Video consultation in general practice: a scoping review on use, experiences, and clinical decisions

Background The coronavirus disease 2019 pandemic forced healthcare workers to use alternative consultation approaches. In general practice, the use of video consultations (VCs) increased manyfold as countries were locked down. This scoping review aimed to summarize scientifc knowledge concerning the use of VC in general practice and focused on (1) the utilization of VC in general practice, (2) the experiences of the users of VC in general practice, and (3) how VC afected the clinical decision-making of general practitioners (GPs). Methods A scoping review was conducted in accordance with the methodology of Joanna Briggs Institute. Review questions were formulated to match each focus area. A three-step search strategy was employed to search scientifc and gray literature sources. MEDLINE, Embase, Scopus, OpenGrey, Google Scholar, and ClinicalTrials.gov were searched from 2010 to March 11th, 2021, and the search was re-run on August 18th, 2021. The extracted data were deductively coded into pre-defned main themes, whereas subthemes were inductively synthesized. The data within each subtheme were analysed through descriptive content analysis and presented in a narrative synthesis. Results Overall, 13 studies were included after screening 3,624 studies. Most patients were satisfed with VCs. VCs were most suitable for simpler issues, often shorter than face-to-face consultations, and were more likely to be used by younger patients. GPs enjoyed the fexibility and shorter duration of VCs; however, they felt an unsatisfactory deterioration in the GP-patient relationship. Despite the loss of clinical examination, diagnostic assessment was mostly successful, with little fear of missing serious illness. Prior clinical experience and a preexisting relationship with the patient were important factors for successful assessment via VC. Conclusions Both GPs and patients can be satisfed with VC in general practice in specifc contexts, and adequate clinical decision-making is possible. However, disadvantages such as a diminishing GP-patient relationship have been highlighted, and the use of VC in non-pandemic settings is limited. The role of VC in the future of general practice remains unclear, and further research is needed on the long-term adoption of VC in general practice.publishedVersio

Birth weight and melanoma risk: a population-based case–control study

We investigated whether lower birth weight was associated with lower risk of melanoma later in life. This population-based case–control study included all incident cases of histologically verified invasive melanoma diagnosed until 31 December 2003 in the Norwegian population born between 1967 and 1986 (n=709). The control group without malignant disease was established by random sampling from the same source population as the cases (n=108 209). Data on birth weight, gender, mother's residence and parental age at the time of birth were collected from the Medical Birth Registry of Norway and data on cancer from the Cancer Registry of Norway. The Mantel–Haenszel test of linear trend showed no trend in risk across the birth weight categories: individuals in the highest quartile of birth weight (⩾3860 g) had an odds ratio (OR) of 1.19 (95% confidence interval, CI: 0.77–1.84) compared to individuals with birth weight <2500 g. The adjusted OR was 0.81 (95% CI: 0.52–1.26) for birth weight below 2500 g (exposed). Though not statistically significant, the results suggest that low birth weight might influence the risk of melanoma later in life

Kompresjonsstrømper som profylakse for posttrombotisk syndrom etter proksimal DVT. Er det fortsatt indikasjon?

I denne oppgaven har vi sett på bruken av kompresjonsstrømper som profylakse mot posttrombotisk syndrom (PTS) etter proksimal dyp venetrombose (DVT). Nyere forskning viser at dette ikke har overbevisende evidens, og dette er dermed noe som burde evalueres med tanke på praksisendring. Ved Sykehuset Østfold Kalnes er DVT-behandlingen organisert på en egen trombosepoliklinikk og tilnærmet 100 % av pasientene som henvises hit får tilpasset kompresjonsstrømper. Trombosepoliklinikken er dermed et naturlige fokus for implementering og evaluering av ny praksis, og det er viktig at de ansatte ved poliklinikken engasjeres allerede fra planleggingsfasen. Som noen av de mulige tiltakene man kan implementere har vi diskutert undervisning, informasjon til pasientene og endret DIPS-dokumentering. Målet er å redusere bruken av kompresjonsstrømper med 50 % innen én måned og 75 % innen tre måneder. Etter en avveiing av fordeler og ulemper - samt en vurdering av ressursene som brukes på å behandle DVT-pasienter, kontra ressursene knyttet til prosjektet - mener vi at dette prosjektet bør gjennomføres