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This cross-sectional study of outpatient dermatology encounters examined the association between dermatology encounter work relative value units and patient age, sex, and race and ethnicity since the 2021 Medicare physician fee schedule update.
This secondary analysis of the COMET randomized clinical trial examines patient-reported outcomes at baseline and over time in patients with low-risk ductal carcinoma in situ randomized to receive either active monitoring or guideline-concordant care.
A 41-year-old immunocompromised man presented to the intensive care unit with neutropenic fevers, and after a 1-week stay, developed oral ulcers and tender, diffuse, erythematous pseudovesicular papules, many umbilicated, on the face, trunk, and extremities. What is your diagnosis?
Italia dietro anche a Gb, Germania e Francia. Network contro gap
Le 5 ‘best practice’ con ambiente e linguaggio al centro
Da Mazzara del Vallo, ora in cura a Milano
Villa, “impegnati a trasformare ricerca in soluzioni per malati”
Villa, “impegnati a trasformare ricerca in soluzioni per malati”
Il 28 febbraio la Giornata mondiale malattie rare
Alcune sono causa di sordocecità,fondamentale intervento precoce
Alcune sono causa di sordocecità,fondamentale intervento precoce
Objectives
Women with an abdominal aortic aneurysm (AAA) are less likely to receive elective repair than men. This study explored the effect of patient sex and other attributes on vascular surgeons’ decision-making for infrarenal AAA repair.
Design
Discrete choice experiment.
Setting
Simulated environment using case scenarios with varying patient attributes.
Participants
Vascular surgeons.
Interventions
Surgical decision-making.
Main outcome measures
AAA repair versus no repair and endovascular versus open repair.
Results
182 surgeons completed 2987 scenarios. When all other attributes were equal, a woman was more likely to be offered an AAA repair (marginal rate of substitution (MRS) 3.86 (95% CI 2.93, 4.79)), while very high anaesthetic risk (MRS –4.33 (95% CI –5.63, –3.03)) and hostile anatomy (MRS –3.28 (95% CI –4.55, –2.01)) were deterrents. Increasing age did not adversely affect the likelihood of offering repair to men but decreased the likelihood for women, which negated women’s selection advantage from the age of 83 years. Women were also more likely to be offered endovascular repair (MRS 2.57 (95% CI 1.30, 3.84)).
Conclusions
Patient sex alone did not account for real-world disparity observed in selection for surgery. Rather, being a woman was associated with a higher likelihood of being offered AAA repair but also a higher likelihood of being offered less invasive endovascular repair. Increased age decreased the likelihood of surgical selection for women but not men. Preference for less invasive repair, combined with inferior rates of anatomical suitability, and the comparably older age of women at the time of AAA repair selection may account for lower rates of repair for women observed.
Per mutazioni genetiche ‘prevenzione e medicina di precisione’
Introduction
People experiencing homelessness (PEH) have diverse and complex health and social needs and experience significant barriers to accessing support. As a result, PEH often use the emergency department (ED) for their unmet health and social needs. To address these challenges, the ED Outreach Programme at St. Michael’s Hospital was developed with community partners within the Downtown East Toronto Ontario Health Team in Toronto, Canada. PEH presenting in the ED are connected to an outreach worker to identify immediate needs for a safe discharge and to access health and social supports in the community. Following discharge, the outreach worker continues to maintain contact with clients to ensure continuity of care and assists with the coordination, navigation and follow-up of healthcare and community services.
Methods
A three-phase community-based participatory research (CBPR) study will be conducted to evaluate patient experience in the ED Outreach Programme. Phase 1 involves conducting interviews with clients and staff/providers to understand their experiences with the programme and identify patient experience domains, constructs and measures. In Phase 2, programme clients, staff/providers and partners with lived experience co-design a set of patient-reported experience measures (PREMs) through focus groups. In Phase 3, the PREMs are pilot-tested to ensure their applicability and utility in the clinical setting. Central to CBPR principles, shared leadership and ownership of the project are facilitated by engaging and empowering community members. This study will contribute to new knowledge of building partnerships with PEH and marginalised communities in healthcare research, evaluation and quality improvement, particularly in developing PREMs.
Ethics and dissemination
This study has been approved by the Unity Health Toronto Research Ethics Board (REB#21–315). Findings will be disseminated in peer-reviewed journals, conferences and forums, as well as through collaborating with partners with lived experience, community agencies and government bodies.
Introduction
Empathy is a core component of high-quality care yet is expressed and received in different ways depending on the characteristics (including gender, race, socioeconomic status and disability) of both practitioners and patients. However, the evidence exploring how these characteristics or their overlap (‘intersectionality’) influence empathy has not been synthesised.
Methods and analysis
We will systematically review and meta-analyse studies exploring the influence of healthcare practitioners and patient characteristics on empathy in healthcare. MEDLINE, EMBASE (via Scopus), Scopus, PsycINFO, CINAHL, CENTRAL Web of Science, Cochrane Database of Systematic Reviews and Database of Abstracts of Reviews of Effects will be searched from database inception to present. Reference chasing will be used to identify additional studies. Studies that report empathy levels using either (1) the patient-reported Consultation and Relational Empathy Measure or (2) the practitioner or student-reported Jefferson Scale of Empathy. This will include validated versions or translations of both scales.
Two reviewers will independently screen titles, abstracts, and full texts and extract data using Rayyan. Discrepancies will be resolved in discussion with a third author if necessary. Two independent authors will evaluate the risk of bias using the Joanna Briggs Institute tools.
Continuous data will be analysed based on the mean, SD, sample size and 95% CIs. Sensitivity analyses will be used to explore the potential impact of risk of bias and use of imputed data. We will explore differences between countries, demographic characteristics, disciplines and lengths of time in practice experience, as well as differences over time (comparing more recent with older studies). We will also explore differences between patient-reported and practitioner-reported empathy.
We will report our findings following the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines and flowchart.
Ethics and dissemination
Ethical approval is not required for this review as primary data will not be collected. The review will be disseminated through peer-reviewed publication and presented at conferences.
PROSPERO registration number
CRD42024604677.
This JAMA Patient Page describes bedbug infestation and bedbug eradication and prevention measures.
