Patient Involvement Research Articles

Telemedicine and outcome in patient care: Review

Telemedicine is a term given to the use of electronic and telecommunication methods in patient’s healthcare. Presently it is being used for diagnostic, treatment and research purposes. Since the recent pandemic telemedicine has become more transformative and has enhanced patient’s access to different medical settings across the globe, this review will evaluate the role of telemedicine in improving patient outcomes. The management of chronic diseases in areas of the world where specialty medical services are not easily accessible has been evaluated along with the patient's involvement and use of modern and state-of-the-art technologies. The overall findings indicate that telemedicine has improved the patient's ability to actively participate in their health management, with more compliance toward the management of the medical problem and fewer OPD visits. On the other hand, it encourages fewer doctor and paramedical staff requirements for a particular population size and the limited role of physical examination of the patient.

Addressing Medication Administration Safety Through Simulation: A Quasi-Experimental Study Among Nursing Students.

Healthcare institutions are dedicated to minimizing medication errors and promoting their reporting. This study investigates the impact of simulation on nursing students' attitudes toward and intention to report medication errors. A quasi-experimental one-group pre-post-test study was conducted. Third-year nursing students (N = 63) participated in a scenario-based simulation for medication administration. Participants' errors were documented. Participants self-reported attitudes toward medication administration safety and intention to report errors. The most reported error was "contraindicated in disease" (61%). The simulation increased attitudes of preparedness by the training program received (p < 0.01) and belief in the patient's involvement in preventing errors (p < 0.01), and decreased the belief that professional incompetence reveals errors (p = 0.015). Intention to report errors was influenced by medication error training received (p = 0.045), confidence in error reporting (p < 0.001), and a sense of responsibility to disclose errors (p = 0.001). Simulation effectively shapes attitudes and intentions regarding medication error reporting. Improving nursing students' awareness, skills, and clinical judgment can foster a safety culture and potentially reduce patient harm. Future research should examine the long-term effects of simulation and its impact on reducing medication errors.

The Impact of Early Rehabilitation and the Acceptance of the Disease on the Quality of Life of Patients after Hip Arthroplasty: An Observational Study.

Background: The early introduction of physiotherapy significantly shortens the time required for a patient to regain full mobility after hip arthroplasty. Obtaining the expected result is determined by cooperation with a physiotherapist and the patient's involvement in the rehabilitation process. The aim of this study was to assess the quality of life, life satisfaction, and motor ability of patients after hip arthroplasty. Methods: This study included 147 patients who underwent hip arthroplasty at the Orthopedic and Trauma Department. The research material was collected using questionnaires, and the study used the Barthel Index (BI), Harris Hip Score (HHS), Visual Analogue Scale (VAS), Acceptance of Illness Scale (AIS), and Quality of Life Assessment Questionnaire (WHOQOL-BREF). In the studied group of patients, the Excia cementless endoprosthesis was primarily used (69.39%), as well as the Metha Short Hip prosthesis (15.65%), AM hip prosthesis (10.20%), and bipolar hip prosthesis (4.76%). Results: The analyzed group of patients included 95 women (64.63%) and 52 men (35.37%); the average age was 67 years. Six weeks after hip arthroplasty, mild disability occurred in 53.74% of the patients, while the remaining 46.26% had no disability, and 95.24% of the patients achieved a high level of acceptance of the disease and quality of life. Conclusions: Early improvement after hip replacement surgery contributes to eliminating the disability of the hip joint in the following areas: pain sensation, functionality, lack of deformation, and range of motion. Each subsequent stage of treatment increased the level of acceptance of the disease in the study group. The applied surgical treatment increased satisfaction with overall health and quality of life.

Neurocognitive disorders in chronic kidney disease

Neurocognitive disorders (NCD) are common in patients with chronic kidney disease (CKD). It is essential to identify and characterize these disorders at an early stage, so as to be able to offer appropriate treatment. In a chronic disease such as CKD, the patient's involvement in decision-making is a major challenge, given the prospects for suppletive treatment: hemodialysis, peritoneal dialysis, kidney transplantation or non-dialytic drug therapy. Many factors are associated with the development and progression of NCD in patients with CKD, and a variety of conditions can influence the outcome of cognitive assessment in these patients.

