Clinical Research Work Research Articles

Looking back on 51years of the Carol Nachman Prize in Rheumatology-significance for the field of spondyloarthritis research.

The city and casino of Wiesbaden, capital of the German state Hessen, have endowed the Carol Nachman Prize to promote research work in the field of rheumatology since 1972. The prize, endowed with 37,500 €, is the second highest medical award in Germany and serves to promote clinical, therapeutic, and experimental research work in the field of rheumatology. In June 2022, the 50-year anniversary was celebrated. In the symposium preceding the award ceremony, an overview was given on the significance of spondyloarthritis for the work of the awardees in the past 30years. This overview has now been put together to inform the interested community of the work performed, including the opinion of the awardees regarding what they consider to be their most important contribution.

Role and Significance of Dietary Protein in the Management of Type 2 Diabetes and Its Complications in India: An Expert Opinion.

Obesity, prediabetes, and type 2 diabetes mellitus (T2DM) pose a triple burden in India. Almost two-thirds of people with diabetes (PWD) in India are found to have suboptimal glycemic, blood pressure, and lipid control. Medical nutrition therapy (MNT) in diabetes has emphasized on the amount and type of carbohydrates for years. However, protein, an important macronutrient in diabetes management, needs to be focused upon, especially in India, where the consumption is found to be lower than the recommendations provided by most guidelines. An expert committee attempted to review the role of dietary protein in the management of T2DM, arrive at a consensus on the significance of increasing dietary protein for various benefits, and offer practical guidance on ways to improve protein intake among Indians. A total of 10 endocrinologists and diabetologists, one nephrologist, and three registered dietitians representing four zones of India formed the expert committee. An in-depth review of literature in the Indian context was carried out, and the draft document was shared with the expert committee, and their views were incorporated into the same. The expert committee then assembled virtually to deliberate on various aspects of the role of protein in T2DM management. The experts from various specialties gave their valuable inputs and suggestions from their extensive personal clinical experience and research work, which helped to reach a consensus on the role and significance of protein in the management of T2DM and its complications in India. There is abundant evidence that MNT is essential for the prevention and management of T2DM and its complications. Experts agreed that increasing protein intake offers myriad health benefits, namely reducing glycemic variability, improving glycemic control, increasing insulin sensitivity, improvement in lipid profile and immunity, and helping in weight management and preservation of muscle mass in PWD. The expert committee suggested aiming for an increase in protein intake by at least 5-10% of the current intake in lieu of carbohydrates in PWD. Experts also highlighted the need for more data quantifying the unmet protein needs in the Indian PWD, especially among vegetarians. Randomized controlled trials to study the effect of protein in diabetes complications such as cardiovascular disease (CVD) and diabetic kidney disease (DKD) and comorbid conditions such as sarcopenia among the Indian population are also warranted. Increasing protein quantity and quality in the diets of Indian PWD could significantly contribute to positive health outcomes. Increased protein intake, preferably through dietary sources to meet the requirements and, when required using diabetes-specific protein supplements (DSPS), is recommended in the prevention and control of T2DM.

Comparison of clinical and microbiological characteristics of community-acquired hypervirulent Klebsiella pneumoniae liver abscess in diabetic and non-diabetic patients.

