Decision analysis in cardiac surgery: a scoping review and methodological primer.

Objectives: Randomized controlled trials are the gold standard for evidence generation in medicine but are limited by their real-world generalizability, resource needs, shorter follow-up durations and inability to be conducted for all clinical questions. Decision analysis (DA) models may simulate trials and observational studies by using existing data and evidence- and expert-informed assumptions and extend analyses over longer time horizons, different study populations and specific scenarios, helping to translate population outcomes to patient-specific clinical and economic outcomes. Here, we present a scoping review and methodological primer on DA for cardiac surgery research.

It's not the arrow, it's the archer: the role of the surgeon leader in a safety driven-era.

Background: In an era where team communication and patient safety are paramount, standardized tools have been deemed critical to safe, efficient practice. In some cases-perhaps most notably in the surgical safety checklist (SSC)-these tools have been elevated as the key to safe patient care. However, effects of the SSC on patient safety in practice remain mixed.

Contextualizing the tone of the operating room in practice: drawing on the literature to connect the dots.

The study of teamwork in the operating room has made significant strides in uncovering key constructs which shape safe and effective intraoperative care. However, in recent years, there have been calls to understand teamwork in the operating room more fully by embracing the complexity of the intraoperative environment. We propose the construct of tone as a useful lens through which to understand intraoperative teamwork.

Predictors of premature termination and completion of randomized controlled trials.

Randomized clinical trials (RCTs) have a key role in progressing biomedical research and guiding clinical decision making, but premature termination remains high (up to 30%), raising concerns regarding funding expenditure and resource allocation. This brief report sought to identify variables associated with RCTs' premature termination and completion.

Engaging medical students in cardiac surgery: a focus on equity, diversity, and inclusion.

Purpose Of Review: The Coronavirus Disease 2019 pandemic prohibited Canadian medical students from in-person observerships. This may be particularly detrimental to under-represented groups that may consider surgical subspecialties. To address the unprecedented need for alternative surgical career exploration and diversity within the profession, The University of Toronto Cardiac Surgery Interest Group and Division of Cardiac Surgery collaborated on virtual experiential programming.

Angiographic Patency of Coronary Artery Bypass Conduits: An Updated Network Meta-Analysis of Randomized Trials.

Introduction: The second best conduit for coronary artery bypass grafting is uncertain. The objective of this study is to determine the second best conduit according to graft patency results from randomized controlled trials using a network meta-analysis.

Methods: A systematic literature search was conducted for randomized controlled trials comparing the angiographic patency rate of the no-touch saphenous vein (NT-SV), the radial artery (RA), the right internal thoracic artery (RITA), and the gastroepiploic artery (GEA) in reference to the conventionally harvested saphenous vein (CON-SV).

Sweet victory: Optimizing glycemic control after coronary artery bypass grafting.

Poor glycemic control, regardless of patients' diabetic status, is associated with worse outcomes after coronary artery bypass grafting. As a result, in the perioperative and postoperative setting, the use of insulin is recommended to maintain glucose levels below 180 mg/dl (10.0 mmol/L).

Impact of the COVID-19 Pandemic on Non-COVID-19 Clinical Trials.

Randomized controlled trials (RCT) were impacted by the COVID-19 pandemic, but no systematic analysis has evaluated the overall impact of COVID-19 on non-COVID-19-related RCTs. The ClinicalTrials.gov database was queried in February 2020.

Coronary artery bypass with single versus multiple arterial grafts in women: A meta-analysis.

Objective: The study objective was to investigate the impact of multiple arterial grafting on long-term all-cause mortality in women undergoing isolated coronary artery bypass grafting.

Methods: A comprehensive search was performed to identify observational studies reporting outcomes after coronary artery bypass grafting reported by sex and stratified into multiple arterial grafting versus single arterial grafting strategies. Articles were considered for inclusion if they were written in English and were propensity-matched observational studies.

Optimizing resource utilization during proficiency-based training of suturing skills in medical students: a randomized controlled trial of faculty-led, peer tutor-led, and holography-augmented methods of teaching.

Background: Suturing is a fundamental skill in undergraduate medical education. It can be taught by faculty-led, peer tutor-led, and holography-augmented methods; however, the most educationally effective and cost-efficient method for proficiency-based teaching of suturing is yet to be determined.

Methods: We conducted a randomized controlled trial comparing faculty-led, peer tutor-led, and holography-augmented proficiency-based suturing training in pre-clerkship medical students.

Machine learning methods for automated technical skills assessment with instructional feedback in ultrasound-guided interventions.

Objective: Currently, there is a worldwide shift toward competency-based medical education. This necessitates the use of automated skills assessment methods during self-guided interventions training. Making assessment methods that are transparent and configurable will allow assessment to be interpreted into instructional feedback.