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1.
Stephanie K. Bezner Erica I. Hodgman Diana L. Diesen Joshua T. Clayton Robert K. Minkes Jacob C. Langer Li Ern Chen 《Journal of pediatric surgery》2014
Background/Purpose
In 2000, we described the variability of pediatric surgical information on the Internet. Since then, online videos have become an increasingly popular medium for education and personal expression. The purpose of this study was to examine the content and quality of videos related to pediatric surgical diagnoses on the Internet.Methods
YouTube™ was searched for videos on gastroschisis, congenital diaphragmatic hernia, pediatric inguinal hernia, and pectus excavatum. The first 40 English language videos for each diagnosis were reviewed for owner and audience characteristics, content and quality.Results
A small majority of videos were made by medical professionals (50.63%, vs. 41.25% by lay persons and 8.13% by fundraising organizations). Eighty percent of videos were intended for a lay audience. Videos by medical professionals were more accurate and complete than those posted by lay persons.Conclusions
The YouTube™ videos varied significantly in content and quality. Videos by lay persons often focused on the emotional aspect of the diagnosis and clinical course. Videos by members of the medical profession tended to be more complete and accurate. These findings underscore the continued need for high quality pediatric surgical information on the Internet for patients and their families. 相似文献2.
Christina R. Vargas MD Danielle J. ChuangBernard T. Lee MD MBA 《The Journal of surgical research》2014
Background
The limited functional health literacy of a significant portion of the adult US population negatively affects their access to appropriate online health information about hernia repair surgery. The National Institutes of Health and American Medical Association recommend that patient-directed content should be written at a sixth-grade reading level. This study aims to evaluate readability of the most frequently used Internet resources for patient information about hernia repair relative to average American literacy.Methods
A web search for “hernia repair surgery” was performed, and the top 12 Web sites were identified. Relevant articles (n = 102) with patient-directed content immediately available from the main sites were downloaded. The 12 most popular consumer magazines in circulation were also identified, and using the same method, the first 10 articles were downloaded from each magazine's Web site for comparison. Readability was assessed using 10 established analyses. A t-test was used to compare the average grade level of hernia repair and magazine articles for each readability test.Results
Web-based information about hernia repair had an overall average reading grade level of 13.6. All 102 articles were above the recommended sixth-grade reading level; these were significantly more difficult to read than the comparison group of articles from popular magazines.Conclusions
Online patient-directed information about hernia repair uniformly exceeds the recommended reading level and may be too difficult to be understood by a large portion of the US population. 相似文献3.
Background
The growing number of bariatric surgery videos shared on YouTube highlights the need for content and quality assessment. The aim of this study was to answer the question ‘Is watching these videos useful to surgeons and patients?’Methods
YouTube was searched using the keywords ‘obesity surgery’, ‘bariatric surgery’ and ‘weight loss surgery’, and 100 videos retrieved using each keyword were classified based on their ‘usefulness score’ as very useful, useful and not useful. Video content; source; length and number of views, likes and dislikes were recorded. Upload sources included doctors or hospitals (DH), medical web sites or TV channels (MW), commercial web sites (CW) or civilians (CI). Between-group differences were compared.Results
Of the 300 videos watched, 175 were included in the study; 53.7% were useful and 24.6% were very useful. There were no between-group differences in the number of likes (p = 0.480), dislikes (p = 0.592) and views (p = 0.104). Most videos were uploaded by MW and DH, also with no significant differences in the number of likes (p = 0.35), dislikes (p = 0.14) and views (p = 0.93). No videos were found with misleading information.Conclusions
The popularity of bariatric surgery and interest of both patients and surgeons are increasing daily. Although videos on bariatric surgery on YouTube may be more useful than those on other surgical procedures, it is important that the videos are uploaded by medical professionals and that specific upload and retrieval filters are applied.4.
