The Experts below are selected from a list of 6762 Experts worldwide ranked by ideXlab platform
David A. Watters - One of the best experts on this subject based on the ideXlab platform.
-
The Economic Value of the Delivery of Primary Cleft Surgery in Timor Leste 2000–2017
World Journal of Surgery, 2020Co-Authors: Priya Nandoskar, Mark H. Moore, Patrick Coghlan, Joao Ximenes, Eileen M. Moore, Jonathan Karnon, David A. WattersAbstract:Background Plastic and reconstructive surgical teams visiting from Australia, a high-income country, have delivered Cleft surgical services to Timor Leste since 2000 on a volunteer basis. This paper aims to estimate the economic benefit of correcting Cleft deformities in this new nation as it evolved its healthcare delivery service from independence in 1999. Methods We have utilised a prospective database of all Cleft surgical interventions performed during 44 plastic surgical missions over the last 18 years. The disability-adjusted life year (DALY) framework was used to calculate the total DALYs averted by primary Cleft lip and palate repair. The 2004 global burden of disease disability weights were used. Economic benefits were calculated using the gross national income (GNI) and the value of a statistical life (VSL) methods for Timor Leste. Estimates were adjusted for treatment effectiveness, counterfactual cases, and complications. Cost estimates included the local hospitalisation costs, the foregone salaries of the visiting surgeons and nurses, other costs associated with providing surgical care, and an estimate for foregone wages of the patients or their carers. Sensitivity analysis was performed with income elasticity set to 0.55, 1.0, and 1.5. Results During 44 visiting plastic surgical missions to Timor Leste, 1500 procedures were performed, including 843 primary Cleft lip and palate operations. The Cleft procedures resulted in the aversion of 842 DALYs and an economic return to Timor Leste of USD 2.2 million (GNI-based) or USD 197,917 (VSL-based). Our programme cost USD 705 per DALY averted. The economic return on investment was 0.3:1 (VSL-based) or 3.8:1 (GNI-based). Conclusion A sustained and consistent visiting team approach providing repair of Cleft lip and palate defects has resulted in considerable economic gain for Timor Leste over an 18-year period. The training of a local surgeon and multidisciplinary team with ongoing support to the in-country Cleft service is expected to reduce the cost per DALY averted once the surgeon and team are able to manage Clefts independently.
-
The Economic Value of the Delivery of Primary Cleft Surgery in Timor Leste 2000-2017.
World journal of surgery, 2020Co-Authors: Priya Nandoskar, Mark H. Moore, Patrick Coghlan, Joao Ximenes, Eileen M. Moore, Jonathan Karnon, David A. WattersAbstract:Plastic and reconstructive surgical teams visiting from Australia, a high-income country, have delivered Cleft surgical services to Timor Leste since 2000 on a volunteer basis. This paper aims to estimate the economic benefit of correcting Cleft deformities in this new nation as it evolved its healthcare delivery service from independence in 1999. We have utilised a prospective database of all Cleft surgical interventions performed during 44 plastic surgical missions over the last 18 years. The disability-adjusted life year (DALY) framework was used to calculate the total DALYs averted by primary Cleft lip and palate repair. The 2004 global burden of disease disability weights were used. Economic benefits were calculated using the gross national income (GNI) and the value of a statistical life (VSL) methods for Timor Leste. Estimates were adjusted for treatment effectiveness, counterfactual cases, and complications. Cost estimates included the local hospitalisation costs, the foregone salaries of the visiting surgeons and nurses, other costs associated with providing surgical care, and an estimate for foregone wages of the patients or their carers. Sensitivity analysis was performed with income elasticity set to 0.55, 1.0, and 1.5. During 44 visiting plastic surgical missions to Timor Leste, 1500 procedures were performed, including 843 primary Cleft lip and palate operations. The Cleft procedures resulted in the aversion of 842 DALYs and an economic return to Timor Leste of USD 2.2 million (GNI-based) or USD 197,917 (VSL-based). Our programme cost USD 705 per DALY averted. The economic return on investment was 0.3:1 (VSL-based) or 3.8:1 (GNI-based). A sustained and consistent visiting team approach providing repair of Cleft lip and palate defects has resulted in considerable economic gain for Timor Leste over an 18-year period. The training of a local surgeon and multidisciplinary team with ongoing support to the in-country Cleft service is expected to reduce the cost per DALY averted once the surgeon and team are able to manage Clefts independently.
