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31 papers 25 to 100 followers Papers reflecting cool ideas, disruptive thinking, and digitalhealth advances - cool stuff in anesthesia and perioperative medicine
By Ron George Anesthesiologist with special interests in Obstetrics, Pain, and Global Health
https://www.readbyqxmd.com/read/29452519/patient-engagement-in-clinical-trials-the-clinical-trials-transformation-initiative-s-leadership-from-theory-to-practical-implementation
#1
Bray Patrick-Lake
Patient engagement is an increasingly important aspect of successful clinical trials. Over the past decade, as patient group involvement in clinical trials has continued to increase and diversify, the Clinical Trials Transformation Initiative has not only recognized the crucial role patients play in improving the clinical trial enterprise but also made a deep commitment to help grow and shape the emerging field of patient engagement. This article describes the evolution of patient engagement including the origins of the patient engagement movement; barriers to successful engagement and remaining challenges to full and valuable collaboration between patient groups and trial sponsors; and Clinical Trials Transformation Initiative's role in influencing the field through organizational practices, formal project work and resulting recommendations, and external advocacy efforts...
February 2018: Clinical Trials: Journal of the Society for Clinical Trials
https://www.readbyqxmd.com/read/29411037/guidelines-for-inclusion-of-patient-reported-outcomes-in-clinical-trial-protocols-the-spirit-pro-extension
#2
Melanie Calvert, Derek Kyte, Rebecca Mercieca-Bebber, Anita Slade, An-Wen Chan, Madeleine T King, Amanda Hunn, Andrew Bottomley, Antoine Regnault, An-Wen Chan, Carolyn Ells, Daniel O'Connor, Dennis Revicki, Donald Patrick, Doug Altman, Ethan Basch, Galina Velikova, Gary Price, Heather Draper, Jane Blazeby, Jane Scott, Joanna Coast, Josephine Norquist, Julia Brown, Kirstie Haywood, Laura Lee Johnson, Lisa Campbell, Lori Frank, Maria von Hildebrand, Michael Brundage, Michael Palmer, Paul Kluetz, Richard Stephens, Robert M Golub, Sandra Mitchell, Trish Groves
Importance: Patient-reported outcome (PRO) data from clinical trials can provide valuable evidence to inform shared decision making, labeling claims, clinical guidelines, and health policy; however, the PRO content of clinical trial protocols is often suboptimal. The SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials) statement was published in 2013 and aims to improve the completeness of trial protocols by providing evidence-based recommendations for the minimum set of items to be addressed, but it does not provide PRO-specific guidance...
February 6, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29384751/gender-differences-in-academic-medicine-retention-rank-and-leadership-comparisons-from-the-national-faculty-survey
#3
Phyllis L Carr, Anita Raj, Samantha E Kaplan, Norma Terrin, Janis L Breeze, Karen M Freund
PURPOSE: Prior studies have found that women in academic medicine do not advance or remain in their careers in parity with men. The authors examined a national cohort of faculty from the 1995 National Faculty Survey to identify predictors of advancement, retention, and leadership for women faculty. METHOD: The authors followed 1,273 faculty at 24 medical schools in the continental United States for 17 years to identify predictors of advancement, retention, and leadership for women faculty...
January 30, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/26467794/is-basic-science-disappearing-from-medicine-the-decline-of-biomedical-research-in-the-medical-literature
#4
Benjamin E Steinberg, Neil M Goldenberg, Gregory D Fairn, Wolfgang M Kuebler, Arthur S Slutsky, Warren L Lee
Explosive growth in our understanding of genomics and molecular biology have fueled calls for the pursuit of personalized medicine, the notion of harnessing biologic variability to provide patient-specific care. This vision will necessitate a deep understanding of the underlying pathophysiology in each patient. Medical journals play a pivotal role in the education of trainees and clinicians, yet we suspected that the amount of basic science in the top medical journals has been in decline. We conducted an automated search strategy in PubMed to identify basic science articles and calculated the proportion of articles dealing with basic science in the highest impact journals for 8 different medical specialties from 1994 to 2013...
