Readability Analysis of Spanish-Language Patient-Reported Outcome Measures in Orthopaedic Surgery.

BACKGROUND: Patient-reported outcome measures (PROMs) are increasingly used to quantify patient symptomatology when assessing intervention effectiveness as well as to guide patient-centered health-care management and research. Previous studies have analyzed the readability of PROMs used in orthopaedics in the English language; however, the readability of PROMs used in orthopaedics in the Spanish language has not been evaluated. Given the increasing number of Spanish-speaking individuals seeking orthopaedic care in the United States, it is imperative that PROMs are at an adequate reading level for patients to answer appropriately in their native language. This study aimed to assess the readability of publicly available Spanish-language PROMs used in orthopaedics. METHODS: Searches of the PubMed, Google Scholar, and Embase databases were conducted to identify publicly available Spanish-language versions of PROMs used in orthopaedics. Additionally, the PROMIS Health Organization was contacted to obtain Spanish-language versions of the PROMIS (Patient-Reported Outcomes Measurement Information System) questionnaires. A total of 42 Spanish-language PROMs were identified and included in this study. The text of each PROM was inserted into multilingual readability software (legible.es), which analyzed the readability of each PROM using the Fernández Huerta and Índice de Legibilidad de Flesch-Szigriszt (INFLESZ) readability formulas. The mean and standard deviation (SD) of the raw readability scores were calculated for the PROMs. The percentage of PROMs at or below the 6th-grade reading level was also calculated. RESULTS: The mean readability of PROMs using the INFLESZ formula was at a 7th to 10th-grade reading level (mean = 63, SD = 16), and the mean readability using the Fernández Huerta formula was 68 (SD = 15). On average, 57% of the PROMs used in orthopaedics were at or below the INFLESZ 6th-grade readability level. CONCLUSIONS: Approximately half of Spanish-language PROMs used in orthopaedics are written at a reading level that does not meet the National Institutes of Health and the American Medical Association recommendations at or below the 6th-grade level. PROM developers and translators should consider the importance of readability when translating PROMs, to maximize their use and efficacy among orthopaedic patients speaking that language.

Open Versus Percutaneous Fixation of Trigger Finger: Meta-Analysis of Clinical Outcomes.

PURPOSE: With variable and conflicting results to date, it remains unclear whether the percutaneous or open surgical A1 pulley release technique is superior regarding safety and efficacy. The goal of this meta-analysis was to compare the two techniques. METHODS: PubMed, Cochrane, and Google Scholar (pages 1-20) were searched through August 2023. Eight randomized controlled trials met the inclusion criteria and were included in this meta-analysis. RESULTS: Of the eight included studies and 548 total patients, there were 278 subjects in the percutaneous release group and 270 subjects in the open release group. There was no significant difference between the two surgical techniques in postoperative rates of revision, complications, or pain. CONCLUSIONS: This meta-analysis found no significant difference between open and percutaneous techniques regarding the need for revision procedures, complications, or postoperative pain. Therefore, both open and percutaneous releases are appropriate. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic I.

Strategies to Increase the Spanish-Speaking Workforce in Orthopaedic Surgery within the United States.

ABSTRACT: Language-concordant care improves patient satisfaction. Given the increase in Spanish-speaking persons requiring orthopaedic care in the United States, it is essential to increase the Spanish-speaking workforce in orthopaedic surgery. We have proposed strategies to improve the proportion of Spanish-speaking orthopaedic surgeons in the U.S. through early exposure to orthopaedic surgery, by creating collaborative advancement and mentorship opportunities, by endorsing Spanish-language immersion opportunities, and by increasing workforce diversity awareness. Furthermore, we have suggested a strategy to better equip non-Spanish-speaking orthopaedic surgeons while caring for Spanish-speaking patients. Together, the suggested strategies offer a variety of approaches that can have a direct, tangible impact on optimizing orthopaedic care while enhancing patient-physician communication in the Spanish language.

[Autoimmune hepatitis and pregnancy: a case series]. / Hepatitis autoinmune y embarazo: serie de casos.

We report four cases of female patients diagnosed with autoimmune hepatitis treated in the liver unit of the National Hospital Arzobispo Loayza in the period 2014-2018, these patients became pregnant during treatment. Pregnancy in all cases came to an end without any complications, patients received immunosuppressive treatment during pregnancy. We present the sequence of events with their results and a review of the literature.

Accuracy of endoscopic and videofluoroscopic evaluations of swallowing for oropharyngeal dysphagia.

OBJECTIVES: A systematic review and meta-analysis of the literature was conducted to compare the accuracy with which flexible endoscopic evaluation of swallowing (FEES) and videofluoroscopic swallowing study (VFSS) assessed oropharyngeal dysphagia in adults. DATA SOURCES: PubMed, Embase, and the Latin American and Caribbean Health Sciences Literature (LILACS) database. METHODS: A review of published studies was conducted in parallel by two groups of researchers. We evaluated the methodological quality, homogeneity, threshold effect, and publication bias. The results are presented as originally published, then with each test compared against the other as a reference and both compared against a composite reference standard, and then pooled using a random effects model. Software use consisted of Meta-DiSc and SPSS. RESULTS: The search yielded 5,697 articles. Fifty-two articles were reviewed in full text, and six articles were included in the meta-analysis. FEES showed greater sensitivity than VFSS for aspiration (0.88 vs. 0.77; P = .03), penetration (0.97 vs. 0.83; P = .0002), and laryngopharyngeal residues (0.97 vs. 0.80; P < .0001). Sensitivity to detect pharyngeal premature spillage was similar for both tests (VFSS: 0.80; FEES: 0.69; P = .28). The specificities of both tests were similar (range, 0.93-0.98). In the sensitivity analysis there were statistically significant differences between the tests regarding residues but only marginally significant differences regarding aspiration and penetration. CONCLUSIONS: FEES had a slight advantage over VFSS to detect aspiration, penetration, and residues. Prospective studies comparing both tests against an appropriate reference standard are needed to define which test has greater accuracy. LEVEL OF EVIDENCE: 2a Laryngoscope, 127:2002-2010, 2017.