Pub Date : 2024-10-01DOI: 10.1016/j.jogc.2024.102697
Alison Shea MD, PhD, Naana Afua Jumah MD, Milena Forte MD, Christina Cantin RN, PhD étudiant, Hamideh Bayrampour MSc, PhD, Kim Butler MD, Diane Francoeur MD, Courtney Green PhD, Jocelynn Cook PhD
<div><h3>Objectif</h3><div>Soutenir le personnel de santé en périnatalité à identifier et à assister les personnes enceintes et en post-partum vivant avec des troubles de santé mentale périnatale, plus particulièrement des troubles de l'humeur et d'anxiété en contexte périnatal. L'accent est mis sur les facteurs de risque et l'identification, le dépistage, le traitement et le référencement.</div></div><div><h3>Population cible</h3><div>Toutes les personnes enceintes ou dans la première année du post-partum.</div></div><div><h3>Résultats</h3><div>Dialogue ouvert et soins basés sur des données probantes lors de troubles périnataux de l'humeur et de l'anxiété, y compris les compétences en matière d'identification, de dépistage, de traitement et de référencement.</div></div><div><h3>Bénéfices, risques et coûts</h3><div>Les personnes enceintes et celles en post-partum atteinte de troubles de santé mentale périnatale non traitée, y compris de troubles de l'humeur et d'anxiété, peuvent subir, ainsi que leur famille, des effets néfastes ainsi que des conséquences négatives à leur santé, à court et à long terme.</div></div><div><h3>Données probantes</h3><div>Une recherche documentaire a été effectuée sur Medline (Ovid), PubMed, Embase et la bibliothèque Cochrane depuis le début jusqu'à juin 2024. Des articles supplémentaires ont été identifiés à partir de bibliographies d'articles et de la littérature grise publiée par des sociétés et des organisations réputées (voir l'<span><span>annexe A</span></span> en ligne).</div></div><div><h3>Méthodes de validation</h3><div>Les auteurs ont évalué la qualité des données probantes et la force des recommandations en utilisant le cadre méthodologique GRADE (Grading of Recommendations, Assessment, Development, and Evaluation). Voir l’<span><span>annexe B</span></span> en ligne (<span><span>tableau B1</span></span> pour les définitions et <span><span>tableau B2</span></span> pour l’interprétation des recommandations fortes et faibles).</div></div><div><h3>Professionnels concernés</h3><div>Tous les prestataires de soins de santé qui fournissent offrent des conseils en périnatalité. Le terme "périnatal" sera utilisé tout au long de cette directive pour désigner ces professionnels de la santé.</div></div><div><h3>Résumé des médias sociaux</h3><div>Nouvelle directive clinique de la SOGC ! Identifier, accompagner et traiter les troubles d'humeur et d'anxiété périnataux. Axée sur les déterminants et les facteurs de risque, le dépistage, le traitement et le référencement tout au long de la trajectoire périnatale. La directive vise un dialogue et des soins personnalisés basés sur des données probantes pour des soins de qualité en contexte de santé mentale périnatale.</div></div><div><h3>DÉCLARATIONS SOMMAIRES</h3><div><ul><li><span>1.</span><span><div>Les troubles périnataux de l'humeur et de l'anxiété sont fréquents (<em>élevée</em>) ; la dépression et l'anxiété post-partum représentent des complications maternelles les plus f
{"title":"Directive clinique N° 454 : Identification et traitement des troubles périnataux de l'humeur et de l'anxiété","authors":"Alison Shea MD, PhD, Naana Afua Jumah MD, Milena Forte MD, Christina Cantin RN, PhD étudiant, Hamideh Bayrampour MSc, PhD, Kim Butler MD, Diane Francoeur MD, Courtney Green PhD, Jocelynn Cook PhD","doi":"10.1016/j.jogc.2024.102697","DOIUrl":"10.1016/j.jogc.2024.102697","url":null,"abstract":"<div><h3>Objectif</h3><div>Soutenir le personnel de santé en périnatalité à identifier et à assister les personnes enceintes et en post-partum vivant avec des troubles de santé mentale périnatale, plus particulièrement des troubles de l'humeur et d'anxiété en contexte périnatal. L'accent est mis sur les facteurs de risque et l'identification, le dépistage, le traitement et le référencement.</div></div><div><h3>Population cible</h3><div>Toutes les personnes enceintes ou dans la première année du post-partum.</div></div><div><h3>Résultats</h3><div>Dialogue ouvert et soins basés sur des données probantes lors de troubles périnataux de l'humeur et de l'anxiété, y compris les compétences en matière d'identification, de dépistage, de traitement et de référencement.