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Commentary on "preoperative cardiology consultations for geriatric patients with hip fractures rarely provide additional recommendations and are associated with prolonged hospital stays and delayed surgery: a retrospective case control study".
Eur J Trauma Emerg Surg
January 2025
Department of Internal Medicine, DOW University of Health Sciences, Karachi, Pakistan.
This letter discusses the recent study by Vahabi et al., which examined the role of preoperative cardiology consultations in geriatric patients undergoing hip fracture surgery. While the study highlights the limited impact of these consultations on treatment modifications and the associated delays in surgical intervention, this letter suggests areas for further exploration.
View Article and Find Full Text PDFDirected Acyclic Graphs in Decision-Analytic Modeling: Bridging Causal Inference and Effective Model Design in Medical Decision Making.
Med Decis Making
January 2025
Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
Our commentary proposes the application of directed acyclic graphs (DAGs) in the design of decision-analytic models, offering researchers a valuable and structured tool to enhance transparency and accuracy by bridging the gap between causal inference and model design in medical decision making.The practical examples in this article showcase the transformative effect DAGs can have on model structure, parameter selection, and the resulting conclusions on effectiveness and cost-effectiveness.This methodological article invites a broader conversation on decision-modeling choices grounded in causal assumptions.
View Article and Find Full Text PDFMatters arising: cost-utility and cost-effectiveness analysis of disease-modifying drugs of relapsing-remitting multiple sclerosis: a systematic review.
Health Econ Rev
January 2025
Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Bari, Italy.
Background: In their interesting systematic review, Gallehzan et al. quoted our article Cost-utility analysis of teriflunomide in naïve vs. previously treated patients with relapsing-remitting multiple sclerosis (RRMS) in Italy.
View Article and Find Full Text PDFMentoring for the Diverse Range of Family Physicians' Engagement in Research.
J Am Board Fam Med
December 2024
From the Department of Family Medicine, University of Colorado School of Medicine, Aurora, Colorado (MLM); Department of Family Medicine, Indiana University School of Medicine, Indianapolis, IN (MS); Department of Family and Community Medicine, University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND (DFS); Department of Family and Community Medicine, McGovern Medical School, University of Texas Houston, Houston, TX (NJR).
Primary care researchers are increasingly at the forefront of developing innovations and new research methods to address complex issues in health care, including multi-morbidity, social determinants of health, health equity, managing population health in clinical practice, patient satisfaction, and provider burnout. Research demonstrates that "primary care is the only health care component where an increased supply is associated with better population health and more equitable outcomes." As a primary care specialty, family medicine has evolved beyond its initial focus on clinical practice and education to realizing the imperative for the discipline to robustly engage in research and embrace the responsibility to generate the evidence that drives changes in primary care practice and policy.
View Article and Find Full Text PDFExploring opposing arguments in the call for randomized controlled trials to demonstrate benefit of Mohs micrographic surgery for cutaneous melanoma.
Dermatol Online J
October 2024
Department of Dermatology, Mayo Clinic, Rochester, Minnesota, USA Division of Dermatologic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
Article Synopsis
- The lack of robust randomized clinical trials (RCTs) comparing Mohs micrographic surgery (MMS) to wide local excision for melanoma treatment is hindering the establishment of clinical guidelines, despite evidence that supports MMS's benefits.
- There is ongoing debate about the necessity of RCTs in dermatologic surgery, with some arguing that the existing retrospective studies and meta-analyses already provide sufficient evidence for MMS's efficacy and cost-effectiveness.
- The absence of clear guidelines has led to confusion among healthcare providers and disparities in access to melanoma treatments across different specialties.
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