approach to acromegaly. It is therefore necessary to choose currently available highly effective second-line medical treatment (pegvisomant and pasireotide) based on the characteristics of the patients.
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Affiliation(s)
- S Grottoli
- Department of Medical Science, Division of Endocrinology, Diabetes and Metabolism, University of Turin, Turin, Italy.
| | - P Maffei
- Department of Medicine (DIMED), 3rd Medical Clinic, Padua University Hospital, Padua, Italy
| | | | - S Granato
- Medical Department, Pfizer Italia, Rome, Italy
| | - L Benedan
- Università Milano-Bicocca, Milan, Italy
| | - P Mariani
- Università Milano-Bicocca, Milan, Italy
| | - A Giustina
- Institute of Endocrine and Metabolic Sciences, Vita-Salute San Raffaele University and IRCCS San Raffaele Hospital, Milan, Italy
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El Chaar M, Rogers AM, Mattar SG, Kukreja SS, Jenkins M, Askew C, Hassan M, Baker R, Smith E, Galvani C. First modified Delphi consensus statement on robotic-assisted da Vinci sleeve gastrectomy. Surg Obes Relat Dis 2024:S1550-7289(24)00628-2. [PMID: 38991936 DOI: 10.1016/j.soard.2024.04.452] [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: 01/25/2024] [Revised: 03/29/2024] [Accepted: 04/26/2024] [Indexed: 07/13/2024]
Abstract
BACKGROUND Sleeve gastrectomy (SG) is the most commonly performed metabolic and bariatric surgery (MBS) procedure. Technical considerations related to the performance of SG are well established and reported in the literature but not in relation to robotic-assisted (RA) SG. We report the results of the first modified Delphi consensus-building exercise addressing technical considerations of RA da Vinci (dV) SG. OBJECTIVES Develop best practices for the performance of robotic-assisted da Vinci sleeve gastrectomy. SETTING Survey based consensus statement. METHODS A consensus building committee (CBC) was created comprising 10 experts in the field of RA surgery and MBS based on strict selection criteria. The CBC developed 49 consensus statements which were then shared with 240 experts in RA surgery. Our stopping criterion was stability in responses (≤15%). The consensus cut point was 70%. RESULTS The overall response rate was 49%. In the first round of voting, there was consensus agreement on 25 statements (51%), consensus disagreement on 14 (28%), and no consensus on the remaining statements (21%). In the second round of voting, we reached agreement on 3 additional statements. Experts recommended the use of the number of pauses generated by the stapler to guide choice of staple height (91.2%) and to upsize the staple height when using buttressing (92%). There was also consensus (81.4%) that the use of the closed staple height of 1.00 mm (white) is acceptable and that stapling of the antrum using a 1.5-mm staple (blue load) is also acceptable (73%). CONCLUSIONS Collective expert opinion structured through a modified Delphi consensus statement presents a practical guide for surgeons interested in performing dV-SG.
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Affiliation(s)
- Maher El Chaar
- Department of Surgery, St Luke's University Hospital and Health Network, Allentown, Pennsylvania.
