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1. Enhancing Pathogen Detection in Implant-Related Infections through Chemical Antibiofilm Strategies: A Comprehensive Review.

Author

Giarritiello, Fabiana, Romanò, Carlo Luca, Lob, Guenter, Benevenia, Joseph, Tsuchiya, Hiroyuki, Zappia, Emanuele, and Drago, Lorenzo

Subjects
PROSTHESIS-related infections, ORTHOPEDIC apparatus, MICROBIAL cultures, CARDIOVASCULAR surgery, BIOFILMS
Abstract

Implant-related infections (IRIs) represent a significant challenge to modern surgery. The occurrence of these infections is due to the ability of pathogens to aggregate and form biofilms, which presents a challenge to both the diagnosis and subsequent treatment of the infection. Biofilms provide pathogens with protection from the host immune response and antibiotics, making detection difficult and complicating both single-stage and two-stage revision procedures. This narrative review examines advanced chemical antibiofilm techniques with the aim of improving the detection and identification of pathogens in IRIs. The articles included in this review were selected from databases such as PubMed, Scopus, MDPI and SpringerLink, which focus on recent studies evaluating the efficacy and enhanced accuracy of microbiological sampling and culture following the use of chemical antibiofilm. Although promising results have been achieved with the successful application of some antibiofilm chemical pre-treatment methods, mainly in orthopedics and in cardiovascular surgery, further research is required to optimize and expand their routine use in the clinical setting. This is necessary to ensure their safety, efficacy and integration into diagnostic protocols. Future studies should focus on standardizing these techniques and evaluating their effectiveness in large-scale clinical trials. This review emphasizes the importance of interdisciplinary collaboration in developing reliable diagnostic tools and highlights the need for innovative approaches to improve outcomes for patients undergoing both single-stage and two-stage revision surgery for implant-related infections. [ABSTRACT FROM AUTHOR]

Published
2024
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5. Radiographic Loss of Contact Between Radial Head Fracture Fragments Is Moderately Reliable

Author

Daniel Hernandez, David R. Miller, Vispi Jokhi, Matthias Turina, J. C. Goslings, Parag Sancheti, J. L. Marsh, Parag Melvanki, Fred Baumgaertel, Charalampos G. Zalavras, Doug Hanel, Scott Edwards, Marc F. Swiontkowski, Jonathan Rosenfeld, Jason Fanuele, Brent Bamberger, Jeffrey Wint, Lisa L. Lattanza, Michael P. Leslie, Saul Kaplan, Matt Mormino, Loren Potter, Ronald Liem, Eric P. Hofmeister, Francisco Javier Aguilar Sierra, Jeremy A. Hall, Mahmoud I. Abdel-Ghany, Jonathan L. Hobby, Sanjev Jain, Taizoon Baxamusa, Martin I. Boyer, Reto Babst, Nikolaos K. Kanakaris, Gregory L. DeSilva, Ramon De Bedout, Ladislav Mica, Thomas B. Hughes, M. Jason Palmer, John S. Taras, Thomas A. DeCoster, Daphne M. Beingessner, Sanjeev Kakar, Lob Guenter, Arie B. van Vugt, Douglas T. Hutchinson, Hans J. Kreder, R. S. Gulve, J. Andrew, Henry Broekhuyse, Milind Merchant, Elena Grosso, David O. Oloruntoba, Nick Meyer, Iain McGraw, Michael Nancollas, Gustavo Mantovani Ruggiero, Rolf W. Peters, Antonio Barquet, Christopher J. Walsh, Thomas W. Wright, Pradeep Choudhari, Peter J. L. Jebson, Grant E. Garrigues, Richard Barth, Sander Spruijt, Scott F. M. Duncan, Taco Gosens, Thierry G. Guitton, Takashi Sasaki, Philipp Lenzlinger, Edward J. Harvey, Richard Buckley, Qiugen Wang, Platz Andreas, K.J. Ponsen, John Glenden DeVine, Peter Kloen, David Ring, Wendy E. Bruinsma, Jose A. Ortiz, Rodrigo Pesantez, Lawrence Weiss, Michael A. Prayson, Denise Eygendaal, Alberto Pérez Castillo, Edward C. Yang, Ross Leighton, John A. McAuliffe, Frede Frihagen, Amal Basak, Clifford B. Jones, Boyd Lumsden, Edward K. Rodriguez, Brett D. Crist, Martin Richardson, James F. Kellam, Kendrick E. Lee, W. Arnnold Batson, Shep Hurwit, Michael W. Grafe, Todd E. Siff, David Weiss, George L. Thomas, Scott A. Mitchell, Steve Helgemo, Ben Sutker, Joseph M. Conflitti, James Wagg, Toni M. McLaurin, Michael H.J. Verhofstad, Richard L. Uhl, Robert D. Zura, Eric Mark Hammerberg, John Wixted, Jorge G. Boretto, Frank L. Walter, Ian A. Harris, Waldo E. Floyd, Michael A. Baskies, John Howlett, I. Trenholm, Peter L. Althausen, Rozental, Brad Petrisor, John T. Bolger, Raymond Malcolm Smith, Rena Stewart, Leon Elmans, David B. Carmack, Ekkehard Bonatz, David M. Kalainov, George M. Kontakis, Rick F. Papandrea, Andrew H. Schmidt, Julie E. Adams, I. J.V. Kleinlugtenbelt, Gregory J. Della Rocca, Charles Cassidy, Catherine Spath, Lars C. Borris, Fabio Suarez, Chris Wilson, Jim Calandruccio, Sidney M. Jacoby, Thomas J. Fischer, Daniel B. Polatsch, Peter Schandelmaier, Jose Nolla, Richard S. Page, Kenneth A. Egol, Steven J. Rhemrev, Alan Kawaguchi, Timothy G. Havenhill, Jay Pomerance, Patrick T. McCulloch, Richard Jenkinson, Fryda Medina Rodríguez, Bernhard Ciritsis, Abhijeet L. Wahegaonkar, Charles Metzger, Vishwanath M. Iyer, Carrie R. Swigart, Lisa Taitsman, Leon S. Benson, Rudolf W. Poolman, Kyle J. Jeray, Peter R. Brink, Niels W. L. Schep, Marc J. Richard, Kevin Eng, Russell Shatford, George S.M. Dyer, Orthopedic Surgery and Sports Medicine, Surgery, Other Research, Other departments, AMS - Amsterdam Movement Sciences, and Graduate School

