Harnessing the power of telemedicine to accomplish international pediatric outcome research during the COVID-19 pandemic

The COVID-19 pandemic occurred during planned neurodevelopmental follow-up of Colombian children with antenatal Zika-virus exposure. The objective of the study was to leverage the institution's telemedicine infrastructure to support international clinical child outcome research. In a prospective cohort study of child neurodevelopment (NCT04398901), we used synchronous telemedicine to remotely train a research team and perform live observational assessments of children in Sabanalarga, Colombia. An observational motor and conceptional standardized tool kit was mailed to Colombia; other materials were translated and emailed; team training was done virtually. Children were recruited by team on the ground. Synchronous activities were video-recorded directly to two laptops, each with a telehealth Zoom link to allow simultaneous evaluation of “table” and “standing” activities, and backup recordings were captured directly on the device in Colombia. The U.S. team attended live over Zoom from four states and five distinct locations, made observational notes, and provided real-time feedback. Fifty-seven, 3–4-year-old children with Zika-virus exposure and 70 non-exposed controls were studied during 10 daytrips. Direct laptop recording ensured complete record of child activities due to internet outages. Telemedicine can be used to successfully perform international neurodevelopmental outcome research in children during the COVID-19 pandemic. Telemedicine can benefit global health studies.

The Evolution of Gender-and Trauma-Responsive Criminal Justice Interventions for Women

For over five decades, the development of risk classification assessments, corrections-based treatment, and the associated outcome research have been focused on men. Thus, it is no surprise that existing treatment frameworks and correctional policies have been established from a male perspective.

Bibliometric Differences Between WEIRD and Non-WEIRD Countries in the Outcome Research on Solution-Focused Brief Therapy

Solution Focused Brief Therapy (SFBT) developed in parallel to Positive Psychology, as a type of intervention that also emphasizes the strengths and resources of clients. The aim of this study was to examine the development of outcome research on SFBT and to determine whether it is predominantly carried out in Western, Educated, Industrialized, Rich and Democratic (WEIRD) countries. A literature review was conducted using a bibliometric methodology, identifying: (a) authors and countries, (b) time trends, (c) language of publications; (d) and journals; (e) samples on which they were tested; (f) characteristics of interventions; and (g) main study designs. A total of 365 original outcome research articles published in scientific journals on solution-focused interventions were extracted. The results show that outcome research on SFBT has grown steadily over the last three decades. Although it started in WEIRD countries, the number of outcome research publications generated in non-WEIRD countries is now higher. There is little international collaboration and, although English is the main language of publication in WEIRD countries, English, Chinese and Parsi predominate in non-WEIRD countries. Productivity is low and most authors have only published one paper. The journals that have published the most papers have a very diverse visibility. The tested interventions are conducted both in clinical and non-clinical samples; mostly in individual and group format; face-to-face; and not only in the form of psychotherapy, but also as coaching and school interventions. Almost half of the publications are randomized controlled trials. The results confirm the wide applicability of SFBT as a single or main component of psychosocial interventions. They support the claim that solution-focused interventions are not a WEIRD practice, but a global practice.

P.217 Patient reported outcomes following surgery for lumbar spinal stenosis: Comparison of a universal and multitier health care system

Background: Canada has a universal health care system while the United States utilizes a combined public and private payer system. The purpose of this study is to investigate whether there are differences in clinical outcomes between those surgically treated for spinal stenosis in Canada as compared to the United States. Methods: Surgical lumbar spinal stenosis patients treated in Canada that were enrolled in the Canadian Spine Outcome Research Network (CSORN) prospective multicenter registry were compared with the surgical cohort enrolled in the Spine Patients Outcome Research Trial (SPORT) study. Spine-related patient reported outcomes (PROs) were compared at 3 months and 1 year post-operatively. Results: The CSORN cohort consisted of 432 patients and the SPORT cohort was made up of 278 patients. The CSORN cohort had a higher proportion of patients with a symptom duration greater than 6 months (92.3% vs. 58.3%, p<0.0001). The CSORN cohort demonstrated significantly greater rates of satisfaction after surgery at 3 months (p=0.003) and 1 year (p<0.001). Conclusions: Patients undergoing surgical treatment for lumbar spinal stenosis in Canada (CSORN cohort) reported higher rates of satisfaction at 3 months and 1 year post-operatively compared to the United States cohort (SPORT) despite having longer durations of symptoms prior to surgery.