Daniel P. Butler Fiona Perry Zameer Shah Jorge Leon-Villapalos 《Burns : journal of the International Society for Burn Injuries》2013
Aim
To evaluate the clinical accuracy and delivery of information on thermal burn first aid available on the leading video-streaming website, YouTube.Methodology
YouTube was searched using four separate search terms. The first 20 videos identified for each search term were included in the study if their primary focus was on thermal burn first aid. Videos were scored by two independent reviewers using a standardised scoring system and the scores totalled to give each video an overall score out of 20.Results
A total of 47 videos were analysed. The average video score was 8.5 out of a possible 20. No videos scored full-marks. A low correlation was found between the score given by the independent reviewers and the number of views the video received per month (Spearman's rank correlation co-efficient = 0.03, p = 0.86).Conclusion
The current standard of videos covering thermal burn first aid available on YouTube is unsatisfactory. In addition to this, viewers do not appear to be drawn to videos of higher quality. Organisations involved in managing burns and providing first aid care should be encouraged to produce clear, structured videos that can be made available on leading video streaming websites. 相似文献5.
Péridurale obstétricale : qualité de l’information médicale en français sur Internet en 2009 et 2010
F. Espitalier M. Barbaz J. Fusciardi M. Laffon 《Annales fran?aises d'anesthèsie et de rèanimation》2013
Objective
The variability of the medical information available on the Internet (MedInfoWeb) raises concern about its quality. There is no data about the quality of MedInfoWeb concerning epidural analgesia for labour (EAL). Our aims were to assess the quality of MedInfoWeb concerning EAL and to study the stability of MedInfoWeb and the ranking of website into search engine (SE) during 1 year.Study design
Observational study.Materials and methods
We created our own data form to analyse the firsts 40 Google®, Alta Vista® and Yahoo® websites. In 2009 and 2010, two independent assessors assessed the quality of the website structure (structure score noted out of 25) and the quality of medical information (medical score noted out of 30). The global score (noted on 55) was the addition of structure and medical scores. A HONcode labelling was noted.Results
Between 2009 and 2010, the average global (23 vs. 22), structure (11 vs. 11) and medical (12 vs. 12) Scores were stable. The SE's quality was comparable. A SE website's rank was not related to its global score. The labelling HONcode websites were the best (26 vs. 21, P = 0.048). The best website in 2009 and 2010 was doctissimo.fr. In 2010, only 58% of the websites were still presents.Conclusion
The quality of MedInfoWeb concerning EAL is poor and did not improve between 2009 and 2010. The MedInfoWeb is unstable: 42% of the websites disappeared in 1 year. No website or SE is currently able to give reliable medical information concerning EAL. 相似文献6.
Rina Parmeshwar Julie A. Margenthaler Emad Allam Ling Chen Katherine S. Virgo Frank E. Johnson 《American journal of surgery》2013
Background
American Society of Clinical Oncology (ASCO) guidelines recommend only office visits and mammograms as the primary modalities for patient surveillance after treatment for breast carcinoma. This study aimed to quantify differences in posttreatment surveillance among medical oncologists, radiation oncologists, and surgeons.Methods
We e-mailed a survey to the 3,245 ASCO members who identified themselves as having breast cancer as a major focus of their practices. Questions assessed the frequency of use of 12 specific surveillance modalities for 5 posttreatment years.Results
Of 1,012 total responses, 846 were evaluable: 5% from radiation oncologists, 70% from medical oncologists, and 10% from surgeons; 15% were unspecified. Marked variation in surveillance practices were noted within each specialty and among specialties.Conclusion
There are notable variations in surveillance intensity. This suggests overuse or underuse or misuse of scarce medical resources. 相似文献7.
8.
Beat Roth Michael P. Wissmeyer Pascal Zehnder Frédéric D. Birkhäuser George N. Thalmann Thomas M. Krause Urs E. Studer 《European urology》2010
Background
Pathoanatomic studies have failed to map accurately the primary lymphatic landing sites of the urinary bladder.Objective
To use single-photon emission computed tomography (SPECT) combined with computed tomography (CT) plus intraoperative gamma probe verification to map the primary lymphatic landing sites of the bladder.Design, setting, and participants
Clinical trial of 60 consecutive cystectomy patients at a single centre.Intervention
Flexible cystoscopy-guided injection of technetium nanocolloid into one of six non-tumour-bearing sites of the bladder for preoperative detection of radioactive lymph nodes (LNs) with SPECT/CT followed by intraoperative verification with a gamma probe. Backup extended pelvic LN dissection (PLND) for ex vivo detection of missed LNs.Measurements
Three-dimensional projection of each LN site.Results and limitations
A median of 4 (range: 1–14) radioactive LNs were detected per site and patient. Ninety-two percent of all LNs were found distal and caudal to where the ureter crosses the common iliac arteries. Eight percent were found proximal to the uretero-iliac crossing, none without simultaneous detection of additional radioactive LNs within the endopelvic region. Extended PLND resected 92% of all primary lymphatic landing sites; limited PLND resected only 52%. A few LNs may have been missed despite preoperative SPECT/CT, intraoperative gamma probe verification, and extended backup PLND.Conclusions
Multimodality SPECT/CT plus intraoperative gamma probe show the template of the bladder's primary lymphatic landing sites to be larger than is often thought. PLND limited to the ventral portion of the external iliac vessels and obturator fossa removes only about 50% of all primary lymphatic landing sites, whereas extended PLND along the major pelvic vessels, including the internal iliac, external iliac, obturator, and common iliac region up to the uretero-iliac crossing, removes about 90%.Trial registration
ClinicalTrials.gov, ISRCTN39379749. 相似文献9.
