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Article ; Online: Building Decision Analysis Tools Through Systematic Review of the Literature: The Importance of Study Quality.

Moloo, Husein / Musselman, Reilly

2019 Volume 62, Issue 1, Page(s) 1–2

MeSH term(s)	Adenomatous Polyposis Coli ; Anastomosis, Surgical ; Data Accuracy ; Decision Support Techniques ; Humans ; Proctocolectomy, Restorative
Language	English
Publishing date	2019-02-04
Publishing country	United States
Document type	Editorial ; Comment
ZDB-ID	212581-x
ISSN	1530-0358 ; 0012-3706
ISSN (online)	1530-0358
ISSN	0012-3706
DOI	10.1097/DCR.0000000000001185
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Article ; Online: Video-based interviewing in medicine: a scoping review.

Selvam, Rajajee / Hu, Richard / Musselman, Reilly / Raiche, Isabelle / McIsaac, Daniel I / Moloo, Husein

Systematic reviews

2022 Volume 11, Issue 1, Page(s) 94

Abstract: Background: The Coronavirus 2019 pandemic necessitated a rapid uptake of video-based interviewing within the personnel selection process in healthcare. While video-based interviews have been evaluated previously, we identified a gap in the literature on ...

Abstract	Background: The Coronavirus 2019 pandemic necessitated a rapid uptake of video-based interviewing within the personnel selection process in healthcare. While video-based interviews have been evaluated previously, we identified a gap in the literature on the implementation of video-based interviews and how they compare to their face-to-face counterparts. Methods: A scoping review was conducted to consolidate the available literature on the benefits and limitations of video-based interviews and to understand the perceived barriers associated with transitioning away from face-to-face interviews. A search strategy, developed in concert with an academic health sciences librarian, was run on Ovid MEDLINE, Embase, PsycInfo, and Cochrane Central. The search was performed on March 31, 2020, and updated on February 21, 2021. Studies that implemented and evaluated the impact of video-based interviewing in healthcare were included in our study. Review articles and editorials were excluded. Results: Forty-three studies were included in our scoping review, of which 17 were conference abstracts and 26 were peer-reviewed manuscripts. The risk of bias was moderate or high in most studies, with only four studies having a low risk of bias. Both financial costs and opportunity costs associated with the selection process were reported to be improved with video-based interviewing, while no studies explored the impact on environmental costs. Technical limitations, which were not prevalent, were easily managed during the interview process. Overall, video-based interviews were well received by both applicants and interviewers, although most participants still reported a preference for face-to-face interviews. Conclusions: While video-based interviewing has become necessary during the Coronavirus 2019 era, there are benefits from a financial, opportunistic, and environmental point of view that argue for its continued use even after the pandemic. Despite its successful implementation with minimal technical issues, a preference still remains for face-to-face interviews. Reasons for this preference are not clear from the available literature. Future studies on the role of nonverbal communication during the video-based interview process are important to better understand how video-based interviewing can be optimized. Systematic review registration: This scoping review was registered with Open Science Framework.
MeSH term(s)	Coronavirus Infections ; Humans ; Medicine ; Pandemics
Language	English
Publishing date	2022-05-16
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2662257-9
ISSN	2046-4053 ; 2046-4053
ISSN (online)	2046-4053
ISSN	2046-4053
DOI	10.1186/s13643-022-01959-8
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Article ; Online: Comparison of non-operative versus operative management of resectable colorectal cancer in elderly patients: study protocol for a systematic review.

Hu, Richard / Selvam, Rajajee / Moloo, Husein / Williams, Lara / Raiche, Isabelle / Musselman, Reilly

Systematic reviews

2022 Volume 11, Issue 1, Page(s) 77

Abstract: Background: In the 2021 Statistics Canada census, 18.5% of the Canadian population were senior (65 years and older), among those 1.7 million (4.5%) were aged 80 years and older. Colorectal cancer (CRC) is the third most common cancer in both men and ... ...