</div></div><div><h3>Bénéfices, risques et coûts</h3><div>Les personnes enceintes et celles en post-partum atteinte de troubles de santé mentale périnatale non traitée, y compris de troubles de l'humeur et d'anxiété, peuvent subir, ainsi que leur famille, des effets néfastes ainsi que des conséquences négatives à leur santé, à court et à long terme.</div></div><div><h3>Données probantes</h3><div>Une recherche documentaire a été effectuée sur Medline (Ovid), PubMed, Embase et la bibliothèque Cochrane depuis le début jusqu'à juin 2024. Des articles supplémentaires ont été identifiés à partir de bibliographies d'articles et de la littérature grise publiée par des sociétés et des organisations réputées (voir l'<span><span>annexe A</span></span> en ligne).</div></div><div><h3>Méthodes de validation</h3><div>Les auteurs ont évalué la qualité des données probantes et la force des recommandations en utilisant le cadre méthodologique GRADE (Grading of Recommendations, Assessment, Development, and Evaluation). Voir l’<span><span>annexe B</span></span> en ligne (<span><span>tableau B1</span></span> pour les définitions et <span><span>tableau B2</span></span> pour l’interprétation des recommandations fortes et faibles).</div></div><div><h3>Professionnels concernés</h3><div>Tous les prestataires de soins de santé qui fournissent offrent des conseils en périnatalité. Le terme \"périnatal\" sera utilisé tout au long de cette directive pour désigner ces professionnels de la santé.</div></div><div><h3>Résumé des médias sociaux</h3><div>Nouvelle directive clinique de la SOGC ! Identifier, accompagner et traiter les troubles d'humeur et d'anxiété périnataux. Axée sur les déterminants et les facteurs de risque, le dépistage, le traitement et le référencement tout au long de la trajectoire périnatale. La directive vise un dialogue et des soins personnalisés basés sur des données probantes pour des soins de qualité en contexte de santé mentale périnatale.</div></div><div><h3>DÉCLARATIONS SOMMAIRES</h3><div><ul><li><span>1.</span><span><div>Les troubles périnataux de l'humeur et de l'anxiété sont fréquents (<em>élevée</em>) ; la dépression et l'anxiété post-partum représentent des complications maternelles les plus f","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"46 10","pages":"Article 102697"},"PeriodicalIF":2.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01DOI: 10.1016/j.jogc.2024.102680
Simone N. Vigod MD, MSc , Benicio N. Frey MD, PhD
{"title":"Towards Better Perinatal Mental Health Care","authors":"Simone N. Vigod MD, MSc , Benicio N. Frey MD, PhD","doi":"10.1016/j.jogc.2024.102680","DOIUrl":"10.1016/j.jogc.2024.102680","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"46 10","pages":"Article 102680"},"PeriodicalIF":2.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142578575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01DOI: 10.1016/j.jogc.2024.102677
Paul J. Yong MD, PhD
{"title":"Extraits de la littérature médicale mondiale : Gynécologie","authors":"Paul J. Yong MD, PhD","doi":"10.1016/j.jogc.2024.102677","DOIUrl":"10.1016/j.jogc.2024.102677","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"46 10","pages":"Article 102677"},"PeriodicalIF":2.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142578578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-01DOI: 10.1016/j.jogc.2024.102681
Simone N. Vigod MD, MSc , Benicio N. Frey MD, PhD
{"title":"Vers de meilleurs soins en santé mentale périnatale","authors":"Simone N. Vigod MD, MSc , Benicio N. Frey MD, PhD","doi":"10.1016/j.jogc.2024.102681","DOIUrl":"10.1016/j.jogc.2024.102681","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"46 10","pages":"Article 102681"},"PeriodicalIF":2.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142578576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sacrospinous ligament suspension is used for suspension of apical prolapse; however, it has a high rate of recurrence compared with sacrocolpopexy, and a high rate of pain compared with uterosacral suspension. We developed a novel surgical procedure of bilateral sacrospinous vaginal vault fixation with synthetic mesh arms. We previously demonstrated its safety, and in Supplementary video 1, we describe a step-by-step surgical approach that could be replicated. This technique restores support, creating an anatomically correct midline configuration of the vaginal axis with minimal tension. A randomized controlled trial is underway to examine durability of mesh versus suture techniques for sacrospinous ligament suspension.