R. Jouffroy L. Lamhaut D. Cremniter K. An P. Carli B. Vivien 《Annales fran?aises d'anesthèsie et de rèanimation》2013
Introduction
Emergency admission of a patient into an intensive care unit (ICU) is a source of stress for family and/or relatives. Expectations of family and/or relatives are important endpoints for the medical and paramedical team in charge of the patient, to better answer to their questions.Objective
The aim of this study was to determine family's and/or relatives expectations concerning a patient emergently hospitalized into an ICU after out-of-hospital medical care of by a samu team.Materials and method
We performed a survey using a questionnaire sent by email to 500 randomly chosen individuals from the French population.Results
We received 220 responses (44 %). Family and/or relatives expectations are different about short, medium and long terms. Elements perceived as the most important in the short term are severity, diagnosis and prognosis, whereas in the medium and long terms they are hospital-stay and potential sequels. Medical language used is considered as too much complex for more than half of respondents. In case of foreseeable unfavourable outcome, 90 % of respondents would like to receive immediate information using a simple and brief language. At last, nearly two thirds of respondents had been really exposed to such a situation before, and assessed the quality of information received as moderate, with a score of 5/10.Conclusion
Information of families and/or relatives of a patient hospitalized in ICU is essential. Their expectations concern short, medium and long terms. At last, most of them prefers that information would be delivered by a physician, and using a simple and brief language. 相似文献10.
11.
Ulrich Koller Wenzel Waldstein Klaus-Dieter Schatz Reinhard Windhager 《International orthopaedics》2016,40(10):1995-2002
Purpose
YouTube is increasingly becoming a key source for people to satisfy the need for additional information concerning their medical condition. This study analyses the completeness of accurate information found on YouTube pertaining to hip arthritis.Methods
The present study analyzed 133 YouTube videos using the search terms: hip arthritis, hip arthritis symptoms, hip arthritis diagnosis, hip arthritis treatment and hip replacement. Two quality assessment checklists with a scale of 0 to 12 points were developed to evaluate available video content for the diagnosis and the treatment of hip arthritis. Videos were grouped into poor quality (grade 0–3), moderate quality (grade 4–7) and excellent quality (grade 8–12), respectively. Three independent observers assessed all videos using the new grading system and independently scored all videos. Discrepancies regarding the categories were clarified by consensus discussion. For intra-observer reliabilities, grading was performed at two occasions separated by four weeks.Results
Eighty-four percent (n?=?112) had a poor diagnostic information quality, 14% (n?=?19) a moderate quality and only 2% (n?=?2) an excellent quality, respectively. In 86% (n?=?114), videos provided poor treatment information quality. Eleven percent (n?=?15) of videos had a moderate quality and only 3% (n?=?4) an excellent quality, respectively.Conclusions
The present study demonstrates that YouTube is a poor source for accurate information pertaining to the diagnosis and treatment of hip arthritis. These finding are of high relevance for clinicians as videos are going to become the primary source of information for patients. Therefore, high quality educational videos are needed to further guide patients on the way from the diagnosis of hip arthritis to its proper treatment.12.