Abstract	Background: In the 2021 Statistics Canada census, 18.5% of the Canadian population were senior (65 years and older), among those 1.7 million (4.5%) were aged 80 years and older. Colorectal cancer (CRC) is the third most common cancer in both men and women, with its highest incidence rate in septu- and octogenarians. As clinicians encounter a growing number of very elderly patients (80 years and older) with resectable colorectal cancer, justifying major surgery in a comorbid population with limited life expectancy is difficult. Therefore, this study aims to systemically review the available literature to compare non-operative management to surgical resection with respect to overall survival and quality of life. Method: We designed and registered a study protocol for a systematic review. We will include all patients above the age of 80 with resectable colorectal cancer. We will search MEDLINE, EMBASE, and the Cochrane Database of Controlled Trials from January 2000 onwards. We will include randomized, non-randomized controlled trials and observational studies comparing non-operative versus operative management of resectable colorectal cancer in elderly patients. The primary outcomes will be overall survival and mortality. Secondary outcomes will include quality of life, and health services/ resources utilization (e.g., treatments, change of level of care…). Two reviewers will independently screen all citations, full-text articles, and abstract data. Potential conflicts will be resolved through discussion. The study methodological quality (or bias) will be appraised using the ROB-2 and ROBIN-I tools. If feasible, we will conduct random effects meta-analysis. Additional analyses will be conducted to explore the potential sources of heterogeneity (e.g., study design and methodological quality). Discussion: This systematic review will synthesize the existing data on the management of colorectal cancer in the very elderly patients, and identify the gap in the literature for potential future research. More specifically, we aim to streamline non-operative outcome data on resectable colorectal cancers to aid clinicians' decision-making with respect to survival outcomes and quality of life. The results of this study will be of interest to multiple audiences including patients, their families, caregivers, healthcare professionals, and policy makers. Results will be published in a peer-reviewed journal.
MeSH term(s)	Aged ; Aged, 80 and over ; Canada/epidemiology ; Colorectal Neoplasms/surgery ; Comorbidity ; Female ; Humans ; Male ; Meta-Analysis as Topic ; Quality of Life ; Research Design ; Systematic Reviews as Topic
Language	English
Publishing date	2022-04-25
Publishing country	England
Document type	Journal Article
ZDB-ID	2662257-9
ISSN	2046-4053 ; 2046-4053
ISSN (online)	2046-4053
ISSN	2046-4053
DOI	10.1186/s13643-022-01949-w
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Article ; Online: Leveraging financial incentives and behavioural economics to engage physicians in achieving quality-improvement process measures.

Moloo, Husein / Lamb, Tyler / Sundaresan, Sudhir / Thavorn, Kednapa / Walsh, Caolan / Musselman, Reilly / Forster, Alan

Canadian journal of surgery. Journal canadien de chirurgie

2022 Volume 65, Issue 2, Page(s) E290–E295

Abstract: Background: Dedicated quality-improvement (QI) initiatives within health care systems are of clear benefit, and physicians respond to financial incentivization. The Canadian health care system often lacks this lever, and many financially incentivized QI ...

Abstract	Background: Dedicated quality-improvement (QI) initiatives within health care systems are of clear benefit, and physicians respond to financial incentivization. The Canadian health care system often lacks this lever, and many financially incentivized QI programs rely on traditional economic principles. We describe our evaluation of financial incentivization for the implementation of QI process metrics in a department of surgery at a Canadian academic hospital system and its impact over a 4-year period. Methods: Quality-improvement processes informed by extant QI incentivization literature and guided by the principles of behavioural economics were implemented within our institution's Department of Surgery. Disbursement of supplemental government funding was modified to be contingent on the ability of divisions within the department to meet predefined QI metrics, including regular multidisciplinary meetings, morbidity and mortality rounds with documented feedback of systemic issues to division members, reviews of adverse events, and implementation of annual patient experience projects. We evaluated the effect of the QI processes from 2015/16 to 2018/19. Results: There was a significant increase in the number of divisions that satisfied all the QI metrics over the study period, from 2 (28%) in 2015/16, to 5 (71%) in 2016/17, to 7 (100.0%) in 2017/18 and 2018/19 ( Conclusion: Incentivizing QI activities in the Canadian health care system is possible and led to improvement in QI processes as a whole in our department. This paper lays out a method of financial reimbursement to facilitate engagement of physicians and establishment of a foundation of important QI processes and measures within a department.
MeSH term(s)	Canada ; Economics, Behavioral ; Humans ; Motivation ; Physicians ; Process Assessment, Health Care
Language	English
Publishing date	2022-04-27
Publishing country	Canada
Document type	Journal Article
ZDB-ID	410651-9
ISSN	1488-2310 ; 0008-428X
ISSN (online)	1488-2310
ISSN	0008-428X
DOI	10.1503/cjs.017320
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Article ; Online: Video-based interviewing in medicine: protocol for a scoping review.

