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Perioperative Research

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133 papers 100 to 500 followers
By Ron George Anesthesiologist with special interests in Obstetrics, Pain, and Global Health
https://read.qxmd.com/read/30721296/effect-of-electroencephalography-guided-anesthetic-administration-on-postoperative-delirium-among-older-adults-undergoing-major-surgery-the-engages-randomized-clinical-trial
#1
Troy S Wildes, Angela M Mickle, Arbi Ben Abdallah, Hannah R Maybrier, Jordan Oberhaus, Thaddeus P Budelier, Alex Kronzer, Sherry L McKinnon, Daniel Park, Brian A Torres, Thomas J Graetz, Daniel A Emmert, Ben J Palanca, Shreya Goswami, Katherine Jordan, Nan Lin, Bradley A Fritz, Tracey W Stevens, Eric Jacobsohn, Eva M Schmitt, Sharon K Inouye, Susan Stark, Eric J Lenze, Michael S Avidan
Importance: Intraoperative electroencephalogram (EEG) waveform suppression, often suggesting excessive general anesthesia, has been associated with postoperative delirium. Objective: To assess whether EEG-guided anesthetic administration decreases the incidence of postoperative delirium. Design, Setting, and Participants: Randomized clinical trial of 1232 adults aged 60 years and older undergoing major surgery and receiving general anesthesia at Barnes-Jewish Hospital in St Louis...
February 5, 2019: JAMA: the Journal of the American Medical Association
https://read.qxmd.com/read/30721279/depth-of-anesthesia-and-postoperative-delirium
#2
EDITORIAL
Thomas E F Abbott, Rupert M Pearse
No abstract text is available yet for this article.
February 5, 2019: JAMA: the Journal of the American Medical Association
https://read.qxmd.com/read/30721300/will-this-patient-be-difficult-to-intubate-the-rational-clinical-examination-systematic-review
#3
Michael E Detsky, Naheed Jivraj, Neill K Adhikari, Jan O Friedrich, Ruxandra Pinto, David L Simel, Duminda N Wijeysundera, Damon C Scales
Importance: Recognizing patients in whom endotracheal intubation is likely to be difficult can help alert physicians to the need for assistance from a clinician with airway training and having advanced airway management equipment available. Objective: To identify risk factors and physical findings that predict difficult intubation. Data Sources: The databases of MEDLINE and EMBASE were searched from 1946 to June 2018 and from 1947 to June 2018, respectively, and the reference lists from the retrieved articles and previous reviews were searched for additional studies...
February 5, 2019: JAMA: the Journal of the American Medical Association
https://read.qxmd.com/read/30700442/a-guide-to-systematic-review-and-meta-analysis-of-prognostic-factor-studies
#4
Richard D Riley, Karel G M Moons, Kym I E Snell, Joie Ensor, Lotty Hooft, Douglas G Altman, Jill Hayden, Gary S Collins, Thomas P A Debray
No abstract text is available yet for this article.
January 30, 2019: BMJ: British Medical Journal
https://read.qxmd.com/read/30686311/evaluation-of-validity-of-the-stop-bang-questionnaire-in-major-elective-noncardiac-surgery
#5
A Sankar, W S Beattie, G Tait, D N Wijeysundera
BACKGROUND: The STOP-BANG questionnaire screens for obstructive sleep apnoea (OSA) in surgical patients. In prior research, the association of STOP-BANG scores with comorbidities and outcomes was inconsistent. The objective of this study was to evaluate the validity of the STOP-BANG score. METHODS: We conducted a retrospective cohort study of patients undergoing major elective noncardiac surgery at the University Health Network (Toronto, ON, Canada) between 2011 and 2015...