Subjects
Joint Instability, Male, medicine.medical_specialty, Sports medicine, Radiography, Elbow, Forearm, Predictive Value of Tests, Elbow Joint, Humans, Medicine, Orthopedics and Sports Medicine, Observer Variation, Orthodontics, business.industry, Reproducibility of Results, General Medicine, Anatomy, Prognosis, musculoskeletal system, body regions, Radius, medicine.anatomical_structure, Symposium: Traumatic Elbow Instability and its Sequelae, Elbow dislocation, Orthopedic surgery, Ligament, Female, Surgery, Radial head fracture, Clinical Competence, Radius Fractures, Elbow Injuries, business, Specialization
Abstract

Loss of contact between radial head fracture fragments is strongly associated with other elbow or forearm injuries. If this finding has adequate interobserver reliability, it could help examiners identify and treat associated ligament injuries and fractures (eg, forearm interosseous ligament injury or elbow dislocation). (1) What is the interobserver agreement on radiographic loss of contact between radial head fracture fragments? (2) Are there factors associated with the observer such as location of practice or subspecialization that increase interobserver reliability? Fully trained practicing orthopaedic and trauma surgeons from around the world evaluated 27 anteroposterior and lateral radiographs of radial head fractures on a web-based platform for the following characteristics: (1) loss of contact between at least one radial head fracture fragment and the remaining radial head and neck; (2) a gap between fragments of 2 mm or greater; (3) anticipated fracture instability (mobility) on operative exposure; (4) anticipated associated ligament injuries; and (5) recommendation for treatment. Agreement among observers was measured using the multirater kappa measure. Kappas for various observer characteristics were compared using 95% confidence intervals. The overall interobserver agreement was moderate (range, 0.49-0.55) for each question except associated ligament injury, which was fair (0.33). Shoulder and elbow surgeons had substantial agreement (range, 0.51-0.61) in many areas, but kappas were generally in the moderate range (0.41-0.59) based on number of years in practice, radial head fractures treated per year, and trainee supervision. Radiographic signs of radial head fracture instability such as loss of contact have moderate reliability. This characteristic seems clinically useful, because loss of contact between at least one radial head fracture fragment and the remaining radial head and neck is strongly associated with associated ligament injury or other fractures. Level III, diagnostic study. See Guidelines for Authors for a complete description of levels of evidence

Published
2014
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6. Loud and silent epidemics in the third millennium: tuning-up the volume.

