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Madadi-Sanjani O, Ure BM. Benchmarks for Pediatric Surgical Registries: Recommendations for the Assessment and Grading of Complications. Eur J Pediatr Surg 2024; 34:182-188. [PMID: 37871645 DOI: 10.1055/a-2196-1755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
Procedure-related registries in general surgical practice offer a platform for prospective trials, the pooling of data, and detailed outcome analysis. Recommendations by the Idea, Development, Exploration, Assessment, and Long-term follow-up (IDEAL) collaboration and Outcome4Medicine have further improved the uniform reporting of complications and adverse events.In the pediatric surgical network, disease-specific registries for rare and inherited congenital anomalies are gaining importance, fostering international collaborations on studies of low-incidence diseases. However, to date, reporting of complications in the pediatric surgical registries has been inconsistent. Therefore, the European Reference Network for Rare Inherited and Congenital Anomalies (ERNICA) recently endorsed the validation of the first severity grading system for children. The planned reform of the European Paediatric Surgical Audit (EPSA) registry, which includes the implementation of the Clavien-Madadi classification, represents a further effort to establish uniform outcome reporting.This article provides an overview of experiences with surgical registries and complication reporting, along with the potential application of this knowledge to future pediatric surgical practice.
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Affiliation(s)
| | - Benno M Ure
- Department of Pediatric Surgery, Hannover Medical School, Hannover, Germany
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2
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Pereira-Rodríguez JA, Hernández-Granados P, Olona-Casa C, López-Cano M. The evolution of incisional hernia repair in Spain. A comparative analysis of results from the EVEREG registry. Cir Esp 2024:S2173-5077(24)00038-3. [PMID: 38307255 DOI: 10.1016/j.cireng.2023.11.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 11/18/2023] [Indexed: 02/04/2024]
Abstract
BACKGROUND The aim of this study was to assess the utility of the EVEREG registry in evaluating the evolution of surgical treatment for incisional hernia and its outcomes in Spain by comparing data from 2 study periods. METHODS A retrospective comparative analysis of hernia surgeries performed between 2011 and 2015 (first period) and between 2017 and 2022 (second period) was conducted using data collected from the EVEREG registry. RESULTS Statistically significant differences were observed in the second cohort, including: a decrease in minimally invasive procedures (11.7% vs 8.2%; P < .001), an increase in emergency surgeries for males (31.7% vs 41.2%; P = .017), an increase in trocar hernia repairs (16% vs 26.2%; P < .0001), a reduction in suture repairs (2.8% vs 1.5%; P < .0001), and an increase in retromuscular techniques (36.4% vs 52.4%; P < .001) in open surgery with mesh. In elective surgery, there was a decrease in the average length of stay (4.9 vs 3.8 days; P < .0001), the percentage of complications (27.9% vs 24.0%; P < .0001), reoperations (3.5% vs 1.4%; P < .0001), and mortality (0.6% vs 0.2%; P = .002). Long-term outcomes included a decrease in recurrences after 12 months (20.7% vs 14.5%; P < .0001) and in chronic pain (13.7% vs 2.5%; P < .0001) and chronic infections (9.1% vs 14.5%; P < .0001) after 6 months. CONCLUSION In recent years, there has been a significant improvement in the outcomes of incisional hernia treatment. The registry serves as a fundamental tool for assessing the evolution of hernia treatment and enables the identification of key areas for improvement and the evaluation of treatment outcomes.
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Affiliation(s)
- J A Pereira-Rodríguez
- Servicio de Cirugía General, Hospital Universitari del Mar, Barcelona, Spain; Departament de Medicina i Ciéncies de la Vida, Universitat Pompeu Fabra, Barcelona, Spain.
| | | | - C Olona-Casa
- Departamento de Cirugía General y Digestiva, Hospital Universitario de Tarragona Joan XXIII, Spain
| | - M López-Cano
- Servicio de Cirugía General, Hospital Vall d'Hebrón, Spain; Departament de Cirurgia, Universitat Autònoma de Barcelona, Spain
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Phillips J, Murdin L, Khondoker M, Grant K, Shepstone L, Sims E, Rea P, Harcourt J. Cluster Analysis to Identify Clinical Subtypes of Ménière's Disease. Laryngoscope 2024. [PMID: 38183314 DOI: 10.1002/lary.31272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 11/22/2023] [Accepted: 12/22/2023] [Indexed: 01/08/2024]
Abstract
OBJECTIVE To identify distinct clinical subtypes of Ménière's disease by analyzing data acquired from a UK registry of patients who have been diagnosed with Ménière's disease. STUDY DESIGN Observational study. METHODS Patients with Ménière's disease were identified at secondary/tertiary care clinics. Cluster analysis was performed by grouping participants sharing similar characteristics and risk factors into groups based on a defined measure of similarity. RESULTS A total of 411 participants were recruited into this study. Two main clusters were identified: participants diagnosed with ear infections (OR = 0.30, p < 0.014, 95% CI: 0.11-0.78) were more likely to be allocated in Cluster 1 (C1). Participants reporting tinnitus in both ears (OR = 11.89, p < 0.001, 95% CI: 4.08-34.64), low pitched tinnitus (OR = 21.09, p < 0.001, 95% CI: 7.47-59.54), and those reporting stress as a trigger for vertigo attacks (OR = 14.94, p < 0.001, 95% CI: 4.54-49.10) were significantly more likely to be in Cluster 2 (C2). Also, participants diagnosed with Benign Paroxysmal Positional Vertigo (OR = 13.14, <0.001, 95% CI: 4.35-39.74), autoimmune disease (OR = 5.97, p < 0.007, 95% CI: 1.62-22.03), depression (OR = 4.72, p < 0.056, 95% CI: 0.96-23.24), migraines (OR = 3.13, p < 0.008, 95% CI: 1.34-7.26), drug allergy (OR = 3.25, p < 0.029, 95% CI: 1.13-9.34), and hay fever (OR = 3.12, p < 0.009, 95% CI: 1.33-7.34) were significantly more likely to be clustered in C2. CONCLUSIONS This study supports the hypothesis that Ménière's disease is a heterogeneous condition with subgroups that may be identifiable by clinical features. Two main clusters were identified with differing putative etiological factors. LEVEL OF EVIDENCE 3 Laryngoscope, 2024.
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Affiliation(s)
- John Phillips
- Department of Otolaryngology, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
| | - Louisa Murdin
- Department of Otolaryngology, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | | | - Kelly Grant
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Lee Shepstone
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Erika Sims
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Peter Rea
- Department of Otolaryngology, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Jonny Harcourt
- Department of Otolaryngology, Imperial College Healthcare NHS Trust, London, UK
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Shafiee F, Sarbaz M, Marouzi P, Banaye Yazdipour A, Kimiafar K. Providing a framework for evaluation disease registry and health outcomes Software: Updating the CIPROS checklist. J Biomed Inform 2024; 149:104574. [PMID: 38101688 DOI: 10.1016/j.jbi.2023.104574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 11/27/2023] [Accepted: 12/08/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND AND AIMS Properly designed and implemented registry systems play an important role in improving health outcomes and reducing care costs, and can provide a true representation of clinical practice, disease outcomes, safety, and efficacy. Therefore, the aim of this study was to redesign and develop a checklist with items for a patient registry software system (CIPROS) Checklist. METHOD The study is descriptive-cross-sectional. The extraction of the data elements of the checklist was first done through a comprehensive review of the texts in PubMed, Science Direct and Scopus databases and receiving articles related to the evaluation of registry systems. Based on the extracted data, a five-point Likert scale questionnaire was created and 30 experts in this field were asked for their opinions using the two-step Delphi method. RESULTS A total of 100 information items were determined as a registry software evaluation checklist. This checklist included 12 groups of software architecture factors, development, interfaces and interactivity, semantics and standardization, internationality, data management, data quality and usability, data analysis, security, privacy, organizational, education and public factors. CONCLUSION By using the results of this research, it is possible to identify the defects and possible strengths of the registry software and put it at the disposal of the relevant officials to make a decision in this field. In this way, among the designers and developers of these softwares, the best and most appropriate ones are selected with the needs of the registry programs.
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Affiliation(s)
- Fatemeh Shafiee
- Department of Health Information Technology, School of Paramedical and Rehabilitation Sciences, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Masoume Sarbaz
- Department of Health Information Technology, School of Paramedical and Rehabilitation Sciences, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Parviz Marouzi
- Department of Health Information Technology, School of Paramedical and Rehabilitation Sciences, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Alireza Banaye Yazdipour
- Department of Health Information Technology, School of Paramedical and Rehabilitation Sciences, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Health Information Management and Medical Informatics, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran; Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran.
| | - Khalil Kimiafar
- Department of Health Information Technology, School of Paramedical and Rehabilitation Sciences, Mashhad University of Medical Sciences, Mashhad, Iran.
