Journal of the American College of Surgeons
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Shared decision making requires informing patients and ensuring that treatment decisions reflect their goals. It is not clear to what extent this happens for patients considering total joint replacement (TJR) for hip or knee osteoarthritis. ⋯ A third of patients who recently made a decision about osteoarthritis treatment met both criteria for a high quality decision. Controlling for treatment, patients reporting more involvement in the decision making process, higher quality of life, and being seen at a site that uses decision aids were associated with higher decision quality.
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Comment Letter
SILC: significantly inferior laparoscopic cholecystectomy?
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Electronic health information platforms have the potential to support standardized care delivery models, engage patients, and deliver patient self-assessment tools. ⋯ Our trial demonstrated that an e-health platform, combined with mobile computing, can effectively deliver customized care plans with which patients can interact. Furthermore, patient self-reported data are predictive of length of stay and discharge disposition.
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This study was undertaken to evaluate our clinical experience during a 6-year period with an implantable device that augments the lower esophageal sphincter for gastroesophageal reflux disease (GERD). The device uses magnetic sphincter augmentation (MSA) to strengthen the antireflux barrier. ⋯ Magnetic sphincter augmentation for GERD in clinical practice provides safe and long-term reduction of esophageal acid exposure, substantial symptom improvement, and elimination of daily PPI use. For candidates of antireflux surgery who have been carefully evaluated before surgery to confirm indication for MSA, MSA has become a standard treatment at our institution because control of reflux symptoms and pH normalization can be achieved with minimal side effects and preservation of gastric anatomy.