The Experts below are selected from a list of 42165 Experts worldwide ranked by ideXlab platform
Kevin C Chung - One of the best experts on this subject based on the ideXlab platform.
-
Litigation in Hand Surgery: A 30-Year Review.
Plastic & Reconstructive Surgery, 2020Co-Authors: Sarah E. Sasor, Kevin C ChungAbstract:BACKGROUND Although Hand Surgery is generally safe and effective, some patients experience complications or poor outcomes prompting them to seek compensation. This study reviews malpractice claims in Hand Surgery using a national data set to assess reasons for litigation and identify predictors of outcome. METHODS The Westlaw database was queried for cases related to Hand Surgery and medical malpractice between 1989 and 2018. Jury verdicts and settlements were reviewed for relevance, and variables including plaintiff and defendant demographics, diagnosis, alleged reason for malpractice, verdicts, and payouts were recorded. RESULTS Four hundred thirty relevant claims were identified. Distal radius fractures (21 percent), carpal tunnel syndrome (14 percent), and tendon lacerations (6 percent) were the most common diagnoses. Alleged reasons for malpractice included failure to diagnose/treat (34 percent), surgical negligence (29 percent), and improper procedure/treatment (19 percent). Thirty-six cases (8 percent) resolved in settlement for a mean payout of $551,957. A plaintiff verdict was reached in 98 cases (25 percent of trials), with a mean payout of $832,258. The remaining 296 cases (75 percent of trials) resulted in defendant verdicts (no payout). Plaintiff age, plaintiff sex, defendant sex, and defendant degree had no impact on trial outcome. Cases involving surgeons without subspecialty certification in Hand Surgery were significantly more likely to result in plaintiff verdicts (27 percent versus 7 percent with Hand subspecialization; p = 0.003). CONCLUSIONS This study reviews malpractice claims in Hand Surgery over the past 30 years. Providing timely diagnoses, managing expectations, and reducing procedural error may decrease the risk of litigation.
-
Establishing a National Registry for Hand Surgery.
The Journal of Hand Surgery, 2020Co-Authors: Robert L. Kane, Kevin C ChungAbstract:Hand Surgery leadership in the United States must identify and define what quality care means for its patients. To achieve this, the surgical team needs a standardized framework to track and improve quality. This is necessary not only in our value-based health care system but also in light of considerable provider variation in the management of common Hand conditions and the ongoing need for evidence-based guidelines to inform decision-making. Building a national registry for the field of Hand Surgery could be the solution and warrants serious consideration. A registry designed by Hand Surgery experts can collect data on process and outcome measures that are meaningful and specific to patients with Hand conditions. These data inform the surgical team regarding where to focus their efforts for improvement. Existing methods of quality measurement are not compatible with Hand Surgery, a field with an ambulatory setting and rare incidence of mortality. Patient-reported outcomes, such as health-related quality of life, represent a more useful measure of quality for Hand Surgery and are just one example of the type of data that could be tracked using a national registry. An investment in a large-scale registry could seamlessly integrate patient preferences, values, and expectations into clinical practice so that desired outcomes can be delivered consistently across the nation.
-
Translating Hand Surgery Evidence to Policy and Practice.
Hand Clinics, 2020Co-Authors: Jacob S. Nasser, Kevin C ChungAbstract:Hand Surgery researchers should focus on developing high-quality evidence to support the development of health policies affecting surgical care. Policy-makers and leaders of national Hand societies can help reduce the variation of care for patients receiving Hand Surgery by incorporating evidence into guidelines and policies. Comprehensive guidelines for perioperative care help encourage the translation of evidence into practice. Moreover, the identification of institutional-level barriers and facilitators of integration ensures the successful implementation of Hand Surgery-specific programs. The development of robust metrics to evaluate the effect of policy on practice helps examine the feasibility of clinical guidelines.
-
cost effectiveness analysis of humanitarian Hand Surgery trips according to who choice thresholds
Journal of Hand Surgery (European Volume), 2018Co-Authors: Xuan Qiu, Jacob S. Nasser, Gloria R Sue, James Chang, Kevin C ChungAbstract:Purpose Hand Surgery outreach programs to low- and middle-income countries (LMICs) provide much-needed surgical care to the underserved populations and education to local providers for improved care. The cost-effectiveness of these surgical trips has not been studied despite a long history of such efforts. This study aimed to examine the economic impact of Hand Surgery trips to LMICs using data from the Touching Hands Project and ReSurge International. We hypothesized that Hand Surgery outreach would be cost-effective in LMICs. Methods We analyzed data on the cost of each trip and the surgical procedures performed. Using methods from the World Health Organization (WHO–Choosing Interventions That Are Cost-Effective [WHO-CHOICE]), we determined whether the procedures performed during the outreach trips would be cost-effective. Results For the 14 Hand Surgery trips, 378 patients received surgical treatment. Trips varied in the country where interventions were provided, the number of patients served, the severity of the conditions, and the total cost. The cost per disability-adjusted life-year averted ranged from United States (US)$222 to $1,525, all of which were very cost-effective according to WHO-CHOICE thresholds. The cost-effectiveness of global Hand Surgery was comparable to that of other medical interventions such as multidrug-resistant tuberculosis treatment in similar regions. We also identified a lack of standardized record keeping for these surgical trips. Conclusions Hand surgeries performed in LMICs are cost-effective based on WHO-CHOICE criteria. However, a standardized record-keeping method is needed for future research and longitudinal comparison. Understanding the economic impact of Hand Surgery global outreach is important to the success and sustainability of these efforts, both to allocate resources effectively and to identify areas for improvement. Type of study/level of evidence Economic/Decision Analysis III.