OP120 Developing A Call To Action For Patient Involvement In Health Technology Assessment (HTA) In Southern Africa

IntroductionIn building health technology assessment (HTA) and related decision processes in Southern Africa, institutions and stakeholders face region-specific challenges such as disease prevalence and population makeup. These can be addressed by collaboratively discussing patient engagement solutions that fit the local culture and systems and serve to ensure equitable and sustainable access to patient-relevant health technologies. Our aim is to initiate a collaboration for driving patient involvement (PI) suitable for the Southern African context and Sub-Saharan patient communities. In addition, we explore current experiences in PI, including the stakeholder expectations, gaps, limitations, and new opportunities.MethodsA one-day hybrid multi-stakeholder PI in HTA workshop was held in Johannesburg, South Africa. Co-created by the participants, the outputs are a call to action and a concept draft for the vital success criteria for PI in the region. The content of the call to action is gathered from pre-workshop surveys, interviews, and outcomes from historic meetings held in conjunction with the Health Technology Assessment International (HTAi) PI workstream as well as facilitated discussion from the actual workshop.ResultsThe workshop was attended by 42 participants from nine countries, representing diverse stakeholder groups. The attendees represented multiple PI stakeholder groups. The workshop survey was completed by 44 respondents, while 12 participants completed the post-event survey. A workshop outcomes document highlighting a high level of alignment and identifying seven key success factors was developed. A workshop proceeding detailing the outcomes is now being drafted.ConclusionsOver 95 percent of respondents to pre-and post-surveys indicated an interest in contributing to a more in-depth description of PI in their country. While the majority of participants were from South Africa, participants from Tanzania, Ethiopia, Zambia, and Zimbabwe emphasized that trans-African-engagement for HTA will provide an additional opportunity for HTA in Africa and patient and community participation in HTA and healthcare decision-making. Hence, a collaborative platform could help all African countries to advance and benefit from improved healthcare decision processes.

PP38 Designing A Training And Capacity Building Pathway In Patient Involvement

IntroductionThe Patient Involvement (PI) Interest Group of the Spanish Network of Health Technology Assessment Agencies (RedETS) was set up in 2017 by a group of health technology assessment (HTA) researchers interested in PI. Since its inception, training and capacity-building to support PI and patient-based evidence in HTA processes has been one of its main aims. The objective of this work was to identify the needs and priorities related to training and capacity building activities to be developed within the framework of the PI Interest Group.MethodsThe PI Interest Group met on November 14, 2022, for its Annual Meeting. The group discussed the needs, priorities and possibilities on training, and carried out a prioritization exercise. For this purpose, a self-reported and anonymous questionnaire was used, which included 16 training activities. Every item was scored with a Likert-type scale ranging from 0 to 10.ResultsThe questionnaire was answered by twenty participants. The most highly rated training activities (mean less than or equal to 8) were: qualitative evidence synthesis (8.75); PI case studies (basic (8.65) and advanced (8.56) level); quality assessment tools for qualitative evidence (8.37); and qualitative research (8.11). Other proposals scoring above 7 points were: ethical aspects related to PI, evaluation of patient participation and impact, identification and recruitment procedures, and discrete choice experiments. The group agreed to organize bi-monthly webinars and three structured training activities for the whole RedETS network on: Qualitative Evidence Synthesis, Qualitative Research and PI Case Studies.ConclusionsThe prioritization of training activities according to PI Interest Group members allowed planning a tailored capacity-building program adapted to the needs of RedETS.