Invasive infection caused by hypervirulent Klebsiella pneumoniae (HvKP) has been reported worldwide. Most of the patients are community population, related to diabetes mellitus (DM), chronic liver disease and other basic diseases, which prone to systemic migratory infection. In this study, we collected 377 patients with community acquired Klebsiella pneumoniae liver abscess in our hospital from January 2013 to December 2018, 65.8% of whom were male, and 49.6% had DM. Patients with DM are prone to eye and central nervous system (CNS) infection, which need continuous local abscess drainage during treatment. Among them, patients with poor blood glucose control have a higher rate of blood stream infections (BSI). 219 strains of HvKP were obtained, with K1/K2 Serotype accounted for 81.7%. The incidence of BSI in K2 patients was higher than that in K1 patients. The PCR results indicate that the carrying rate of virulence genes (rmpA、areo、kfu、allS、iroN、magA、uge、wcaG) in K1/K2 type strains is significantly higher than that in non K1/K2 type strains. ST23 and ST65 are the most common multilocus sequence typing (MLST), which belong to K1 and K2 Serotype respectively. All of HvKP strains showed high sensitivity to commonly used clinical antibiotics other than ampicillin, with 54.3% of the strains exhibiting high viscosity characteristics. Meanwhile, 35 classic Klebsiella pneumoniae (cKP) strains were collected, and their serum typing is mainly non K1/K2. The carrying rate of virulence genes and viscosity degree in HvKP are significantly higher than those in cKP. Primary liver abscess caused by HvKP is prone to multiple tissue and organ infections, but it shows higher sensitivity to most commonly used antibiotics in clinical practice except for ampicillin. After effective treatment, the overall prognosis of patients is better. This study analyzes the pathogenic characteristics of HvKP and elaborates on the clinical characteristics of patients, which can provide reference for clinical and scientific research work.

Defining the emergency general surgery patient population in the era of ICD-10 : Evaluating an established crosswalk from ICD-9 to ICD-10 diagnosis codes.

In 2015, the United States moved from the International Classification of Diseases, Ninth Revision ( ICD-9 ), to the International Classification of Diseases, Tenth Revision ( ICD-10 ), coding system. The American Association for the Surgery of Trauma Committee on Severity Assessment and Patient Outcomes previously established a list of ICD-9 diagnoses to define the field of emergency general surgery (EGS). This study evaluates the general equivalence mapping (GEM) crosswalk to generate an equivalent list of ICD-10 -coded EGS diagnoses. The GEM was used to generate a list of ICD-10 codes corresponding to the American Association for the Surgery of Trauma ICD-9 EGS diagnosis codes. These individual ICD-9 and ICD-10 codes were aggregated by surgical area and diagnosis groups. The volume of patients admitted with these diagnoses in the National Inpatient Sample in the ICD-9 era (2013-2014) was compared with the ICD-10 volumes to generate observed to expected ratios. The crosswalk was manually reviewed to identify the causes of discrepancies between the ICD-9 and ICD-10 lists. There were 485 ICD-9 codes, across 89 diagnosis categories and 11 surgical areas, which mapped to 1,206 unique ICD-10 codes. A total of 196 (40%) ICD-9 codes have an exact one-to-one match with an ICD-10 code. The median observed to expected ratio among the diagnosis groups for a primary diagnosis was 0.98 (interquartile range, 0.82-1.12). There were five key issues identified with the ability of the GEM to crosswalk ICD-9 EGS diagnoses to ICD-10 : (1) changes in admission volumes, (2) loss of necessary modifiers, (3) lack of specific ICD-10 code, (4) mapping to a different condition, and (5) change in coding nomenclature. The GEM provides a reasonable crosswalk for researchers and others to use when attempting to identify EGS patients in with ICD-10 diagnosis codes. However, we identify key issues and deficiencies, which must be accounted for to create an accurate patient cohort. This is essential for ensuring the validity of policy, quality improvement, and clinical research work anchored in ICD-10 coded data. Diagnostic Test/Criteria; Level III.

Promoting Women and Historically Excluded Minorities in Medicine as Essential Leaders of Research

Women and historically excluded minorities are underrepresented in clinical research. At the ASTRO 2021 annual meeting, the authors reviewed several strategies to improve on this issue. Implementation of such strategies should not only improve their visibility but also provide increased opportunities for their advancement and work in clinical research.

