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Article: The Golden Patient Initiative: A Systematic Review.

Khan, Saad / Azam, Bassil / Elbayouk, Abdulrahman / Qureshi, Alham / Qureshi, Mobeen / Ali, Adam / Hadi, Saif / Halim, Usman Ali

Cureus

2023 Volume 15, Issue 5, Page(s) e39685

Abstract: Operating theatres and surgical resource consumption comprise a significant proportion of healthcare costs. Inefficiencies in theatre lists remain an important focus for cost management, along with reducing patient morbidity and mortality. With the ... ...

Abstract	Operating theatres and surgical resource consumption comprise a significant proportion of healthcare costs. Inefficiencies in theatre lists remain an important focus for cost management, along with reducing patient morbidity and mortality. With the emergence of the coronavirus disease 2019 (COVID-19) pandemic, the number of patients on theatre waiting lists has surged. Hence, there is a pressing need to utilise the already limited theatre time and fraught resources with innovative methods. In this systematic review, we discuss the Golden Patient Initiative (GPI), in which the first patient on the operating list is pre-assessed the day prior to surgery, and we aim to assess its impact and overall efficacy. A literature search using the following four databases was conducted to identify and select all clinical research concerning the GPI: Medical Literature Analysis and Retrieval System Online (MEDLINE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Excerpta Medica Database (EMBASE), and the Cochrane library. Two independent authors screened articles against the eligibility criteria, using a process adapted from the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Data extracted included outcomes measured, follow-up period, and study design. The results showed significant heterogeneity, and hence a narrative review was conducted; 13 of the 73 eligible articles were included for analysis. Outcomes included delay in theatre start time, number of surgical case cancellations, and changes to total case numbers. Across the studies, a 19-30-minute improvement in theatre start time was reported (p<0.05), as well as a statistically significant decrease in case cancellations. Our analysis provides encouraging conclusions with regard to greater theatre efficiency following the application of GPI, a low-cost solution that can easily be implemented to help improve patient safety and lead to cost savings. However, at present, it is largely implemented among local trusts, and hence larger multi-centre studies are required to gather conclusive evidence about the efficacy of the initiative.
Language	English
Publishing date	2023-05-30
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.39685
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Orthopaedics and the gender pay gap: A systematic review.

Halim, Usman A / Qureshi, Alham / Dayaji, Sa'ad / Ahmad, Shoaib / Qureshi, Mobeen K / Hadi, Saif / Younis, Fizan

The surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and Ireland

2023 Volume 21, Issue 5, Page(s) 301–307

Abstract: Aims: Gender pay gaps are present in a wide range of industries, with the medical profession being no exception. The aim of this systematic review was to analyse the peer-reviewed literature to identify whether there is a gender pay gap in orthopaedics.! ...

Abstract	Aims: Gender pay gaps are present in a wide range of industries, with the medical profession being no exception. The aim of this systematic review was to analyse the peer-reviewed literature to identify whether there is a gender pay gap in orthopaedics. Methods: A systematic review was conducted by searching the following databases: MEDLINE, Health & Medical Collection, Nursing & Allied Health Database, Publicly Available Content Database, Consumer Health Database and Healthcare Administration Database. Original research papers pertaining to the earnings of male and female orthopaedic surgeons were included for review. Results: Of 745 papers acquired through the database search, 12 were eligible for inclusion. These were published in the USA, Canada and Taiwan. 6 looked at the relationship between sex and annual income, 4 studied industry payments, one analysed hourly earnings and one compared payments per case between males and females. Men were found to earn significantly higher annual incomes than women, even when confounding factors such as rank, practice setting and subspeciality were accounted for. Men also receive significantly higher payments from industry, and earn more per hour than women. Conclusion: This systematic review has demonstrated that there is a gender pay gap in orthopaedics, with women commonly earning significantly less than their male colleagues. The reasons for this, however, remain unclear, and deserve further investigation. It is incumbent upon orthopaedic departments, healthcare providers and orthopaedic associations to raise awareness and ensure that men and women are paid the same for equal work.
MeSH term(s)	Humans ; Male ; Female ; Orthopedics ; Salaries and Fringe Benefits ; Orthopedic Procedures ; Canada
Language	English
Publishing date	2023-03-12
Publishing country	Scotland
Document type	Systematic Review ; Journal Article ; Review
ZDB-ID	2102927-1
ISSN	1479-666X
ISSN	1479-666X
DOI	10.1016/j.surge.2023.02.003
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Article: Correction: Limb Salvage Versus Amputation: A Review of the Current Evidence.

