Skip to main content

Main menu

  • Home
  • Content
    • Current issue
    • Past issues
    • Collections
  • Authors & Reviewers
    • Overview for Authors
    • Preparing manuscripts
    • Submission Checklist
    • Publication Fees
    • Forms
    • Editorial Policies
    • Editorial Process
    • Patient-Oriented Research
    • Submit a manuscript
    • Manuscript Progress
    • Submitting a letter
    • Information for Reviewers
    • Open access
  • Alerts
    • Email alerts
    • RSS
  • About
    • General information
    • Staff
    • Editorial board
    • Contact
  • CMAJ JOURNALS
    • CMAJ
    • CJS
    • JAMC
    • JPN

User menu

Search

  • Advanced search
CMAJ Open
  • CMAJ JOURNALS
    • CMAJ
    • CJS
    • JAMC
    • JPN
CMAJ Open

Advanced Search

  • Home
  • Content
    • Current issue
    • Past issues
    • Collections
  • Authors & Reviewers
    • Overview for Authors
    • Preparing manuscripts
    • Submission Checklist
    • Publication Fees
    • Forms
    • Editorial Policies
    • Editorial Process
    • Patient-Oriented Research
    • Submit a manuscript
    • Manuscript Progress
    • Submitting a letter
    • Information for Reviewers
    • Open access
  • Alerts
    • Email alerts
    • RSS
  • About
    • General information
    • Staff
    • Editorial board
    • Contact
  • Subscribe to our alerts
  • RSS feeds
  • Follow CMAJ Open on Twitter
Research

A research agenda to improve patients’ experience of knee replacement surgery: a patient-oriented modified Delphi study of patients of South Asian origin in British Columbia