A National Survey of Perspectives of Physician Assistants in Academic Plastic and Reconstructive Surgery

Background: Physician assistants (PAs) are an essential part of the healthcare team who improve access and efficiencies in patient care. A better understanding of the impact and current utilization of PAs in plastic and reconstructive surgery is needed. The purpose of this national survey was to evaluate the role and scope of practice of PAs in academic plastic surgery, as well as characterize current trends of PA utilization, compensation, and perceived value from a PA perspective. Methods: A voluntary, anonymous 50-question survey was distributed via SurveyMonkey to practicing PAs at 98 academic plastic surgery programs. The survey included questions about employment characteristics, involvement in clinical research and academic work, structural organization, academic benefits, compensation, and position held. Results: Ninety-one PAs from 35 plastic surgery programs completed the survey and were included (overall program response rate = 36.8%, participants response rate = 30.4%). Practice environments included outpatient clinics, the operating room, and inpatient care. Most commonly, respondents supported multiple surgeons as opposed to one surgeon’s practice. For 57% of respondents, compensation is based on a tiered system that accounts for specialty and experience. The reported mode base salary range corroborates national averages and most reported annual bonuses based on merit. The majority of respondents felt valued in their role. Conclusions: Through this national survey, we provide granularity as to how PAs are utilized and compensated in academic plastic surgery. We offer insight into the overall perceived value from a PA perspective that helps define the role and will ultimately help strengthen collaboration.

Stimulus- and Person-Level Variables Influence Word Production and Response to Anomia Treatment for Individuals With Chronic Poststroke Aphasia.

The impact of stimulus-level psycholinguistic variables and person-level semantic and phonological processing skills on treatment outcomes in individuals with aphasia requires further examination to inform clinical decision making in treatment prescription and stimuli selection. This study investigated the influence of stimulus-level psycholinguistic properties and person-level semantic and phonological processing skills on word production accuracy and treatment response. This retrospective analysis included 35 individuals with chronic, poststroke aphasia, 30 of whom completed typicality-based semantic feature treatment. Mixed-effects logistic regression models were used to predict binary naming accuracy (a) at baseline and (b) over the course of treatment using stimulus-level psycholinguistic word properties and person-level semantic and phonological processing skills as predictors. In baseline naming, words with less complex lexical-semantic and phonological properties showed greater predicted accuracy. There was also an interaction at baseline between stimulus-level lexical-semantic properties and person-level semantic processing skills in predicting baseline naming accuracy. With treatment, words that were more complex from a lexical-semantic standpoint (vs. less complex) and less complex from a phonological standpoint (vs. more complex) improved more. Individuals with greater baseline semantic and phonological processing skills showed a greater treatment response. This study suggests that future clinical research and clinical work should consider semantic and phonological properties of words in selecting stimuli for semantically based treatment. Furthermore, future clinical research should continue to evaluate baseline individual semantic and phonological profiles as predictors of response to semantically based treatment. https://doi.org/10.23641/asha.21256341.

Treatment-resistant schizophrenia: How far have we traveled?

Treatment-resistant schizophrenia is a lack of adequate response to antipsychotic medications resulting in incomplete functional and social recovery from the illness. Different definitions have been proposed for clinical practice and research work. Antipsychotics that are used in the management of schizophrenia mainly act on multiple dopaminergic pathways which are implicated in the development of symptoms of schizophrenia. Newer antipsychotics also are implicated to affect the serotonergic pathways. Clozapine is the only evidence-based treatment available for the management of treatment-resistant cases. Neurobiologically, there is a considerable overlap between treatment-resistant and treatment-responsive cases. The factors that are implicated in the evolution of treatment resistance are still not conclusive. These make the management of such patients a challenge. However, certain peculiarities of treatment-resistant schizophrenia have been identified which can guide us in the early identification and precise treatment of the treatment-resistant cases.

Autophagy in renal fibrosis: Protection or promotion?