PP13 Results Of An International Survey About Barriers In Patient Involvement In Health Technology Assessment Of Digital Health Technologies

IntroductionIn recent years, several efforts have been initiated by health technology assessment (HTA) agencies to increasingly incorporate patient involvement (PI) into their assessment processes. The rationale behind PI in HTA is that patients can give their perspective and experiences about health, illness and the use of health technologies, complementing clinical and healthcare system standpoints.A recent systematic review summarized current evidence on the barriers and facilitators of PI in HTA. Barriers and facilitators were classified according to the context in which they appear, as organizational, decision-making, political and community-related.Digital health technologies offer a singular opportunity to address some challenges faced by healthcare systems. However, we hypothesized that their intrinsic characteristics may have some implications for PI in digital HTA. We conducted a survey to gain knowledge about barriers in PI in digital HTA.MethodsThe survey was elaborated using Microsoft Forms and consisted of 31 questions divided into four blocks (organizational, decision-making, political and community-related). It was sent to three Spanish, one Catalan and one International patient umbrella organizations. The results were analysed using Microsoft Excel.ResultsA total of four responses were received from three Spanish and one Catalan patient umbrella organizations. Results showed high, partial, and low concordance among organizations in 65 percent, 19 percent and 16 percent of the answers received, respectively. According to the results, most of the barriers for PI seem to be the same for HTA of digital health technologies as for other types of health technologies. However, two or three of the four umbrella organizations consider that HTA of digital health technologies might pose greater challenges in terms of achieving significant patient participation, sufficient patient training and knowledge of HTA processes, proper preparation and tools of the HTA experts and logistics during the HTA process.ConclusionsBarriers in PI are mostly the same for digital or other types of health technologies. Few differences are related to patient training, tools, and logistics during HTA process.

Factors influencing delayed discharge after day-surgery laparoscopic cholecystectomy: the DeDiLaCo study protocol.

Laparoscopic cholecystectomy (LC) is the gold standard for most benign gallbladder diseases. Early discharge (<24 hours) has the same outcomes as longer (>24 hours) hospital stay. Nevertheless, the rate of delayed discharge >24 hours range from 4.6% to 37%. The primary endpoint of this Italian nationwide study is to analyze the prevalence of patients undergoing elective LC who experienced a delayed discharge >24 hours and identify potential limiting factors of early discharge. Results from these analyses will be used to select patients who can be safely discharged on the same day after surgery. Secondary endpoints will be to evaluate the patient's quality of life (QoL), assess the direct health costs associated with late discharge, and quantify the patient's involvement in the treatment process. This prospective, observational study was conducted following a resident-led model and the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) guidelines. All patients were treated according to the local hospital protocol and received routine care as standard therapy. We expected to obtain the enrollment of at least 500 patients based on an assumed difference in discharge delay between the reference and the recruitable population of 6% and the identification of factors related to discharge failure within 24 h. Early discharge after LC leads to advantages both in terms of clinical outcomes and quality of life of the patient, and it is highly effective in terms of health costs and shortening the waiting list. However, clinical reality differs from the results of randomized studies by a complex series of non-objectionable real-world data influencing treatment plans. Therefore, we expected to identify independent predictors and factors of failure of early discharge. Clinical reality often differs from randomized trial results. In Italy, the vast majority of delayed discharges after LC may not be related to surgery and can be prevented both with logistical reorganization and with a readjustment of the trust reimbursement policies.

