Healthcare Stakeholders Research Articles

Recommendations on Rapid Diagnostic Point-of-care Molecular Tests for Respiratory Infections in the United Arab Emirates

Traditional testing methods in the Middle East Region, including the United Arab Emirates (UAE), particularly the testing of Respiratory Syncytial Virus (RSV), influenza, group A streptococcus (GAS), and COVID-19 have the potential to be upgraded to new and advanced diagnostics methods that improve lead time to diagnosis, consumption of healthcare resources and patient experience. In addition, based on the research, it was reported that there is an underreporting of respiratory cases, overuse of antibiotics, and prolonged hospitalizations which is posing pressure on UAE healthcare stakeholders. A literature review was done exploring UAE's current diagnostic practices, recommended guidelines, diagnostic gaps, and challenges in RSV, GAS, Influenza, and COVID-19. This was followed by stakeholder discussions focusing on assessing current diagnostic practices, usage of rapid molecular point-of-care (POC) diagnostic tests, current gaps in diagnosis, targeted profiles for POC testing, and potential impact on patient management for targeted respiratory infections. A round table discussion with healthcare experts, insurance experts, key opinion leaders, and pulmonologists discussed challenges and opportunities in treating respiratory diseases. UAE healthcare stakeholders suggest that introducing alternative and up-to-date diagnostic methods such as POC molecular testing is expected to improve healthcare outcomes, optimize resources, and develop a robust case management of respiratory tract infections. It is essential to emphasize that by introducing POC testing, precision medicine is reinforced, efficiency is achieved, and the overall management of population health is enhanced.

Reported foodservice environmental sustainability practices in Australian healthcare and aged care services pre and post the onset of COVID-19.

Healthcare foodservices substantially impact global environmental changes. This study investigated environmentally sustainable practices in Australian health foodservices; and perceptions of the influence of COVID-19 on foodservice environmental sustainability. An observational study was undertaken collecting data at two time points (2019 and 2022) via a pre-workshop survey with healthcare foodservice stakeholders. The survey used rating scales and free text options to explore sustainable practices, perceived barriers and enablers to sustainable practices, and a free-text response on the impact of COVID-19. Analysis included independent samples t-tests (continuous, normally distributed),Mann-Whitney U tests (continuous non-normally distributed data), and Pearson chi-squared tests (categorical data). A qualitative analysis of free text responses to a single question about the impact of COVID-19 was used to identify, analyse, and report positive and negative aspects of COVID-19 for sustainable foodservice practices. Demographic and employment characteristics were similar between timepoints n = 37 (2019) and n = 30 (2022), except for number who had attendedsustainability training (n = 14, 38.8% vs n = 19, 63.3%; p = 0.038). There were fewer private hospital (n = 6, 16.2% vs n = 0), (0%) and more rural site representation in 2022 (n = 2, 5.4% vs n = 13, 43.3%; p <0.001). Sustainable foodservice practices were consistent across timepoints (overall mean (SD) sum score for sustainable practices 63.3 (20.7) vs 61.3 (20.4); p = 0.715), with recycling cardboard (n = 27, 90.0% vs n = 22, 84.6%), and the use of reusable cutlery (n = 26, 86.7% vs n = 22, 84.6%) the most prevalent practices at both timepoints. A 'lack of equipment' was the primary reported barrier while passionate staff ("champions") was the primary reported enabler. Participants reported that the COVID-19 pandemic led to an increase in single-use disposable items. This study describes negligible changes in reported environmental sustainability practices by Australian healthcare foodservice stakeholders from 2019 to 2022. The study provides useful information on sustainability beliefs and practices in healthcare foodservices.

In Pursuit of Recovery: A Comparative Study of Stakeholder Perspectives on Outcomes of People with Psychosis.