Autophagy is a process that degrades endogenous cellular protein aggregates and damaged organelles via the lysosomal pathway to maintain cellular homeostasis and energy production. Baseline autophagy in the kidney, which serves as a quality control system, is essential for cellular metabolism and organelle homeostasis. Renal fibrosis is the ultimate pathological manifestation of progressive chronic kidney disease. In several experimental models of renal fibrosis, different time points, stimulus intensities, factors, and molecular mechanisms mediating the upregulation or downregulation of autophagy may have different effects on renal fibrosis. Autophagy occurring in a single lesion may also exert several distinct biological effects on renal fibrosis. Thus, whether autophagy prevents or facilitates renal fibrosis remains a complex and challenging question. This review explores the different effects of the dual regulatory function of autophagy on renal fibrosis in different renal fibrosis models, providing ideas for future work in related basic and clinical research.

Challenges in publication forAyurvedic professionals

During pandemic covid 19 ayurved professionals has done remarkable work in clinical research but due to fear of framing manuscripts in proper classical guidelines as stated by equator network, ICMJE, and fear of rejection of submitted manuscript for open access , double blind peer reviewed research journals, henceforth documented research was not published.Professionals need scientific guidance , motivation, encouragement, financial support as well as knowledge of scientific medical writings and guidelines of publication ethics .One can get solution on every problems for medical writings of a manuscript to be accepted for publication. By understanding the exact pattern of challenges faced by ayurved professionals solutions can be executed through arranging workshops on scientific medical writings for Ayurvedic system of medical sciences.

The HDAT Helper - Developing an Online Tool to Improve the Safety and Accuracy of Antipsychotic Prescribing

AimsHigh Dose Antipsychotic Therapy (HDAT) prescriptions and combinations of antipsychotic agents are not currently recommended as standard practice by the RCPsych. College guidance (RCPsych, CR 190) advises that there is “little convincing evidence that off-label prescription of doses of antipsychotic medication above the licensed dosage range has any therapeutic advantage in any clinical setting” and that “any prescription of high-dose antipsychotic medication should be seen as an explicit, time-limited individual trial with a distinct treatment target”. Despite this, both national and local data demonstrate that HDAT has continued to be used regularly across psychiatric inpatient settings, often out of hours and often secondary to the use of PRN Antipsychotics, without a clear treatment plan or rationale. My aim was to create a simple, accessible, online tool that would allow prescribers to quickly and efficiently calculate the BNF percentage of any antipsychotic prescription and that this will enable safer prescribing.MethodsWith the support of a web-developer, I developed an online tool quickly and easily calculate antipsychotic BNF percentages. The tool can be found here: www.hdat.co.ukResultsThe HDAT Helper has been well received at local presentations and I have recently gained the support of senior management at Southern Health NHS Foundation Trust to develop an education programme on HDAT and the HDAT Helper to expand use of the tool across Southern Health.ConclusionThe current expert guidance, clinical research and my own audit work demonstrates that there are ongoing issues with the prescription of high dose antipsychotics and that at times this occurs inadvertently when different agents are combined.I believe that the HDAT Helper can make prescribing of antipsychotic agents clearer and more efficient and as a result significantly improve patient safety.

The Integration of a Canonical Workflow Framework with an Informatics System for Disease Area Research

Abstract A recurring pattern of access to existing databases, data analyses, formulation of new hypotheses, use of an experimental design, institutional review board approvals, data collection, curation, and storage within trusted digital repositories is observable during clinical research work. The workflows that support the repeated nature of these activities can be ascribed as a Canonical Workflow Framework for Research (CWFR). Disease area clinical research is protocol specific, and during data collection, the electronic case report forms can use Common Data Elements (CDEs) that have precisely defined questions and are associated with the specified value(s) as responses. The CDE-based CWFR is integrated with a biomedical research informatics computing system, which consists of a complete stack of technical layers including the Protocol and Form Research Management System. The unique data dictionaries associated with the CWFR for Traumatic Brain Injury and Parkinson's Disease resulted in the development of the Federal Interagency Traumatic Brain Injury and Parkinson's Disease Biomarker systems. Due to a canonical workflow, these two systems can use similar tools, applications, and service modules to create findable, accessible, interoperable, and reusable Digital Objects. The Digital Objects for Traumatic Brain Injury and Parkinson's disease contain all relevant information needed from the time data is collected, validated, and maintained within a Storage Repository for future access. All Traumatic Brain Injury and Parkinson's Disease studies can be shared as Research Objects that can be produced by aggregating related resources as information packages and is findable on the Internet by using unique identifiers. Overall, the integration of CWFR with an informatics system has resulted in the reuse of software applications for several National Institutes of Health-supported biomedical research programs.

