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Xiao J, Kopycka-Kedzierawski D, Ragusa P, Mendez Chagoya LA, Funkhouser K, Lischka T, Wu TT, Fiscella K, Kar KS, Al Jallad N, Rashwan N, Ren J, Meyerowitz C. Acceptance and Usability of an Innovative mDentistry eHygiene Model Amid the COVID-19 Pandemic Within the US National Dental Practice-Based Research Network: Mixed Methods Study. JMIR Hum Factors 2023; 10:e45418. [PMID: 37594795 PMCID: PMC10474507 DOI: 10.2196/45418] [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: 12/30/2022] [Revised: 04/17/2023] [Accepted: 06/17/2023] [Indexed: 08/19/2023] Open
Abstract
BACKGROUND Amid the COVID-19 pandemic and other possible future infectious disease pandemics, dentistry needs to consider modified dental examination regimens that render quality care and ensure the safety of patients and dental health care personnel (DHCP). OBJECTIVE This study aims to assess the acceptance and usability of an innovative mDentistry eHygiene model amid the COVID-19 pandemic. METHODS This pilot study used a 2-stage implementation design to assess 2 critical components of an innovative mDentistry eHygiene model: virtual hygiene examination (eHygiene) and patient self-taken intraoral images (SELFIE), within the National Dental Practice-Based Research Network. Mixed methods (quantitative and qualitative) were used to assess the acceptance and usability of the eHygiene model. RESULTS A total of 85 patients and 18 DHCP participated in the study. Overall, the eHygiene model was well accepted by patients (System Usability Scale [SUS] score: mean 70.0, SD 23.7) and moderately accepted by dentists (SUS score: mean 51.3, SD 15.9) and hygienists (SUS score: mean 57.1, SD 23.8). Dentists and patients had good communication during the eHygiene examination, as assessed using the Dentist-Patient Communication scale. In the SELFIE session, patients completed tasks with minimum challenges and obtained diagnostic intraoral photos. Patients and DHCP suggested that although eHygiene has the potential to improve oral health care services, it should be used selectively depending on patients' conditions. CONCLUSIONS The study results showed promise for the 2 components of the eHygiene model. eHygiene offers a complementary modality for oral health data collection and examination in dental offices, which would be particularly useful during an infectious disease outbreak. In addition, patients being able to capture critical oral health data in their home could facilitate dental treatment triage and oral health self-monitoring and potentially trigger oral health-promoting behaviors.
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Affiliation(s)
- Jin Xiao
- Eastman Institute for Oral Health, University of Rochester, Rochester, NY, United States
| | | | - Patricia Ragusa
- Eastman Institute for Oral Health, University of Rochester, Rochester, NY, United States
| | | | | | - Tamara Lischka
- Kaiser Permanente Center for Health Research, Portland, OR, United States
| | - Tong Tong Wu
- Department of Biostatistics and Computational Biology, University of Rochester, Rochester, NY, United States
| | - Kevin Fiscella
- Department of Family Medicine, University of Rochester, Rochester, NY, United States
| | - Kumari Saswati Kar
- Eastman Institute for Oral Health, University of Rochester, Rochester, NY, United States
| | - Nisreen Al Jallad
- Eastman Institute for Oral Health, University of Rochester, Rochester, NY, United States
| | - Noha Rashwan
- Eastman Institute for Oral Health, University of Rochester, Rochester, NY, United States
| | - Johana Ren
- River Campus, University of Rochester, Rochester, NY, United States
| | - Cyril Meyerowitz
- Eastman Institute for Oral Health, University of Rochester, Rochester, NY, United States
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Ragusa P, Lo Moro G, Aglietta M, Airoldi M, Comandone A, Previti C, Bert F, Siliquini R. Impact of the pandemic on surgical oncology in Piedmont, Italy: a retrospective observational study. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac131.079] [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: 11/14/2022] Open
Abstract
Abstract
Background
To prevent the spread of SARS-CoV-2, containment measures were implemented leading to huge healthcare changes worldwide. This study aimed to describe the impact of COVID-19 pandemic on surgical oncology healthcare in a large Italian sample.
Methods
A retrospective observational study included 99651 patients admitted to the hospitals of Piedmont (Northern Italy) to undergo oncological surgery, provided in ordinary hospitalization. We compared data of 2020 with 2016-2019 mean values. Data were stratified by tumor site, year, month and admission way. Chi-squared tests were used to assess differences in the percentage of admission modes between 2020 and 2016-2019.
