scholarly journals Radiology reporting in oncology—oncologists’ perspective

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Elisabeta Valeria Spînu-Popa ◽  
Dania Cioni ◽  
Emanuele Neri
Keyword(s):  
Clinical Practice ◽  
Electronic Mail ◽  
Online Survey ◽  
Daily Practice ◽  
Added Value ◽  
Web Pages ◽  
Oncologic Imaging ◽  
Level Of Satisfaction ◽  
Oncologic Patients ◽  
Structured Reports

Abstract Background Structured reporting and standardized criteria are increasingly recognized as means of improving both radiological and clinical practice by allowing for better content and clarity. Our aim was to examine oncologists’ opinions and expectations concerning the radiologist’s report to identify general needs in daily practice and ways to improve interdisciplinary communication. Methods A 19-question survey was sent to 230 oncologists from three different countries (France, Romania, Switzerland) identified on the online web pages of different hospitals and private clinics. The survey was sent by electronic mail with an online survey program (Google Forms®). All recipients were informed of the purpose of the study. The data were collected by the online survey program and analysed through filtering the results and cross-tabulation. Results A total of 52 responses were received (response rate of 22.6%). The majority of the respondents (46/52, 88%) preferred the structured report, which follows a predefined template. Most of the respondents (40/52, 77%) used RECIST 1.1 or iRECIST in tumour assessment. Nearly half of the oncologists (21/52, 40%) measured 1–3 cases per week. On a 10-point Likert scale, 34/52 (65%) oncologists rated their overall level of satisfaction with radiologists’ service between 7 and 10. In contrast, 12/52 (19%) oncologists rated the radiologists’ service between 1 and 4. Moreover, 42/52 (80%) oncologists acknowledged that reports created by a radiologist with a subspecialty in oncologic imaging were superior to those created by a general radiologist. Conclusion Structured reports in oncologic patients and the use of RECIST criteria are preferred by oncologists in their daily clinical practice, which signals the need for radiologists also to implement such reports to facilitate communication. Furthermore, most of the oncologists we interviewed recognized the added value provided by radiologists specializing in oncologic imaging. Because this subspecialty is present in only a few countries, generally in large clinics, further training might become a challenge; nevertheless, intensive efforts should be made to enhance expertise in cancer imaging.

scholarly journals Perceptions of Compensation Strategies for Gait Impairments in Parkinson’s Disease: A Survey Among 320 Healthcare Professionals

2020 ◽  
Vol 10 (4) ◽  
pp. 1775-1778
Author(s):  
Anouk Tosserams ◽  
Maarten J. Nijkrake ◽  
Ingrid H.W.M. Sturkenboom ◽  
Bastiaan R. Bloem ◽  
Jorik Nonnekes
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Clinical Practice ◽  
Online Survey ◽  
Healthcare Professionals ◽  
Daily Practice ◽  
Clinical Implications ◽  
Knowledge Gap ◽  
Gait Impairments ◽  
Specific Expertise

Compensation strategies are an essential part of managing gait impairments in people with Parkinson’s disease (PD). We conducted an online survey among 320 healthcare professionals with specific expertise in PD management, to evaluate their knowledge of compensation strategies for gait impairments in people with PD, and whether they applied these in daily practice. Only 35% of professionals was aware of all categories of compensation strategies. Importantly, just 23% actually applied all seven available categories of strategies when treating people with PD in clinical practice. We discuss the clinical implications, and provide recommendations to overcome this knowledge gap.

Pediatric neurosurgery in Asia and Australasia: training and clinical practice

2021 ◽  
Vol 27 (1) ◽  
pp. 93-101
Author(s):  
Ronnie E. Baticulon ◽  
Michael C. Dewan ◽  
Nunthasiri Wittayanakorn ◽  
Philipp R. Aldana ◽  
Wirginia J. Maixner
Keyword(s):  
Clinical Practice ◽  
Online Survey ◽  
Vascular Malformations ◽  
Economic Status ◽  
Pediatric Neurosurgery ◽  
Income Group ◽  
Fellowship Training ◽  
Pediatric Epilepsy ◽  
Skill Sets ◽  
Survey Responses

