Assessment of a Telehealth Platform in Evaluating the Urgency of Ophthalmical Consultation in the Middle East and North Africa Region: The Red Flags of Retinal Detachment.

Background: The availability and utilization of telehealth services have been rapidly increasing in the past decade, which paved the way for ophthalmological care to be offered more easily and conveniently. However, the proficiency of telehealth in the context of ophthalmical care still requires further studies to prove its effectiveness. This study examined the proficiency of general practitioners in a telemedicine platform in identifying red flag symptoms, suggestive of retinal detachment, and devising optimal management strategies. Methods: Our cross-sectional study used chat-based consultations on Altibbi Telemedicine platform (2018-2023) to study ophthalmical patients presenting with "blurred vision" or "blindness." Those endorsing red flag symptoms were categorized as having "positive symptomatology" and those reporting none as having "negative symptomatology." Management plans were classified as referral or reassuring. Statistical analysis was performed using IBM's Statistical Package for Social Sciences to examine associations between symptomatology and other variables. p values below 0.05 were considered statistically significant. Results: Five hundred and fifty (n = 550) patients with a mean age 22.5 ± 13 years were included. Patients expressing positive symptomatology were more likely to be referred relative to those expressing negative symptomatology (81% vs. 61%, p < 0.001). No significant difference was found between genders and referral (p = 0.053) or age and referral (p = 0.231). Multivariate regression showed a significant correlation between positive symptoms and referral (adjusted odds ratio [aOR]: 2.0; 95% confidence interval [95% CI]: 1.3-3.3), none between gender (aOR: 1.5; 95% CI: 0.9-2.2) or age (aOR: 1.0; 95% CI: 0.9-1.1) and referral odds. Conclusion: The telemedicine platform studied is effective in referring cases with red flag symptoms to urgent care, regardless of age and gender.

Assessment of COVID-19-related meta-analysis reporting quality.

BACKGROUND: Meta-analysis of high-quality primary articles represents the top-quality evidence in medical literature. In this project, our aim was to assess the number and quality of COVID-related meta-analysis published since the beginning of the COVID-19 pandemic. METHODS: The search included the period from January 1, 2020, when the beginning of primary articles on COVID-19, till October 31, 2020. We screened a total of 793 studies. We excluded non-meta-analytic non-COVID-19-related studies. We obtained different characteristics, and we determined the quality of reporting using the AMSTAR tool, an 11-items tool that assesses the content validity and methodological quality of systematic reviews and meta-analysis. RESULTS: A total of 538 studies were included in our assessment. The first meta-analysis included was published in March, while the last one was on the 31st of October. Upon comparing the mean AMSTAR score for meta-analysis published during each month, we found a significant difference (p < 0.001, F = 4.139), where the mean score almost steadily increased since March. CONCLUSION: The urge to publish during the COVID-19 period or any other surge in publishing should not be at the expense of quality.

Assessment of final-year medical students' performance in diagnosing critical findings on chest X-ray.

PURPOSE: Due to the recently emerging shortage in medical staff during the novel corona virus pandemic, several countries have rushed their undergraduate medical students into the emergency department. The accuracy of diagnosing critical findings on X-rays by senior medical students is not well assessed. In this study, we aim to assess the knowledge and accuracy of undergraduate final-year medical students in diagnosing life-threatening emergency conditions on chest x-ray. METHOD: This is a cross-sectional nationwide survey across all medical schools in Jordan. Through an electronic questionnaire, participants were sequentially shown a total of six abnormal X-rays and one normal. For each X-ray, participants were asked to choose the most likely diagnosis, and to grade the degree of self-confidence regarding the accuracy of their answer in a score from 0 (not confident) to 10 (very confident). RESULTS: We included a total of 530 participants. All participants answered at least six out of seven questions correctly, out of them, 139 (26.2%) participants answered all questions correctly. Pneumoperitoneum was the highest correct answer (93.8%), whereas flail chest was the least correctly answered case with only 310 (58.5%) correct answers. Regarding self-confidence for each question, 338 participants (63.8%) reported very high overall self-confidence level. Answers related to tension pneumothorax had the highest confidence level. CONCLUSION: Senior Jordanian medical students showed good knowledge with high confidence levels in diagnosing life-threatening conditions on chest x-rays, supporting their incorporation in the emergency department during pandemics and confirming the reliability of information they can extract.

The impact of skin involvement on the psychological well-being of patients with sarcoidosis.

BACKGROUND: Physicians frequently face challenges when screening and managing mental health impairment caused by different diseases, particularly those involving the skin. OBJECTIVE: We aim to identify the major aspects of mental health impairment related to secondary skin involvement occurring in sarcoidosis patients. METHODS: A total of 718 patients with a biopsy-confirmed diagnosis of sarcoidosis were included from the A Case Control Etiologic Study of Sarcoidosis (ACCESS) study. Sample was divided into two groups depending on presence or absence of skin involvement. Each recruited patient underwent mental health assessment using two measures: depression and mood scales. Demographic data of participants was obtained. RESULTS: A total of 143 sarcoidosis patients had secondary skin involvement, and 575 had no skin involvement. Sarcoidosis patients with skin involvement had lost their appetite more frequently, experienced low mood more frequently, and had frequently encountered a significant loss of acceptance compared to patients without skin involvement. CONCLUSION: A multidisciplinary approach including a focused psychological assessment for patients with sarcoidosis; particularly those with skin involvement, is encouraged.