Browsing by Author "Davies, Louise"

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    Factors Associated with Physicians’ Recommendations for Managing Low-Risk Papillary Thyroid Cancer
    (Elsevier, 2021) McDow, Alexandria D.; Roman, Benjamin R.; Saucke, Megan C.; Jensen, Catherine B.; Zaborek, Nick; Jennings, Jamia Linn; Davies, Louise; Brito, Juan P.; Pitt, Susan C.; Surgery, School of Medicine
    Background: The 2015 American Thyroid Association endorsed less aggressive management for low-risk papillary thyroid cancer (LR-PTC). We aimed to identify factors influencing physicians' recommendations for LR-PTC. Methods: We surveyed members of three professional societies and assessed respondents' recommendations for managing LR-PTC using patient scenarios. Multivariable logistic regression models identified clinical and non-clinical factors associated with recommending total thyroidectomy (TT) and active surveillance (AS). Results: The 345 respondents included 246 surgeons and 99 endocrinologists. Physicians' preference for their own management if diagnosed with LR-PTC had the strongest association with their recommendation for TT and AS (TT: OR 12.3; AS: OR 7.5, p < 0.001). Physician specialty and stated patient preference were also significantly associated with their recommendations for both management options. Respondents who received information about AS had increased odds of recommending AS. Conclusions: Physicians' recommendations for LR-PTC are strongly influenced by non-clinical factors, such as personal treatment preference and specialty.
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    Safety Recommendations for Evaluation and Surgery of the Head and Neck During the COVID-19 Pandemic
    (AMA, 2020-03) Givi, Babak; Schiff, Bradley A.; Chinn, Steven B.; Clayburgh, Daniel; Iyer, N. Gopalakrishna; Jalisi, Scharukh; Moore, Michael G.; Nathan, Cherie-Ann; Orloff, Lisa A.; O'Neill, James P.; Parker, Noah; Zender, Chad; Morris, Luc G. T.; Davies, Louise; Otolaryngology -- Head and Neck Surgery, School of Medicine
    Importance The rapidly expanding novel coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2, has challenged the medical community to an unprecedented degree. Physicians and health care workers are at added risk of exposure and infection during the course of patient care. Because of the rapid spread of this disease through respiratory droplets, health care workers who come in close contact with the upper aerodigestive tract during diagnostic and therapeutic procedures, such as otolaryngologists–head and neck surgeons, are particularly at risk. A set of safety recommendations was created based on a review of the literature and communications with physicians with firsthand knowledge of safety procedures during the COVID-19 pandemic. Observations A high number of health care workers were infected during the first phase of the pandemic in the city of Wuhan, China. Subsequently, by adopting strict safety precautions, other regions were able to achieve high levels of safety for health care workers without jeopardizing the care of patients. The most common procedures related to the examination and treatment of upper aerodigestive tract diseases were reviewed. Each category was reviewed based on the potential risk imposed to health care workers. Specific recommendations were made based on the literature, when available, or consensus best practices. Specific safety recommendations were made for performing tracheostomy in patients with COVID-19. Conclusions and Relevance Preserving a highly skilled health care workforce is a top priority for any community and health care system. Based on the experience of health care systems in Asia and Europe, by following strict safety guidelines, the risk of exposure and infection of health care workers could be greatly reduced while providing high levels of care. The provided recommendations, which may evolve over time, could be used as broad guidance for all health care workers who are involved in the care of patients with COVID-19.