КОНТРОЛЬ НАЗНАЧЕНИЙ ВРАЧА И ПОВЫШЕНИЕ ПРИВЕРЖЕННОСТИ ПАЦИЕНТА К ЛЕЧЕНИЮ ЗАБОЛЕВАНИЙ ПАРОДОНТА. ОЦЕНКА ЭФФЕКТИВНОСТИ

Object. Periodontitis, as a chronic disease, must be treated comprehensively, in stages, with subsequent preventive medical examination. Periodontal treatment being a time-consuming process, requires special cooperation from both the doctor and for the patient. The results of the treatment largely depend on the patient's involvement in the process of treatment. It depends on how efficiently and timely patients fulfill all the recommendations. The task of a dentist is to assess and increase the level of patients’ compliance to treatment.&#x0D; Objective. To study the effect of the use of doctor's appointment monitoring using the patient's self-monitoring diary on the effectiveness of periodontitis treatment.&#x0D; Materials and methods. The object of the study was 63 patients diagnosed with chronic generalized periodontitis aged 32 to 63 years, who were 44.6 ± 5.8 years old in average. The patients were divided into two groups (No. 1 and No. 2). Group No. 1, after diagnosis, a conversation was conducted about the importance of compliance with doctor’s recommendations and sequence of prescribed treatment. Also, every patient was given a step-by-step list of appointments with the patient's diary, which they were to fill out. Group No. 2 received only medical appointments and recommendations. Diagnosis and treatment were carried out in accordance with the protocol for the management of patients with periodontal diseases developed by Federal State Budgetary Educational Institution of Higher Education "Moscow State Medical and Dental University named after A. I. Evdokimov" of the Ministry of Health and Social Development of the Russian Federation, 2012. On the 7th day and after 1 month of the study, the effectiveness of the prescribed therapy was evaluated.&#x0D; Conclusions. The results of our study show that the appointment list and self-monitoring diary issued to patient are good ways to increase the patient's adherence to treatment, evaluation of medication intake, compliance with doctor's recommendations. This method undoubtedly increases the effectiveness of the prescribed treatment.

Challenges in using patient involvement principles in substance use treatment

ABSTRACT Background Health professionals are responsible for implementing patient involvement (PI) in the choice of treatment approach. Previous studies within the field of substance use disorder (SUD) treatment have shown positive patient experiences with PI. However, little is known about challenges experienced by health professionals in converting principles of PI into clinical practice. Aims To explore challenges with PI in the treatment of SUD. Method Five health professionals working in a Norwegian institution for inpatient treatment of SUD were included and took part in a semi-structured interview. Data were analysed using a systematic text condensation approach. Results PI in SUD was perceived as challenging due to conceptual unclarities as well as treatment dilemmas that may challenge the notion of PI as a universal and unified ideological foundation of substance use treatment. Conclusions The findings point to a need to critically examine the PI concept and to take a flexible approach in adjusting PI principles to good clinical practice. A framework is launched, allowing the reported challenges in implementing PI in clinical practice to be accepted, acknowledged, and recognized by clinicians as well as by administrators and heads of clinical units.

The Impact of a Patient Participating in Evaluating Patient Safety by Using the Patient Measure of Safety in Saudi Arabia: A Cross-Sectional Study.

Patient safety is an essential element for delivering quality of healthcare. Many studies focus on measuring patient safety from the healthcare provider's perspective to improve patient safety in healthcare facilities. However, patient participation may reduce medical errors and improve patient safety by providing information regarding the safety of their care. This study aimed to evaluate patient safety from the inpatients' perspective and the extent of the influence of the sociodemographic factors on their assessment. A cross-sectional study was conducted at hospitals in different Saudi Arabian regions with 1569 inpatient adults 18 years of older who voluntarily completed an online questionnaire using the Patient Measure of Safety tool (Arabic translated). Two questions were added to assess patient feedback about the overall perception of safety and witnessing patient safety events. COVID-19 patients and those with a mental disorder or incapable of providing informed consent were excluded. The total number of participants was 1569 inpatients from 17 hospitals. Sixty-one percent of the participants were female, and 41.62% were from the 18- to 35-year age group. Less than half (38.69%) of patients stayed at the hospital between 3 and 5 days. Percentages of positive responses were more than 90% observed in dignity and respect, communication and teamworking, and organization and care planning domains. Percentages of negative responses were more than 20% found in organization and care planning, access to resources, and ward type and layout domains. Among the respondents, 57.3% (n = 899) rated the safety of their wards as excellent as opposed to 2.9% (n = 46) who rated it as poor. Approximately 5% (n = 79) have noticed 1 event, and 2.3% (n = 36) have noticed 2 or 3 events. Unemployed participants had a significantly lower rate of positive responses in domains of communication, access to resources, and ward type. In contrast, the no-schooling group had a significantly greater rate of negative responses in care planning and ward-type domains. The patient plays a key role in enhancing the quality of care and has the potential to detect adverse events. The study highlighted the need to focus on better communication processes for patients with low education levels to enhance their engagement in their care. Further steps should be taken to understand the extent of the patient's involvement in the improvement that could be tackled from feedback on the safety of care.

Patient and carer involvement in the formulation of research questions: findings from the Italian guideline on palliative care in adults with glioma.

