Patient-selected media and knowledge of risk to kidneys of nonsteroidal anti-inflammatory drugs.

OBJECTIVES: Nonsteroidal anti-inflammatory drugs (NSAIDs) can cause community-acquired acute kidney injury, especially in high-risk populations. Both the U.S. Food and Drug Administration (FDA) medication guide and over-the-counter labeling vaguely describe kidney risks of NSAIDs and do not provide information for patients to evaluate their risk for kidney problems. The purpose of this study was to use a mobile application to evaluate the impact of patient choice of media delivering NSAID avoidance education on patient knowledge about kidney risks associated with NSAIDs. DESIGN: Prospective cohort study. The mobile application was used to deliver either a redesigned FDA medication guide or a video focused on NSAID risks (selected by the patient), followed by patient knowledge questions (PKQs) and a kidney risk assessment. SETTING AND PARTICIPANTS: One hundred fifty adult primary care patients in southeast Michigan. MAIN OUTCOME MEASURES: The primary outcome was the score on 5 NSAID PKQs between the media selected. Secondary outcomes included characterization of media choice among different demographic and NSAID kidney risk groups. The relationship between kidney risk assessment and self-reported NSAID avoidance behavior also was evaluated. RESULTS: The majority of participants (72.7%) chose to review print material. Those that chose print had significantly higher PKQ scores (5 total points) compared with participants who selected the video: mean scores 4.2 ± 0.9 with print and 3.8 ± 1.0 with video (P = 0.034). Older patients (>65 years) had significantly lower PKQ scores compared with other age groups. Forty-four percent of individuals (n = 66) reported current NSAID use, and 65% stated that they would avoid NSAIDs after the selected education material. CONCLUSION: Scores for questions related to NSAID kidney risk knowledge were higher among participants who chose print compared with video education material. Education regarding NSAID kidney risks encouraged patients to limit their use. Targeted education may be beneficial in high-risk (e.g., older) patients and should be further studied.

Occupational Safety in the Age of the Opioid Crisis: Needle Stick Injury among Baltimore Police.

At a time of resurgence in injection drug use and injection-attributable infections, needle stick injury (NSI) risk and its correlates among police remain understudied. In the context of occupational safety training, a convenience sample of 771 Baltimore city police officers responded to a self-administered survey. Domains included NSI experience, protective behaviors, and attitudes towards syringe exchange programs. Sixty officers (8%) reported lifetime NSI. Officers identifying as Latino or other race were almost three times more likely (aOR 2.58, 95% CI 1.12-5.96) to have experienced NSI compared to whites, after adjusting for potential confounders. Findings highlight disparate burdens of NSIs among officers of color, elevating risk of hepatitis, HIV, and trauma. Training, equipment, and other measures to improve occupational safety are critical to attracting and safeguarding police, especially minority officers.

The influence of age, playing position, anthropometry and fitness on career attainment outcomes in rugby league.

This study evaluated the influence of annual-age category, relative age, playing position, anthropometry and fitness on the career attainment outcomes of junior rugby league players originally selected for a talent identification and development (TID) programme. Junior rugby league players (N = 580) were grouped retrospectively according to their career attainment level (i.e., amateur, academy and professional). Anthropometric (height, sitting height, body mass, sum of four skinfolds), maturational (age at peak height velocity; PHV) and fitness (power, speed, change of direction speed, estimated[Formula: see text]) characteristics were assessed at the Under 13s, 14s and 15s annual-age categories. Relative age (Q2 = 8.5% vs. Q4 = 25.5%) and playing position (Pivots = 19.5% vs. Props = 5.8%) influenced the percentage of players attaining professional status. Anthropometry and fitness had a significant effect on career attainment at the Under 14 (P = 0.002, η(2) = 0.16) and 15 (P = 0.01, η(2) = 0.12) annual-age categories. Findings at the Under 14s showed future professional players were significantly later maturing compared to academy and amateur players. Findings suggest that relative age, playing position, anthropometry and fitness can influence the career attainment of junior rugby league players. TID programmes within rugby league, and other related team sports, should be aware and acknowledge the factors influencing long-term career attainment, and not delimit development opportunities during early adolescence.

