scholarly journals Consensus-based classification system for intra-operative management of labral tears during hip arthroscopy—aggregate recommendations from high-volume hip preservation surgeons

2021 ◽  
Author(s):  
Ajay C Lall ◽  
Shawn Annin ◽  
Jeff W Chen ◽  
Samantha Diulus ◽  
Hari K Ankem ◽  
...  
Keyword(s):  
Decision Making ◽  
Classification System ◽  
High Volume ◽  
Operative Management ◽  
Labral Repair ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
System A ◽  
Labral Tears ◽  
Comprehensive Classification

Abstract The purpose of this study was to survey high-volume hip preservation surgeons regarding their perspectives on intra-operative management of labral tears to improve decision-making and produce an effective classification system. A cross-sectional survey of high-volume hip preservation surgeons was conducted in person and anonymously, using a questionnaire that is repeated for indications of labral debridement, repair and reconstruction given the torn labra are stable, unstable, viable or non-viable. Twenty-six high-volume arthroscopic hip surgeons participated in this survey. Provided the labrum was viable (torn tissue that is likely to heal) and stable, labral debridement would be performed by 76.92% of respondents for patients >40 years of age and by >84% of respondents for stable intra-substance labral tears in patients without dysplasia. If the labrum was viable but unstable, labral repair would be performed by >80% of respondents for patients ≤40 years of age and > 80% of respondents if the labral size was >3 mm and located anteriorly. Presence of calcified labra or the Os acetabuli mattered while deciding whether to repair a labrum. In non-viable (torn tissue that is unlikely to heal) and unstable labra, labral reconstruction would be performed by 84.62% of respondents if labral size was <3 mm. The majority of respondents would reconstruct calcified and non-viable, unstable labra that no longer maintained a suction seal. Surgeons performing arthroscopic hip labral treatment may utilize this comprehensive classification system, which takes into consideration patient age, labral characteristics (viability and stability) and bony morphology of the hip joint. When choosing between labral debridement, repair or reconstruction, consensus recommendations from high-volume hip preservation surgeons can enhance decision-making.

scholarly journals How has arthroscopic management of the iliopsoas evolved, and why? A survey of high-volume arthroscopic hip surgeons

2020 ◽  
Vol 7 (2) ◽  
pp. 322-328
Author(s):  
Austin W Chen ◽  
Matthew J Steffes ◽  
Joseph R Laseter ◽  
David R Maldonado ◽  
Victor Ortiz-Declet ◽  
...  
Keyword(s):  
High Volume ◽  
Labral Repair ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Arthroscopic Management ◽  
Literature Evidence ◽  
Poor Outcomes ◽  
High Level ◽  
Hip Flexion ◽  
Based Medicine

Abstract The rapid growth of hip preservation has left surgeons following trends based on limited, or even anecdotal, evidence in certain circumstances. A consensus as well as high-level research on how best to manage the iliopsoas is lacking. Arthroscopic treatment of the iliopsoas may be an example of how treatment patterns and trends can shift with limited evidence-based medicine. A cross-sectional survey of 16 high-volume hip preservation surgeons was conducted to gather perspectives and opinions on how and why the arthroscopic management of the iliopsoas has evolved. All participants completed the survey in person and anonymously. Of the surveyed surgeons, the mean career hip preservation volume was 1031.25 cases (250 to >3000) with an average annual volume of 162.08 cases (75–400). Of the surveyed surgeons’ caseload, 16.1% involved an iliopsoas tenotomy or fractional lengthening mostly commonly (75%) for recalcitrant internal snapping. Labral repair/reconstruction is performed concomitantly 87.5% of the time. Seventy-five percent of surgeons indicated a decrease in frequency of iliopsoas tenotomy over the course of their practice most commonly (56.3%) because of hip flexion weakness; however, 0% of the surgeons could cite literature evidence to support their practices. Perceived poor outcomes in individual practices was the most common (56.3%) source of this complication. Surgeons were less inclined to perform tenotomy on patients with borderline dysplasia (75%) or ligamentous laxity (56.3%).

scholarly journals Monitoring caesarean births using the Robson ten group classification system: A cross-sectional survey of private for-profit facilities in urban Bangladesh

PLoS ONE ◽  
2019 ◽  
Vol 14 (8) ◽  
pp. e0220693 ◽  
Author(s):  
Tahmina Begum ◽  
Herfina Nababan ◽  
Aminur Rahman ◽  
Md Rajibul Islam ◽  
Alayne Adams ◽  
...  
Keyword(s):  
Classification System ◽  
Group Classification ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
For Profit ◽  
System A

Knowledge, Attitudes and associated factors to Use District Health Information System (DHIS2 data) for decision making among health professionals in a Resource limited settings: Cross-sectional Survey (Preprint)

2020 ◽  
Author(s):  
Shuma Gosha Kanfe ◽  
Nebyu Demeke Mengiste ◽  
Mohammedjud Hassen Ahmed ◽  
Gebiso Roba Debele ◽  
Berhanu Fikadie Endehabtu
Keyword(s):  
Decision Making ◽  
Health Professionals ◽  
Associated Factors ◽  
Good Knowledge ◽  
Cross Sectional Survey ◽  
District Health ◽  
Cross Sectional ◽  
Determinant Factors ◽  
Knowledge And Attitudes ◽  
Health Need