| | | | | | | | | | | | | | | | - Eric Smith
- Kentucky Bariatric Institute, Georgetown, Kentucky
| | - Carlos Galvani
- Department of Surgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana
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47
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Calzone KA, Stokes L, Peterson C, Badzek L. Update to the essential genomic nursing competencies and outcome indicators. J Nurs Scholarsh 2024. [PMID: 38797885 DOI: 10.1111/jnu.12993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 05/07/2024] [Accepted: 05/10/2024] [Indexed: 05/29/2024]
Abstract
INTRODUCTION Genomic healthcare applications have relevance to all healthcare professionals including nursing, and most evidence-based clinical applications impact the quality and safety of healthcare. To guide nursing genomic competency initiatives, the Essential Nursing Competencies and Curricula Guidelines for Genetics and Genomics were established through a process of consensus in 2005. A 2009 update incorporated outcome indicators consisting of specific areas of knowledge and clinical performance indicators, to help support academic integration. Almost 20 years have elapsed since these competencies were first established, yet incorporating the competencies into general and specialty scope and standards of nursing practice is inconsistent, competency integration into curricula is highly uneven, continuing education in genomics for nurses is limited, and the genomic capacity of the nursing workforce remains low. These deficits have persisted despite substantial advances in genomic technology which substantially reduced costs and increased evidence-based clinical applications, including direct to consumer genomic tests, the integration of genomics into evidence-based guidelines, and evidence that genomics impacts the quality and safety of healthcare. DESIGN The aim of this project was to update and achieve consensus on genomic competencies applicable to all registered nurses. This was a mixed methods study. METHODS The update to the competencies was performed based first on a literature review to update the competencies based on the current state of the evidence. Using the updated content, a modified Delphi study was conducted with registered nurse panelists from clinical, academic, and research settings. Once consensus was achieved, the competencies were made available through the American Nurses Association for public comment. Public comments were then reviewed and integrated as needed. RESULTS The literature review resulted in a transition from genetics to genomics, given the reduction in costs, which resulted in an expansion of the scope of testing in both the germline and somatic contexts. Two Delphi rounds were required to reach consensus prior to the public comment period. Public comments were solicited through the American Nurses Association, and each comment was reviewed by the authors and addressed as indicated. CONCLUSION The Essentials of Genomic Nursing: Competencies and Outcome Indicators constitute the minimum competency in genomics required of all registered nurses regardless of the level of academic training, role, or specialty. CLINICAL RELEVANCE Evidence-based genomic applications span the entire healthcare continuum and, therefore, are relevant for all registered nurses regardless of academic training, role, practice setting, or clinical expertise. These competencies serve as the guide for the minimum requirements for registered nurse practice as well as guide curricula and continuing education for all registered nurses, including but not limited to administrators, educators, nursing leaders, practicing nurses, and researchers.
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Affiliation(s)
- Kathleen A Calzone
- Genetics Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland, USA
| | - Liz Stokes
- Center for Ethics and Human Rights, American Nurses Association, Silver Spring, Maryland, USA
| | - Cheryl Peterson
- Nursing Programs, American Nurses Association, Silver Spring, Maryland, USA
| | - Laurie Badzek
- Penn State University, State College, Pennsylvania, USA
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Karami M, Hafizi N, Nickfarjam AM, Refahi S. Development of minimum data set and dashboard for monitoring adverse events in radiology departments. Heliyon 2024; 10:e30054. [PMID: 38707457 PMCID: PMC11068645 DOI: 10.1016/j.heliyon.2024.e30054] [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: 02/14/2024] [Revised: 04/14/2024] [Accepted: 04/18/2024] [Indexed: 05/07/2024] Open
Abstract
Background To reduce the risk of errors, patient safety monitoring in the medical imaging department is crucial. Interventions are required and these can be provided as a framework for documenting, reporting, evaluating, and recognizing events that pose a threat to patient safety. The aim of this study was to develop minimum data set and dashboard for monitoring adverse events in radiology departments. Material and methods This developmental research was conducted in multiple phases, including content determination using the Delphi technique; database designing using SQL Server; user interface (UI) building using PHP; and dashboard evaluation in three aspects: the accuracy of calculating; UI requirements; and usability. Results This study identified 26 patient safety (PS) performance metrics and 110 PS-related significant data components organized into 14 major groupings as the system contents. The UI was built with three tabs: pre-procedure, intra-procedure, and post-procedure. The evaluation results proved the technical feasibility of the dashboard. Finally, the dashboard's usability was highly rated (76.3 out of 100). Conclusion The dashboard can be used to supplement datasets to obtain a more accurate picture of the PS condition and to draw attention to characteristics that professionals might otherwise overlook or undervalue.