Police Encounters Among Needle Exchange Clients in Baltimore: Drug Law Enforcement as a Structural Determinant of Health.

OBJECTIVES: We piloted a monitoring mechanism to document police encounters around programs targeting people who inject drugs (PWID), and assessed their demographic predictors at 2 Baltimore, Maryland, needle exchange program (NEP) sites. METHODS: In a brief survey, 308 clients quantified, characterized, and sited recent police encounters. Multivariate linear regression determined encounter predictors, and we used geocoordinate maps to illustrate clusters. RESULTS: Within the past 6 months, clients reported a median of 3 stops near NEP sites (interquartile range [IQR] = 0-7.5) and a median of 1 arrest in any location (IQR = 0-2). Three respondents reported police referral to the NEP. Being younger (P = .009), being male (P = .033), and making frequent NEP visits (P = .02) were associated with reported police stops. Among clients reporting arrest or citation for syringe possession, Whites were significantly less likely than non-Whites to report being en route to or from an NEP (P < .001). Reported encounters were clustered around NEPs. CONCLUSIONS: Systematic surveillance of structural determinants of health for PWID proved feasible when integrated into service activities. Improved monitoring is critical to informing interventions to align policing with public health, especially among groups subject to disproportionate levels of drug law enforcement.

Structural vulnerabilities to HIV/STI risk among female exotic dancers in Baltimore, Maryland.

Female exotic dancers (FEDs) are an important, yet understudied group of women who may engage in drug- and sex-related HIV/STI risk behaviors through their work. The study objective was to identify co-occurring indicators of vulnerability (e.g., housing, income, incarceration) associated with HIV/STI risk behavior among FEDs in Baltimore, Maryland. Surveys administered during July 2008-February 2009 captured socio-demographic characteristics, drug use, and sexual practices among dancers (N = 101) aged ≥18 years. Multivariate logistic regression was used to assess the relationship between vulnerability and risk behavior. Dancers with a high vulnerability score (i.e., 2 or more indicators) were more likely to report sex exchange (AOR: 10.7, 95% CIs: 2.9, 39.9) and multiple sex partnerships (AOR: 6.4, 95% CIs: 2.3, 18.3), controlling for demographics and drug use, compared to their less vulnerable counterparts. Findings point to primacy of macro-level factors that need to be addressed in HIV/STI prevention efforts targeting this and other high-risk populations.

N-terminal modification of VEGF-A C terminus-derived peptides delineates structural features involved in neuropilin-1 binding and functional activity.

The interaction between VEGF-A and its neuropilin (NRP) receptors mediates a number of important biological effects. NRP1 and the related molecule NRP2 are widely expressed on multiple tumour types and throughout the tumour vasculature, and are emerging as critical molecules required for the progression of angiogenic diseases. Given the increasing evidence supporting a role for NRP1 in tumour development, there is growing interest in developing inhibitors of NRP1 interactions with VEGF and its other ligands. In order to probe the interaction we synthesised a number of exon 7- and 8-derived bicyclic peptides with N-terminal lipophilic groups and found a simple N-octanoyl derivative (EG00086) to be the most potent and functionally active. Detailed modelling studies indicated that new intramolecular hydrogen bonds were formed, stabilising the structure and possibly contributing to the potency. Removal of a salt bridge between D142 and R164 implicated in VEGF-A binding to neuropilin-1 had a minor effect on potency. Isothermal calorimetry was used to assess binding of EG00086 to NRP1 and NRP2, and the stability of the peptide in serum and in vivo was investigated. EG00086 is a potent blocker of VEGF-promoted cellular adhesion to extracellular matrices, and phosphorylation of p130Cas contributes to this effect.

Wounds on wheels: implementing a specialized wound clinic within an established syringe exchange program in Baltimore, Maryland.