Author

Romanò, Carlo Luca, Drago, Lorenzo, del Sel, Hernán, Johari, Ashok, Lob, Guenter, Mavrogenis, Andreas F., Benzakour, Thami, and World Association against Infection in Orthopedics and Trauma (WAIOT) Study Group On Bone And Joint Infection Definitions

Subjects
SURGICAL site infections, EPIDEMICS, CROSS infection, INTRAOPERATIVE awareness, COVID-19, VIRAL pneumonia, MASS media, DISEASE incidence, PUBLIC health, INFECTION, COMMUNICATION, COMPLICATIONS of prosthesis
Abstract

The media play a key role in promoting public health and influencing debate regarding health issues; however, some topics seem to generate a stronger response in the public, and this may be related to how the media construct and deliver their messages. Mass media coverage of COVID-19 epidemic has been exceptional with more than 180,000 articles published each day in 70 languages from March 8 to April 8, 2020. One may well wonder if this massive media attention ever happened in the past and if it has been finally proven to be beneficial or even just appropriate. Surgical site and implant-related infections represent a substantial part of health care-associated infections; with an estimated overall incidence of 6% post-surgical infection, approximately 18 million new surgical site infections are expected each year globally, with 5 to 10% mortality rate and an astounding economic and social cost. In the current mediatic era, orthopaedic surgeons need to refocus some of their time and energies from surgery to communication and constructive research. Only raising mediatic awareness on surgical site and implant-related infections may tune up the volume of silent epidemics to a level that can become audible by governing institutions. [ABSTRACT FROM AUTHOR]

Published
2020
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7. The Effect of Price on Surgeons' Choice of Implants: A Randomized Controlled Survey

Author

James A. Gillespie, Kyle J. Jeray, Constanza L. Moreno-Serrano, Peter J. Evans, Burak Altintas, Ofer Levy, Chad Manke, Raj Karia, Stephen K. Westly, Platz Andreas, Clifford B. Jones, Sergio Rowinski, Robert D. Zura, Neil Wilson, Lars C. Borris, Fabio Suarez, Marinis Pirpiris, Jeffrey Yao, Craig M. Rodner, Anna N. Miller, Efsthathios G. Ballas, Peter L. Althausen, Julie E. Adams, Scott F. M. Duncan, Nata Parnes, Parag Sancheti, Michael W. Grafe, Lars Adolfsson, Thierry G. Guitton, Kevin M. Rumball, Rolf W. Peters, Timothy Omara, Kendrick E. Lee, J. Biert, Eitan Melamed, Julius A. Bishop, Eric P. Hofmeister, Benjamin W. Sears, S.A. Meylaerts, Jorge Rubio, Jose Eduardo Grandi Ribeiro Filho, James F. Nappi, Daniel Rikli, Ryan P. Calfee, Ippokratis Pountos, Edward J. Harvey, Erik T. Walbeehm, P. Lygdas, J. Carel Goslings, Lewis B. Lane, Doug Hanel, F. J. Seibert, Grant J. Bayne, A.B. Arne Berner, Luke S. Austin, Mohamed Shafi, David S. Ruch, Stephen A. Kennedy, Milind Merchant, Leon S. Benson, Ricardo J. Bello, Peter J. L. Jebson, Robin N. Kamal, Jerry I. Huang, Ladislav Mica, Michael Nancollas, Juan Martín Patiño, Michael W. Kessler, John A. Scolaro, Marc F. Swiontkowski, Steve Kronlage, Alexander Marcus, M. Jason Palmer, Lob Guenter, Nikolaos K. Kanakaris, Russell Shatford, Harold Alonso Villamizar, Evan D. Schumer, Radzeli Mohd Ramli, Andrew John Powell, Nicholas L. Shortt, A.J.H. Vochteloo, Francisco Lopez-Gonzalez, Saul Kaplan, Ralph M. Costanzo, Gregory L. DeSilva, Carl Ekholm, Ngozi M. Akabudike, Thomas A. DeCoster, Shep Hurwit, John T. Capo, Karel Chivers, Richard S. Gilbert, Daniel Haverkamp, Marc J. Richard, Rodrigo Pesantez, Giuseppe Porcellini, Peter Krause, Matej Kastelec, Brett D. Crist, Amy S. Wasterlain, Carlos Henrique Fernandes, Other departments, Surgery, AMS - Ageing & Morbidty, and AMS - Restoration & Development