In 2017, the European Association for Neuro-Oncology (EANO) published the guideline for palliative care (PC) in adults with glioma. The Italian Society of Neurology (SIN), the Italian Association for Neuro-Oncology (AINO), and the Italian Society for Palliative Care (SICP) joined forces to update and adapt this guideline to the Italian context and aimed to involve patients and carers in the formulation of the clinical questions. During semi-structured interviews with glioma patients and focus group meetings (FGMs) with family carers of deceased patients, participants rated the importance of a set of pre-specified intervention topics, shared their experience, and suggested additional topics. Interviews and FGMs were audio-recorded, transcribed, coded, and analyzed (framework and content analysis). We held 20 interviews and five FGMs (28 carers). Both parties considered the pre-specified topics as important, chiefly information/communication, psychological support, symptoms management, and rehabilitation. Patients aired the impact of focal neurological and cognitive deficits. Carers reported difficulties in dealing with patient's behavior and personality changes and appreciated the preservation of patient's functioning via rehabilitation. Both affirmed the importance of a dedicated healthcare path and patient's involvement in the decision-making process. Carers expressed the need to be educated and supported in their caregiving role. Interviews and FGMs were well informative and emotionally challenging. Both parties confirmed the importance of the pre-specified topics, and carers suggested one additional topic: education/support to caregivers. Our findings strengthen the importance of a comprehensive care approach and of addressing the needs of both patients and their family carers.

Chronic Illness Patients' Perceptions of Quality of Care During Hospitalization: A Qualitative Study.

The rising prevalence of patients living with chronic illnesses and frequent hospitalizations represent many challenges in delivering high-quality care. Assessing patients' perceptions and needs regarding the quality of health care services is a critical step in improving quality of care. This study sought to explore the perception of quality of care from the perspectives and experiences of chronically ill patients during hospitalization. This study was conducted using a qualitative descriptive design. Face-to-face semi-structured individual interviews were conducted with 15 chronically ill patients at their bedside during their current hospital admission. Analysis followed Braun and Clarke's thematic analysis approach. Overall patients were pleased with their hospitalization experience; however, they highlighted many aspects of care that can be addressed to improve the quality of care provided. Five themes were identified from the analysis as follows: defining quality of care; aspects related to the healthcare providers; unmet care needs; patient's involvement in healthcare decisions and care expectations and outcomes. A key finding of this study was the association between quality of care and healthcare providers' skills, clinical competence, and attitudes. Poor communication and discoordination of care were the most significant impediment expressed. Actively involving patients in care may be effective when combined with meeting expectations. The findings of this study helped to identify the strength points and areas of improvement that are the cornerstone for developing tailored and patient-centered strategies to improve the quality of care during hospitalizations among chronically ill Saudis.

Communicating Patient Safety Information Through Video and Oral Formats-A Comparison.

One way to decrease adverse events is to increase patient participation in their own care. Sahlgrenska University Hospital has introduced a patient safety advisory, consisting of an animated video and structured oral information. This article investigates how the animated video and structured oral information regarding was perceived by the patients and determines which communication method the patients preferred. In this study, we compared patients' attitudes toward patient safety information delivered in video or oral format. Data were collected after intervention through a survey consisting of 5 questions. One hundred thirty-four patients were recruited to the study. Ninety-two patients either watched the video or received oral information. Forty-two patients were given both oral information and viewed the video. Information received by the patients was rated as good or very good by 90% of those viewing the video and by 100% who received the oral presentation ( P = 0.007). Of the 42 participants who received both formats, 74% preferred the oral presentation ( P < 0.001). The patients thought the patient safety information to be good and beneficial. An informative video can complement the oral information, but not replace, when informing patients about patient safety. Providing patients with information in a manner they prefer may increase patient's involvement in their care and possibly reduce the risk of adverse events.