BACKGROUND Evidence based practice is a key to increase effectiveness and efficiency of quality health services. To achieve this, utilization of health facility data (DHIS2 data) is required which is determined by knowledge and attitudes of health professionals. Thus, this study aimed to assess knowledge and attitudes of health professionals to use DHIS2 data for decision making. OBJECTIVE This study aimed to assess the knowledge, attitudes and its associated factors among health professionals to use DHIS2 data for decision making at South west of Ethiopia 2020 METHODS Cross sectional quantitative study methods was conducted to assess Knowledge and Attitudes of health professionals to use DHIS2 data. A total of 264 participants were approached. SPSS version 22 software was used for data entry and analysis. Descriptive and analytical statistics including Bivariable and Multivariable analyses was done RESULTS Overall 130(49.2%) of the respondents had good knowledge to use DHIS2 data (95% CI: [43, 55.3]), whereas over 149 (56.4%) of the respondents had favorable attitudes towards the use of DHIS2 data for decision making purpose (95% CI: [53.2, 59.8]). Skills [AOR=2.20,95% CI:(1.16, 4.19)], Age [AOR= 1.92, 95% CI: (1.03, 3.59)] ,Resources[AOR=2.56, 95% CI:(1.35,4.86)], Staffing[AOR= 2.85, 95% CI : (1.49, 5.48)] and Experiences[AOR= 4.66, 95% CI: (1.94, 5.78)] were variables associated with knowledge to use DHIS2 data whereas Training [AOR= 5.59, 95% CI: (2.48, 5.42)], Feedback [AOR= 4.08, 95% CI: (1.87, 8.91)], Motivation [AOR=2.87, 95% CI: (1.36, 6.06)] and Health need [AOR=2.32, 95% CI: (1.10-4.92)] were variables associated with attitudes of health professionals to use DHIS2 data CONCLUSIONS In general, about half of the study participants had good knowledge of DHIS2 data utilization whereas more than half of respondents had favorable attitudes. Skills, resources, ages, staffing and experiences were the most determinant factors for the knowledge to use DHIS2 data whereas health need, motivation, feedback and training were determinant factors for attitudes to use DHIS2 data

scholarly journals Public knowledge, preferences and experiences about medical substitute decision-making: a national cross-sectional survey

2021 ◽  
pp. bmjspcare-2020-002619
Author(s):  
Marcus Sellars ◽  
Julien Tran ◽  
Linda Nolte ◽  
Ben White ◽  
Craig Sinclair ◽  
...  
Keyword(s):  
Decision Making ◽  
Online Survey ◽  
Public Knowledge ◽  
Cross Sectional Survey ◽  
Medical Decisions ◽  
Cross Sectional ◽  
Minimal Support ◽  
Substitute Decision Maker ◽  
Final Sample ◽  
Advance Care

ObjectiveTo describe the Australian adult public’s knowledge and experiences regarding substitute decision-making for medical decisions and their preferences for obtaining information about the substitute decision-maker (SDM) role.MethodsThis is a national cross-sectional online survey of the Australian adult public. The survey examined participants’ advance care planning (ACP) awareness and experience, SDM experiences and preferences for obtaining more information about SDM, and participant knowledge about SDM.ResultsOf 1586 people who opened the survey, 1120 (70.6%) were included in the final sample. 13% (n=142) of participants indicated they had acted as an SDM. A median score of two correct responses out of five showed low to moderate knowledge about the SDM role among all participants, with only 33% reporting awareness of SDM laws existing in Australia. While most (59%) participants ranked a health professional as their preferred source of obtaining information about supporting SDMs, few participants who had been an SDM (n=64, 45%) reported obtaining any support in making medical decisions. The median SDM knowledge scores for people who had discussed ACP (3.0 vs 2.0, U=1 45 222, z=6.910, p<0.001), documented their ACP preferences (3.0 vs 2.0, U=71 984, z=4.087, p<0.001) or acted in the SDM role (3.0 vs 2.0, U=56 353, z=−3.694, p<0.001) were significantly higher compared with those who had not.ConclusionsThe Australian public may have low to moderate knowledge about the SDM role and access only minimal support when making challenging medical decisions.

scholarly journals US-based cross-sectional survey of clinicians’ knowledge and attitudes about shared decision-making across healthcare professions and specialties

BMJ Open ◽  
2018 ◽  
Vol 8 (10) ◽  
pp. e022730 ◽  
Author(s):  
Rachel C Forcino ◽  
Renata West Yen ◽  
Maya Aboumrad ◽  
Paul J Barr ◽  
Danielle Schubbe ◽  
...  
Keyword(s):  
Decision Making ◽  
Family Medicine ◽  
Shared Decision Making ◽  
Nurse Practitioners ◽  
Physician Assistants ◽  
Shared Decision ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Knowledge And Attitudes ◽  
Positive Attitudes