There is no consensus on the definition of recovery of people with psychosis. This may be attributed to the broad concept including clinical, functional and personal recovery domains and the diverse interests of stakeholders involved. We hypothesized that service users, informal caregivers and healthcare professionals would exhibit differences in prioritization, reflecting varying roles and viewpoints. Through an open online anonymous questionnaire, stakeholders shared their perspectives on most important aspects of clinical, functional and personal recovery and on facilitators and barriers of recovery. Stakeholder collaboration in study design and interpretation enhanced the study's robustness. The answers on open questions of respondents were categorized for statistical analyses to compare the answers between respondent groups on the different aspects of recovery. 226 stakeholders participated. While commonalities prevailed, distinctions emerged in recovery domain priorities. Service users and informal caregivers accorded equal importance to clinical, functional and personal recovery, whereas healthcare professionals emphasized clinical recovery. Regarding functional recovery, service users seemed to focus on practical issues while informal caregivers addressed the underlying causes. Disparities were notable in the role of healthcare that was considered as both a facilitator or a barrier to recovery, with informal caregivers prioritizing aspects of healthcare more frequently as most important than healthcare professionals. While commonalities prevailed, we identified several differences in prioritizing recovery domains among stakeholder groups. Awareness and understanding of these differences is crucial for effective communication and collaboration between stakeholders in recovery-oriented healthcare. The study underscores the need for ongoing dialogue between stakeholders.

The Relationship Between Self-Compassion and Resilience in the General Population: Protocol for a Systematic Review and Meta-Analysis.

Resilience can protect individuals from the negative impact of adversity, facilitating a swift recovery. The exploration of protective factors contributing to resilience has been a central focus of research. Self-compassion, a positive psychological construct that involves treating oneself with kindness, holds the potential to bolster resilience. Although several studies have indicated an association between self-compassion and resilience, there is a lack of systematic reviews and meta-analyses examining this relationship and the potential moderators and mechanisms. This study aimed to systematically review the literature on the relationship between self-compassion and resilience in the general population, perform a meta-analysis to quantify the effect size of their association, and explore potential moderators (eg, age, gender, culture, and health status) and mediators. We will search the Web of Science, PsycINFO, MEDLINE, Scopus, CINAHL, and CNKI databases for peer-reviewed studies (including observational and experimental studies) that examined the relationship between self-compassion and resilience, with no language restrictions. There are no restrictions regarding participants' age, gender, culture, or health status. Qualitative studies, conference abstracts, review articles, case reports, and editorials will be excluded. Two reviewers (XL and JH) will independently screen the literature, extract data, and assess the quality of the eligible studies. If possible, the pooled effect size between self-compassion and resilience will be meta-analyzed using a random-effect model. Meta-regression and subgroup analysis will be conducted to examine the moderating roles of age, gender, culture, health status, and other potential moderators. The characteristics and main findings of eligible studies will be summarized in tables and narrative descriptions. Results from the meta-analysis, meta-regression, and subgroup analysis will be presented quantitatively. We registered our protocol with PROSPERO, conducted the search, and initiated the screening in April 2024. We expect to start data analysis in October 2024 and finalize the review by March 2025. The systematic review and meta-analysis will provide evidence on the protective role of self-compassion in resilience under adversity. Our investigation into potential moderators will highlight the contexts and groups where the benefits of self-compassion can be maximized. The findings are expected to provide valuable insights for health care professionals and stakeholders, informing the development of interventions aimed at enhancing resilience by fostering self-compassion. PROSPERO CRD42024534390; https://tinyurl.com/3j3rmcja. PRR1-10.2196/60154.

Inflation-adjusted analysis of ICER’s Unsupported Price Increase reports: contextualizing drug spending changes

Objective The Institute for Clinical and Economic Review (ICER) publishes annual Unsupported Price Increase (UPI) reports on prescription drugs, which have gained attention from policymakers and healthcare stakeholders. These reports do not adjust for inflation in their analyses of net price changes. This study aimed to evaluate the economic context of reported drug price increases in ICER’s UPI reports by applying inflation adjustments to the estimated impact on healthcare spending. Methods Separate inflation adjustments using the Medical Consumer Price Index (Medical CPI) and the Consumer Price Index for All Urban Consumers (CPI-U) were applied to unadjusted UPI findings. The study analyzed data from four most recent UPI reports spanning pricing data from 2018 to 2019 (report year 2020) to 2021 to 2022 (report year 2023), focusing on drugs classified as having “unsupported” price increases. Results Inflation-adjusted analyses showed lower estimates of real changes in spending compared to ICER’s unadjusted figures across all drugs analyzed. Across the four UPI reports, the average report-year difference in Medical CPI inflation adjustment spending versus unadjusted findings was 53%, whereas the average report-year difference in CPI-U inflation adjustment spending versus unadjusted findings was 80%. In the most recent report year of 2023, ICER’s unadjusted estimate of a $1.3 billion increase in healthcare spending transformed to a $134 million decrease when adjusted by Medical CPI and a $1.51 billion decrease when adjusted by CPI-U. Conclusion This study demonstrates that inflation adjustment can alter not only the findings but also the interpretation of drug spending changes in UPI reports. The findings highlight the importance of considering economic context in evaluating drug pricing trends and suggest that unadjusted figures may overstate the impact of real price changes. Given the influence of these reports on policy discussions, incorporating inflation adjustments into analyses is one of many steps toward informing evidence-based policy decisions.

