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Developing a maturity model for cancer multidisciplinary teams.

Int J Med Inform 2021 Oct 4;156:104610. Epub 2021 Oct 4.

Sydney West Translational Cancer Research Centre, Western Sydney Local Health District, Westmead NSW 2145, Australia; Western Sydney Local Health District, Westmead NSW 2145, Australia. Electronic address:

Background: Multidisciplinary teams (MDTs) are considered the "gold standard" of care for patients with cancer but how well they function and the role they play in decision making varies widely. Although several observational tools have been developed to evaluate MDT performance, they are resource intensive and only assess MDT performance at a static point in time. The aim of this study was to develop a validated maturity model as a self-assessment instrument for MDTs to evaluate their performance and monitor improvement over time. Read More

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October 2021

Nanoparticle-assisted detection of nucleic acids in a polymeric nanopore with a large pore size.

Biosens Bioelectron 2021 Oct 8;196:113697. Epub 2021 Oct 8.

Department of Chemistry, Illinois Institute of Technology, 3101 S Dearborn St, Chicago, IL, 60616, USA. Electronic address:

Rapid and accurate detection of nucleic acids is of paramount importance in many fields, including medical diagnosis, gene therapy and virus identification. In this work, by taking advantage of two DNA hybridization probes, one of which was immobilized on the surface of gold nanoparticles, while the other was free in solution, detection of short length nucleic acids was successfully achieved using a large size (20 nm tip diameter) polyethylene terephythalate (PET) nanopore. The sensor was sensitive and selective: DNA samples with concentrations at as low as 0. Read More

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October 2021

Health Plans Struggle to Report on Depression Quality Measures that Require Clinical Data.

Acad Pediatr 2021 Oct 11. Epub 2021 Oct 11.

National Committee for Quality Assurance (E Morden, S Byron, L Roth, SS Olin and H Scholle), Wash.

Objective: Depression quality measures aligned with evidence-based practices require that health care organizations use standardized tools for tracking and monitoring patient-reported symptoms and functioning over time. This study describes challenges and opportunities for reporting five HEDIS measures which use electronic clinical data to assess adolescent and perinatal depression care quality.

Methods: Two learning collaboratives were convened with 10 health plans from five states to support reporting of the depression measures. Read More

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October 2021

Advance Care Planning Coaching in CKD Clinics: A Pragmatic Randomized Clinical Trial.

Am J Kidney Dis 2021 Oct 11. Epub 2021 Oct 11.

George Washington University Milken Institute School of Public Health.

Rationale And Objective: Although guidelines recommend more and earlier advance care planning (ACP) for patients with chronic kidney disease (CKD), scant evidence exists to guide incorporation of ACP into clinical practice for patients not yet requiring maintenance dialysis. Involving nephrology team members in addition to primary care providers in this important patient-centered process may increase its accessibility. Our objective was to examine the effect of coaching implemented in CKD clinics on patient engagement with ACP. Read More

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October 2021

Prognosis of patients with hepatocellular carcinoma treated with immunotherapy - development and validation of the CRAFITY score.

J Hepatol 2021 Oct 11. Epub 2021 Oct 11.

Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria; Vienna Hepatic Hemodynamic Laboratory, Medical University of Vienna, Vienna, Austria; Christian-Doppler Laboratory for Portal Hypertension and Liver Fibrosis, Medical University of Vienna, Vienna, Austria; Ludwig Boltzmann Institute for Rare and Undiagnosed Diseases, Vienna, Austria; CeMM Research Center for Molecular Medicine of the Austrian Academy of Sciences, Vienna, Austria.

Background: Immunotherapy with atezolizumab plus bevacizumab represents the new standard of care in systemic front-line treatment of hepatocellular carcinoma (HCC). Prognostic biomarkers are an unmet need.

Methods: Patients with HCC put on PD-(L)1-based immunotherapy in 6 European centers (training set; n=190) and in 8 European centers (validation set; n=102) were included. Read More

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October 2021

Characteristics of the clinical treatment of Brazilian and French older adults with diabetes.

Diabetes Res Clin Pract 2021 Oct 11:109088. Epub 2021 Oct 11.

Department of Internal Medicine, Geriatrics and Therapeutics, Saint Julien Hospital, Rouen University Hospital. Electronic address:

Objective: The study aimed to compare the drug therapy profile between French older adults with diabetes of the GERODIAB cohort and Brazilian older adults with diabetes assessed in a cross-sectional study conducted in Brazil.