Subjects
Male, medicine.medical_specialty, External fixator, Attitude of Health Personnel, Dentistry, Choice Behavior, Locking plate, 03 medical and health sciences, 0302 clinical medicine, Cost, implant, price, surgeon, survey, Female, Humans, Orthopedic Surgeons, Practice Patterns, Physicians', Prostheses and Implants, Surveys and Questionnaires, Health Care Costs, medicine, Orthopedics and Sports Medicine, 030212 general & internal medicine, Specific model, health care economics and organizations, 030222 orthopedics, Descriptive statistics, business.industry, Evidence-based medicine, Surgery, Reconstructive and regenerative medicine Radboud Institute for Molecular Life Sciences [Radboudumc 10], Extremity fractures, Orthopedic surgery, Implant, business
Abstract

Item does not contain fulltext PURPOSE: Surgical costs are under scrutiny and surgeons are being held increasingly responsible for cost containment. In some instances, implants are the largest component of total procedure cost, yet previous studies reveal that surgeons' knowledge of implant prices is poor. Our study aims to (1) understand drivers behind implant selection and (2) assess whether educating surgeons about implant costs affects implant selection. METHODS: We surveyed 226 orthopedic surgeons across 6 continents. The survey presented 8 clinical cases of upper extremity fractures with history, radiographs, and implant options. Surgeons were randomized to receive either a version with each implant's average selling price ("price-aware" group), or a version without prices ("price-naive" group). Surgeons selected a surgical implant and ranked factors affecting implant choice. Descriptive statistics and univariate, multivariable, and subgroup analyses were performed. RESULTS: For cases offering implants within the same class (eg, volar locking plates), price-awareness reduced implant cost by 9% to 11%. When offered different models of distal radius volar locking plates, 25% of price-naive surgeons selected the most expensive plate compared with only 7% of price-aware surgeons. For cases offering different classes of implants (eg, plate vs external fixator), there was no difference in implant choice between price-aware and price-naive surgeons. Familiarity with the implant was the most common reason for choosing an implant in both groups (35% vs 46%). Price-aware surgeons were more likely to rank cost as a factor (29% vs 21%). CONCLUSIONS: Price awareness significantly influences surgeons' choice of a specific model within the same implant class. Merely including prices with a list of implants leads surgeons to select less expensive implants. This implies that an untapped opportunity exists to reduce surgical expenditures simply by enhancing surgeons' cost awareness. TYPE OF STUDY/LEVEL OF EVIDENCE: Economic/Decision Analyses I.

