Rosacea Core Domain Set for Clinical Trials and Practice: A Consensus Statement.

Importance: Inconsistent reporting of outcomes in clinical trials of rosacea is impeding and likely preventing accurate data pooling and meta-analyses. There is a need for standardization of outcomes assessed during intervention trials of rosacea. Objective: To develop a rosacea core outcome set (COS) based on key domains that are globally relevant and applicable to all demographic groups to be used as a minimum list of outcomes for reporting by rosacea clinical trials, and when appropriate, in clinical practice. Evidence Review: A systematic literature review of rosacea clinical trials was conducted. Discrete outcomes were extracted and augmented through discussions and focus groups with key stakeholders. The initial list of 192 outcomes was refined to identify 50 unique outcomes that were rated through the Delphi process Round 1 by 88 panelists (63 physicians from 17 countries and 25 patients with rosacea in the US) on 9-point Likert scale. Based on feedback, an additional 11 outcomes were added in Round 2. Outcomes deemed to be critical for inclusion (rated 7-9 by ≥70% of both groups) were discussed in consensus meetings. The outcomes deemed to be most important for inclusion by at least 85% of the participants were incorporated into the final core domain set. Findings: The Delphi process and consensus-building meetings identified a final core set of 8 domains for rosacea clinical trials: ocular signs and symptoms; skin signs of disease; skin symptoms; overall severity; patient satisfaction; quality of life; degree of improvement; and presence and severity of treatment-related adverse events. Recommendations were also made for application in the clinical setting. Conclusions and Relevance: This core domain set for rosacea research is now available; its adoption by researchers may improve the usefulness of future trials of rosacea therapies by enabling meta-analyses and other comparisons across studies. This core domain set may also be useful in clinical practice.

Risk factors for hospital-based surgical site infections.

Surgical site infections (SSIs) contribute to morbidity and are costly to the healthcare system. To identify factors associated with SSIs. Case-control study analyzing the Nationwide Readmission Database (NRD). We identified 45,445 SSIs. Infection rates were higher in those who were obese (BMI ≥ 30) (OR: 1.39, 95% CI 1.28-1.51), tobacco users (OR: 1.08, 95% CI 1.02-1.15), diagnosed with diabetes (OR: 1.16, 95% CI 1.10-1.22), with Elixhauser Comorbidity Index ≥ 2 (OR: 1.14, 95% CI 1.09-1.20), admitted to hospital for 4-6 days (OR: 1.35, 95% CI 1.29-1.42), in medium-size hospital (OR: 1.15, 95% CI 1.05-1.26), or large-size hospital (OR: 1.43, 95% CI 1.31-1.56). In contrast, patients who were 60-79 years old (OR: 0.78, 95% CI 0.73-0.84), 80 years or older (OR: 0.66, 95% CI 0.59-0.73), female (OR: 0.95, 95% CI 0.91-0.99), underweight (BMI < 18.5) (OR: 0.14, 95% CI 0.03-0.59), in a non-metropolitan hospital (OR: 0.83, 95% CI 0.75-0.91), self-pay (OR: 0.82, 95% CI 0.74-0.91), or covered by Medicare (OR: 0.86, 95% CI 0.80-0.91) had lower odds. Initial data entry to NRD is susceptible to human error. Patients who are obese, use tobacco, have multiple comorbidities, and have long hospital stays in medium-to-large-size hospitals are at risk of SSIs. Conversely, odds of SSIs are lower in females, age ≥ 60, BMI < 18.5, self-pay or Medicare (versus private insurance), or at smaller hospitals. Understanding factors associated with SSIs may help surgeons anticipate complications.

A Cross-Sectional Analysis of Breast Reconstruction with Fat Grafting Content on TikTok.

As of November 2021, TikTok has one billion monthly active users and is recognized as the most engaging social media platform. TikTok has seen a surge in users and content creators, ranging from athletes to medical professionals. In the past year, content creators have utilized the app to advocate for social reforms, education, and other uses that were not previously considered. Breast cancer is the most commonly diagnosed cancer in women, with an expected 281,550 new cases of invasive breast cancer in 2021. As more individuals with breast cancer choose to undergo resection, the demand for autologous fat grafting in breast reconstruction has increased due to the natural look and feel of breast tissue. The purpose of this article is to analyze content related to breast reconstruction with fat grafting found on TikTok and recommend methods to improve patient education, care, and outcomes. We searched TikTok on November 1, 2021, for videos using the phrase "breast reconstruction with fat grafting." The top 200 videos retrieved from the TikTok search algorithm were analyzed, and all commentaries, duplicates, and nonrelevant videos were removed. Video characteristics were collected, and two independent reviewers generated a DISCERN score A total of 131 videos were included in the study. They were found to have a combined 1,871,980 likes, 41,113 comments, and 58,662 shares. The videos had an average DISCERN score of 2.16. Content creators had an overall low DISCERN score in items involving the use of references, disclosure of risks for not obtaining treatment, and support for shared decision-making. When stratified, the DISCERN score was higher for videos created by physicians (DISCERN average 2.48) than for videos created by nonphysicians (DISCERN average 1.99; p < 0.001). Content creators can improve the quality of their videos by disclosing treatment risks, benefits and risks, discussing risks for not obtaining treatment, and advocating for shared decision-making. Furthermore, including citations and academic references may offer increased credibility and promote evidence practice. This article is limited by the variability seen on the TikTok platform that is influenced by algorithmic trends. The top 200 search results vary, making each compilation of videos selected for analysis unique. Furthermore, although DISCERN is a reliable source to assess patient information, it has not been tested for its reliability with videos such as on TikTok. Despite TikTok being developed as a social media platform, it has shown to be a medium for patient outreach and an educational tool.