February 2016: FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology
https://www.readbyqxmd.com/read/29361334/progress-in-clinical-research-in-surgery-and-ideal
#5
Peter McCulloch, Joshua Feinberg, Yiannis Philippou, Angelos Kolias, Sean Kehoe, Gillian Lancaster, Jenny Donovan, Tatjana Petrinic, Riaz Agha, Christopher Pennell
The quality of clinical research in surgery has long attracted criticism. High-quality randomised trials have proved difficult to undertake in surgery, and many surgical treatments have therefore been adopted without adequate supporting evidence of efficacy and safety. This evidence deficit can adversely affect research funding and reimbursement decisions, lead to slow adoption of innovations, and permit widespread adoption of procedures that offer no benefit, or cause harm. Improvement in the quality of surgical evidence would therefore be valuable...
January 17, 2018: Lancet
https://www.readbyqxmd.com/read/26294709/resilient-health-care-turning-patient-safety-on-its-head
#6
Jeffrey Braithwaite, Robert L Wears, Erik Hollnagel
The current approach to patient safety, labelled Safety I, is predicated on a 'find and fix' model. It identifies things going wrong, after the event, and aims to stamp them out, in order to ensure that the number of errors is as low as possible. Healthcare is much more complex than such a linear model suggests. We need to switch the focus to what we have come to call Safety II: a concerted effort to enable things to go right more often. The key is to appreciate that healthcare is resilient to a large extent, and everyday performance succeeds much more often than it fails...
October 2015: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29343479/postsurgical-prescriptions-for-opioid-naive-patients-and-association-with-overdose-and-misuse-retrospective-cohort-study
#7
Gabriel A Brat, Denis Agniel, Andrew Beam, Brian Yorkgitis, Mark Bicket, Mark Homer, Kathe P Fox, Daniel B Knecht, Cheryl N McMahill-Walraven, Nathan Palmer, Isaac Kohane
OBJECTIVE: To quantify the effects of varying opioid prescribing patterns after surgery on dependence, overdose, or abuse in an opioid naive population. DESIGN: Retrospective cohort study. SETTING: Surgical claims from a linked medical and pharmacy administrative database of 37 651 619 commercially insured patients between 2008 and 2016. PARTICIPANTS: 1 015 116 opioid naive patients undergoing surgery. MAIN OUTCOME MEASURES: Use of oral opioids after discharge as defined by refills and total dosage and duration of use...
January 17, 2018: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29344622/barriers-to-and-facilitators-of-implementing-enhanced-recovery-pathways-using-an-implementation-framework-a-systematic-review
#8
Alexander B Stone, Christina T Yuan, Michael A Rosen, Michael C Grant, Lauren E Benishek, Elizabeth Hanahan, Lisa H Lubomski, Clifford Ko, Elizabeth C Wick
Importance: Enhanced recovery pathways (ERPs) have the potential to reduce length of hospital stay, costs, and complications following surgery but can be challenging to implement. Objective: To examine the body of literature on ERPs to assess how authors describe barriers and facilitators of ERP implementation and identify, in aggregate, the best practices that should be considered utilizing the Consolidated Framework for Implementation Research (CFIR) to extract these elements and summarize common barriers and facilitators according to its 5 major domains: (1) intervention characteristics, (2) inner setting, (3) outer setting, (4) characteristics of the individuals, and (5) the process of implementation...
January 17, 2018: JAMA Surgery
https://www.readbyqxmd.com/read/29300198/addressing-implicit-bias-to-improve-cross-cultural-care
#9
Brenda Pereda, Margaret Montoya
Health disparities cluster around race, ethnicity, education, neighborhoods, and income. Systems of exclusion that correlate with social determinants compound the disproportionate burden of poor health experienced by people of color. By 2056, ~50% of the population is expected to fall into categories currently labeled "under-represented minorities" (URMs), primarily African Americans, Latinxs, and American Indians. Although URMs comprise 30% of the general population, only 9% of medical doctors [Association of American Medical Colleges (AAMC)] are URMs...
