Opinions Of Physicians Research Articles

YouTube as a source of information in cardiopulmonary resuscitation for 2020 AHA Resuscitation Guidelines.

The Internet has transformed global information access, particularly through platforms like YouTube, which launched in 1995 and has since become the second largest search engine worldwide with over two billion monthly users. While YouTube offers extensive educational content, including health topics like cardiopulmonary resuscitation (CPR) and basic life support (BLS), it also poses risks due to potential misinformation. Our study focuses on evaluating the accuracy of CPR and BLS videos on YouTube according to the latest 2020 American Heart Association (AHA) guidelines. This research aims to highlight inconsistencies and provide insights into improving YouTube as a reliable educational resource for both lay rescuers and healthcare professionals. In this cross-sectional observational study, English YouTube videos uploaded between October 21, 2020, and May 1, 2023, were searched using keywords related to CPR and basic life support. Videos were assessed for their source, duration, views, use of human or mannequin models, and mean assessment scores by two emergency medicine physicians. A third physician's opinion was sought in cases of disagreement. The first assessment evaluated video validity based on specified information criteria, while the second assessed their ability to convey advanced medical information aligned with the 2020 AHA guidelines. In this study, 201 English YouTube videos uploaded between October 21, 2020, and May 1, 2023, were evaluated based on search terms related to CPR and BLS, resulting in 95 videos meeting inclusion criteria after excluding 106 due to various reasons. Most included videos were from healthcare professionals (49.5%), followed by anonymous sources (29.5%) and official medical organizations (21.1%). Video durations ranged widely from 43 to 6,019 seconds, with an average of 692 seconds. Videos featuring mannequins predominated (91.6%), followed by those using human subjects (5.3%) or both (3.2%). Healthcare professional and official medical organization videos scoring significantly higher than those of unknown origin (p=0.001). Video length did not correlate significantly with view counts, although shorter videos under 5 minutes tended to have higher average views. The results presented in this study demonstrated that English-language videos on YouTube related to BLS and CPR, throughout the study period, did not conform to the 2020 AHA guidelines in terms of providing basic information for lay rescuers. Furthermore, healthcare professionals cannot obtain advanced medical knowledge through these videos. We recommend a professional oversight mechanism in health-related videos that does not tolerate such misinformation.

Medical futility at the end of life: the first qualitative study of ethical decision-making methods among Turkish doctors

BackgroundThe swift advancement of intensive care medicine, coupled with technological possibilities, has prompted numerous ethical inquiries regarding decision-making processes concerning the withholding or withdrawal of treatment due to medical futility. This study seeks to delineate the decision-making approaches employed by intensive care physicians in Türkiye when faced with medical futility at the end of life, along with an ethical evaluation of these practices.MethodsGrounded theory, a qualitative analysis method was employed, conducting semi-structured, in-depth interviews with eleven intensive care physicians in Türkiye. The subsequent text analysis was carried out using MAXQDA software.ResultsParticipants assert that the decisions made by Turkish physicians determine whether treatment is futile, rely on medical consensus, and lack a standardized decision-making process. The decisions are influenced by legal and social pressures, resource constraints, and occasional conflicts of interest. The significance of professional hierarchy is notable, with limited consideration given to the opinions of nurses and other staff. The unstructured medical consensus processes are shaped by normative concepts such as benefit, age, justice, and conscience. Furthermore, it was observed that the conscientious opinions of physicians carry more weight than adherence to ethical principles and guidelines.ConclusionTo create optimal conditions for doctors to make ethically justifiable decisions, the dynamics within the treatment team should be improved, emphasizing the minimization of hierarchy, and ensuring the active participation of all team members in the decision-making process. Additionally, efforts should be directed toward narrowing the gap between the conscience of the individual doctor and established ethical principles. A potential solution lies in the nationwide implementation of clinical ethics committees and the establishing of clinical ethics guidelines, aiming to address, and overcome the identified challenges.

Should we measure quality of life among people with HIV? A multicentre survey of physicians' opinions in Spain.