Stirling Bryan, Laurie J. Goldsmith, Nitya Suryaprakash, Richard Sawatzky, Marilyn Mulldoon, Moira Le Mercier, David Moorthy, Rajiv Gandhi, Satwinder Kaur Bains, Linda C. Li, Mary Doyle-Waters and Sean Brown
March 27, 2020 8 (1) E226-E233; DOI: https://doi.org/10.9778/cmajo.20190128
Stirling Bryan
School of Population and Public Health (Bryan), University of British Columbia, Vancouver, BC; Faculty of Health Sciences (Goldsmith), Simon Fraser University, Burnaby, BC; GoldQual Consulting (Goldsmith), Toronto, Ont.; Centre for Clinical Epidemiology & Evaluation (Bryan, Suryaprakash, Doyle-Waters), Vancouver Coastal Health Research Institute, Vancouver, BC; Department of Nursing (Sawatzky), Trinity Western University, Langley, BC; patient partners (Mulldoon, Le Mercier, Moorthy), BC; Department of Surgery (Gandhi), University of Toronto, Toronto, Ont.; South Asian Studies Institute (Bains), University of the Fraser Valley, Abbotsford, BC; Department of Physical Therapy (Li), University of British Columbia, Vancouver, BC; Arthritis Research Canada (Li), Richmond, BC; Fraser Health (Brown), Surrey, BC
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Laurie J. Goldsmith
School of Population and Public Health (Bryan), University of British Columbia, Vancouver, BC; Faculty of Health Sciences (Goldsmith), Simon Fraser University, Burnaby, BC; GoldQual Consulting (Goldsmith), Toronto, Ont.; Centre for Clinical Epidemiology & Evaluation (Bryan, Suryaprakash, Doyle-Waters), Vancouver Coastal Health Research Institute, Vancouver, BC; Department of Nursing (Sawatzky), Trinity Western University, Langley, BC; patient partners (Mulldoon, Le Mercier, Moorthy), BC; Department of Surgery (Gandhi), University of Toronto, Toronto, Ont.; South Asian Studies Institute (Bains), University of the Fraser Valley, Abbotsford, BC; Department of Physical Therapy (Li), University of British Columbia, Vancouver, BC; Arthritis Research Canada (Li), Richmond, BC; Fraser Health (Brown), Surrey, BC
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Nitya Suryaprakash
School of Population and Public Health (Bryan), University of British Columbia, Vancouver, BC; Faculty of Health Sciences (Goldsmith), Simon Fraser University, Burnaby, BC; GoldQual Consulting (Goldsmith), Toronto, Ont.; Centre for Clinical Epidemiology & Evaluation (Bryan, Suryaprakash, Doyle-Waters), Vancouver Coastal Health Research Institute, Vancouver, BC; Department of Nursing (Sawatzky), Trinity Western University, Langley, BC; patient partners (Mulldoon, Le Mercier, Moorthy), BC; Department of Surgery (Gandhi), University of Toronto, Toronto, Ont.; South Asian Studies Institute (Bains), University of the Fraser Valley, Abbotsford, BC; Department of Physical Therapy (Li), University of British Columbia, Vancouver, BC; Arthritis Research Canada (Li), Richmond, BC; Fraser Health (Brown), Surrey, BC
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Richard Sawatzky
School of Population and Public Health (Bryan), University of British Columbia, Vancouver, BC; Faculty of Health Sciences (Goldsmith), Simon Fraser University, Burnaby, BC; GoldQual Consulting (Goldsmith), Toronto, Ont.; Centre for Clinical Epidemiology & Evaluation (Bryan, Suryaprakash, Doyle-Waters), Vancouver Coastal Health Research Institute, Vancouver, BC; Department of Nursing (Sawatzky), Trinity Western University, Langley, BC; patient partners (Mulldoon, Le Mercier, Moorthy), BC; Department of Surgery (Gandhi), University of Toronto, Toronto, Ont.; South Asian Studies Institute (Bains), University of the Fraser Valley, Abbotsford, BC; Department of Physical Therapy (Li), University of British Columbia, Vancouver, BC; Arthritis Research Canada (Li), Richmond, BC; Fraser Health (Brown), Surrey, BC
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Marilyn Mulldoon
School of Population and Public Health (Bryan), University of British Columbia, Vancouver, BC; Faculty of Health Sciences (Goldsmith), Simon Fraser University, Burnaby, BC; GoldQual Consulting (Goldsmith), Toronto, Ont.; Centre for Clinical Epidemiology & Evaluation (Bryan, Suryaprakash, Doyle-Waters), Vancouver Coastal Health Research Institute, Vancouver, BC; Department of Nursing (Sawatzky), Trinity Western University, Langley, BC; patient partners (Mulldoon, Le Mercier, Moorthy), BC; Department of Surgery (Gandhi), University of Toronto, Toronto, Ont.; South Asian Studies Institute (Bains), University of the Fraser Valley, Abbotsford, BC; Department of Physical Therapy (Li), University of British Columbia, Vancouver, BC; Arthritis Research Canada (Li), Richmond, BC; Fraser Health (Brown), Surrey, BC
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Moira Le Mercier
School of Population and Public Health (Bryan), University of British Columbia, Vancouver, BC; Faculty of Health Sciences (Goldsmith), Simon Fraser University, Burnaby, BC; GoldQual Consulting (Goldsmith), Toronto, Ont.; Centre for Clinical Epidemiology & Evaluation (Bryan, Suryaprakash, Doyle-Waters), Vancouver Coastal Health Research Institute, Vancouver, BC; Department of Nursing (Sawatzky), Trinity Western University, Langley, BC; patient partners (Mulldoon, Le Mercier, Moorthy), BC; Department of Surgery (Gandhi), University of Toronto, Toronto, Ont.; South Asian Studies Institute (Bains), University of the Fraser Valley, Abbotsford, BC; Department of Physical Therapy (Li), University of British Columbia, Vancouver, BC; Arthritis Research Canada (Li), Richmond, BC; Fraser Health (Brown), Surrey, BC
