Factors affecting the risk of erroneous interpretation of online surgeon rating websites among the general population.

2017 ◽  
Vol 35 (6_suppl) ◽  
pp. 121-121
Author(s):  
Christopher J. Weight ◽  
Brett Watson ◽  
Lucas Labine ◽  
Jacob Albersheim-Carter ◽  
Badrinath R. Konety
Keyword(s):  
General Public ◽  
College Graduates ◽  
Demographic Data ◽  
The United States ◽  
Complication Rates ◽  
Graduate Degree ◽  
Health Care Decisions ◽  
Factors Affecting ◽  
Lower Ranking ◽  
Make Health Care

121 Background: Several websites present estimated individual surgeon complication rates for surgeons in both the United States and Great Britain. Though some researchers have raised questions as to the validity and appropriateness of these publicly displayed outcome measures, there remains very little research into how the general public may interpret these data to make health care decisions. Methods: We invited attendees of the 2016 Minnesota State Fair who met entry criteria, (adults > 18 years old, English speakers who were able to use a tablet computer) to complete our survey. Demographic data was presented along with various screen shots from online surgeon rating websites. Patients were then asked to interpret these graphics and report complication rates. Some graphics displayed complications rates for one surgeon alone, while others compared multiple surgeons side-by-side. Results: 392 participants completed the survey from a broad geographic distribution from the upper Midwest (179 unique zip codes). Median age was 49 (Interquartile range 28-61), the female:male ratio was 3:2, 57% had completed a college or graduate degree and 85% were Caucasian vs. 15% ethnic minorities. The majority of participants (76%) were able to correctly estimate complication rates when a single surgeon and his or her complication rates were shown, but when respondents were asked to compare/rank multiple surgeons, respondents overestimated complication rates by 5-7 fold, on average, for the lower ranking surgeons and only 15% of respondents could correctly identify the complication rate of the lowest performing surgeon. College graduates and those with a graduate degree were more likely to correctly estimate complication rates compared to participants with less education (odds ratio 1.98 95% CI 1.04-3.75, p = 0.035). Conclusions: Online surgeon rating websites that compare and rank surgeons may lead the general public to drastically overestimate the risk of postoperative complications. These errors in estimating complication rates appear to be reduced amongst those who are college educated and when viewing single surgeon outcomes in the absence of a comparison.

“Thanks, But No Thanks!” Patient Refusal of ED Diagnosis and Treatment

2020 ◽  
pp. 25-32
Author(s):  
Arthur R. Derse
Keyword(s):  
Medical Treatment ◽  
Legal Protection ◽  
Opportunity To Learn ◽  
The United States ◽  
Best Interest ◽  
Health Care Decisions ◽  
Patient Refusal ◽  
Right To Refuse Treatment ◽  
Make Health Care ◽  
The Right

Patient refusal of medical treatment that appears to be in the patient’s best interest is a common challenge for emergency physicians. In the United States, adults have the right to refuse treatment, including life-sustaining medical treatment. The patient must both possess the capacity to make the decision and be offered an opportunity to understand the potential consequences of refusal. The determination of capacity is necessary in deciding when to honor a patient’s refusal. Parents and guardians generally have the right to make health care decisions for their children, but those decisions need to align with the best interests of the child. Documentation of the patient’s refusal of treatment against medical advice may be of some evidentiary value but does not ensure legal protection from liability. Patients who have the capacity to refuse medical treatment should be offered the opportunity to learn and consider the potential consequences before physicians respect their autonomous refusal.

scholarly journals Developing a Field of Study in Implementation Science for the Africa Region: The Wits–UNC AIDS Implementation Science Fogarty D43

2020 ◽  
Vol 6 (1) ◽  
pp. 46-55
Author(s):  
Rohit Ramaswamy ◽  
Tobias Chirwa ◽  
Kathryn Salisbury ◽  
Jabulani Ncayiyana ◽  
Latifat Ibisomi ◽  
...  
Keyword(s):  
Implementation Science ◽  
Research Training ◽  
Scale Up ◽  
The United States ◽  
Academic Program ◽  
Global Health Research ◽  
Graduate Degree ◽  
Factors Affecting ◽  
Systematic Assessment ◽  
Hiv Interventions

From 2014 to 2019, the Wits–UNC (University of Witwatersrand and University of North Carolina at Chapel Hill) AIDS Implementation Science D43 Training Program laid critical academic foundation by creating a graduate degree program in implementation science (IS) for master’s- and doctoral-level students in the Department of Epidemiology and Biostatistics at the Wits School of Public Health. Before this collaboration, funded by the Fogarty International Center (FIC) at National Institutes of Health, no IS degree existed in Southern Africa. The FIC “D43” is an international research training grant mechanism to strengthen global health research expertise through education. Historically, students from low-resource settings have been trained in health sciences at universities in the United States or the United Kingdom. This is not scalable or sustainable and therefore this D43 focused on building capacity in South Africa where HIV-related challenges are located. Consequently, South Africans and other African international students were able to apply to the newly offered program, allowing training at significantly lower costs. IS allows a systematic assessment of factors affecting the implementation of HIV interventions and in developing strategies for addressing them. It guides the successful scale-up of effective programs and informs policy to improve programs. The training aims to assist in lowering the HIV incidence rate, suppressing viral load for those infected, and meeting the UN 2030 Agenda for Sustainable Development. A second cycle of funding from 2019 to 2024 will enable the infrastructure built in the first program to train South African HIV researchers and practitioners in the field who are unable to enroll in a formal academic program.