ObjectiveIn this study, we aim to compare shared decision-making (SDM) knowledge and attitudes between US-based physician assistants (PAs), nurse practitioners (NPs) and physicians across surgical and family medicine specialties.SettingWe administered a cross-sectional, web-based survey between 20 September 2017 and 1 November 2017.Participants272 US-based NPs, PA and physicians completed the survey. 250 physicians were sent a generic email invitation to participate, of whom 100 completed the survey. 3300 NPs and PAs were invited, among whom 172 completed the survey. Individuals who met the following exclusion criteria were excluded from participation: (1) lack of English proficiency; (2) area of practice other than family medicine or surgery; (3) licensure other than physician, PA or NP; (4) practicing in a country other than the US.ResultsWe found few substantial differences in SDM knowledge and attitudes across clinician types, revealing positive attitudes across the sample paired with low to moderate knowledge. Family medicine professionals (PAs) were most knowledgeable on several items. Very few respondents (3%; 95% CI 1.5% to 6.2%) favoured a paternalistic approach to decision-making.ConclusionsRecent policy-level promotion of SDM may have influenced positive clinician attitudes towards SDM. Positive attitudes despite limited knowledge warrant SDM training across occupations and specialties, while encouraging all clinicians to promote SDM. Given positive attitudes and similar knowledge across clinician types, we recommend that SDM is not confined to the patient-physician dyad but instead advocated among other health professionals.

Ethics knowledge of recent paediatric residency graduates: the role of residency ethics curricula

2016 ◽  
Vol 42 (12) ◽  
pp. 809-814 ◽  
Author(s):  
Jennifer C Kesselheim ◽  
Julie Najita ◽  
Debra Morley ◽  
Elizabeth Bair ◽  
Steven Joffe
Keyword(s):  
Decision Making ◽  
Knowledge Score ◽  
Educational Interventions ◽  
Cross Sectional Survey ◽  
Passage Rate ◽  
Cross Sectional ◽  
Formal Curriculum ◽  
Incorrect Decision ◽  
Primary Specialty ◽  
Residency Programme

ObjectiveTo evaluate the relationship between recently trained paediatricians' ethics knowledge and exposure to a formal ethics or professionalism curriculum during residency.MethodsWe conducted a cross-sectional survey of recently trained paediatricians which included a validated 23-item instrument called the Test of Residents' Ethics Knowledge for Pediatrics. The sample included paediatricians who completed medical school in 2006–2008, whose primary specialty was paediatrics or a paediatric subspecialty, and who completed paediatric residency training in 2010–2011. This sample was stratified based on residency programme variables: presence of a formal curriculum in ethics or professionalism, programme size and American Board of Pediatrics certifying exam passage rate. Paediatricians were randomly selected from each stratum for survey participation.ResultsAmong the 370 responding paediatricians (55%), the mean knowledge score was 17.3 (SD 2.2) out of a possible 23. Presence of a formal curriculum in ethics and/or professionalism was not significantly associated with knowledge. Knowledge was lowest on items about parental requests for a child to undergo genetic testing (2 items, 44% and 85% incorrect), preserving patient confidentiality over email (55% incorrect), decision-making regarding life-sustaining technologies (61% incorrect), and decision-making principles such as assent and parental permission (2 items, 47% and 49% incorrect).ConclusionsThis study highlights several areas in which paediatricians' knowledge may be low and that are amenable to targeted educational interventions. These findings should prompt discussion and research among ethicists and educators about how ethics and professionalism curricula can more consistently influence paediatricians' knowledge.

Elite Athletes’ Perspectives on Providing Whereabouts Information: A Survey of Athletes in the Norwegian Registered Testing Pool / Das Meldesystem und die Anti-Doping-Bestimmungen aus der Sicht der Athleten: Eine Befragung norwegischer Athleten

2009 ◽  
Vol 6 (1) ◽  
Author(s):  
Dag V. Haristad ◽  
Eivind A. Skille ◽  
Miranda Thurston
Keyword(s):  
Information System ◽  
Response Rate ◽  
Elite Athletes ◽  
Unintended Consequences ◽  
Elite Sport ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
System A ◽  
Structured Questionnaire

SummaryThis paper reports on the perspectives of elite athletes on anti-doping work in general and on the whereabouts system in particular, and uses a figurational perspective to explore the unintended consequences of the planned introduction of the whereabouts system. A cross-sectional survey of all the athletes in the Norwegian registered testing pool (n = 236, response rate = 80.8%) was carried out in 2006, using a structured questionnaire. Overall, 70.6% of the athletes agreed that doping was a problem in elite sport in general, but paradoxically only 17.5% agreed that doping was a problem in their own sport. However, more than four in ten (43%) of the athletes agreed that the whereabouts information system made a contribution to a “cleaner” sport. Some athletes thought the system was unfair. The whereabouts information system had, despite all good intentions, outcomes other than those planned and intended by the WADA. Thus, athletes’ views might fruitfully be integrated with other perspectives when anti-doping work is developed further.

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