Background: Primary care providers (PCPs) frequently address dermatologic concerns and perform skin examinations during clinical encounters. For PCPs who evaluate concerning skin lesions, dermoscopy (a noninvasive skin visualization technique) has been shown to increase the sensitivity for skin cancer diagnosis compared with unassisted clinical examinations. Because no formal consensus existed on the fundamental knowledge and skills that PCPs should have with respect to dermoscopy for skin cancer detection, the objective of this study was to develop an expert consensus statement on proficiency standards for PCPs learning or using dermoscopy.
Methods: A 2-phase modified Delphi method was used to develop 2 proficiency standards. In the study's first phase, a focus group of PCPs and dermatologists generated a list of dermoscopic diagnoses and associated features. In the second phase, a larger panel evaluated the proposed list and determined whether each diagnosis was reflective of a foundational or intermediate proficiency or neither.
Results: Of the 35 initial panelists, 5 PCPs were lost to follow-up or withdrew; 30 completed the fifth and last round. The final consensus-based list contained 39 dermoscopic diagnoses and associated features.
Conclusions: This consensus statement will inform the development of PCP-targeted dermoscopy training initiatives designed to support early cancer detection.
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http://dx.doi.org/10.3122/jabfm.2022.220143R1 | DOI Listing |
J Natl Compr Canc Netw
December 2024
27University of Pittsburgh School of Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA.
Trends in diagnostic biopsy sample collection approaches for primary bone sarcomas have shifted in the past 2 decades. Although open/incisional biopsies used to be the predominant approach to obtain diagnostic material for Ewing sarcoma and osteosarcoma, image-guided core needle biopsies have increased in frequency and are safe for patients. These procedures are less invasive and reduce recovery times but have potential limitations.
View Article and Find Full Text PDFJ Pediatr Gastroenterol Nutr
December 2024
Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
As rates of obesity rise worldwide, incidence of metabolic dysfunction-associated steatotic liver disease (MASLD), formerly referred to as nonalcoholic fatty liver disease, is increasing, worsening the burden of healthcare systems. The council of the Federation of International Societies for Pediatric Gastroenterology, Hepatology, and Nutrition (FISPGHAN) identified the topic of MASLD epidemiology, treatment, and prevention as a global priority issue to be addressed by an expert team, with the goal to describe feasible and evidence-based actions that may contribute to reducing MASLD risk. The FISPGHAN member societies nominated experts in the field.
View Article and Find Full Text PDFFront Endocrinol (Lausanne)
December 2024
The Fertility Clinic, Skive Regional Hospital, Skive, Department of Clinical Medicine, Aarhus University, Skive, Denmark.
Background: In a global effort to assess expert perspectives on the use of recombinant gonadotropins, recombinant human luteinizing hormone (r-hLH) and recombinant human follicle-stimulating hormone (r-hFSH), a consensus meeting was held in Dubai. The key aim was to address three critical questions: What are the factors that influence follicle response to gonadotropins? Which categories of patients are most likely to benefit from LH supplementation? And what are the optimal management strategies for these patients?
Methods: A panel of thirty-six experts reviewed and refined the initial statements and references proposed by the Scientific Coordinator. Consensus was defined as agreement or disagreement by more than two-thirds (66%) of the panel members for each statement.
BMJ Paediatr Open
December 2024
Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, California, USA.
Background: To minimise the referral gap to pain psychology, the purpose of this study was to describe clinician-perceived patient suitability for pain psychology referral, develop a referral plan and outline essential elements of a referral conversation via a modified Delphi approach with multidisciplinary paediatric pain providers.
Methods: We employed a three-round modified Delphi approach consulting multidisciplinary paediatric pain providers (n=18) including physicians, psychologists, physical therapists, occupational therapists and nurse practitioners (PT, OT, NP). Based on the responses to an online survey (Round 1), initial statements regarding the pain psychology referral process were developed.
BMJ Open
December 2024
Teaching and Research Section of Clinical Nursing, Xiangya Hospital Central South University, Changsha, Hunan, China.
Introduction: Opioid-induced constipation (OIC) affects up to 90% of patients with cancer receiving long-term opioid-related analgesic therapy, resulting in various potential complications, compromised pain management and decreased quality of life. Laxatives stimulate or facilitate bowel evacuation. Traditional laxatives, such as polyethylene glycol and lactulose, are widely used because of their low cost, easy accessibility and tolerability.
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