YouTube as a Source of Patient and Trainee Education in Vascular Surgery: A Systematic Review.

Objective: Due to its video based approach, YouTube has become a widely accessed educational resource for patients and trainees. This systematic review characterised and evaluated the peer reviewed literature investigating YouTube as a source of patient or trainee education in vascular surgery. Data sources: A comprehensive literature search was conducted using EMBASE, MEDLINE, and Ovid HealthStar from inception until 19 January 2023. All primary studies and conference abstracts evaluating YouTube as a source of vascular surgery education were included. Review methods: Video educational quality was analysed across several factors, including pathology, video audience, and length. Results: Overall, 24 studies were identified examining 3 221 videos with 123.1 hours of content and 37.1 million views. Studies primarily examined YouTube videos on diabetic foot care (7/24, 29%), peripheral arterial disease (3/24, 13%), carotid artery stenosis (3/24, 13%), varicose veins (3/24, 13%), and abdominal aortic aneurysm (2/24, 8%). Video educational quality was analysed using standardised assessment tools, author generated scoring systems, or global author reported assessment of quality. Six studies assessed videos for trainee education, while 18 studies evaluated videos for patient education. Among the 20 studies which reported on the overall quality of educational content, 10/20 studies deemed it poor, and 10/20 studies considered it fair, with 53% of studies noting poor educational quality for videos intended for patients and 40% of studies noting poor educational quality in videos intended for trainees. Poor quality videos had more views than fair quality videos (mean 27 348, 95% CI 15 154-39 543 views vs. 11 372, 95% CI 3 115-19 629 views, p = .030). Conclusion: The overall educational quality of YouTube videos for vascular surgery patient and trainee education is suboptimal. There is significant heterogeneity in the quality assessment tools used in their evaluation. A standardised approach to online education with a consistent quality assessment tool is required to better support online patient and trainee education in vascular surgery.

Evaluating YouTube as a Source of Education for Patients Undergoing Surgery: A Systematic Review.

OBJECTIVE: The objective of this systematic review is to characterize the peer-reviewed literature investigating YouTube as a source of patient education for patients undergoing surgery. SUMMARY BACKGROUND DATA: YouTube is the largest online video sharing platform and has become a substantial source of health information that patients are likely to access before surgery, yet there has been no systematic assessment of peer-reviewed studies. A comprehensive literature search was conducted using EMBASE, MEDLINE, and Ovid HealthStar from inception through to December of 2021. METHODS: All primary studies evaluating YouTube as a source of patient education relating to surgical procedures (general, cardiac, urology, otolaryngology, plastic, vascular) were included. Study screening and data extraction occurred in duplicate with two reviewers. Characteristics extracted included video length, view count, upload source, overall video educational quality, and quality of individual studies. RESULTS: Among 6,453 citations, 56 studies were identified that examined 6,797 videos with 547 hours of content and 1.39 billion views. There were 49 studies that evaluated the educational quality of the videos. A total of 43 quality assessment tools were used, with each study using a mean of 1.90 assessment tools. Per the global rating for assessments, 34/49 studies (69%) concluded that the overall quality of educational content was poor. CONCLUSIONS: While the impact of non-peer-reviewed YouTube videos on patient knowledge for surgery is unclear, the large amount of online content suggests that they are in demand. The overall educational content of these videos is poor, however, and there is substantial heterogeneity in the quality assessment tools used in their evaluation. A peer-reviewed and standardized approach to online education with video content is needed to better support patients.

Delivering Point-of-Care ultrasound teaching using a video conferencing technique.

Point-of-care ultrasound (POCUS) has usually been taught using a hands-on, in-person approach. We present a novel approach to delivering POCUS virtually using a dual image videoconferencing technique. We outline an easily implementable approach and summarize medical students' experience and feedback. This form of delivery has potential to improve instructional delivery in resource restricted settings or during pandemic restrictions where a hands-on approach may not be possible.

L'échographie au chevet fait généralement l'objet d'un enseignement pratique, en personne. Nous présentons une nouvelle approche, virtuelle, pour son enseignement, par visioconférence à double flux vidéo. L'approche que nous décrivons est facile à mettre en œuvre. Nous résumons l'expérience et les commentaires des étudiants en médecine sur cette modalité qui est susceptible d'améliorer l'enseignement dans des contextes où les ressources sont limitées ou en cas de pandémie, lorsque l'approche pratique n'est pas possible.

Waist circumference does not improve established cardiovascular disease risk prediction modeling.