Results
An overall reduction in oncological surgery (-12.3%) was observed in 2020 (n = 17923) compared to the mean of period 2016-2019 (n = 20432). A relevant decrease began in March (-11%), continued in April (-18%) and peaked in May (-26%). There was a greater reduction in surgery of breast (-19.2%), bladder (-17.5%), colorectal (-16.5%), kidney (-14.2%), prostate (-14%). Little or no difference was observed for liver (-5.2%), body of uterus (-0.54%), ovary (-0.07%), lymphoma (+4.5%). There was a marked reduction of non-emergency admissions (-13.6%), in particular for some tumor sites: colorectal (-19.4%), breast (-19.4%), bladder (-18.7%). The overall volume of surgeries following an emergency access was unchanged (-0.3%). The proportion of hospitalizations with emergency access increased (p < 0.001).
Conclusions
Our results highlight the burden of the reduction in cancer surgery in 2020 and the risk of delays in diagnosis and treatment for time-dependent conditions. For cancers that can be diagnosed early thanks to screening, the reduction in surgery is likely to be an indirect consequence of discontinuing screening activities. Therefore, further studies are needed to assess, as soon as data are available, the trend in 2021, and to compare our results with those reported in other European countries.
Key messages
• The COVID-19 pandemic caused a significant decline in cancer surgeries in 2020 in Piedmont, Italy. It is necessary to compare our results with those reported in other European countries.
• These results show an increase in the proportion of oncological surgical admissions following emergency access in 2020 compared to the average for 2016-2019.
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Affiliation(s)
- P Ragusa
- Department of Public Health Sciences, University of Turin , Turin, Italy
| | - G Lo Moro
- Department of Public Health Sciences, University of Turin , Turin, Italy
| | - M Aglietta
- Department of Oncology, University of Turin , Turin, Italy
- Candiolo Cancer Institute-FPO-IRCCS , Candiolo, Italy
- Rete Oncologica del Piemonte e della Valle d'Aosta , Turin, Italy
| | - M Airoldi
- Rete Oncologica del Piemonte e della Valle d'Aosta , Turin, Italy
- Oncology Unit 2, A.O.U. City of Health and Science of Turin , Turin, Italy
| | - A Comandone
- Rete Oncologica del Piemonte e della Valle d'Aosta , Turin, Italy
- Department of Oncology, San Giovanni Bosco Hospital , Turin, Italy
- Italian Group of Rare Tumors , Turin, Italy
| | - C Previti
- Department of Public Health Sciences, University of Turin , Turin, Italy
| | - F Bert
- Department of Public Health Sciences, University of Turin , Turin, Italy
| | - R Siliquini
- Department of Public Health Sciences, University of Turin , Turin, Italy
- A.O.U. City of Health and Science of Turin , Turin, Italy
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Fredericks-Younger J, Fine DH, Subramanian G, Coker MO, Meyerowitz C, Ragusa P, Allareddy V, McBurnie MA, Funkhouser E, Gennaro ML, Feldman CA. The Pragmatic Return to Effective Dental Infection Control Through Triage and Testing (PREDICT) Study: Protocol for a Prospective Clinical Study in the National Dental Practice-Based Research Network. JMIR Res Protoc 2022; 11:e38386. [PMID: 35944181 PMCID: PMC9439378 DOI: 10.2196/38386] [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: 03/30/2022] [Revised: 08/03/2022] [Accepted: 08/06/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Dental practice has been greatly affected by the COVID-19 pandemic. As SARS-CoV-2 infection is transmitted by respiratory fluids, dental practice techniques, which include aerosol-generating procedures, can increase the risk of transmission causing heightened safety concerns for both dental health care workers (DHCWs) and patients. These concerns have resulted in the reduction in patient volume and the available workforce within dental practices across the United States. Standardized methods for COVID-19 triage and testing may lead to increased safety and perceptions of safety for DHCWs and their patients and promote willingness to provide and access oral health care services. OBJECTIVE This study is designed to develop procedures that test the feasibility of enhanced COVID-19 triage and testing in dental offices. It will provide preliminary data to support a larger network-wide study grant application aimed at developing protocols to address safety concerns of patients and DHCWs in a peri-COVID-19 pandemic era. METHODS The feasibility study is being conducted in 4 private dental practices, each of which has a dentist member of the National Dental Practice-Based Research Network. Participants include the DHCWs and patients of the dental practice. Study procedures include completion of COVID-19 triage, completion of COVID-19 testing (point-of-care [POC] or laboratory-based [LAB] SARS-CoV-2 viral, antigen, and antibody tests based on office designation), and administration of perception and attitude surveys for participating DCHWs and patients of the dental practice over a defined study period. The office designation and the participant's role in the practice determines which testing protocol is executed within the office. There are 4 study groups following 4 distinct protocols: (1) POC DHCWs, (2) POC patients, (3) LAB DHCWs, and (4) LAB patients. RESULTS Data collection began in December of 2021 and concluded in March 2022. Study results are expected to be published in fall 2022. CONCLUSIONS The results of this feasibility study will help identify the viability and functionality of COVID-19 triage and testing in dental practices and inform a larger network-wide study grant application that develops protocols that address safety concerns of patients and DHCWs in a COVID-19 environment. TRIAL REGISTRATION ClinicalTrials.gov NTC05123742; https://clinicaltrials.gov/ct2/show/NCT05123742?term=NCT05123742. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/38386.