February 2019: British Journal of Anaesthesia
https://read.qxmd.com/read/30674527/building-research-culture-and-capacity-in-academic-family-medicine-departments-insights-from-a-simulation-workshop
#6
Bridget L Ryan, Cathy Thorpe, Merrick Zwarenstein, Jamie Wickett, Nayana Talukdar, Leslie Boisvert, Stephen J Wetmore
OBJECTIVE: To use data from a workshop in which various representatives from departments of family medicine (DFMs) aimed to identify strategies to increase research activity, particularly among clinical faculty members. DESIGN: Descriptive qualitative study using data from a workshop in which participants role-played (ie, as clinician-teachers, department chairs, and mentors) and, while in the role-playing scenario, were asked to imagine strategies that would encourage the clinical faculty members to engage in research...
January 2019: Canadian Family Physician Médecin de Famille Canadien
https://read.qxmd.com/read/30615031/perioperative-glucose-control-in-patients-with-diabetes-undergoing-elective-surgery
#7
Vinaya Simha, Pankaj Shah
No abstract text is available yet for this article.
January 7, 2019: JAMA: the Journal of the American Medical Association
https://read.qxmd.com/read/30648259/a-review-of-asa-physical-status-historical-perspectives-and-modern-developments
#8
REVIEW
D Mayhew, V Mendonca, B V S Murthy
The American Society of Anesthesiologists (ASA) physical status is a tool commonly used to classify a patient's physical fitness before surgery. Since its introduction in 1941 it has undergone very few modifications to improve its reliability and to eliminate subjectivity, despite vast changes in both surgical and anaesthetic technique. We present the history of the ASA physical status and review the literature on its applicability to contemporary anaesthetic practice.
January 15, 2019: Anaesthesia
https://read.qxmd.com/read/30169341/what-we-can-learn-from-big-data-about-factors-influencing-perioperative-outcome
#9
Victor G B Liem, Sanne E Hoeks, Felix van Lier, Jurgen C de Graaff
PURPOSE OF REVIEW: This narrative review will discuss what value Big Data has to offer anesthesiology and aims to highlight recently published articles of large databases exploring factors influencing perioperative outcome. Additionally, the future perspectives of Big Data and its major pitfalls will be discussed. RECENT FINDINGS: The potential of Big Data has given an incentive to create nationwide and anesthesia-initiated registries like the MPOG and NACOR. These large databases have contributed in elucidating some of the rare perioperative complications, such as declined cognition after exposure to general anesthesia and epidural hematomas in parturients...
December 2018: Current Opinion in Anaesthesiology
https://read.qxmd.com/read/29452519/patient-engagement-in-clinical-trials-the-clinical-trials-transformation-initiative-s-leadership-from-theory-to-practical-implementation
#10
Bray Patrick-Lake
Patient engagement is an increasingly important aspect of successful clinical trials. Over the past decade, as patient group involvement in clinical trials has continued to increase and diversify, the Clinical Trials Transformation Initiative has not only recognized the crucial role patients play in improving the clinical trial enterprise but also made a deep commitment to help grow and shape the emerging field of patient engagement. This article describes the evolution of patient engagement including the origins of the patient engagement movement; barriers to successful engagement and remaining challenges to full and valuable collaboration between patient groups and trial sponsors; and Clinical Trials Transformation Initiative's role in influencing the field through organizational practices, formal project work and resulting recommendations, and external advocacy efforts...
February 2018: Clinical Trials: Journal of the Society for Clinical Trials
https://read.qxmd.com/read/29411037/guidelines-for-inclusion-of-patient-reported-outcomes-in-clinical-trial-protocols-the-spirit-pro-extension
#11
Melanie Calvert, Derek Kyte, Rebecca Mercieca-Bebber, Anita Slade, An-Wen Chan, Madeleine T King, Amanda Hunn, Andrew Bottomley, Antoine Regnault, An-Wen Chan, Carolyn Ells, Daniel O'Connor, Dennis Revicki, Donald Patrick, Doug Altman, Ethan Basch, Galina Velikova, Gary Price, Heather Draper, Jane Blazeby, Jane Scott, Joanna Coast, Josephine Norquist, Julia Brown, Kirstie Haywood, Laura Lee Johnson, Lisa Campbell, Lori Frank, Maria von Hildebrand, Michael Brundage, Michael Palmer, Paul Kluetz, Richard Stephens, Robert M Golub, Sandra Mitchell, Trish Groves
Importance: Patient-reported outcome (PRO) data from clinical trials can provide valuable evidence to inform shared decision making, labeling claims, clinical guidelines, and health policy; however, the PRO content of clinical trial protocols is often suboptimal. The SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials) statement was published in 2013 and aims to improve the completeness of trial protocols by providing evidence-based recommendations for the minimum set of items to be addressed, but it does not provide PRO-specific guidance...