Selvam, Rajajee / Hu, Richard / Musselman, Reilly / Raiche, Isabelle / Moloo, Husein

Systematic reviews

2020 Volume 9, Issue 1, Page(s) 219

Abstract: Background: Careers in healthcare involve an extensive interview process as transitions are made from one level of training to the next. For physicians, interviews mark the gateway from entrance into medical school, acceptance into residency, ... ...

Abstract	Background: Careers in healthcare involve an extensive interview process as transitions are made from one level of training to the next. For physicians, interviews mark the gateway from entrance into medical school, acceptance into residency, fellowships, and subsequent job opportunities. Previous literature outlining the costs associated with face-to-face interviews and concerns regarding the climate crisis has triggered an interest in video-based interviews. Barriers to transitioning away from in-person interviews include concerns regarding lack of rapport between applicants and interviewers, and applicants being less able to represent themselves. In a new era ushered in by COVID where many of us have utilized virtual meetings more than any prior time both personally and for work, we wanted to consolidate the current literature on the use of video-based interviews in healthcare and summarize the findings. Methods: A scoping review will be conducted to explore the benefits and limitations of video-based interviews for both applicants and interviewers within healthcare fields, as well as the perceived barriers associated with transitioning away from face-to-face interviews. The scoping review methodology outlined by Arksey and O'Malley will be implemented. The search strategy developed by the authors in collaboration with an academic health sciences librarian will be conducted across four electronic databases (Embase, MEDLINE, Cochrane Central, and PsycInfo) and supplemented by a review of the grey literature and reference lists of included studies. The study selection process will be documented using the PRISMA flow diagram, and reasons for exclusion following full-text review will be recorded. The extracted data will be analyzed using quantitative and qualitative analysis. Discussion: Despite previous literature on the costs associated with face-to-face interviews, there has been hesitancy with transitioning to video-based interviews due to concerns of lack of rapport between applicants and interviewers, and applicants being less able to represent themselves. While these limitations have been explored in previous studies, a succinct review of the current literature to guide the effective restructuring of the interview process is lacking. With our scoping review, we hope to fill this gap in the literature to better understand barriers to transitioning from face-to-face interviews and directions for future research.
MeSH term(s)	COVID-19 ; Humans ; Internship and Residency ; Medicine ; Physicians ; Review Literature as Topic ; SARS-CoV-2 ; Systematic Reviews as Topic
Keywords	covid19
Language	English
Publishing date	2020-09-25
Publishing country	England
Document type	Journal Article
ZDB-ID	2662257-9
ISSN	2046-4053 ; 2046-4053
ISSN (online)	2046-4053
ISSN	2046-4053
DOI	10.1186/s13643-020-01484-6
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Book ; Online: Sampling procedure for lake or stream surface water chemistry

Musselman, Robert

(Research note RMRS ; RN-49)

2012

Institution	Rocky Mountain Research Station (Fort Collins, Colo.),
Author's details	Robert Musselman
Series title	Research note RMRS ; RN-49
Keywords	Water/Sampling/Methodology ; Water/Analysis/Methodology ; Groundwater/Sampling ; Groundwater/Sampling. ; Water/Analysis/Methodology. ; Water/Sampling/Methodology.
Language	English
Size	1 online resource (11 pages) :, color illustrations.
Document type	Book ; Online
Note	Title from caption (viewed May 18, 2016). ; "May 2012."
Database	NAL-Catalogue (AGRICOLA)

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Article: A Mobile App for Wound and Symptom Surveillance After Colorectal Surgery: Protocol for a Feasibility Randomized Controlled Trial.

Valk, Heather Anne / Garcia-Ochoa, Carlos / Fontaine Calder, Jessica / Miller, Toba / Rashidi, Babak / McIsaac, Corrine / Musselman, Reilly

JMIR research protocols

2022 Volume 11, Issue 1, Page(s) e26717

Abstract: Background: Surgical site infections (SSIs) are the most common nosocomial infection and occur in 16.3% of patients undergoing colorectal surgery at our institution (The Ottawa Hospital), the majority of which are identified after discharge from ... ...