Method: This quantitative cross-sectional study was conducted with a sample of 246 Brazilian people aged 65 and over receiving care through the Unified Health System in the city of Fortaleza, Northeastern Brazil, who were compared to a sample of 987 French people aged 70 and over receiving care the Rouen University Center in France.

Results: The French participants treated for type 2 diabetes (T2D) with insulin alone, insulin + oral hypoglycemic agent (OHA) or OHA/GLP-1 analogue were older and presented higher mean values for body mass index, waist circumference and duration of diabetes in years. Read More

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October 2021

[Antibiotic-induced organ dysfunction in intensive care patients].

Authors:
Jiří Chvojka

Klin Mikrobiol Infekc Lek 2020 Dec;26(4):134-137

Metabolic Intensive Care Unit, First Department of Internal Medicine, University Hospital Pilsen, Czech Republic, e-mail:

The aim of this review is to point out the dark side of antibiotic treatment in critically ill patients. Although antibiotics are crucial for survival of patients with infection, the risk of organ dysfunction potentiated by them cannot be overlooked. Antibiotic classes and their influence on organ dysfunction and the development of bacterial resistance are discussed in the text. Read More

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December 2020

Point-of-care molecular diagnosis of Mycoplasma pneumoniae including macrolide sensitivity using quenching probe polymerase chain reaction.

PLoS One 2021 14;16(10):e0258694. Epub 2021 Oct 14.

Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan.

Objectives: Macrolides are generally considered to be the drugs of choice for treatment of patients with Mycoplasma pneumoniae infection. However, macrolide-resistant M. pneumoniae has been emerging since about 2000. Read More

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October 2021

Do medical students and residents impact the quality of patient care? An assessment from different stakeholders in an Italian academic hospital, 2019.

PLoS One 2021 14;16(10):e0258633. Epub 2021 Oct 14.

Department of Medicine, University of Udine, Udine, Italy.

Medical students and residents play an important role in patient care and ward activities, thus they should follow hospital procedures and ensure best practices and patient safety. A survey concerning staff on training was conducted to assess the perceived quality of healthcare from healthcare workers (HCWs), residents, medical students and patients in Udine Academic Hospital, Italy. Between December, 2018 and March, 2019, a 5-point Likert-scale questionnaire was administered in 21 units, covering four thematic areas: patients and medical staff satisfaction with the quality of care provided by residents and students, patient privacy, clinical risk management, patient perception of staff on training. Read More

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October 2021

Functional Outcomes of Arthroscopic Acetabular Labral Repair with and without Bone Marrow Aspirate Concentrate.

J Bone Joint Surg Am 2021 Oct 14. Epub 2021 Oct 14.

The Hospital for Special Surgery, New York, NY.

Background: Osteoarthritis (OA) of the hip is a debilitating condition associated with inferior outcomes in patients undergoing hip arthroscopy. To provide symptom relief and improve outcomes in these patients, bone marrow aspirate concentrate (BMAC) has been applied as an adjuvant therapy with the hope of halting progression of cartilage damage. The current study examined the clinical efficacy of BMAC application in patients undergoing arthroscopic acetabular labral repair by comparing patient-reported outcome measures (PROMs) between groups with and without BMAC application. Read More

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October 2021

Electroanalytical Paper-Based Nucleic Acid Amplification Biosensors with Integrated Thread Electrodes.

Anal Chem 2021 Oct 14. Epub 2021 Oct 14.

School of Engineering Sciences in Chemistry, Biotechnology, and Health, KTH Royal Institute of Technology, Teknikringen 56, Stockholm 10044, Sweden.

Nucleic acid amplification tests (NAATs) are very sensitive and specific methods, but they mainly rely on centralized laboratories and therefore are not suitable for point-of-care testing. Here, we present a 3D microfluidic paper-based electrochemical NAAT. These devices use off-the-shelf gold plasma-coated threads to integrate electroanalytical readouts using self-assembled monolayer formation on the threads prior to assembling into the paper device. Read More

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October 2021

High-throughput fabrication of high aspect ratio Ag/Al nanopillars for optical detection of biomarkers.

J Mater Chem B 2021 Oct 14. Epub 2021 Oct 14.

Micro/Bio/Nanofluidics Unit, Okinawa Institute of Science and Technology Graduate University, 1919-1 Tancha, Onna-son, Okinawa 904-0412, Japan.

Nanomaterial-based optical techniques for biomarker detection have garnered tremendous attention from the nanofabrication community due to their high precision and enhanced limit of detection (LoD) features. These nanomaterials are highly responsive to local refractive index (RI) fluctuations, and their RI unit sensitivity can be tuned by varying the chemical composition, geometry, and dimensions of the utilized nanostructures. To improve the sensitivity and LoD values of these nanomaterials, it is common to increase both dimensions and aspect ratios of the fabricated nanostructures. Read More

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October 2021

A portable SERS sensor for pyocyanin detection in simulated wound fluid and through swab sampling.