Advancing a virtual home hospital: a blueprint for development and expansion

BackgroundThe rising demand for hospitals has spurred increased interest in adopting virtual home hospital (VHH) care models. Development in this area often uses rigid research methods. This study describes a...

Recent Breakthroughs in PET-CT Multimodality Imaging: Innovations and Clinical Impact

This review presents a detailed examination of the most recent advancements in positron emission tomography–computed tomography (PET-CT) multimodal imaging over the past five years. The fusion of PET and CT technologies has revolutionized medical imaging, offering unprecedented insights into both anatomical structure and functional processes. The analysis delves into key technological innovations, including advancements in image reconstruction, data-driven gating, and time-of-flight capabilities, highlighting their impact on enhancing diagnostic accuracy and clinical outcomes. Illustrative case studies underscore the transformative role of PET-CT in lesion detection, disease characterization, and treatment response evaluation. Additionally, the review explores future prospects and challenges in PET-CT, advocating for the integration and evaluation of emerging technologies to improve patient care. This comprehensive synthesis aims to equip healthcare professionals, researchers, and industry stakeholders with the knowledge and tools necessary to navigate the evolving landscape of PET-CT multimodal imaging.

Innovation in Baby Massage Services "Rembulan" (Relaxation for Healthy, Active, and Comfortable Growth) to Reduce Stunting Prevalence at Lontar Health Center, Surabaya

This study aims to explore and analyze the effectiveness of the "Rembulan" baby massage service innovation at Lontar Health Center, Surabaya, in reducing stunting prevalence. This service enhances infant health and well-being through massage methods that support relaxation, optimal growth, and motor development. In the context of efforts to reduce stunting rates, the program focuses on infants and children under two years old who are at risk of malnutrition and growth delay. This research employs a qualitative approach with in-depth interviews, field observations, and secondary data analysis. Respondents include healthcare workers, parents, and stakeholders directly involved in the baby massage service. The results indicate that the "Rembulan" baby massage program increases infants' nutritional intake by boosting appetite, optimizing digestion, and improving sleep quality. These benefits contribute to better growth and development, reducing the risk of stunting. The study concludes that baby massage innovation has significant potential as a non-pharmacological intervention in public health programs. This service is effective when integrated with nutrition education and continuous health monitoring. Proper implementation can make baby massage a comprehensive solution in government efforts to reduce stunting prevalence in Indonesia

Mental Health Review Board Members' understanding of the policy guideline on 72-hour assessment.

TheMental Health Care Act (No 17 of 2002)promotes the involvement of Mental Health Review Board (MHRB) members in the oversight, execution and evaluation of assessments and admissions of individuals in accordance with the 72-h policy guidelines. However, the MHRB experiences dissatisfaction with the implementation of policy guidelines on 72-h assessment of involuntary Mental Health Care Users (MHCUs). This study explores and describes the MHRB members' understanding of the policy guidelines on 72-h assessment of involuntary MHCUs in South Africa. A qualitative exploratory, descriptive and contextual research design was used. Data were collected using Focus Group Discussions (FGDs) from MHRB from three provinces of South Africa, namely North West, Northern Cape and Gauteng. Three FGDs involving a total of 13 participants were conducted. Three themes emerged from the data, namely: MHRBs' understanding of the policy guideline on 72-h assessment of involuntary MHCUs, MHRBs' challenges with the policy guideline on 72-h assessment of involuntary MHCUs and MHRBs' recommendations to strengthen the implementation of policy guideline on 72-h assessment of involuntary MHCUs. Certain issues regarding dissatisfaction related to improper implementation of the 72-h policy guideline persist. Therefore, MHRB recommends that there should be skilled Mental Health Care Practitioners, adequate infrastructure, community involvement, and family and stakeholder collaboration to improve care towards the involuntary MHCUs.Contribution:The study illustrated there is a need to strengthen the implementation of 72-h assessment of involuntary MHCUs through ensuring enough human resources, designated facilities and involvement of the community as raised by the MHRBs.

