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Complex and expanding data sets in clinical oncology applications require flexible and interactive visualization of patient data to provide the maximum amount of information to physicians and other medical practitioners. Interdisciplinary tumor conferences in particular profit from customized tools to integrate, link, and visualize relevant data from all professions involved. The scoping review proposed in this protocol aims to identify and present currently available data visualization tools for tumor boards and related areas. The objective of the review will be to provide not only an overview of digital tools currently used in tumor board settings, but also the data included, the respective visualization solutions, and their integration into hospital processes. The planned scoping review process is based on the Arksey and O'Malley scoping study framework. The following electronic databases will be searched for articles published in English: PubMed, Web of Knowledge, and SCOPUS. Eligible articles will first undergo a deduplication step, followed by the screening of titles and abstracts. Second, a full-text screening will be used to reach the final decision about article selection. At least 2 reviewers will independently screen titles, abstracts, and full-text reports. Conflicting inclusion decisions will be resolved by a third reviewer. The remaining literature will be analyzed using a data extraction template proposed in this protocol. The template includes a variety of meta information as well as specific questions aiming to answer the research question: \"What are the key features of data visualization solutions used in molecular and organ tumor boards, and how are these elements integrated and used within the clinical setting?\" The findings will be compiled, charted, and presented as specified in the scoping study framework. Data for included tools may be supplemented with additional manual literature searches. The entire review process will be documented in alignment with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) flowchart. The results of this scoping review will be reported per the expanded PRISMA-ScR guidelines. A preliminary search using PubMed, Web of Knowledge, and Scopus resulted in 1320 articles after deduplication that will be included in the further review process. We expect the results to be published during the second quarter of 2024. Visualization is a key process in leveraging a data set's potentially available information and enabling its use in an interdisciplinary setting. The scoping review described in this protocol aims to present the status quo of visualization solutions for tumor board and clinical oncology applications and their integration into hospital processes. DERR1-10.2196/53627.

Background: Globally, safety of patients in healthcare environment has been an issue of the decade, especially in resource-constrained settings. The Hippocratic maxim primum non nocere requires medical practitioners to give utmost importance to the principle of beneficence and safety in attending to patients. It is a current paradigm in quality of care metrics that determines what happens to patients who interface with the healthcare system. Aim: The study was aimed at describing the experience, drivers, barriers and preventive measures for patient safety incidents and accidents in a cross-section of medical practitioners in Abia State, Southeast Nigeria. Participants and Methods: This was a cross-sectional study carried out on 185 physicians in Southeast Nigeria. Data collection was done using a pre-tested, self-administered questionnaire that elicited information on experience, drivers, barriers and preventive measures for patient safety incidents. Results: The mean age ± standard deviation of the respondents was 36 ± 5.6 years, with a range of 25-72 years. There were 163 (88.1%) males and 22 (11.9%) females. Lifetime and previous 1-year committal of patient safety incidents were 100% (185/185) and 61.0% (113/185), respectively, with the most committed safety incident being medication errors. The most common driver of patient safety incidents was physician stress and burnout (100%) (185/185), whereas the most common barrier was communication (100%) (185/185). The most common preventive measure was patient safety incident reporting system (100%) (185/185). One-year committal of patient safety incidents was associated with duration of practice <10 years (P = 0.00001) and sex (P = 0.011). Conclusion: Patient safety incidents occurred amongst the study participants, with the most committed safety incident being medication errors. The most common driver was physician stress and burnout. The most common barrier was communication and feedback barrier, whereas the most common preventive measure was patient safety incident reporting system. Patient safety information, education and training should be the target for continuing professional development in order to safeguard the health of the patients in healthcare environment.