February 6, 2018: JAMA: the Journal of the American Medical Association
https://read.qxmd.com/read/29361334/progress-in-clinical-research-in-surgery-and-ideal
#12
Peter McCulloch, Joshua Feinberg, Yiannis Philippou, Angelos Kolias, Sean Kehoe, Gillian Lancaster, Jenny Donovan, Tatjana Petrinic, Riaz Agha, Christopher Pennell
The quality of clinical research in surgery has long attracted criticism. High-quality randomised trials have proved difficult to undertake in surgery, and many surgical treatments have therefore been adopted without adequate supporting evidence of efficacy and safety. This evidence deficit can adversely affect research funding and reimbursement decisions, lead to slow adoption of innovations, and permit widespread adoption of procedures that offer no benefit, or cause harm. Improvement in the quality of surgical evidence would therefore be valuable...
July 7, 2018: Lancet
https://read.qxmd.com/read/29343479/postsurgical-prescriptions-for-opioid-naive-patients-and-association-with-overdose-and-misuse-retrospective-cohort-study
#13
Gabriel A Brat, Denis Agniel, Andrew Beam, Brian Yorkgitis, Mark Bicket, Mark Homer, Kathe P Fox, Daniel B Knecht, Cheryl N McMahill-Walraven, Nathan Palmer, Isaac Kohane
OBJECTIVE: To quantify the effects of varying opioid prescribing patterns after surgery on dependence, overdose, or abuse in an opioid naive population. DESIGN: Retrospective cohort study. SETTING: Surgical claims from a linked medical and pharmacy administrative database of 37 651 619 commercially insured patients between 2008 and 2016. PARTICIPANTS: 1 015 116 opioid naive patients undergoing surgery. MAIN OUTCOME MEASURES: Use of oral opioids after discharge as defined by refills and total dosage and duration of use...
January 17, 2018: BMJ: British Medical Journal
https://read.qxmd.com/read/29344622/barriers-to-and-facilitators-of-implementing-enhanced-recovery-pathways-using-an-implementation-framework-a-systematic-review
#14
Alexander B. Stone, Christina T. Yuan, Michael A. Rosen, Michael C. Grant, Lauren E. Benishek, Elizabeth Hanahan, Lisa H. Lubomski, Clifford Ko, Elizabeth C. Wick
No abstract text is available yet for this article.
March 1, 2018: JAMA Surgery
https://read.qxmd.com/read/28576285/intraoperative-ketamine-for-prevention-of-postoperative-delirium-or-pain-after-major-surgery-in-older-adults-an-international-multicentre-double-blind-randomised-clinical-trial
#15
RANDOMIZED CONTROLLED TRIAL
Michael S Avidan, Hannah R Maybrier, Arbi Ben Abdallah, Eric Jacobsohn, Phillip E Vlisides, Kane O Pryor, Robert A Veselis, Hilary P Grocott, Daniel A Emmert, Emma M Rogers, Robert J Downey, Heidi Yulico, Gyu-Jeong Noh, Yonghun H Lee, Christine M Waszynski, Virendra K Arya, Paul S Pagel, Judith A Hudetz, Maxwell R Muench, Bradley A Fritz, Witold Waberski, Sharon K Inouye, George A Mashour
BACKGROUND: Delirium is a common and serious postoperative complication. Subanaesthetic ketamine is often administered intraoperatively for postoperative analgesia, and some evidence suggests that ketamine prevents delirium. The primary purpose of this trial was to assess the effectiveness of ketamine for prevention of postoperative delirium in older adults. METHODS: The Prevention of Delirium and Complications Associated with Surgical Treatments [PODCAST] study is a multicentre, international randomised trial that enrolled adults older than 60 years undergoing major cardiac and non-cardiac surgery under general anaesthesia...
