Orthochina.org : Case-based Orthopaedic Wiki Project in China

Abstract

Traditional continuing medical education (CME) depended primarily on periodic courses and conferences. The cost-effectiveness of these courses has not been established, and often the content is not tailored to best meet the needs of the students. Internet training has the potential to accomplish these goals. Over the last 10 years, we have developed a Web site entitled ''Orthochina.org,'' based upon the wiki concept, which uses an interactive, case-based format. We describe the development of online case discussions, and various technical and administrative requirements. As of December 31, 2007, there were 33,984 registered users, 9,759 of which passed the confirmation procedures. In 2007, an average of 211 registrants visited daily. The average number of first page clicks was 4,248 per day, and the average number of posts was 70 per day. All cases submitted for discussion include the patient's complaint, physical examination findings, and relevant images based on specific criteria for case discussion. The case discussions develop well professionally. No spam posting or unauthorized personal advertisement is permitted. In conclusion, online academic discussions proceed well when the orthopaedic surgeons who participate have established their identities.

Wikis and Collaborative Writing Applications in Health Care: A Scoping Review

“…As previous authors have stated [183,320], measuring the quality of user-generated content and its change over time is a challenging task requiring research [322]. Finding ways of assuring the scientific integrity of evidence within CWAs and recognizing authorship are significant stumbling blocks that need to be addressed for health care [102,114,130,171,176,323]. Studying each specific behavior involved in using CWAs (ie, to use, to contribute, to edit, to delete) with the help of theoretical frameworks will also help inform future interventions.…”

<p>Gain and loss from transcatheter intra-arterial limb infusion of cisplatin for extremity osteosarcoma: a retrospective study of 99 cases in the past six years</p>

“…The value of serial arteriography to assess tumor response, predict necrosis, and individualize the duration of a combined IV and IA neoadjuvant chemotherapy protocol in patients with high-grade osteosarcoma has been investigated for decades through retrospective7,9,27 or prospective studies 4,6,12. Although we are aware of the predictive accuracy of the change in TNV during serial arteriography to evaluate the local response of the tumor instead of morphological change of primary osteogenic tumors,3,10,13,14 this procedure has seldom been used recently because of the proven evidence of no long-term survival advantage 3,5,6,10,12,15,27. Nevertheless, it is believed that the introduction of aggressive chemotherapy has dramatically improved the prognosis of osteosarcoma, yielding a five-year OS rate in the range of 60–70% as compared with the previous approximate rate of 15–20% with only local treatment 1,2,7,12.…”

“…Kaplan–Meier analysis was used to determine OS, event-free survival (EFS), and recurrence-free survival. We calculated the tumor response rates in different groups as the percentage of patients who had a tumor necrosis rate of more than 90%,3,6,10,12 which, according to the results of EURAMOUS-1,1 should be 51.9% (724/1395) for routine chemo-protocols. If we want tumor response elevated from 51.9% to 70% with setting of α-error at 0.05 and β-error at 0.20, at least 61 patients were needed for statistical calculation.…”

“…Response of the primary lesions to preoperative chemotherapy and surgical margins has emerged as important prognostic factors associated with metastasis 2. Although no major benefit was reported by some classic prospective trials investigating the advantage of intra-arterial (IA) administration of systemic treatment for nonmetastatic extremity osteosarcoma, including IOR/OS-3,3,4 IOR/OS-5,5 and COSS 86,6 preoperative chemotherapy with IA administration of cisplatin was still used for decades to achieve a better tumor response by delivering chemotherapy directly into the arterial bed supplying the neoplasm as local extremity venous concentrations of a drug given via the IA route can reach up to five times higher than those obtained by using the systemic route of delivery for the same therapeutic agent 7–10…”

Desarrollo de una aplicación web para el montaje de una mesa quirúrgica en el área de traumatología

“…Algunos sitios web que apoyan la formación en el área de la traumatología son: www.orthochina.org, es un sitio web con el concepto de Wiki, sin ánimo de lucro, dedicado a la cirugía ortopédica, donde los contenidos son creados en colaboración con usuarios y cirujanos especializados; los datos se clasifican en categorías y subespecialidades, y funciona como una plataforma de intercambio académico que proporciona libros electrónicos, videos y material didáctico en diferentes formatos (Ma et al, 2008). www.aofoundation.org, dispone de varios módulos de e-learning y cursos online en el área de la traumatología, además cuenta con t r a n s m i s i o n e s i n t e r a c t i v a s e n v i vo d e procedimientos clínicos entregados en directo desde el quirófano (AO Fundation, 2013); www.ortho.hyperguides.com, creado en 2009 por Vindico Medical Education, es un sitio web que cuenta con una completa colección de tutoriales en línea, conferencias y ensayos; los tutoriales proporcionan información de características clínicas, radiológicas, diagnóstico de factores de riesgo, evaluación, tratamiento y resultados de los pacientes, además está acreditado por el Consejo de Acreditación para Educación Médica Continua (ACCME).…”