We assessed the opinions of physicians caring for people with HIV (PWH) from the multicentre Spanish CoRIS cohort regarding the assessment of health-related quality of life (HRQoL). We designed an online self-administered questionnaire comprising 27 structured questions across four domains: (i) sociodemographic and clinical data; (ii) usefulness of measuring HRQoL; (iii) information, training and resource needed; and (iv) whether and how HRQoL should be measured. Physicians completed the questionnaire between April and June 2023. Of 131 physicians surveyed [53.8% men, median age 52 years (interquartile range: 42-60)], 90.9% and 88.6% agreed that measuring HRQoL is useful for both PWH and medical decision-making, respectively. However, 67.2% needed training on what HRQoL is and how to measure it, 79.4% required information on validated tools, and 80.9% felt that clinical guidelines are needed. Overall, 90.1% of physicians agreed that HRQoL should be measured among PWH. Most physicians (82.8%) supported using specific scales for PWH, with 74.1% recommending annual measurement, 49.1% suggesting that nurses from HIV units conduct the assessments, and 43.1% favouring personal interviews during medical visits. At the time of the survey, 55.3% of physicians did not measure HRQoL in any patients due to time or resource constraints (75.8%). Despite the recognized importance of HRQoL measurement in PWH, Spanish physicians encounter barriers such as time constraints and limited resources. Developing clear guidelines, using tailored scales, and integrating digital tools along with multidisciplinary support could enhance routine HRQoL assessments and improve patient-centred care.

Sharing for Caring? A Patients' and Clinicians' View on Handling Personal Medical Data in the Context of Digitization: An Exploratory Study.

The healthcare sector is currently undergoing a significant transformation, driven by an increased utilization of data. In this evolving landscape, surveys are of pivotal importance to the comprehension of patient needs and preferences. Moreover, the digital affinity of patients and physicians within the healthcare system is reforming the manner in which healthcare services are accessed and delivered. The utilization and donation of data are influencing the future of medical research and treatment, while artificial intelligence (AI) is empowering patients and physicians with knowledge and improving healthcare delivery. In order to evaluate the opinions of patients and physicians regarding the management of personal health data and the functionality of upcoming data management devices in the context of healthcare digitization, we conducted an exploratory study and designed a survey. The survey focused on a number of key areas, including demographics, experience with digitization, data handling, the identification of needs for upcoming digitization, and AI in healthcare. A total of 40 patients and 15 physicians participated in the survey. The results indicate that data security, timesaving/administrative support, and digital communication are aspects that patients associate with patient-friendly digitization. Based on the responses provided by physicians, it might be concluded that future digital platforms should prioritize usability, time efficacy, data security, and interoperability. In terms of expectations for future digital platforms, there is a notable overlap between the needs expressed by patients and those identified by physicians, particularly in relation to usability, time management, data security, and digital communication. This suggests that the requirements of different stakeholders can be combined in a future system, although individual issues may still require attention.

Cooccurrence of Capsular Liver Lesions Along with Peritoneal Carcinomatosis and Hematogenous Metastases in Ovarian Cancer Patients on Consecutive 18F-FDG PET/CT Studies.

The aim of our study was to evaluate the cooccurrence of capsular liver lesions along with peritoneal carcinomatosis and hematogenous metastases in other regions of the body in ovarian cancer patients on follow-up F-18 fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) studies. Consecutive 18F-FDG PET/CT studies of 54 women with ovarian cancer between August 2012 and January 2020 and a total of 192 scans were analysed retrospectively. All patients had at least one hepatic and/or capsular lesion with high 18F-FDG uptake and at least two PET/CT examinations. According to interpretation, of 54 patients with hepatic or capsular lesions, 44 (81.4%), 5 (9.3%) and 5 (9.3%) of them were concluded as perihepatic implants, hematogenous liver metastases and both, respectively. Accompanying peritoneal carcinomatosis on follow-up PET/CT images was found in 42 (95.4%) and 3 (60%) patients with solely capsular lesions and solely hematogenous liver metastases, respectively. Extrahepatic hematogenous organ metastases on follow-up PET/CT images were seen in 4 (9.0%) and 3 (60%) patients with solely capsular lesions and solely hematogenous liver metastases, respectively. Lungs, bones, spleen and brain were detected metastases sites. Cooccurrence of peritoneal carcinomatosis in other regions of abdomen was found to be higher in comparison to hematogenous organ metastases on consecutive PET/CT studies of ovarian cancer patients with capsular liver lesions. The primary opinion of the nuclear medicine physician is essential along with the other patient data for differential diagnosis and treatment approach in this particular patient group.