July 15, 2017: Lancet
https://read.qxmd.com/read/28351670/preemptive-analgesia-for-postoperative-hysterectomy-pain-control-systematic-review-and-clinical-practice-guidelines
#16
REVIEW
Adam C Steinberg, Megan O Schimpf, Amanda B White, Cara Mathews, David R Ellington, Peter Jeppson, Catrina Crisp, Sarit O Aschkenazi, Mamta M Mamik, Ethan M Balk, Miles Murphy
OBJECTIVE: The objective of the study was to investigate the effectiveness of preemptive analgesia at pain control in women undergoing total abdominal hysterectomy. DATA SOURCES: Eligible studies, published through May 31, 2016, were retrieved through Medline, Cochrane Central Register for Controlled Trials, and Cochrane Database of Systematic Reviews. STUDY ELIGIBILITY: We included randomized controlled trials with the primary outcome of pain control in women receiving a preemptive medication prior to total abdominal hysterectomy...
September 2017: American Journal of Obstetrics and Gynecology
https://read.qxmd.com/read/28288254/variation-in-physician-spending-and-association-with-patient-outcomes
#17
Yusuke Tsugawa, Ashish K Jha, Joseph P Newhouse, Alan M Zaslavsky, Anupam B Jena
Importance: While the substantial variation in health care spending across regions and hospitals is well known, key clinical decisions are ultimately made by physicians. However, the degree to which spending varies across physicians and the clinical consequences of that variation are unknown. Objective: To investigate variation in spending across physicians and its association with patient outcomes. Design, Setting, and Participants: For this retrospective data analysis, we analyzed a 20% random sample of Medicare fee-for-service beneficiaries 65 years and older who were hospitalized with a nonelective medical condition and treated by a general internist between January 1, 2011, and December 31, 2014...
May 1, 2017: JAMA Internal Medicine
https://read.qxmd.com/read/28219884/measuring-what-matters-to-patients
#18
EDITORIAL
Angela Coulter
No abstract text is available yet for this article.
February 20, 2017: BMJ: British Medical Journal
https://read.qxmd.com/read/28137536/postoperative-complications-and-hospital-payment-implications-for-achieving-value
#19
Jason B Liu, Julia R Berian, Shenglin Chen, Mark E Cohen, Karl Y Bilimoria, Bruce L Hall, Clifford Y Ko
BACKGROUND: As the current healthcare structure moves toward value-based purchasing, it is helpful for stakeholders to understand costs, particularly for those associated with postoperative complications. The objectives of this study were to assess hospital reimbursements for postoperative complications and generate insight into sustainability of quality. STUDY DESIGN: American College of Surgeons NSQIP and Medicare claims data from 2009 to 2012 were merged for elective colectomy, total knee arthroplasty, and carotid endarterectomy...
May 2017: Journal of the American College of Surgeons
https://read.qxmd.com/read/27984343/value-based-purchasing-for-osteoarthritis-and-total-knee-arthroplasty-what-role-for-patient-reported-outcomes
#20
Catherine MacLean
Prompted by the aims to improve the patient experience of care (including quality and satisfaction), improve the health of populations, and reduce the per capita cost of health care, the US healthcare system is embarking upon a new era in care delivery that seeks to optimize healthcare value. Value, the consideration of quality relative to cost, can be increased by improving quality, reducing cost, or doing both. Given that patient-reported outcomes related to pain, function, and quality of life underlay both the reason patients seek care for and the benchmarks by which treatment success is measured for osteoarthritis, measures of these patient-reported outcomes figure prominently in understanding the quality and hence value...
February 2017: Journal of the American Academy of Orthopaedic Surgeons
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