Project description:BackgroundWithin today's competency-based medical education, traditional set number proficiency benchmarks have been called into question. Checklists may help guide individualized training and standardized outcomes. However, multicenter expert consensus checklists based on established guidelines with supporting validity evidence have not been published for specific emergency ultrasound (EUS) applications. We describe a robust national EUS expert consensus methodology for developing a checklist for the extended focused assessment with sonography in trauma (eFAST examination).MethodsUtilizing the ACEP imaging compendium as a primary reference, 10 national EUS experts iteratively refined and agreed upon a final checklist. To obtain initial reliability and validity evidence, two different EUS experts blinded to resident experience then assessed 24 residents performing an eFAST in a simulated environment. Inter-rater reliability of the checklist was assessed using Cohen's kappa coefficient. Validity was assessed by comparing mean performance with the Student's t-test and discriminant ability of individual checklist items using item-total correlation.ResultsThe 10 EUS experts agreed on the final checklist items after two rounds of iterations. When evaluating 24 emergency medicine (EM) PGY-1 to -4 residents, the kappa correlation between two blinded EUS faculty raters was moderate at 0.670. Kappa and agreement were near-perfect or perfect in right and left chest image optimization, right upper quadrant (RUQ) probe placement, RUQ anatomy identification, and pelvic first-view anatomy identification. The difference in checklist performance between junior and senior EM residents was significant at -8.1% (p = 0.004). Identification of pelvic structures and placement of the probe for pelvic views were found to have an excellent item-total correlation with values of >0.4.ConclusionsWe have described a robust national EUS expert consensus methodology for developing an eFAST checklist based on the ACEP imaging guidelines. Based on this encouraging initial reliability and validity evidence, further research and checklist development is warranted for additional EUS applications.

Project description:PurposeRecent expert consensus publications have highlighted the issue of poor reproducibility in magnetic resonance spectroscopy (MRS) studies, mainly due to the lack of standardized reporting criteria, which affects their clinical applicability. To combat this, guidelines for minimum reporting standards (MRSinMRS) were introduced to aid journal editors and reviewers in ensuring the comprehensive documentation of essential MRS study parameters. Despite these efforts, the implementation of MRSinMRS standards has been slow, attributed to the diverse nomenclature used by different vendors, the variety of raw MRS data formats, and the absence of appropriate software tools for identifying and reporting necessary parameters. To overcome this obstacle, we have developed the REproducibility Made Easy (REMY) standalone toolbox.MethodsREMY software supports a range of MRS data formats from major vendors like GE (p. file), Siemens (.twix, .rda, .dcm), Philips (.spar/.sdat), and Bruker (.method), facilitating easy data import and export through a user-friendly interface. REMY employs external libraries such as spec2nii and pymapVBVD to accurately read and process these diverse data formats, ensuring compatibility and ease of use for researchers in generating reproducible MRS research outputs. Users can select and import datasets, choose the appropriate vendor and data format, and then generate an MRSinMRS table, log file, and methodological documents in both Latex and PDF formats.ResultsREMY effectively populated key sections of the MRSinMRS table with data from all supported file types. In the hardware section, it successfully read and filled in fields for Field Strength [T], Manufacturer Name, and Software Version, covering three of the five required hardware fields. However, it could not input data for RF coil and additional hardware information due to their absence in the files. For the acquisition section, REMY accurately read and populated fields for the pulse sequence name, nominal voxel size, repetition time, echo time, number of acquisitions/excitations/shots, spectral width [Hz], and number of spectral points, significantly contributing to the completion of the Acquisition fields of the table. Furthermore, REMY generates a boilerplate methods text section for manuscripts.ConclusionThis approach reduces effort and obstacles associated with writing and reporting acquisition parameters and should lead to the widespread adoption of MRSinMRS within the MRS community.