OBJECTIVEThere are limited data on the pediatric neurosurgical workforce in Asia and Australasia. The training and clinical practice of pediatric neurosurgeons need to be characterized in order to identify gaps in knowledge and skills, thereby establishing a framework from which to elevate pediatric neurosurgical care in the region.METHODSAn online survey for pediatric neurosurgeons was created in REDCap (Research Electronic Database Capture), collecting demographic information and data on pediatric neurosurgical training and clinical practice. The link to answer the survey was sent to the mailing lists of the Asian Australasian Society for Pediatric Neurosurgery and the Japanese Society for Pediatric Neurosurgery, disseminated during the 2019 Asian Australasian Pediatric Neurosurgery Congress, and spread through social media. The survey was open to neurosurgeons who operated on patients ≤ 18 years old in Asian Australasian countries, whether or not they had completed fellowship training in pediatric neurosurgery. Descriptive statistics were computed and tabulated. Data were stratified and compared based on surgeon training and World Bank income group.RESULTSA total of 155 valid survey responses were analyzed, representing neurosurgeons from 21 countries. A total of 107 (69%) considered themselves pediatric neurosurgeons, of whom 66 (43%) had completed pediatric neurosurgery training. Neurosurgeons in East Asia commonly undergo a fellowship in their home countries, whereas the rest train mostly in North America, Europe, and Australia. A majority (89%) had operating privileges, and subspecialty pediatric training usually lasted from 6 months to 2 years. On average, trained pediatric neurosurgeons perform a higher number of pediatric neurosurgical operations per year compared with nonpediatric-trained respondents (131 ± 129 vs 56 ± 64 [mean ± SD], p = 0.0001). The mean number of total neurosurgical operations per year is similar for both groups (184 ± 129 vs 178 ± 142 [mean ± SD], p = 0.80). Respondents expressed the desire to train further in pediatric epilepsy, spasticity, vascular malformations, craniofacial disorders, and brain tumors.CONCLUSIONSBoth pediatric and general neurosurgeons provide neurosurgical care to children in Asia and Australasia. There is a need to increase pediatric neurosurgery fellowship programs in the region. Skill sets and training needs in pediatric neurosurgery vary depending on the country’s economic status and between pediatric-trained and nonpediatric-trained surgeons.

scholarly journals Rheumatologist perspective of the Brazilian consensus for detection of auto antibodies in HEp-2 CELLS

2021 ◽  
Vol 61 (1) ◽  
Author(s):  
Isadora Carvalho Medeiros Francescantonio ◽  
Leandro Augusto Rodrigues dos Santos ◽  
Paulo Luiz Carvalho Francescantonio ◽  
Luiz Eduardo Coelho Andrade ◽  
Wilson de Melo Cruvinel
Keyword(s):  
Clinical Practice ◽  
Immunofluorescence Assay ◽  
Chi Square ◽  
Dichotomous Data ◽  
Level Of Satisfaction ◽  
Significant Difference ◽  
Chi Square Test ◽  
Geographic Regions ◽  
Relevant Pattern ◽  
Structured Questionnaire

Abstract Objective To evaluate the perception of rheumatologists regarding the recommendations of the Brazilian Consensus for detection of Autoantibodies (BCA) on HEp-2 Cells by Indirect Immunofluorescence assay (IFA) and how BCA recommendations help in clinical practice. Methodology A structured questionnaire regarding the BCA recommendations for detection and interpretations of autoantibodies in HEp-2 cells was applied to randomly selected rheumatologists. The results were tabulated using the Microsoft® Excel program, expressed as a simple percentage and the dichotomous data were analyzed using the Chi-square test and the Epi Info® program. Results Four hundred fuorteen rheumatologists participated in the study: 70% of them considered their knowledge of the HEp-2 IFA test satisfactory or excellent, and 43% said they knew the BCA recommendations in general, without distinguishing the edition of the BCA to which they refer. The Revista Brasileira de Rheumatologia/Advances in Rheumatology was the means of dissemination most consulted by specialists (50%). According to the rheumatologists’ opinion, the most relevant pattern was the homogeneous nuclear (78%) and 65% stated they were satisfied with the BCA recommendations at a level of satisfaction greater than or equal to 80%. There was no significant difference in the perception of rheumatologists from the several Brazilian geographic regions. Conclusion Brazilian rheumatologists are aware of the BCA guidelines and most are satisfied with the content published, considering that the BCA recommendations assist positively in the clinical practice. Most rheumatologists recognize the patterns associated with rheumatic autoimmune diseases and have used BCA recommendations to interpret the results of the HEp-2 IFA test.

scholarly journals THU0647-HPR SHARED DECISION MAKING AMONGST RHEUMATOLOGISTS IN TRAINING IN THE NETHERLANDS: WHERE DO WE STAND?

