Department of Surgery, McGovern Medical School at University of Texas Health, 5656 Kelley Street, Houston, TX, 77026, USA.
Division of General Surgery, Dallas VA Hospital, University of Texas Southwestern, Dallas, TX, USA.
Surg Endosc. 2020 Nov;34(11):5041-5045. doi: 10.1007/s00464-019-07299-4. Epub 2020 Apr 13.
Many surgeons rely on the American College of Surgeons (ACS) Community Forums for advice on managing complex patients. Our objective was to assess the safety and usefulness of advice provided on the most popular surgical forum.
Overall, 120 consecutive, deidentified clinical threads were extracted from the General Surgery community in reverse chronological order. Three groups of three surgeons (mixed academic and community perspectives) evaluated the 120 threads for unsafe or dangerous posts. Positive and negative controls for safe and unsafe answers were included in 20 threads, and reviewers were blinded to their presence. Reviewers were free to access all online and professional resources.
There were 855 unique responses (median 7, 2-15 responses per thread) to the 120 clinical threads/scenarios. The review teams correctly identified all positive and negative controls for safety. While 58(43.3%) of threads contained unsafe advice, the majority (33, 56.9%) were corrected. Reviewers felt that a there was a standard of care response for 62/120 of the threads of which 50 (80.6%) were provided by the responses. Of the 855 responses, 107 (12.5%) were considered unsafe/dangerous.
The ACS Community Forums are generally a safe and useful resource for surgeons seeking advice for challenging cases. While unsafe or dangerous advice is not uncommon, other surgeons typically correct it. When utilizing the forums, advice should be taken as a congregate, and any single recommendation should be approached with healthy skepticism. However, social media such as the ACS Forums is self-regulating and can be an appropriate method for surgeons to communicate challenging problems.
许多外科医生依靠美国外科医师学院（ACS）社区论坛来获取管理复杂患者的建议。我们的目的是评估最受欢迎的外科论坛上提供的建议的安全性和有用性。
总共从一般外科社区中按逆时间顺序提取了 120 个连续的匿名临床线程。三组三名外科医生（混合学术和社区观点）评估了 120 个线程，以确定不安全或危险的帖子。在 20 个线程中包含了安全和不安全答案的阳性和阴性对照，并且审阅者对其存在是盲目的。审阅者可以自由访问所有在线和专业资源。
对 120 个临床线程/情况有 855 个唯一响应（中位数为 7，每个线程 2-15 个响应）。审查团队正确识别了所有安全的阳性和阴性对照。虽然 58 个（43.3％）线程包含不安全的建议，但大多数（33 个，56.9％）被纠正了。审阅者认为有 62/120 个线程有标准的护理反应，其中 50 个（80.6％）是由回复提供的。在 855 个回复中，有 107 个（12.5％）被认为是不安全/危险的。
ACS 社区论坛通常是外科医生寻求有关挑战性病例建议的安全且有用的资源。虽然不安全或危险的建议并不罕见，但其他外科医生通常会纠正它。在使用论坛时，应将建议视为一个集体，并且任何单一建议都应持健康的怀疑态度。但是，像 ACS 论坛这样的社交媒体是自我监管的，并且可以是外科医生交流具有挑战性的问题的合适方法。