Health Communication: Implications for Diverse Populations

2011 ◽  
Vol 18 (1) ◽  
pp. 12-19
Author(s):  
Amy Hasselkus
Keyword(s):  
Health Care ◽  
Health Communication ◽  
Negative Impact ◽  
Linguistically Diverse ◽  
Good Health ◽  
The United States ◽  
Poor Health ◽  
Health Care Decisions ◽  
Diverse Backgrounds ◽  
Health Related

The need for improved communication about health-related topics is evident in statistics about the health literacy of adults living in the United States. The negative impact of poor health communication is huge, resulting in poor health outcomes, health disparities, and high health care costs. The importance of good health communication is relevant to all patient populations, including those from culturally and linguistically diverse backgrounds. Efforts are underway at all levels, from individual professionals to the federal government, to improve the information patients receive so that they can make appropriate health care decisions. This article describes these efforts and discusses how speech-language pathologists and audiologists may be impacted.

Factors affecting water quality in selected carbonate aquifers in the United States,1993-2005

2009 ◽  
Author(s):  
Bruce D. Lindsey ◽  
Marian P. Berndt ◽  
Brian G. Katz ◽  
Ann F. Ardis ◽  
Kenneth A. Skach
Keyword(s):  
United States ◽  
Water Quality ◽  
The United States ◽  
Factors Affecting ◽  
Carbonate Aquifers

Operation of a hyperbaric oxygen therapy center in Korea: Report of our experience from a setting in its nascent stages

2019 ◽  
pp. 135-143
Author(s):  
Yoon Seop Kim ◽  
Yoonsuk Lee ◽  
Sun Ju Kim ◽  
Sung Oh Hwang ◽  
Yong Sung Cha ◽  
...  
Keyword(s):  
Critically Ill ◽  
Hyperbaric Oxygen ◽  
Critically Ill Patients ◽  
Demographic Data ◽  
Developed Countries ◽  
The United States ◽  
Medical Society ◽  
Hyperbaric Medicine ◽  
Therapy Center ◽  
Hbo2 Therapy

Purpose: Hyperbaric medicine is nascent in Korea when compared to other developed countries, such as the United States and Japan. Our facility has been managed by physicians with certifications from the Undersea and Hyperbaric Medical Society (UHMS) and National Oceanic and Atmospheric Administration in diving and clinical diseases since October 2016. This study was conducted to share similar issues that are encountered during the establishment of a program in a new area through our experiences in the operation of a hyperbaric oxygen (HBO2) therapy center. Methods: In this retrospective observational study we collected data on HBO2 patients treated at our center between October 2016 and June 2018 after HBO2 was conducted by HBO2-certified physicians. We then compared demographic data of patients with data from January 2011 to September 2015 – before HBO2 operations were conducted by HBO2-certified physicians. Result: A total of 692 patients received 5,130 treatments. Twelve indicated diseases were treated using HBO2 therapy. Fifty-six critically ill patients with intubation received HBO2. Although two patients experienced seizure due to oxygen toxicity during the study period, certified physicians and inside attendant took immediate corrective action. Conclusion: After the establishment of the HBO2 center operated by physicians with certification, more patients, including critically ill patients, received HBO2 safely for various diseases. In order to improve the practice of hyperbaric medicine in Korea, the Korean Academy of Undersea and Hyperbaric Medicine (KAUHM), an advanced and well-organized academic society, should communicate often with HBO2 centers, with the aim to set Korean education programs at UHMS course levels and increase reimbursement for HBO2 therapy.

scholarly journals Examining the Economic and Environmental Impacts of COVID-19 Using Earth Observation Data

2020 ◽  
Vol 13 (1) ◽  
pp. 5
Author(s):  
William Straka ◽  
Shobha Kondragunta ◽  
Zigang Wei ◽  
Hai Zhang ◽  
Steven D. Miller ◽  
...  
Keyword(s):  
Air Quality ◽  
Los Angeles ◽  
Environmental Impacts ◽  
Demographic Data ◽  
The United States ◽  
Earth Observation ◽  
Observation Data ◽  
Washington Dc ◽  
Mobility Data ◽  
Earth Observation Data

The COVID-19 pandemic has infected almost 73 million people and is responsible for over 1.63 million fatalities worldwide since early December 2019, when it was first reported in Wuhan, China. In the early stages of the pandemic, social distancing measures, such as lockdown restrictions, were applied in a non-uniform way across the world to reduce the spread of the virus. While such restrictions contributed to flattening the curve in places like Italy, Germany, and South Korea, it plunged the economy in the United States to a level of recession not seen since WWII, while also improving air quality due to the reduced mobility. Using daily Earth observation data (Day/Night Band (DNB) from the National Oceanic and Atmospheric Administration Suomi-NPP and NO2 measurements from the TROPOspheric Monitoring Instrument TROPOMI) along with monthly averaged cell phone derived mobility data, we examined the economic and environmental impacts of lockdowns in Los Angeles, California; Chicago, Illinois; Washington DC from February to April 2020—encompassing the most profound shutdown measures taken in the U.S. The preliminary analysis revealed that the reduction in mobility involved two major observable impacts: (i) improved air quality (a reduction in NO2 and PM2.5 concentration), but (ii) reduced economic activity (a decrease in energy consumption as measured by the radiance from the DNB data) that impacted on gross domestic product, poverty levels, and the unemployment rate. With the continuing rise of COVID-19 cases and declining economic conditions, such knowledge can be combined with unemployment and demographic data to develop policies and strategies for the safe reopening of the economy while preserving our environment and protecting vulnerable populations susceptible to COVID-19 infection.

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