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 568.2-568
Author(s):  
L. Kranenburg ◽  
M. Dankbaar ◽  
N. Basoski ◽  
W. Van den Broek ◽  
J. Hazes
Keyword(s):  
Decision Making ◽  
The Netherlands ◽  
Shared Decision Making ◽  
Online Survey ◽  
Daily Practice ◽  
Clear Understanding ◽  
Shared Decision ◽  
Professional Activities ◽  
Self Evaluation ◽  
The Subject

Background:The training curriculum for rheumatologists in training in the Netherlands describes competences and entrusted professional activities (EPA) to monitor the progress in learning. However, this training program does not discuss training of Shared Decision Making. As the basis for shared care and patient participation is made during these years, the question arises how rheumatologist in training think about Shared Decision Making and how they use this in daily practice.Objectives:Inventory of vision, experience and self-evaluation of skills related to Shared Decision Making amongst rheumatologists in training in the Netherlands in order to identify barriers in the implementation of Shared Decision Making in daily practice.Methods:Qualitative data was collected from on online survey amongst rheumatologists in training who were registered in January 2018 by the Dutch Society of Rheumatology.Results:Forty-two rheumatologists in training from various years of training responded (60%). Respondents think that Shared Decision Making is important. A third applies Shared Decision Making on a regular basis in daily practice. Self rating of skills for Shared Decision Making varies from sufficient to good. However, respondents are uncertain about their performance due to a lack of feedback and unclearness of the concept. They indicate that Shared Decision Making is not possible for all patients and find it difficult to assess whether the patient has a clear understanding of the options. Patient’s preferences are discussed only by 33% of the doctors on a regular basis when starting new treatment.Conclusion:Rheumatologists in training agree on the importance of Shared Decision Making, but are uncertain about their performance. Unclearness of the concept is described as a known barrier in literature1,2and is frequently mentioned by respondents. Rheumatologist in training indicate that not all patients are fit for Shared Decision Making. Regarding the limited training on the subject this could also be a misjudgment of patients preferences and lack of experience how to deal with different patient types. There is a clear plea for more training and feedback on the subject. Training should be integrated in the curriculum focusing on how to assess patients preferences and how to apply Shared Decision Making also for patients who indicate to leave decisions up to their doctor.References:[1]van Veenendaal, H.et al.Accelerating implementation of shared decision-making in the Netherlands: An exploratory investigation.Patient Educ Couns101, 2097-2104 (2018).[2]Legare, F., Ratte, S., Gravel, K. & Graham, I. D. Barriers and facilitators to implementing shared decision-making in clinical practice: update of a systematic review of health professionals’ perceptions.Patient Educ Couns73, 526-535 (2008).Disclosure of Interests:Laura Kranenburg Grant/research support from: Pfizer and UCB for the development of the Reuma App, a tool to support selfmanagement for patients. This is not used for the research related to the submitted abstract., Mary Dankbaar: None declared, Natalja Basoski: None declared, Walter Van den Broek: None declared, Johanna Hazes: None declared

scholarly journals Impact of the COVID-19 Pandemic on Physicians Working in the Head and Neck Field

2021 ◽  
Vol 25 (01) ◽  
pp. e150-e159
Author(s):  
Rui Imamura ◽  
Ricardo F. Bento ◽  
Leandro L. Matos ◽  
William N. William ◽  
Gustavo N. Marta ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Head And Neck ◽  
Personal Protective Equipment ◽  
Outpatient Care ◽  
Online Survey ◽  
Family Income ◽  
Protective Equipment ◽  
Psychological Burden ◽  
The Public ◽  
The Third

Abstract Background With the COVID-19 pandemic, the clinical practice of physicians who work in the head and neck field in Brazil dropped dramatically. The sustained impact of the pandemic is not known. Methods An anonymous online survey was distributed to Brazilian otolaryngologists, head and neck surgeons, medical and radiation oncologists, asking about their clinical practice in the third to fourth months of the pandemic. Results The survey was completed by 446 specialists. About 40% reported reduction of more than 75% in outpatient care. A reduction of 90% to 100% in airway endoscopies was reported by 50% of the responders, and the same rate of reduction regarding surgeries (pediatric or nasosinusal) was reported by 80% of them. Family income decreased by 50%, and the psychological burden on physicians was considerable. The availability of personal protective equipment and safety precautions were limited, especially in the public sector. Conclusion COVID-19 is still impacting the head and neck field, and safety concerns may hinder the prompt resumption of elective care.

scholarly journals Evaluation of the added value of 1H-magnetic resonance spectroscopy for the diagnosis of pediatric brain lesions in clinical practice

