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JBJS Rev ; 9(7)2021 07 16.
Article in English | MEDLINE | ID: covidwho-1511874


¼: Telemedicine and remote care administered through technology are among the fastest growing sectors in health care. The utilization and implementation of virtual-care technologies have further been accelerated with the recent COVID-19 pandemic. ¼: Remote, technology-based patient care is not a "one-size-fits-all" solution for all medical and surgical conditions, as each condition presents unique hurdles, and no true consensus exists regarding the efficacy of telemedicine across surgical fields. ¼: When implementing virtual care in orthopaedics, as with standard in-person care, it is important to have a well-defined team structure with a deliberate team selection process. As always, a team with a shared vision for the care they provide as well as a supportive and incentivized environment are integral for the success of the virtual-care mechanism. ¼: Future studies should assess the impact of primarily virtual, integrated, and multidisciplinary team-based approaches and systems of care on patient outcomes, health-care expenditure, and patient satisfaction in the orthopaedic population.

COVID-19 , Musculoskeletal Diseases/diagnosis , Musculoskeletal Diseases/therapy , Patient Care Team , Telemedicine , Humans
Int Orthop ; 44(8): 1467-1471, 2020 08.
Article in English | MEDLINE | ID: covidwho-996365


PURPOSE: The purpose of this review is to quantify the landscape of current clinical trials ongoing for therapies in the treatment of COVID-19. A secondary purpose is to examine the relationship between public and scientific interests in potential therapies for COVID-19. METHODS: A systematic search of was undertaken on April 22, 2020, to identify all currently registered clinical trials investigating potential therapies for patients with COVID-19. Public interest in the various therapies was quantified utilizing Google Trends. Public interest in hydroxychloroquine and chloroquine was plotted against the cumulative number of active clinical trials evaluating antimalarials as potential COVID-19 therapies over time. RESULTS: There were 341 interventional studies and 208 different therapies actively registered on whose primary aim is the treatment of COVID-19. The median sample size was 120 patients (range 4-6000) with 154 (45%) trials reporting a planned sample size of 100 patients or less. There was a strong positive correlation (r = 0.76, p = 0.01) between the number of registered clinical trials and the public interest in the top ten proposed therapies. Following the spike in public interest, the average number of new trials increased tenfold with respect to antimalarial therapies. CONCLUSIONS: The relatively small sample sizes and the number of independent trials investigating similar therapies are concerning. Resources may not be being allocated based on scientific merit and may be driven by public consciousness and speculation. Moving forward, a concerted effort focused on implementing large, well-coordinated and carefully designed multi-armed clinical trials will help to ensure that the most promising therapeutic options are rigorously studied and clinically meaningful results produced.

Betacoronavirus , Coronavirus Infections , Pandemics , Pneumonia, Viral , Betacoronavirus/drug effects , COVID-19 , Clinical Trials as Topic , Coronavirus Infections/drug therapy , Humans , Hydroxychloroquine/adverse effects , Hydroxychloroquine/therapeutic use , Pneumonia, Viral/drug therapy , SARS-CoV-2
Int Orthop ; 44(8): 1461-1466, 2020 08.
Article in English | MEDLINE | ID: covidwho-996361


PURPOSE: In the current COVID-19 pandemic, it is more important than ever to maximize communication in the scientific and medical community. In the context of academic meetings and conferences, there is the growing need for a set of guidelines secondary to the COVID-19 pandemic, and the growing environmental and economic challenges that large academic and medical conferences face. These Virtual Meetings Best Practices were established in response to the scant evidence and guidance on the topic. METHODS: These best practice guidelines were developed from a scoping review of peer-reviewed literature, grey literature and lay literature. MEDLINE and Embase databases were scoped for relevant, non-duplicate articles. For lay articles, Google searches were utilized. The recommendations that comprise this document are a compilation of nonexperimental descriptive studies (e.g. case studies) and expert committee reports, opinions and/or experience of respected authorities, and lay articles. RESULTS: We identified four phases of the meeting cycle: Pre-planning considerations, Planning, Accomplishing conference goals through execution, gauging Response and Engaging the target audience for future cycles (PrePARE). Akin to the Plan, Do, Study, Act Cycle of quality improvement interventions, this document is meant to drive meaningful initial and subsequent interventions in the meetings of the medical and academic community. This covers actions and preparation for registration, scheduling, speakers, attendees, event type, technology, monetization/marketing, dealing with disruptions, post-event deliverables, response and engagement strategies. Enhanced access to integrated, high-quality and efficient virtual meetings will establish a new norm as an effective alternative for innovative health research, education and information dissemination in orthopaedics and beyond. CONCLUSIONS: Given the uncertainty of whether large in-person gatherings will be permitted, advisable or responsible later into the summer of 2020 and beyond, these guidelines will aid events being converted and scheduled as virtual-only meetings. As we move forward in the era of increased utility and utilization of virtual conferencing, these guidelines will serve as a benchmark and standard for surgeons in the field.

Coronavirus Infections , Pandemics , Pneumonia, Viral , Betacoronavirus , COVID-19 , Group Processes , Guidelines as Topic , Humans , SARS-CoV-2 , User-Computer Interface