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Abstract
PROLOGUE: Glaucoma surgery has been, for many decades now, dominated by the universal gold standard which is trabeculectomy augmented with antimetabolites. Tubes also came into the scene to complement what we use to call conventional or traditional glaucoma surgery. More recently we experienced a changing glaucoma surgery environment with the "advent" of what we have become used to calling Minimally Invasive Glaucoma Surgery (MIGS). What is the unmet need, what is the gap that these newcomers aim to fill? Hippocrates taught us "bring benefit, not harm" and new glaucoma techniques and devices aim to provide safer surgery compared to conventional surgery. For the patient, but also for the clinician, safety is important. Is more safety achieved with new glaucoma surgery and, if so, is it associated with better, equivalent, or worse efficacy? Is new glaucoma surgery intended to replace conventional surgery or to complement it as an 'add-on' to what clinicians already have in their hands to manage glaucoma? Which surgery should be chosen for which patient? What are the options? Are they equivalent? These are too many questions for the clinician! What are the answers to the questions? What is the evidence to support answers? Do we need more evidence and how can we produce high-quality evidence? This EGS Guide explores the changing and challenging glaucoma surgery environment aiming to provide answers to these questions. The EGS uses four words to highlight a continuum: Innovation, Education, Communication, and Implementation. Translating innovation to successful implementation is crucially important and requires high-quality evidence to ensure steps forward to a positive impact on health care when it comes to implementation. The vision of EGS is to provide the best possible well-being and minimal glaucomainduced visual disability in individuals with glaucoma within an affordable healthcare system. In this regard, assessing the changes in glaucoma surgery is a pivotal contribution to better care. As mentioned, this Guide aims to provide answers to the crucial questions above. However, every clinician is aware that answers may differ for every person: an individualised approach is needed. Therefore, there will be no uniform answer for all situations and all patients. Clinicians would need, through the clinical method and possibly some algorithm, to reach answers and decisions at the individual level. In this regard, evidence is needed to support clinicians to make decisions. Of key importance in this Guide is to provide an overview of existing evidence on glaucoma surgery and specifically on recent innovations and novel devices, but also to set standards in surgical design and reporting for future studies on glaucoma surgical innovation. Designing studies in surgery is particularly challenging because of many subtle variations inherent to surgery and hence multiple factors involved in the outcome, but even more because one needs to define carefully outcomes relevant to the research question but also to the future translation into clinical practice. In addition this Guide aims to provide clinical recommendations on novel procedures already in use when insufficient evidence exists. EGS has a long tradition to provide guidance to the ophthalmic community in Europe and worldwide through the EGS Guidelines (now in their 5th Edition). The EGS leadership recognized that the changing environment in glaucoma surgery currently represents a major challenge for the clinician, needing specific guidance. Therefore, the decision was made to issue this Guide on Glaucoma Surgery in order to help clinicians to make appropriate decisions for their patients and also to provide the framework and guidance for researchers to improve the quality of evidence in future studies. Ultimately this Guide will support better Glaucoma Care in accordance with EGS's Vision and Mission. Fotis Topouzis EGS President
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Affiliation(s)
| | - Gordana Sunaric Mégevand
- Eye Research Centre, Adolphe de Rothschild Hospital, Geneva, Switzerland and Centre Ophtalmologique de Florissant, Geneva, Switzerland
| | - Ingeborg Stalmans
- Ingeborg Stalmans, University Hospitals UZ Leuven, Catholic University KU Leuven
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Serban AM, Ionescu NS. Surgical patient registries: scoping study of challenges and solutions. J Public Health Policy 2023; 44:523-534. [PMID: 37726394 DOI: 10.1057/s41271-023-00442-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2023] [Indexed: 09/21/2023]
Abstract
Patient surgical registries are essential tools for public health specialists, creating research opportunities through linkage of registry data with healthcare outcomes. However, little is known regarding data error sources in the management of surgical registries. In June 2022, we undertook a scoping study of the empirical literature including publications selected from the PUBMED and EMBASE databases. We selected 48 studies focussing on shared experiences centred around developing surgical patient registries. We identified seven types of data specific challenges, grouped in three categories- data capture, data analysis and result dissemination. Most studies underlined the risk for a high volume of missing data, non-uniform geographic representation, inclusion biases, inappropriate coding, as well as variations in analysis reporting and limitations related to the statistical analysis. Finally, to expand data usability, we discussed cost-effective ways of addressing these limitations, by citing aspects from the protocols followed by established exemplary registries.
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Affiliation(s)
- Andreea Madalina Serban
- Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474, Bucharest, Romania.
- Maria Sklodowska Curie Emergency Hospital for Children, 20 Brancoveanu Blvd., 077120, Bucharest, Romania.
| | - Nicolae Sebastian Ionescu
- Carol Davila University of Medicine and Pharmacy, 8 Eroii Sanitari Blvd., 050474, Bucharest, Romania
- Maria Sklodowska Curie Emergency Hospital for Children, 20 Brancoveanu Blvd., 077120, Bucharest, Romania
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Aruparayil N, Gnanaraj J, Mishra A, Bains L, Corrigan N, Brown J, Ensor T, King R, Shinkins B, Jayne D. Gasless laparoscopy in rural India-registry outcomes and evaluation of the learning curve. Surg Endosc 2023; 37:8227-8235. [PMID: 37653156 PMCID: PMC10615921 DOI: 10.1007/s00464-023-10392-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 08/13/2023] [Indexed: 09/02/2023]
Abstract
BACKGROUND A program of gasless laparoscopy (GL) has been implemented in rural North-East India. To facilitate safe adoption, participating rural surgeons underwent rigorous training prior to independent clinical practice. An online registry was established to capture clinical data on safety and efficacy and to evaluate initial learning curves for gasless laparoscopy. METHODS Surgeons who had completed the GL training program participated in the online RedCap Registry. Patients included in the registry provided informed consent for the use of their data. Data on operative times, conversion rates, perioperative complications, length of stay, and hospital costs were collected. Fixed reference cumulative sum (CUSUM) model was used to evaluate the learning curve based on operative times and conversion rates published in the literature. RESULTS Four surgeons from three rural hospitals in North-East India participated in the registry. The data were collected over 12 months, from September 2019 to August 2020. One hundred and twenty-three participants underwent GL procedures, including 109 females (88.6%) and 14 males. GL procedures included cholecystectomy, appendicectomy, tubal ligation, ovarian cystectomy, diagnostic laparoscopy, and adhesiolysis. The mean operative time was 75.3 (42.05) minutes for all the surgeries. Conversion from GL to open surgery occurred in 11.4% of participants, with 8.9% converted to conventional laparoscopy. The main reasons for conversion were the inability to secure an operative view, lack of operating space, and adhesions. The mean length of stay was 3 (2.1) days. The complication rate was 5.7%, with one postoperative death. The CUSUM analysis for GL cholecystectomy showed a longer learning curve for operative time and few conversions. The learning curve for GL tubal ligation was relatively shorter. CONCLUSION Gasless laparoscopy can be safely implemented in the rural settings of Northeast India with appropriate training programs. Careful case selection is essential during the early stages of the surgical learning curve.
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Affiliation(s)
- N Aruparayil
- Leeds Institute of Medical Research, University of Leeds, Leeds, UK.
- St. James's University Hospital, Level 7, Clinical Sciences Building, Leeds, LS9 7TF, UK.
| | | | - A Mishra
- Maulana Azad Medical College, Delhi, India
| | - L Bains
- Maulana Azad Medical College, Delhi, India
| | - N Corrigan
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | - J Brown
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | - T Ensor
- Nuffield Centre for International Health and Development, University of Leeds, Leeds, UK
| | - R King
- Nuffield Centre for International Health and Development, University of Leeds, Leeds, UK
| | - B Shinkins
- Academic Unit of Health Economics, University of Leeds, Leeds, UK
- Division of Health Sciences, University of Warwick, Coventry, UK
| | - D Jayne
- Leeds Institute of Medical Research, University of Leeds, Leeds, UK
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Pascucci S, Langella F, Franzò M, Tesse MG, Ciminello E, Biondi A, Carrani E, Sampaolo L, Zanoli G, Berjano P, Torre M. National spine surgery registries' characteristics and aims: globally accepted standards have yet to be met. Results of a scoping review and a complementary survey. J Orthop Traumatol 2023; 24:49. [PMID: 37715871 PMCID: PMC10505129 DOI: 10.1186/s10195-023-00732-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 08/15/2023] [Indexed: 09/18/2023] Open
Abstract
BACKGROUND Surgery involving implantable devices is widely used to solve several health issues. National registries are essential tools for implantable device surveillance and vigilance. In 2017, the European Union encouraged Member States to establish "registries and databanks for specific types of devices" to evaluate device safety and performance and ensure their traceability. Spine-implantable devices significantly impact patient safety and public health; spine registries might help improve surgical outcomes. This study aimed to map existing national spine surgery registries and highlight their features and organisational standards to provide an essential reference for establishing other national registries. METHODS A scoping search was performed using the Embase, PubMed/Medline, Scopus, and Web of Science databases for the terms "registry", "register", "implantable", and all terms and synonyms related to spinal diseases and national registries in publications from January 2000 to December 2020. This search was later updated and finalised through a web search and an ad hoc survey to collect further detailed information. RESULTS Sixty-two peer-reviewed articles were included, which were related to seven national spine registries, six of which were currently active. Three additional active national registries were found through the web search. The nine selected national registries were set up between 1998 and 2021. They collect data on the procedure and use patient-reported outcome measures (PROMs) for the follow-up. CONCLUSION Our study identified nine currently active national spine surgery registries. However, globally accepted standards for developing a national registry of spine surgery are yet to be established. Therefore, an international effort to increase result comparability across registries is highly advisable. We hope the recent initiative from the Orthopaedic Data Evaluation Panel (ODEP) to establish an international collaboration will meet these needs.
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Affiliation(s)
- Simona Pascucci
- Scientific Secretariat of the President's Office, Italian National Institute of Health, Istituto Superiore di Sanità, Viale Regina Elena, 299, 00161, Rome, Italy
- Department of Mechanical and Aerospace Engineering, La Sapienza University of Rome, Rome, Italy
| | | | - Michela Franzò
- Department of Medico-Surgical Sciences and Biotechnologies, Rome, Italy
| | - Marco Giovanni Tesse
- Orthopaedics Section, Department of Neuroscience and Organs of Sense, Faculty of Medicine and Surgery, University of Bari, AOU Consorziale Policlinico, 70124, Bari, Italy
| | - Enrico Ciminello
- Scientific Secretariat of the President's Office, Italian National Institute of Health, Istituto Superiore di Sanità, Viale Regina Elena, 299, 00161, Rome, Italy
| | - Alessia Biondi
- Scientific Secretariat of the President's Office, Italian National Institute of Health, Istituto Superiore di Sanità, Viale Regina Elena, 299, 00161, Rome, Italy
| | - Eugenio Carrani
- Scientific Secretariat of the President's Office, Italian National Institute of Health, Istituto Superiore di Sanità, Viale Regina Elena, 299, 00161, Rome, Italy
| | - Letizia Sampaolo
- National Centre for Disease Prevention and Health Promotion, Italian National Institute of Health, Rome, Italy
| | | | | | - Marina Torre
- Scientific Secretariat of the President's Office, Italian National Institute of Health, Istituto Superiore di Sanità, Viale Regina Elena, 299, 00161, Rome, Italy.