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
David Moorthy
School of Population and Public Health (Bryan), University of British Columbia, Vancouver, BC; Faculty of Health Sciences (Goldsmith), Simon Fraser University, Burnaby, BC; GoldQual Consulting (Goldsmith), Toronto, Ont.; Centre for Clinical Epidemiology & Evaluation (Bryan, Suryaprakash, Doyle-Waters), Vancouver Coastal Health Research Institute, Vancouver, BC; Department of Nursing (Sawatzky), Trinity Western University, Langley, BC; patient partners (Mulldoon, Le Mercier, Moorthy), BC; Department of Surgery (Gandhi), University of Toronto, Toronto, Ont.; South Asian Studies Institute (Bains), University of the Fraser Valley, Abbotsford, BC; Department of Physical Therapy (Li), University of British Columbia, Vancouver, BC; Arthritis Research Canada (Li), Richmond, BC; Fraser Health (Brown), Surrey, BC
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Rajiv Gandhi
School of Population and Public Health (Bryan), University of British Columbia, Vancouver, BC; Faculty of Health Sciences (Goldsmith), Simon Fraser University, Burnaby, BC; GoldQual Consulting (Goldsmith), Toronto, Ont.; Centre for Clinical Epidemiology & Evaluation (Bryan, Suryaprakash, Doyle-Waters), Vancouver Coastal Health Research Institute, Vancouver, BC; Department of Nursing (Sawatzky), Trinity Western University, Langley, BC; patient partners (Mulldoon, Le Mercier, Moorthy), BC; Department of Surgery (Gandhi), University of Toronto, Toronto, Ont.; South Asian Studies Institute (Bains), University of the Fraser Valley, Abbotsford, BC; Department of Physical Therapy (Li), University of British Columbia, Vancouver, BC; Arthritis Research Canada (Li), Richmond, BC; Fraser Health (Brown), Surrey, BC
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Satwinder Kaur Bains
School of Population and Public Health (Bryan), University of British Columbia, Vancouver, BC; Faculty of Health Sciences (Goldsmith), Simon Fraser University, Burnaby, BC; GoldQual Consulting (Goldsmith), Toronto, Ont.; Centre for Clinical Epidemiology & Evaluation (Bryan, Suryaprakash, Doyle-Waters), Vancouver Coastal Health Research Institute, Vancouver, BC; Department of Nursing (Sawatzky), Trinity Western University, Langley, BC; patient partners (Mulldoon, Le Mercier, Moorthy), BC; Department of Surgery (Gandhi), University of Toronto, Toronto, Ont.; South Asian Studies Institute (Bains), University of the Fraser Valley, Abbotsford, BC; Department of Physical Therapy (Li), University of British Columbia, Vancouver, BC; Arthritis Research Canada (Li), Richmond, BC; Fraser Health (Brown), Surrey, BC
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Linda C. Li
School of Population and Public Health (Bryan), University of British Columbia, Vancouver, BC; Faculty of Health Sciences (Goldsmith), Simon Fraser University, Burnaby, BC; GoldQual Consulting (Goldsmith), Toronto, Ont.; Centre for Clinical Epidemiology & Evaluation (Bryan, Suryaprakash, Doyle-Waters), Vancouver Coastal Health Research Institute, Vancouver, BC; Department of Nursing (Sawatzky), Trinity Western University, Langley, BC; patient partners (Mulldoon, Le Mercier, Moorthy), BC; Department of Surgery (Gandhi), University of Toronto, Toronto, Ont.; South Asian Studies Institute (Bains), University of the Fraser Valley, Abbotsford, BC; Department of Physical Therapy (Li), University of British Columbia, Vancouver, BC; Arthritis Research Canada (Li), Richmond, BC; Fraser Health (Brown), Surrey, BC
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Mary Doyle-Waters
School of Population and Public Health (Bryan), University of British Columbia, Vancouver, BC; Faculty of Health Sciences (Goldsmith), Simon Fraser University, Burnaby, BC; GoldQual Consulting (Goldsmith), Toronto, Ont.; Centre for Clinical Epidemiology & Evaluation (Bryan, Suryaprakash, Doyle-Waters), Vancouver Coastal Health Research Institute, Vancouver, BC; Department of Nursing (Sawatzky), Trinity Western University, Langley, BC; patient partners (Mulldoon, Le Mercier, Moorthy), BC; Department of Surgery (Gandhi), University of Toronto, Toronto, Ont.; South Asian Studies Institute (Bains), University of the Fraser Valley, Abbotsford, BC; Department of Physical Therapy (Li), University of British Columbia, Vancouver, BC; Arthritis Research Canada (Li), Richmond, BC; Fraser Health (Brown), Surrey, BC
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Sean Brown
School of Population and Public Health (Bryan), University of British Columbia, Vancouver, BC; Faculty of Health Sciences (Goldsmith), Simon Fraser University, Burnaby, BC; GoldQual Consulting (Goldsmith), Toronto, Ont.; Centre for Clinical Epidemiology & Evaluation (Bryan, Suryaprakash, Doyle-Waters), Vancouver Coastal Health Research Institute, Vancouver, BC; Department of Nursing (Sawatzky), Trinity Western University, Langley, BC; patient partners (Mulldoon, Le Mercier, Moorthy), BC; Department of Surgery (Gandhi), University of Toronto, Toronto, Ont.; South Asian Studies Institute (Bains), University of the Fraser Valley, Abbotsford, BC; Department of Physical Therapy (Li), University of British Columbia, Vancouver, BC; Arthritis Research Canada (Li), Richmond, BC; Fraser Health (Brown), Surrey, BC
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Tables
  • Related Content
  • Responses
  • Metrics
  • PDF
Loading