Clinical Evaluation of Uttar Bastiand some Herbo-Mineral Compounds in Female Infertility

Introduction: Infertility is an emerging health problem that has profound socioeconomic and health implication on both the individual and society. Ayurveda explained female infertility as Vandhyatvaand mentioned Garbha Sambhava Samagri(proper union of four factors like fertile period, healthy reproductive system, nutrition and healthy ovum and sperm) and Manasika Abhitapa(psychological and emotional factors) as chief factors responsible for conception.The efficacy of Uttar basti of Kalyanak Ghritawith oral Garbhadharak yogwith anupana of Ashwagandha Ksheerpakamixed with Kalyanak Ghritahas encouraging effects for the management of primary cases of Bandhyatva. Methods: In this trial, randomly categorized the patients of primary infertility and grouped them into A, B & C who were ineligible for fertility after the several years of unprotected intercourses.The Group A patientswere treated with Kalyanak Ghrita Uttarbasti, 3 days alternatively in a month for consecutive three cycle. The Group B patients were treated with Oral Garbhadharak Yogawhile Group C patients were treated with Kalyanak Ghrita Uttarbasti and OralGarbhadharak Yoga for three months consecutively. Result:Total 60 patients were investigated for Bandhyatvafor present study. The effect of Uttar basti of Kalyanak Ghritawith oral yog (Garbhadharak yogwith the anupana of Ashwagandha Ksheerpakamixed with Kalyanak Ghrita) in Group C Patients Shows maximum relief in cervical mucus was 50.00%, Viscosity 65%, Spinnbarkeit formation 54.54%, cellularity 37.83% reduced Fern pattern on 22ndday was 48.27%, PCT 27.77%, Leucorrhea 83.33%, Amount of blood loss 17.50%, Regularity 71.42%, Dysmenorrhea 88.88%, and improvement in follicular growth was 54.16%. Conclusion:In Group C, out of 20 patients 05 patients were conceived showing 25% relief in primary infertility.The overall effectiveness of therapy in all studied 60 patients of primary infertility was 15%.The statistical analysis data of the clinical research work done on all 60 patients of infertility shows the highly significant result (p<0.001)

The role of emotional sensitivity to probability in the decision to choose genetic testing.

While the availability of genetic testing is rapidly increasing, many opt out of testing. The decision to test or not is emotionally charged, and both clinical research and theoretical work in psychology show that in emotional decisions, people often struggle to interpret and utilize risk information. Clinical research on genetic testing uptake also shows that feeling overwhelmed by numeric information may be a deterrent to testing. However, recent psychological research indicates that some portion of the population has greater emotional sensitivity to probability, (i.e., the extent to which emotional reactions to risk depend on probabilities) than others. We hypothesize that participants high in emotional sensitivity to probability will be more interested in genetic testing as an opportunity to seek greater precision in risk estimates and that this relationship is moderated by the testing context itself. In an online survey of a nationally representative sample (not recruited as patients), participants were presented with a hypothetical scenario describing a suspected diagnosis with an option for genetic testing. The scenario experimentally varied the pre-test probability estimate of the diagnosis (low or high) and whether the test results would result in certainty (ruling in or ruling out the diagnosis), or reduced uncertainty (providing a more precise individual risk estimate). Results indicated that emotional sensitivity to probability was a strong predictor of intention to test, particularly when the test allowed participants to rule out a diagnosis, reducing an already low probability to zero. These results highlight the way patients' individual characteristics interact with the testing context to guide decision-making and provide important insight into the way patients integrate risk probability information into intensely emotional decisions.