Assessing diagnosis-related groups based direct medical expenditures of chronic disease patients in general hospital of lower southern Thailand

BackgroundAssessment of the cost-related burden of chronic diseases is important for making informed decisions. An effective and efficient methodology for examining medical expenditures is one of the most significant challenges for stakeholders. The objective of this study was to examine the role of the variables of diagnosis-related group (DRG) in determining the direct expense of chronic diseases in lower southern Thailand and suggest the determinants having high explainability.MethodsThe records of 6,147 patients admitted to Satun Hospital from 2014 to 2018 and diagnosed with chronic conditions were analyzed in this study. Descriptive analysis was used to summarize the main characteristics. Correlation was used to analyze the strength of the relationship. A log-linear regression model was used to evaluate the adjusted mean cost using determinants of DRG.ResultsThe overall average medical expense for chronic disease was Thailand Baht (THB) 17,985. Chronic kidney and chronic obstructive pulmonary diseases were the most expensive chronic diseases with an average expense of about THB 20,000 and 25,000. All the determinants were significantly contributing to overall expense of chronic disease with a p-value < 0.001. However, the length of stay, number of diagnoses, and number of procedures had high explainability in the expense model.ConclusionsThe expense assessment model plays a significant role in controlling and preventing the medical costs associated with chronic diseases. Healthcare administrators, stakeholders, and researchers need to make strategies by considering the results of this study to improve the DRGs-based hospital cost model.

Strategies and interventions for achieving cardiovascular disease risk factor control in low- and middle-income countries: a review of the literature

AbstractCardiovascular diseases (CVDs) are the leading cause of morbidity and mortality globally, with increasing rates in low- and low-middle-income countries (LMICs), particularly sub-Saharan Africa (SSA). These occur due to exposure to various risk factors, such as tobacco smoking, physical inactivity, hypertension, and diabetes. There are unique features in LMICs that contribute to the risk factor profile and quality of care offered in these countries. These include cultural influences on diet (carbohydrate-dense diet, use of salt-based spices and preservatives), the lack of dedicated spaces for physical activity, and perceptions of desirable body sizes. The attendant complications affect individuals, families and the community at large. Furthermore, there is a dearth of research to inform change at both the individual and policy level in LMICs. Lifestyle modification is the cornerstone of risk factor control and requires engaging relevant stakeholders in healthcare to enforce sustainable behaviour change among individuals. This includes measures from the individual level to national leadership and requires multisectoral collaboration to ensure sustainability. Such methods include building health worker capacity through a task shifting approach, strengthening the health worker-patient relationship, employing digital/technological applications, and engaging families and communities to serve as accountability partners in the management of CVD and related risk factors. There is a need for increased contextually relevant research output to inform contemporary methods to improve CVD and risk factor control in LMICs.

PHR-NFT: Decentralized Blockchain Framework with Hyperledger and NFTs for Secure and Transparent Patient Health Records

Blockchain technology holds significant promise for healthcare by enhancing the security and integrity of patient health records (PHRs) through decentralized storage and transparent access. However, it has substantial limitations, including problems with scalability, high transaction costs, privacy concerns, and intricate stakeholder access management. This study presents PHR-NFT, a novel framework that strengthens PHR privacy by utilizing Hyperledger Fabric and non-fungible tokens (NFTs) to address these issues. PHR-NFT improves privacy and communication by letting patients keep control of their medical records while permitting temporary, permission-based access by medical professionals. PHR-NFT offers a transparent solution that increases trust among healthcare stakeholders through the robust and decentralized architecture of the Hyperledger Fabric. This study demonstrates the viability and effectiveness of the PHR-NFT framework through performance evaluations focused on transaction latency, throughput, and security. This research has valuable implications for enhancing data privacy and security in healthcare practices and insightful information about blockchain-based healthcare systems.

Increasing Access to Palliative Care in Cameroon: Progress, Gaps, and Recommendations.