Priya Nandoskar - One of the best experts on this subject based on the ideXlab platform.
-
The Economic Value of the Delivery of Primary Cleft Surgery in Timor Leste 2000–2017
World Journal of Surgery, 2020Co-Authors: Priya Nandoskar, Mark H. Moore, Patrick Coghlan, Joao Ximenes, Eileen M. Moore, Jonathan Karnon, David A. WattersAbstract:Background Plastic and reconstructive surgical teams visiting from Australia, a high-income country, have delivered Cleft surgical services to Timor Leste since 2000 on a volunteer basis. This paper aims to estimate the economic benefit of correcting Cleft deformities in this new nation as it evolved its healthcare delivery service from independence in 1999. Methods We have utilised a prospective database of all Cleft surgical interventions performed during 44 plastic surgical missions over the last 18 years. The disability-adjusted life year (DALY) framework was used to calculate the total DALYs averted by primary Cleft lip and palate repair. The 2004 global burden of disease disability weights were used. Economic benefits were calculated using the gross national income (GNI) and the value of a statistical life (VSL) methods for Timor Leste. Estimates were adjusted for treatment effectiveness, counterfactual cases, and complications. Cost estimates included the local hospitalisation costs, the foregone salaries of the visiting surgeons and nurses, other costs associated with providing surgical care, and an estimate for foregone wages of the patients or their carers. Sensitivity analysis was performed with income elasticity set to 0.55, 1.0, and 1.5. Results During 44 visiting plastic surgical missions to Timor Leste, 1500 procedures were performed, including 843 primary Cleft lip and palate operations. The Cleft procedures resulted in the aversion of 842 DALYs and an economic return to Timor Leste of USD 2.2 million (GNI-based) or USD 197,917 (VSL-based). Our programme cost USD 705 per DALY averted. The economic return on investment was 0.3:1 (VSL-based) or 3.8:1 (GNI-based). Conclusion A sustained and consistent visiting team approach providing repair of Cleft lip and palate defects has resulted in considerable economic gain for Timor Leste over an 18-year period. The training of a local surgeon and multidisciplinary team with ongoing support to the in-country Cleft service is expected to reduce the cost per DALY averted once the surgeon and team are able to manage Clefts independently.
-
The Economic Value of the Delivery of Primary Cleft Surgery in Timor Leste 2000-2017.
World journal of surgery, 2020Co-Authors: Priya Nandoskar, Mark H. Moore, Patrick Coghlan, Joao Ximenes, Eileen M. Moore, Jonathan Karnon, David A. WattersAbstract:Plastic and reconstructive surgical teams visiting from Australia, a high-income country, have delivered Cleft surgical services to Timor Leste since 2000 on a volunteer basis. This paper aims to estimate the economic benefit of correcting Cleft deformities in this new nation as it evolved its healthcare delivery service from independence in 1999. We have utilised a prospective database of all Cleft surgical interventions performed during 44 plastic surgical missions over the last 18 years. The disability-adjusted life year (DALY) framework was used to calculate the total DALYs averted by primary Cleft lip and palate repair. The 2004 global burden of disease disability weights were used. Economic benefits were calculated using the gross national income (GNI) and the value of a statistical life (VSL) methods for Timor Leste. Estimates were adjusted for treatment effectiveness, counterfactual cases, and complications. Cost estimates included the local hospitalisation costs, the foregone salaries of the visiting surgeons and nurses, other costs associated with providing surgical care, and an estimate for foregone wages of the patients or their carers. Sensitivity analysis was performed with income elasticity set to 0.55, 1.0, and 1.5. During 44 visiting plastic surgical missions to Timor Leste, 1500 procedures were performed, including 843 primary Cleft lip and palate operations. The Cleft procedures resulted in the aversion of 842 DALYs and an economic return to Timor Leste of USD 2.2 million (GNI-based) or USD 197,917 (VSL-based). Our programme cost USD 705 per DALY averted. The economic return on investment was 0.3:1 (VSL-based) or 3.8:1 (GNI-based). A sustained and consistent visiting team approach providing repair of Cleft lip and palate defects has resulted in considerable economic gain for Timor Leste over an 18-year period. The training of a local surgeon and multidisciplinary team with ongoing support to the in-country Cleft service is expected to reduce the cost per DALY averted once the surgeon and team are able to manage Clefts independently.