Adam C. Frischknecht Margaret L. Boehler Cathy J. Schwind Melissa E. Brunsvold Larry D. Gruppen Michael J. Brenner Linnea S. Hauge 《American journal of surgery》2014
Background
This study evaluated a simulated pages curriculum that was developed to assess communication and clinical decision making in medical students and interns.Methods
A curriculum consisting of 14 simulated pages was administered across 5 institutions to 150 senior medical students. A 3-case subset was administered to interns who did not participate in the curriculum. Six expert surgeons identified critical fails and set passing scores for case-specific assessments using the Graphical Hofstee Method.Results
Participants in the curriculum demonstrated superior clinical decision making compared with non-participants across all cases scenarios (P < .01). Average medical student scores for clinical decision making were 46.9%. Global ratings averaged 6.0 for communication and 5.2 for patient care. Passing rates averaged 46%.Conclusions
Participation in a mock page curriculum improved performance. The performance of participants based on expert standards set for simulated page performance highlight the need for innovative approaches to improve interns' preparedness to take calls. 相似文献13.
Charity C. Glass Robert D. Acton Patrice G. Blair Andre R. Campbell Ellen S. Deutsch Daniel B. Jones Kathleen R. Liscum Ajit K. Sachdeva Daniel J. Scott Stephen C. Yang 《American journal of surgery》2014
Background
Simulation can enhance learning effectiveness, efficiency, and patient safety and is engaging for learners.Methods
A survey was conducted of surgical clerkship directors nationally and medical students at 5 medical schools to rank and stratify simulation-based educational topics. Students applying to surgery were compared with others using Wilcoxon's rank-sum tests.Results
Seventy-three of 163 clerkship directors (45%) and 231 of 872 students (26.5%) completed the survey. Of students, 28.6% were applying for surgical residency training. Clerkship directors and students generally agreed on the importance and timing of specific educational topics. Clerkship directors tended to rank basic skills, such as examination skills, higher than medical students. Students ranked procedural skills, such as lumbar puncture, more highly than clerkship directors.Conclusions
Surgery clerkship directors and 4th-year medical students agree substantially about the content of a simulation-based curriculum, although 4th-year medical students recommended that some topics be taught earlier than the clerkship directors recommended. Students planning to apply to surgical residencies did not differ significantly in their scoring from students pursuing nonsurgical specialties. 相似文献14.
A. Cuisinier C. Schilte P. Declety M. Baudrant J. Picard K. Berger P. Bouzat S. Gay D. Falcon J.-L. Bosson J.-F. Payen P. Albaladejo 《Annales fran?aises d'anesthèsie et de rèanimation》2012
Background
Assess efficacy, satisfaction and usefulness of an educational maze based on posters and audioguide for major trauma care teaching to medical students. The educational maze consists of posters with audio comments recorded in an audioguide. This tool was part of a larger educational program including medical simulation.Study design
Prospective, interventional, observational, monocentric study.Student
Medical student of Grenoble University Hospital, in the four last years of medical school, following a training course in anesthesia, emergency medical services and intensive care units.Method
Forty essentials key messages for major trauma management were included in 10 posters and audioguides. A first assessment with short opened answers was handed to the students at the end of the educational maze to assess their memorization. A second assessment with simple choice answers regarding satisfaction and usefulness of this new educational tool was realized at the end of the entire program.Result
One hundred and eighty-four medical students attending the major trauma program were included in this study. On the first test, 75% of essential knowledge on major trauma management was memorized by more than 50% of the medical students. On the second test, 94% of medical students had a high satisfaction level of this educational maze.Conclusion
An educational maze based on posters and audioguides seems to be an efficient, useful tool for teaching essential knowledge on major trauma management to medical students. 相似文献15.
Background
In the Netherlands, as in many other countries, a paucity of research exists on the attitudes and intentions of medical students toward organ donation. These students are of interest for the effect that increasing medical knowledge might have on the willingness to register as a donor.Objective
To examine which factors determine medical students' willingness to register as donors.Methods
We conducted a cross-sectional survey among medical students at the University of Amsterdam. Our questionnaire included questions on actual donor registration, motives, knowledge, and attitudes toward donation. To assess which factors were related to self-reported donor registration status, we conducted multivariate logistic regression analyses.Results
We received 506 questionnaires (response rate at least 84%). The majority of respondents (80%) intended to donate organs, while 59% were registered. Self-reported medical knowledge and positive attitudes on donation were independently associated with registering as a donor. A rising study year was associated with registering as a donor; this could be explained by increasing medical knowledge and changing attitudes.Conclusion
The results of our study suggest that willingness to register as a donor increases with a rising level of knowledge on organ donation up to some minimal level. 相似文献16.
