Background: Online resources for emergency medicine (EM) trainees and physicians have variable quality and inconsistent coverage of core topics. In this first entry of the Society for Academic Emergency Medicine Systematic Online Academic Resource (SOAR) series, we describe the application of a systematic methodology to comprehensively identify, collate, and curate online content for topic-specific modules. Methods: A list of module topics and related terms was generated from the American Board of EmergencyMedicine's Model of the Clinical Practice of Emergency Medicine. The authors selected "renal and genitourinary" for the first module, which contained 35 terms; all MeSH headers and colloquial synonyms related to the topic and related terms were searched both within the 100 most impactful online educational websites per the Social Media Index and the FOAMsearch.net search engine. Duplicate entries, journal articles, images, and archives were excluded. The quality of each article was rated using the revised METRIQ (rMETRIQ) score.Results: The search yielded 13,058 online resources. After 12,717 items were excluded, 341 underwent quality assessment. All renal/genitourinary topics were covered by at least one resource. The median rMETRIQ score was 11 of 21 (interquartile range = 8-14). Calculus of urinary tract was most prominently featured with 60 posts. Thirty-four posts (10% of full-text screened FOAM articles) covering 12 core topics were identified as high quality (rMETRIQ ≥ 16). Conclusions:We demonstrated the feasibility of systematically identifying and curating FOAM resources for a specific EM topic and identified an overrepresentation of some subtopics. This curated list of resources may guide trainees, teacher recommendations, and resource producers. Further entries in the series will address other topics relevant to EM.T he well-documented growth and use, both formally (in residency curricula 1,2 ) and informally, 3-5 of free online medical education resources (FOAM) in emergency medicine (EM) have been remarkable. 3,4,6,7 However, resources are scattered across an enormous number of sites, of variable and difficult to evaluate quality, 8-10 and may not be at the appropriate level for all learners. 11 Additionally, various topics are covered extensively while others receive no or scant coverage 12 with no synthesis describing specific topics coverage, extent, level of intended learner, and quality.
Summary Background Post-mastectomy pain syndrome (PMPS) is a known debilitating surgical complication. While research on prevention, risk factors, and treatments have been conducted, there remains no cohesive treatment paradigm. The aim of our study is to synthesize the existing evidence on PMPS treatment, which may facilitate the implementation of standardized, effective management strategies. Methods Using Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, a comprehensive search was developed and translated for MEDLINE, Cochrane Library, EMBASE, CINAHL, PsycINFO, Web of Science, and ClinicalTrials.gov. The databases were searched using a combination of free terms, phrase searching, and database-specific controlled vocabulary related to PMPS. All unique records were by two independent reviewers. Publications on chronic (>3 months duration) pain after breast cancer-related surgery were included. Limited case series, case reports, and editorials were not included. Results A total of 3402 articles from the years 1946–2019 resulted from the literature search after deduplication. Twenty-seven articles met final inclusion criteria for analysis, which revealed 10 major treatment modalities: fat grafting, neuroma surgery, lymphedema surgery, nerve blocks and neurolysis, laser, antidepressants, neuromodulators, physical therapy, mindfulness-based cognitive therapy, and capsaicin. Conclusions In this review, we present a comprehensive assessment of the treatments available for PMPS that may help guide breast surgeons and reconstructive surgeons to employ the most effective treatment strategies for these patients. This review supports the importance of multimodal, multidisciplinary care in improving the management of PMPS.
SUMMARY Background Post-mastectomy pain syndrome (PMPS) is a surgical complication of breast surgery characterized by chronic neuropathic pain. The development of PMPS is multifactorial and research on its prevention is limited. The objective of this systematic review is to synthesize the existing evidence on interventions for lowering the incidence of persistent neuropathic pain after breast surgery. Methods Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we performed a comprehensive search of the electronic databases of MEDLINE, Cochrane Library, Embase, CINAHL, PsycINFO, Web of Science, and ClinicalTrials.gov using a combination of database-specific controlled vocabulary and keyword searches. Two reviewers independently screened all unique records. Publications on chronic (>3-month duration) pain after breast cancer-related surgery were included. Studies were classified by modality. Results Our literature search yielded 7092 articles after deduplication. We identified 45 studies that met final inclusion criteria for analysis, including 37 randomized-controlled trials. These studies revealed seven major intervention modalities for prevention of PMPS: physical therapy, mindfulness-based cognitive therapy, oral medications, surgical intervention, anesthesia, nerve blocks, and topical medication therapy. Conclusion High-quality data on preventative techniques for PMPS are required to inform decisions for breast cancer survivors. We present a comprehensive assessment of the modalities available that can help guide breast and reconstructive surgeons employ effective strategies to lower the incidence and severity of PMPS. Our review supports the use of multimodal care involving both a peripherally targeted treatment and centrally acting medication to prevent the development of PMPS.
Twelve evidence-based profiles of roles across the translational workforce and two patients were made available through clinical and translational science (CTS) Personas, a project of the Clinical and Translational Science Awards (CTSA) Program National Center for Data to Health (CD2H). The persona profiles were designed and researched to demonstrate the key responsibilities, motivators, goals, software use, pain points, and professional development needs of those working across the spectrum of translation, from basic science to clinical research to public health. The project’s goal was to provide reliable documents that could be used to inform CTSA software development projects, educational resources, and communication initiatives. This paper presents the initiative to create personas for the translational workforce, including the methodology, engagement strategy, and lessons learned. Challenges faced and successes achieved by the project may serve as a roadmap for others searching for best practices in the creation of Persona profiles.
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