Despite considerable evidence demonstrating that waist circumference (WC) is independently associated with cardiovascular disease (CVD) and/or all-cause mortality, whether the addition of WC improves risk prediction models is unclear. The objective was to evaluate the improvement in risk prediction with the addition of WC, alone or in combination with BMI, to the Framingham Risk Score (FRS) and a population specific model. 34,377 men and 9,477 women aged 20 to 79 years who completed a baseline examination at the Cooper Clinic (Dallas, TX) during 1977-2003 and enrolled in the Aerobics Center Longitudinal Study (ACLS). WC was measured at the level of the umbilicus and expressed as a continuous variable. Deaths among participants were identified using the National Center for Health Statistics National Death Index. A total of 728 fatal cardiovascular disease (CVD) events occurred over a mean follow-up period of 13.1 ± 7.5 years. WC was significantly higher in CVD decedents (P = .002). The FRS C-statistic for fatal CVD in men was 0.836 (0.816-0.855) and 0.883 (0.851-0.915) in women. The addition of WC did not improve the C-statistic in men (0.831 (0.809-0.853)) or women (0.883 (0.850-0.916)). Similar findings were observed for non-fatal CVD and all-cause mortality, and when WC was added to a population specific model. Upon adding WC, the net-reclassification index was 0.024 with an integrated discrimination improvement of -0.0004. The addition of WC, alone or in combination with BMI, did not substantively improve risk prediction for CVD or all-cause mortality compared to the Framingham Risk Score or a population specific model.

Does blood lactate predict the chronic adaptive response to training: A comparison of traditional and talk test prescription methods.

The purpose of this study was to test the hypotheses (i) that interindividual variability in acute blood lactate responses during exercise at 65% of peak work rate (WRpeak; relative WRpeak protocol (REL)) will predict variability in the chronic responses to exercise training and (ii) that exercising at an intensity that causes uncomfortable speech production (negative talk test (TT) stage (NEG)) elicits high acute blood lactate responses and large adaptations to training. Twenty-eight participants completed 4 weeks of exercise training consisting of REL (n = 14) or NEG (TT, n = 14). Fifteen additional participants were assigned to a no-exercise control group (n = 15). In REL, acute blood lactate responses during the first training session significantly predicted changes in peak oxygen consumption (r = 0.69) after training. TT resulted in consistently high acute blood lactate responses. REL and TT improved (p < 0.05) peak oxygen consumption, WRpeak, and work rate at the onset of blood lactate accumulation (WROBLA). Despite nonsignificance, small to medium between-group effect sizes for changes in peak oxygen consumption, WRpeak, and WROBLA and a higher work rate, heart rate, rating of perceived exertion, and blood lactate during training at NEG support the potential superiority of TT over REL. When exercise is prescribed using a traditional method (a fixed percentage of WRpeak; REL), acute metabolic stress may partly explain the variance in the adaptations to training. In addition, TT elicited significant increases in peak oxygen consumption, WRpeak, and WROBLA, and although our small sample size limits our ability to confidently compare training adaptations between groups, our preliminary results suggest that future investigations with larger sample sizes should assess the potential superiority of TT over REL.

Moving beyond threshold-based dichotomous classification to improve the accuracy in classifying non-responders.

We examined maximal oxygen consumption responses following exercise training to demonstrate the limitations associated with threshold-based dichotomous classification of responders and non-responders and proposed alternative methods for classification. Specifically, we: 1) calculated individual probabilities of response, and 2) classified individuals using response confidence intervals (CI) and reference points of zero and a smallest worthwhile change of 0.5 METs. Our findings support the use of individual probabilities and individual CIs to improve the accuracy in non-response classification.

Acute upregulation of PGC-1α mRNA correlates with training-induced increases in SDH activity in human skeletal muscle.

The purpose of the present study was to determine if acute responses in PGC-1α, VEGFA, SDHA, and GPD1-2 mRNA expression predict their associated chronic skeletal muscle molecular (SDH-GPD activity and substrate storage) and morphological (fibre-type composition and capillary density) adaptations following training. Skeletal muscle biopsies were collected from 14 recreationally active men (age: 22.0 ± 2.4 years) before (PRE) and 3 h after (3HR) the completion of an acute bout of sprint interval training (SIT) (eight 20-s intervals at ∼170% peak oxygen uptake work rate separated by 10 s of recovery). Participants then completed 6 weeks of SIT 4 times per week with additional biopsies after 2 (MID) and 6 (POST) weeks of training. Acute increases in PGC-1α mRNA strongly predicted increases in SDH activity (a marker of oxidative capacity) from PRE and MID to POST (PRE-POST: r = 0.81, r2 = 0.65, p < 0.01; MID-POST: r = 0.79, r2 = 0.62, p < 0.01) and glycogen content from MID to POST (r = 0.60, r2 = 0.36, p < 0.05). No other significant relationships were found between acute responses in PGC-1α, VEGFA, SDHA, and GPD1-2 mRNA expression and chronic adaptations to training. These results suggest that acute upregulation of PGC-1α mRNA relates to the magnitude of subsequent training-induced increases in oxidative capacity, but not other molecular and morphological chronic skeletal muscle adaptations. Additionally, acute mRNA responses in PGC-1α correlated with VEGFA, but not SDHA, suggesting a coordinated upregulation between PGC-1α and only some of its proposed targets in human skeletal muscle.