Association between oral health-related quality of life and general health among dental patients: a cross-sectional study.

SummaryGlobally, the prevalence of chronic diseases is increasing significantly, causing deterioration of oral and general health and therefore quality of life. The present study was designed to assess the relationship between oral health-related quality of life and general health of dental patients. The study is part of the University’s plan to achieve the United Nations Sustainable Development Goals number 1, 3, 4 and 5. Dental school students’ satisfaction with their early engagement in clinical activities and research work was also evaluated. A convenience sample of 600 subjects attending dental clinics aged ≥18 years of both sexes was included in the study. Second-year dental students conducted the study under the supervision of public health staff members over two successive academic years (2015–2016 and 2016–2017). Oral health-related quality of life was assessed using the Dental Impact on Daily Living (DIDL) questionnaire. Blood pressure, random blood glucose level, body mass index, and waist circumference were measured as indicators of general health. There were statistically significant inverse correlations between DIDL scores and both mean blood pressure (r = −0.215, p < 0.001) and mean blood glucose level (r = −0.272, p < 0.001). Non-significant inverse correlations were observed between DIDL scores and both body mass index (r = −0.062, p = 0.131) and waist circumference (r = −0.040, p = 0.340). Students’ satisfaction scores with research activities were high, ranging from 75.9% to 78%. Dentists must raise patients’ awareness about the importance of oral health and its impact on their quality of life and general health. Participation of dental students in dental research is encouraged even in their early academic years.

Association between oral health-related quality of life and general health among dental patients: a cross-sectional study

Abstract Globally, the prevalence of chronic diseases is increasing significantly, causing deterioration of oral and general health and therefore quality of life. The present study was designed to assess the relationship between oral health-related quality of life and general health of dental patients. The study is part of the University’s plan to achieve the United Nations Sustainable Development Goals number 1, 3, 4 and 5. Dental school students’ satisfaction with their early engagement in clinical activities and research work was also evaluated. A convenience sample of 600 subjects attending dental clinics aged ≥18 years of both sexes was included in the study. Second-year dental students conducted the study under supervision of public health staff members over two successive academic years (2015–2016 and 2016–2017). Oral health-related quality of life was assessed using the Dental Impact on Daily Living (DIDL) questionnaire. Blood pressure, random blood glucose level, body mass index, and waist circumference were measured as indicators of general health. There were statistically significant inverse correlations between DIDL scores and both mean blood pressure (r = −0.215, p < 0.001) and mean blood glucose level (r = −0.272, p < 0.001). Non-significant inverse correlations were observed between DIDL scores and both body mass index (r = −0.062, p = 0.131) and waist circumference (r = −0.040, p = 0.340). Students’ satisfaction scores with research activities were high, ranging from 75.9% to 78%. Dentists must raise patients’ awareness about the importance of oral health and its impact on their quality of life and general health. Participation of dental students in dental research is encouraged even in their early academic years.

Annual progress in critical care medicine in 2020

The epidemic of coronavirus disease 2019 (COVID-19) puts higher demands on critical care medicine. Lots of studies have been conducted to solve COVID-19-related problems. Therefore, we reviewed the annual progress for COVID-19-related issues including antivirals threapies, respiratory support and immunomodulatory therapies and other critical issues, including the effect of antibiotic on mitochondrial damage and its relationship with sepsis, the goal and direction of antimicrobial de-escalation, drug prophylaxis of constipation, bleeding in gastrointestinal disorders and management of critical illness in the informalization era and so on. We hope to provide reference for clinical and scientific research work of the intensivists.