Published
2017

8. Interobserver variability in the treatment of little finger metacarpal neck fractures

Author

Lewis B. Lane, Rick F. Papandrea, Minoo Patel, P. Hahn, Andrew H. Schmidt, Gerald A. Kraan, William Dias Belangero, David E. Ruchelsman, Henry Broekhuyse, J. H. Scheer, Vassilios S. Nikolaou, Travis M. Hughes, C.J.H. Veillette, N. Bijlani, Aida Garcia, Charles Cassidy, S. Moghtaderi, M. A J Van De Sande, Timothy Omara, B. Watkins, E. Forigua Jaime, C. Young, Philipp N. Streubel, A. Berner, R. de Bedout, M. P. J. van den Bekerom, Maurizio Calcagni, Grant Bayne, T. Higgins, Mahmoud I. Abdel-Ghany, Rick Tosti, L. C. Bainbridge, Matthew Rg Menon, Lior Paz, M. Soong, Warren C. Hammert, Yoram A. Weil, Randy M. Hauck, Grant E. Garrigues, S. G. Kaar, D.M. Silva, Thomas G. Stackhouse, Richard L. Hutchison, Augustus D. Mazzocca, Lars C. Borris, M. Quell, Fabio Suarez, Daniel Haverkamp, Chris Wilson, R. Omid, Gladys Cecilia Zambrano Caro, Daniel B. Polatsch, Theodoros I. Tosounidis, Marco Rizzo, Jose Nolla, F. García, Richard S. Page, Charalampos G. Zalavras, Asif M. Ilyas, E.T. Tolo, Megan M. Wood, H. Durchholz, G. Kohut, Michael J. Behrman, Peter Kloen, Christos Garnavos, David L. Nelson, Charles A. Goldfarb, R. Gaston, Michael W. Kessler, Koroush Kabir, Chad Manke, John M. Erickson, Thomas Mittlmeier, Prosper Benhaim, Seth D. Dodds, V. Philippe, K. Dickson, Richard Buckley, Karel Chivers, Bernard F. Hearon, Jonathan Isaacs, M. Ladislav, H. Goost, Peter R. Brink, Edward J. Harvey, Richard S. Gilbert, D.K. Kirkpatrick, Ronald Liem, H. W. Grunwald, R. Wallensten, Sergio Rowinski, Jim Calandruccio, Minos Tyllianakis, G.J. Della Rocca, H. B. Bamberger, Thomas J. Fischer, Kevin J. Malone, Marc J. Richard, Saurabh P. Mehta, Niels W. L. Schep, E.M. Hammerberg, Peter Schandelmaier, Jeffrey Wint, German Ricardo Hernandez, J. Moreta-Suarez, Christopher M. Jones, Taizoon Baxamusa, Martin I. Boyer, W.T. Benjamin, Jennifer Moriatis Wolf, M. Bonczar, Jos J. Mellema, J. Munyak, Julie E. Adams, Matej Kastelec, Milind Merchant, Erik T. Walbeehm, Robert Haverlag, Thomas Apard, C. Klostermann, Sanjeev Kakar, Peter J. L. Jebson, N.L. Leung, A. L. Van Der Zwan, W. A. Batson, Lob Guenter, Denise Eygendaal, S.A. Meylaerts, Renato M. Fricker, Anže Kristan, Michael W. Grafe, T. Begue, Kevin Eng, D. F. P. van Deurzen, Steven Beldner, Martin Richardson, C. J. Barreto, J.F. Di Giovanni, Lars Adolfsson, M. Darowish, Gregory L. DeSilva, Gary K. Frykman, K. Erol, Theresa O Wyrick, Evan D. Schumer, Christopher B. Wall, Antonio Barquet, L.M.S.J. Poelhekke, Scott A. Mitchell, Paul M. Guidera, Constanza L. Moreno-Serrano, E. Stojkovska Pemovska, Frank L. Walter, Michael J. Prayson, John A. McAuliffe, N. Elias, Robert D. Zura, Christopher J. Wilson, Marc F. Swiontkowski, Oleg M. Semenkin, Russell Shatford, Jack Choueka, Ryan P. Calfee, Gary M. Pess, Stanley Casimir Marczyk, C. Taleb, Andrew P. Gutow, Nikolaos K. Kanakaris, Neil Wilson, John T. Capo, Vincenzo Giordano, C. D. Oliveira Miranda, J. Itamura, Joseph M. Conflitti, A. B. Shafritz, George S.M. Dyer, Ralph M. Costanzo, B. E. Kreis, Carl Ekholm, R. Cardoso, Scott F. M. Duncan, David Ring, Nicholas L. Shortt, A.J.H. Vochteloo, Lawrence Weiss, A. Platz, Valentin Neuhaus, T. Havlicek, Charles Metzger, Andrew L. Terrono, Thierry G. Guitton, Kendrick E. Lee, Marinis Pirpiris, Thomas W. Wright, Gertraud Gradl, Georg M. Huemer, B. M. Nolan, David M. Kalainov, D.O. Oloruntoba, Paul A. Martineau, Sander Spruijt, Kyle J. Jeray, Carlos Henrique Fernandes, Frank J. Raia, G. C. Babis, J. Biert, P. Lygdas, Axel Jubel, Brian P.D. Wills, Michael A. Baskies, Peter L. Althausen, Kevin M. Rumball, Rodrigo Pesantez, Mohamed Shafi, Harold Alonso Villamizar, Carrie R. Swigart, Francisco Lopez-Gonzalez, Frede Frihagen, Thomas Dienstknecht, Saul Kaplan, Matt Mormino, M. J. Palmer, Thomas A. DeCoster, A. B. Spoor, Job N Doornberg, W. Satora, Todd E. Siff, Eric P. Hofmeister, Joshua M. Abzug, George W. Balfour, J. C. Goslings, P. Inna, Stephen A. Kennedy, Parag Melvanki, Jochen Fischer, Raymond Malcolm Smith, P. V. van Eerten, George S. Athwal, Diederik O. Verbeek, D. Brilej, L.A.B. Campinhos, Daniel A. Osei, K.J. Ponsen, Iain McGraw, Michael Nancollas, R. van Riet, Philip E. Blazar, C. Cornell, Craig A. Bottke, Taco Gosens, F. T. D. Kaplan, George M. Kontakis, Graduate School, Orthopedic Surgery and Sports Medicine, Other departments, Surgery, Other Research, and AMS - Amsterdam Movement Sciences