Article Figures & Tables

Figures

  • Tables
  • Figure 1:
    • Download figure
    • Open in new tab
    • Download powerpoint
    Figure 1:

    Sample Delphi question from the second-round survey. The research topic for this question was information on lifestyle changes (e.g., weight loss, diet, exercise) to prevent or delay osteoarthritis.

Tables

  • Figures
    • View popup
    Table 1:

    Patient research priorities elicited from the focus group discussion

    Research themeResearch topics
    Avoiding knee replacement surgeryInformation on lifestyle changes (e.g., weight loss, diet, exercise) to prevent or delay osteoarthritis
    Improving other surgical techniques (e.g., arthroscopy) to avoid or delay need for knee replacement surgery
    Managing knee symptoms (e.g., use of pain medication) to avoid or delay need for knee replacement surgery
    Preparing for and deciding when to have knee replacement surgeryUnderstanding differences between patient and surgeon views on the right time for knee replacement surgery
    Improving wait times for surgery
    Effectively managing knee pain before surgery (e.g., medication, complementary and alternative medicine such as massage, homeopathy, diet)
    Information on lifestyle changes (e.g., weight loss, diet, exercise) before surgery to improve recovery after surgery
    Improving patient understanding of what to expect during and after surgery
    Providing emotional and psychological support to patients before surgery from other patients
    Providing emotional and psychological support to patients before surgery from professional counsellors
    Knee implantsImproving knee implants that allow for kneeling, squatting and walking downhill
    Surgical cutsImproving surgical practices (e.g., stitching) for best healing and scar minimization
    Understanding the role of genetics in surgical scar formations
    Recovery in hospitalManaging other illnesses while in hospital including medication interaction
    Promoting respectful behaviour between patients and clinicians in clinical settings
    Improving practices for physiotherapy after surgery
    Understanding differences between the patient and clinician views on the right time to discharge from the hospital
    Effectiveness of discharge to a rehabilitation hospital before being sent home
    Recovery longer term (i.e., after hospital discharge)Integrating family doctors into recovery after surgery at the hospital and after discharge from hospital
    Exploring the best role of the surgeon after hospital discharge
    Effective use of pain medication after hospital discharge
    Effective support from the health care system after surgery
    Effective self-management after hospital discharge
    Promoting exercise following surgery
    Providing effective support to patients with ongoing recovery problems
    • View popup
    Table 2:

    Characteristics of patients and caregivers who participated in the surveys

    CharacteristicNo. (%) of respondents
    Patients
    n = 31
    Caregivers
    n = 5
    Age, yr
     ≤ 501 (3)1 (20)
     51–601 (3)
     61–7014 (45)3 (60)
     71–8012 (39)1 (20)
     > 813 (10)
    Sex
     Female19 (61)3 (60)
     Male12 (39)2 (40)
    Currently working
     Yes10 (32)3 (60)
     No21 (68)2 (40)
    Education
     Did not complete high school10 (32)
     High school diploma9 (29)1 (20)
     College or technical school diploma or degree3 (10)3 (60)
     Undergraduate university degree
     Graduate university degree6 (19)1 (20)
     Other (no formal education)3 (10)
    • Note: This table describes the patients and caregivers who responded to the first round of the survey. Of this group, 27 patients and 5 caregivers responded to the second round survey.

