Scottish Medical Journal最新文献

{"title":"Systematic reviews and data analyses: Guide to clinical practice and research.","authors":"Qiushuo Wu, Ghulam Nabi","doi":"10.1177/00369330231193888","DOIUrl":"10.1177/00369330231193888","url":null,"abstract":"This issue of the Scottish Medical Journal has a few systematic reviews and critical analysis of literature in many areas. We feel that for clinical practice, evidence is essential and systematic reviews summarize evidence for us through a scientific synthesis. The range of topics of systematic reviews.1–8 in this issue has been wide and not focusing on a particular problem, however, publications should generate awareness, some glimpse into methodology and associated discussions around evidence-based medicine. Evidence-based medicine is a combination of individual clinical knowledge and the results of clinical trials. And as a doctor, there is a great need for some strong evidence to support his diagnosis and treatment and all aspects of it. Due to the proliferation of medical literature and the limited time available to clinicians and researchers, systematic evaluation was born. The systematic evaluation aims to obtain stronger clinical evidence for clinical decisionmaking by systematically searching medical databases. So high-quality systematic reviews are needed. The quality of a systematic review depends on the number and quality of the studies included and the presence of heterogeneity. Choosing a good topic is the beginning of preparing a systematic review. Once you have chosen a topic, you can start with the Protocol. At this stage, most journals recommend that we use The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) to assist in the writing of our articles. PROSPERO (http://www.crd.york.ac.uk/prospero/) is a well-known platform for registration of system overviews, so it is best to make a registration on such a platform. And check if anyone has done any relevant research to avoid duplication. In particular, for clinical questions, authors should use the “Participants, Interventions, Comparisons and Outcomes (PICO)” to analyze the question before starting the process of conducting a systematic review. The search strategy is mainly to link some keywords by means of ‘and’ and ‘or’ to achieve a search of the relevant literature. Then it is a matter of selecting the appropriate database for the search, e.g. PubMed, Web of Science, Embase, Cochrane Library, CENTRAL, Cinahl, and LiLacs., etc. Searches can be conducted within them using keywords and appropriate filters such as time frame, language, type of literature, etc. It is recommended to search using multiple databases to increase the coverage of the literature. Before literature screening, screening criteria should be determined, including inclusion criteria and exclusion criteria. The selection of literature is divided into 2 parts, firstly by determining the type of literature and reading the abstract to determine whether the literature meets the search requirements to exclude some literature, and secondly by reading the full text of the article to determine whether the selected literature meets the requirements and whether there is a lack of data to determi","PeriodicalId":21683,"journal":{"name":"Scottish Medical Journal","volume":"68 3","pages":"69-71"},"PeriodicalIF":2.7,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10549119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scottish Paediatric Society Summer Meeting, Stirling Court Hotel, University of Stirling, Friday 10th June 2022.","authors":"","doi":"10.1177/00369330231187719","DOIUrl":"10.1177/00369330231187719","url":null,"abstract":"Objectives: Determine the association between socio-economic status and features of Paediatric Emergency","PeriodicalId":21683,"journal":{"name":"Scottish Medical Journal","volume":"68 3","pages":"NP11-NP16"},"PeriodicalIF":2.7,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10196937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scottish Paediatric Society Summer meeting Friday 9th June 2023 Suttie Centre for Teaching and Learning in Healthcare Foresthill Site, University of Aberdeen.","authors":"","doi":"10.1177/00369330231187718","DOIUrl":"10.1177/00369330231187718","url":null,"abstract":"Background: Clinical decision scores are used to target antibiotic use for acute sore throat (AST) but are not well validated in children under 5 years old. NICE guidance recommends antibiotics in AST where FeverPAIN score is >4. Following an increase in Group A streptococcal (GAS) transmission in December 2022, Public Health Scotland (PHS) interim guidance lowered this prescribing