{"title":"Bilateral Sacrospinous Vaginal Vault Fixation With Synthetic Mesh Arms: A Novel Technique","authors":"Roxana Geoffrion MDCM, Nicole Koenig BA, CCRP, Lina Roa MD, MPH","doi":"10.1016/j.jogc.2024.102671","DOIUrl":"10.1016/j.jogc.2024.102671","url":null,"abstract":"<div><div>Sacrospinous ligament suspension is used for suspension of apical prolapse; however, it has a high rate of recurrence compared with sacrocolpopexy, and a high rate of pain compared with uterosacral suspension. We developed a novel surgical procedure of bilateral sacrospinous vaginal vault fixation with synthetic mesh arms. We previously demonstrated its safety, and in Supplementary video 1, we describe a step-by-step surgical approach that could be replicated. This technique restores support, creating an anatomically correct midline configuration of the vaginal axis with minimal tension. A randomized controlled trial is underway to examine durability of mesh versus suture techniques for sacrospinous ligament suspension.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"46 12","pages":"Article 102671"},"PeriodicalIF":2.0,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-28DOI: 10.1016/j.jogc.2024.102670
Vrati M. Mehra BSc, MSc , Ellen M. Greenblatt BSc, MD , Hala Tamim BSc, MSc, PhD , John W. Snelgrove BSc, MD, MSc , Claire A. Jones BSc, MD
Recent national studies on awareness of folic acid (FA) prior to pregnancy among Canadian women are lacking. Using the 2017–2018 Canadian Community Health Survey, we aimed to estimate prevalence and risk factors associated with Canadian women who reported they were unaware of the benefits of FA supplementation before pregnancy. Prevalence of unawareness of FA was 22.1%. Lower education, lack of a health care provider, low household income, and an immigrant background were associated with greater odds of unawareness of the benefits of FA supplementation. Persistent associations with measures of social disadvantage and social determinants of health emphasize the need for new targeted public health campaigns.
