Report from the third international consensus meeting to harmonise core outcome measures for atopic eczema/dermatitis clinical trials (HOME).

This report provides a summary of the third meeting of the Harmonising Outcome Measures for Eczema (HOME) initiative held in San Diego, CA, U.S.A., 6-7 April 2013 (HOME III). The meeting addressed the four domains that had previously been agreed should be measured in every eczema clinical trial: clinical signs, patient-reported symptoms, long-term control and quality of life. Formal presentations and nominal group techniques were used at this working meeting, attended by 56 voting participants (31 of whom were dermatologists). Significant progress was made on the domain of clinical signs. Without reference to any named scales, it was agreed that the intensity and extent of erythema, excoriation, oedema/papulation and lichenification should be included in the core outcome measure for the scale to have content validity. The group then discussed a systematic review of all scales measuring the clinical signs of eczema and their measurement properties, followed by a consensus vote on which scale to recommend for inclusion in the core outcome set. Research into the remaining three domains was presented, followed by discussions. The symptoms group and quality of life groups need to systematically identify all available tools and rate the quality of the tools. A definition of long-term control is needed before progress can be made towards recommending a core outcome measure

Successful retrieval of an embolised intracardiac umbilical venous catheter fragment in a 1190 gm preterm

Umbilical venous catheters (UVC) can be lifesaving in preterms and sick neonates. Although safe and effective, they are prone to various rare complications, most importantly, embolization of catheter fragments. We report a case of accidental transection of an UVC that was lodged in the left atrium appendage (LAA), with its inferior end within the inferior vena cava (IVC) and a challenging, however, successful retrieval using an EN Snare Catheter technique with improvised use of a Fogarty Balloon. To our knowledge, our case is the first reported in East Africa

The use of mHealth apps in interactive health literacy – perspectives from healthcare professionals.

Title: The use of mHealth apps in interactive health literacy – perspectives from healthcare professionals. (1) Purpose/Objective; The World Health Organisation (WHO) advocates the use of mobile and wireless technologies to support the achievement of health objectives (mHealth). Apps currently focus primarily on the improvement of patient communication, monitoring and education; improving access to health services, clinical diagnosis and treatment adherence. Evidence supporting the effectiveness and impact of mHealth apps is limited but a recent systematic review identified a beneficial impact in chronic disease management. Careviz is a free app that regroups the resources needed during and after treatment. It connects patients with loved ones and the wider patient community, provides a way to keep track of symptoms over time, and offers the possibility to purchase wellbeing products that have been helpful to other patients. The aim of this study was to determine how a mobile app (Careviz) could support the interactive health literacy of users to more effectively manage consultations with their health care providers from the perspective health professionals. Specific objectives: • The explore the views of different health professionals on how the app could support communication with patients. (2) Material/Methods A qualitative methodology was utilised to collect data through semi-structured interviews. The study was conducted in collaboration with a local London Cancer Centre. Health professionals (n=5) working in oncology were identified through purposive sampling to represent the diverse professionals involved in the patient pathway (oncologist, therapeutic radiographer, clinical nurse specialist, oncology information specialist and brachytherapy specialist). Participants were asked to attend a Careviz launch session showing how the app works, and were then given two weeks to ‘play’ with the app and determine it’s usefulness within the oncology setting. Interviews were audio recorded and transcribed thematically. (3) Results Preliminary results showed potential use for mHealth apps in recording signs and symptoms by the patient in preparation for their consultation or follow-up appointments. Thus enabling better communication during consultations. Information useful to clinical care and treatment could be made available through the app; however there is concern over the validity and specificity required for individual patient care and understanding. The sheer volume of information could result in the loss of relevance. It is recognised that the app might not be appropriate for all patient groups within an oncology setting. (4) Conclusion. Low health literacy is a barrier facing many patients with chronic diseases and low levels of interactive health literacy may impact on effective use of services. Effective communication is a key component of interactive health literacy and interventions aimed at improving patient-doctor communication positively correlate with improved health. mHealth has been presented as offering the potential to improve levels of health literacy , however, research into mHealth as a patient empowerment tool requires further research