Understanding how organisational culture supports patient involvement in a national research agency

Abstract Background The Belgian Health Care Knowledge Centre (KCE) formally involves stakeholders in its researches since 2012. Patients are treated as one stakeholder amongst others, but it is recognized that patient involvement (PI) requires a different approach. The success of implementing PI depends, however, on the organizational culture towards PI. Objectives The objective of this study was to map the PI culture at KCE in the context of the development of organization-wide supported position statements about PI. Methods A nominal group technique was used to measure the PI culture at KCE. Arguments for and against PI and conditions for PI in different phases of the research process were collected. A literature review and interviews fed the draft position statements, for which support was assessed by means of a two-round Delphi process. Results Arguments in favour of PI in research related to the relevance of the scope, expertise with data collection, bringing in fresh ideas for study design, access to survey participants, validation of data analyses, adherence to recommendations. Disadvantages and risks included the lack of scientific knowledge of involved patients, resources requirements, conflicts of interest, and heterogeneity within patient populations. Conditions for meaningful PI referred to measures mitigating the identified disadvantages. Eighteen position statements supported by KCE could be formulated. Conclusions The KCE culture seems predominantly positive towards PI, although attitudes vary between researchers. KCE recognizes the potential value of PI in research, but considers the level of involvement to be contingent on the topic and phase in the research process. Key messages • Organizational culture towards patient involvement is a driver of successful researches. • 18 position statements supported implementation of patient involvement in a national health agency.

Supporting patient involvement in health service research: development of a methodological guidance

Abstract Background The Belgian Health Care Knowledge Centre (KCE) issued a Position Paper in 2019 regarding the Patient Involvement (PI) in its researches as stakeholders. After previously investigating the organizational culture of the KCE, a key element for a successful implementation of PI was providing methodological guidance to the researchers. Objectives The objective of this study was to develop a methodological guidance for implementing PI into the practices of researchers at KCE. Methods In order to build a practical and effective process note, reflecting the needs and points of attention of all involved participants, different methods were combined: a literature review, workshops with the umbrellas of patient associations, patients and patient representatives, Delphi survey and a pilot project involving patients as research partners. Results The resulting guidance identified 5 prerequisites and conditions for implementation of patient involvement at the organisational level. The guidance also focused on how to involve patients (which patients, how, when, what for) and included general recommendations to researchers during the collaboration (communication, relational aspects, animation techniques, specific needs of patients). Recommendations for the reporting and evaluation of PI were also formulated. Alongside the guidance for researchers, supports for patients were also developed and validated by the patient associations. Conclusions The KCE guidance for PI in research could inspire other agencies willing to implement PI in their practices. Implementation will therefore require additional human and financial resources. Key messages

OPHTHALMOLOGIC INVOLVEMENT IN PATIENTS WITH HEREDITARY TRANSTHYRETIN AMYLOIDOSIS.

The aim of this study was to determine the ophthalmologic involvement in patients with hereditary transthyretin amyloidosis and its correlation with the mutations described in the literature. Cross-sectional, noninterventional study. Fifty-two eyes of 26 consecutive patients diagnosed with hereditary transthyretin amyloidosis who visited the Puerta de Hierro-Majadahonda University Hospital from September 2019 to March 2022. All patients underwent complete ophthalmologic examination and multimodal imaging. Cardiologic, neurologic, digestive, and renal examinations were also recorded. Eighteen eyes of the total (34.61%) showed amyloid-related ocular involvement, vitreous amyloid deposits being the most common ocular manifestation (18/52). Statistically significant differences were found for the presence of vitreous amyloid deposits ( P < 0.01), crystalline amyloid deposits ( P < 0.05), parenchymal amyloid deposits ( P < 0.01), and vascular alterations ( P < 0.01) when comparing affected and unaffected eyes. Moreover, affected eyes showed worse best-corrected visual acuity ( P < 0.01). Ocular manifestations are present in a substantial number of patients with ATTR that could potentially lead to devastating consequences to patients' best-corrected visual acuity and quality of life. Therefore, it is important to emphasize the importance of multidisciplinary management and ophthalmologic assessment, follow-up and surgical treatment when necessary. To the best of our knowledge, this represents the largest series in Spain of amyloidosis' ophthalmologic involvement.