March 2018: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29260229/guidelines-for-the-content-of-statistical-analysis-plans-in-clinical-trials
#10
Carrol Gamble, Ashma Krishan, Deborah Stocken, Steff Lewis, Edmund Juszczak, Caroline Doré, Paula R Williamson, Douglas G Altman, Alan Montgomery, Pilar Lim, Jesse Berlin, Stephen Senn, Simon Day, Yolanda Barbachano, Elizabeth Loder
Importance: While guidance on statistical principles for clinical trials exists, there is an absence of guidance covering the required content of statistical analysis plans (SAPs) to support transparency and reproducibility. Objective: To develop recommendations for a minimum set of items that should be addressed in SAPs for clinical trials, developed with input from statisticians, previous guideline authors, journal editors, regulators, and funders. Design: Funders and regulators (n = 39) of randomized trials were contacted and the literature was searched to identify existing guidance; a survey of current practice was conducted across the network of UK Clinical Research Collaboration-registered trial units (n = 46, 1 unit had 2 responders) and a Delphi survey (n = 73 invited participants) was conducted to establish consensus on SAPs...
December 19, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28514230/causes-of-death-of-residents-in-acgme-accredited-programs-2000-through-2014-implications-for-the-learning-environment
#11
COMPARATIVE STUDY
Nicholas A Yaghmour, Timothy P Brigham, Thomas Richter, Rebecca S Miller, Ingrid Philibert, DeWitt C Baldwin, Thomas J Nasca
PURPOSE: To systematically study the number of U.S. resident deaths from all causes, including suicide. METHOD: The more than 9,900 programs accredited by the Accreditation Council for Graduate Medical Education (ACGME) annually report the status of residents. The authors aggregated ACGME data on 381,614 residents in training during years 2000 through 2014. Names of residents reported as deceased were submitted to the National Death Index to learn causes of death...
July 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29233843/cesarean-delivery-rates-among-family-physicians-versus-obstetricians-a-population-based-cohort-study-using-instrumental-variable-methods
#12
Russell Eric Dawe, Jessica Bishop, Amanda Pendergast, Susan Avery, Kelly Monaghan, Norah Duggan, Kris Aubrey-Bassler
BACKGROUND: Previous research suggests that family physicians have rates of cesarean delivery that are lower than or equivalent to those for obstetricians, but adjustments for risk differences in these analyses may have been inadequate. We used an econometric method to adjust for observed and unobserved factors affecting the risk of cesarean delivery among women attended by family physicians versus obstetricians. METHODS: This retrospective population-based cohort study included all Canadian (except Quebec) hospital deliveries by family physicians and obstetricians between Apr...
December 11, 2017: CMAJ Open
https://www.readbyqxmd.com/read/25214614/prioritizing-integrated-mhealth-strategies-for-universal-health-coverage
#13
Garrett Mehl, Alain Labrique
As countries strive toward universal health coverage, mobile wireless technologies-mHealth tools-in support of enumeration, registration, unique identification, and maintenance of health records will facilitate improved health system performance. Electronic forms and registry systems will enable routine monitoring of the coverage of essential interventions for individuals within relevant target populations. A cascading model is presented for prioritizing and operationalizing the role of integrated mHealth strategies...
September 12, 2014: Science
https://www.readbyqxmd.com/read/27778172/participation-of-canadian-anesthesiology-departments-in-undergraduate-medical-education
#14
Colin Hamlin, Kanwar Bhangu, Alexander Villafranca, Manpreet Bhangu, Robert Brown, Marshall Tenenbein, Eric Jacobsohn
PURPOSE: Historically, anesthesiology departments have played a small role in teaching the pre-clerkship component of undergraduate medical education (UGME). The purpose of this study was to measure the current participation of Canadian anesthesiologists in UGME with a focus on pre-clerkship. METHODS: Three surveys were developed in collaboration with the Association of Canadian Departments of Anesthesia. After an initial series of validation procedures, the surveys were distributed to anesthesia department heads, UGME directors, and associate deans at the 17 Canadian medical schools...