Project description:IntroductionAcademic medicine continues to struggle in its efforts to compensate scholarly productivity. Academic achievements receive less recognition compared to clinical work, evidenced by a lack of reduced clinical hours or financial incentive. Core departmental education responsibilities are often distributed inequitably across academic departments. An approach using an incentive program, which emphasizes transparency, equity, and consensus may help academic departments share core education responsibilities and reward scholarly activity.MethodsWe launched a two-stage approach to confront the inequitable distribution of educational responsibilities and to recognize the scholarly work among our faculty. In the first stage, baseline education expectations were implemented for all faculty members, which included accountability procedures tied to a financial incentive. The second stage involved the creation of an aAcademic rRelative vValue uUnit (ARVU) system which contained additional activities that were derived and weighted based on stakeholder consensus. The points earned in the ARVU system were applied towards additional financial incentive at academic year-end. We compared education contributions before and after implementation as well as total points earned in the ARVU system.ResultsIn the first year of implementing education expectations, 87% of faculty fulfilled requirements. Those with a heavier clinical load made up the majority of deficient faculty. Those who did not meet education expectations were notified and had their year-end incentive reduced to reflect this. Faculty conference attendance increased by 21% (P<.001) and the number of resident assessments completed increased by 30% (P<.001) compared to the previous year. To date, faculty across the department have logged a total of 1,240 academic activities in the database, which will be converted into financial bonus amounts at year-end.ConclusionWe have seen significant increases in faculty participation in educational activities and learner assessments as well as documentation of activities in the ARVU system. A similar system using different specialty-specific activities may be generalizable and employed at other institutions.

Project description:Cue reactivity is one of the most frequently used paradigms in functional magnetic resonance imaging (fMRI) studies of substance use disorders (SUDs). Although there have been promising results elucidating the neurocognitive mechanisms of SUDs and SUD treatments, the interpretability and reproducibility of these studies is limited by incomplete reporting of participants' characteristics, task design, craving assessment, scanning preparation and analysis decisions in fMRI drug cue reactivity (FDCR) experiments. This hampers clinical translation, not least because systematic review and meta-analysis of published work are difficult. This consensus paper and Delphi study aims to outline the important methodological aspects of FDCR research, present structured recommendations for more comprehensive methods reporting and review the FDCR literature to assess the reporting of items that are deemed important. Forty-five FDCR scientists from around the world participated in this study. First, an initial checklist of items deemed important in FDCR studies was developed by several members of the Enhanced NeuroImaging Genetics through Meta-Analyses (ENIGMA) Addiction working group on the basis of a systematic review. Using a modified Delphi consensus method, all experts were asked to comment on, revise or add items to the initial checklist, and then to rate the importance of each item in subsequent rounds. The reporting status of the items in the final checklist was investigated in 108 recently published FDCR studies identified through a systematic review. By the final round, 38 items reached the consensus threshold and were classified under seven major categories: 'Participants' Characteristics', 'General fMRI Information', 'General Task Information', 'Cue Information', 'Craving Assessment Inside Scanner', 'Craving Assessment Outside Scanner' and 'Pre- and Post-Scanning Considerations'. The review of the 108 FDCR papers revealed significant gaps in the reporting of the items considered important by the experts. For instance, whereas items in the 'General fMRI Information' category were reported in 90.5% of the reviewed papers, items in the 'Pre- and Post-Scanning Considerations' category were reported by only 44.7% of reviewed FDCR studies. Considering the notable and sometimes unexpected gaps in the reporting of items deemed to be important by experts in any FDCR study, the protocols could benefit from the adoption of reporting standards. This checklist, a living document to be updated as the field and its methods advance, can help improve experimental design, reporting and the widespread understanding of the FDCR protocols. This checklist can also provide a sample for developing consensus statements for protocols in other areas of task-based fMRI.

Project description:ObjectivesThe Self-Management Analysis in Chronic Conditions (SMACC) checklist was developed as a guidance tool to support the development, comparison and evaluation of self-management support programmes for persons with a chronic condition. The checklist was based on a previously performed concept analysis of self-management. The aim of this study was to validate its content using an international Delphi study and to deliver a final version.DesignA two-round Delphi study was conducted between October 2022 and January 2023. Using the researchers' networks, professionals with research or clinical expertise in self-management support and chronic conditions were recruited via online purposive snowball sampling. Participants were asked to score each item of the checklist (16 items total) on 3 content validity indicators: (1) clarity and comprehensibility, (2) relevance and importance and (3) degree of alignment with the overall goal of the checklist to promote adequate and comprehensive self-management support programmes. A consensus threshold of 75% agreement was used. The participants were also asked general questions about the checklist as a whole and were asked to provide feedback considering its refinement.ResultsFifty-four professionals with an average 14.5 years of experience participated in round 1, 48 with an average 12.5 years of experience participated in round 2. The majority of professionals were from Western Europe. For the majority of items consensus was reached after round 1. In round 2, 3 of the 4 remaining items reached consensus, 1 last item was retained based on highly recurring feedback.ConclusionsThe SMACC checklist was considered a valid and comprehensive tool to aid the development, evaluation and comparison of self-management support programmes. It was acknowledged as a useful instrument to supplement existing frameworks and was seen as feasible to implement in both research and clinical settings. Further validation in the field, with input from patients and peer experts, will be valuable.

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A consensus-based transparency checklist.

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