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  1. Article ; Online: The Semantics of 'Hip Pain' and its Impact on Clinical Practice in Patient-Reported Outcome Measures (PROMs) of Disease: Results from a Clinical and Radiological Evaluation Cohort.

    Karela, Mayuri / Rickard, Lloyd / Roussou, Euthalia

    Mediterranean journal of rheumatology

    2020  Volume 31, Issue 4, Page(s) 389–392

    Abstract: Introduction: The item 'hip pain' is widely used in questionnaires related to Spondyloarthritis and/or Ankylosing spondylitis (AS), either in clinics with patients being physically present or remotely, as the hip joint is known to affect AS in ... ...

    Abstract Introduction: The item 'hip pain' is widely used in questionnaires related to Spondyloarthritis and/or Ankylosing spondylitis (AS), either in clinics with patients being physically present or remotely, as the hip joint is known to affect AS in particular. Patients in clinics often claim to have hip pain. However, by stating "hip" they are referring to variable structures located in the hip region not necessarily related to hip joint itself.
    Objective: To assess which structure(s) patients mean when referring to hip pain.
    Methods: A diagram used as a proforma for patients to indicate the site of 'hip pain' following a detailed history and examination was used. Radiological imaging was utilised for those patients with multiple sites or clinically unclear causes of "hip" pain.
    Results: From 54 patients 7 different anatomical sites described which were: Trochanter, (27.2%), hip joint (20.8%), iliac crests (anterior superior [6.9%], posterior superior [8.3%], and anterior inferior [4.1%]), lumbar spine (8.3%), sacroiliac joint (6.9%). More than 1 sites in the same patient: (17.5%). Diagnoses were: Trochanteric bursitis (27%), osteoarthritis of hip and spine, (25%), enthesitis (22%), sacroiliitis (6.7%), synovitis (5%), fibromyalgia (3.4%), and hip dislocation (1.6%). More than 1 diagnosis in same patient: 9.3%.
    Conclusion: 'hip pain' as an item used in questionnaires must be interpreted with caution.
    Language English
    Publishing date 2020-12-28
    Publishing country Greece
    Document type Journal Article
    ZDB-ID 3019943-8
    ISSN 2529-198X ; 2459-3516
    ISSN (online) 2529-198X
    ISSN 2459-3516
    DOI 10.31138/mjr.31.4.389
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Variable rate insulin infusions on medical and surgical wards: are we getting it right?

    Coulden, Amy / Rickard, Lloyd / Jalota, Priya / Austin, Emily / Samani, Niraj / Lane, Brighid / Dawson, Deborah / Peters, Lesley / Salahuddin, Sofia / Ghosh, Sandip

    Future healthcare journal

    2019  Volume 6, Issue Suppl 1, Page(s) 11

    Language English
    Publishing date 2019-07-30
    Publishing country England
    Document type Journal Article
    ZDB-ID 3016427-8
    ISSN 2514-6653 ; 2514-6645
    ISSN (online) 2514-6653
    ISSN 2514-6645
    DOI 10.7861/futurehosp.6-1-s11
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Three wound-dressing strategies to reduce surgical site infection after abdominal surgery: the Bluebelle feasibility study and pilot RCT.

    Reeves, Barnaby C / Rooshenas, Leila / Macefield, Rhiannon C / Woodward, Mark / Welton, Nicky J / Waterhouse, Benjamin R / Torrance, Andrew D / Strong, Sean / Siassakos, Dimitrios / Seligman, William / Rogers, Chris A / Rickard, Lloyd / Pullyblank, Anne / Pope, Caroline / Pinkney, Thomas D / Pathak, Samir / Owais, Anwar / O'Callaghan, Jamie / O'Brien, Stephen /
    Nepogodiev, Dmitri / Nadi, Khaldoun / Murkin, Charlotte E / Munder, Tonia / Milne, Tom / Messenger, David / McMullan, Christel M / Mathers, Jonathan M / Mason, Matthew / Marshall, Morwena / Lovegrove, Richard / Longman, Robert J / Lloyd, Jessica / Lim, Jeffrey / Lee, Kathryn / Korwar, Vijay / Hughes, Daniel / Hill, George / Harris, Rosie / Hamdan, Mohammed / Brown, Hannah Gould / Gooberman-Hill, Rachael / Glasbey, James / Fryer, Caroline / Ellis, Lucy / Elliott, Daisy / Dumville, Jo C / Draycott, Tim / Donovan, Jenny L / Cotton, David / Coast, Joanna / Clout, Madeleine / Calvert, Melanie J / Byrne, Benjamin E / Brown, Oliver D / Blencowe, Natalie S / Bera, Katarzyna D / Bennett, Joanne / Bamford, Richard / Bakhbakhi, Danya / Atif, Muhammad / Ashton, Kate / Armstrong, Elizabeth / Andronis, Lazaros / Ananthavarathan, Piriyankan / Blazeby, Jane M