January 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28264090/comparison-of-male-vs-female-resident-milestone-evaluations-by-faculty-during-emergency-medicine-residency-training
#15
COMPARATIVE STUDY
Arjun Dayal, Daniel M O'Connor, Usama Qadri, Vineet M Arora
Importance: Although implicit bias in medical training has long been suspected, it has been difficult to study using objective measures, and the influence of sex and gender in the evaluation of medical trainees is unknown. The emergency medicine (EM) milestones provide a standardized framework for longitudinal resident assessment, allowing for analysis of resident performance across all years and programs at a scope and level of detail never previously possible. Objective: To compare faculty-observed training milestone attainment of male vs female residency training...
May 1, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28570962/climate-change-policies-the-role-of-democracy-and-social-cognitive-capital
#16
Anastassia V Obydenkova, Raufhon Salahodjaev
The impact of democracy on governments' choice of environmental policies has attracted significant academic attention in recent years. However, less attention has been devoted to the role of the social cognitive capital of the national population. Does society's cognitive capital matter in governmental choice regarding environmental policies, if at all? This study addresses this question through a large-N analysis of 94 countries accounting for the role of both political regimes and social capital in governmental choice of climate change policies...
August 2017: Environmental Research
https://www.readbyqxmd.com/read/28427805/confounding-causality-and-confusion-the-role-of-intermediate-variables-in-interpreting-observational-studies-in-obstetrics
#17
Cande V Ananth, Enrique F Schisterman
Prospective and retrospective cohorts and case-control studies are some of the most important study designs in epidemiology because, under certain assumptions, they can mimic a randomized trial when done well. These assumptions include, but are not limited to, properly accounting for 2 important sources of bias: confounding and selection bias. While not adjusting the causal association for an intermediate variable will yield an unbiased estimate of the exposure-outcome's total causal effect, it is often that obstetricians will want to adjust for an intermediate variable to assess if the intermediate is the underlying driver of the association...
August 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28410247/ce-original-research-creating-an-evidence-based-progression-for-clinical-advancement-programs
#18
Kathleen G Burke, Tonya Johnson, Christine Sites, Jane Barnsteiner
: Background: The Institute of Medicine (IOM) and the Quality and Safety Education for Nurses (QSEN) project have identified six nursing competencies and supported their integration into undergraduate and graduate nursing curricula nationwide. But integration of those competencies into clinical practice has been limited, and evidence for the progression of competency proficiency within clinical advancement programs is scant. Using an evidence-based approach and building on the competencies identified by the IOM and QSEN, a team of experts at an academic health system developed eight competency domains and 186 related knowledge, skills, and attitudes (KSAs) for professional nursing practice...
May 2017: American Journal of Nursing
https://www.readbyqxmd.com/read/28399145/a-systematic-identification-and-analysis-of-scientists-on-twitter
#19
REVIEW
Qing Ke, Yong-Yeol Ahn, Cassidy R Sugimoto
Metrics derived from Twitter and other social media-often referred to as altmetrics-are increasingly used to estimate the broader social impacts of scholarship. Such efforts, however, may produce highly misleading results, as the entities that participate in conversations about science on these platforms are largely unknown. For instance, if altmetric activities are generated mainly by scientists, does it really capture broader social impacts of science? Here we present a systematic approach to identifying and analyzing scientists on Twitter...
2017: PloS One
https://www.readbyqxmd.com/read/28405531/will-the-meikirch-model-a-new-framework-for-health-induce-a-paradigm-shift-in-healthcare
#20
REVIEW
Johannes Bircher, Eckhart G Hahn
Over the past decades, scientific medicine has realized tremendous advances. Yet, it is felt that the quality, costs, and equity of medicine and public health have not improved correspondingly and, both inside and outside the USA, may even have changed for the worse. An initiative for improving this situation is value-based healthcare, in which value is defined as health outcomes relative to the cost of achieving them. Value-based healthcare was advocated in order to stimulate competition among healthcare providers and thereby reduce costs...
March 6, 2017: Curēus
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