V. Minville T. PlanteB. Eychenne A. ColombaniO. Fourcade 《Annales fran?aises d'anesthèsie et de rèanimation》2009
Objective
The aim of this study was to assess the anaesthetic technique used for emergency shoulder luxation management in a university hospital.Study design
Retrospective observational study.Patients and methods
During a six-year period, all patients who were anaesthetized for shoulder luxation were included. Data were collected from administrative database and patient's files.Results
Two hundred and twenty-four patients were included. Ninety-seven regional anaesthesias were performed (17 failures) and so, 144 general anaesthesias were performed. Among general anaesthesia, 89 patients were not fasten, only four rapid sequence inductions were performed. Sixteen (8%) complications occurred, all during general anaesthesia, among them one inhalation. In not fasten patients, anaesthesia was performed not in accordance with guidelines in 56% of cases of all anaesthetic technique and 96% for patient who had general anaesthesia. Accordance with guidelines was independent from the anaesthesiologist experience or the time of the anaesthesia (night/day).Conclusion
We must spread guidelines information to physicians because of the morbidity. 相似文献17.
Farhang Rabbani Luis Herran YunisRodrigo Pinochet Lucas NogueiraKinjal C. Vora James A. EasthamBertrand Guillonneau Vincent LaudonePeter T. Scardino Karim Touijer 《European urology》2010
Background
The lack of standardized reporting of the complications of radical prostatectomy in the literature has made it difficult to compare incidences across institutions and across different surgical approaches.Objective
To define comprehensively the incidence, severity, and timing of onset of medical and surgical complications of open retropubic prostatectomy (RP) and laparoscopic radical prostatectomy (LP) using a standardized reporting methodology to facilitate comparison.Design, setting, and participants
Between January 1999 and June 2007, 4592 consecutive patients underwent RP or LP without prior radiation or hormonal therapy. Median follow-up was 36.9 mo (interquartile range: 20.3–60.6).Intervention
Open or laparoscopic radical prostatectomy.Measurements
All medical and surgical complications of radical prostatectomy were captured and graded according to the modified Clavien classification and classified by timing of onset.Results and limitations
There were 612 medical complications in 467 patients (10.2%) and 1426 surgical complications in 925 patients (20.1%). The overall incidences of early minor and major medical and surgical complications for RP were 8.5% and 1.5% for medical and 11.4% and 4.9% for surgical complications, respectively. The overall incidences of early minor and major medical and surgical complications for LP were 14.2% and 2.3% for medical and 23.1% and 6.6% for surgical complications, respectively. On multivariate analysis, LP approach was associated with a higher incidence of any grade medical and surgical complications but a lower incidence of major surgical complications than RP. Six hundred fifty-two men (14.2%) visited the emergency department, and 240 men (5.2%) required readmission. The main limitation is the retrospective nature.Conclusions
With standardized reporting, the incidence of some complications is higher than recognized in the literature. Although most complications are minor in severity, medical and surgical complications are observed in approximately 10% and 20% of patients, respectively. Accurate reporting of complications through a standardized methodology is essential for counseling patients regarding risk of complications, for identifying modifiable risk factors, and for facilitating comparison across institutions and approaches. 相似文献18.
C. De Pasquale M.L. Pistorio I. Lauretta P. Fatuzzo M. Fornaro D. Conti S. Di Nuovo N. Sinagra A. Giaquinta D. Zerbo M. Veroux 《Transplantation proceedings》2014
Background
The dialysis delivered after a chronic kidney disease (CDK) or any otherwise severe end-stage renal failure is a complex medical task, leading to major medical and psychopathological distress for the patient. The aim of the present study was to analyze the impact of the dialysis experience on the nephrologic patient's global quality of life.Methods
In the present cross-sectional study, involving 96 patients with end-stage renal disease receiving hemodialysis, demographic, medical, and psychological differential features across different CDK diagnoses were accounted and were then correlated each other.Results
Among other differential features, the “acknowledgement of dependence” (from the medical device delivering the dialysis) emerged as a factor correlated to “self-sufficiency” in CDK patients receiving hemodialysis.Conclusions
Although further, larger-sampled studies on the topic are needed, medical and psychological interventions are useful to ensure a better global quality of life and good therapeutic adherence in dialysis patients. 相似文献19.
José Guillén-Perales Aurelio Luna-Maldonado María Fernández-Prada José Francisco Guillén-Solvas Aurora Bueno-Cavanillas 《Cirugía espa?ola》2013