threshold to a FeverPAIN score >3. Objectives: To audit antibiotic prescribing for upper respiratory tract infection (URTI)/AST in the PED in the context of the GAS public health alert in December 2022 with NICE and interim PHS guidance as reference standards. To determine the diagnostic accuracy of the FeverPAIN score in predicting con fi rmed GAS infection. Population: All children aged 3 to 16 years who presented to the PED between 3 and 16 December 2022, who had a throat swab for bacterial culture. Methods: Cases were identi fi ed from laboratory sample data. FeverPAIN scores retrospectively assigned from clinical records. Descriptive statistics were calculated in excel. Received operator characteristic (ROC)curves were created using XLSTAT. Only children with a diagnosis of URTI/AST and calculable FeverPAIN score were included.","PeriodicalId":21683,"journal":{"name":"Scottish Medical Journal","volume":"68 3","pages":"NP6-NP10"},"PeriodicalIF":2.7,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10196941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of prehospital intubation on mortality rates in patients with traumatic brain injury: A systematic review and meta-analysis.","authors":"Fang Ji, Xiaohui Zhou","doi":"10.1177/00369330231189886","DOIUrl":"10.1177/00369330231189886","url":null,"abstract":"<p><strong>Objective: </strong>It is unclear if prehospital intubation improves survival in patients with traumatic brain injury. We performed a systematic review and meta-analysis to assess the impact of prehospital intubation on mortality rates of traumatic brain injury.</p><p><strong>Methods: </strong>PubMed, CENTRAL, Web of Science, and Embase databases were searched without any language restriction up to 20 June 2022 for all types of comparative studies reporting survival of traumatic brain injury patients based on prehospital intubation.</p><p><strong>Results: </strong>In total, 18 studies with 41,185 patients were eligible for inclusion. Meta-analysis showed that traumatic brain injury patients receiving prehospital intubation had higher odds of mortality as compared to those not receiving prehospital intubation. Meta-analysis of adjusted data also indicated that prehospital intubation was associated with increased odds of mortality in traumatic brain injury patients. The results did not change on sensitivity analysis. Subgroup analysis based on study type, the severity of traumatic brain injury, inclusion of isolated traumatic brain injury, emergency department intubation in the control group, and prehospital intubation group sample size demonstrated variable results.</p><p><strong>Conclusion: </strong>Heterogeneous data from mostly observational studies demonstrates higher mortality rates among traumatic brain injury patients receiving prehospital intubation. The efficacy of prehospital intubation is difficult to judge without taking into account multiple confounding factors.</p>","PeriodicalId":21683,"journal":{"name":"Scottish Medical Journal","volume":"68 3","pages":"80-90"},"PeriodicalIF":2.7,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10168449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of weekend admission on mortality risk in patients with sepsis and septic shock: A systematic review and meta-analysis.","authors":"Haiyan Xiong, Linlin Shi","doi":"10.1177/00369330231189887","DOIUrl":"10.1177/00369330231189887","url":null,"abstract":"<p><strong>Background: </strong>There is an ongoing debate if weekend admissions of critically ill patients are associated with higher mortality rates. The current review aimed to specifically assess this effect in sepsis and septic shock patients by comparing mortality rates with weekend versus weekday admissions.</p><p><strong>Methods: </strong>PubMed, CENTRAL, Scopus, Web of Science, and Embase were searched up to 20th February 2023 with an additional search of Google Scholar for gray literature.</p><p><strong>Results: </strong>Nine studies were eligible. Meta-analysis of all nine studies with data from 1,134,417 patients demonstrated that sepsis or septic shock patients admitted on weekends don't have higher mortality as compared to those admitted on weekdays (OR: 1.04; 95% CI: 1.00, 1.09; p = 0.05; I²= 93%). On subgroup analysis based on sample size (>2000 or <2000 patients) and timing of mortality, we noted no difference in the significance of the results. However, there was a small significant increased risk of mortality with weekend admission noted in studies on the Asian population and including septic shock patients.