Analyst 2021 Oct 14. Epub 2021 Oct 14.

Institute of Materials Research and Engineering, A*STAR (Agency for Science, Technology and Research), 2 Fusionopolis Way, Innovis, #08-03, Singapore 138634.

A portable surface-enhanced Raman spectroscopy (SERS) sensor for detecting pyocyanin (PYO) in simulated wound fluid and from bacteria samples was developed. Solution-phase SERS detection protocols are designed to be compatible with two different clinical practices for wound exudate collection, namely negative pressure liquid collection and swabbing. For citrate-coated metal nanoparticles of three different compositions, gold (AuNPs), alloyed silver/gold (AgAuNPs), and silver (AgNPs), we firstly confirmed their interaction with PYO in the complex wound fluid, using fluorescence quenching experiments, which rationalized the Raman enhancement effects. Read More

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October 2021

Dual-functional gold-iron oxide core-satellite hybrid nanoparticles for sensitivity enhancement in biosensors nanoplasmonic and preconcentration effects.

Analyst 2021 Oct 14. Epub 2021 Oct 14.

Department of Chemistry and Biochemistry, National Chung Cheng University, Chiayi 621, Taiwan.

A common strategy to improve the sensitivity of a biosensor for the detection of a low abundance analyte is to preconcentrate the analyte molecules before detection. A dual-functional gold-iron oxide core-satellite hybrid nanoparticle structure is proposed in this work to overcome the drawbacks of traditional sample pretreatment methods and the methods using non-magnetic nanomaterials for sample pretreatment. The new dual-functional hybrid nanoparticle structure can simultaneously serve as a signal reporter of a biorecognition event and a preconcentrator of a target at an extremely low concentration in a nanoplasmonic biosensor. Read More

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October 2021

Microfluidic devices based on textile threads for analytical applications: state of the art and prospects.

Anal Methods 2021 Oct 14. Epub 2021 Oct 14.

Institute of Chemistry, State University of Campinas (Unicamp), Campinas, SP, 13083-861, Brazil.

Microfluidic devices based on textile threads have interesting advantages when compared to systems made with traditional materials, such as polymers and inorganic substrates (especially silicon and glass). One of these significant advantages is the device fabrication process, made more cheap and simple, with little or no microfabrication apparatus. This review describes the fundamentals, applications, challenges, and prospects of microfluidic devices fabricated with textile threads. Read More

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October 2021

[Effectiveness and challenges in cancer palliative home-care services: a retrospective cohort study.]

Recenti Prog Med 2021 Oct;112(10):647-652

UOC Cure Palliative, Azienda ULSS 8 Berica, Vicenza.

Introduction: Management by the palliative care network (RLCP) has been identified as one of the major determinants of clinical appropriateness and reduction of hospital admissions in cancer patient's end of life. The patient's transition process from hospital cancer care to palliative home care is particularly frail from both a clinical and organizational point of view, requiring a multidimensional assessment (VMD) and the draft of an individual care plan (PAI). The aim of this study was to assess the impact of appropriate home-based palliative care in reducing hospitalizations, and also to identify critical issues in the patient's transition to home palliative care. Read More

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October 2021

[The Neumarkt concept of nursing case responsibility: A framework for consequent and person-centred realization of the nursing process].

Pflege 2021 Oct 15:1-9. Epub 2021 Oct 15.

Klinikum Neumarkt, Neumarkt in der Oberpfalz.

The Neumarkt concept of nursing case responsibility: A framework for consequent and person-centred realization of the nursing process An essential requirement for the realization of person-centred practice is a practice environment, that supports the forming of professional nurse-patient-relationships. Therefore, Klinikum Neumarkt implemented in context of practice development a concept for nursing case responsibility, that offers a framework for a person-centred and systematic coordination of the nursing process. Because of the existing conflict between economic and nursing interests, it is essential to prove the effectiveness of the concept. Read More

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October 2021

Mathematically arterialised venous blood is a stable representation of patient acid-base status at steady state following acute transient changes in ventilation.

J Clin Monit Comput 2021 Oct 13. Epub 2021 Oct 13.

Respiratory and Critical Care (RCare) Group, Aalborg University, Fredrik Bajers Vej 7E, 9220, Aalborg Øst, Denmark.