This paper presents the case study of a British doctor who posted videos on social media platforms denying the existence of COVID-19. The case examines the approach taken by the UK’s medical regulator in dealing with doctors who espouse conspiratorial views at odds with accepted medical opinion. In such cases, there may be a conflict between the safety of patients and the public (which is the principal function of medical regulators) and the doctor’s freedom of expression (whether under the First Amendment, Article 10 of the European Convention on Human Rights, or another international human rights instrument). During this protracted three-and-a-half-year case, the UK’s Medical Practitioners’ Tribunal, High Court and —latterly—Court of Appeal have each made it clear that doctors remain free to express views contrary to medical orthodoxy except where they lack any supporting evidentiary basis. In September 2023, an order was made revoking the doctor’s licence. Rather than accept the Tribunal’s guidance following his initial suspension, he chose to continue promoting his conspiratorial views in a public forum.

Based on case studies indicating that apologies from physicians to patients can promote healing, understanding, and dispute resolution, thirty-nine states (and the District of Columbia) have sought to reduce litigation and medical malpractice liability by enacting apology laws. Apology laws facilitate apologies by making them inadmissible as evidence in subsequent malpractice trials. The underlying assumption of these laws is that after receiving an apology, patients will be less likely to pursue malpractice claims and will be more likely to settle claims that are filed. However, once a patient has been made aware that the physician has committed a medical error, the patient’s incentive to pursue a claim may increase even though the apology itself cannot be introduced as evidence. Thus, apology laws could lead to either increases or decreases in overall medical malpractice liability risk. Despite apology laws’ status as one of the most widespread tort reforms in the country, there is little evidence that they achieve their goal of reducing litigation. This Article provides critical new evidence on the role of apology laws by examining a dataset of malpractice claims obtained directly from a large national malpractice insurer. This dataset includes substantially more information than is publicly available, and thus presents a unique opportunity to understand the effect of apology laws on the entire litigation landscape in ways that are not possible using only publicly available data. Decomposing medical malpractice liability risk into the frequency of claims and the magnitude of those claims, we examine the malpractice claims against 90% of physicians in the country who practice within a particular specialty over an eight-year period. The analysis demonstrates that for physicians who regularly perform surgery—a context in which patients are more likely to be aware of potential risks—apology laws do not have a substantial effect on the probability that a physician will face a claim or the average payment made to resolve a claim. For nonsurgeons, we find that apology laws increase the probability of facing a lawsuit and increase the average payment made to resolve a claim, a finding which is consistent with the presence of asymmetric information. Overall, our findings indicate that on balance, apology laws increase rather than limit medical malpractice liability risk.

Background Medical education offers the foundational base for future healthcare professionals, with basic sciences playing a pivotal role in providing essential knowledge and skills for clinical practice. However, the long-term retention and application of this knowledge in clinical practice remain a significant challenge. This systematic review synthesised global evidence from diverse studies on the short / long-term retention and clinical application of basic sciences among medical doctors. Methods A comprehensive search was conducted across six databases, including Web of Science, Scopus, Medline, CINAHL, Emcare, and Informit. The review included studies that encompassed a variety of study designs, participant groups, and educational interventions. The Quality Assessment with Diverse Studies (QuADS) tool was utilised to assess the quality of the reviewed studies. Results A total of 10 studies were included in the review. The findings revealed that rehearsals significantly optimise the retention of basic science knowledge among medical practitioners. Retention varied by discipline, with medical practitioners retaining more knowledge in anatomy (mean scores ranging from 45.0 to 82.9%), while microbiology had the lowest retention score (39.1%). Factors influencing retention included age, gender, and curriculum type. Educational interventions such as targeted courses, integration of basic sciences with clinical skills, generative retrieval and continuous quality improvement in the curriculum were found to enhance both knowledge retention and clinical reasoning. The concept of ‘encapsulated knowledge’ demonstrates that integrated basic science knowledge helps in synthesising clinical presentations, reducing the need for detailed recall as clinical experience increases. The reviewed studies primarily involved interns and surgeons, leaving a significant gap in research for specialties like internal medicine and primary care/ general practice. Conclusion Detailed retention of basic science knowledge may diminish over time; however, the conceptual framework remains essential for ongoing learning and clinical reasoning. This review’s findings highlight the need for specialised educational interventions to improve long-term retention. Continuous professional development and targeted educational techniques are vital for maintaining clinical competence and applying basic science knowledge effectively throughout a medical career. Further research is needed to address gaps in specialty-specific knowledge application and the impact of different instructional methods.