Motoric Competence of children with Specific Language Impairment: Variability and Effect of different Variables

Background: The heterogeneous clinical presentation of children with Specific Language Impairment (SLI) turned the wheel of clinical research work toward verification of the nature of this disorder. Tools that assess language skills among children with language delay of unidentified causes should be overlooked, updated and standardized in order to help in understanding language development in relation to other developmental profile.Patients and Methods: A comparative cross-sectional study carried on in the period between January 2017 and January 2019. Two groups of children were examined: 20 children previously diagnosed by exclusionary and inclusionary criteria as children with SLI and 40 (20 males and 20 females) were normally developed children matching the socio-demographic data of children in the first group. They were subjected to an assessment protocol that included: Standardized Arabic test (Modified Preschool Language Scale -4th edition Arabic form (PLS-4) and assessment of gross and fine motor skills by developmental scale of preschool children (Arabic standardized LAP)).Results: Children with SLI were significantly impaired in the gross-motor developmental quotient as well as their fine-motor developmental quotient. Delayed developmental quotient in the motoric domains were mainly related to late age of presentation of language deficit, first order of birth, increased the gap between language age and chronological age.Conclusion: SLI showed varied degrees of motoric deficit either on the gross aspects or fine one. This deficit was related to some aspects of the disorder.

Design and application of moxibustion mechanical arm

Traditional moxibustion treatment mainly relies on doctors using specific techniques to stimulate the patient's acupoints with ignited moxa sticks. In view of the poor reproducibility, and different methods of different doctors, difficult to carry out quantitative and qualitative research work in clinical research, a moxibustion mechanical arm was designed. The hardware modules of the mechanical arm are composed of power, micro controller STM32, position servos, moxibustion strip thruster, human-computer interaction panel and sensors; the software parts are composed of main control program and interrupt service program. The use of this moxibustion mechanical arm will enhance the system's multi-task adaptability and could perform a variety of moxibustion methods including circling moxibustion and sparrow-pecking moxibustion. The data collected in real time will be transmitted to PC through bluetooth, displayed on OLED, and the system operation modes could be switched by button. Clinical trials showed that moxibustion mechanical arm had the same treatment effects with traditional moxibustion. Meanwhile, its convenience of ope-ration, repeatability of treatment, doctors and patients's treatment experience are all better than those of traditional moxibustion.

EAES Recommendations for Recovery Plan in Minimally Invasive Surgery Amid COVID-19 Pandemic

BackgroundCOVID-19 pandemic presented an unexpected challenge for the surgical community in general and Minimally Invasive Surgery (MIS) specialists in particular. This document aims to summarize recent evidence and experts’ opinion and formulate recommendations to guide the surgical community on how to best organize the recovery plan for surgical activity across different sub-specialities after the COVID-19 pandemic.MethodsRecommendations were developed through a Delphi process for establishment of expert consensus. Domain topics were formulated and subsequently subdivided into questions pertinent to different surgical specialities following the COVID-19 crisis. Sixty-five experts from 24 countries, representing the entire EAES board, were invited. Fifty clinicians and six engineers accepted the invitation and drafted statements based on specific key questions. Anonymous voting on the statements was performed until consensus was achieved, defined by at least 70% agreement.ResultsA total of 92 consensus statements were formulated with regard to safe resumption of surgery across eight domains, addressing general surgery, upper GI, lower GI, bariatrics, endocrine, HPB, abdominal wall and technology/research. The statements addressed elective and emergency services across all subspecialties with specific attention to the role of MIS during the recovery plan. Eighty-four of the statements were approved during the first round of Delphi voting (91.3%) and another 8 during the following round after substantial modification, resulting in a 100% consensus.ConclusionThe recommendations formulated by the EAES board establish a framework for resumption of surgery following COVID-19 pandemic with particular focus on the role of MIS across surgical specialities. The statements have the potential for wide application in the clinical setting, education activities and research work across different healthcare systems.