Perception and Opinion of Physicians Regarding Artificial Intelligence in Egypt

Perception and Opinion of Physicians Regarding Artificial Intelligence in Egypt

Physician Opinions on Artificial Intelligence Chatbots In Dermatology: A National Online Cross-Sectional Survey of Dermatologists.

Artificial intelligence chatbots (AIC) have sharply risen in popularity. Dermatology, heavily involving visual, clinical, and pathological pattern-recognition techniques, will be impacted by AIC. Thus, this study aims to categorize the attitudes and beliefs of American dermatologists towards AIC and their potential uses, benefits, and risks. An online cross-sectional survey was distributed to dermatologists across the United States. Questions explored opinions on AIC along with perceived benefits, risks, and important considerations for the incorporation of AIC into the practice of dermatology. Demographic data and self-reported understanding of AIC were also collected. 192 complete responses were received. 53.6% of respondents were female. 44.3% were between ages 30 to 39. 41.1% had 0 to 10 years of experience as attending physicians. 76.5% of participants believed it is somewhat or very likely that AIC will be formally incorporated into dermatology. Higher self-reported understanding of AIC was associated with an increased perceived likelihood of AIC implementation as well as decreased perceived risk associated with AIC. Notably, 86% of respondents believed AIC would impact "patient education," while concerns regarding "misinformation" and "incorrect diagnoses" were prevalent (89% and 78.5%, respectively). Participants anticipated AIC's role primarily in administrative tasks, with 75.7% citing "reduced work burden on physicians" as a potential benefit. Dermatologists in the United States foresee the integration of AIC into their practice, emphasizing its potential in administrative roles. Concerns revolve around the complexity of medical understanding and effective patient communication. As AIC continues to evolve, ongoing studies are crucial to evaluate their safety and efficacy in dermatological practice. J Drugs Dermatol. 2024;23(11):972-978. doi:10.36849/JDD.8239.

The Role of the most Important Fruits in the Prevention and Treatment of Cardiovascular Diseases in Persian Traditional Medicine

Abstract: Cardiovascular diseases (CVD) are the leading cause of health problems worldwide. CVD are defined as conditions affecting the heart and blood vessels. Mortality due to cardiovascular diseases has increased in recent years. However, they can be easily controlled by reducing risk factors, including lipid profile, blood pressure, tobacco, alcohol, and low physical activity. Fruits have an important role in improving the risk factors of CVD. Ancient medical sources can play an important role in generating ideas for new research. In this study, the most common fruits that have been recommended by Persian traditional physicians in patients with CVD were reviewed. New documents supporting these effects were also extracted through a search on electronic databases. The findings showed that some fruits have a therapeutic role in CVD, according to Persian traditional medicine. Old Persian traditional physicians, such as Avicenna, advised fruits, including apples, lemon, pomegranate, pineapple, quince, cucumber, plums, and citron, for the treatment of CVDs. Several studies have been carried out on the effects of the above fruits, including apple (Malus pumila), pomegranate (Punica granatum), pineapple (Ananas comosus), Quince (Cydonia oblonga Mill.), fig (Ficus carica L.), and olive (Olea europaea). Modulation of signaling pathways and molecular properties that leads to reducing lipid metabolism disorders, correcting endothelial dysfunction, reducing blood pressure, reducing oxidative stress, and suppressing inflammation responses are the major mechanisms conducted by these fruits in preventing CVD. These pieces of evidence show that the opinion of Iranian medicine physicians regarding choosing fruits for treating CVD is worthy of consideration and an entry for deriving hypotheses for future studies.

Elicitation of Physician Opinions of the Impact of Dynamic Changes in Biomarkers on Perceived Relapse Propensity in ANCA-Associated Vasculitis: Impact of Individual Expert and Patient Characteristics

Elicitation of Physician Opinions of the Impact of Dynamic Changes in Biomarkers on Perceived Relapse Propensity in ANCA-Associated Vasculitis: Impact of Individual Expert and Patient Characteristics

Embracing industry in the development of robotic coronary bypass grafting-the sun rises in the East.