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Lovett A, Eastwood M, Metcalfe C, Muzaffar J, Monksfield P, Bance M. Outcomes of Cochlear implantation in early-deafened patients with Waardenburg syndrome: A systematic review and narrative synthesis. Laryngoscope Investig Otolaryngol 2023; 8:1094-1107. [PMID: 37621295 PMCID: PMC10446317 DOI: 10.1002/lio2.1110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 05/23/2023] [Accepted: 06/17/2023] [Indexed: 08/26/2023] Open
Abstract
Objective This systematic review aims to establish the expected hearing and speech outcomes following cochlear implantation (CI) in patients with profound congenital deafness secondary to Waardenburg syndrome (WS). Methods A systematic review of the literature and narrative synthesis was performed in accordance with the PRISMA statement. Databases searched: Medline, Pubmed, Embase, Web of Science, Cochrane Collection, and ClinicalTrials.gov. No limits were placed on language or year of publication. Results Searches identified 186 abstracts and full texts. Of these, 16 studies met inclusion criteria reporting outcomes in 179 patients and at least 194 implants. Hearing outcomes of those receiving cochlear implantation were generally good. Five studies included genetic analysis of one or more of the participants. A total of 11 peri/post-operative complications were reported. The methodological quality of included studies was modest, mainly comprising noncontrolled case series with small cohort size. All studies were OCEBM grade III-IV. Conclusion Cochlear implantation in congenitally deafened children with Waardenburg Syndrome is a well-established intervention as a method of auditory rehabilitation. Due to the uncommon nature of the condition, there is a lack of large-scale high-quality studies examining the use of cochlear implantation in this patient group. However, overall outcomes following implantation are positive with the majority of patients demonstrating improved audiometry, speech perception and speech intelligibility supporting its use in appropriately selected cases.
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Affiliation(s)
- Amy Lovett
- Royal Stoke University HospitalStoke on TrentUK
| | | | - Chris Metcalfe
- Royal Stoke University HospitalStoke on TrentUK
- University Hospitals Birmingham NHS Foundation TrustQueen Elizabeth Hospital BirminghamEdgbastonUK
| | - Jameel Muzaffar
- University Hospitals Birmingham NHS Foundation TrustQueen Elizabeth Hospital BirminghamEdgbastonUK
- Department of Clinical NeurosciencesUniversity of CambridgeCambridgeUK
| | - Peter Monksfield
- University Hospitals Birmingham NHS Foundation TrustQueen Elizabeth Hospital BirminghamEdgbastonUK
| | - Manohar Bance
- Department of Clinical NeurosciencesUniversity of CambridgeCambridgeUK
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Kifle F, Kifleyohanes T, Moore J, Teshome A, Biccard BM. Indications, Challenges, and Characteristics of Successful Implementation of Perioperative Registries in Low Resource Settings: A Systematic Review. World J Surg 2023; 47:1387-1396. [PMID: 36656359 PMCID: PMC10156757 DOI: 10.1007/s00268-023-06909-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/25/2022] [Indexed: 01/20/2023]
Abstract
Perioperative registries can be utilised to track outcomes, develop risk prediction models, and make evidence-based decisions and interventions. To better understand and support initiatives to establish clinical registries, this study aimed to assess the indications, challenges, and characteristics of successful perioperative registries in low-resource settings, where there is unmet surgical demand and patients have a mortality rate up to double that of high-income countries. We conducted a librarian-assisted literature search of international research databases of articles published between January 1969 and January 2021. Studies were filtered using predefined criteria and responses to two Mixed Method Appraisal Tool screening questions. A Direct Content Analysis Method was used to synthesis. e data for eligible studies based on predefined criteria. The search identified 2793 abstracts. After removing duplicates and excluding studies that did not meet eligibility criteria, twelve studies were included, conducted in South America (n = 4), Africa (n = 5), the Middle East (n = 2), and Asia (n = 1). The lack of context-specific data for determining and evaluating patient outcomes (n = 7) was the major indication for implementation. Organising local research teams and engaging stakeholders in the host country were associated with successful implementation. Inadequate funding for data collectors and monitoring data quality were identified as challenges (n = 4). The goal of a perioperative registry is to generate data to influence and support quality improvement, and national surgical policies. Efforts to establish perioperative registries in low- and middle-income countries should engage local teams and stakeholders and seek to overcome challenges in data collection and monitoring.
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Affiliation(s)
- Fitsum Kifle
- Division of Global Surgery, University of Cape Town (UCT), Cape Town, South Africa. .,College of Medicine, Asrat Weldyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia. .,African Perioperative Research Group, Network for Perioperative and Critical Care (APORG-N4PCc), Addis Ababa, Ethiopia.
| | - Tewodros Kifleyohanes
- College of Medicine, Asrat Weldyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia.,African Perioperative Research Group, Network for Perioperative and Critical Care (APORG-N4PCc), Addis Ababa, Ethiopia
| | - Jolene Moore
- College of Medicine, Asrat Weldyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia.,School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK.,African Perioperative Research Group, Network for Perioperative and Critical Care (APORG-N4PCc), Addis Ababa, Ethiopia
| | | | - Bruce M Biccard
- Division of Global Surgery, University of Cape Town (UCT), Cape Town, South Africa.,African Perioperative Research Group, Network for Perioperative and Critical Care (APORG-N4PCc), Addis Ababa, Ethiopia.,Department of Anaesthesia and Perioperative Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, Western Cape, South Africa
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Oomen L, De Wall LL, Krupka K, Tönshoff B, Wlodkowski T, Van Der Zanden LFM, Bonthuis M, Duus Weinreich ID, Koster-Kamphuis L, Feitz WFJ, Bootsma-Robroeks CMHHT. The strengths and complexities of European registries concerning paediatric kidney transplantation health care. Front Pediatr 2023; 11:1121282. [PMID: 37033192 PMCID: PMC10073744 DOI: 10.3389/fped.2023.1121282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 03/01/2023] [Indexed: 04/11/2023] Open
Abstract
Introduction Patient data are increasingly available in (multi)national registries, especially for rare diseases. This study aims to provide an overview of current European registries of paediatric kidney transplantation (PKT) care, their coverage, and their focus. Based on these data, we assess whether the current status is optimal for achieving our common goal: the optimalisation of health care. Methods A list of all PKT centres within the European Union (EU) as well as active PKT registries was compiled using existing literature and the European Platform on Rare Disease Registration. Registry staff members were contacted to obtain information about the parameters collected and the registry design. These data were compared between registries. Results In total, 109 PKT centres performing PKT surgery were identified in the 27 EU Member States. Currently, five European PKT registries are actively collecting data. In 39% of these centres, no data were registered within any of these five existing international registries. A large variety was observed in the number of patients, centres, and countries involved in the registries. Furthermore, variability existed regarding the inclusion criteria, definitions used, and parameters collected. Collection of perioperative urologic data are currently underrepresented in the registries. Discussion Currently, multiple registries are collecting valuable information in the field of PKT, covering the majority of PKT centres in Europe. Due to a large variety in the parameters collected as well as different focuses, data collection is currently fragmented and suboptimal; therefore, the current existing data are incomplete. In addition, a considerable proportion of the transplantation centres do not enter data in any international registry. Combining available information and harmonising future data collection could empower the aim of these registries-namely increasing insights into the strengths and potential of current care and therefore improve healthcare.
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Affiliation(s)
- Loes Oomen
- Division of Paediatric Urology, Department of Urology, Radboudumc Amalia Children’s Hospital, Nijmegen, Netherlands
- Correspondence: Loes Oomen
| | - Liesbeth L. De Wall
- Division of Paediatric Urology, Department of Urology, Radboudumc Amalia Children’s Hospital, Nijmegen, Netherlands
| | - Kai Krupka
- CERTAIN Registry, Department of Paediatrics I, University Children's Hospital Heidelberg, Heidelberg, Germany
| | - Burkhard Tönshoff
- CERTAIN Registry, Department of Paediatrics I, University Children's Hospital Heidelberg, Heidelberg, Germany
| | - Tanja Wlodkowski
- ERKReg, Division of Paediatric Nephrology, Centre for Pediatrics and Adolescent Medicine, University of Heidelberg, Heidelberg, Germany
| | | | - Marjolein Bonthuis
- ESPN/ERA Registry, Department of Medical Informatics, Amsterdam UMC Location University of Amsterdam, Amsterdam, Netherlands
- Department Quality of Care, Amsterdam Public Health, Quality of Care, Amsterdam, Netherlands
| | - Ilse D. Duus Weinreich
- Department of Clinical Medicine, Scandiatransplant, Aarhus University Hospital, Aarhus, Denmark
| | - Linda Koster-Kamphuis
- Department of Paediatric Nephrology, Radboudumc Amalia Children’s Hospital, Nijmegen, Netherlands
| | - Wout FJ Feitz
- Division of Paediatric Urology, Department of Urology, Radboudumc Amalia Children’s Hospital, Nijmegen, Netherlands
| | - Charlotte MHHT Bootsma-Robroeks
- Department of Paediatric Nephrology, Radboudumc Amalia Children’s Hospital, Nijmegen, Netherlands
- Department of Paediatrics, Paediatric Nephrology, University of Groningen, University Medical Centre Groningen, Beatrix Children’s Hospital, Groningen, Netherlands
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12
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Hinchliffe RJ. Tracking the performance of endovascular devices. BMJ 2022; 379:o2448. [PMID: 36283725 DOI: 10.1136/bmj.o2448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Robert J Hinchliffe
- Department of Vascular Surgery, University of Bristol & North Bristol NHS trust, Bristol, UK
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13
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Hernández-Granados P, Pereira Rodríguez JA, Gimeno López M. Registries and databases: How can we use them? Cir Esp 2022; 100:517-519. [PMID: 35580753 DOI: 10.1016/j.cireng.2021.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 10/25/2021] [Indexed: 06/15/2023]
Affiliation(s)
- Pilar Hernández-Granados
- Unidad de Cirugía General, Hospital Universitario Fundación Alcorcón, Universidad Rey Juan Carlos, Alcorcón, Spain.