Abstract	Background: Surgical site infections (SSIs) are the most common nosocomial infection and occur in 16.3% of patients undergoing colorectal surgery at our institution (The Ottawa Hospital), the majority of which are identified after discharge from hospital. Patients who suspect having an SSI generally present to the emergency department or surgery clinic. Both options for in-person interaction are costly to the health care system and patients. A mobile app, how2trak, has proven to be beneficial for patients with complex wounds at our institution by facilitating at-home monitoring and virtual consultations. Objective: This study aims to assess the feasibility of a randomized controlled trial to assess if how2trak can improve patients' experience and increase detection of SSIs after colorectal surgery while reducing patients' risk of COVID-19 exposure. Methods: In this single-center prospective feasibility trial, eligible patients undergoing colorectal surgery will be randomized to either standard care or how2trak postoperative monitoring of their incision, symptoms, and ostomy function. Patient self-assessments will be monitored by a nurse specialized in wound and ostomy care who will follow-up with patients with a suspected SSI. The primary outcome is feasibility as measured by enrollment, randomization, app usability, data extraction, and resource capacity. Results: This study was approved by our institution's ethics board on February 26, 2021, and received support from The Ottawa Hospital Innovation and Care Funding on November 12, 2021. Recruitment started June 3, 2021, and 29 were patients enrolled as of September 2021. We expect to publish results in spring 2022. Conclusions: This study will determine the feasibility of using a mobile app to monitor patients' wounds and detect SSIs after colorectal surgery. If feasible, we plan to assess if this mobile app facilitates SSI detection, enhances patient experience, and optimizes their care. Trial registration: ClinicalTrials.gov NCT04869774; https://clinicaltrials.gov/ct2/show/NCT04869774. International registered report identifier (irrid): DERR1-10.2196/26717.
Language	English
Publishing date	2022-01-14
Publishing country	Canada
Document type	Journal Article
ZDB-ID	2719222-2
ISSN	1929-0748
ISSN	1929-0748
DOI	10.2196/26717
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Article ; Online: Derivation and external validation of a 30-day mortality risk prediction model for older patients having emergency general surgery.

Feng, Simon / van Walraven, Carl / Lalu, Manoj M / Moloo, Husein / Musselman, Reilly / McIsaac, Daniel I

British journal of anaesthesia

2022 Volume 129, Issue 1, Page(s) 33–40

Abstract: Background: Older people (≥65 yr) are at increased risk of morbidity and mortality after emergency general surgery. Risk prediction models are needed to guide decision making in this high-risk population. Existing models have substantial limitations and ...

Abstract	Background: Older people (≥65 yr) are at increased risk of morbidity and mortality after emergency general surgery. Risk prediction models are needed to guide decision making in this high-risk population. Existing models have substantial limitations and lack external validation, potentially limiting their applicability in clinical use. We aimed to derive and validate, both internally and externally, a multivariable model to predict 30-day mortality risk in older patients undergoing emergency general surgery. Methods: After protocol publication, we used the National Surgical Quality Improvement Program (NSQIP) database (2012-6; estimated to contain 90% data from the USA and 10% from Canada) to derive and internally validate a model to predict 30-day mortality for older people having emergency general surgery using logistic regression with elastic net regularisation. Internal validation was done with 10-fold cross-validation. External validation was done using a temporally separate health administrative database exclusively from Ontario, Canada. Results: Overall, 6012 (12.0%) of the 50 221 patients died within 30 days. The model demonstrated strong discrimination (area under the curve [AUC]=0.871) and calibration across the spectrum of observed and predicted risks. Ten-fold internal cross-validation demonstrated minimal optimism (AUC=0.851, optimism 0.019 [standard deviation=0.06]) with excellent calibration. External validation demonstrated lower discrimination (AUC=0.700) and degraded calibration. Conclusion: A multivariable mortality risk prediction model was strongly discriminative and well calibrated internally. However, poor external validation suggests the model may not be generalisable to non-NSQIP data and hospitals. The findings highlight the importance of external validation before clinical application of risk models.
MeSH term(s)	Aged ; Area Under Curve ; Humans ; Logistic Models ; Ontario ; Risk Assessment/methods ; Risk Factors
Language	English
Publishing date	2022-05-18
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	80074-0
ISSN	1471-6771 ; 0007-0912
ISSN (online)	1471-6771
ISSN	0007-0912
DOI	10.1016/j.bja.2022.04.007
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Article ; Online: The Surgical Site Infection Risk Score (SSIRS): A Model to Predict the Risk of Surgical Site Infections.

van Walraven, Carl / Musselman, Reilly

PloS one

2013 Volume 8, Issue 6, Page(s) e67167

Abstract: Background: Surgical site infections (SSI) are an important cause of peri-surgical morbidity with risks that vary extensively between patients and surgeries. Quantifying SSI risk would help identify candidates most likely to benefit from interventions ... ...

