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Gu JZ, Baird GL, Escamilla Guevara A, Sohn YJ, Lydston M, Doyle C, Tevis SEA, Miles RC. A systematic review and meta-analysis of English language online patient education materials in breast cancer: Is readability the only story? Breast 2024; 75:103722. [PMID: 38603836 PMCID: PMC11019273 DOI: 10.1016/j.breast.2024.103722] [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: 07/24/2023] [Revised: 02/09/2024] [Accepted: 03/25/2024] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND Online patient education materials (OPEMs) are an increasingly popular resource for women seeking information about breast cancer. The AMA recommends written patient material to be at or below a 6th grade level to meet the general public's health literacy. Metrics such as quality, understandability, and actionability also heavily influence the usability of health information, and thus should be evaluated alongside readability. PURPOSE A systematic review and meta-analysis was conducted to determine: 1) Average readability scores and reporting methodologies of breast cancer readability studies; and 2) Inclusion frequency of additional health literacy-associated metrics. MATERIALS AND METHODS A registered systematic review and meta-analysis was conducted in Ovid MEDLINE, Web of Science, Embase.com, CENTRAL via Ovid, and ClinicalTrials.gov in June 2022 in adherence with the PRISMA 2020 statement. Eligible studies performed readability analyses on English-language breast cancer-related OPEMs. Study characteristics, readability data, and reporting of non-readability health literacy metrics were extracted. Meta-analysis estimates were derived from generalized linear mixed modeling. RESULTS The meta-analysis included 30 studies yielding 4462 OPEMs. Overall, average readability was 11.81 (95% CI [11.14, 12.49]), with a significant difference (p < 0.001) when grouped by OPEM categories. Commercial organizations had the highest average readability at 12.2 [11.3,13.0]; non-profit organizations had one of the lowest at 11.3 [10.6,12.0]. Readability also varied by index, with New Fog, Lexile, and FORCAST having the lowest average scores (9.4 [8.6, 10.3], 10.4 [10.0, 10.8], and 10.7 [10.2, 11.1], respectively). Only 57% of studies calculated average readability with more than two indices. Only 60% of studies assessed other OPEM metrics associated with health literacy. CONCLUSION Average readability of breast cancer OPEMs is nearly double the AMA's recommended 6th grade level. Readability and other health literacy-associated metrics are inconsistently reported in the current literature. Standardization of future readability studies, with a focus on holistic evaluation of patient materials, may aid shared decision-making and be critical to increased screening rates and breast cancer awareness.
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Affiliation(s)
- Joey Z Gu
- Department of Medicine, Roger Williams Medical Center, Providence, RI, USA.
| | - Grayson L Baird
- Department of Diagnostic Imaging, Warren Alpert Medical School of Brown University, Providence, RI, USA; Lifespan Biostatistics, Epidemiology, and Research Design, Providence, RI, USA
| | | | - Young-Jin Sohn
- Harvard Medical School Center for Primary Care, Boston, MA, USA
| | - Melis Lydston
- Treadwell Virtual Library, Massachusetts General Hospital, Boston, MA, USA
| | - Christopher Doyle
- Department of Radiology and Medical Imaging, Denver Health Hospital and Authority, Denver, CO, USA
| | - Sarah E A Tevis
- Department of Surgery, School of Medicine Anschutz Medical Campus, Aurora, CO, USA
| | - Randy C Miles
- Department of Radiology and Medical Imaging, Denver Health Hospital and Authority, Denver, CO, USA
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Wilens TE, Stone M, Lanni S, Berger A, Wilson RLH, Lydston M, Surman CB. Treating Executive Function in Youth With Attention Deficit Hyperactivity Disorder: A Review of Pharmacological and Non-Pharmacological Interventions. J Atten Disord 2024; 28:751-790. [PMID: 38178649 DOI: 10.1177/10870547231218925] [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] [Indexed: 01/06/2024]
Abstract
INTRODUCTION Executive function (EF) deficits are common in youth with ADHD and pose significant functional impairments. The extent and effect of interventions addressing EF in youth with ADHD remain unclear. METHODS We conducted a systematic literature review using PRISMA guidelines. Included studies were randomized controlled trials of interventions to treat EF in youth with ADHD. RESULTS Our search returned 136 studies representing 11,443 study participants. We identified six intervention categories: nonstimulant pharmacological (N = 3,576 participants), neurological (N = 1,935), psychological (N = 2,387), digital (N = 2,416), physiological (N = 680), and combination (N = 366). The bulk of the evidence supported pharmacological interventions as most effective in mitigating EF, followed by psychological and digital interventions. CONCLUSION A breadth of treatments exists for EF in youth with ADHD. Pharmacological, psychotherapeutic, and digital interventions had the most favorable, replicable outcomes. A lack of outcome standardization across studies limited treatment comparison. More data on the persistence of intervention effects are necessary.