People who inject drugs (PWID) experience a high incidence of abscesses and chronic wounds. However, many PWID delay seeking care for their wounds. In 2012, the Baltimore Needle Exchange Program (BNEP) in Baltimore, Maryland, partnered with the Johns Hopkins Wound Healing Center to establish a mobile BNEP Wound Clinic. This clinic provided specialized wound care for BNEP patients. In sixteen months, the clinic treated 78 unique patients during 172 visits overall. On average, each visit cost the program $146.45, which was substantially less than clinic-based treatment. This program demonstrates that specialized wound care can be effectively provided through mobile outreach. A community-based service delivery approach might serve as a model for local health departments looking to improve the health of PWID.

Variable and changing trajectories in youth athlete development: further verification in advocating a long-term inclusive tracking approach.

Athlete development through adolescence can vary greatly because of maturational processes. For example, variation can be observed in anthropometric and fitness measures with later maturing individuals "catching up" their earlier maturing peers at later time points. This study examined a methodological issue concerning how best to assess anthropometric and fitness change (i.e., "across age categories" or "per year") relative to an age and skill-matched population (N = 1,172). Furthermore, it examined changes in anthropometric and fitness characteristics in 3 cases of youth rugby league players (aged 13-15) across a 2-year period. Findings identified the "per year" method as generating less deviated z-scores across anthropometric and fitness measures (e.g., mean change p < 0.001), suggesting less substantial change in case players relative to the population. When applied to additional players, z-score and radar graphs showed developmental variability and longitudinal change. The possibility of a "later maturing player" increasing anthropometric (e.g., height: player 4 = 3.3 cm; player 5 = 13.2 cm; and player 6 = 15.7 cm) and fitness (e.g., 30-m sprint: player 4 = -0.18 s, player 5 = -0.46 s, and player 6 = -0.59 s) characteristics compared with early maturing players was confirmed. Findings affirm the potential for variable and changing trajectories in adolescent athletes. Practical implications advocate a long-term inclusive tracking approach of athletes, the avoidance of (de)selection, and the reduction of a performance emphasis in adolescent stages of sport systems.

Online learning applied to a course on rational therapeutics: an international comparison between final year students of two medical schools.

INTRODUCTION: Poor prescribing is probably the most common cause of preventable medication errors and many of these events involve junior doctors. In 2009, an electronic problem-based therapeutics course developed at the University of Michigan Medical School (UMMS) was translated and adapted for use at the University of Zagreb Medical School (UZMS). METHODS: After students from both schools took the course in 2010, we compared their responses with an online questionnaire addressing the course quality and its effectiveness. RESULTS: There were no statistically significant differences in the overall average grades awarded for the course (UZMS 4.11 ± 0.86 vs. UMMS 3.96 ± 0.93; 95% CI mean difference (MD) -0.36, 0.07; P = 0.175) with both student groups expressing high satisfaction rates with its quality, accessibility and overall design. UZMS students reported spending less time working through the course than their American colleagues (2.14 ± 1.01 vs. 2.89 ± 1.02 on a five point Likert scale; 95% CI MD 0.51, 0.99; P < 0.05). Furthermore, Croatian students indicated greater difficulty with course materials (3.54 ± 0.59 vs. 3.25 ± 0.59; 95% CI MD -0.42, -0.15; P < 0,05) and weekly multiple choice questions (3.83 ± 0.62 vs. 3.4 ± 0.61; 95% CI MD -0.58, -0.29; P < 0,05) compared with the UMMS students. CONCLUSION: It is possible to adapt and translate successfully whole online teaching resources and implement them internationally in different countries and health care systems, achieving similar, high student satisfaction rates while decreasing administrative and cost burdens. Web based learning may have great potential to offer a cost effective and safe environment in which prescribing skills can be improved.

An individualized longitudinal approach to monitoring the dynamics of growth and fitness development in adolescent athletes.