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Affiliation(s)
| | - Daniel H Fine
- School of Dental Medicine, Rutgers University, Newark, NJ, United States
| | | | - Modupe O Coker
- School of Dental Medicine, Rutgers University, Newark, NJ, United States
| | - Cyril Meyerowitz
- Eastman Institute for Oral Health, University of Rochester, Rochester, NY, United States
| | - Patricia Ragusa
- Eastman Institute for Oral Health, University of Rochester, Rochester, NY, United States
| | - Veerasathpurush Allareddy
- Department of Orthodontics, College of Dentistry, University of Illinois at Chicago, Chicago, IL, United States
| | - Mary Ann McBurnie
- Center for Health Research, Kaiser Permanente Northwest, Portland, OR, United States
| | - Ellen Funkhouser
- Department of Medicine, University of Alabama, Birmingham, AL, United States
| | - Maria Laura Gennaro
- Public Health Research Institute, New Jersey Medical School, Rutgers University, Newark, NJ, United States
| | - Cecile A Feldman
- School of Dental Medicine, Rutgers University, Newark, NJ, United States
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Xiao J, Meyerowitz C, Ragusa P, Funkhouser K, Lischka TR, Mendez Chagoya LA, Al Jallad N, Wu TT, Fiscella K, Ivie E, Strange M, Collins J, Kopycka-Kedzierawski DT. Assessment of an Innovative Mobile Dentistry eHygiene Model Amid the COVID-19 Pandemic in the National Dental Practice-Based Research Network: Protocol for Design, Implementation, and Usability Testing. JMIR Res Protoc 2021; 10:e32345. [PMID: 34597259 PMCID: PMC8549859 DOI: 10.2196/32345] [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] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 09/20/2021] [Accepted: 09/22/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Amid COVID-19, and other possible future infectious disease pandemics, dentistry needs to consider modified dental examination regimens that render quality care, are cost effective, and ensure the safety of patients and dental health care personnel (DHCP). Traditional dental examinations, which number more than 300 million per year in the United States, rely on person-to-person tactile examinations, pose challenges to infection control, and consume large quantities of advanced-level personal protective equipment (PPE). Therefore, our long-term goal is to develop an innovative mobile dentistry (mDent) model that takes these issues into account. This model supplements the traditional dental practice with virtual visits, supported by mobile devices such as mobile telephones, tablets, and wireless infrastructure. The mDent model leverages the advantages of digital mobile health (mHealth) tools such as intraoral cameras to deliver virtual oral examinations, treatment planning, and interactive oral health management, on a broad population basis. Conversion of the traditional dental examinations to mDent virtual examinations builds upon (1) the reliability of teledentistry, which uses intraoral photos and live videos to make diagnostic decisions, and (2) rapid advancement in mHealth tool utilization. OBJECTIVE In this pilot project, we designed a 2-stage implementation study to assess 2 critical components of the mDent model: virtual hygiene examination (eHygiene) and patient self-taken intraoral photos (SELFIE). Our specific aims are to (1) assess the acceptance and barriers of mDent eHygiene among patients and DHCP, (2) assess the economic impact of mDent eHygiene, and (3) assess the patient's capability to generate intraoral photos using mHealth tools (exploratory aim, SELFIE). METHODS This study will access the rich resources of the National Dental Practice-Based Research Network to recruit 12 dentists, 12 hygienists, and 144 patients from 12 practices. For aims 1 and 2, we will use role-specific questionnaires to collect quantitative data on eHygiene acceptance and economic impact. The questionnaire components include participant characteristics, the System Usability Scale, a dentist-patient communication scale, practice operation cost, and patient opportunity cost. We will further conduct a series of iterative qualitative research activities using individual interviews to further elicit feedback and suggestion for changes to the mDent eHygiene model. For aim 3, we will use mixed methods (quantitative and qualitative) to assess the patient's capability of taking intraoral photos, by analyzing obtained photos and recorded videos. RESULTS The study is supported by the US National Institute of Dental and Craniofacial Research. This study received "single" institutional review board approval in August 2021. Data collection and analysis are expected to conclude by December 2021 and March 2022, respectively. CONCLUSIONS The study results will inform the logistics of conducting virtual dental examinations and empowering patients with mHealth tools, providing better safety and preserving PPE amid the COVID-19 and possible future pandemics. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/32345.