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Affiliation(s)
- Timothy E Wilens
- Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Mira Stone
- Massachusetts General Hospital, Boston, MA, USA
| | | | - Amy Berger
- Massachusetts General Hospital, Boston, MA, USA
| | | | | | - Craig B Surman
- Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
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Duff JP, Morse KJ, Seelandt J, Gross IT, Lydston M, Sargeant J, Dieckmann P, Allen JA, Rudolph JW, Kolbe M. Debriefing Methods for Simulation in Healthcare: A Systematic Review. Simul Healthc 2024; 19:S112-S121. [PMID: 38240623 DOI: 10.1097/sih.0000000000000765] [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] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
ABSTRACT Debriefing is a critical component in most simulation experiences. With the growing number of debriefing concepts, approaches, and tools, we need to understand how to debrief most effectively because there is little empiric evidence to guide us in their use. This systematic review explores the current literature on debriefing in healthcare simulation education to understand the evidence behind practice and clarify gaps in the literature. The PICO question for this review was defined as "In healthcare providers [P], does the use of one debriefing or feedback intervention [I], compared to a different debriefing or feedback intervention [C], improve educational and clinical outcomes [O] in simulation-based education?" We included 70 studies in our final review and found that our current debriefing strategies, frameworks, and techniques are not based on robust empirical evidence. Based on this, we highlight future research needs.
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Affiliation(s)
- Jonathan P Duff
- From the Department of Pediatrics (J.P.D.), University of Alberta. Edmonton, Canada; College of Nursing and Health Professions (K.J.M.), Drexel University, Philadelphia, PA; Simulation Centre (J.S., M.K.), University Hospital, Zurich, Switzerland; Department of Pediatrics, Section of Emergency Medicine (I.T.G.), Yale University School of Medicine, New Haven, CT; Treadwell Virtual Library (M.L.), Massachusetts General Hospital, Boston, MA; Faculty of Medicine (J.S.), Dalhousie University, Halifax, Canada; Copenhagen Academy for Medical Education and Simulation (CAMES) (P.D.), Herlev, Denmark; Department of Quality and Health Technology (P.D.), University of Stavanger, Stavanger, Norway; Department of Public Health (P.D.), University of Copenhagen, Denmark; Department of Family and Preventive Medicine (J.A.A.), University of Utah, Salt Lake City, UT; Center for Medical Simulation (J.W.R.), Boston, MA; and ETH Zurich (M.K.), Zurich, Switzerland
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Levison JH, Del Cueto P, Mendoza JV, Ashour D, Lydston M, Freedberg KA, Shebl FM. Systematic Review and Meta-analysis of Linkage to HIV Care Interventions in the United States, Canada, and Ukraine (2010-2021). AIDS Behav 2023; 27:4070-4083. [PMID: 37523048 PMCID: PMC10598185 DOI: 10.1007/s10461-023-04121-0] [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] [Accepted: 06/19/2023] [Indexed: 08/01/2023]
Abstract
We conducted a systematic review and meta-analysis of interventions targeting linkage to HIV care in the US, Canada, and Europe. We searched six databases (PubMed, Embase, Cochrane Library, Web of Science and CINAHL). Inclusion criteria were English language studies in adults in the US, Canada, or Europe, published January 1, 2010 to January 1, 2021. We synthesized interventions by type and linkage to care outcome. The outcome was cumulative incidence of 3-month linkage. We estimated cumulative incidence ratios of linkage with 95% confidence intervals (CIs). We screened 945 studies; 13 met selection criteria (n = 1 from Canada, n = 1 from Ukraine, n = 11 from the US) and were included after full text review (total 37,549 individuals). The cumulative incidence of 3-month linkage in the intervention group was 0.82 (95% CI 0.68-0.94) and control group 0.71 (95% CI 0.50-0.90); cIR of linkage for intervention versus control was 1.30 (95% CI 1.13, 1.49). Interventions to improve linkage to care after HIV diagnosis warrant further attention.
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Affiliation(s)
- Julie H Levison
- Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, 100 Cambridge Street, Suite 1600, Boston, MA, 02114, USA.
