1) What are patients' AF and SPAF therapy values and preferences? 2) How are SPAF therapy values and preferences affected by patient factors? 3) How does conveying risk information affect SPAF therapy preferences? and 4) What is known about patient values and preferences regarding novel oral anticoagulants (NOACs) for SPAF? Twenty-five studies were included. Overall study quality was moderate. Severe stroke was associated with the greatest disutility among AF outcomes and most patients value the stroke prevention efficacy of therapy more than other attributes. Utilities, values, and preferences about other outcomes and attributes of therapy are heterogeneous and unpredictable. Patients' therapy preferences usually align with their values when individualised risk information is presented, although divergence from this is common. Patients value the attributes of NOACs but frequently do not prefer NOACs over warfarin when all therapy-related attributes are considered. In conclusion, patients' values and preferences for SPAF antithrombotic therapy are heterogeneous and there is no substitute for directly clarifying patients' individual values and preferences. Research using choice modelling and tools to help clinicians and patients clarify their SPAF therapy values and preferences are needed.

Summary: Field sterility is commonly used for skin and minor hand surgery performed in the ambulatory setting. Surgical site infection (SSI) rates are similar for these same procedures when performed in the main operating room (OR). In this paper, we aim to look at both current evidence and common sense logic supporting the use of some of the techniques and apparel designed to prevent SSI. This is a literature review of the evidence behind the ability of gloves, masks, gowns, drapes, head covers, footwear, and ventilation systems to prevent SSIs. We used MEDLINE, EMBASE, and PubMed and included literature from the inception of each database up to March 2019. We could not find substantial evidence to support the use of main OR sterility practices such as head covers, gowns, full patient draping, laminar airflow, and footwear to reduce SSIs in skin and minor hand surgery. Field sterility in ambulatory minor procedure rooms outside the main OR is appropriate for most skin and minor hand surgery procedures. SSIs in these procedures are easily treatable with minimal patient morbidity and do not justify the cost and waste associated with the use of main OR sterility.

Background: The internet is becoming a common source of health information for hand surgery patients. This study evaluates the quality of web-based resources on ganglion cysts of the hand. Methods: We completed a search for “ganglion cyst” on 3 search engines (Google, Dogpile, and Yippy). The quality of the top-100 patient education websites was assessed using a validated internet rating tool. Websites were evaluated based on affiliation, accountability, currency, interactivity, website organization, readability, coverage, and accuracy. Results: Of the 100 websites, the majority (74%) had commercial affiliations. Only 34% of websites identified an author, and even fewer identified the authors’ credentials (27%) or affiliations (26%). A third of the websites cited references, and less than half provided an update date. The average readability based on Flesch-Kincaid grade level was 9.2, and only 3% could be read at or below 6th grade reading level. Prevention was the most poorly covered topic at 13% due to omission. In all, 66% of the websites were completely accurate in terms of global accuracy. Websites were most likely to present inaccurate information on treatment, often failing to mention conservative treatment (watch-and-wait approach) or promoting the use of natural health products. We also found 5% of websites presented closed rupture of the ganglion cyst as a legitimate home remedy. Conclusions: The overall quality of online information on ganglion cysts is highly variable and may occasionally be harmful for patients. It is increasingly important for physicians to prompt patients about their internet use.

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