The introduction of robotic surgical devices nearly two decades ago led to a significant reduction in the invasiveness of cardiac procedures. The further worldwide implementation of robotic surgical devices in cardiac surgery, especially coronary artery bypass grafting and mitral valve repair or replacement, has, however, been stalled by numerous challenges. First, there is the high complexity of the procedures that involve a significant learning curve; second, there is the significant cost of robotic surgical devices. Furthermore, significant changes in the medical device regulation have occurred in recent years, hindering further technological development and the emergence of new players on the market. Finally, clinical evidence regarding the benefits of robotic-cardiac procedures remains scarce at this time. We invited all players active in or planning to throw themselves into robotic-assisted cardiac surgery to discuss these challenges in a semi-structured interview. Two promising and ambitious companies showed interest in participating in this project: Medicaroid and SS Innovations. The main conclusions from the interview are that both companies aim (I) to launch an affordable alternative compared to the current robotic surgical devices, (II) to further develop their robotic devices based on the opinion of physicians, and (III) to engage in overcoming the steep learning curve correlated with robotic-assisted cardiac procedures.

Investigation of Prevalence, Etiological Factors and Risk Factors of Urinary Tract Infection in Spinal Cord Injury Patients

Background: Urinary tract infection (UTI) is a common infection that constitutes a significant portion of all hospital infections. Objectives: Given the importance of spinal cord trauma, this study aimed to investigate the prevalence, etiological factors, and risk factors of UTI in spinal cord injury (SCI) patients. Methods: In this study, patients were examined daily. If a diagnosis of UTI was confirmed, based on laboratory results and the attending physician's opinion, they were included in the study. A researcher-made checklist was then completed by the researchers. Results: The results showed that 89 (67.4%) of the patients were male, and 101 (76.5%) were married. Additionally, 44.7% of the patients were hospitalized due to traffic accidents. The results also indicated that 30.3% of patients had hematuria, 35.5% had fever, and 12.9% had scrotal pain or turbid urine. Regarding the microorganisms identified, 55.3% of patients had Escherichia coli, 11.4% had Proteus, 9.1% had Klebsiella, and 7.6% had Candida spp. Conclusions: Given the significant prevalence of UTI in patients, necessary preventive measures should be implemented to prevent infections.

Patient and Physician Perspectives on Discussing Addiction Recovery and Spirituality in the Primary Care Setting.

Spirituality is an important component of recovery for many individuals with substance use disorder (SUD). However, few studies have compared patient and physician attitudes on spirituality in SUD recovery. This study investigates patient and physician beliefs about the role of spirituality in SUD recovery and about discussing spirituality in relationship to recovery in primary care settings. Semi-structured interviews were conducted with primary care physicians recruited at two academic hospitals, and patients recruited from a faith-based residential therapeutic community. Interview transcripts were independently coded by two researchers and a grounded theory approach was used to generate themes that reflected participants' experiences. Interviews were conducted with 15 patients and 10 physicians. Patients had diverse views about the impact of spirituality on their SUD recovery, including positive, negative, and neutral. Patient and physician opinions on discussing spirituality in a primary care setting differed: most physicians felt positively towards this, believing that understanding their patients' spirituality helped them care for their patients as whole people. Many patients felt neutral, stating that they did not feel like these conversations were necessary for their care, and that they believed physicians preferred not to discuss spirituality in medical settings. Tolerance from both the patient and physician, open-ended questioning, and an individualized approach were identified as facilitators to effective discussions about spirituality and recovery. Spirituality can have diverse effects on an individual's SUD recovery. Physicians endorsed the benefits of discussing spirituality in the context of their patients' recovery, while patients expressed reservations about engaging in these conversations with their physicians. This variation in perspectives highlights the need for additional research to understand the individual and structural factors that contribute to it, as well as best practices for engaging in effective, non-judgmental conversations about spirituality in recovery.