Qureshi, Mobeen K / Ghaffar, Ali / Tak, Sameem / Khaled, Ahmad

Cureus

2020 Volume 12, Issue 10, Page(s) c38

Abstract: This corrects the article DOI: 10.7759/cureus.10092.]. ...

Abstract	[This corrects the article DOI: 10.7759/cureus.10092.].
Language	English
Publishing date	2020-10-07
Publishing country	United States
Document type	Published Erratum
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.c38
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Article: Limb Salvage Versus Amputation: A Review of the Current Evidence.

Qureshi, Mobeen K / Ghaffar, Ali / Tak, Sameem / Khaled, Ahmad

Cureus

2020 Volume 12, Issue 8, Page(s) e10092

Abstract: In the trauma situation where the trauma team is faced with a severely injured limb, it requires judicious thinking and evaluating not only the injury in isolation but the patient as a whole when considering the management options. The aim must be to ... ...

Abstract	In the trauma situation where the trauma team is faced with a severely injured limb, it requires judicious thinking and evaluating not only the injury in isolation but the patient as a whole when considering the management options. The aim must be to give the best quality of life and avoid repeated admissions to hospital for associated complications in the future. The decision to amputate or salvage a limb should be based on numerous factors, such as the patient's pre-injury status, injury factors (soft tissue injury, location, contamination and physiological status), patient's wish and available resources. The biggest challenge when faced with a complex limb injury is deciding what management route to take with a satisfactory outcome for the patient being the main goal. Many studies have been undertaken looking at the outcome of successful limb salvage versus primary amputation. Studies such as the Learning Early About Peanut Allergy (LEAP) study have concluded that there was no difference of outcome at the two-year stage between the two strategies.
Language	English
Publishing date	2020-08-28
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.10092
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Adolescent Tillaux Fractures: A Systematic Review of the Literature.

Tak, Sameem / Qureshi, Mobeen K / Ackland, James A / Arshad, Rizwan / Salim, Javed

Cureus

2021 Volume 13, Issue 1, Page(s) e12860

Abstract: The Tillaux fracture is an uncommon injury to the anterolateral distal tibial epiphysis. It occurs during a distinct time period when adolescent patients are transitioning to skeletal maturity. Owing to its rarity, the optimal management strategy for ... ...

Abstract	The Tillaux fracture is an uncommon injury to the anterolateral distal tibial epiphysis. It occurs during a distinct time period when adolescent patients are transitioning to skeletal maturity. Owing to its rarity, the optimal management strategy for this fracture is not well-described. The aim of this review was to assess the outcomes of operatively and nonoperatively managed displaced adolescent Tillaux fractures. We analysed articles from The Cochrane Library, PubMed, MEDLINE, and EMBASE databases that met our predetermined inclusion and exclusion criteria according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statements. A descriptive data analysis was performed. A total of 461 articles were identified from the data search, of which 13 articles were included for full-text analysis. Five of these studies reported recognised patient outcome measures and the remaining eight reported on radiographic follow-up. The reported studies included a total of 114 patients with Tillaux fractures; 58.8% of patients were female and 34.2% were male. Mean ages ranged from 12.5 to 15 years, with the youngest patient being 12 years old and the oldest 17 years old. Overall mean follow-up was 42.8 months. Of the patients, 40.4% were treated with open reduction internal fixation (ORIF), 14.9% with closed reduction internal fixation (CRIF), and 1.8% arthroscopically. The remainder were treated nonoperatively. Outcome measures were excellent for all patients irrespective of operative management choice. Follow-up radiographic deformity was only evident in Tillaux fractures that were managed nonoperatively; deformity included poor joint congruity, angular deformity, and tibial shortening. These nonoperative patients have a residual fracture displacement of 2 mm. There were no reported instances of premature physeal closure for any patient. This review shows that excellent patient outcomes have been reported for different methods of operative fixation, however, study sizes are small and data is sparse. Further robust comparative studies are required to identify definitive conclusions. The use of established clinical and radiographic outcome measures will help improve the quality of future studies for this relatively rare injury.
Language	English
Publishing date	2021-01-22
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.12860
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Article: Financial Impact of Inaccurate Coding Plus Cost-Effectiveness Analysis for Surgically Managed Patients With Periprosthetic Fractures.

