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In a typical nasal surgery department performing about 150 rhinoplasty procedures per annum, the mirror system offers cost and time savings generated as a result of reducing the documentation burden by 750 photographs.
Qualitative appraisal of reactions to the simplified register system suggests that CHOs welcome the reduced documentation burden and additional time for service and outreach.
Other potentially relevant clinical variables like smoking and duration of symptoms were not part of the already high documentation burden for surgeons, accordingly not allowing for their adjustment.
After the consultation process with stakeholders it was decided that these indicators will be collected only for a sample of patients to limit the documentation burden.
Finally, additional technological advances should also be incorporated, such as linking the printouts to electronic medical records to reduce the documentation burden on the clinician and the use of voice to facilitate reading by patients and to address literacy issues.
The documentation burden in clinical studies is huge and increasing: According to Getz [ 1] based on an analysis of approximately 10.000 study protocols the average amount of case report forms (CRFs) per patient in a clinical trial increased from 55 (1999-2002) to 180 pages (2003-2006).
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The effort won't save much money at first, and it will impose additional testing and documentation burdens on many hospitals, but it should promote better care.
With documentation of Mr. Burden's early performance work consigned to the museum's small fifth-floor gallery, the exhibition unfolds on the lower floors, each with two to six works that effectively contrast scale, process, materials and meaning.
Increasingly heavy demands of documentation and administrative burden have been implicated as well, with a number of studies suggesting residents spend more time on their computers than with a patient on a given day.
For a definite conclusion to be drawn about the relation between both osteopontin and VEGF-A with stage, a larger patient cohort, including documentation of tumor burden and residual disease is needed.
While these reports provide documentation of the burden of RA on paid and unpaid work, a challenge lies in how best to measure these outcomes and to report the impact of RA interventions in reducing the work limitations due to the disease.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com