</p><p><strong>Conclusion: </strong>Weekend admission does not have an adverse impact on mortality rates of sepsis and septic shock patients. Results must be interpreted with caution owing to high interstudy heterogeneity and variation in confounders adjusted by individual studies.</p>","PeriodicalId":21683,"journal":{"name":"Scottish Medical Journal","volume":"68 3","pages":"91-100"},"PeriodicalIF":2.7,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10174576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burnout and patient safety perceptions among surgeons in the United Kingdom during the early phases of the coronavirus disease 2019 pandemic: A two-wave survey.","authors":"Tmam Al-Ghunaim,&nbsp;Judith Johnson,&nbsp;Chandra S Biyani,&nbsp;Marina Yiasemidou,&nbsp;Daryl B O'Connor","doi":"10.1177/00369330231163378","DOIUrl":"https://doi.org/10.1177/00369330231163378","url":null,"abstract":"<p><strong>Background: </strong>Surgeons in the UK report high burnout levels. Burnout has been found to be associated with adverse patient outcomes but there are few studies that have examined this association in surgeons and even fewer which have examined this relationship over time.</p><p><strong>Purpose: </strong>The main aim was to examine the relationships between surgeon burnout and surgeons' perceptions of patient safety cross-sectionally and longitudinally. The secondary aim was to test whether surgeons' burnout levels varied over the first six months of the coronavirus disease 2019 pandemic.</p><p><strong>Methods: </strong>This paper reports data from a two-wave survey (first wave from 5 May and 30 June 2020, the second wave 5 January to 30 February 2021). The dataset was divided into a longitudinal group (for surgeons who responded at both the time points) and two cross-sectional groups (for surgeons who responded at a one-time point, but not the other).</p><p><strong>Results: </strong>The first key finding was that burnout was associated with patient safety outcomes measured at the same time point (Group 1 = 108, <i>r =</i> 0.309<i>,</i> <i>p</i> < 0.05 and Group 2 = 84, <i>r = </i>0.238, <i>p</i> < 0.05). Second, burnout predicted poor patients' safety perceptions over time, and poor patient safety predicted burnout over time (Group 3 = 39, <i>p</i> < 0.05). Third, burnout increased between the first and second surveys (<i>t</i> = -4.034, <i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>Burnout in surgeons may have serious implications for patient safety. Interventions to support surgeons should be prioritised, and healthcare organisations, surgeons and psychological specialists should collaborate on their development.</p>","PeriodicalId":21683,"journal":{"name":"Scottish Medical Journal","volume":"68 2","pages":"41-48"},"PeriodicalIF":2.7,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10067362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9500680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraoperative feedback: A survey of surgical trainees' perspective.","authors":"Mohammed Gadoora Fadelalla,&nbsp;Sabreen Elbakri,&nbsp;Michael Poon","doi":"10.1177/00369330231163375","DOIUrl":"https://doi.org/10.1177/00369330231163375","url":null,"abstract":"<p><strong>Introduction: </strong>Intraoperative feedback can be associated with improved surgical performance. Quality feedback can reduce the time required by trainees to achieve proficiency in psychomotor skills. Operative training time has become increasingly limited, and it has become imperative to use surgical training time effectively.</p><p><strong>Aim: </strong>In this survey, we assessed trainees' perspectives of intraoperative feedback. We included several aspects of feedback including its occurrence, quality, and potential barriers.</p><p><strong>Methods: </strong>All surgical trainees in a single centre were invited to complete an electronic questionnaire. Participants were anonymised. We summarised data using descriptive statistics.</p><p><strong>Results: </strong>Most trainees (85%) reported they had the opportunity to share their training goals with trainers. Just under three-quarters of trainees felt they always or sometimes got timely feedback. Only half of the trainees were signposted to feedback and 23% felt feedback was not part of their department's culture. Half of the trainees did not always feel comfortable asking for feedback from their trainers stating their reasons as fear of criticism, lack of time and competing clinical commitments.</p><p><strong>Conclusion: </strong>There is no denying the importance of feedback on operative performance, however, this survey shows that many of the pillars of quality feedback are poorly adhered to.