Toner, Ethan / Khaled, Ahmad / Ramesh, Ashwanth / Qureshi, Mobeen K / Al Suyyagh, Kais / Dunkow, Paul

Cureus

2021 Volume 13, Issue 2, Page(s) e13060

Abstract: Background An upward trend is seen in a number of periprosthetic fractures. Their management often requires complex surgical intervention, expert skills and expensive equipment. Hospitals get paid according to Healthcare Resource Group (HRG) tariffs. HRG ...

Abstract	Background An upward trend is seen in a number of periprosthetic fractures. Their management often requires complex surgical intervention, expert skills and expensive equipment. Hospitals get paid according to Healthcare Resource Group (HRG) tariffs. HRG gets generated once diagnoses, Charlson comorbidity (CC) index score, surgical procedures, investigations and length of stay have been coded for. Coding departments consist of non-clinicians. Although auditing systems are in and made of internal and external auditors, we hypothesized that multiple errors can still occur which may result in significant financial losses. Objectives To assess the accuracy of coding for management of periprosthetic fractures. To identify causes for inaccurate coding and assess the financial impact of highly complex trauma in a district general hospital (DGH). Methods Retrospective comparative analysis of case notes for patients with an M966 diagnosis code (periprosthetic fracture) between 1st November 2017 and 1st November 2018. All cases were analysed and data for primary procedure, primary diagnosis, secondary procedures and secondary diagnosis, comorbidities and length of stay were extrapolated and re-coded using the same software in use by the coding team. Costs incurred for each surgically managed patient were calculated using a rough estimate of cost of each procedure. Finally, cost-effectiveness analysis was carried out by comparing our calculated figures to the actual final claim by our institution. Results Twenty-nine patients with the diagnosis of periprosthetic fracture were identified by the coding team using M966 code. A further case was identified by reviewing operating software (Operating Room Management Information System [ORMIS®]). In four cases (13.3 %), the primary diagnosis was coded incorrectly by the coding team. Overall coders accuracy for surgically managed patients (n=21) was 52% (n=11). This resulted in an estimated incurred loss of £25,000. Wrong/omitted site of surgery was found to be the most influential coder error with up to £8000 loss in one case (P<0.05). Cost-effectiveness analysis demonstrated the stark differences in costs for HRG tariffs when used in trauma setting vs non-trauma setting. Open reduction and internal fixation (ORIF) was associated with less financial loss to our trust with closer procedural costs to HRG tariff (average cost of £9200 for ORIF vs £22,030 for a massive endoprosthesis). Conclusions Surgeons should carefully review codes for such complex procedures before or soon after surgery. Wrong/omitted site of surgery is the key cause for losses in our cohort, followed by inadequate recording of comorbidities. Coders can only code for what is documented. Following cost-effectiveness analysis our study highlights the need for HRG tariffs to be revised for such procedures. The cost of ORIF vs massive endoprosthesis should be noted, signifying the implant costs when such specialised revision surgery performed over less expensive ORIF surgery.
Language	English
Publishing date	2021-02-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.13060
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Article: Trapeziectomy with Ligament Reconstruction and Tendon Interposition versus Trapeziometacarpal Joint Replacement for Thumb Carpometacarpal Osteoarthritis: A Systematic Review and Meta-Analysis.