Roberto L. Flores - One of the best experts on this subject based on the ideXlab platform.
-
Simulation in Cleft Surgery.
Plastic and reconstructive surgery. Global open, 2019Co-Authors: Rami S. Kantar, Jesus Rodrigo Diaz-siso, Allyson R. Alfonso, Elie P. Ramly, Corstiaan C. Breugem, Roberto L. FloresAbstract:A number of digital and haptic simulators have been developed to address challenges facing Cleft Surgery education. However, to date, a comprehensive review of available simulators has yet to be performed. Our goal is to appraise Cleft Surgery simulators that have been described to date, their role within a simulation-based educational strategy, the costs associated with their use, and data supporting or refuting their utility. Methods The following PubMed literature search strategies were used: "Cleft AND Simulation," "Cleft Surgery AND Simulation," "Cleft Lip AND Simulation," "Cleft Palate AND Simulation." Only English language articles up to May 1, 2019, were included. Simulation phases of learning were classified based on our previously proposed model for simulation training. Results A total of 22 articles were included in this study. Within identified articles, 11 (50%) were strictly descriptive of simulator features, whereas the remaining 11 (50%) evaluated specific outcomes pertinent to the use of Cleft Surgery simulators. The 22 included articles described 16 Cleft Surgery simulators. Out of these 16 Cleft Surgery simulators, 7 (43.8%) were high fidelity haptic simulators, 5 (31.2%) were low fidelity haptic simulators, and 4 (25.0%) were digital simulators. The cost to simulator user ranged from freely available up to $300. Conclusions Cleft Surgery simulators vary considerably in their features, purpose, cost, availability, and scientific evidence in support of their use. Future multi-institutional collaborative initiatives should focus on demonstrating the efficacy of current Cleft simulators and developing standardized assessment scales.
-
A Prospective, Randomized, Blinded Trial Comparing Digital Simulation to Textbook for Cleft Surgery Education.
Plastic and reconstructive surgery, 2019Co-Authors: Natalie M. Plana, Rami S. Kantar, Jesus Rodrigo Diaz-siso, William J. Rifkin, Joshua A. David, Samantha G. Maliha, Scott J. Farber, David A. Staffenberg, Barry H Grayson, Roberto L. FloresAbstract:BACKGROUND Simulation is progressively being integrated into surgical training; however, its utility in plastic Surgery has not been well described. The authors present a prospective, randomized, blinded trial comparing digital simulation to a surgical textbook for conceptualization of Cleft lip repair. METHODS Thirty-five medical students were randomized to learning Cleft repair using a simulator or a textbook. Participants outlined markings for a standard Cleft lip repair before (preintervention) and after (postintervention) 20 minutes of studying their respective resource. Two expert reviewers blindly graded markings according to a 10-point scale, on two separate occasions. Intrarater and interrater reliability were calculated using intraclass correlation coefficients. Paired and independent t tests were performed to compare scoring between study groups. A validated student satisfaction survey was administered to assess the two resources separately. RESULTS Intrarater grading reliability was excellent for both raters for preintervention and postintervention grading (rater 1, intraclass correlation coefficient = 0.94 and 0.95, respectively; rater 2, intraclass correlation coefficient = 0.60 and 0.92, respectively; p < 0.001). Mean preintervention performances for both groups were comparable (0.82 ± 1.17 versus 0.64 ± 0.95; p = 0.31). Significant improvement from preintervention to postintervention performance was observed in the textbook (0.82 ± 1.17 versus 3.50 ± 1.62; p < 0.001) and simulator (0.64 ± 0.95 versus 6.44 ± 2.03; p < 0.001) groups. However, the simulator group demonstrated a significantly greater improvement (5.81 ± 2.01 versus 2.68 ± 1.49; p < 0.001). Participants reported the simulator to be more effective (p < 0.001) and a clearer tool (p < 0.001), that allowed better learning (p < 0.001) than textbooks. All participants would recommend the simulator to others. CONCLUSION The authors present evidence from a prospective, randomized, blinded trial supporting online digital simulation as a superior educational resource for novice learners, compared with traditional textbooks.