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Abstract
ABSTRACT Nowadays, several options are available to treat patients with conductive or mixed hearing loss. Whenever surgical intervention is not possible or contra-indicated, and amplification by a conventional hearing device (e.g., behind-the-ear device) is not feasible, then implantable hearing devices are an indispensable next option. Implantable bone-conduction devices and middle-ear implants have advantages but also limitations concerning complexity/invasiveness of the surgery, medical complications, and effectiveness. To counsel the patient, the clinician should have a good overview of the options with regard to safety and reliability as well as unequivocal technical performance data. The present consensus document is the outcome of an extensive iterative process including ENT specialists, audiologists, health-policy scientists, and representatives/technicians of the main companies in this field. This document should provide a first framework for procedures and technical characterization to enhance effective communication between these stakeholders, improving health care.
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15
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Lazem M, Sheikhtaheri A. Barriers and facilitators for disease registry systems: a mixed-method study. BMC Med Inform Decis Mak 2022; 22:97. [PMID: 35410297 PMCID: PMC9004114 DOI: 10.1186/s12911-022-01840-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 04/05/2022] [Indexed: 11/17/2022] Open
Abstract
Background A Disease Registry System (DRS) is a system that collects standard data on a specific disease with an organized method for specific purposes in a population. Barriers and facilitators for DRSs are different according to the health system of each country, and identifying these factors is necessary to improve DRSs, so the purpose of this study was to identify and prioritize these factors. Methods First, by conducting 13 interviews with DRS specialists, barriers and facilitators for DRSs were identified and then, a questionnaire was developed to prioritize these factors. Then, 15 experts answered the questionnaires. We prioritized these factors based on the mean of scores in four levels including first priority (3.76–5), second priority (2.51–3.75), third priority (1.26–2.50), and the fourth priority (1–1.25). Results At first, 139 unique codes (63 barriers and 76 facilitators) were extracted from the interviews. We classified barriers into 9 themes, including management problems (24 codes), data collection-related problems (8 codes), poor cooperation/coordination (7 codes), technological problems and lack of motivation/interest (6 codes for each), threats to ethics/data security/confidentiality (5 codes), data quality-related problems (3 codes), limited patients’ participation and lack of or non-use of standards (2 codes for each). We also classified facilitators into 9 themes including management facilitators (36 codes), improving data quality (8 codes), proper data collection and observing ethics/data security/confidentiality (7 codes for each), appropriate technology (6 codes), increasing patients’ participation, increasing motivation/interest, improving cooperation/coordination, and the use of standards (3 codes for each). The first three ranked barriers based on mean scores included poor stakeholder cooperation/coordination (4.30), lack of standards (4.26), and data quality-related problems (4.06). The first three ranked facilitators included improving data quality (4.54), increasing motivation/interest (4.48), and observing ethics/data security/confidentiality (4.36). Conclusion Stakeholders’ coordination, proper data management, standardization and observing ethics, security/confidentiality are the most important areas for planning and investment that managers must consider for the continuation and success of DRSs. Supplementary Information The online version contains supplementary material available at 10.1186/s12911-022-01840-7.
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Affiliation(s)
- Mina Lazem
- Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Abbas Sheikhtaheri
- Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
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16
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Baumgarten C, Lazard A, Magro E, Roche P, Hamel O, Haegelen C, De Schlichting E. Results of a French pilot database of standard of care of chronic subdural hematoma. Neurochirurgie 2022. [DOI: 10.1016/j.neuchi.2022.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 01/24/2022] [Accepted: 01/25/2022] [Indexed: 11/18/2022]
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17
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Lazem M, Sheikhtaheri A. Barriers and facilitators for the implementation of health condition and outcome registry systems: a systematic literature review. J Am Med Inform Assoc 2022; 29:723-734. [PMID: 35022765 PMCID: PMC8922163 DOI: 10.1093/jamia/ocab293] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 09/29/2021] [Accepted: 12/27/2021] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE Health condition and outcome registry systems (registries) are used to collect data related to diseases and other health-related outcomes in specific populations. The implementation of these programs encounters various barriers and facilitators. Therefore, the present review aimed to identify and classify these barriers and facilitators. MATERIALS AND METHODS Some databases, including PubMed, Embase, ISI Web of Sciences, Cochrane Library, Scopus, Ovid, ProQuest, and Google Scholar, were searched using related keywords. Thereafter, based on the inclusion and exclusion criteria, the required data were collected using a data extraction form and then analyzed by the content analysis method. The obtained data were analyzed separately for research and review studies, and the developed and developing countries were compared. RESULTS Forty-five studies were reviewed and 175 unique codes were identified, among which 93 barriers and 82 facilitators were identified. Afterward, these factors were classified into the following 7 categories: barriers/facilitators to management and data management, poor/improved collaborations, technological constraints/appropriateness, barriers/facilitators to legal and regulatory factors, considerations/facilitators related to diseases, and poor/improved patients' participation. Although many of these factors have been more cited in the literature related to the developing countries, they were found to be common in both developed and developing countries. CONCLUSION Lack of budget, poor performance of managers, low data quality, and low stakeholders' interest/motivation on one hand, and financing, providing adequate training, ensuring data quality, and appropriate data collection on the other hand were found as the most common barriers or facilitators for the success of the registry implementation.
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Affiliation(s)
- Mina Lazem
- Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Abbas Sheikhtaheri
- Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran,Health Management and Economics Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran,Corresponding Author: Abbas Sheikhtaheri, PhD, Health Management and Economics Research Center, Health Management Research Institute, Iran University of Medical Sciences, Yasemi St, Valiasr Ave, Tehran, Iran;
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18
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Moore CJS, Avery KNL, Young A, Hinchliffe RJ, Griffin XL, Potter S. Mapping the Landscape of Surgical Registries in the United Kingdom: A Review According to the SWiM Methodology. Int J Surg Protoc 2021; 25:257-261. [PMID: 35083395 PMCID: PMC8719474 DOI: 10.29337/ijsp.169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 12/18/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Well-designed surgical registries are essential for high-quality patient centred evaluation of implantable devices and surgical procedures. The importance of registries was highlighted in the recent Cumberlege report that detailed important innovation failures such as the use of vaginal mesh. Many surgical registries exist, but it is currently unclear how different registries are funded, governed, designed, and how their databases are hosted and utilised. There is therefore a need to understand the variation and characteristics of existing surgical registries to identify limitations and make recommendations for improvement. This work aims to understand the characteristics and heterogeneity in the design, governance, and function of existing surgical registries in the United Kingdom (UK). METHODS Existing surgical registries will be identified using multiple data sources including surgical society websites; search engine review; a targeted search of the Medline and Embase databases and expert knowledge. The data identified were reviewed following the synthesis without meta-analysis (SWiM) methodology. This information will be gathered from sources in the public domain only to fully understand registry transparency for professionals and the public. Details of each registry including disease area/condition/device evaluated; types of outcomes collected; governance, consent, and oversight; linkage to other datasets and funding will be extracted using a standardised data extraction tool. Characteristics of identified registries will be summarised into a narrative review. DISSEMINATION Findings will be presented at national and international conferences and published in peer-reviewed journals. Results will be presented to key stakeholders including surgeons, methodologists, trialists, regulators, data managers and patients to provide an up-to-date description of the current state of surgical registries in the UK. This work will inform a consensus process to agree how the design of new and existing registries can be optimised to support high quality research to benefit patients and the NHS. HIGHLIGHTS Well-designed surgical registries are essential for high-quality patient centred evaluation of implantable devices and surgical proceduresPresently there is limited understanding on how these registries are designed, governed, what data they collect and how this data is utilised for research.This review aims to map the landscape of surgical registries in the UK, and understand how they are optimised for research.
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Affiliation(s)
- Connor J. S. Moore
- Bristol Centre for Surgical Research, Bristol Medical School, Department of Population Health Sciences, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, United Kingdom
| | - Kerry N. L. Avery
- Bristol Centre for Surgical Research, Bristol Medical School, Department of Population Health Sciences, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, United Kingdom
| | - Amber Young
- Bristol Centre for Surgical Research, Bristol Medical School, Department of Population Health Sciences, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, United Kingdom
| | - Robert J. Hinchliffe
- Bristol Centre for Surgical Research, Bristol Medical School, Department of Population Health Sciences, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, United Kingdom
| | - Xavier L. Griffin
- Barts Bone and Joint Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
- Department of Trauma and Orthopaedic Surgery, Barts Health NHS Trust, London, UK
| | - Shelley Potter
- Bristol Centre for Surgical Research, Bristol Medical School, Department of Population Health Sciences, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, United Kingdom
- Bristol Breast Care Centre Southmead Hospital, Southmead Road, Westbury-on-Trym, Bristol, BS10 5NB, UK
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19
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Goodney PP. Building Systems to Measure Success and Improve Outcomes in Dialysis Access-Not a "Steal" but Probably a Bargain. JAMA Surg 2021; 156:1119. [PMID: 34550321 DOI: 10.1001/jamasurg.2021.4528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Philip P Goodney
- Heart and Vascular Center, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
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20
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Hernández-Granados P, Pereira Rodríguez JA, Gimeno López M. Registros y bases de datos: ¿Cómo utilizarlos? Cir Esp 2021. [DOI: 10.1016/j.ciresp.2021.10.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Abstract
Poisoning, as a well-known medical condition, puts everyone at risk. As a data management tool, a registry plays an important role in monitoring the poisoned patients. Having a poisoning minimum data set is a major requirement for creating a poisoning registry. Therefore, the present systematic review was conducted in 2019 to identify the minimum data set for a poisoning registry. Searches were performed in four scientific databases, i.e., PubMed, Scopus, Web of Science, and Embase. The keywords used in the searches included minimum data set, "poison", and "registry". Two researchers independently evaluated the titles, abstracts, and texts of the papers. The data were collected from the related papers. Ultimately, the minimum data set was identified for the poisoning registry. Data elements extracted from the sources were classified into two general categories: administrative data and clinical data. Ninety-eight data elements in the administrative data category were subdivided into three sections: general data, admission data, and discharge data. One-hundred and thirty-one data elements in the clinical data category were subdivided into five sections: clinical observation data, clinical assessment data, past medical history data, diagnosis data, and treatment plan data. The minimum data set is a prerequisite for creating and using a poisoning registry and data system. It is suggested to evaluate and use the poisoning minimum data set in accordance with the national laws, needs, and standards based on the opinion of the local experts.