{"title":"Prevalence and Associated Risk Factors with Unawareness of Folic Acid Benefits Prior to Pregnancy: Results From Canadian Community Health Survey","authors":"Vrati M. Mehra BSc, MSc , Ellen M. Greenblatt BSc, MD , Hala Tamim BSc, MSc, PhD , John W. Snelgrove BSc, MD, MSc , Claire A. Jones BSc, MD","doi":"10.1016/j.jogc.2024.102670","DOIUrl":"10.1016/j.jogc.2024.102670","url":null,"abstract":"<div><div>Recent national studies on awareness of folic acid (FA) prior to pregnancy among Canadian women are lacking. Using the 2017–2018 Canadian Community Health Survey, we aimed to estimate prevalence and risk factors associated with Canadian women who reported they were unaware of the benefits of FA supplementation before pregnancy. Prevalence of unawareness of FA was 22.1%. Lower education, lack of a health care provider, low household income, and an immigrant background were associated with greater odds of unawareness of the benefits of FA supplementation. Persistent associations with measures of social disadvantage and social determinants of health emphasize the need for new targeted public health campaigns.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"46 12","pages":"Article 102670"},"PeriodicalIF":2.0,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-27DOI: 10.1016/j.jogc.2024.102669
Hannah Matthews BSc , Jo Watson PhD, RN(EC), IBCLC , Sue Hermann MN, RN, IBCLC, PNC(C) , Karen Fleming MD
This study aimed to describe exclusive breastfeeding (EBF) rates at discharge at Sunnybrook Health Sciences Centre and explore factors that contributed to changes in breastfeeding rates during the COVID-19 pandemic. Overall, 4762 patient charts were reviewed, 2000 from the pre-pandemic period, and 2762 from the lockdown period. Data was collected on EBF status at discharge, on maternal health history, and on infant characteristics. EBF rates fell from 75.8% to 73.85% from the pre-COVID-19 to COVID-19 period. During the pandemic, EBF was positively associated with BMI <30, spontaneous conception, and infants at risk of low blood sugar. Non-spontaneous conception was associated with lower EBF.
{"title":"Exclusive Breastfeeding Rates Upon Hospital Discharge at a Tertiary Centre Prior to and During the COVID-19 Pandemic","authors":"Hannah Matthews BSc , Jo Watson PhD, RN(EC), IBCLC , Sue Hermann MN, RN, IBCLC, PNC(C) , Karen Fleming MD","doi":"10.1016/j.jogc.2024.102669","DOIUrl":"10.1016/j.jogc.2024.102669","url":null,"abstract":"<div><div>This study aimed to describe exclusive breastfeeding (EBF) rates at discharge at Sunnybrook Health Sciences Centre and explore factors that contributed to changes in breastfeeding rates during the COVID-19 pandemic. Overall, 4762 patient charts were reviewed, 2000 from the pre-pandemic period, and 2762 from the lockdown period. Data was collected on EBF status at discharge, on maternal health history, and on infant characteristics. EBF rates fell from 75.8% to 73.85% from the pre-COVID-19 to COVID-19 period. During the pandemic, EBF was positively associated with BMI <30, spontaneous conception, and infants at risk of low blood sugar. Non-spontaneous conception was associated with lower EBF.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"46 12","pages":"Article 102669"},"PeriodicalIF":2.0,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-27DOI: 10.1016/j.jogc.2024.102672
Amy Nakajima MD, MSc
{"title":"Incorporating Teaching of Intimate Partner Violence and Trauma- and Violence-Informed Care into Medical Education Curricula","authors":"Amy Nakajima MD, MSc","doi":"10.1016/j.jogc.2024.102672","DOIUrl":"10.1016/j.jogc.2024.102672","url":null,"abstract":"","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"46 12","pages":"Article 102672"},"PeriodicalIF":2.0,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-26DOI: 10.1016/j.jogc.2024.102668
Sarah J. Mah MD, MSc , Lori A. Brotto PhD, R Psych , Maggie Bryce MSc , Susan Keast CHRL , Arianne Albert PhD , Marette Lee MD, MPH
Objectives
Cervical cancer is on the rise in Canada. Addressing patient anxiety and improving patient understanding of colposcopy and results may improve adherence. This randomized controlled trial examined the impact of colposcopy results delivery by a Nurse Liaison versus the referring primary care provider (PCP) on patient anxiety, and secondary outcomes including patient satisfaction, knowledge of diagnosis, and 9-month adherence to follow-up.