2017 ◽  
Vol 5 (1) ◽  
pp. 18-27 ◽  
Author(s):  
Karen Manias ◽  
Simrandip K Gill ◽  
Niloufar Zarinabad ◽  
Paul Davies ◽  
Martin English ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Magnetic Resonance ◽  
Brain Lesions ◽  
Added Value ◽  
Tumor Board ◽  
Resonance Spectroscopy ◽  
Noninvasive Diagnosis ◽  
Tumor Characterization ◽  
Mri Diagnosis ◽  
Pediatric Brain

Abstract Background Magnetic resonance spectroscopy (MRS) aids noninvasive diagnosis of pediatric brain tumors, but use in clinical practice is not well documented. We aimed to review clinical use of MRS, establish added value in noninvasive diagnosis, and investigate potential impact on patient care. Methods Sixty-nine children with lesions imaged using MRS and reviewed by the tumor board from 2014 to 2016 met inclusion criteria. Contemporaneous MRI diagnosis, spectroscopy analysis, histopathology, and clinical information were reviewed. Final diagnosis was agreed on by the tumor board at study end. Results Five cases were excluded for lack of documented MRI diagnosis. The principal MRI diagnosis by pediatric radiologists was correct in 59%, increasing to 73% with addition of MRS. Of the 73%, 19.1% (95% CI, 9.1%-33.3%) were incorrectly diagnosed with MRI alone. MRS led to a significant improvement in correct diagnosis over all tumor types (P = .012). Of diagnoses correctly made with MRI, confidence increased by 37% when adding MRS, with no patients incorrectly re-diagnosed. Indolent lesions were diagnosed noninvasively in 85% of cases, with MRS a major contributor to 91% of these diagnoses. Of all patients, 39% were managed without histopathological diagnosis. MRS contributed to diagnosis in 68% of this group, modifying it in 12%. MRS influenced management in 33% of cases, mainly through avoiding and guiding biopsy and aiding tumor characterization. Conclusion MRS can improve accuracy and confidence in noninvasive diagnosis of pediatric brain lesions in clinical practice. There is potential to improve outcomes through avoiding biopsy of indolent lesions, aiding tumor characterization, and facilitating earlier family discussions and treatment planning.

scholarly journals Rotator cuff disorders: a survey of current (2016) UK physiotherapy practice

2017 ◽  
Vol 10 (1) ◽  
pp. 52-61 ◽  
Author(s):  
Julie Bury ◽  
Chris Littlewood
Keyword(s):  
Clinical Practice ◽  
Rotator Cuff ◽  
Management Strategy ◽  
Online Survey ◽  
Exercise Prescription ◽  
Current Evidence ◽  
Positive Finding ◽  
Cross Sectional ◽  
Initial Management ◽  
Physiotherapy Practice

Background Shoulder pain is a common musculoskeletal presentation, with disorders of the rotator cuff (RC) regarded as the most frequent cause. Conservative treatment is often the initial management; however, findings from a previous survey showed considerable variations in clinical practice, including the use of modalities that are not supported in the literature, suggesting that research is not impacting on practice. The present study aimed to survey current UK physiotherapy practice for the management of RC disorders and to determine whether this has changed over the 5-year period since the last survey was conducted. Methods A cross-sectional online survey of UK physiotherapists was conducted. Results One hundred and ninety-one respondents completed the survey which showed that advice/education and some form of exercise therapy are most commonly used as a management strategy for RC disorders. There is a lack of agreement however regarding exercise prescription. The survey suggests less use of passive modalities, indicating that practice has advanced over the last 5 years in line with the current evidence. Conclusions The present study has highlighted that the clinical practice of the survey respondents was in line with current recommendations from research. Hence, in contrast to the survey conducted 5 years previously, research appears to be impacting on practice, which is a positive finding.

scholarly journals Clinical practice patterns in indirect peroral cholangiopancreatoscopy: outcome of a European survey

2021 ◽  
Vol 09 (11) ◽  
pp. E1704-E1711
Author(s):  
Pauline M.C. Stassen ◽  
Pieter Jan F. de Jonge ◽  
George J.M. Webster ◽  
Mark Ellrichmann ◽  
Arno J. Dormann ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Bile Duct ◽  
Online Survey ◽  
Practice Patterns ◽  
International Consensus ◽  
Clinical Practice Patterns ◽  
European Survey ◽  
Standardized Protocol ◽  
Pancreatic Duct Stones