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Affiliation(s)
- Azam Sabahi
- Department of Health Information Technology and Management, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Ferdows Chamran Hospital, Birjand University of Medical Sciences, South Khorasan, Iran
| | - Farkhondeh Asadi
- Department of Health Information Technology and Management, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shahin Shadnia
- Toxicological Research Center, Department of Clinical Toxicology, Loghman Hakim Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reza Rabiei
- Department of Health Information Technology and Management, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Azamossadat Hosseini
- Department of Health Information Technology and Management, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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22
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Thomas JD, Fafaj A, Zolin SJ, Rosen MJ, Lipman JM, French JC, Prabhu AS, Krpata DM, Rosenblatt S, Horne CM, Khandelwal C, Petro CC. Registry-based Trainee Assessments: Leveraging a Quality Collaborative for Surgical Education. J Surg Res 2021; 268:136-144. [PMID: 34311295 DOI: 10.1016/j.jss.2021.06.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 06/08/2021] [Accepted: 06/11/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION We present our experience developing and embedding a registry-based module for resident feedback. METHODS At our institution, entering operative data into the institutional quality collaborative registry is standard practice. In February 2019, a surgical education module was embedded into the registry to capture procedure-specific resident operative assessments. Faculty engagement with the sugical education module was assessed during its first year in existence (February 2019-February 2020). RESULTS In total, 1074 of 1269 (85%) operative assessments were completed by 27 faculty via the surgical education registry module. Median faculty engagement rate with the module following resident-assisted procedures was 91% [IQR 76%-100%]. Residents received a median of 7 operative assessments [IQR 2-19] over the study period. CONCLUSION By embedding a surgical education module into an existing surgical quality collaborative registry, procedure-specific operative assessments can be routinely captured.
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Affiliation(s)
- Jonah D Thomas
- Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio
| | - Aldo Fafaj
- Department of General Surgery, Cleveland Clinic, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Samuel J Zolin
- Department of General Surgery, Cleveland Clinic, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Michael J Rosen
- Department of General Surgery, Cleveland Clinic, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Jeremy M Lipman
- Department of General Surgery, Cleveland Clinic, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Judith C French
- Department of General Surgery, Cleveland Clinic, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Ajita S Prabhu
- Department of General Surgery, Cleveland Clinic, Cleveland Clinic Foundation, Cleveland, Ohio
| | - David M Krpata
- Department of General Surgery, Cleveland Clinic, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Steven Rosenblatt
- Department of General Surgery, Cleveland Clinic, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Charlotte M Horne
- Department of General Surgery, Cleveland Clinic, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Cathleen Khandelwal
- Department of General Surgery, Cleveland Clinic, Cleveland Clinic Foundation, Cleveland, Ohio
| | - Clayton C Petro
- Department of General Surgery, Cleveland Clinic, Cleveland Clinic Foundation, Cleveland, Ohio.
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Naemi R, Barikani HR, Shahmoradi L. Dental implant quality registries and databases: A systematic review. J Educ Health Promot 2021; 10:214. [PMID: 34395651 PMCID: PMC8318161 DOI: 10.4103/jehp.jehp_1302_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 10/09/2020] [Indexed: 06/13/2023]
Abstract
BACKGROUND The importance of dental implant quality register has been well-documented. However, no systematic review conducted on dental implant quality register can be found in the literature. Therefore, the purpose of this study was to study the existed dental implant quality registries to explain the goals, data elements, and reports of dental implant quality registries. MATERIALS AND METHODS This systematic study was conducted in PubMed, Scopus, Web of Science, and Embase databases. For evaluating dental implant quality registers, all studies in the English language were examined with no time limitation. Case reports, conference abstracts, and letters to the editor were excluded. The analysis of the quality of the studies was done by the STrengthening the Reporting of OBservational studies in Epidemiology checklist. RESULTS The primary search identified 5565 articles. After eliminating duplicate articles and articles that did not meet the inclusion criteria and reviewing 40 full texts, 11 studies were included in this study. In this review, seven countries as Sweden, the USA, Canada, Germany, Finland, Australia, and South Korea had dental implant quality registers. Furthermore, the goals of dental implant quality registers were classified into the categories of research, epidemiology, administrative, clinical, and surveillance. CONCLUSION The results of this study provide dentists and other stakeholders useful information on the existed dental implant quality registers and databases worldwide. It also provides a framework of the goals, data elements, and reports of dental implant quality registry. The establishment of dental implant quality register will be beneficial for societies and also allows them to control the complications of dental implants in future.
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Affiliation(s)
- Roya Naemi
- Department of Health Information Management, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
- Department of Health Information Management, School of Paramedical Sciences, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Hamid Reza Barikani
- Dental Implant Research Center, Dental Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Shahmoradi
- Department of Health Information Management, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
- Halal Research Center of IRI, FDA, Tehran, Iran
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Reichold M, Dietzel N, Chmelirsch C, Kolominsky-Rabas PL, Graessel E, Prokosch HU. Designing and Implementing an IT Architecture for a Digital Multicenter Dementia Registry: digiDEM Bayern. Appl Clin Inform 2021; 12:551-563. [PMID: 34134149 PMCID: PMC8208839 DOI: 10.1055/s-0041-1731286] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Background
Registries are an essential research tool to investigate the long-term course of diseases and their impact on the affected. The project digiDEM Bayern will set up a prospective dementia registry to collect long-term data of people with dementia and their caregivers in Bavaria (Germany) supported by more than 300 research partners.
Objective
The objective of this article is to outline an information technology (IT) architecture for the integration of a registry and comprehensive participant management in a dementia study. Measures to ensure high data quality, study governance, along with data privacy, and security are to be included in the architecture.
Methods
The architecture was developed based on an iterative, stakeholder-oriented process. The development was inspired by the Twin Peaks Model that focuses on the codevelopment of requirements and architecture. We gradually moved from a general to a detailed understanding of both the requirements and design through a series of iterations. The experience learned from the pilot phase was integrated into a further iterative process of continuous improvement of the architecture.
Results
The infrastructure provides a standardized workflow to support the electronic data collection and trace each participant's study process. Therefore, the implementation consists of three systems: (1) electronic data capture system for Web-based or offline app-based data collection; (2) participant management system for the administration of the identity data of participants and research partners as well as of the overall study governance process; and (3) videoconferencing software for conducting interviews online. First experiences in the pilot phase have proven the feasibility of the framework.
Conclusion
This article outlines an IT architecture to integrate a registry and participant management in a dementia research project. The framework was discussed and developed with the involvement of numerous stakeholders. Due to its adaptability of used software systems, a transfer to other projects should be easily possible.
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Affiliation(s)
- Michael Reichold
- Department of Medical Informatics, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Nikolas Dietzel
- Interdisciplinary Center for Health Technology Assessment (HTA) and Public Health (IZPH), Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Christina Chmelirsch
- Interdisciplinary Center for Health Technology Assessment (HTA) and Public Health (IZPH), Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Peter L Kolominsky-Rabas
- Interdisciplinary Center for Health Technology Assessment (HTA) and Public Health (IZPH), Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Elmar Graessel
- Center for Health Services Research in Medicine, Department of Psychiatry and Psychotherapy, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Hans-Ulrich Prokosch
- Department of Medical Informatics, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
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Rocca A, Cipriani F, Belli G, Berti S, Boggi U, Bottino V, Cillo U, Cescon M, Cimino M, Corcione F, De Carlis L, Degiuli M, De Paolis P, De Rose AM, D'Ugo D, Di Benedetto F, Elmore U, Ercolani G, Ettorre GM, Ferrero A, Filauro M, Giuliante F, Gruttadauria S, Guglielmi A, Izzo F, Jovine E, Laurenzi A, Marchegiani F, Marini P, Massani M, Mazzaferro V, Mineccia M, Minni F, Muratore A, Nicosia S, Pellicci R, Rosati R, Russolillo N, Spinelli A, Spolverato G, Torzilli G, Vennarecci G, Viganò L, Vincenti L, Delrio P, Calise F, Aldrighetti L. The Italian Consensus on minimally invasive simultaneous resections for synchronous liver metastasis and primary colorectal cancer: A Delphi methodology. Updates Surg 2021; 73:1247-65. [PMID: 34089501 DOI: 10.1007/s13304-021-01100-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 05/12/2021] [Indexed: 12/17/2022]
Abstract
At the time of diagnosis synchronous colorectal cancer, liver metastases (SCRLM) account for 15-25% of patients. If primary tumour and synchronous liver metastases are resectable, good results may be achieved performing surgical treatment incorporated into the chemotherapy regimen. So far, the possibility of simultaneous minimally invasive (MI) surgery for SCRLM has not been extensively investigated. The Italian surgical community has captured the need and undertaken the effort to establish a National Consensus on this topic. Four main areas of interest have been analysed: patients' selection, procedures, techniques, and implementations. To establish consensus, an adapted Delphi method was used through as many reiterative rounds were needed. Systematic literature reviews were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses instructions. The Consensus took place between February 2019 and July 2020. Twenty-six Italian centres participated. Eighteen clinically relevant items were identified. After a total of three Delphi rounds, 30-tree recommendations reached expert consensus establishing the herein presented guidelines. The Italian Consensus on MI surgery for SCRLM indicates possible pathways to optimise the treatment for these patients as consensus papers express a trend that is likely to become shortly a standard procedure for clinical pictures still on debate. As matter of fact, no RCT or relevant case series on simultaneous treatment of SCRLM are available in the literature to suggest guidelines. It remains to be investigated whether the MI technique for the simultaneous treatment of SCRLM maintain the already documented benefit of the two separate surgeries.
