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Background and Objectives: The utility of postdischarge remote monitoring with patient self-measurement of physiological parameters has not been utilized in the elective colorectal surgical setting till date. Before full application of this utility, patient-acquired measurements’ accuracy, and ability to detect deviation from normal physiological must be assessed. This study aims to ascertain the congruency of patient-measured and nurse-measured readings in the postoperative in-hospital setting, before future application in the home setting. Methods: This is a prospective single-institution study comparing patient and nurse measured readings of blood pressure, heart rate, oxygen saturation, and temperature, in ambulatory patients in the postoperative setting. Patients were provided with and trained on the usage of a handheld computing device with bluetooth-enabled measuring adjuncts preoperatively. Patients were instructed to acquire two sets of readings per day for 2 days. These were compared with nurse-acquired measurements and extrapolated to the modified “National Early Warning Score” system. Inter-rater concordance was analyzed using the Bland-Altman method for raw physiological measurements and for modified-National Early Warning Score (NEWS) risk and response categories. Results: A total of 40 elective colorectal patients were prospectively approached. Twenty-seven completed the study with 25 patients (15 males, age range 18-79, undergoing a variety of colorectal procedures) accruing a total of 98 datasets of physiological parameter readings. There were no significant differences/bias between blood pressure (P = 0.572), heart rate (0.122), and oxygen saturation (P = 0.308) readings. Patient and linked nurse measurements for all patients elicited the same modified NEWS clinical risk and required response in all instances. Conclusion: Patient self-measurement of physiological parameters and subsequent derived modified NEWS categories using a remote monitoring system are comparable to nurse-acquired measurements. Remote monitoring is technically feasible, and the next steps would be to trial this technology in the home setting.
Background and Objectives: The utility of postdischarge remote monitoring with patient self-measurement of physiological parameters has not been utilized in the elective colorectal surgical setting till date. Before full application of this utility, patient-acquired measurements’ accuracy, and ability to detect deviation from normal physiological must be assessed. This study aims to ascertain the congruency of patient-measured and nurse-measured readings in the postoperative in-hospital setting, before future application in the home setting. Methods: This is a prospective single-institution study comparing patient and nurse measured readings of blood pressure, heart rate, oxygen saturation, and temperature, in ambulatory patients in the postoperative setting. Patients were provided with and trained on the usage of a handheld computing device with bluetooth-enabled measuring adjuncts preoperatively. Patients were instructed to acquire two sets of readings per day for 2 days. These were compared with nurse-acquired measurements and extrapolated to the modified “National Early Warning Score” system. Inter-rater concordance was analyzed using the Bland-Altman method for raw physiological measurements and for modified-National Early Warning Score (NEWS) risk and response categories. Results: A total of 40 elective colorectal patients were prospectively approached. Twenty-seven completed the study with 25 patients (15 males, age range 18-79, undergoing a variety of colorectal procedures) accruing a total of 98 datasets of physiological parameter readings. There were no significant differences/bias between blood pressure (P = 0.572), heart rate (0.122), and oxygen saturation (P = 0.308) readings. Patient and linked nurse measurements for all patients elicited the same modified NEWS clinical risk and required response in all instances. Conclusion: Patient self-measurement of physiological parameters and subsequent derived modified NEWS categories using a remote monitoring system are comparable to nurse-acquired measurements. Remote monitoring is technically feasible, and the next steps would be to trial this technology in the home setting.
Introduction: Certain methodological principles should be inexcusably followed when designing clinical or observational research to avoid bias and presentation of results that do not reflect the truth about the phenomenon that is the object of the study. Aim: The aim of this study was to compare the methodological quality of clinical trials and observational studies published in medical journals from ex-Yugoslav countries indexed in Pubmed/MEDLINE. Methods: Clinical studies published in medical journals of ex-Yugoslav countries were retrieved from the Pubmed/MEDLINE database, and the sample for analysis was randomly chosen from the retrieved publications. The rate of the most common errors in the design of clinical/observational studies was established by a careful reading of the sampled publications and their checking against predefined criteria. Results: The studies published in two countries that are now member states of the European Union (Slovenia and Croatia) have significantly higher citation rates, impact factor, and methodological quality scores than studies from other ex-Yugoslav countries. While publications from Croatia show clear improvement trend throughout the last two decades, which is visible also in the last 10 years in Slovenia and Bosnia and Herzegovina, quality of clinical research published in journals from Serbia was stagnating in the same period. Conclusions: There are significant differences in methodological quality and scientometric characteristics of clinical research published in medical journals of ex-Yugoslav countries that could be mitigated by more intensive training of clinical researchers in statistics and research design, as well as by more rigorous editorial practices.
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