Hyper- or hypoventilation are commonly occurring stress responses to arterial puncture around the time of blood sampling and have been shown to rapidly alter arterial blood acid-base parameters. This study aimed to evaluate a physiology-based mathematical method to transform peripheral venous blood acid-base values into mathematically arterialised equivalents following acute, transient changes in ventilation. Data from thirty patients scheduled for elective surgery were analysed using the physiology-based method. Read More

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October 2021

Access to the Emergency Contraceptive Pill and Women's Reproductive Health: Evidence From Public Reform in Chile.

Demography 2021 Oct 14. Epub 2021 Oct 14.

Institute of Sociology, Pontificia Universidad Católica de Chile, Santiago, Chile.

We examine the sharp expansion in availability of the emergency contraceptive pill in Chile following legalized access through municipal public health care centers. We study the period 2002-2016 and a broad rollout of the emergency contraceptive pill occurring between 2008 and 2011. By combining a number of administrative data sets on health outcomes and pharmaceutical use, and using event-study and difference-in-differences methods, we document that this expansion improved certain classes of women's reproductive health outcomes, notably reducing rates of abortion-related morbidity. Read More

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October 2021

Genetic analysis with pyrosequencing using loop pipetting and a light dependent resistor.

Anal Methods 2021 Oct 14. Epub 2021 Oct 14.

Department of Biological Sciences, Faculty of Basic & Applied Sciences, International Islamic University, Sector H-10, Islamabad, Pakistan.

DNA sequencing is among the most important techniques in biology to decipher the key genetic players of health and disease. The existing laboratory instruments for DNA sequencing are well established and reliable. However, these instruments are still out of reach of most laboratories in the world due to very high equipment and running costs and require trained personnel to keep them running. Read More

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October 2021

A Combination of N-Terminal proB-Type Natriuretic Peptide and Myoglobin Can Predict Severe Complications After Major Non-Cardiac Surgery in Elderly Patients: A Prospective Observational Cohort Study.

Front Med (Lausanne) 2021 27;8:679260. Epub 2021 Sep 27.

Departments of Anesthesiology, West China Hospital of Sichuan University, Chengdu, China.

Previous studies have demonstrated that serum N-terminal proB-type natriuretic peptide (NT-proBNP) was a predictor of adverse cardiovascular outcomes after surgery. We performed a prospective study to evaluate if NT-proBNP could be a sensitive marker of overall postoperative outcomes in older patients undergoing major elective non-cardiac surgery when combined with myoglobin (MYO). Two hundred and three adults aged ≥65 years were enrolled in the study. Read More

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September 2021

Spirituality and Wellness in Plastic Surgery: A Survey of ASPS Members.

Plast Reconstr Surg Glob Open 2021 Oct 7;9(10):e3853. Epub 2021 Oct 7.

Department of Plastic and Reconstructive Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio.

Spirituality is an important, yet often overlooked, component of personal well-being. The purpose of this study was to assess whether spirituality plays an important role in the well-being of US plastic surgeons and residents, and whether spirituality is viewed as an important component of patient care.

Methods: An anonymous and voluntary email survey was distributed to 3375 members of ASPS during the months of April through June of 2020. Read More

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October 2021

Clinical Wide-Field Retinal Image Deep Learning Classification of Exudative and Non-Exudative Age-Related Macular Degeneration.

Cureus 2021 Aug 30;13(8):e17579. Epub 2021 Aug 30.

Ophthalmology, California Northstate University College of Medicine, Elk Grove, USA.

Background:  Age-related macular degeneration (AMD) is a disease that currently affects approximately 196 million individuals and is projected to affect 288 million in 2040. As a result, better and earlier detection methods for this disease are needed in an effort to provide a higher quality of care. One way to achieve this is through the utilization of machine learning. Read More

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Management of Peritonsillar Abscess Within a Local Emergency Department: A Quality Analysis Study.

Cureus 2021 Aug 29;13(8):e17545. Epub 2021 Aug 29.

Otolaryngology - Head and Neck Surgery, Lehigh Valley Health Network, Allentown, USA.

Objective: Peritonsillar abscess (PTA) is the most common deep space infection of the head and neck, affecting thousands of people annually with high treatment costs. The purpose of this project was to determine how in-network emergency departments (EDs) adhere to generally accepted guidelines regarding diagnosis and management of potential PTAs.

Methods: The authors performed a retrospective chart review to identify patients with PTA in five EDs in one year. Read More

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Quantifying SARS-CoV-2 nucleocapsid antigen in oropharyngeal swabs using single molecule array technology.

Sci Rep 2021 10 13;11(1):20323. Epub 2021 Oct 13.

Department of Biochemistry and Immunology, Lillebaelt Hospital, University Hospital of Southern Denmark, Vejle, Denmark.