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Lazem M, Sheikhtaheri A, Hooman N. Lessons learned from hemolytic uremic syndrome registries: recommendations for implementation. Orphanet J Rare Dis 2021; 16:240. [PMID: 34034793 PMCID: PMC8146148 DOI: 10.1186/s13023-021-01871-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 05/14/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Hemolytic uremic syndrome (HUS) is a rare condition which diagnosed with the triad of thrombocytopenia, microangiopathic hemolytic anemia, and acute renal injury. There is a high requirement for research to discover treatments. HUS registries can be used as an important information infrastructure. In this study, we identified and compared the different features of HUS registries to present a guide for the development and implementation of HUS registries. RESULTS The purposes of registries were classified as clinical (9 registries), research (7 registries), and epidemiological (5 registries), and only 3 registries pursued all three types of purposes. The data set included demographic data, medical and family history, para-clinical and diagnostic measures, treatment and pharmacological data, complications, and outcomes. The assessment strategies of data quality included monthly evaluation and data audit, the participation of physicians to collect data, editing and correcting data errors, increasing the rate of data completion, following guidelines and data quality training, using specific data quality indicators, and real-time evaluation of data at the time of data entry. 8 registries include atypical HUS patients, and 7 registries include all patients regardless of age. Only two registries focused on children. 4 registries apply prospective and 4 applied both prospective, and retrospective data collection. Finally, specialized hospitals were the main data source for these registries. CONCLUSION Based on the findings, we suggested a learning framework for developing and implementing an HUS registry. This framework includes lessons learned and suggestions for HUS registry purposes, minimum data set, data quality assurance, data collection methods, inclusion and exclusion criteria as well as data sources. This framework can help researchers develop HUS registries.
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Affiliation(s)
- Mina Lazem
- Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Abbas Sheikhtaheri
- Health Management and Economics Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran.
| | - Nakysa Hooman
- Pediatric Nephrology Department, Aliasghar Clinical Research Development Center (AACRDC), Aliasghar Children Hospital, Iran University of Medical Sciences, Tehran, Iran
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Calfee RP, Antes AL, Rozental TD, Goldfarb CA, Wolf JM, Levin LS, Chung KC. Applying the Delphi Method to Define a Focus for the National Outcomes Registry for Tracking the Hand (NORTH). J Hand Surg Am 2021; 46:417-420. [PMID: 33722474 DOI: 10.1016/j.jhsa.2021.01.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 01/18/2021] [Indexed: 02/02/2023]
Abstract
Surgical registries have provided reliable, generalizable, and applicable clinical data that have shaped many fields. Broad collection of defined data can answer clinical questions with greater numbers of patients and more ability to generalize to routine clinical care than randomized trials. National hand surgical registries exist outside the United States. Before the pursuit of a registry, the focus of such an effort must be defined to ensure that registry goals are feasible. This article presents the consensus process conducted by the American Society for Surgery of the Hand's Registry Task Force exploring potential diagnoses for a hand registry.
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Affiliation(s)
- Ryan P Calfee
- Department of Orthopaedic Surgery, Washington University School of Medicine, St Louis, MO.
| | - Alison L Antes
- Division of General Medical Sciences, Washington University School of Medicine, St Louis, MO
| | - Tamara D Rozental
- Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Charles A Goldfarb
- Department of Orthopaedic Surgery, Washington University School of Medicine, St Louis, MO
| | - Jennifer M Wolf
- Department of Orthopaedic Surgery, University of Chicago School of Medicine, Chicago, IL
| | - L Scott Levin
- Department of Orthopaedic Surgery, Division of Plastic Surgery, University of Pennsylvania School of Medicine, Philadelphia, PA; Department of Surgery, Division of Plastic Surgery, University of Pennsylvania School of Medicine, Philadelphia, PA
| | - Kevin C Chung
- Department of Surgery, Section of Plastic and Reconstructive Surgery, University of Michigan, Ann Arbor, MI
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Rathore K. Need to develop national registry of cardiothoracic surgery: another step in the direction of improving patient care and research. Indian J Thorac Cardiovasc Surg 2021; 37:488-489. [PMID: 34220039 DOI: 10.1007/s12055-021-01189-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 03/23/2021] [Accepted: 03/24/2021] [Indexed: 11/26/2022] Open
Affiliation(s)
- Kaushalendra Rathore
- Department of Cardiothoracic Surgery, Sir Charles Gairdner Hospital, Nedlands, Perth, WA 6009 Australia
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Zarei J, Dastoorpoor M, Jamshidnezhad A, Cheraghi M, Sheikhtaheri A. Regional COVID-19 registry in Khuzestan, Iran: A study protocol and lessons learned from a pilot implementation. Inform Med Unlocked 2021; 23:100520. [PMID: 33495736 PMCID: PMC7816600 DOI: 10.1016/j.imu.2021.100520] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 01/14/2021] [Accepted: 01/14/2021] [Indexed: 02/08/2023] Open
Abstract
Disease registry systems provide a strong information infrastructure for decision-making and research. The purpose of this study is to describe the implementation method and protocol of the COVID-19 registry in Khuzestan province, Iran. We established a steering committee and formulated the purposes of the registry. Then, based on reviewing the literature, and expert panels, the minimum data set, the data collection forms and the web-based software were developed. Data collection is done retrospectively through Hospital Information Systems, Medical Care Monitoring Center system (MCMC), Management of Communicable Disease Prevention and Control system (MCDPC) as well as, patients' records. For prospective data collection, the data collection forms are compiled with patients' medical records by the medical staff and are then entered into the registry system. We collect patients' administrative and demographic data, history and physical examinations, test and imaging results, disease progression, treatment, outcomes, and follow-ups of the confirmed and suspected inpatients and outpatients. From April 20 to December 5, 2020, the data of 4,812 confirmed cases and 7,113 suspected cases were collected from two COVID-19 referral hospitals. Based on our experience, recording information along with providing care for patients and putting patients' data registration in the medical staff's routine, structuring data, having a flexible technical team and rapid software development for multiple and continuous updates, automating data collection by connecting the registry to existing information systems and having different incentives, the registration process can be strengthened.
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Affiliation(s)
- Javad Zarei
- Health Information Technology Department, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Maryam Dastoorpoor
- Department of Biostatistics and Epidemiology, Social Determinants of Health Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Amir Jamshidnezhad
- Health Information Technology Department, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Maria Cheraghi
- Social Determinant of Health Research Center, Department of Public Health, School of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Abbas Sheikhtaheri
- Health Management and Economics Research Center, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
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Muzaffar J, Monksfield P, Bance M. Cochlear Implant Outcome Reviews. J Int Adv Otol 2020; 16:393-394. [PMID: 33136023 DOI: 10.5152/iao.2020.9024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Jameel Muzaffar
- University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Bigmingham, UK
| | - Peter Monksfield
- University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Bigmingham, UK
| | - Manohar Bance
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
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Metcalfe C, Muzaffar J, Monksfield P, Bance M. Outcomes of Cochlear Implantation in Patients with Jervell and Lange-Nielsen Syndrome: A Systematic Review and Narrative Synthesis. J Int Adv Otol 2020; 16:456-462. [PMID: 33136028 DOI: 10.5152/iao.2020.9025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Establish outcomes following cochlear implantation (CI) in patients with Jervell and Lange-Nielsen Syndrome (JLNS). Methods Systematic review and narrative synthesis. Databases searched on Medline, Pubmed, Embase, Web of Science, Cochrane Collection and ClinicalTrials.gov. No limits placed on language or year of publication. Review conducted in accordance with the PRISMA statement. Searches identified 63 abstracts and 19 full texts. Of these, 9 studies met inclusion criteria reporting outcomes in 66 patients with at least 72 implants. Hearing outcomes were generally good. Mortality secondary to cardiac complications within the follow up period occurred in at least five cases (7.6%), though three of these were thought to be unrelated to surgery. Potentially dangerous arrhythmias without associated morbidity were also noted in at least five patients. The methodological quality of included studies was modest, predominantly consisting of case reports and non-controlled case series with small numbers of patients. All studies were OCEBM grade IV. One study contributed 41/66 patients (62%). Hearing outcomes following CI in JLNS are generally good with the majority of patients experiencing useful hearing improvement. Significant peri-operative cardiac risks exist and should be discussed with the patient and family during pre-operative counselling and prompt thorough investigation, pre-operative optimisation and peri-operative monitoring.
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Affiliation(s)
- Chris Metcalfe
- University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Bigmingham, UK
| | - Jameel Muzaffar
- University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Bigmingham, UK
| | - Peter Monksfield
- University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Bigmingham, UK
| | - Manohar Bance
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
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Chaudhry A, Chaudhry D, Muzaffar J, Crundwell G, Monksfield P, Bance M. Outcomes of Cochlear Implantation in Patients with Superficial Siderosis: A Systematic Review and Narrative Synthesis. J Int Adv Otol 2020; 16:443-455. [PMID: 33136027 DOI: 10.5152/iao.2020.9037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
This study aimed to establish outcomes following cochlear implantation (CI) in patients with superficial siderosis (SS). MEDLINE, Embase, Web of Science, Cochrane, and ClinicalTrials.gov databases were searched for this systematic review. No limits were placed on the language or the year of publication. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Of a total of 46 studies, 19 studies met the inclusion criteria reporting outcomes in 38 patients. Of the 44 implants, 23 implants (52.27%) had good hearing outcomes at the last follow-up, 9 (20.45%) were initially beneficial for the patient, but then the performance deteriorated (4 of which were re-implanted), and 12 (27.27%) were not beneficial for the patient. All studies were classified as grade 4 studies using the Oxford Centre for Evidence-Based Medicine (OCEBM) grading system, being retrospective in nature and consisting of case reports and noncontrolled case series with a small number of patients. Of the 44 implants, 32 (72.73%) showed improved hearing outcomes following CI for SS at some point in time, of which 23 (52.2%) implants showed sustained benefit at the last follow-up (average follow-up time was 21.97 months). It is difficult to predict the longevity of benefit owing to the progressive nature of the disease or the patients in whom it may be beneficial, as the preoperative investigations inadequately predict benefit. Preimplantation and postimplantation counseling with the patient and their family regarding the potential limited benefit and eventual parallel decline with the neurological disease are crucial, along with thorough clinical investigations.