Access to palliative care is an urgent global need. Countries with the greatest palliative care needs have limited access. In Cameroon, demand for palliative care is growing due to the rising incidence of life-limiting conditions. Identifying available palliative care services and programs could provide an understanding of access gaps and inform future roadmaps for palliative care development in the country. We aim to map available palliative care services, identify gaps and inform recommendations to promote early access to palliative care in Cameroon. We undertook a literature review of articles reporting any aspects of palliative care in Cameroon. We searched Embase, MEDLINE, Scopus, PsycINFO, CINAHL, PubMed and gray literature. Data were analyzed thematically using the World Health Organization model for the assessment of palliative care development. We identified 41 articles reporting 21 organizations with some form of palliative care services such as clinical services, education, advocacy and research. These were led mostly by individual health care providers or private and faith-based organizations. Major palliative care initiatives included training in the form of workshops, and adult and pediatric outpatient, in-patient and community-based palliative care. There were few reports of oral morphine production, community engagement, advocacy and palliative care research. Progress in palliative care development was reported in five regions of Cameroon over the last two decades. Findings suggest the need for an intersectoral approach including government, community, and health care stakeholders to achieve sustainable palliative care. This could potentially ensure equitable access to palliative care in Cameroon.

Improving access to gene therapies: a holistic view of current challenges and future policy solutions in the United States.

Gene therapies hold the promise of delivering groundbreaking improvements in health outcomes for previously intractable diseases.These therapies possess unique characteristics that differ from traditional small molecule or biologic treatments, posing new challenges for healthcare stakeholders. While previous analyses have predominantly focused on the payment challenges associated with emerging gene therapies, a more holistic examination reveals numerous obstacles that currently hinder optimal patient access. In the United States (US), these include production and distribution issues, logistical and treatment administration challenges and coverage and reimbursement limitations imposed by US healthcare payers. Several opportunities exist to address these challenges and improve patient access, including the use of appropriate value assessment methods, the development of innovative payment solutions, the removal of inappropriate access barriers imposed by payers and improving education and awareness regarding treatment availability, benefits and risks. Moving forward, we must collectively strive for comprehensive policy and market solutions that are sensitive to the uniqueness of gene therapies to ensure their full potential is realized and these treatments are made available to those in need.

Understanding the socioeconomic dimensions of antibiotic resistance: a critical marketting perspective of healthcare stakeholders.

To explore the socioeconomic dimensions of antimicrobial resistance, emphasising the risks associated with imprudent use of antibiotics and the consequent emergence of drug-resistant "superbugs." The study employed constructivist grounded theory to investigate the perspectives of stakeholders, including physicians, patients, pharmacists, sales managers, and Drug Regulatory Authority of Pakistan (DRAP) employees. In-depth interviews were conducted with these stakeholders at their workplaces in 2022 and 2023, and transcripts were meticulously transcribed for analysis. The process of data analysis consists of open coding, then axial coding, and finally, selective coding to integrate categories into theories while the constant comparison of data was exercised to develop a cohesive theory. Data analysis revealed a dominant theme: "Navigating the Socioeconomic Terrain of Antimicrobial Resistance." Subsequently, several categories emerged, such as pharmaceutical marketting transgression, materialism among physicians and marketers, imprudent antibiotic usage, self-medication practices, lack of awareness among patients and the general public, and malpractice by unqualified and illicit practitioners. The results of the study demonstrated that critical marketting could mitigate the socioeconomic repercussions of AMR by encouraging ethical practices among the healthcare stakeholders, and hence benefit the entire society.

Delayed presentation of breast cancer patients and contributing factors in East Africa: Systematic review and meta-analysis.