This study evaluated the development of anthropometric and fitness characteristics of 3 individual adolescent junior rugby league players and compared their characteristics with a cross-sectional population matched by age and skill level. Cross-sectional anthropometric and fitness assessments were conducted on 1,172 players selected to the Rugby Football League's talent development program (i.e., the Player Performance Pathway) between 2005 and 2008. Three players of differing relative age, maturational status, and playing position were measured and tracked once per year on 3 occasions (Under 13s, 14s, 15s age categories) and compared against the cross-sectional population. Results demonstrated that the later maturing players increased height (player 1 = 9.2%; player 2 = 7.8%) and a number of fitness characteristics (e.g., 60-m speed-player 1 = -14.9%; player 2 = -9.9%) more than the earlier maturing player (player 3-Height = 2.0%, 60-m sprint = -0.7%) over the 2-year period. The variation in the development of anthropometric and fitness characteristics between the 3 players highlights the importance of longitudinally monitoring individual characteristics during adolescence to assess the dynamic changes in growth, maturation, and fitness. Findings showcase the limitations of short-term performance assessments at one-off time points within annual-age categories, instead of advocating individual development and progression tracking without deselection. Coaches should consider using an individual approach, comparing data with population averages, to assist in the prescription of appropriate training and lifestyle interventions to aid the development of junior athletes.

The Group Questionnaire: a clinical and empirically derived measure of group relationship.

The Group Questionnaire (GQ) is a recently developed self-report measure of the therapeutic relationship based on Johnson and colleagues (2005) three-factor model; Positive Bonding, Positive Working, and Negative Relationship. This study validated Johnson's model with a new and extended sample and created a shorter 40-item trial version. SEM analysis of the GQ tested whether it produced the same three-factor structure found in three earlier studies with 486 participants from three populations-outpatient university counseling center, non-patient AGPA process groups, and inpatient state hospital. Results of further SEM refinements demonstrated that a final 30-item version had good fit to the three-factor model although distinct differences in response pattern were found between the three populations. Implications for future utility and clinical relevance of the GQ are discussed.

A Double-blind, Placebo-controlled, Randomized, Single Ascending, and Multiple Dose Phase 1 Study to Evaluate the Safety, Tolerability, and Pharmacokinetics of Oral Dose Isomyosamine Capsules in Healthy Adult Subjects.

BACKGROUND: Aging is tightly linked to chronic disease, frailty, and death. Multi-morbidity, defined as the presence in the same patient of three or more conditions such as neoplastic, cardiovascular, neurodegenerative, metabolic, or autoimmune diseases, becomes more common with age. METHODS: The study was performed in a double-blind fashion. Subjects within each dose cohort (Cohorts 1, 2, 3, and 4) were randomly assigned to receive Isomyosamine doses (between 150 mg to 600 mg or placebo) or placebo in a 3:1 ratio (6 active: 2 placebo). RESULTS: Isomyosamine single daily doses each of 150 mg, 300 mg, and 450 mg for 3 days and multiple daily doses of 600 mg for 6 days were safe and well tolerated in healthy subjects. In one dose group, there was a decrease in TNF-α levels found in Isomyosamine treated subjects, but no change in the levels in subjects given placebo. The increase in Isomyosamine exposure was proportional to dose across the dose range of 300 mg to 600 mg when administered as a single dose. There was minimal accumulation of Isomyosamine following 5 days of once daily dosing of Isomyosamine 600 mg. Isomyosamine half-life ranged from approximately 15 minutes to 45 minutes across all doses in the single ascending dose and multiple ascending dose portion of the study. Elimination of Isomyosamine included the renal pathway as a minor route. CONCLUSION: Isomyosamine will continue to be investigated in phase 2 clinical trials for the treatment of sarcopenia/frailty, hashimoto's thyroiditis and rheumatoid arthritis.

What would you like to ask your audience? Enhancing feedback value in PM&R grand rounds through customizable evaluation forms with presenter-generated questions.