This study aimed to develop a highly sensitive SARS-CoV-2 nucleocapsid antigen assay using the single molecule array (Simoa) technology and compare it with real time RT-PCR as used in routine clinical practice with the ambition to achieve a comparative technical and clinical sensitivity. Samples were available from 148 SARS-CoV-2 real time RT-PCR positive and 73 SARS-CoV-2 real time RT-PCR negative oropharyngeal swabs. For determination of technical sensitivity SARS-CoV-2 virus culture material was used. Read More

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October 2021

A novel benchmark for COVID-19 pandemic testing effectiveness enables the accurate prediction of new Intensive Care Unit admissions.

Sci Rep 2021 10 13;11(1):20308. Epub 2021 Oct 13.

Center for Preventive Medicine & Longevity, Bioiatriki Healthcare Group, 11525, Athens, Greece.

The positivity rate of testing is currently used both as a benchmark of testing adequacy and for assessing the evolution of the COVID-19 pandemic. However, since the former is a prerequisite for the latter, its interpretation is often conflicting. We propose as a benchmark for COVID-19 testing effectiveness a new metric, termed 'Severity Detection Rate' (SDR), that represents the daily needs for new Intensive Care Unit (ICU) admissions, per 100 cases detected (t - i) days ago, per 10,000 tests performed (t - i) days ago. Read More

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October 2021

Efficacy of metamizole versus ibuprofen and a short educational intervention versus standard care in acute and subacute low back pain: a study protocol of a randomised, multicentre, factorial trial (EMISI trial).

BMJ Open 2021 Oct 13;11(10):e048531. Epub 2021 Oct 13.

Department of General Internal Medicine, Bern University Hospital, Bern, Switzerland.

Introduction: Low back pain (LBP) is among the top three most common diseases worldwide, resulting in a life with pain-related disability. To date, no study has assessed the efficacy of metamizole (dipyrone), a non-opioid analgesic and antipyretic prodrug compared with the conventional non-steroidal anti-inflammatory drug ibuprofen, in patients with an acute LBP episode. Further, it is unclear, whether a short educational intervention is superior to usual care alone. Read More

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October 2021

Screening for SARS-CoV-2 infection in asymptomatic individuals using the Panbio COVID-19 antigen rapid test (Abbott) compared with RT-PCR: a prospective cohort study.

BMJ Open 2021 10 13;11(10):e048206. Epub 2021 Oct 13.

Department of Medical Microbiology, UMC Utrecht, Utrecht, The Netherlands

Background: Antigen-based point-of-care tests for identification of SARS-CoV-2 may markedly enhance effectiveness of population-based controlling strategies. Previous studies have demonstrated >70% sensitivity and high specificity compared with reverse transcriptase real-time PCR (RT-PCR) in symptomatic individuals, but test performance for asymptomatic individuals is unknown.

Methods: Test performance of the Panbio COVID-19 Ag Rapid Test (Abbott) was compared with RT-PCR in a longitudinal cohort study of asymptomatic football players and staff members of professional football clubs. Read More

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October 2021

Integrating HIV, diabetes and hypertension services in Africa: study protocol for a cluster randomised trial in Tanzania and Uganda.

BMJ Open 2021 Oct 13;11(10):e047979. Epub 2021 Oct 13.

MRC International Statistics and Epidemiology Group, London School of Hygiene & Tropical Medicine, London, UK.

Introduction: HIV programmes in sub-Saharan Africa are well funded but programmes for diabetes and hypertension are weak with only a small proportion of patients in regular care. Healthcare provision is organised from stand-alone clinics. In this cluster randomised trial, we are evaluating a concept of integrated care for people with HIV infection, diabetes or hypertension from a single point of care. Read More

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October 2021

How Should We Use Patient-Reported Outcome Measures at the Point of Care in Hand Surgery?

Authors:

J Hand Surg Am 2021 Oct 10. Epub 2021 Oct 10.

Purpose: Despite the importance of collecting patient-reported outcome measures (PROMs), there are few process guidelines for physicians on how to collect and communicate individualized PROMs in patients at the point of care. The purpose of this study was to develop process guidelines on how to routinely collect and communicate individualized PROMs at the point of care in hand surgery.

Methods: A consortium of 9 fellowship-trained hand or upper limb surgeons and experts in quality measure development evaluated the importance, feasibility, usability, and scientific acceptability of 12 candidate process guidelines regarding the collection and use of individualized PROMs at the point of care using a modified RAND/University of California Los Angeles Delphi appropriateness method. Read More

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October 2021