Methods
Patients ≥18 years old presenting for initial appointment at the study colposcopy clinic were randomized 1:1 to an intervention group (Nurse Liaison) versus a control group (PCP). After receiving colposcopy results, participants completed online measures of anxiety (State-Trait Anxiety Inventory), health care satisfaction scales (Patient Satisfaction Questionnaire-18, Health Anxiety Inventory, Visit-Specific Satisfaction Questionnaire-9), self-reported colposcopy diagnosis, and demographics. Chart review at 9 months assessed adherence to recommended colposcopy follow-up. Groups were compared on continuous and categorical variables, controlling for diagnosis severity and trait anxiety.
Results
The intervention group had significantly lower state anxiety with State-Trait Anxiety Inventory-state mean scores of 37.3 versus 40.7 in controls (P = 0.03). Intervention group participants were more likely to correctly report their diagnosis (84% vs. 66.3%, P = 0.003). Questionnaire responders were more likely to be in the intervention group and had a higher proportion of cervical intraepithelial neoplasia 2+ pathology. There were no differences in demographics, patient satisfaction, or adherence to follow-up between groups.
Conclusions
Direct delivery of colposcopy results by a trained Nurse Liaison was associated with decreased patient anxiety around colposcopy results, and increased patient knowledge regarding diagnosis. This model may be considered to improve patient-centred care.
{"title":"A Parallel-Group, Randomized Trial Examining Impact of Colposcopy Results Delivery by a Nurse Liaison on Patient-Reported Outcomes and Adherence","authors":"Sarah J. Mah MD, MSc , Lori A. Brotto PhD, R Psych , Maggie Bryce MSc , Susan Keast CHRL , Arianne Albert PhD , Marette Lee MD, MPH","doi":"10.1016/j.jogc.2024.102668","DOIUrl":"10.1016/j.jogc.2024.102668","url":null,"abstract":"<div><h3>Objectives</h3><div>Cervical cancer is on the rise in Canada. Addressing patient anxiety and improving patient understanding of colposcopy and results may improve adherence. This randomized controlled trial examined the impact of colposcopy results delivery by a Nurse Liaison versus the referring primary care provider (PCP) on patient anxiety, and secondary outcomes including patient satisfaction, knowledge of diagnosis, and 9-month adherence to follow-up.</div></div><div><h3>Methods</h3><div>Patients ≥18 years old presenting for initial appointment at the study colposcopy clinic were randomized 1:1 to an intervention group (Nurse Liaison) versus a control group (PCP). After receiving colposcopy results, participants completed online measures of anxiety (State-Trait Anxiety Inventory), health care satisfaction scales (Patient Satisfaction Questionnaire-18, Health Anxiety Inventory, Visit-Specific Satisfaction Questionnaire-9), self-reported colposcopy diagnosis, and demographics. Chart review at 9 months assessed adherence to recommended colposcopy follow-up. Groups were compared on continuous and categorical variables, controlling for diagnosis severity and trait anxiety.</div></div><div><h3>Results</h3><div>The intervention group had significantly lower state anxiety with State-Trait Anxiety Inventory-state mean scores of 37.3 versus 40.7 in controls (<em>P</em> = 0.03). Intervention group participants were more likely to correctly report their diagnosis (84% vs. 66.3%, <em>P</em> = 0.003). Questionnaire responders were more likely to be in the intervention group and had a higher proportion of cervical intraepithelial neoplasia 2+ pathology. There were no differences in demographics, patient satisfaction, or adherence to follow-up between groups.</div></div><div><h3>Conclusions</h3><div>Direct delivery of colposcopy results by a trained Nurse Liaison was associated with decreased patient anxiety around colposcopy results, and increased patient knowledge regarding diagnosis. This model may be considered to improve patient-centred care.</div></div>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":"46 12","pages":"Article 102668"},"PeriodicalIF":2.0,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-23DOI: 10.1016/j.jogc.2024.102664
Anna Kobylianskii, Jessica Blom, Geneviève Horwood, Neha Sarna, Margot Rosenthal, Marta Cybulsky, Azra Shivji, Carmen McCaffrey, John J Matelski, Meghan McGrattan, Ally Murji
Objective: To evaluate the quality of operative reports for endometriosis surgeries performed by fellowship-trained, high-volume endometriosis surgeons.