Background General practitioners (GPs) are gatekeepers to specialist attention for endometriosis in the public system in Aotearoa New Zealand (Aotearoa‐NZ). Their perspective of the endometriosis care landscape in Aotearoa‐NZ has not been previously assessed. Design Semi‐structured interviews. Participants Nine GPs self‐selected to participate in interviews that were 13–28 min in duration to discuss their perspectives on endometriosis care. Objective These interviews included their views on existing guidelines, common characteristics of endometriosis patients, and what the future of endometriosis care could look like. Results and Discussion The GPs of this study expressed that the overloaded nature of specialist appointments in the public health system compromised the care of endometriosis patients. Resultingly, patients were subject to challenging journeys through diagnosis and management exacerbated by these health system factors. Furthermore, GPs identified that there were challenges that could prevent patients from presenting to the clinic to share their health concerns, such as a lack of awareness of ‘normal’ and pathologic menstrual‐related symptoms. Once in the clinic, patients can struggle to feel they can talk openly with their GP, due to issues such as cultural taboos around discussing menstruation. The GPs highlighted that necessary avenues to improve endometriosis care require investment into the public health system to improve its function. They also highlighted potential solutions to improve care that can be incorporated into the existing system, including expanded endometriosis guidelines, improved relationship‐building and introducing endometriosis specialist GPs or nurses. Patient or Public Contribution Two of the authors who designed the study approach, interpreted the data and prepared the manuscript were assessed and treated for endometriosis symptoms.

Different clinical medicine programs exist in China, which are mainly the 3-year junior college medical program, the 5-year medical bachelor's degree program, the 5 + 3 medical master's degree program, and the 8-year medical doctoral degree program. Medical graduates obtain different degrees from various medical programs, leading to inequality and polarization of the cultivation. The extended length of schooling discourages talented students from pursuing clinical medicine. The current situation has worsened due to the mismatch between clinical competence and promotion, as well as insufficient remuneration. The most critical reform measure is to establish separate degree systems for scientific research skill training and clinical training, which helps clarify the boundaries between these two. Students who receive academic postgraduate education obtain academic degrees, such as the master of medical science and doctor of philosophy; students who take part in the national standardized resident training, specialist training, or general practitioner training obtain professional degrees, such as master of medicine and doctor of medicine. It is imperative to consider shortening the duration of medical education, with an ideal limit of eight years on average. Optimizing the way to promotion and raising the expenditure of remuneration are also crucial. The reform of medical education system in China still has a long way to go and requires gradual adjustment and optimization.

Background Bangladesh outperforms its Least Developed Country (LDC) status on a range of health measures including life expectancy. Its frontline medical practitioners, however, are not formally trained medical professionals, but instead lightly-trained ‘village doctors’ able to prescribe modern pharmaceuticals. This current study represents the most complete national survey of these practitioners and their informal ‘clinics’. Methods The study is based on a national Computer Assisted Telephone Interviewing (CATI) of 1,000 informal practitioners. Participants were sampled from all eight divisions and all 64 districts of Bangladesh, including 682 participants chosen from the purposively recruited Refresher Training program conducted by the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), supplemented with 318 additional participants recruited through snowball sampling. Primary and secondary outcome measures In addition to demographics, village doctors were asked about the characteristics of their ‘clinics’ including their equipment, their training, income and referral practices. Results Three quarters of the wholly male sample had not completed an undergraduate program, and none of the sample had received any bachelor-level university training in medicine. Medical training was confined to a range of short-course offerings. Village doctor ‘clinics’ are highly dependent on the sale of pharmaceuticals, with few charging a consultation fee. Income was not related to degree of short-course uptake but was related positively to degree of formal education. Finally, practitioners showed a strong tendency to refer patients to the professional medical care system. Conclusions Bangladesh’s village doctor sector provides an important pathway to professional, trained medical care, and provides some level of care to those who cannot afford or otherwise access the nation’s established healthcare system. However, the degree to which relatively untrained paramedical practitioners are prescribing conventional medicines has concerning health implications.