Qureshi, Mobeen Khalid / Halim, Usman Ali / Khaled, Ahmad Sulaiman / Roche, Simon John / Arshad, Mohammed Shoaib

Journal of wrist surgery

2021 Volume 11, Issue 3, Page(s) 272–278

Abstract: ... ...

Abstract	Background
Language	English
Publishing date	2021-07-15
Publishing country	United States
Document type	Journal Article
ZDB-ID	2678060-4
ISSN	2163-3924 ; 2163-3916
ISSN (online)	2163-3924
ISSN	2163-3916
DOI	10.1055/s-0041-1731818
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Article ; Online: CRP monitoring in fractured neck of femur. A waste of resource?

Qureshi, Mobeen / Liew, Ignatius / Bailey, Oliver

Injury

2018 Volume 49, Issue 10, Page(s) 1855–1858

Abstract: Aim: We aim to assess post-operative CRP serum values in a cohort of patients who underwent surgical treatment for neck of femur fracture (NOF#), and whether CRP is a valid tool for the assessment of these patients post-operatively.: Study design and ... ...

Abstract	Aim: We aim to assess post-operative CRP serum values in a cohort of patients who underwent surgical treatment for neck of femur fracture (NOF#), and whether CRP is a valid tool for the assessment of these patients post-operatively. Study design and methods: Retrospective analysis was carried out on all NOF#'s admitted for surgical fixation between August 2015 and July 2016 in a district general hospital. Primary analysis included serum CRP levels until day 7 post-operatively, with secondary analysis of any documented evidence of post-operative complications (medical and surgical) within 30 days post-operatively. Results: A total of 365 patients were surgically treated for NOF#'s over the study period. CRP serum levels peaked over the first two days post-operatively to median (IQ range) of 226 mg/L (158-299 mg/L), decreasing to 67 mg/L (45.5-104 mg/L) by day 7 post-operatively. 116 patients had documented post-operative complications within 30 daysof operation. CRP levels in patients with and without complications showed no statistical significance in day-1, day-2 and day-3 post-operatively. However, a significant difference was demonstrated on day-4 (p = 0.017), day-5 (p = 0.003), day-6 (p = 0.02) and day-7 (p = 0.031). Conclusions: During the first three days of the postoperative period we cannot recommend routine CRP serum blood test monitoring in NOF# patients, as it is not diagnostic in the acute inflammatory phase for medical or surgical complications.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Biomarkers/blood ; C-Reactive Protein/metabolism ; Female ; Femoral Neck Fractures/surgery ; Fracture Fixation, Internal ; Humans ; Male ; Middle Aged ; Postoperative Complications/metabolism ; Postoperative Period ; Predictive Value of Tests ; Retrospective Studies ; Time Factors ; Unnecessary Procedures
Chemical Substances	Biomarkers ; C-Reactive Protein (9007-41-4)
Language	English
Publishing date	2018-07-11
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	218778-4
ISSN	1879-0267 ; 0020-1383
ISSN (online)	1879-0267
ISSN	0020-1383
DOI	10.1016/j.injury.2018.07.005
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Zs.A 778: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 10: Show issues

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Article ; Online: Novel technique to accurately measure femoral diameter using a Thomas splint.

Liew, Ignatius / Qureshi, Mobeen / Joseph, Jibu / Bailey, Oliver

Injury

2017 Volume 48, Issue 11, Page(s) 2606–2607

Abstract: Introduction: During surgical management of femoral shaft fractures, difficulties arise when treating patients with narrow femoral diaphyseal canals, such as young patients and those with dysplastic femurs secondary to underlying pathology. Accurate pre- ...