-
the first year of global Cleft Surgery education through digital simulation a proof of concept
The Cleft Palate-Craniofacial Journal, 2018Co-Authors: Natalie M. Plana, Court B. Cutting, Rodrigo J Diazsiso, Derek M Culnan, Roberto L. FloresAbstract:Introduction:Parallel to worldwide disparities in patient access to health care, the operative opportunities of surgical trainees are increasingly restricted across the globe. Efforts have been directed toward enhancing surgical education outside the operating room and reducing the wide variability in global trainee operative experience. However, high costs and other logistical concerns may limit the reproducibility and sustainability of nonoperative surgical education resources.Methods:A partnership between the academic, nonprofit, and industry sectors resulted in the development of an online virtual surgical simulator for Cleft repair. First year global access patterns were observed.Results:The simulator is freely accessible online and includes 5 normal and pathologic anatomy modules, 5 modules demonstrating surgical markings, and 7 step-by-step procedural modules. Procedural modules include high-definition intraoperative footage to supplement the virtual animation in addition to include multiple-choice...
-
Internet-Based Digital Simulation for Cleft Surgery Education: A 5-Year Assessment of Demographics, Usage, and Global Effect
Journal of Surgical Education, 2018Co-Authors: Rami S. Kantar, Natalie M. Plana, Court B. Cutting, Jesus Rodrigo Diaz-siso, Roberto L. FloresAbstract:Background In October 2012, a freely available, internet-based Cleft simulator was created in partnership between academic, nonprofit, and industry sectors. The purpose of this educational resource was to address global disparities in Cleft Surgery education. This report assesses demographics, usage, and global effect of our simulator, in its fifth year since inception. Objective Evaluate the global effect, usage, and demographics of an internet-based educational digital simulation Cleft Surgery software. Setting and Participants Simulator modules, available in five languages demonstrate surgical anatomy, markings, detailed procedures, and intraoperative footage to supplement digital animation. Available data regarding number of users, sessions, countries reached, and content access were recorded. Surveys evaluating the demographic characteristics of registered users and simulator use were collected by direct e-mail. Results The total number of simulator new and active users reached 2865 and 4086 in June 2017, respectively. By June 2017, users from 136 countries had accessed the simulator. From 2015 to 2017, the number of sessions was 11,176 with a monthly average of 399.0 ± 190.0. Developing countries accounted for 35% of sessions and the average session duration was 9.0 ± 7.3 minutes. This yields a total simulator screen time of 100,584 minutes (1676 hours). Most survey respondents were surgeons or trainees (87%) specializing in plastic, maxillofacial, or general Surgery (89%). Most users found the simulator to be useful (88%), at least equivalent or more useful than other resources (83%), and used it for teaching (58%). Conclusions Our internet-based interactive Cleft Surgery platform reaches its intended target audience, is not restricted by socioeconomic barriers to access, and is judged to be useful by surgeons. More than 4000 active users have been reached since inception. The total screen time over approximately 2 years exceeded 1600 hours. This suggests that future surgical simulators of this kind may be sustainable by stakeholders interested in reaching this target audience.
Mark H. Moore - One of the best experts on this subject based on the ideXlab platform.
-
The Economic Value of the Delivery of Primary Cleft Surgery in Timor Leste 2000–2017
World Journal of Surgery, 2020Co-Authors: Priya Nandoskar, Mark H. Moore, Patrick Coghlan, Joao Ximenes, Eileen M. Moore, Jonathan Karnon, David A. WattersAbstract:Background Plastic and reconstructive surgical teams visiting from Australia, a high-income country, have delivered Cleft surgical services to Timor Leste since 2000 on a volunteer basis. This paper aims to estimate the economic benefit of correcting Cleft deformities in this new nation as it evolved its healthcare delivery service from independence in 1999. Methods We have utilised a prospective database of all Cleft surgical interventions performed during 44 plastic surgical missions over the last 18 years. The disability-adjusted life year (DALY) framework was used to calculate the total DALYs averted by primary Cleft lip and palate repair. The 2004 global burden of disease disability weights were used. Economic benefits were calculated using the gross national income (GNI) and the value of a statistical life (VSL) methods for Timor Leste. Estimates were adjusted for treatment effectiveness, counterfactual cases, and complications. Cost estimates included the local hospitalisation costs, the foregone salaries of the visiting surgeons and nurses, other costs associated with providing surgical care, and an estimate for foregone wages of the patients or their carers. Sensitivity analysis was performed with income elasticity set to 0.55, 1.0, and 1.5. Results During 44 visiting plastic surgical missions to Timor Leste, 1500 procedures were performed, including 843 primary Cleft lip and palate operations. The Cleft procedures resulted in the aversion of 842 DALYs and an economic return to Timor Leste of USD 2.2 million (GNI-based) or USD 197,917 (VSL-based). Our programme cost USD 705 per DALY averted. The economic return on investment was 0.3:1 (VSL-based) or 3.8:1 (GNI-based). Conclusion A sustained and consistent visiting team approach providing repair of Cleft lip and palate defects has resulted in considerable economic gain for Timor Leste over an 18-year period. The training of a local surgeon and multidisciplinary team with ongoing support to the in-country Cleft service is expected to reduce the cost per DALY averted once the surgeon and team are able to manage Clefts independently.