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Affiliation(s)
- Mahtab Karami
- Clinical Research Development Center of Shahid Sadoughi Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Research Center for Health Technology Assessment and Medical Informatics, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Health Information Technology and Management, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Nasrin Hafizi
- Health Information Management Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | - Ali-Mohammad Nickfarjam
- Health Information Management Research Center, Kashan University of Medical Sciences, Kashan, Iran
- Department of Health Information Technology and Management, School of Allied-Medical Sciences, Kashan University of Medical Sciences, Kashan, Iran
| | - Soheila Refahi
- Department of Medical Physics, Faculty of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
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LaBella D, Khanna O, McBurney-Lin S, Mclean R, Nedelec P, Rashid AS, Tahon NH, Altes T, Baid U, Bhalerao R, Dhemesh Y, Floyd S, Godfrey D, Hilal F, Janas A, Kazerooni A, Kent C, Kirkpatrick J, Kofler F, Leu K, Maleki N, Menze B, Pajot M, Reitman ZJ, Rudie JD, Saluja R, Velichko Y, Wang C, Warman PI, Sollmann N, Diffley D, Nandolia KK, Warren DI, Hussain A, Fehringer JP, Bronstein Y, Deptula L, Stein EG, Taherzadeh M, Portela de Oliveira E, Haughey A, Kontzialis M, Saba L, Turner B, Brüßeler MMT, Ansari S, Gkampenis A, Weiss DM, Mansour A, Shawali IH, Yordanov N, Stein JM, Hourani R, Moshebah MY, Abouelatta AM, Rizvi T, Willms K, Martin DC, Okar A, D'Anna G, Taha A, Sharifi Y, Faghani S, Kite D, Pinho M, Haider MA, Alonso-Basanta M, Villanueva-Meyer J, Rauschecker AM, Nada A, Aboian M, Flanders A, Bakas S, Calabrese E. A multi-institutional meningioma MRI dataset for automated multi-sequence image segmentation. Sci Data 2024; 11:496. [PMID: 38750041 PMCID: PMC11096318 DOI: 10.1038/s41597-024-03350-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 05/07/2024] [Indexed: 05/18/2024] Open
Abstract
Meningiomas are the most common primary intracranial tumors and can be associated with significant morbidity and mortality. Radiologists, neurosurgeons, neuro-oncologists, and radiation oncologists rely on brain MRI for diagnosis, treatment planning, and longitudinal treatment monitoring. However, automated, objective, and quantitative tools for non-invasive assessment of meningiomas on multi-sequence MR images are not available. Here we present the BraTS Pre-operative Meningioma Dataset, as the largest multi-institutional expert annotated multilabel meningioma multi-sequence MR image dataset to date. This dataset includes 1,141 multi-sequence MR images from six sites, each with four structural MRI sequences (T2-, T2/FLAIR-, pre-contrast T1-, and post-contrast T1-weighted) accompanied by expert manually refined segmentations of three distinct meningioma sub-compartments: enhancing tumor, non-enhancing tumor, and surrounding non-enhancing T2/FLAIR hyperintensity. Basic demographic data are provided including age at time of initial imaging, sex, and CNS WHO grade. The goal of releasing this dataset is to facilitate the development of automated computational methods for meningioma segmentation and expedite their incorporation into clinical practice, ultimately targeting improvement in the care of meningioma patients.