Abstract Background and aims Indirect peroral cholangiopancreatoscopy (IPOC) is a relatively new diagnostic and therapeutic tool for biliopancreatic diseases. This international survey aimed to evaluate clinical practice patterns in IPOC among endoscopists in Europe. Methods An online survey was developed comprising 66 questions on the use of IPOC. Questions were grouped into four domains. The survey was sent to 369 endoscopists who perform IPOC. Results 86 respondents (23.3 %) from 21 different countries across Europe completed the survey. The main indications for cholangioscopy were determination of biliary strictures (85 [98.8 %]) and removal of common bile duct or intrahepatic duct stones (79 [91.9 %]), accounting for an estimated use of 40 % (interquartile range [IQR] 25–50) and 40 % (IQR 30–60), respectively, of all cases undergoing cholangioscopy. Pancreatoscopy was mainly used for removal of pancreatic duct stones (68/76 [89.5 %]), accounting for an estimated use of 76.5 % (IQR 50–95) of all cases undergoing pancreatoscopy. Only 13/85 respondents (15.3 %) had an institutional standardized protocol for targeted cholangioscopy-guided biopsy sampling. IPOC with lithotripsy was used as first-line treatment in selected patients with bile duct stones or pancreatic stones by 24/79 (30.4 %) and 53/68 (77.9 %) respondents, respectively. Conclusions This first European survey on the clinical practice of IPOC demonstrated wide variation in experience, indications, and techniques. These results emphasize the need for prospective studies and development of an international consensus guideline to standardize the practice and quality of IPOC.

scholarly journals Clinical pathways for primary care: current use, interest and perceived usability

2018 ◽  
Vol 25 (7) ◽  
pp. 901-906 ◽  
Author(s):  
Jennifer M Toy ◽  
Adam Drechsler ◽  
Richard C Waters
Keyword(s):  
Primary Care ◽  
Online Survey ◽  
Clinical Pathways ◽  
Decision Support Tool ◽  
Daily Practice ◽  
Support Tool ◽  
System Usability Scale ◽  
Primary Care Clinicians ◽  
Perceived Usability ◽  
Tool Types

Abstract Objective Translating clinical evidence to daily practice remains a challenge and may improve with clinical pathways. We assessed interest in and usability of clinical pathways by primary care professionals. Methods An online survey was created. Interest in pathways for patient care and learning was assessed at start and finish. Participants completed baseline questions then pathway-associated question sets related to management of 2 chronic diseases. Perceived pathway usability was assessed using the system usability scale. Accuracy and confidence of answers was compared for baseline and pathway-assisted questions. Results Of 115 participants, 17.4% had used clinical pathways, the lowest of decision support tool types surveyed. Accuracy and confidence in answers significantly improved for all pathways. Interest in using pathways daily or weekly was above 75% for the respondents. Conclusion There is low utilization of, but high interest in, clinical pathways by primary care clinicians. Pathways improve accuracy and confidence in answering written clinical questions.

Use of Neuromuscular Electrical Stimulationfor Swallowing Habilitation in High-Risk Infants: A Survey of Clinical Practice

2021 ◽  
pp. 1-16
Author(s):  
Deborah Acevedo Bustamante ◽  
Allison M. Plumb ◽  
Dallin J. Bailey ◽  
Mary J. Sandage
Keyword(s):  
Clinical Practice ◽  
High Risk ◽  
Clinical Judgment ◽  
Online Survey ◽  
Clinical Decision Making ◽  
Therapeutic Modality ◽  
Electrode Placement ◽  
Dose Frequency ◽  
Published Evidence ◽  
High Risk Infants

Purpose: The purpose of this clinical focus article was to identify clinical practice patterns of speech-language pathologists (SLPs) who use neuromuscular electrical stimulation (NMES) with the high-risk infants, specifically, the modality treatment parameters and physiological rationale. Method: An online survey was disseminated to query use of NMES by licensed SLPs who routinely address swallowing habilitation in high-risk infants. Results: Eleven of the 40 practicing SLPs who completed the survey indicated they have used NMES on neonates and infants. Most survey respondents reported not using NMES with infants. Of the SLPs who used this modality, over half reported they relied on clinical judgment for determination of NMES dose, frequency of treatments, electrode placement, and discharge determination. While SLPs acknowledged that little empirical evidence is available, those who used this modality indicated that the American Speech-Language-Hearing Association should support this modality in infants. Conclusions: Reliance on clinical judgment, as indicated by SLPs who use NMES on high-risk infants, is not consistent with the evidence-based practice triad, which encourages the use of high-quality peer-reviewed published evidence to inform clinical decision-making. Additional basic and applied research is needed to support use of NMES as a therapeutic modality in infants.

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