February Newsletter - 2015

The Sultan Qaboos Grand Mosque in Muscat, Oman where the first NYSORA Oman ESOP program took place

Dear NYSORA Newsletter Reader,

What an exciting time it has been for NYSORA! We are thrilled to be putting the final touches on our next two international events; NYSORA Middle East in Abu Dhabi, and NYSORA Latin America, in Cartagena, Colombia. In this month's newsletter, we will start off with an installment of Statistics in Small Doses with Maxine Kuroda, MD. The topic for t his month is standard study designs. Some of our faculty has recently returned from the NYSORA ESOP program in Oman and are eager to share. To commemorate this endeavor, we will feature photos and highlights from Oman by Dr Jeff Gadsden. We look forward to seeing you soon!

Sincerely,

Statistics in Small Doses with Maxine Kuroda, PhD

Highlights and photos from NYSORA ESOP Oman - Jeff Gadsden, MD

NYSORA Latin America Workshop Highlight: Point Of Care UltraSound (POCUS) in Anesthesiology Practice

NYSORA Opinion Poll

Featured Educational Video

Max Kuroda, PhD
Epidemiology division, NAICE (North American Institute for Continuous Education)
New York, NY 10025

Statistics in small doses - What are the standard study designs?

There are many study designs, each is a 'neighborhood' that contains utilities and other services for addressing your research questions. The 3 most frequently visited neighborhoods are portrayed in the accompanying grid, along with their epidemiologic characteristics. Investigators may use the facilities in whichever neighborhood offers the most appropriate and feasible services to answer their research question(s). It seems, however, that many investigators regard the clinical trial as the only worthy research design - and most certainly superior to the case-control and prospective cohort observational studies. In fact, the observational studies should not be disparaged as it is not always possible, say, for ethical reasons, to conduct a clinical trial, and the results of clinical trials can only be generalized to patients similar to those studied. Moreover, observational studies in the form of case reports, pilot studies and small case-control studies often pave the way for expensive clinical trials of new local anesthetics and monitoring devices.

Data from a study that was poorly designed or data that were collected haphazardly cannot be 'fixed' with fancy statistics. Thus design and data issues must be discussed with a statistician early in the planning phase of research. This will help to eliminate confusion within the research team and will enable the statistician to estimate a reasonable sample size and to sketch out a straightforward analysis plan that addresses the specific aims of the research study.

Next month, 'statistics in small doses' will overview the 2 flavors of data analysis and the importance of a data dictionary in research studies.

Three most commonly used research designs in regional anesthesiology and some of their epidemiologic characteristics

Faculty and Delegates

Sun, sand and scanning – all were present in large quantities this past November at the NYSORA's Educational Outreach Program (ESOP) on Ultrasound Guided Regional Anesthesia in Oman. The event took place on November 7th and 8th, 2014, in the beautiful and dramatic seaside capital city of Muscat, Oman. The two days of workshops and lectures, hosted by the Sultan Qaboos University Hospital (SQUH), were a tremendous success, drawing 110 delegates from the Sultanate of Oman, the other Gulf States and from as far away as India.

Amar Salti lecturing in the Medical Lecture Theatre

The symposium was requested and hosted by the Department of Anesthesia and Intensive Care at SQUH. The local team saw an opportunity to join forces with NYSORA in order to exchange ideas and bring an broader international flavor to the locally-run education. Drs. Javier Cubillos from Colombia, Ana Lopez from Spain, Ammar Salti from Abu Dhabi, Roman Zuercher from Switzerland, and Jeff Gadsden from the US represented the International NYSORA team members.

Drs. Ana Lopez and Roman Zuercher demonstrating the supraclavicular block

The organizing committee, led by Dr. Rajini Kausalya and Dr. Mohamed Al Ismaili, planned a thoughtful, diverse and extremely well-organized 2-day session that included a series of lectures, hands-on scanning workshops and instruction on gross and sonographic anatomy in a cadaver laboratory. The hands-on workshop sessions were particularly effective—each session began with a live demonstration to the entire group in a classroom in the skills lab. Flat screen monitors mounted around the entire room and on the central column broadcast the sonographic image as well as the video feed from a camera operator that was filming the operators hands, needle position, etc. Small groups then broke out to individual scanning rooms to practice their skills under the guidance of both a local faculty member as well as a NYSORA team member. Lectures were interesting and provocative, ranging from technical aspects of nerve blockade to complications to outcomes data. The level of delegate experience was wide-ranging, with some attendees starting from scratch and others seemingly quite handy with several techniques. Every effort was made by the faculty to ensure that everyone left with their goals satisfied.

Delegates watching the live demonstration in the skills lab

The most gratifying part of the symposium was the collaborative relationships that were built over the few short days. The members of the organizing committee were exceptionally kind hosts whose enthusiasm for sharing and advancing the science of regional anesthesia was clearly contagious amongst their own department, as well as the rest of the delegates that attended. As a member of the NYSORA team, I felt immediately embraced as a friend, and we all quickly found ourselves sitting with our new colleagues, sipping strong Omani coffee and discussing regional anesthesia into the evening hours. In addition to fulfilling the immediate goals of teaching regional anesthesia techniques to delegates from the region, this exciting new collaborative symposium helped to further the broader NYSORA mission of cultivating new instructors in the NYSORA ranks–several of the SQUH department members will be teaching faculty at the 1^st NYSORA Middle East International Symposium on Regional Anesthesia, Pain and Perioperative Medicine, March 26–28 in Abu Dhabi.

Dr. Mohamed Al Ismaili teaching an upper extremity block

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