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Affiliation(s)
- Dominic LaBella
- Department of Radiation Oncology, Duke University Medical Center, Durham, NC, USA
| | - Omaditya Khanna
- Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA, USA
| | - Shan McBurney-Lin
- Center for Intelligent Imaging (ci2), Department of Radiology & Biomedical Imaging, University of California San Francisco (UCSF), San Francisco, CA, USA
| | | | - Pierre Nedelec
- Center for Intelligent Imaging (ci2), Department of Radiology & Biomedical Imaging, University of California San Francisco (UCSF), San Francisco, CA, USA
| | - Arif S Rashid
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | | | | | - Ujjwal Baid
- Division of Computational Pathology, Department of Pathology and Laboratory Medicine, School of Medicine, Indiana University, Indianapolis, IN, USA
| | - Radhika Bhalerao
- Center for Intelligent Imaging (ci2), Department of Radiology & Biomedical Imaging, University of California San Francisco (UCSF), San Francisco, CA, USA
| | | | - Scott Floyd
- Department of Radiation Oncology, Duke University Medical Center, Durham, NC, USA
| | - Devon Godfrey
- Department of Radiation Oncology, Duke University Medical Center, Durham, NC, USA
| | | | | | - Anahita Kazerooni
- Center for Data-Driven Discovery in Biomedicine (D3b), The Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Neurosurgery, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Collin Kent
- Department of Radiation Oncology, Duke University Medical Center, Durham, NC, USA
| | - John Kirkpatrick
- Department of Radiation Oncology, Duke University Medical Center, Durham, NC, USA
| | - Florian Kofler
- Helmholtz AI, Helmholtz Munich, Neuherberg, Germany
- Department of Computer Science, TUM School of Computation, Information and Technology, Technical University of Munich, Munich, Germany
- TranslaTUM - Central Institute for Translational Cancer Research, Tech nical University of Munich, Munich, Germany
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Kevin Leu
- Center for Intelligent Imaging (ci2), Department of Radiology & Biomedical Imaging, University of California San Francisco (UCSF), San Francisco, CA, USA
| | | | | | - Maxence Pajot
- Center for Intelligent Imaging (ci2), Department of Radiology & Biomedical Imaging, University of California San Francisco (UCSF), San Francisco, CA, USA
| | - Zachary J Reitman
- Department of Radiation Oncology, Duke University Medical Center, Durham, NC, USA
| | - Jeffrey D Rudie
- Department of Radiology, University of California San Diego, San Diego, CA, USA
| | - Rachit Saluja
- Department of Radiology, Cornell University, Ithaca, NY, USA
| | - Yury Velichko
- Department of Radiology, Northwestern University, Evanston, IL, USA
| | - Chunhao Wang
- Department of Radiation Oncology, Duke University Medical Center, Durham, NC, USA
| | - Pranav I Warman
- Duke University Medical Center, School of Medicine, Durham, NC, USA
| | - Nico Sollmann
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany
- TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | | | - Khanak K Nandolia
- Department of Diagnostic and Interventional Radiology, All India Institute of Medical Sciences, Rishikesh, India
| | - Daniel I Warren
- Department of Neuroradiology, Washington University, St. Louis, MO, USA
| | - Ali Hussain
- University of Rochester Medical Center, Rochester, NY, USA
| | - John Pascal Fehringer
- Faculty of Medicine, Jena University Hospital, Friedrich Schiller University Jena, Jena, Germany
| | | | - Lisa Deptula
- Ross University School of Medicine, Bridgetown, Barbados
| | - Evan G Stein
- Department of Radiology, New York University Grossman School of Medicine, New York, NY, USA
| | | | | | - Aoife Haughey
- Department of Neuroradiology, JDMI, University of Toronto, Toronto, TO, Canada
| | | | - Luca Saba
- Department of Radiology, Azienda Ospedaliero Universitaria of Cagliari-Polo di Monserrato, Cagliari, Italy
| | | | | | | | | | - David Maximilian Weiss
- Department of Neuroradiology, University Hospital Essen, Essen, North Rhine-Westphalia, Germany
| | | | - Islam H Shawali
- Department of Radiology, Kasr Alainy, Cairo University, Cairo, Egypt
| | - Nikolay Yordanov
- Faculty of Medicine, Medical University of Sofia, Sofia, Bulgaria
| | - Joel M Stein
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Roula Hourani
- Department of Radiology, American University of Beirut Medical center, Beirut, Lebanon
| | | | | | - Tanvir Rizvi
- Department of Radiology and Medical Imaging, University of Virginia Health, Charlottesville, VA, USA
| | | | - Dann C Martin
- Department of Radiology and Radiologic Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Abdullah Okar
- Faculty of Medicine, Hamburg University, Hamburg, Germany
| | - Gennaro D'Anna
- Neuroimaging Unit, ASST Ovest Milanese, Legnano, Milan, Italy
| | - Ahmed Taha