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Affiliation(s)
- Abdullah Chaudhry
- University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Bigmingham, UK
| | - Daoud Chaudhry
- University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Bigmingham, UK
| | - Jameel Muzaffar
- University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Bigmingham, UK
| | - Gemma Crundwell
- Emmeline Centre for Hearing Implants, Cambridge University Hospitals NHS Foundation Trust, Cambridge
| | - Peter Monksfield
- University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Bigmingham, UK
| | - Manohar Bance
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
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Kane RL, Nasser JS, Chung KC. Establishment of a National Hand Surgery Data Registry: An Avenue for Quality Improvement. Hand Clin 2020; 36:221-229. [PMID: 32307053 DOI: 10.1016/j.hcl.2020.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Considerable variation exists in the practice of hand surgery that may lead to wasteful spending and less than optimal quality of care. Hand surgeons can benefit from a centralized system that tracks process and outcome measures, delivers national benchmarking, and encourages the sharing of knowledge. A national registry can fulfill these needs for hand surgeons and incorporate quality improvement into their daily routine. Leaders in hand surgery should convene to appraise the organization of a national registry for their field and reach consensus on how the registry can be designed and funded.
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Affiliation(s)
- Robert L Kane
- Michigan Center for Hand Outcomes and Innovation Research, 2800 Plymouth Road, Building 14, Suite G200, Ann Arbor, MI 48109, USA
| | - Jacob S Nasser
- George Washington School of Medicine and Health Sciences, Washington, DC, USA
| | - Kevin C Chung
- Section of Plastic Surgery, University of Michigan Medical School, Ann Arbor, MI, USA.
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Abstract
Large cohort and collaborative studies to date have shown that the short-term oncological outcomes appear to be at least as good as traditional laparoscopic surgery. These results need confirmation in randomized controlled trials, which are currently underway (GRECCAR 11 and COLOR III). The functional data on transanal total mesorectal excision is still very scarce and more mature data on quality of life and function outcomes are eagerly awaited.
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Affiliation(s)
- Roel Hompes
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Marta Penna
- Department of Colorectal Surgery, Oxford University Hospitals, Oxford, United Kingdom
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Köckerling F, Lammers B, Weyhe D, Reinpold W, Zarras K, Adolf D, Riediger H, Krüger CM. What is the outcome of the open IPOM versus sublay technique in the treatment of larger incisional hernias?: A propensity score-matched comparison of 9091 patients from the Herniamed Registry. Hernia 2020; 25:23-31. [PMID: 32100213 PMCID: PMC7867529 DOI: 10.1007/s10029-020-02143-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 02/11/2020] [Indexed: 12/16/2022]
Abstract
Introduction In an Expert Consensus guided by systematic review, the panel agreed that for open elective incisional hernia repair, sublay mesh location is preferred, but open intraperitoneal onlay mesh (IPOM) may be useful in certain settings. This analysis of data from the Herniamed Registry aimed to compare the outcomes of open IPOM and sublay technique. Methods Propensity score matching of 9091 patients with elective incisional hernia repair and with defect width ≥ 4 cm was performed. The following matching variables were selected: age, gender, risk factors, ASA score, preoperative pain, defect size, and defect localization. Results For the 1977 patients with open IPOM repair and 7114 patients with sublay repair, n = 1938 (98%) pairs were formed. No differences were seen between the two groups with regard to the intraoperative, postoperative and general complications, complication-related reoperations and recurrences. But significant disadvantages were identified for the open IPOM repair in respect of pain on exertion (17.1% vs. 13.7%; p = 0.007), pain at rest (10.4% vs. 8.3%; p = 0.040) and chronic pain requiring treatment (8.8% vs. 5.8%; p < 0.001), in addition to rates of 3.8%, 1.1% and 1.1%, respectively, occurring in both matched patients. No relationship with tacker mesh fixation was identified. There are only very few reports in the literature with comparable findings. Conclusion Compared with sublay repair, open IPOM repair appears to pose a higher risk of chronic pain. This finding concords with the Expert Consensus recommending that incisional hernia should preferably be repaired using the sublay technique.
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Affiliation(s)
- F Köckerling
- Department of Surgery and Center for Minimally Invasive Surgery, Academic Teaching Hospital of Charité Medical School, Vivantes Hospital, Neue Bergstrasse 6, 13585, Berlin, Germany.
| | - B Lammers
- Department of Surgery I - Section Coloproctology and Hernia Surgery, Lukas Hospital, Preussenstr. 84, 41464, Neuss, Germany
| | - D Weyhe
- University Clinic for Visceral Surgery, Pius Hospital Oldenburg, Georgstraße 12, 26121, Oldenburg, Germany
| | - W Reinpold
- Wilhelmsburger Hospital Groß-Sand, Groß-Sand 3, 21107, Hamburg, Germany
| | - K Zarras
- Marien Hospital Düsseldorf, Rochusstraße 2, 40479, Düsseldorf, Germany
| | - D Adolf
- StatConsult GmbH, Halberstädter Strasse 40 a, 39112, Magdeburg, Germany
| | - H Riediger
- Vivantes Humboldt Hospital, Am Nordgraben 2, 13509, Berlin, Germany
| | - C M Krüger
- Immanuel Hospital Rüdersdorf, Seebad 82/83, 155562, Rüdersdorf, Germany
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Ford JE, Alqahtani AS, Abuzinada SAA, Cameron PA, Fitzgerald MC, Alenizi AS, Farjou D. Experience gained from the implementation of the Saudi TraumA Registry (STAR). BMC Health Serv Res 2020; 20:18. [PMID: 31906941 PMCID: PMC6945484 DOI: 10.1186/s12913-019-4881-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 12/27/2019] [Indexed: 11/18/2022] Open
Abstract
Background Trauma registries are essential to trauma systems, to enable collection of the data needed to enhance clinical knowledge and monitor system performance. The King Saud Medical City (KSMC) in Riyadh, Kingdom of Saudi Arabia (KSA) is aiming to become a Level 1 Trauma Centre, and required a trauma registry in order to do so. Our objective was to establish the Saudi TraumA Registry (STAR) at the (KSMC) and ready it for national deployment. The challenge was that no formal trauma data collection had occurred previously and clinicians had no prior experience of trauma registries. Methods To develop the registry, a novel 12 step implementation plan was created and followed at the KSMC. Registry criteria and a Minimum Dataset were selected; training was delivered; database specifications were written; operating procedures were developed and regular reporting was initiated. Results Data collection commenced on August 1st 2017. The registry was fully operational by April 2018, eight months ahead of schedule. During the first year of data collection an average of 216 records per month were entered into the database. An inaugural report was presented at the Saudi Trauma Conference in February 2019. Conclusions The strategy deployed at the KSMC has successfully established the STAR. In the short term, process indicators will track the development of the hospital into a Level 1 Trauma Centre. In the medium to long term the STAR will be rolled out nationally to capture the impact of public health initiatives aimed at reducing injury in the KSA. The effect of the STAR will be that the country is better equipped to deliver continuous improvements in trauma systems and quality of care.
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Affiliation(s)
- Jane E Ford
- Department Epidemiology and Preventive Medicine, Monash University Level 3, 553 St Kilda Road, MELBOURNE, 3004, Australia.
| | | | - Shatha A A Abuzinada
- King Saud Medical City, Al Imam Turki Ibn Abdullah Ibn Muhammad, Ulaishah, RIYADH, 12746, Saudi Arabia
| | - Peter A Cameron
- Department Epidemiology and Preventive Medicine, Monash University, Level 3, 553 St Kilda Road, MELBOURNE, 3004, Australia
| | - Mark C Fitzgerald
- National Trauma Research Institute, Burnett Building, 85-89 Commercial Road, MELBOURNE, 3004, Australia
| | - Ahmed S Alenizi
- King Saud Medical City, Al Imam Turki Ibn Abdullah Ibn Muhammad, Ulaishah, RIYADH, 12746, Saudi Arabia
| | - Dina Farjou
- Monash University, Wellington Road, CLAYTON, 3800, Australia
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Caballero C, Burock S, Carrion-Alvarez L, Nilsson H, Ruers T, Senellart P, Rivoire M, Stattner S, Primavesi F, Troisi R, Gruenberger T, Heil J, Schnitzbauer AA, Rahbari NN, Swijnenburg RJ, Malik H, Protic M, Kataoka K, Mauer M, Ducreux M, Poston G, Evrard S. Building a collaboration to improve surgical research through EORTC/ESSO 1409-CLIMB study: A prospective liver metastasis database with an integrated quality assurance program. Eur J Surg Oncol 2019; 45:1870-1875. [DOI: 10.1016/j.ejso.2019.05.028] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 05/13/2019] [Accepted: 05/23/2019] [Indexed: 01/20/2023] Open
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Hall AC, Mandavia R, Selvadurai D. Total endoscopic stapes surgery: Systematic review and pooled analysis of audiological outcomes. Laryngoscope 2019; 130:1282-1286. [PMID: 31566754 DOI: 10.1002/lary.28294] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 08/15/2019] [Accepted: 08/27/2019] [Indexed: 12/11/2022]
Abstract
OBJECTIVE This study evaluates the current evidence base for total endoscopic stapes surgery, specifically to establish current efficacy and safety of the technique within clinical practice. DATA SOURCES A systematic review of the literature on endoscopic stapes surgery was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis checklist. A comprehensive search of PubMed, Embase, and the Cochrane Central Register of Controlled Trials database for relevant publications for all available dates with appropriate Medical Subject Headings search criteria in January 2018. STUDY SELECTION Out of the 160 articles identified in the search, 14 met the inclusion criteria for further analysis. Four of these were level III and 10 level IV evidence. DATA EXTRACTION A pooled patient population of 314 individuals was analyzed. DATA SYNTHESIS Documented postoperative air bone gap closure to within 20 dB was found in 95.3% of individuals (285 patients). Facial nerve palsy (temporary) occurred in three patients (0.6%), with all recovering. No total sensorineural hearing losses were recorded, but two moderate sensorineural hearing losses occurred (0.6%). Perilymph fistula was noted on four occasions (1.3%). Chorda tympani trauma was documented in 3.5% of cases, with taste disturbance documented in 13 patients (5%). CONCLUSIONS Our pooled analysis uses the current published evidence to establish the complication rate and audiological outcome for the endoscopic approach to stapes surgery. These outcomes are comparable to those documented in traditional use of the microscope for stapedectomy. Laryngoscope, 130:1282-1286, 2020.