Methods: In this retrospective review, 5 consecutive deidentified surgical reports per surgeon were evaluated by two reviewers. Each dictation was assigned a quality score (between 0 and 28), based on the number of components from the American Association of Gynecologic Laparoscopists (AAGL) classification system that were documented. Primary outcome was the proportion of reports for which endometriosis AAGL 2021 stage could be assigned. Secondary outcomes included median dictation quality scores, proportion of dictations for fertility-preserving cases where Endometriosis Fertility Index (EFI) score could be assigned, individual quality score components, and quality score variation between surgeons, institutions, and reporting methods.
Results: 82 operative reports were reviewed from 16 surgeons across 7 sites in Ontario. AAGL stage could be assigned in 48/82 (59%) of cases, and EFI score could be assigned in 31/45 of fertility-preserving cases (69%). Median quality score was 57% (range 18%-86%). Only 13% of operative reports included comment on residual disease. Quality score consistency between reports was poor for a given surgeon (ICC = 0.22, 95% CI 0.03-0.49). Quality scores differed significantly between surgeons (chi-square = 30.6, df = 16, P = .015) and institutions (chi-square = 19.59, df = 7, P = .007). Operative report quality score did not differ based on completion by trainee or staff, template use, or whether the report was completed by telephone or typed.
Conclusion: There is significant variability and inconsistency in endometriosis surgery documentation. There is a need to standardize surgical documentation for endometriosis surgeries, enhancing communication and ultimately patient care.
{"title":"Evaluating the Quality of Endometriosis Operative Reports among High Volume Endometriosis Surgeons.","authors":"Anna Kobylianskii, Jessica Blom, Geneviève Horwood, Neha Sarna, Margot Rosenthal, Marta Cybulsky, Azra Shivji, Carmen McCaffrey, John J Matelski, Meghan McGrattan, Ally Murji","doi":"10.1016/j.jogc.2024.102664","DOIUrl":"https://doi.org/10.1016/j.jogc.2024.102664","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the quality of operative reports for endometriosis surgeries performed by fellowship-trained, high-volume endometriosis surgeons.</p><p><strong>Methods: </strong>In this retrospective review, 5 consecutive deidentified surgical reports per surgeon were evaluated by two reviewers. Each dictation was assigned a quality score (between 0 and 28), based on the number of components from the American Association of Gynecologic Laparoscopists (AAGL) classification system that were documented. Primary outcome was the proportion of reports for which endometriosis AAGL 2021 stage could be assigned. Secondary outcomes included median dictation quality scores, proportion of dictations for fertility-preserving cases where Endometriosis Fertility Index (EFI) score could be assigned, individual quality score components, and quality score variation between surgeons, institutions, and reporting methods.</p><p><strong>Results: </strong>82 operative reports were reviewed from 16 surgeons across 7 sites in Ontario. AAGL stage could be assigned in 48/82 (59%) of cases, and EFI score could be assigned in 31/45 of fertility-preserving cases (69%). Median quality score was 57% (range 18%-86%). Only 13% of operative reports included comment on residual disease. Quality score consistency between reports was poor for a given surgeon (ICC = 0.22, 95% CI 0.03-0.49). Quality scores differed significantly between surgeons (chi-square = 30.6, df = 16, P = .015) and institutions (chi-square = 19.59, df = 7, P = .007). Operative report quality score did not differ based on completion by trainee or staff, template use, or whether the report was completed by telephone or typed.</p><p><strong>Conclusion: </strong>There is significant variability and inconsistency in endometriosis surgery documentation. There is a need to standardize surgical documentation for endometriosis surgeries, enhancing communication and ultimately patient care.</p>","PeriodicalId":16688,"journal":{"name":"Journal of obstetrics and gynaecology Canada","volume":" ","pages":"102664"},"PeriodicalIF":2.0,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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