Subjects
Adult, Male, medicine.medical_specialty, Radiography, Fractures, Bone, Random Allocation, Finger Injuries, medicine, Humans, Lateral view, Orthopedics and Sports Medicine, Practice Patterns, Physicians', Nonoperative management, Aged, Observer Variation, Orthodontics, business.industry, Other Research Radboud Institute for Health Sciences [Radboudumc 0], Neck fracture, Little finger, Middle Aged, Surgery, medicine.anatomical_structure, Reconstructive and regenerative medicine Radboud Institute for Molecular Life Sciences [Radboudumc 10], Orthopedic surgery, Female, Metacarpus, business, Angular deformity
Abstract

Purpose To address the null hypothesis that surgeons shown radiographs of little finger metacarpal neck fractures with measured fracture angulation would recommend surgery as often as surgeons shown unmarked radiographs. Methods Members of the Science of Variation Group, an international collaboration of fully trained orthopedic and trauma surgeons, were asked to review 20 little finger metacarpal neck fracture cases, which included a vignette and 3 high-quality radiographs. Members were then randomized to review radiographs with or without measured fracture angulation on the lateral view and select operative or nonoperative management. Results Surgeons shown radiographs with measured angulation were more likely to recommend surgery, and there was less variability among these surgeons, particularly for fractures with less angular deformity. Conclusions Measured fracture angulation has a small but significant influence on treatment recommendations for little finger metacarpal neck fractures. Copyright (C) 2014 by the American Society for Surgery of the Hand. All rights reserved