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Affiliation(s)
- Andrew C Hall
- Department of Otolaryngology, Royal National Throat Nose and Ear Hospital, London, United Kingdom
| | - Rishi Mandavia
- Department of Otolaryngology, Royal National Throat Nose and Ear Hospital, London, United Kingdom
| | - David Selvadurai
- Department of Otolaryngology, St. George's Hospital, London, United Kingdom
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Schilder AG, Su MP, Mandavia R, Anderson CR, Landry E, Ferdous T, Blackshaw H. Early phase trials of novel hearing therapeutics: Avenues and opportunities. Hear Res 2019; 380:175-86. [DOI: 10.1016/j.heares.2019.07.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 06/27/2019] [Accepted: 07/03/2019] [Indexed: 11/19/2022]
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Schrittwieser R, Köckerling F, Adolf D, Hukauf M, Gruber-Blum S, Fortelny RH, Petter-Puchner AH. Small and Laterally Placed Incisional Hernias Can be Safely Managed with an Onlay Repair. World J Surg 2019; 43:1921-1927. [PMID: 30859264 DOI: 10.1007/s00268-019-04980-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
INTRODUCTION In meta-analyses and systematic reviews, clear advantages have been identified for the sublay versus onlay technique for treatment of incisional hernias. Nonetheless, an expert panel has noted that the onlay mesh location may be useful in certain settings. MATERIALS AND METHODS First, unadjusted analysis of data from the Herniamed Registry was performed to compare 6797 sublay operations with 1024 onlay operations for repair of incisional hernias. Then, using propensity score matching to account for the influence of variables age, gender, ASA score, BMI, risk factors, preoperative pain, defect size, and defect localization, 1016 pairs were formed and compared with each other. RESULTS Unadjusted analysis revealed that the onlay operation was used significantly more often for small defects, lateral defect localization, and in women. After comparing the propensity score-matched pairs, no significant difference was found between the sublay and onlay technique in the outcome criteria intra- and postoperative complications, general complications, complication-related reoperations, pain at rest, pain on exertion, chronic pain requiring treatment, and recurrence on 1-year follow-up. But that was true only for this carefully selected patient collective. CONCLUSION In a selected patient collective with small and lateral incisional hernias and with a large proportion of women, outcomes obtained for the onlay and sublay techniques do not differ significantly.
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Affiliation(s)
- Rudolf Schrittwieser
- Department of General Surgery, Country Hospital Hochsteiermark, Steiermärkische Krankenanstaltengesellschaft m.b.H., Tragösserstrasse 1 und 1a, 8600, Bruck an der Mur, Austria
| | - Ferdinand Köckerling
- Department of Surgery, Center for Minimally Invasive Surgery, Academic Teaching Hospital of Charité Medical School, Vivantes Hospital, Neue Bergstrasse 6, 13585, Berlin, Germany.
| | - Daniela Adolf
- StatConsult GmbH, Halberstädter Strasse 40 a, 39112, Magdeburg, Germany
| | - Martin Hukauf
- StatConsult GmbH, Halberstädter Strasse 40 a, 39112, Magdeburg, Germany
| | - Simone Gruber-Blum
- Department of General Surgery, Wilhelminen Hospital, Montleartstrasse 37, 1160, Vienna, Austria
| | - René H Fortelny
- Department of General Surgery, Wilhelminen Hospital, Montleartstrasse 37, 1160, Vienna, Austria.,Medical Faculty, Sigmund Freud University, Freudplatz 3, 1020, Vienna, Austria
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Mulder DS, Spicer J. Registry-Based Medical Research: Data Dredging or Value Building to Quality of Care? Ann Thorac Surg 2019; 108:274-282. [DOI: 10.1016/j.athoracsur.2018.12.060] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 10/31/2018] [Accepted: 12/29/2018] [Indexed: 12/16/2022]
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Schilder AGM, Su MP, Blackshaw H, Lustig L, Staecker H, Lenarz T, Safieddine S, Gomes-santos CS, Holme R, Warnecke A. Hearing Protection, Restoration, and Regeneration: An Overview of Emerging Therapeutics for Inner Ear and Central Hearing Disorders. Otol Neurotol 2019; 40:559-70. [DOI: 10.1097/mao.0000000000002194] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Mandavia R, Mehta N, Veer V. Guidelines on the surgical management of sleep disorders: A systematic review. Laryngoscope 2019; 130:1070-1084. [PMID: 31042014 DOI: 10.1002/lary.28028] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 01/28/2019] [Accepted: 04/08/2019] [Indexed: 01/29/2023]
Abstract
OBJECTIVE To facilitate the development of U.K. guidelines for sleep surgery and to guide sleep surgeons to existing guidelines relevant to their practice, we provide a systematic review and quality assessment of all existing guidelines on the surgical management of sleep disorders. METHODS Systematic review using preferred reporting items for systematic reviews and meta-analyses (PRISMA) recommendations. Medline and Embase databases were searched from inception to April 2018. Publications were included if they described a guideline for the surgical management of sleep disorders. Three assessors used the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument to evaluate included guidelines. RESULTS The systematic search revealed 1,161 publications. Twenty-two guidelines from eight countries were included. Fourteen focused on adults, five on children, and three on both. The guidelines discussed nasal, tonsillar, palatal, tongue, hyoid, maxillomandibular, tracheal, bariatric, and multilevel surgeries. The mean overall AGREE II quality score of included guidelines was 3.5 (range = 2 to 5.3; maximum possible score = 7). CONCLUSION This article provides a summary and quality assessment of all published guidelines on the surgical management of sleep disorders. No U.K. guidelines were identified, and existing guidelines have several shortcomings. This highlights the need for robust U.K. national guidelines on sleep surgery to promote clinical and cost-effective care in this field. Our findings can be used by stakeholders as a foundation for the development of new guidelines and can be used by sleep surgeons to direct them to existing guidelines relevant to their practice, promoting evidence-based clinical care. Laryngoscope, 130:1070-1084, 2020.
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Affiliation(s)
- Rishi Mandavia
- Royal National Throat, Nose and Ear Hospital, London, United Kingdom
| | - Nishchay Mehta
- Royal National Throat, Nose and Ear Hospital, London, United Kingdom
| | - Vik Veer
- Royal National Throat, Nose and Ear Hospital, London, United Kingdom
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Mandavia R, Knight A, Carter AW, Toal C, Mossialos E, Littlejohns P, Schilder AG. What are the requirements for developing a successful national registry of auditory implants? A qualitative study. BMJ Open 2018; 8:e021720. [PMID: 30209155 PMCID: PMC6144326 DOI: 10.1136/bmjopen-2018-021720] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVES Hearing loss is an area of unmet need, and industry is targeting this field with a growing range of surgically implanted hearing devices. Currently, there is no comprehensive UK registry capturing data on these devices; in its absence, it is difficult to monitor clinical and cost-effectiveness and develop national policy. Recognising that developing such a registry faces considerable challenges, it is important to gather opinions from stakeholders and patients. This paper builds on our systematic review on surgical registry development and aims to identify the specific requirements for developing a successful national registry of auditory implants. DESIGN Qualitative study. PARTICIPANTS Data were collected in two ways: (1) semistructured interviews with UK professional stakeholders; and (2) focus groups with patients with hearing loss. The interview and focus group schedules were informed by our systematic review on registry development. Data were analysed using directed content analysis. Judges mapped the themes obtained against a conceptual framework developed from our systematic review on registry development. The conceptual framework consisted of five categories for successful registry development: (1) planning, (2) registry governance, (3) registry dataset, (4) anticipating challenges, (5) implementing solutions. RESULTS Twenty-seven themes emerged from 40 semistructured interviews with professional stakeholders and 18 themes emerged from three patient focus groups. The most important factor for registry success was high rates of data completion. Benefits of developing a successful registry of auditory implants include: strengthening the evidence base and regulation of auditory implants, driving quality and safety improvements, increased transparency, facilitating patient decision-making and informing policy and guidelines development. CONCLUSIONS This study identifies the requirements for developing a successful national registry of auditory implants, benefiting from the involvement of numerous professional stakeholder groups and patients with hearing loss. Our approach may be used internationally to inform successful registry development.
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Affiliation(s)
- Rishi Mandavia
- evidENT, UCL Ear Institute, Royal National Throat, Nose and Ear Hospital, London, UK
| | - Alec Knight
- Health Service and Population Research Department, King's College London, London, UK
| | | | - Connor Toal
- School of Medicine, University College London, London, UK
| | - Elias Mossialos
- Centre for Health Policy, Imperial College London, London, UK
| | - Peter Littlejohns
- Health Service and Population Research Department, King's College London, London, UK
| | - Anne Gm Schilder
- evidENT, UCL Ear Institute, Royal National Throat, Nose and Ear Hospital, London, UK
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