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Affiliation(s)
- Jin Xiao
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, United States
| | - Cyril Meyerowitz
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, United States
| | - Patricia Ragusa
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, United States
| | | | - Tamara R Lischka
- Kaiser Permanente Center for Health Research, Portland, OR, United States
| | | | - Nisreen Al Jallad
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, United States
| | - Tong Tong Wu
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, United States
| | - Kevin Fiscella
- Department of Family Medicine, University of Rochester Medical Center, Rochester, NY, United States
| | - Eden Ivie
- Mouthwatch LLC, Metuchen, NJ, United States
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Berkowitz RJ, Koo H, McDermott MP, Whelehan MT, Ragusa P, Kopycka-Kedzierawski DT, Karp JM, Billings R. Adjunctive chemotherapeutic suppression of mutans streptococci in the setting of severe early childhood caries: an exploratory study. J Public Health Dent 2010; 69:163-7. [PMID: 19486465 DOI: 10.1111/j.1752-7325.2009.00118.x] [Citation(s) in RCA: 20] [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: 11/26/2022]
Abstract
OBJECTIVES This investigational study assessed the suppressive effect of 10 percent povidone iodine (PI) coupled with elimination of active carious lesions on salivary mutans streptococci (MS) populations in children with severe early childhood caries (S-ECC). METHODS 77 children (38 females, 39 males) were treated for S- ECC in one session; a 0.2 ml PI solution was applied to the dentition after dental surgery was completed and immediately wiped off. The subjects aged from 2 to 5 years (mean = 3.78 years) at baseline. Whole nonstimulated saliva samples were obtained at baseline, 30 days, 60 days, and 90 days post dental surgery. Samples were placed on ice and processed within 2 hours. The MS level in each sample was expressed as colony forming units (CFUs) per ml of saliva. RESULTS Approximately 50 percent of subjects had a >95 percent reduction in CFU/ml of saliva at each time point after baseline. The percentages of subjects with a >50 percent reduction in MS level were 85 percent at 30 days, 83 percent at 60 days, 84 percent at 90 days. The median (25th, 75th percentiles) CFUs/ml of saliva counts were 8.40 x 10(5) (1.49 x 10(5), 5.00 x 10(6)) at baseline (n= 77), 4.12 x 10(4) (8.40 x 10(3), 1.89 x 10(5)) at 30 days (n = 74), 4.62 x 10(4) (7.00 x 10(3), 1.36 x 10(5)) at 60 days (n = 70), and 5.09 x 10(4) (1.16 x 10(4), 1.00 x 10(5)) at 90 days (n = 70). The changes from baseline to 30 days, 60 days, and 90 days were statistically significant (P < 0.0001). CONCLUSIONS PI coupled with dental surgery has a significant suppressive effect on salivary MS levels in the setting of S-ECC for at least 90 days. These data strongly suggest that treatment with PI may be an important adjunct to dental surgery for S-ECC.
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Affiliation(s)
- Robert J Berkowitz
- University of Rochester/Eastman Dental Center, 625 Elmwood Avenue, Rochester, NY 14620, USA.
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