A qualitative approach to assess the opinion of physicians about the challenges and prospects of pharmacogenomic testing implementation in clinical practice in Greece

BackgroundPharmacogenomics (PGx) constitutes an important part of personalized medicine and has several clinical applications. PGx role in clinical practice is known, however, it has not been widely adopted yet. In this study, we aim to investigate the perspectives of Greek physicians regarding the implementation of PGx testing in clinical practice and the key issues associated with it.MethodsFourteen interviews were conducted with physicians of various specialties for which PGx applications are available. A semi-structured interview guide was utilized based on the Consolidated Framework for Implementation Research (CFIR) context and the Diffusion of Innovation model. Transcripts were coded independently and compared by two members of the research team. Descriptive statistics were generated using Microsoft Excel.ResultsSix main themes emerged: awareness and use of PGx testing; source of information; key stakeholders of the PGx supply chain, their interactions and change agents; clinical benefit and significance of PGx testing; barriers and lack of reimbursement; and recommendations to boost the PGx adoption rate. Most respondents were aware of PGx applications, but only three had already recommended PGx testing. Peer-reviewed journals along with clinical guidelines were regarded as the most used source of information while stakeholders of the PGx supply chain were discussed. PGx was considered that promote patient-centered care, enhance medication clinical effectiveness, decrease the risk of side effects, and reduce healthcare costs. Lack of reimbursement, scarcity of resources, and high PGx cost were the foremost barriers affecting PGx adoption.ConclusionsIt was concluded that if case PGx testing is reimbursed and physicians’ training is reinforced, PGx implementation will be boosted and improved shortly.

Evaluation of the effectiveness of the Program for Providing Certain Categories of Citizens with Necessary Medicines based on a sociological survey of physicians’ opinions

The opinions of physicians regarding the effectiveness of the Program for Providing Certain Categories of Citizens with Necessary Medicines (Program) are the leading component of feedback conducted to create an idea of the activities of the benefit segment.Objectives. Based on a sociological survey of physicians involved in prescribing treatment to beneficiary patients, recommendations for increasing the effectiveness of pharmacotherapy included in the program.Materials and methods. Based on a sociological survey of physicians involved in prescribing treatment to beneficiary patients, recommendations for increasing the effectiveness of pharmacotherapy included in the program.Results. The questionnaire was developed and assessed quantitative indicators based on the answers of the surveyed specialists, and recommendations for increasing the effectiveness of pharmacotherapy in the Program.Conclusions. A sociological survey of physicians involved in prescribing pharmacotherapy to patients in the Program, conducted using a Questionnaire, is a highly informative method that makes it possible to meaningfully study the main problems of Preferential Medicinal Providing and offer recommendations for increasing the effectiveness of pharmacotherapy in the Program.

Controversies in prostate cancer management: Consensus recommendations from experts in northern Spain

In recent years, various aspects of prostate cancer (PC) management have undergone significant changes, including the implementation of therapeutic strategies such as the use of new hormonal agents like abiraterone, apalutamide, enzalutamide or darolutamide and the incorporation of next generation imaging techniques (NGI). However, the evidence regarding the role of NGI and the therapeutic decision-making based on their findings is not solid. Following the methodology of the Advanced Prostate Cancer Consensus Conference (APCCC), a multidisciplinary expert consensus was developed to address controversial questions concerning the use of NGI and clinical management in four priority scenarios: localized PC, PC after radical prostatectomy, PC after radiotherapy with curative intent, and metastatic hormone-sensitive PC. This consensus represents the opinions of medical oncology, radiation oncology and urology physicians and provides useful recommendations for clinical practice.

Evaluation of Physician Opinions Against Patient Complaints and Administrative and Judicial Instigations

Evaluation of Physician Opinions Against Patient Complaints and Administrative and Judicial Instigations

Fast absorbing gut sutures in dermatologic surgery: a systematic review and meta-analysis.

Fast gut cutaneous sutures have become more prominent due to their low tissue reactivity, rapid absorption, and elimination of suture removal visits. It is not known how fast gut sutures compare to other closure modalities. A comprehensive literature review was conducted to identify randomized controlled trials comparing fast gut sutures to alternative closure methods during dermatologic surgery. Data collected included patient and physician assessed cosmetic outcome as well as standardized complication rates. Six studies were included in final analysis and reported on 208 patients. Fast gut sutures were associated with lower physician opinions of final scar when compared to polypropylene sutures (SMD 0.438; 95% CI 0.082 to 0.794). No differences existed between physician opinion of fast gut sutures and cyanoacrylate tissue adhesive (SMD -0.024; 95% CI -0.605 to 0.556). Complications with fast gut suture placement were rare, and included infection, dehiscence, and hematomas. Fast gut sutures were less likely to experience wound dehiscence than tissue adhesive (p = 0.01). If no contraindications to polypropylene sutures exist, they may provide superior cosmetic outcomes compared to fast gut sutures. Further research is required to better quantify cosmetic outcomes and optimal use of fast gut sutures.