Breast cancer remains a significant public health issue, with delayed medical attention often leading to advanced stages and poorer survival rates. In East Africa, evidence on the prevalence and factors contributing to the delayed presentation of breast cancer is limited. As a result, this study aims to assess the pooled prevalence of delayed breast cancer presentation and identify contributing factors in East Africa. We conducted a systematic review of observational studies from East Africa using PubMed, Google Scholar, Embase, Cochrane Library, Hinari, and Mednar databases. The Newcastle Ottawa 2016 Critical Appraisal Checklist assessed methodological quality. Publication bias was evaluated using a funnel plot and Egger's test, and heterogeneity was examined with the I-squared test. Data were extracted with Microsoft Excel and analyzed using Stata 11. The pooled prevalence of delayed presentation among breast cancer patients in East Africa was 61.85% (95% Confidence Interval: 48.83%-74.88%). Significant factors contributing to delayed presentation included visiting traditional healers (Adjusted Odds Ratio: 3.52; 95% CI: 1.43-5.59), low educational levels (Adjusted Odds Ratio: 3.61; 95% CI: 2.39-4.82), age>40 years (Adjusted Odds Ratio 1.87; 1.03, 2.71), absence of breast pain (Adjusted Odds Ratio 2.42; 1.09, 3.74), distance >5km away from home to health institution (Adjusted Odds Ratio 2.89; 1.54, 4.24), and rural residence (Adjusted Odds Ratio: 3.33; 95% CI: 2.16-4.49). This meta-analysis's findings demonstrated that over half of breast cancer patients in East Africa delayed detection. Significant factors associated with delayed presentation include age over 40 years, illiteracy, rural residence, use of traditional healers, distance greater than 5 km from a health facility, and absence of breast pain. Healthcare stakeholders and policymakers must be focused on raising awareness and educating people to encourage early detection and prompt therapy.

QOL-20. NATIONAL BRAIN TUMOR SOCIETY BRAIN TUMOR QUALITY OF LIFE RESEARCH AGENDA

Abstract BACKGROUND QoL is a critical aspect of health care outcomes, particularly in the context of brain tumor treatment and survivorship. There are evidence gaps in optimal strategies for improving QoL among brain tumor patients and care partners. Understanding the multifaceted dimensions of QoL and identifying key areas for brain tumor QoL research can significantly enhance patient care and support. Engaging the brain tumor community in defining QoL outcomes and determining research priorities can help orient research resources to community needs and perspectives. OBJECTIVE To summarize the process and outcomes of an NBTS-led collaborative effort to co-design a comprehensive research agenda on QoL for brain tumor patients and care partners, as outlined in the “Brain Tumor QoL Research Agenda.” METHODS The agenda was developed through a collaborative effort involving experts in neuro-oncology, patients, care partners, patient advocacy groups, and healthcare professionals over a two-year period. A review of existing literature, patient experiences, and expert opinions informed the identification of key research priorities. A multistakeholder advisory group held monthly meetings where brain tumor QoL was defined. In 2023, we conducted two “Research Roundtables” for adults and pediatric/AYA. The World Cafe method captured data and a survey consensus process to validate findings. RESULTS The QoL research agenda delineates a multifaceted framework encompassing domains crucial for understanding and improving QoL in brain tumor patients. Key focus areas include symptom management, psychosocial support, care burden, treatment decision-making, survivorship issues, and health care delivery models. An RFP was released by NBTS with input from stakeholder advisors in April 2024. CONCLUSION The Brain Tumor QoL Research Agenda created a roadmap for advancing research efforts aimed at enhancing the QoL of individuals affected by brain tumors. By addressing the identified research priorities, healthcare stakeholders can work towards implementing effective interventions and policies to optimize patient outcomes and well-being. This program was funded through a Patient-Centered Outcomes Research Institute® (PCORI®) Eugene Washington PCORI Engagement Award (EACB-23261).

Cost-effectiveness and cost-utility analysis of a nurse-led, transitional care model to improve care coordination for patients with cardiovascular diseases: results from the "Cardiolotse" study.

To assess the 12-month cost-effectiveness of the nurse-led transitional care program "Cardiolotse" (CL) for patients with cardiovascular diseases compared to usual care (UC). A cost-effectiveness analysis (CEA) and cost-utility analysis (CUA) were conducted from the perspective of statutory health insurance (SHI), covering a time horizon of 12 months. Analyzed outcomes included the number of rehospitalizations and health-related quality of life (HRQoL). Total costs comprised program costs and the utilization of healthcare resources. Point estimates are presented as incremental cost-effectiveness ratios (ICERs) and incremental cost-utility ratios (ICURs). Sensitivity and subgroup analyses were conducted to illustrate uncertainty and provide insights into the impact mechanisms of the CL program. The study population consisted of 2550 patients, with 1256 allocated to the intervention group and 1294 to the control group. Patients who received support from CLs experienced fewer rehospitalizations and lower inpatient costs from an SHI perspective, compared to the UC group. HRQoL assessments indicated higher utility values for CL patients at the 12-month follow-up. Total program costs amounted to €1454.65 per patient. The CEA and CUA demonstrate that the CL program is dominant compared to UC from the SHI perspective. Our study shows that the CL program not only reduces the number of rehospitalizations and costs but increases HRQoL, resulting in a dominant ICER and ICUR. Further research is necessary to evaluate longer periods of time, different levels of care intensity, and perspectives of different healthcare stakeholders. German Clinical Trial Register DRKS00020424, 2020-06-18, retrospectively registered.