Published
2014

9. How surgeons make decisions when the evidence is inconclusive

Author

Prashanth Ina, Robert R.L. Gray, Gustavo Mantovani Ruggiero, David J. Rowland, Yoram Weil, M. R. de Vries, Renato M. Fricker, Georges Kohut, Antonio Barquet, Karl Josef Prommersberger, Takashi Sasaki, Eckart Schwab, Taco Gosens, Joseph M. Conflitti, David Ring, M. A. Aita, Ladislav Mica, Joseph A. Abboud, Michael Jones, Daniel Hernandez, Gregory L. DeSilva, Hal MccUtchan, Thomas W. Wright, Kendrick E. Lee, Marinis Pirpiris, Ian A. Harris, Marc F. Swiontkowski, Neil Wilson, Norah M. Harvey, Eric P. Hofmeister, Howard D. Routman, Lawrence Weiss, Nicholas L. Shortt, Jorge Rubio, Axel Jubel, John S. Taras, Gustavo Regazzi, Sergio L. Checchia, Jack Choueka, Jorge L. Orbay, Michael A. Baskies, Rolf Norlin, Vispi Jokhi, Todd E. Siff, Ashish S. Ranade, Lisa L. Lattanza, Jeff W. Johnson, Hans J. Kreder, Rozental, Cayón Cayón, Rajat Varma, Paul T. Appleton, Leonid I. Katolik, Asheesh Bedi, Filip Celestyn Dolatowski, Steve Kronlage, Paul M. Guidera, Elisabeth Prelog-Igler, David M. Kalainov, Charles L. Getz, Chunyan Jiang, Porcellini, A. Iossifidis, J Andrew I Trenholm, Frede Frihagen, K. Sprengel, Minos Tyllianakis, Steven J. McCabe, David Weiss, C. Taleb, Andrew P. Gutow, Sebastian Kluge, Jin Young Park, Michael R. Hausman, Paul A. Martineau, Michel P J Van Den Bekerom, W. A H Van Der Stappen, Thomas G. Stackhouse, Thomas Dienstknecht, Babst H. Reto, Jonathan L. Hobby, Iain McGraw, Tony Wanich, Augustus D. Mazzocca, Samir Sodha, J. Biert, Matthias Turina, Ines C. Lin, Daniel Rikli, Fischmeister Martin, Chad Manke, Roman Pfeifer, Lars C. Borris, M. Quell, Fabio Suarez, Daniel B. Whelan, John P. Evans, Michael Nancollas, Marco Rizzo, Lawrence S. Halperin, Carl Ekholm, David E. Tate, Steven J. Morgan, Betsy M. Nolan, F. J. Seibert, W. Arnnold Batson, Richard Barth, Brent Bamberger, A. B. Spoor, Seth D. Dodds, Jeffrey A. Greenberg, Victoria D. Knoll, Wade R. Smith, Michael D. McKee, Rolf W. Peters, Christopher J. Walsh, Jochen Fischer, Martin I. Boyer, Raymond Malcolm Smith, P. V. van Eerten, Philipp N. Streubel, Thomas B. Hughes, Milind Merchant, Peter J. L. Jebson, Bret C. Peterson, Theodoros H. Tosounidis, Luke S. Austin, David L. Nelson, M. R. Krijnen, K.J. Ponsen, Chris Wilson, Gladys Cecilia Zambrano Caro, Daniel B. Polatsch, Matthew D. Budge, Reza Omid, Louis W. Catalano, Emil H. Schemitsch, Roy G. LiemKulick, Richard S. Page, Michael W. Kessler, Donald Endrizzi, Anna N. Miller, Jorge G. Boretto, Peter Kloen, J. Michael Wiater, Fidel Ernesto, German Ricardo Hernandez, Leon S. Benson, Peter J. Evans, John Howlett, Verhofstad, Michael J. Behrman, A. L. Van Der Zwan, Ryan P. Calfee, Robert D. Zura, Leon Elmans, Anica Eschler, D. Kaplan, Richard S. Gilbert, F. Thomas, Johannes M. Rueger, Eon K. Shin, Sam Moghtaderi, Julie E. Adams, Jaimo Ahn, D. F. P. van Deurzen, Ralf Nyszkiewicz, W. Jaap Willems, Huub Van Der Heide, Aida Garcia, L.M.S.J. Poelhekke, Philip E. Blazar, Daniel C. Wascher, Luis Antonio Buendia, S. Prashanth, Peter Krause, Maarten W.G.A. Bronkhorst, Noah D. Weiss, Kyle J. Jeray, Ronald Liem, Andrew L. Terrono, Niels W. L. Schep, Sander Sprujt, Ryan Klinefelter, Robert Haverlag, Steven Beldner, Nikolaos G. Lasanianos, Ramon De Bedout, Rudolf W. Poolman, I. J.V. Kleinlugtenbelt, Alexander Marcus, Greg Merrell, Naquira Escobar Luis Felipe, Kimberlly S. Chhor, Jeffrey Yao, Lob Guenter, Parag Melvanki, Arie B. van Vugt, Francisco Lopez-Gonzalez, Craig Lomita, Saul Kaplan, Matt Mormino, Theresa O Wyrick, Gregory J. Della Rocca, C. Noel Henley, Edgardo Ramos Maza, Christopher B. Wall, Fred Baumgaertel, Roger P. van Riet, Sebastian Rodriguez-Elizalde, Stuart M. Hilliard, George S. Athwal, Peter V. Giannoudis, Angela A. Wang, Tamir Pritsch, John A. McAuliffe, Robert J. Feibel, Timothy Omara, Paul Levin, Jonathan Rosenfeld, Michael J. Prayson, Mark E. Baratz, R. Bryan Benafield, Christian Perrotto, George L. Thomas, Punita V. Solanki, George M. Kontakis, Robert Wagenmakers, Charles A. Goldfarb, Andrew H. Schmidt, Abhay Shrivastava, Mark D. Lazarus, Frederico C M Vallim, L. Marsh, Keith A. Segalman, H. Goost, Peter R. Brink, Michael W. Grafe, Jonathan P. Braman, April D. Armstrong, Charles Cornell, Thomas A. DeCoster, Daphne M. Beingessner, Neal C. Chen, Charalampos Zalavras, M. A J Van De Sande, Jennifer L. Giuffre, Thuan V. Ly, Georg M. Huemer, Vani J. Sabesan, Rodrigo Pesantez, Kevin Eng, A. Lee Osterman, Darren S. Drosdowech, Michael Moskal, B. Van Den, Nigel Rossiter, Michael Baumgaertner, Christian Heiss, James F. Kellam, P. C. Fuchs, Matej Kastelec, David J. Hak, Karel Chivers, Amy L. Ladd, Reid A. Abrams, Bob Arciero, Russell Shatford, Toni M. McLaurin, George S.M. Dyer, Ralph M. Costanzo, Frank L. Walter, Craig M. Torosian, Koroush Kabir, Timothy G. Havenhill, Brian L. Badman, Joachim P. Overbeck, Charles Metzger, Vishwanath M. Iyer, Annette K B Wikerøy, Carlos Henrique Fernandes, Jay Pomerance, Patrick T. McCulloch, Megan M. Wood, Richard Jenkinson, Brian J. Cross, Christos Garnavos, Marcus Lehnhardt, Ashok K. Shyam, Michael LeCroy, Abhijeet L. Wahegaonkar, Carrie R. Swigart, Lisa Taitsman, Vasileios S. Nikolaou, Gerald R. Williams, J. H. Peters, Sergio Rowinski, William Dias Belangero, Ibrahim Ibrahim, Jeremy A. Hall, Charles Cassidy, Mahmoud I. Abdel-Ghany, Michiel G.J.S. Hageman, M. Jason Palmer, Joseph P A M Vroemen, Frank J. P. Beeres, Alberto Pérez Castillo, Gustavo Borges Laurindo De Azevedo, Martin Richardson, Wolfgang Baer, Shep Hurwit, J. V. Clarke, Robert Tashijan, Scott F. M. Duncan, Thierry G. Guitton, Steven J. Rhemrev, J. Wolkenfelt, Richard Wallensten, Neil Saran, Brett D. Crist, J. Carel Goslings, Qiugen Wang, Francisco Javier Aguilar Sierra, Leonardo Alves De Mendonca, Paula M. Hasenboehler, Sanjeev Kakar, Grant E. Garrigues, Leonardo Rocha, Joel Murachovsky, Vidyadhar Telang, Edward J. Harvey, Richard Buckley, Jose A. Ortiz, Schandelmaier, Edward K. Rodriguez, Konul Erol, H. J. Helling, Nikolaos K. Kanakaris, Jeffry T. Watson, Desirae M. McKee, Graduate School, Orthopedic Surgery and Sports Medicine, AMS - Amsterdam Movement Sciences, Surgery, Other Research, and Other departments