- University of Manitoba, Winnipeg, Manitoba, Canada
| | - Yasaman Sharifi
- Department of Radiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Shahriar Faghani
- Radiology Informatics Lab, Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Dominic Kite
- Department of Radiology, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
| | - Marco Pinho
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | | | - Michelle Alonso-Basanta
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Javier Villanueva-Meyer
- Center for Intelligent Imaging (ci2), Department of Radiology & Biomedical Imaging, University of California San Francisco (UCSF), San Francisco, CA, USA
| | - Andreas M Rauschecker
- Center for Intelligent Imaging (ci2), Department of Radiology & Biomedical Imaging, University of California San Francisco (UCSF), San Francisco, CA, USA
| | - Ayman Nada
- University of Missouri, Columbia, MO, USA
| | - Mariam Aboian
- Department of Radiology, Children's Hospital of Philadelphia (CHOP), Philadelphia, PA, USA
| | - Adam Flanders
- Department of Radiology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Spyridon Bakas
- Division of Computational Pathology, Department of Pathology and Laboratory Medicine, School of Medicine, Indiana University, Indianapolis, IN, USA
- Department of Neurological Surgery, School of Medicine, Indiana University, Indianapolis, IN, USA
- Department of Radiology and Imaging Sciences, School of Medicine, Indiana University, Indianapolis, IN, USA
| | - Evan Calabrese
- Department of Radiology, Duke University Medical Center, Durham, NC, USA.
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50
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Sebong PH, Pardosi J, Goldman RE, Suryo AP, Susianto IA, Meliala A. Identifying Physician Public Health Competencies to Address Healthcare Needs in Underserved, Border, and Outer Island Areas of Indonesia: A Rapid Assessment. TEACHING AND LEARNING IN MEDICINE 2024:1-12. [PMID: 38743583 DOI: 10.1080/10401334.2024.2353573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 05/03/2024] [Indexed: 05/16/2024]
Abstract
Phenomenon: Most medical schools in Indonesia have developed innovations to integrate public health content into the curricula. However, ensuring that all schools meet appropriate standards regarding the quality of subjects, content relevancy, and course delivery takes time and effort. Approach: This study employed a rapid assessment procedure to identify the current knowledge and competencies required to practice medicine effectively in underserved, border, and outer island areas of Indonesia. Ninety-three participants from six remote districts were involved in 12 focus group discussions. Qualitative data were analyzed using content analysis using the social determinants of health as a guiding framework. Findings: Under decentralized health system governance, the local socio-geographical context is critical to understanding the current public health landscape. Medical education with respect to public health must emphasize physicians' ability to advocate and encourage the coordination of healthcare services in responding to disasters, as well as community-based surveillance and other relevant data for synergistic disease control. As part of a healthcare facility management team, prospective doctors should be able to apply systems thinking and provide critical input to improve service delivery at local health facilities. Also, recognizing underlying factors is essential to realizing effective interprofessional collaboration practices and aligning them with leadership skills. Insights: This study outlines recommendations for medical schools and relevant colleges in formulating compulsory block or integrated public health curricula. It also provides a public health learning topic that may aid medical schools in training their students to be competent for practice in underserved, border, and outer island areas. Medical schools should offer initiatives for students to acquire the necessary public health competencies merited by the population's health needs.
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Affiliation(s)
- Perigrinus Hermin Sebong
- Department of Public Health, Faculty of Medicine, Soegijapranata Catholic University, Semarang, Indonesia
| | - Jerico Pardosi
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - Roberta Ellen Goldman
- Department of Social and Behavioral Sciences, Harvard Chan School of Public Health, Boston, Massachusetts
- Department of Family Medicine, Alpert Medical School of Brown University, Providence, Rhode Island
| | | | - Indra Adi Susianto
- Faculty of Medicine, Soegijapranata Catholic University, Semarang, Indonesia
| | - Andreasta Meliala
- Center for Health Policy and Management, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
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