    Health technology assessment (Winchester, England)

    2019  Volume 23, Issue 39, Page(s) 1–166

    Abstract: Background: Surgical site infection (SSI) affects up to 20% of people with a primary closed wound after surgery. Wound dressings may reduce SSI.: Objective: To assess the feasibility of a multicentre randomised controlled trial (RCT) to evaluate the ... ...

    Abstract Background: Surgical site infection (SSI) affects up to 20% of people with a primary closed wound after surgery. Wound dressings may reduce SSI.
    Objective: To assess the feasibility of a multicentre randomised controlled trial (RCT) to evaluate the effectiveness and cost-effectiveness of dressing types or no dressing to reduce SSI in primary surgical wounds.
    Design: Phase A - semistructured interviews, outcome measure development, practice survey, literature reviews and value-of-information analysis. Phase B - pilot RCT with qualitative research and questionnaire validation. Patients and the public were involved.
    Setting: Usual NHS care.
    Participants: Patients undergoing elective/non-elective abdominal surgery, including caesarean section.
    Interventions: Phase A - none. Phase B - simple dressing, glue-as-a-dressing (tissue adhesive) or 'no dressing'.
    Main outcome measures: Phase A - pilot RCT design; SSI, patient experience and wound management questionnaires; dressing practices; and value-of-information of a RCT. Phase B - participants screened, proportions consented/randomised; acceptability of interventions; adherence; retention; validity and reliability of SSI measure; and cost drivers.
    Data sources: Phase A - interviews with patients and health-care professionals (HCPs), narrative data from published RCTs and data about dressing practices. Phase B - participants and HCPs in five hospitals.
    Results: Phase A - we interviewed 102 participants. HCPs interpreted 'dressing' variably and reported using available products. HCPs suggested practical/clinical reasons for dressing use, acknowledged the weak evidence base and felt that a RCT including a 'no dressing' group was acceptable. A survey showed that 68% of 1769 wounds (727 participants) had simple dressings and 27% had glue-as-a-dressing. Dressings were used similarly in elective and non-elective surgery. The SSI questionnaire was developed from a content analysis of existing SSI tools and interviews, yielding 19 domains and 16 items. A main RCT would be valuable to the NHS at a willingness to pay of £20,000 per quality-adjusted life-year. Phase B - from 4 March 2016 to 30 November 2016, we approached 862 patients for the pilot RCT; 81.1% were eligible, 59.4% consented and 394 were randomised (simple,
    Limitations: Multiple activities, often in parallel, were challenging to co-ordinate. An amendment took 4 months, restricting recruitment to the pilot RCT. Only 67% of participants completed the SSI questionnaire. We could not implement photography in theatres.
    Conclusions: A main RCT of dressing strategies is feasible and would be valuable to the NHS. The SSI questionnaire is sufficiently accurate to be used as the primary outcome. A main trial with three groups (as in the pilot) would be valuable to the NHS, using a primary outcome of SSI at discharge and patient-reported SSI symptoms at 4-8 weeks.
    Trial registration: Phase A - Current Controlled Trials ISRCTN06792113; Phase B - Current Controlled Trials ISRCTN49328913.
    Funding: This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in
    MeSH term(s) Abdomen/surgery ; Adult ; Aged ; Bandages/classification ; Bandages/microbiology ; Cesarean Section/adverse effects ; Cost-Benefit Analysis ; Feasibility Studies ; Female ; Humans ; Male ; Middle Aged ; Pilot Projects ; Quality-Adjusted Life Years ; Reproducibility of Results ; Surgical Procedures, Operative/adverse effects ; Surgical Wound Infection/microbiology ; Surgical Wound Infection/prevention & control ; Surveys and Questionnaires
    Language English
    Publishing date 2019-09-04
    Publishing country England
    Document type Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
    ZDB-ID 2006765-3
    ISSN 2046-4924 ; 1366-5278
    ISSN (online) 2046-4924
    ISSN 1366-5278
    DOI 10.3310/hta23390
    Database MEDical Literature Analysis and Retrieval System OnLINE

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