-
Essentials of Hand Surgery
2015Co-Authors: Kevin C ChungAbstract:Essentials of Hand Surgery / , Essentials of Hand Surgery / , کتابخانه دیجیتال جندی شاپور اهواز
Sandra V. Kotsis - One of the best experts on this subject based on the ideXlab platform.
-
Teaching Pediatric Hand Surgery in Vietnam
HAND, 2007Co-Authors: Kevin C Chung, Sandra V. KotsisAbstract:Background International volunteering missions are becoming an important focus of plastic surgeons in the United States. The purpose of this paper is to describe the teaching of pediatric Hand Surgery in Vietnam to share the lessons learned from this project. Methods Two medical education trips were conducted to the no. 1 Children’s Hospital in Ho Chi Minh city (Saigon) to teach pediatric Hand and burn reconstructive Surgery to the surgeons and therapists. This is the main referral children’s hospital for the country, and pediatric Hand Surgery expertise is not available. Results Structured education programs were conducted over two trips to introduce congenital Hand Surgery and burn reconstructive procedures using flap techniques. The education programs included lectures and surgical demonstrations of selected procedures. Their proficiency was verified by supervised conduct of these operations. Conclusions A well-conceived medical education program can introduce complex surgical discipline to a country. Through two trips, the surgeons at this referral center will have the capability to take care of many children requiring reconstructive Hand Surgery.
-
Teaching pediatric Hand Surgery in Vietnam.
HAND, 2007Co-Authors: Kevin C Chung, Sandra V. KotsisAbstract:Background International volunteering missions are becoming an important focus of plastic surgeons in the United States. The purpose of this paper is to describe the teaching of pediatric Hand Surgery in Vietnam to share the lessons learned from this project.
-
Factors influencing residents' decisions to pursue a career in Hand Surgery: a national survey.
The Journal of Hand Surgery, 2004Co-Authors: Kevin C Chung, Sandra V. Kotsis, Frank H. Lau, H. Myra KimAbstract:Abstract Purpose The number of programs offering Hand Surgery fellowships has remained approximately the same over a 6-year period while the number of fellows within these programs has decreased by 46%. This study aimed to identify factors that persuaded or dissuaded orthopedic and plastic Surgery residents in choosing Hand Surgery as a career. Methods We conducted a national survey of final-year orthopedic (n = 600) and plastic Surgery (n = 177) residents. We developed an internet questionnaire based on literature review and focus group discussions. A Web site link was sent via e-mail to program directors of accredited orthopedic and plastic Surgery programs for distribution of this anonymous survey to the residents. Factor analysis combined items into an "intellectual issues" category and a "lifestyle issues" category. Logistic regression was used to evaluate factors that predict an outcome of entering a Hand Surgery fellowship. Results We achieved a 30% response rate. Respondents and nonrespondents were not significantly different in terms of gender and race. After controlling for age, gender, marital status, and specialty, residents who enjoyed the intellectual issues of the Hand Surgery field were more likely to pursue a Hand Surgery fellowship (odds ratio=10.1; 95% confidence interval=3.3–30.8). Although a positive attitude toward lifestyle issues of the Hand Surgery field tended to be associated with pursuit of a Hand Surgery fellowship, the relationship was much weaker (odds ratio=2.5; 95% confidence interval=0.8–7.3). Conclusions Lifestyle issues associated with a career in Hand Surgery such as low reimbursement and long hours were not the most important factors to residents when considering a career in the field. Residents pursued Hand Surgery primarily because of factors such as interest in and exposure to this field. To prevent a potential shortfall of Hand surgeons, both orthopedic and plastic Surgery programs must strengthen residents' exposure to Hand Surgery education in their training.
David Ring - One of the best experts on this subject based on the ideXlab platform.
-
surgical site infection in Hand Surgery
International Orthopaedics, 2015Co-Authors: Mariano E Menendez, Sebastian Unizony, Hyon K Choi, David RingAbstract:Purpose As ambulatory Surgery becomes increasingly common, there is growing interest in assessing, monitoring, and tracking complications that occur secondary to outpatient procedures. We sought to determine the rates of 14- and 30-day acute care visits for surgical site infection after outpatient Hand Surgery, and to identify associated factors.