</p>","PeriodicalId":21683,"journal":{"name":"Scottish Medical Journal","volume":"68 2","pages":"58-62"},"PeriodicalIF":2.7,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9502961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can automated CT body composition analysis predict high-grade Clavien-Dindo complications in patients with RCC undergoing partial and radical nephrectomy?","authors":"Emin Demirel,&nbsp;Okan Dilek","doi":"10.1177/00369330231166122","DOIUrl":"https://doi.org/10.1177/00369330231166122","url":null,"abstract":"<p><strong>Introduction: </strong>This study investigated the relationship between body tissue composition analysis and complications according to the Clavien-Dindo classification in patients with renal cell carcinoma (RCC) who underwent partial (PN) or radical nephrectomies (RN).</p><p><strong>Methods: </strong>We obtained all data of 210 patients with RCC from the 2019 Kidney and Kidney Tumor Segmentation Challenge (C4KC-KiTS) dataset and obtained radiological images from the cancer image archive. Body composition was assessed with automated artificial intelligence software using the convolutional network segmentation technique from abdominal computed tomography images. We included 125 PN and 63 RN in the study. The relationship between body fat and muscle tissue distribution and complications according to the Clavien-Dindo classification was evaluated between these two groups.</p><p><strong>Results: </strong>Clavien-Dindo 3A and higher (high grade) complications were developed in 9 of 125 patients who underwent PN and 7 of 63 patients who underwent RN. There was no significant difference between all body composition values between patients with and without high-grade complications.</p><p><strong>Conclusion: </strong>This study showed that body muscle-fat tissue distribution did not affect patients with 3A and above complications according to the Clavien-Dindo classification in patients who underwent nephrectomy due to RCC.</p>","PeriodicalId":21683,"journal":{"name":"Scottish Medical Journal","volume":"68 2","pages":"63-67"},"PeriodicalIF":2.7,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9500683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ABSTRACTS 2022.","authors":"","doi":"10.1177/00369330221164244","DOIUrl":"10.1177/00369330221164244","url":null,"abstract":"S 2022","PeriodicalId":21683,"journal":{"name":"Scottish Medical Journal","volume":"68 2","pages":"NP14-NP45"},"PeriodicalIF":2.7,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9555978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The need for a course to complete urological education for consultant practice using a simulated 'boot camp' structure at the end of specialist training: A survey-based study.","authors":"Karl H Pang,&nbsp;Sunjay Jain,&nbsp;Chandra Shekhar Biyani,&nbsp;Stephen R Payne","doi":"10.1177/00369330231163376","DOIUrl":"https://doi.org/10.1177/00369330231163376","url":null,"abstract":"<p><strong>Background and aims: </strong>To obtain opinions from urology trainees and consultants regarding the need for, and structure of, a post-specialty training Urology Simulation Boot Camp (USBC) for consultant practice.</p><p><strong>Methods and results: </strong>A survey-based study was conducted, and 'Google Forms' were distributed electronically via social media. Urology specialist trainees (ST) in years 5-7 (ST5-ST7), post-certification of completion of training (CCT) fellows and ST3 boot camp faculty consultants in practice for ≤5 years and >5 years were included. One hundred and seven responses were received. 97.2% of responders thought a pre-consultant USBC was worthwhile; 55.1% selected the course duration to be 2 days. 47.7% felt that the USBC should be delivered post-exam in ST7. 91.6%, 43.9%, 73.8%, 87.9% and 74.8% considered that modules in emergency operative procedures, novel uro-technologies, delivering multidisciplinary team (MDT) meetings, non-clinical consultant roles and responsibilities, stress and burnout to be important, respectively. 62.6% and 31.8% felt that the course should be wholly or part-funded by Health Education England (HEE).</p><p><strong>Conclusions: </strong>A post-specialty training, pre-consultant, USBC delivered post-exam in ST7, is worthwhile and should include modules on emergency operative procedures, leading MDTs, non-clinical roles and responsibilities and managing stress and burnout in consultant careers. Ideally, it should be fully/part-funded by HEE.</p>","PeriodicalId":21683,"journal":{"name":"Scottish Medical Journal","volume":"68 2","pages":"49-57"},"PeriodicalIF":2.7,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9505989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}