The organisation of physiotherapy for people with multiple sclerosis across Europe: a multicentre questionnaire survey

Background Understanding the organisational set-up of physiotherapy services across different countries is increasingly important as clinicians around the world use evidence to improve their practice. This also has to be taken into consideration when multi-centre international clinical trials are conducted. This survey aimed to systematically describe organisational aspects of physiotherapy services for people with multiple sclerosis (MS) across Europe. Methods Representatives from 72 rehabilitation facilities within 23 European countries completed an online web-based questionnaire survey between 2013 and 2014. Countries were categorised according to four European regions (defined by United Nations Statistics). Similarities and differences between regions were examined. Results Most participating centres specialized in rehabilitation (82 %) and neurology (60 %), with only 38 % specialising in MS. Of these, the Western based Specialist MS centres were predominately based on outpatient services (median MS inpatient ratio 0.14), whilst the Eastern based European services were mostly inpatient in nature (median MS inpatient ratio 0.5). In almost all participating countries, medical doctors - specialists in neurology (60 %) and in rehabilitation (64 %) - were responsible for referral to/prescription of physiotherapy. The most frequent reason for referral to/prescription of physiotherapy was the worsening of symptoms (78 % of centres). Physiotherapists were the most common members of the rehabilitation team; comprising 49 % of the team in Eastern countries compared to approximately 30 % in the rest of Europe. Teamwork was commonly adopted; 86 % of centres based in Western countries utilised the interdisciplinary model, whilst the multidisciplinary model was utilised in Eastern based countries (p = 0.046). Conclusion This survey is the first to provide data about organisational aspects of physiotherapy for people with MS across Europe. Overall, care in key organisational aspects of service provision is broadly similar across regions, although some variations, for example the models of teamwork utilised, are apparent. Organisational framework specifics should be considered anytime a multi-centre study is conducted and results from such studies are applied.PubMedWoSScopu

Assessing the generalizability of a performance predictive model

Algorithms and the Foundations of Software technolog

Meta-Analysis of Coronary Bypass Graft Patency Assessment With Invasive vs Computed Tomographic Angiography

BACKGROUND: Computed tomography (CT) coronary angiography has emerged as a non-invasive alternative for evaluating graft patency after coronary artery bypass grafting (CABG), but there is ongoing debate regarding its diagnostic performance compared to invasive coronary angiography, particularly for arterial and composite grafts. METHODS: MEDLINE, Embase, and Cochrane databases were searched to identify studies comparing CT coronary angiography to invasive coronary angiography for detection of graft occlusion in post-CABG patients. Outcomes included sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy. Meta-regression explored key modifiers. Pooled estimates were calculated using random-effects models, with heterogeneity measured via I2. RESULTS: Fifty studies met inclusion criteria, including 3,449 patients (25% women). CT coronary angiography sensitivity for graft occlusion was 0.96 (I2 = 48%), specificity was 0.97 (I2 = 46%), positive predictive value was 0.94 (I2 = 62%), negative predictive value was 0.98 (I2 = 41%) and overall diagnostic accuracy was 0.97 (I2 = 58%). The pooled incidence rate of graft occlusion across 7,506 included grafts was 0.08 per graft-year (PGY) (95% CI: 0.06-0.10) using a random-effects model, and 0.07 PGY (95% CI: 0.07-0.08). At meta-regression, study year, sample size, β-blocker use, number of slices, and time since surgery, but not type and configuration of CABG grafts, were significantly associated with CT coronary angiography sensitivity. CONCLUSIONS: CT coronary angiography detects coronary artery bypass graft occlusion with a high degree of sensitivity and specificity independently of graft type and configuration and can be used for imaging of every type of CABG graft.2026-07-0