-
Infection After Hand Surgery
Hand Clinics, 2015Co-Authors: Kyle R. Eberlin, David RingAbstract:Postoperative infections are uncommon after Hand Surgery. Infection can delay recovery and contribute to scarring and stiffness. Measures intended to reduce the risk of infection after Hand Surgery include Hand washing, skin preparation, sterile technique, and prophylactic antibiotics. The role of prophylactic antibiotics for small, clean, elective Hand Surgery procedures lasting less than 2 hours is debated.
Kyle R. Eberlin - One of the best experts on this subject based on the ideXlab platform.
-
Infection After Hand Surgery
Hand Clinics, 2015Co-Authors: Kyle R. Eberlin, David RingAbstract:Postoperative infections are uncommon after Hand Surgery. Infection can delay recovery and contribute to scarring and stiffness. Measures intended to reduce the risk of infection after Hand Surgery include Hand washing, skin preparation, sterile technique, and prophylactic antibiotics. The role of prophylactic antibiotics for small, clean, elective Hand Surgery procedures lasting less than 2 hours is debated.
-
High-impact articles in Hand Surgery
HAND, 2012Co-Authors: Kyle R. Eberlin, Brian I. Labow, Joseph Upton, Amir H. TaghiniaAbstract:Background There have been few attempts to identify classic papers within the Hand Surgery literature. This study used citation analysis to identify and characterize the top 50 highly cited Hand Surgery articles published in six peer-reviewed journals. Methods The 50 most highly cited Hand Surgery articles were identified in the Journal of Bone and Joint Surgery (JBJS) American, JBJS British, Plastic and Reconstructive Surgery, Journal of Hand Surgery (JHS) American, JHS British/European, and Hand. Articles were evaluated for citations per year, surgical/anatomical topic, and type of study. Clinical studies were further sub-categorized by level of evidence. The distribution of topics was compared with all indexed Hand Surgery articles. The educational relevance was assessed via comparison with lists of “classic” papers. Results The most common subjects were distal radius fracture, carpal tunnel syndrome, and flexor tendon repair. There was moderate correlation between the distribution of these topics and all indexed Hand Surgery articles (rho = 0.71). There were 31 clinical studies, of which 16 were therapeutic, ten were prognostic, and five were diagnostic. These articles assessed the outcomes of an intervention, described an anatomical/functional observation, introduced an innovation, presented a discovery/classification, or validated a questionnaire. There were only three randomized trials. Using citations per year to control for the influence of time since publication, 36 articles were consistently highly cited. Twenty-three articles were on Stern’s Selected Readings in Hand Surgery, considered important in education. Conclusions The top 50 highly cited articles in Hand Surgery reflect the most common clinical, scientific, and educational efforts of the field.
-
High-impact articles in Hand Surgery.
HAND, 2012Co-Authors: Kyle R. Eberlin, Brian I. Labow, Joseph Upton, Amir H. TaghiniaAbstract:Background There have been few attempts to identify classic papers within the Hand Surgery literature. This study used citation analysis to identify and characterize the top 50 highly cited Hand Surgery articles published in six peer-reviewed journals.
Amir H. Taghinia - One of the best experts on this subject based on the ideXlab platform.
-
High-impact articles in Hand Surgery
HAND, 2012Co-Authors: Kyle R. Eberlin, Brian I. Labow, Joseph Upton, Amir H. TaghiniaAbstract:Background There have been few attempts to identify classic papers within the Hand Surgery literature. This study used citation analysis to identify and characterize the top 50 highly cited Hand Surgery articles published in six peer-reviewed journals. Methods The 50 most highly cited Hand Surgery articles were identified in the Journal of Bone and Joint Surgery (JBJS) American, JBJS British, Plastic and Reconstructive Surgery, Journal of Hand Surgery (JHS) American, JHS British/European, and Hand. Articles were evaluated for citations per year, surgical/anatomical topic, and type of study. Clinical studies were further sub-categorized by level of evidence. The distribution of topics was compared with all indexed Hand Surgery articles. The educational relevance was assessed via comparison with lists of “classic” papers. Results The most common subjects were distal radius fracture, carpal tunnel syndrome, and flexor tendon repair. There was moderate correlation between the distribution of these topics and all indexed Hand Surgery articles (rho = 0.71). There were 31 clinical studies, of which 16 were therapeutic, ten were prognostic, and five were diagnostic. These articles assessed the outcomes of an intervention, described an anatomical/functional observation, introduced an innovation, presented a discovery/classification, or validated a questionnaire. There were only three randomized trials. Using citations per year to control for the influence of time since publication, 36 articles were consistently highly cited. Twenty-three articles were on Stern’s Selected Readings in Hand Surgery, considered important in education. Conclusions The top 50 highly cited articles in Hand Surgery reflect the most common clinical, scientific, and educational efforts of the field.
-
High-impact articles in Hand Surgery.
HAND, 2012Co-Authors: Kyle R. Eberlin, Brian I. Labow, Joseph Upton, Amir H. TaghiniaAbstract:Background There have been few attempts to identify classic papers within the Hand Surgery literature. This study used citation analysis to identify and characterize the top 50 highly cited Hand Surgery articles published in six peer-reviewed journals.