Subjects
Male, medicine.medical_specialty, Decision Making, Alternative medicine, Likert scale, medicine, Humans, Orthopedics and Sports Medicine, Somewhat Important, Reimbursement, Social influence, Evidence-Based Medicine, business.industry, Mentors, Perspective (graphical), Evidence-based medicine, Hand, Surgery, Orthopedics, Family medicine, Practice Guidelines as Topic, Female, Clinical Competence, business, Null hypothesis
Abstract

Purpose To address the factors that surgeons use to decide between 2 options for treatment when the evidence is inconclusive. Methods We tested the null hypothesis that the factors surgeons use do not vary by training, demographics, and practice. A total of 337 surgeons rated the importance of 7 factors when deciding between treatment and following the natural history of the disease and 12 factors when deciding between 2 operative treatments using a 5-point Likert scale between "very important" and "very unimportant." Results According to the percentages of statements rated very important or somewhat important, the most popular factors influencing recommendations when evidence is inconclusive between treatment and following the natural course of the illness were "works in my hands," "familiarity with the treatment," and "what my mentor taught me." The most important factors when evidence shows no difference between 2 surgeries were "fewer complications," "quicker recovery," "burns fewer bridges," "works in my hands" and "familiarity with the procedure." Europeans rated "works in my hands" and "cheapest/most resourceful" of significantly greater importance and "what others are doing," "highest reimbursement," and "shorter procedure" of significantly lower importance than surgeons in the United States. Observers with fewer than 10 years in independent practice rated "what my mentor taught me," "what others are doing" and "highest reimbursement" of significantly lower importance compared to observers with 10 or more years in independent practice. Conclusions Surgeons deciding between 2 treatment options, when the evidence is inconclusive, fall back to factors that relate to their perspective and reflect their culture and circumstances, more so than factors related to the patient's perspective, although this may be different for younger surgeons. Clinical relevance Hand surgeons might benefit from consensus fallback preferences when evidence is inconclusive. It is possible that falling back to personal comfort makes us vulnerable to unhelpful commercial and societal influences.

Published
2013

10. Status of Road Safety and Injury Burden

Author

Andruszkow, Hagen, primary, Haasper, Carl, additional, Lob, Guenter, additional, Pfeifer, Roman, additional, Stengel, Dirk, additional, Hildebrand, Frank, additional, and Pape, Hans-Christoph, additional

Published
2014
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11. 24th International Conference on Safe Community; count down to decade of action for road safety.

Author

Hanson, Dale, Namaki, Saeed, Somi, Mohammad Hossein, Bazargani, Homayoun Sadegki, Shuey, Ray, Benekohal, Rahim Farahnak, Lowerv Wilson, Michael, Lob, Guenter, Mohammadi, Reza, Deljavan Anvarv, Reza, and Saadati, Mohammad

Subjects
TRAFFIC safety, AUTOMOBILE driving, COMMUNITY health services, CONFERENCES & conventions, SAFETY, WOUNDS & injuries
Abstract

The article offers information on the 24th International Conference on Safe Community in 2020.

Published
2020
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