Abstract	Background: Surgical site infections (SSI) are an important cause of peri-surgical morbidity with risks that vary extensively between patients and surgeries. Quantifying SSI risk would help identify candidates most likely to benefit from interventions to decrease the risk of SSI. Methods: We randomly divided all surgeries recorded in the National Surgical Quality Improvement Program from 2010 into a derivation and validation population. We used multivariate logistic regression to determine the independent association of patient and surgical covariates with the risk of any SSI (including superficial, deep, and organ space SSI) within 30 days of surgery. To capture factors particular to specific surgeries, we developed a surgical risk score specific to all surgeries having a common first 3 numbers of their CPT code. Results: Derivation (n = 181 894) and validation (n = 181 146) patients were similar for all demographics, past medical history, and surgical factors. Overall SSI risk was 3.9%. The SSI Risk Score (SSIRS) found that risk increased with patient factors (smoking, increased body mass index), certain comorbidities (peripheral vascular disease, metastatic cancer, chronic steroid use, recent sepsis), and operative characteristics (surgical urgency; increased ASA class; longer operation duration; infected wounds; general anaesthesia; performance of more than one procedure; and CPT score). In the validation population, the SSIRS had good discrimination (c-statistic 0.800, 95% CI 0.795-0.805) and calibration. Conclusion: SSIRS can be calculated using patient and surgery information to estimate individual risk of SSI for a broad range of surgery types.
MeSH term(s)	Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Models, Biological ; Multivariate Analysis ; Quality Improvement ; Random Allocation ; Risk Assessment ; Surgical Wound Infection/diagnosis ; Time Factors ; United States
Language	English
Publishing date	2013-06-27
Publishing country	United States
Document type	Journal Article
ISSN	1932-6203
ISSN (online)	1932-6203
DOI	10.1371/journal.pone.0067167
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Article ; Online: Ready to Go Home? Patients' Experiences of the Discharge Process in an Enhanced Recovery After Surgery (ERAS) Program for Colorectal Surgery.

Jones, D / Musselman, R / Pearsall, E / McKenzie, M / Huang, H / McLeod, Robin S

Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract

2017 Volume 21, Issue 11, Page(s) 1865–1878

Abstract: Background: With the adoption of enhanced recovery after surgery (ERAS) programs, patients are being discharged earlier and require more post-discharge teaching, educational materials, and information.: Objective: The purpose of this study is to ... ...

Abstract	Background: With the adoption of enhanced recovery after surgery (ERAS) programs, patients are being discharged earlier and require more post-discharge teaching, educational materials, and information. Objective: The purpose of this study is to assess satisfaction, discharge needs, and follow-up concerns of patients within an ERAS implementation program (iERAS). Methods: Between 2012 and 2015, the iERAS program was undertaken at an academic hospital where 554 patients having elective colorectal surgery were enrolled. After discharge, patients were sent a survey containing multiple choice questions, preference ranking, and open-ended questions. Free-text responses were analyzed through a thematic approach. Results: Overall, 496 patients were mailed surveys and 219 (44.2%) completed the survey. Ninety-three percent were satisfied with the discharge information, and 90% felt they were ready for discharge. Eighty-six percent of patients saw their surgeon at 6 weeks, and 88% were satisfied with this follow-up plan. Some patients felt they had inadequate post-operative information, including how to resolve complications while at home and lack of reliable information for common post-operative occurrences. Patients with ostomies wanted more information about what to expect post-discharge and what symptoms were normal. Support from the homecare team and having a surgical nurse available were considered to be essential. Conclusions: Improved post-operative education for surgical patients prior to discharge within iERAS is required to facilitate patient-centered discharge planning. Such interventions may help decrease unplanned hospital visits during the immediate post-discharge period.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Colon/surgery ; Digestive System Surgical Procedures ; Elective Surgical Procedures ; Female ; Humans ; Male ; Middle Aged ; Patient Discharge/standards ; Patient Discharge Summaries ; Patient Education as Topic ; Patient Satisfaction ; Rectum/surgery ; Surveys and Questionnaires ; Young Adult
Language	English
Publishing date	2017-09-20
Publishing country	United States
Document type	Journal Article
ZDB-ID	2012365-6
ISSN	1873-4626 ; 1934-3213 ; 1091-255X
ISSN (online)	1873-4626 ; 1934-3213
ISSN	1091-255X
DOI	10.1007/s11605-017-3573-0
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