Assessing diagnostic challenges in acute soft-tissue knee injuries.

This Delphi study assessed the challenges of diagnosing soft-tissue knee injuries (STKIs) in acute settings among orthopaedic healthcare stakeholders. This modified e-Delphi study consisted of three rounds and involved 32 orthopaedic healthcare stakeholders, including physiotherapists, emergency nurse practitioners, sports medicine physicians, radiologists, orthopaedic registrars, and orthopaedic consultants. The perceived importance of diagnostic components relevant to STKIs included patient and external risk factors, clinical signs and symptoms, special clinical tests, and diagnostic imaging methods. Each round required scoring and ranking various items on a ten-point Likert scale. The items were refined as each round progressed. The study produced rankings of perceived importance across the various diagnostic components. In Round 1, the study revealed widespread variability in stakeholder opinions on diagnostic components of STKIs. Round 2 identified patterns in the perceived importance of specific items within each diagnostic component. Round 3 produced rankings of perceived item importance within each diagnostic component. Noteworthy findings include the challenges associated with accurate and readily available diagnostic methods in acute care settings, the consistent acknowledgment of the importance of adopting a patient-centred approach to diagnosis, and the transition from divergent to convergent opinions between Rounds 2 and 3. This study highlights the potential for a paradigm shift in acute STKI diagnosis, where variability in the understanding of STKI diagnostic components may be addressed by establishing a uniform, evidence-based framework for evaluating these injuries.

Retrospective Analysis of RSV Infection in Pediatric Patients: Epidemiology, Comorbidities, Treatment, and Costs in Dubai (2014-2023)

Background: Infections attributable to respiratory syncytial virus (RSV) are a major cause of hospitalization among young children worldwide. Despite substantial clinical and economic burden, real-world data associated with RSV infections in the United Arab Emirates (UAE) are limited. Objectives: This study aimed to assess among children (&lt;18 years) diagnosed with RSV the epidemiology, seasonality, comorbidities, treatment patterns, length of hospital stay, healthcare resource utilization (HCRU), and costs associated with pediatric infection in Dubai, UAE. Methods: This 10-year retrospective cohort study (Jan. 1, 2014–Sept. 30, 2023) utilized Dubai Real-World Database, a private insurance claims database. Patients aged &lt;18 years with a first-episode diagnosis claim (primary or secondary, or a hospital admission) for RSV any time during the index period (Jan. 1, 2014–June 30, 2023) were included. Outcomes were analyzed during a 3-month follow-up. Patients were stratified into 3 cohorts: Cohort 1 (&lt;2 years), Cohort 2 (2 to &lt;6 years), and Cohort 3 (6 to &lt;18 years). Results: Of 28 011 patients identified, 25 729 were aged &lt;18 years with RSV infection. An increasing trend in reported cases was observed from 2014 to 2022, with an average annual increase of 55%. Half of study patients (49.3%) belonged to Cohort 1, with a mean age of 0.6 years, while less than 2% had known risk factors and 22% of the patients in cohort 1 were hospitalized. In Cohort 1, 32.0% had upper respiratory tract infections, 39.4% had lower respiratory tract infections, and 44.4% of patients had an “other respiratory disease.” The average length of hospitalization was about 4 days across all cohorts. The total hospitalization cost was highest in patients &lt;2 years, amounting to US $9 798 174 (median, US $2241.30). Conclusion: Among the RSV patients, 49.3% were &lt;2 years of age and few had recognized risk factors. Among patients &lt;2 years, 22% were hospitalized, with an average hospital stay of 4 days; the cost of hospitalization totaled US $9 798 174. These findings can inform healthcare stakeholders about future policy measures and the need for effective preventive strategies.