- Harvard Medical School, Boston, MA, USA.
| | - Paola Del Cueto
- Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, 100 Cambridge Street, Suite 1600, Boston, MA, 02114, USA
- Harvard Medical School, Boston, MA, USA
| | - Jaime Vladimir Mendoza
- Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, 100 Cambridge Street, Suite 1600, Boston, MA, 02114, USA
| | - Dina Ashour
- Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, MA, USA
| | - Melis Lydston
- Treadwell Library, Massachusetts General Hospital, Boston, MA, USA
| | - Kenneth A Freedberg
- Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, 100 Cambridge Street, Suite 1600, Boston, MA, 02114, USA
- Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Fatma M Shebl
- Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, 100 Cambridge Street, Suite 1600, Boston, MA, 02114, USA
- Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
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Samost-Williams A, Rosen R, Hannenberg A, Lydston M, Nash GM, Brindle M. Perioperative Team-Based Morbidity and Mortality Conferences: A Systematic Review of the Literature. Ann Surg Open 2023; 4:e321. [PMID: 37746600 PMCID: PMC10513145 DOI: 10.1097/as9.0000000000000321] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 07/14/2023] [Indexed: 09/26/2023] Open
Abstract
Objective This systematic review aimed to identify key elements of perioperative team-based morbidity and mortality conferences (TBMMs) and their impact on patient safety, education, and quality improvement outcomes. Background Patient safety in the perioperative period is influenced by system, team, and individual behaviors. However, despite this recognition, single-discipline morbidity and mortality conferences remain a mainstay of educational and quality improvement efforts. Methods A structured search was conducted in MEDLINE Complete, Embase, Web of Science, ClinicalTrials.gov, Cochrane CENTRAL, and ProQuest Dissertations and Theses Global in July 2022. Search results were screened, and the articles meeting inclusion criteria were abstracted. Results Seven studies were identified. Key TBMM elements were identified, including activities done before the conference-case selection and case investigation; during the conference-standardized presentation formats and formal moderators; and after the conference-follow-up emails and quality improvement projects. The impacts of TBMMs on educational, safety, and quality improvement outcomes were heterogeneous, and no meta-analysis could be conducted; however, improvement was typically shown in each of these domains where comparisons were made. Conclusions Recommendations for key TBMM elements can be drawn from the reports of successful perioperative TBMMs. Possible benefits of structured TBMMs over single-discipline conferences were identified for further exploration, including opportunities for rich educational contributions for trainees, improved patient safety, and the potential for system-wide quality improvement. Design and implementation of TBMM should address meticulous preparation of cases, standardized presentation format, and effective facilitation to increase the likelihood of realizing the potential benefits.
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Affiliation(s)
- Aubrey Samost-Williams
- From the Department of Anesthesia, Critical Care, and Pain Medicine, University of Texas Health Science Center at Houston, Houston, TX
| | - Roni Rosen
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York City, NY
| | | | - Melis Lydston
- Treadwell Library, Massachusetts General Hospital, Boston, MA
| | - Garrett M. Nash
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York City, NY
| | - Mary Brindle
- Ariadne Labs, Harvard T. H. Chan School of Public Health, Boston, MA
- Department of Surgery, University of Calgary, Calgary, Alberta, Canada
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Abstract
Alternate care sites (ACSs) are temporary medical locations established in response to events that disrupt or limit the ability of established medical facilities to provide adequate care. As with established medical facilities, ACSs require careful consideration of infection prevention and control (IPC) practices to mitigate risk of nosocomial transmission and occupational exposure. We conducted a rapid systematic review of published literature from the date of inception of each database until the date the search was run (September 2021) on the IPC practices in ACSs. The practices described were categorized using the National Institute of Occupational Safety and Health hierarchy of controls framework, including elimination, substitution, engineering controls, administrative controls, and personal protective equipment. Of 313 articles identified, 55 were included. The majority (n=45, 81.8%) were case reports and described ACSs established in the context of infectious disease outbreaks (n=48, 87.3%), natural disasters (n=5, 9%), and military deployments (n=2, 3.6%). Implementation of engineering and/or administrative control practices predominated, with personal protective equipment emphasized in articles related to infectious disease outbreaks. These findings emphasize both a need for more high-quality research into the best practices for IPC in ACSs and how to incorporate the most effective strategies in these settings in response to future events.
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Affiliation(s)
- Molly L Paras
- Molly L. Paras, MD, is an Assistant Physician, Division of Infectious Diseases, Massachusetts General Hospital, and an Assistant Professor, Harvard Medical School
| | - Eileen F Searle
- Eileen F. Searle, PhD, RN, CCRN, is Director of Funded Projects, Center for Disaster Medicine, Department of Emergency Medicine, Massachusetts General Hospital
| | - Melis Lydston
- Melis Lydston, MLS, is Knowledge Specialist, Treadwell Library, Massachusetts General Hospital
| | - Erica S Shenoy
- Erica S. Shenoy, MD, PhD, is Medical Director, Infection Control, Mass General Brigham; an Associate Professor, Harvard Medical School; and a Physician, Division of Infectious Diseases, Massachusetts General Hospital
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