Framework for health care quality and evidence-based practice in radiology departments: A regional study on radiographer's perceptions

IntroductionThe main goals of this study were to describe, in an integrated and multidimensional way, the conditions related to the quality of care in radiology departments from Algarve (Portugal), to assess the perspective of radiographers on the use of scientific evidence in clinical practice and to validate a model that characterizes the conditions for continuous improvement. MethodsA cross sectional study was performed in four radiology departments from public and private healthcare facilities from Algarve region (Portugal). A paper-based survey was sent to all radiographers to assess the quality systems implemented in their radiology departments and their perspective on the use of scientific evidence in clinical practice. ResultsIn total, 62 radiographers (61.4%) completed the survey. The quality dimensions that obtained the highest degree of compliance were the existence of quality assurance and improvement activities (43.0%), existence of standards in clinical practice of radiographers (42.7%) and the existence of special provisions (37.6%). The quality dimension related to patient's involvement was the one with the lowest level of compliance. Moreover, from the radiographers perspective, positive responses were obtained related to evidence-based actions (83.0%), sources of evidence (76.0%) and the significance of research activities (74.0%). ConclusionThese findings suggest that a new framework based on four factors (Support for Information; Organizational Capability to Technical Quality of Care; Patient Involvement and Evidence-Based Radiology), should be considered in the establishment of strategic policies that better define the provision of diagnostic procedures and professional practices in radiology departments from Algarve region, based on quality improvement systems and better patient safety. Implications for PracticeThere is a need to include patients in the decision-making process, to involve radiographers in quality assurance and improvement activities and to implement quality monitoring mechanisms within radiology departments under study.

657. COMPARISON BETWEEN GASTRIC TUBE AND COLOPLASTY IN ESOPHAGECTOMY AND ESOPHAGEAL BYPASS IN ESOPHAGEAL STENOSIS DUE TO INGESTION CORROSIVE SUBSTANCE

Abstract The treatment of ingestion of caustic agents is controversial in the literature. Surgical therapy has been shown to be the best way to proceed, but the surgical methodology has been varied according to the patient's involvement. This study aims to expose the experience of a single institution in relation to the methodology used for the surgical treatment of esophageal stenosis by ingestion of a caustic substance. A retrospective study was carried out in which data were collected from 27 patients who underwent a surgical procedure for the treatment of esophageal stenosis due to alkali ingestion at the Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo between 2010 and 2019 and their subsequent comparison between the conduits used in the surgical intervention. Fisher's test was performed to compare the groups regarding cervical leakage and post-surgical symptoms with a significance level of 5%. Of the 27 surgical procedures for esophageal stenosis due to alkali ingestion, 12 performed gastric conduits and 15 colon conduits. When comparing the groups regarding cervical leaks, no statistically significant difference was noted (p = 0.7060). There were also no statistically significant differences regarding the presence of symptoms in the postoperative period (p &amp;gt; 0.99...) Surgical intervention by both gastric and colon conduits showed no differences in cervical leakage and symptom control. Surgical intervention by both gastric and colon conduits showed no differences in cervical leakage and symptom control.

Patient involvement in priority-setting for medical research: A mini review of initiatives in the rare disease field.

Patient involvement (PI) in determining medical research priorities is an important way to ensure that limited research funds are allocated to best serve patients. As a disease area for which research funds are limited, we see a particular utility for PI in priority-setting for medical research on rare diseases. In this review, we argue that PI initiatives are an important form of evidence for policymaking. We conducted a study to identify the extent to which PI initiatives are being conducted in the rare disease field, the features of such initiatives, the trends in the priorities elicited, and the extent to which translation into policy is reported in the academic literature. Here, we report the results of this exploratory review of the English-language literature gathered through online databases and search engines, with the aim of identifying journal articles published prior to December 2020, describing PI initiatives focused on determining priorities for medical research funding in the rare disease field. We identified seven recently-published articles and found that the majority made use of structured methodologies to ensure the robustness of the evidence produced, but found little reported practical implementation or concrete plans for implementation of the results of the initiatives. We conclude that priority-setting initiatives are meaningful mechanisms for involving patients in determining research directions. However, we highlight the importance of translation into policy as a necessary next step to fully utilize the results and move beyond well-intentioned exercises. Finally, we draw attention to the benefits of involving patients throughout this process.