-
The Economic Value of the Delivery of Primary Cleft Surgery in Timor Leste 2000-2017.
World journal of surgery, 2020Co-Authors: Priya Nandoskar, Mark H. Moore, Patrick Coghlan, Joao Ximenes, Eileen M. Moore, Jonathan Karnon, David A. WattersAbstract:Plastic and reconstructive surgical teams visiting from Australia, a high-income country, have delivered Cleft surgical services to Timor Leste since 2000 on a volunteer basis. This paper aims to estimate the economic benefit of correcting Cleft deformities in this new nation as it evolved its healthcare delivery service from independence in 1999. We have utilised a prospective database of all Cleft surgical interventions performed during 44 plastic surgical missions over the last 18 years. The disability-adjusted life year (DALY) framework was used to calculate the total DALYs averted by primary Cleft lip and palate repair. The 2004 global burden of disease disability weights were used. Economic benefits were calculated using the gross national income (GNI) and the value of a statistical life (VSL) methods for Timor Leste. Estimates were adjusted for treatment effectiveness, counterfactual cases, and complications. Cost estimates included the local hospitalisation costs, the foregone salaries of the visiting surgeons and nurses, other costs associated with providing surgical care, and an estimate for foregone wages of the patients or their carers. Sensitivity analysis was performed with income elasticity set to 0.55, 1.0, and 1.5. During 44 visiting plastic surgical missions to Timor Leste, 1500 procedures were performed, including 843 primary Cleft lip and palate operations. The Cleft procedures resulted in the aversion of 842 DALYs and an economic return to Timor Leste of USD 2.2 million (GNI-based) or USD 197,917 (VSL-based). Our programme cost USD 705 per DALY averted. The economic return on investment was 0.3:1 (VSL-based) or 3.8:1 (GNI-based). A sustained and consistent visiting team approach providing repair of Cleft lip and palate defects has resulted in considerable economic gain for Timor Leste over an 18-year period. The training of a local surgeon and multidisciplinary team with ongoing support to the in-country Cleft service is expected to reduce the cost per DALY averted once the surgeon and team are able to manage Clefts independently.
-
Cleft Surgery in East timor: the first four years.
ANZ journal of surgery, 2006Co-Authors: Mark H. Moore, Antonio E. L. FernandesAbstract:Background: Following the vote for independence in 1999, this team commenced the first coherent reconstructive surgical service in East Timor. The aim of this paper is to report the Cleft lip and palate surgical experience during the 4 years since independence. Methods: From June 2000, a record of all Cleft surgical procedures carried out by our team in East Timor has been maintained. This has been reviewed to identify the clinical experience, procedures carried out and the outcomes of the Cleft population in this, the poorest and newest, nation in Asia. Results: From the 519 reconstructive surgical procedures carried out by this team in East Timor during the first 4 years, 267 were for Cleft lip and palate deformity. Cleft lip and nose repairs were most commonly undertaken, although over the period of the study increasing numbers of Cleft palate repairs were evident, reflecting the developing confidence in the service by the local population. Conclusion: The establishment of a regular, consistent Cleft lip and palate surgical team in East Timor has not only seen the successful correction of a large number of untreated Cleft patients, but has also contributed to a restoration of trust in the newly developing health system in East Timor.
Patrick Coghlan - One of the best experts on this subject based on the ideXlab platform.
