Assessment of the Readability, Adequacy, and Suitability of Online Patient Education Resources for Benign Vascular Tumours Using the DISCERN Instrument.

OBJECTIVE: This study aims to assess the quality and readability of Internet-based patient resources for vascular tumours in order to understand which areas require improvement. METHODS: A World Wide Web search was performed, in addition to a literature review using PubMed, Ovid MEDLINE, and EMBASE. Any material that contained information on vascular tumours pertaining to patient education was included. We evaluated resources with DISCERN and Flesch Reading Ease scores when applicable. The language of publication was restricted to English and French. This review was registered with PROSPERO (CRD42018087885). RESULTS: A total of 117 online resources were screened, with 73 resources included in the final analysis. The overall DISCERN rating for the patient resources was 1.8 (0.8). The majority of online resources failed to depict the entire spectrum of benign vascular tumours. The mean Flesch score was 36 (19), which translates to a college-level readability. CONCLUSION: The majority of resources were not adequate or comprehensive and were written at a much higher level than the average reader would be expected to comprehend.

OBJECTIF: La présente étude vise à évaluer la qualité et la lisibilité de ressources en ligne sur les tumeurs vasculaires pour les patients afin de déterminer les améliorations à apporter. MÉTHODOLOGIE: Les chercheurs ont effectué une recherche dans Internet et procédé à une analyse bibliographique dans PubMed, Ovid MEDLINE et EMBASE. Tous les documents qui contenaient de l'information sur les tumeurs vasculaires à l'intention des patients étaient inclus. Les chercheurs ont évalué les ressources à l'aide des scores de DISCERN et de Flesch Reading Ease, si la situation le justifiait. La langue des publications était restreinte à l'anglais et au français. La présente analyse a été enregistrée dans PROSPERO (CRD42018087885). RÉSULTATS: Au total, les chercheurs ont examiné 117 ressources en ligne, dont 73 ont fait partie de l'analyse définitive. La classification DISCERN globale des ressources pour les patients était de 1,8 (0,8). La majorité des ressources en ligne ne décrivaient pas tout le spectre des tumeurs vasculaires bénignes. Le score de Flesch moyen s'élevait à 36 (19), soit une lisibilité de niveau collégial. CONCLUSION: La majorité des ressources étaient inadéquates ou incomplètes et étaient rédigées à un niveau de lecture beaucoup plus élevé que ce à quoi on pourrait s'attendre chez un lecteur moyen.

Dermal regenerative matrix use in burn patients: A systematic review.

BACKGROUND: Dermal regenerative matrices (DRMs) have been used for several decades in the treatment of acute and reconstructive burn injury. The objective of this study was to perform a systematic review of the literature to assess clinical outcomes and safety profile of DRMs in full-thickness burn injury. METHODS: Comprehensive searches of MEDLINE, EMBASE, CINAHL, and Cochrane Library were performed from 1988 to 2017. Two independent reviewers completed preliminary and full-text screening of all articles. English-language articles reporting on DRM use in patients with full-thickness burn injury were included. RESULTS: Literature search generated 914 unique articles. Following screening, 203 articles were assessed for eligibility, and 72 met inclusion criteria for analysis. DRM was applied to1084 patients (74% acute burns, 26% burn reconstruction). Of the twelve studies that described changes in ROM, significant improvement was observed in 95% of reconstructive patients. The most frequently treated reconstructive sites were the neck, hand/wrist, lower extremity, and axilla. Vancouver scar scale was used in eight studies and indicated a significant improvement in the scar quality with DRM. The overall complication rate was 13%, most commonly infection, graft loss, hematoma formation, and contracture. CONCLUSIONS: Although variability in functional and cosmetic outcomes was observed, DRM demonstrates improvements in ROM and scar appearance without objective regression. Essential demographic data were lacking in many studies, highlighting the need for future standardization of reporting outcomes in burns following application of dermal substitutes.

Surgical Exploration and Discovery Program: Early Exposure to Surgical Subspecialties and Its Influence on Student Perceptions of a Surgical Career.

OBJECTIVE: Interest in pursuing a surgical career has been declining among North American medical students. Numerous factors are known to influence student interest in pursuing surgery as a career, such as prestige, income potential, and overall lifestyle. Given that many of these factors are rooted in bias, it may be possible to properly address several of these stereotypes through first-hand, early exposure to the field of surgery via the Surgical Exploration and Discovery (SEAD) Program. The purpose of this study is twofold: (1) to investigate whether participation in an intensive, 2-week surgical program may alter student opinion, bias, and/or preconceived assumptions of a career in surgery, and (2) to determine whether these changes in perception, if present, has an impact on student interest in pursuing a surgical career compared to baseline. DESIGN: This was a prospective cohort study. The analysis cohort consisted of 30 first-year medical students who participated in the 2-week SEAD program. The control group consisted of 29 first-year medical students who did not participate in the SEAD program. Both the SEAD and control groups completed two surveys: (1) an entry survey distributed prior to the start of the SEAD program, and (2) an exit survey distributed upon completion of the SEAD program. The surveys were designed to assess students' motivations for choosing a specialty in medicine, previous surgical experience, as well as perceptions and biases surrounding a surgical career, pre- and post-exposure. SETTING: Undergraduate Medical Education, Faculty of Medicine, at the University of Ottawa in Ottawa, Ontario, Canada. PARTICIPANTS: 30 medical students in the SEAD group, and 29 in the control group. RESULTS: Students' perceptions of the lifestyle, call schedule as a staff or resident, diversity of practice and gender changed significantly following the SEAD program compared to students in the control group. Furthermore, students' perceptions of surgeons as intimidating declined following the 2-week program (p = 0.003), however they were more likely to view surgery as a field requiring physical strength (p = 0.022). Overall, there was no significant change with regards to desire to pursue a career in surgery in the treatment group (p = 0.625) or in the control group (p = 1.00). CONCLUSIONS: Early exposure to surgery through the SEAD program alters student perceptions of surgical specialties, yet it does not significantly influence students to pursue a career in the surgical field. Nonetheless, participation in the SEAD program continues to assist medical students with career decision making.