Background Informal and unregulated rural medical practitioners (RMPs) provide healthcare services to about two-thirds of people in Bangladesh, although their service is assumed to be substandard by qualified providers. As the RMPs are embedded in the local community and provide low-cost services, their practice pattern demands investigation to identify the shortfalls and design effective strategies to ameliorate the service. Methods We conducted a cross-sectional study in 2015–16 using a convenient sample from all 64 districts of Bangladesh. Personnel practising modern medicine, without any recognized training, or with recognized training but practising outside their defined roles, and without any regulatory oversight were invited to take part in the study. Appropriateness of the diagnosis and the rationality of antibiotic and other drug use were measured as per the Integrated Management of Childhood Illness guideline. Results We invited 1004 RMPs, of whom 877 consented. Among them, 656 (74.8%) RMPs owned a drugstore, 706 (78.2%) had formal education below higher secondary level, and 844 (96.2%) had informal training outside regulatory oversight during or after induction into the profession. The most common diseases encountered by them were common cold, pneumonia, and diarrhoea. 583 (66.5%) RMPs did not dispense any antibiotic for common cold symptoms. 59 (6.7%) and 64 (7.3%) of them could identify all main symptoms of pneumonia and diarrhoea, respectively. In pneumonia, 28 (3.2%) RMPs dispensed amoxicillin as first-line treatment, 819 (93.4%) dispensed different antibiotics including ceftriaxone, 721 (82.2%) dispensed salbutamol, and 278 (31.7%) dispensed steroid. In diarrhoea, 824 (94.0%) RMPs dispensed antibiotic, 937 (95.4%) dispensed ORS, 709 (80.8%) dispensed antiprotozoal, and 15 (1.7%) refrained from dispensing antibiotic and antiprotozoal together. Conclusions Inappropriate diagnoses, irrational use of antibiotics and other drugs, and polypharmacy were observed in the practising pattern of RMPs. The government and other stakeholders should acknowledge them as crucial partners in the healthcare sector and consider ways to incorporate them into curative and preventive care.

Background In recent times, medical regulators have been taking measures to strengthen CPD requirements for medical practitioners. In particular, greater emphasis has been placed on CPD activities linked to workplace-based assessment, health outcomes measurement, and quality improvement. These activities require the use of health data, and eHealth data analytics is emerging as a digital solution to simplify tasks and processes. Although there is a growing interest and need for alignment between regulatory policies, impactful CPD activities, and digital health research and innovation, there is little or no research into the role that medical regulations and regulators are playing in fostering the use of eHealth data to strengthen CPD. Methods Medical regulations and CPD requirements of 5 selected countries (Australia, Canada, New Zealand, UK, USA) were collected and analysed using the systematic READ approach for qualitative health policy research. Online semi-structured interviews were conducted with 20 key informants from 13 medical bodies to validate findings and gather additional insights. Informants were purposively selected because of their direct involvement in policy development. The interviews were analysed using a hybrid approach of deductive and inductive thematic analysis. The COREQ checklist was used for reporting the findings. Results The documents analysed do not mention the use of eHealth data for CPD purposes or refer to it only as a potential data source for CPD completion and compliance. Participants corroborated the document analysis results and provided insights into the following themes: context and rationale of current policy choices and future policy development; roles, responsibilities, and functions of relevant medical bodies in fostering the use of eHealth data for strengthened CPD; barriers, challenges, and enablers for implementation. Conclusion Current medical regulations and CPD requirements do not foster the use of eHealth data for CPD purposes. Recommendations for future policy development are reliant on further research on key policy concepts, regulators’ internal organisational factors, and interorganisational collaboration within the CPD ecosystem. The alignment of all relevant CPD stakeholders is required to tackle existing barriers and challenges and promote digital health innovation in the CPD landscape. Medical regulators are called to play a leadership role in this scenario.