-
The Economic Value of the Delivery of Primary Cleft Surgery in Timor Leste 2000–2017
World Journal of Surgery, 2020Co-Authors: Priya Nandoskar, Mark H. Moore, Patrick Coghlan, Joao Ximenes, Eileen M. Moore, Jonathan Karnon, David A. WattersAbstract:Background Plastic and reconstructive surgical teams visiting from Australia, a high-income country, have delivered Cleft surgical services to Timor Leste since 2000 on a volunteer basis. This paper aims to estimate the economic benefit of correcting Cleft deformities in this new nation as it evolved its healthcare delivery service from independence in 1999. Methods We have utilised a prospective database of all Cleft surgical interventions performed during 44 plastic surgical missions over the last 18 years. The disability-adjusted life year (DALY) framework was used to calculate the total DALYs averted by primary Cleft lip and palate repair. The 2004 global burden of disease disability weights were used. Economic benefits were calculated using the gross national income (GNI) and the value of a statistical life (VSL) methods for Timor Leste. Estimates were adjusted for treatment effectiveness, counterfactual cases, and complications. Cost estimates included the local hospitalisation costs, the foregone salaries of the visiting surgeons and nurses, other costs associated with providing surgical care, and an estimate for foregone wages of the patients or their carers. Sensitivity analysis was performed with income elasticity set to 0.55, 1.0, and 1.5. Results During 44 visiting plastic surgical missions to Timor Leste, 1500 procedures were performed, including 843 primary Cleft lip and palate operations. The Cleft procedures resulted in the aversion of 842 DALYs and an economic return to Timor Leste of USD 2.2 million (GNI-based) or USD 197,917 (VSL-based). Our programme cost USD 705 per DALY averted. The economic return on investment was 0.3:1 (VSL-based) or 3.8:1 (GNI-based). Conclusion A sustained and consistent visiting team approach providing repair of Cleft lip and palate defects has resulted in considerable economic gain for Timor Leste over an 18-year period. The training of a local surgeon and multidisciplinary team with ongoing support to the in-country Cleft service is expected to reduce the cost per DALY averted once the surgeon and team are able to manage Clefts independently.
-
The Economic Value of the Delivery of Primary Cleft Surgery in Timor Leste 2000-2017.
World journal of surgery, 2020Co-Authors: Priya Nandoskar, Mark H. Moore, Patrick Coghlan, Joao Ximenes, Eileen M. Moore, Jonathan Karnon, David A. WattersAbstract:Plastic and reconstructive surgical teams visiting from Australia, a high-income country, have delivered Cleft surgical services to Timor Leste since 2000 on a volunteer basis. This paper aims to estimate the economic benefit of correcting Cleft deformities in this new nation as it evolved its healthcare delivery service from independence in 1999. We have utilised a prospective database of all Cleft surgical interventions performed during 44 plastic surgical missions over the last 18 years. The disability-adjusted life year (DALY) framework was used to calculate the total DALYs averted by primary Cleft lip and palate repair. The 2004 global burden of disease disability weights were used. Economic benefits were calculated using the gross national income (GNI) and the value of a statistical life (VSL) methods for Timor Leste. Estimates were adjusted for treatment effectiveness, counterfactual cases, and complications. Cost estimates included the local hospitalisation costs, the foregone salaries of the visiting surgeons and nurses, other costs associated with providing surgical care, and an estimate for foregone wages of the patients or their carers. Sensitivity analysis was performed with income elasticity set to 0.55, 1.0, and 1.5. During 44 visiting plastic surgical missions to Timor Leste, 1500 procedures were performed, including 843 primary Cleft lip and palate operations. The Cleft procedures resulted in the aversion of 842 DALYs and an economic return to Timor Leste of USD 2.2 million (GNI-based) or USD 197,917 (VSL-based). Our programme cost USD 705 per DALY averted. The economic return on investment was 0.3:1 (VSL-based) or 3.8:1 (GNI-based). A sustained and consistent visiting team approach providing repair of Cleft lip and palate defects has resulted in considerable economic gain for Timor Leste over an 18-year period. The training of a local surgeon and multidisciplinary team with ongoing support to the in-country Cleft service is expected to reduce the cost per DALY averted once the surgeon and team are able to manage Clefts independently.