BACKGROUND: Feedback and evaluation are important in the professional development of academic physiatrists. Yet, physical medicine and rehabilitation (PM&R) learners giving academic presentations receive limited narrative feedback through generic evaluation forms. OBJECTIVE: To assess whether customizable evaluation forms that integrate a presenter's specific questions would be associated with an increase in quantity and quality of narrative feedback received from the audience. DESIGN: Separate samples pre-post intervention study. SETTING: A large academic PM&R department's grand rounds. PARTICIPANTS: PM&R faculty and trainees attending grand rounds (10-50 attendees with one presenter per session). The study included 20 presentations pre intervention (across 1 year) and 38 presentations post intervention (across about 3 years). INTERVENTION: A customizable evaluation form that integrates a presenter's own questions into a tailored evaluation form comprising both standardized and presenter-built questions. MAIN OUTCOME MEASURE(S): Narrative feedback quantity was defined as the mean percentage and number of evaluation forms per presentation with at least one comment. Narrative feedback quality included three metrics: mean percentage and number of evaluation forms per presentation with comments that (1) contained ≥8 words, (2) referenced something specific, and (3) offered an actionable suggestion. RESULTS: Compared to preintervention, presentations in the postintervention period had a greater mean percentage of evaluation forms containing at least one comment (pre = 33.4%, post =74.7%, p < .001), a comment that contained ≥8 words (pre = 20.2%, post = 44.2%, p < .001), a comment that referenced something specific (pre = 19.6%, post = 55.1%, p < .001), and a comment that offered an actionable suggestion (pre = 10.2%, post = 22.2%, p < .001). CONCLUSIONS: Use of a customizable evaluation form in PM&R grand rounds that integrates a presenter's own questions was associated with a greater mean percentage of evaluation forms containing comments as well as comments meeting quality metrics related to length, specificity, and actionability.

A consensus viewpoint on the role of direct factor Xa inhibitors in the management of cancer-associated venous thromboembolism in the UK.

OBJECTIVE: Cancer patients are at high risk of venous thromboembolism (VTE), a significant cause of cancer-related death. Historically, low molecular weight heparins (LMWH) were the gold standard therapy for cancer-associated VTE, but recent evidence supports the use of direct factor Xa inhibitors in cancer-associated VTE and this is now reflected in many guidelines. However, uptake of direct factor Xa inhibitors varies and guidance on the use of direct factor Xa inhibitors in specific cancer sub-populations and clinical situations is lacking. This review presents consensus expert opinion alongside evaluation of evidence to support healthcare professionals in the use of direct factor Xa inhibitors in cancer-associated VTE. METHODS: Recent guidelines, meta-analyses, reviews and clinical studies on anticoagulation therapy for cancer-associated VTE were used to direct clinically relevant topics and evidence to be systematically discussed using nominal group technique. The consensus manuscript and recommendations were developed based on these discussions. RESULTS: Considerations when prescribing anticoagulant therapy for cancer-associated VTE include cancer site and stage, systemic anti-cancer therapy (including vascular access), drug-drug interactions, length of anticoagulation, quality of life and needs during palliative care. Treatment of patients with kidney or liver impairment, gastrointestinal disorders, extremes of bodyweight, elevated bleeding or recurrence risk, VTE recurrence and COVID-19 is discussed. CONCLUSION: Anticoagulant therapy for cancer-associated VTE patients should be carefully selected with consideration given to the relative benefits of specific drugs when individualizing care. Direct factor Xa inhibitors are typically the treatment of choice for preventing VTE recurrence in non-cancer patients and should also be considered as such for cancer-associated VTE in most situations.

An Update on Anti-thrombotic Therapy Following Transcatheter Aortic Valve Implantation: Expert Cardiologist Opinion from a UK and Ireland Delphi Group.