Abstract	Introduction: During surgical management of femoral shaft fractures, difficulties arise when treating patients with narrow femoral diaphyseal canals, such as young patients and those with dysplastic femurs secondary to underlying pathology. Accurate pre-operative assessment of the femoral diaphyseal canal diameter would allow the surgeon to plan surgical technique and ensure appropriate equipment was available, such as narrow, unreamed or paediatric sized nails. Technique: When secured to the patient both longitudinal rods of the main Thomas Splint component lie parallel with the femoral shaft and horizontal to the radiographic x-ray plate. The diameter of these rods are 13mm (Adult and paediatric). Using the calibration tool, we calibrate the diameter of the Thomas Splint to 13mm, accurately measuring any further detail on that radiograph, such as the diaphyseal canal diameter. Conclusion: Accurate knowledge pre-operatively of radiographic measurements is highly valuable to the operating surgeon. This technique can accurately measure femoral canal diameter using the Thomas splint, negates the requirement for a calibration marker, is reproducible, easy to perform, and is indispensible when faced with a patient with a narrow femoral canal in a diaphyseal femoral fracture. (181 words).
MeSH term(s)	Bone Nails ; Calibration ; Femoral Fractures/diagnostic imaging ; Femoral Fractures/surgery ; Femur/anatomy & histology ; Femur/diagnostic imaging ; Humans ; Radiography ; Reproducibility of Results ; Splints/utilization
Language	English
Publishing date	2017-09-06
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	218778-4
ISSN	1879-0267 ; 0020-1383
ISSN (online)	1879-0267
ISSN	0020-1383
DOI	10.1016/j.injury.2017.08.068
Database	MEDical Literature Analysis and Retrieval System OnLINE

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In stock of ZB MED Cologne/Königswinter

Zs.A 778: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article: Trapeziectomy with Ligament Reconstruction and Tendon Interposition versus Trapeziometacarpal Joint Replacement for Thumb Carpometacarpal Osteoarthritis: A Systematic Review and Meta-Analysis

Qureshi, Mobeen Khalid / Halim, Usman Ali / Khaled, Ahmad Sulaiman / Roche, Simon John / Arshad, Mohammed Shoaib

Journal of Wrist Surgery

2021 Volume 11, Issue 03, Page(s) 272–278

Abstract: Background: The trapeziometacarpal articulation in the thumb is a joint that is second-most commonly affected by osteoarthritis, and this can lead to considerable hand pain and disability. Currently, there is a multiplicity of surgical options available ...

Abstract	Background: The trapeziometacarpal articulation in the thumb is a joint that is second-most commonly affected by osteoarthritis, and this can lead to considerable hand pain and disability. Currently, there is a multiplicity of surgical options available to address this problem, yet none has proven to be significantly superior to the others. Objective: This study aims to compare the outcome of trapeziectomy with ligament reconstruction and tendon interposition versus trapeziometacarpal joint replacement for thumb carpometacarpal osteoarthritis. Materials and Methods: A systematic review and meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement standards. The NICE Healthcare Databases Advanced Search (HDAS) tool was used to search articles. One randomized controlled trial (RCT), one prospective cohort study and two retrospective cohort studies were identified. Results: Our results demonstrate a significant difference in the Quick Disabilities of the Arm Shoulder and Hand (QDASH) score between the trapeziectomy with ligament reconstruction and tendon interposition (LRTI) and Joint Replacement groups with the joint replacement group exhibiting better QDASH scores than the LRTI group. We also found that those who had a joint replacement had a significantly better thumb opposition than those in the LRTI group, as demonstrated by a superior Kapandji score. However, the complication rate of joint replacement appears to be higher. Conclusion: Our study reveals that while both treatment options are valid, the limited body of evidence currently available shows that joint replacement carries more risks and thus should not replace the current standard treatment of trapeziectomy with LRTI. This study highlights the need for more trials to be performed to more accurately compare the two treatment modalities. For the time being, we advocate that joint replacement is only performed by surgeons who perform this procedure regularly to reduce the risk of complications.
Keywords	trapeziectomy ; carpometacarpal osteoarthritis ; carpometacarpal joint ; ligament reconstruction and tendon interposition
Language	English
Publishing date	2021-07-15
Publisher	Thieme Medical Publishers, Inc.
Publishing place	Stuttgart ; New York
Document type	Article
ZDB-ID	2678060-4
ISSN	2163-3924 ; 2163-3916 ; 2163-3924
ISSN (online)	2163-3924
ISSN	2163-3916 ; 2163-3924
DOI	10.1055/s-0041-1731818
Database	Thieme publisher's database

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