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Introduction We live in an age where new technologies are constantly being developed to tackle a wide variety of problems, changing the way we live, communicate, travel and work. Today, new technologies are mainly digital solutions which use
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opportunity to act for the benefit of patients and healthcare professionals (surgeons, nurses, and physical therapists). To date, the digitized solutions in orthopaedics and traumatology are mainly driven by the new digital technologies and methods to
Ludwig Maximilians University Munich, Department of Orthopaedic and Trauma Surgery, Musculoskeletal University Center Munich (MUM), Campus Grosshadern, Munich, Germany
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Translational Health Sciences, Bristol Medical School, Musculoskeletal Research Unit, University of Bristol, Southmead Hospital, Bristol, UK
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Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina, CIBER-BBN, Madrid, Spain
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Department of Clinical Medicine, Faculty of Health & Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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The objectives of the 1st EFORT European Consensus on ‘Medical and Scientific Research Requirements for the Clinical Introduction of Artificial Joint Arthroplasty Devices’ were foremost to focus on patient safety by establishing performance requirements for medical devices.
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The 1st EFORT European Consensus applied an a priori-defined, modified Delphi methodology to produce unbiased, high-quality recommendation statements, confirmed by consensus voting of a European expert panel.
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Intended key outcomes are practical guidelines justified by the current stage of knowledge and based on a broad European Expert Consensus, to maintain innovation and optimisation of orthopaedic devices within the boundaries of MDR 2017/745.
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Twenty-one main research areas of relevance were defined relying on input from the EFORT IPSI WG1 ‘Introduction of Innovation’ recommendations and a related survey.
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A modified Delphi approach with a preparatory literature review and work in small groups were used to prepare answers to the research questions in the form of 32 draft Consensus statements.
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A Consensus Conference in a hybrid format, on-site in the Carl Gustav Carus University of Dresden was organised to further refine the draft statements and define consensus within the complete group of participants by final voting, intended to further quantify expert opinion knowledge.
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The modified Delphi approach provides practical guidelines for hands-on orientation for orthopaedic surgeons, research institutes and laboratories, orthopaedic device manufacturers, patient representatives, Notified Bodies, National Institutes and authorities.
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For the first time, initiated by the EFORT IPSI (WG1 ‘Introduction of Innovation’), knowledge of all related stakeholders was combined in the 1st EFORT European Consensus to develop guidelines and result in a comprehensive set of recommendations.
National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
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Department of Physical Education and Sport Sciences, Faculty of Literature and Human Sciences, Lorestan University, Khoramabad, Iran
Department of Physical Education and Sport Sciences, Faculty of Literature and Humanities, Vali-E-Asr University of Rafsanjan, Rafsanjan, Iran
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Department of Pediatrics, Kyung Hee University College of Medicine, Seoul, Republic of Korea
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National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
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National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
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Objective
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The aim of the study was to evaluate the efficacy and safety of teriparatide compared to other treatments for postmenopausal osteoporosis.
Methods
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A review of studies from 2000 to January 2023 analyzed randomized controlled trials on postmenopausal women treated with teriparatide (PTH 1–34), comparing it to placebo or other osteoporosis treatments. The analysis focused on bone mineral density (BMD), bone turnover markers, and clinical outcomes, employing Review Manager 5.4.1 and the RoB 2 tool for bias assessment.
Results
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Our analysis of 23 randomized controlled trials (RCTs) found that PTH (134) treatment significantly increased lumbar spine BMD (mean difference (MD) = 0.02, 95% CI: 0.01–0.03) and femoral neck BMD (MD = 0.01, 95% CI: 0.00–0.01). However, there were no significant changes in total hip and radial bone BMD among the 3536 and 2046 participants, respectively. We also found that PTH (1–34) increased P1NP in a larger cohort (n = 1415) when compared to osteocalcin (n = 206). Although the risk of adverse events increased (relative risk (RR) = 1.65, 95% CI: 1.32–2.07), the incidence of fractures decreased significantly (RR = 0.57, 95% CI: 0.45–0.072), with no significant difference observed in mortality rates between treatment and control groups.
Conclusion
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Teriparatide improves lumbar spine and femoral neck BMD in postmenopausal women. Particularly notable is the novel finding regarding its effect on radius BMD, an area less explored in previous research. Despite an uptick in adverse events, the marked decrease in fracture incidence confirms its clinical utility for high-risk osteoporosis patients, highlighting the necessity for ongoing investigations into its full skeletal effects.
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-profit organization with which one or more of the authors are associated. References 1. Cowen AR Kengyelics SM Davies AG . Solid-state, flat-panel, digital radiography detectors and their physical imaging characteristics
Health Sciences PhD Program, Universidad Católica de Murcia UCAM, Murcia, Spain
Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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-making processes ( 3 ). There are numerous examples of medical specialties that leverage imaging support with AI tools. These include endocrinology for categorizing thyroid nodules, gynecology through the implementation of digital mammograms, and neurology for
Health Sciences PhD Program, Universidad Católica de Murcia UCAM, Murcia, Spain
Harvard T.H. Chan School of Public Health, Boston, USA
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healthcare system of the population ( 1 ). The current Fourth Industrial Revolution (4IR, or Industry 4.0) is a combination of multiple digital and software technologies. Artificial intelligence (AI) stands out as the main engine of this industry, empowering
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Conference on Advanced Computer Control , 2009 ; 420 - 4 . 3 Gonzales RC , Woods RE , Eddins SL . Digital image processing using Matlab . Upper Saddle River, New Jersey : Pearson Prentice Hall , 2004 . 4
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purpose of controlling AI risks in order to deem AI trustworthy ( https://digital-strategy.ec.europa.eu/en/library/ethics-guidelines-trustworthy-ai ). The guidelines explicitly call for the application of AI to be technically robust, lawful, ethical and
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simple techniques that orthopaedic surgeons can use to improve their use of web-based information and e-learning resources. Bibliographic databases A bibliographic database is an organised digital collection of references to published literature