P.218 Patient reported outcomes following surgery for lumbar disk herniation: comparison of a universal and multitier health care system.

Background: Canada has a universal health care system that is funded by the government while the United States utilizes a combined public and private payer system. The purpose of this study is to investigate whether there are differences in clinical outcomes between those surgically treated for lumbar disk herniation in Canada as compared to the United States. Methods: Surgical lumbar disk herniation patients enrolled in the Canadian Spine Outcome Research Network (CSORN) prospective registry. were compared with the surgical cohort enrolled in the Spine Patients Outcome Research Trial (SPORT) study. Spine-related patient reported outcomes (PROs) were compared at 3 months and 1 year. Results: The CSORN cohort consisted of 443 patients and the SPORT cohort was made up of 573 patients. Patients in the CSORN cohort were older (p<0.001), and were more likely to be employed (p=0.003). The CSORN cohort demonstrated significantly greater rates of satisfaction after surgery at 3 months (87.2% vs. 65.5%, p=0.003) and 1 year (85.6% vs. 69.0%, p<0.0001). The CSORN cohort was a significant independent predictor of patient satisfaction at 1 year. Conclusions: Patients undergoing surgical treatment for lumbar disc herniation in Canada reported higher rates of satisfaction at 3 months and 1 year post-operatively compared to the United States.

Describing long-term opioid use utilizing Nordic Prescription Registers – A Norwegian example

Previous studies have defined long-term opioid use in varying ways, decreasing comparability, reproducibility and clinical applicability of the research. Based on recent systematic reviews, we aimed to estimate long-term opioid use defined as use persisting more than three months using one of the Nordic prescription registers. We used the Norwegian Prescription Register (NorPD) to extract data on all opioid dispensations between January 1st 2004 and October 31st 2019. New users of opioids (washout 365 days) were defined as long-term users if they filled two criteria: 1) they had ≥2 dispensations of opioids, 91-180 days apart; 2) days 0-90 included ≥90 dispensed administration units (e.g., tablets) of opioids. Overall, there were 2,543,224 new users of opioids during the study period. Of these, 354,666 (13.9%) filled the criteria for long-term opioid use at least once. Compared to those who did not fill the criteria (short-term users), long-term users were older, more likely women, and used tramadol, oxycodone, and buprenorphine more frequently as their first opioid. In conclusion, we found that 1/7 of opioid users continued use longer than 3 months. Future outcome research should identify the clinically most important dose requirements for long-term opioid use criteria.

Describing long-term opioid use utilizing Nordic Prescription Registers – A Norwegian example

Previous studies have defined long-term opioid use in varying ways, decreasing comparability, reproducibility and clinical applicability of the research. Based on recent systematic reviews, we aimed to estimate long-term opioid use defined as use persisting more than three months using one of the Nordic prescription registers. We used the Norwegian Prescription Register (NorPD) to extract data on all opioid dispensations between January 1st 2004 and October 31st 2019. New users of opioids (washout 365 days) were defined as long-term users if they filled two criteria: 1) they had ≥2 dispensations of opioids, 91-180 days apart; 2) days 0-90 included ≥90 dispensed administration units (e.g., tablets) of opioids. Overall, there were 2,543,224 new users of opioids during the study period. Of these, 354,666 (13.9%) filled the criteria for long-term opioid use at least once. Compared to those who did not fill the criteria (short-term users), long-term users were older, more likely women, and used tramadol, oxycodone, and buprenorphine more frequently as their first opioid. In conclusion, we found that 1/7 of opioid users continued use longer than 3 months. Future outcome research should identify the clinically most important dose requirements for long-term opioid use criteria.