Transcatheter aortic valve implantation (TAVI) is an effective and established treatment for symptomatic aortic stenosis. However, there is a lack of consensus concerning the need for peri- and post-procedural anti-thrombotic medication. Contemporary guidelines recommend that anti-thrombotic therapy is balanced against a patient's bleeding risk following TAVI, but do not fully consider the evolving evidence base. The purpose of the Delphi panel recommendations presented here is to provide a consensus elicited from a panel of experts who regularly prescribe anti-thrombotic therapy post-TAVI. The goal was to address evidence gaps across four key topics: anti-thrombotic therapy (anti-platelet and/or anti-coagulant) in TAVI patients in sinus rhythm; anti-thrombotic therapy in TAVI patients with AF; direct oral anti-coagulants versus vitamin K antagonists; and the need for UK/Ireland specific guidance. This consensus statement aims to inform clinical decision-making by providing a concise, evidence-based summary of best practice for prescribing anti-thrombotic therapies following TAVI and highlights areas where further research is needed.

Meta-Analysis Comparing Apixaban Versus Rivaroxaban for Management of Patients With Nonvalvular Atrial Fibrillation.

To compare the efficacy and safety of apixaban and rivaroxaban for the prevention of stroke in patients with nonvalvular atrial fibrillation (NVAF) by way of a meta-analysis informed by real-world evidence. Systematic review and meta-analysis of observational studies including patients with NVAF on apixaban and rivaroxaban, which reported stroke/systemic embolism and/or major bleeding. Prospero registration number: CRD42021251719. Estimates of relative treatment effect (based on hazard ratios[HRs]) were pooled using the inverse variance method. Fixed-effects and random effect analyses were conducted. Exploratory meta-regression analyses that included study-level covariates were conducted using the metareg (meta-regression) command of Stata Statistical Software: Release 15.1 (College Station, Texas. StataCorp LLC.). Study level covariates explored in the meta-regression analyses were CHA2DS2-VASc and HAS-BLED scores. A total of 10 unique retrospective real-world evidence studies reported comparative estimates for apixaban versus rivaroxaban in patients with NVAF and were included in the meta-analysis. Adjusted HR was 0.88 (95% [confidence interval] CI 0.81 to 0.95), indicating a significantly lower hazard of stroke/systemic embolism associated with apixaban versus rivaroxaban. Pairwise meta-analysis for a major bleeding episode was significantly lower with apixaban compared with rivaroxaban (HR 0.62; 95% CI 0.56 to 0.69), whereas apixaban was associated with a lower risk of gastrointestinal bleeding compared with rivaroxaban (HR 0.57; 95% CI 0.50 to 0.64). In conclusion, this study suggests that patient CHA2DS2-VASc and HAS-BLED scores might be an important factor when selecting which direct oral anticoagulants to use, given the relation these scores have on treatment outcomes. Apixaban is associated with lower rates of both major and gastrointestinal bleeding than rivaroxaban, with no loss of efficacy.

Correlates of current transactional sex among a sample of female exotic dancers in Baltimore, MD.

Transactional sex work, broadly defined as the exchange of money, drugs, or goods for sexual services, occurs in a wide range of environments. There is a large body of research characterizing the risks and harms associated with street- and venue-based sex work, but there is a dearth of research characterizing the risk associated with the environment of exotic dance clubs. The current study aimed to: (1) characterize the nature of female exotic dancers' sex- and drug-related risk behaviors, (2) to examine the role of the club environment in these behaviors, and (3) to examine correlates of currently exchanging sex. From June 2008 to February 2009, we conducted a cross-sectional study among women who were aged 18 years or older and reported exotic dancing within the past 3 months (n = 98). The survey ascertained socio-demographic characteristics, personal health, medical history, sexual practices, drug use, and employment at clubs on the block. Bivariate and multivariate Poisson regression with robust variance was used to identify correlates of current sex exchange. Participants were a median of 24 years old, and were 58% white; 43% had not completed high school. Seventy-four percent reported ever having been arrested. Twenty-six percent reported having injected heroin and 29% reported having smoked crack in the past 3 months. Fifty-seven percent reported using drugs in the club in the past 3 months. Sixty-one percent had ever engaged in transactional sex, and 67% of those did so for the first time after beginning to dance. Forty-three percent reported selling any sex in the club in the past 3 months. In multiple Poisson regression, factors associated with current sex exchange included: race, ever having been arrested, and using drugs in the club. High levels of both drug use and transactional sex among this sample of exotic dancers were reported. These findings indicate that there are a number of drug- and sex-related harms faced by exotic dancers in strip clubs, implicating the environment in the promotion of HIV/STI risk-taking behaviors. Prevention and intervention programs targeting this population are needed to reduce the harms faced by exotic dancers in this environment.