Decisions and Influential Factors Regarding Class-Specific School Closures Against Seasonal Influenza Outbreak.

Background One of the characteristics of school closure in Japan is class-specific school closure, which involves a reactive, short-term closure in the event of an infectious disease outbreak. These closures are implemented at each school in reaction to the annual seasonal influenza outbreaks. Very little research has addressed the formation of class-specific school closures to combat infectious diseases in elementary schools.We carried out a survey on factors involved in the decision to close classes and the determination of the timing and duration of class closures in elementary schools in Japan. Methods A mail-based questionnaire survey of elementary schools from four prefectures in western Japan was conducted between August and September 2021. The questions addressed the criteria for school closures (the timing and duration of class closure), various considerations, and confusion regarding class closures, with answers analyzed using descriptive statistical methods. Results In total, 714 elementary schools responded to the survey (37.9%). Furthermore, 398 (55.7%) schools established criteria for class closures during seasonal influenza. Class closure was most frequently initiated in schools with criteria when either 20% or 30% of class pupils were absent; the most common duration was three days. The duration of class closures was decided upon depending on the outbreak in some schools (69.8%), depending on the circumstances of the outbreak. Regarding class closure decisions, schools viewed school physicians' opinions as a priority, followed by school events, adjustments for Saturdays and Sundays, and Yogo teachers' opinions. Schools answering "no criteria for class closure" or "adjustments for Saturdays and Sundays" had difficulty determining class closure duration. Conclusion To guarantee the continuation of children's education and improve the effectiveness of preventive efforts against seasonal influenza, the following were considered important and helpful in class closure decision-making in elementary schools: scientific evidence, the school physician's opinion, and Yogo teachers' analysis of children's health information.

Controversias en el abordaje del cáncer de próstata: consenso de recomendaciones de expertos del norte de España

In recent years, various aspects of prostate cancer (PC) management have undergone significant changes, including the implementation of therapeutic strategies such as the use of new hormonal agents like abiraterone, apalutamide, enzalutamide or darolutamide and the incorporation of next generation imaging techniques. However, the evidence regarding the role of next generation imaging techniques and the therapeutic decision-making based on their findings is not solid. Following the methodology of the Advanced Prostate Cancer Consensus Conference, a multidisciplinary expert consensus was developed to address controversial questions concerning the use of next generation imaging techniques and clinical management in 4 priority scenarios: localized PC, PC after radical prostatectomy, PC after radiotherapy with curative intent, and metastatic hormone-sensitive PC. This consensus represents the opinions of medical oncology, radiation oncology and urology physicians, and provides useful recommendations for clinical practice.

Complementary and Alternative Medicine for People with Epilepsy: Opinions of Physicians in Oman.

Several studies have explored the opinions of healthcare workers on the use of complementary and alternative medicine (CAM) in epilepsy treatment. We sought to survey the views of non-neurologist and non-psychiatrist physicians in Oman on the use of CAM for epilepsy. We used convenience sampling to recruit physicians (except neurologists and psychiatrists) from all 11 governorates of Oman. The online questionnaire was open to physicians from 5 January 2022 to 15 February 2023. This study collected anonymous data on their demographics, discipline, work settings, geographical area, and years of practice. Additionally, participants were asked to answer questions about their perception of CAM use and its effectiveness in treating epilepsy. A total of 190 physicians participated, of whom 69.5% were men. Respondents were mostly 36 to 45 years old (51.1%). The majority (52.1%) were general practitioners, 21.1% were internists, 17.9% were pediatricians, and 8.9% were family physicians. Most participants (n = 144; 75.8%) believed that CAM may help treat patients with epilepsy (PWE). The most common therapies that participants considered helpful were meditation (46.0%), prayers (44.7%), yoga (32.6%), and exercise (31.1%). While the evidence supporting the use of CAM for the treatment of epilepsy is scarce, this survey showed that most physicians (non-neurologists and non-psychiatrists), who manage PWE in Oman, believed that some CAM modalities would help treat epilepsy. Well-designed controlled trials are needed to provide reliable evidence on the usefulness of CAM options in PWE.