With trends toward increasing patient involvement in medical decision-making, decreasing clinic times, and the availability of the Internet, patients and their caregivers are increasingly researching cancer diagnoses online. It is essential for physicians to understand patient Internet usage as it relates to their own health education. Internet usage trends have been studied in various areas, but not in thoracic diseases. This prospective cohort study surveyed 337 thoracic surgery patients and their caregivers with both cancer and non-cancer diagnoses to examine their Internet usage trends. Cancer subjects were more likely to research their condition online if they were younger, had a higher income, had a higher education level, and were currently employed. Only age and income level were predictive for non-cancer subjects. Separately, cancer subjects were more likely to trust information found on the Internet if they had a higher education. Subjects were most likely to conduct research on a hospital website than other websites. These data will be helpful to thoracic surgeons who want to appropriately educate patients and their caregivers and direct them to reliable Internet sources. These data also illustrate the importance of developing trustworthy hospital websites with disease-specific information.
Recently, both living and deceased organ donation rates have hit a plateau, despite increases in need for viable organs. One approach to improve donation rate is public education and policy; thus, it is necessary to understand the information the public is receiving regarding organ donation. We hypothesized that primetime medical dramas portray organ donation and transplantation in a negative manner. We compiled data on all primetime medical drama episodes with transplant themes from November 2008 through June 2010 and assessed depictions of organ donors and transplant candidates. Positive and negative thematic elements surrounding the process and individuals involved were also identified. One hundred and fifty-five million and 145 million households watched episodes containing any negative message and any positive message, respectively. Episodes containing only negative messages had over twice the household viewership per episode compared to episodes containing only positive messages (8.4 million vs. 4.1 million, p = 0.01). Widespread exposure to these representations may reinforce public misconceptions of transplantation. The transplant community should consider the popularity of medical dramas as an opportunity to impact the perception of organ donation and transplantation for millions of Americans.
IntroductionAlthough diuretics are mainly used for the treatment of acute decompensated heart failure (ADHF), inadequate responses and complications have led to the use of extracorporeal ultrafiltration (UF) as an alternative strategy for reducing volume overloads in patients with ADHF.ObjectiveThe aim of our study is to perform meta-analysis of the results obtained from studies on extracorporeal venous ultrafiltration and compare them with those of standard diuretic treatment for overload volume reduction in acute decompensated heart failure.MethodsMEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials databases were systematically searched using a pre‑specified criterion. Pooled estimates of outcomes after 48 h (weight change, serum creatinine level, and all-cause mortality) were computed using random effect models. Pooled weighted mean differences were calculated for weight loss and change in creatinine level, whereas a pooled risk ratio was used for the analysis of binary all-cause mortality outcome.ResultsA total of nine studies, involving 613 patients, met the eligibility criteria. The mean weight loss in patients who underwent UF therapy was 1.78 kg [95% Confidence Interval (CI): −2.65 to −0.91 kg; p < 0.001) more than those who received standard diuretic therapy. The post-intervention creatinine level, however, was not significantly different (mean change = −0.25 mg/dL; 95% CI: −0.56 to 0.06 mg/dL; p = 0.112). The risk of all-cause mortality persisted in patients treated with UF compared with patients treated with standard diuretics (Pooled RR = 1.00; 95% CI: 0.64–1.56; p = 0.993).ConclusionCompared with standard diuretic therapy, UF treatment for overload volume reduction in individuals suffering from ADHF, resulted in significant reduction of body weight within 48 h. However, no significant decrease of serum creatinine level or reduction of all-cause mortality was observed.
Objectives: There is a tremendous amount of effort put into creating and maintaining hospital and health care related websites with patient related disease information. Very few have evaluated patients’ use of these websites, and if patients with cancer use the internet more for research, versus those with non-cancer disease processes. We hoped to evaluate all patients in our surgery clinics to assess for differences in internet use with regards to age and disease process. Methods: We surveyed 350 patients and family members over a 10 week period in our institution's thoracic surgery clinics. We assessed people for their demographic data, baseline internet availability and use, and for disease specific internet research and local hospital website utilization. Results: 350 people complete the survey. The mean age of cancer patients was 59 years old, while the mean of those with non-cancer diseases was 51. There was no difference in the internet availability or internet research when comparing patients with cancer, and without cancer. We stratified patients by age, into an over 50 year old group (Group A), and a second 50 years and younger group (Group B). Group B had a significantly higher internet availability versus Group B (95% vs 78%), and had higher weekly internet use, and daily hourly use. 71% of people within Group B used the internet to research their diseases, versus 51% in Group A. When we looked at only cancer patients, and stratified by age, 82% of patients 50 years old or younger researched their cancers, versus only 51% of those over age 50. When we analyzed only those patients in Group B, those with cancer had a significantly higher internet research rate (82%) than those without cancer (67%). Although younger patients with cancer tended to perform more internet research, they felt that the information was not trustful 44% of the time, versus only 23% of the over 50 cancer age group. WebMD ® was the most popular single website cited as a source of information. Conclusions: Having a diagnosis of cancer did not lead to more internet research overall, but there was significantly more internet research performed by patients 50 years and younger with cancer, than those older cancer patients, or those younger patients without cancer. Interestingly though, this same group tended to be most distrustful of the information that it found on the internet. It does seem that internet research will increase as the younger population ages. Further research should be performed to assess for other sources of disease information, and for reasons why internet information isn't trusted. This will help us improve our website design for greatest patient benefit. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 1832. doi:10.1158/1538-7445.AM2011-1832
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