3D - Printed Patient Specific Instrumentation in Corrective Osteotomy of the Femur and Pelvis: A Review of the Literature.

BACKGROUND: The paediatric patient population has considerable variation in anatomy. The use of Computed Tomography (CT)-based digital models to design three-dimensionally printed patient specific instrumentation (PSI) has recently been applied for correction of deformity in orthopedic surgery. This review sought to determine the existing application of this technology currently in use within paediatric orthopaedics, and assess the potential benefits that this may provide to patients and surgeons. METHODS: A review was performed of MEDLINE, EMBASE, and CENTRAL for published literature, as well as Web of Science and clinicaltrials.gov for grey literature. The search strategy revolved around the research question: "What is the clinical impact of using 3D printed PSI for proximal femoral or pelvic osteotomy in paediatric orthopaedics?" Two reviewers, using predetermined inclusion criteria, independently performed title and abstract review in order to select articles for full text review. Data extracted included effect on operating time and intraoperative image use, as well as osteotomy and screw positioning accuracy. Data were combined in a narrative synthesis; meta-analysis was not performed given the diversity of study designs and interventions. RESULTS: In total, ten studies were included: six case control studies, three case series and a case report. Five studies directly compared operating time using PSI to conventional techniques, with two showing a significant decrease in the number of intraoperative images and operative time. Eight studies reported improved accuracy in executing the surgical plan compared to conventional methods. CONCLUSION: Compared to conventional methods of performing femoral or pelvic osteotomy, use of PSI has led to improved accuracy and precision, decreased procedure times, and decreased intra-operative imaging requirements. Additionally, the technology has become more cost effective and accessible since its initial inception and use.

Analysis of completeness of reporting utilizing the Reporting Items for practice Guidelines in Healthcare Statement in gastroenterology clinical practice guidelines.

AIM: Assessing reporting quality is important as it allows distinctions to be made between poor methodology and poor reporting practices. The Reporting Items for practice Guidelines in Healthcare (RIGHT) Statement checklist was published in 2017 to improve the thoroughness and reporting quality of clinical practice guidelines (CPGs). CPGs are evidence-based recommendations developed to assist clinician decision-making in the diagnosis and management of patients. The aim of this study is to assess the completeness of reporting in CPGs listed by the American College of Gastroenterology (ACG) and their frequency of reporting items listed in the RIGHT Statement. METHODS: Using the 22 criteria (35 items) of the RIGHT Statement checklist, two researchers independently documented the adherence to each item for all eligible guidelines listed by the ACG. This study was conducted from 01/10/18 to 05/12/18. Data were recorded onto a prespecified Google data abstraction form and extracted into MS Excel for statistical analysis. RESULTS: Out of 38 eligible guidelines, nine of the 35 RIGHT (25.7%) checklist items were met with less than 50% adherence. The mean adherence was 26.8 (SD ±â€Š9.5); median adherence was 30 (interquartile range 21.5-33.5). The publication dates ranged from 2007 to 2017 with seven of the guidelines (18.4%) published between 2007 and 2009, 11 (29%) published between 2010 and 2013, and 20 (52.6%) published between 2014 and 2017. CONCLUSION: The completeness of reporting in CPGs listed by the ACG remains inadequate in several key areas. Poor adherence to items of the RIGHT Statement checklist demonstrates that there is area for improvement in reporting quality.