    • View popup
    Table 3:

    Characteristics of clinicians who participated in the surveys

    CharacteristicNo. (%) of respondents
    n = 27
    Sex
     Female13 (48)
     Male14 (52)
    Type of practice
     Orthopedic surgery7 (26)
     Physiotherapy8 (30)
     Occupational therapy3 (11)
     Family medicine/general practice8 (30)
     Orthopedic nursing1 (4)
    South Asian ethnicity
     No15 (56)
     Yes12 (44)
    Length of time providing care to South Asian patients who undergo TKA, yr
     < 57 (26)
     6–103 (11)
     > 1017 (63)
    • Note: This table describes the clinician who responded to the first round of the survey. Of this group, 25 responded to the second round survey.

    • View popup
    Table 4:

    Delphi responses for “strong support” (“essential” or “very important”), by survey round and stakeholder group

    Research topicNo. (%) of respondents; survey round, stakeholder group
    First roundSecond round
    Patients and caregivers
    n = 36
    Clinicians
    n = 27
    Combined
    n = 63
    Patients and caregivers
    n = 32
    Clinicians
    n = 25
    Combined
    n = 57
    Information on lifestyle changes to prevent or delay osteoarthritis25 (70)22 (81)47 (75)27 (84)23 (92)50 (88)
    Improving other surgical techniques to avoid or delay need for knee replacement surgery28 (78)7 (26)35 (56)26 (81)7 (28)33 (58)
    Managing knee symptoms to avoid or delay need for knee replacement surgery24 (67)18 (67)42 (67)
    Understanding differences between patient and surgeon views on the right time for knee replacement30 (83)18 (67)48 (76)29 (91)17 (68)46 (81)
    Improving wait times for surgery27 (75)19 (70)46 (73)29 (91)18 (72)47 (82)
    Effectively managing knee pain before surgery26 (72)18 (67)44 (70)27 (84)21 (84)48 (84)
    Information on lifestyle changes before surgery to improve recovery after surgery25 (69)23 (85)48 (76)28 (88)24 (96)52 (91)
    Improving patient understanding of what to expect during and after surgery31 (86)22 (81)53 (84)30 (94)21 (84)51 (90)
    Providing emotional and psychological support to patients before surgery from other patients20 (56)11 (41)31 (49)
    Providing emotional and psychological support to patients before surgery from professional counsellors18 (50)8 (30)26 (41)
    Improving knee implants that allow for kneeling, squatting and walking downhill31 (86)17 (63)48 (76)29 (91)16 (64)45 (79)
    Improving surgical practices for best healing and scar minimization25 (70)11 (41)36 (57)
    Understanding the role of genetics in surgical scar formations20 (56)5 (18)25 (40)
    Managing other illnesses while in hospital including medication interaction25 (70)15 (56)40 (64)
    Promoting respectful behaviour between patients and clinicians in clinical settings21 (58)15 (56)36 (57)
    Improving practices for physiotherapy after surgery32 (89)23 (85)55 (87)30 (94)23 (92)53 (93)
    Understanding differences between the patient and clinician views on the right time to discharge from the hospital24 (67)17 (63)41 (65)
    Effectiveness of discharge to a rehabilitation hospital before being sent home25 (70)11 (41)36 (57)
    Integrating family doctors into surgery recovery at the hospital and after discharge from hospital23 (64)13 (48.1)36 (57)
    Exploring the best role of the surgeon after hospital discharge33 (92)9 (33)42 (67)28 (88)9 (36)37 (65)
    Effective use of pain medication after hospital discharge29 (81)22 (81)51 (81)28 (88)20 (80)48 (84)
    Effective support from the health care system after surgery32 (89)19 (70)51 (81)28 (88)19 (74)47 (82)
    Effective self-management after hospital discharge31 (86)23 (85)54 (86)29 (91)23 (92)52 (91)
    Promoting exercise following surgery33 (92)23 (85)56 (89)30 (94)24 (96)54 (95)
    Providing effective support to patients with ongoing recovery problems27 (75)16 (59)43 (68)29 (91)15 (60)44 (77)
    • Note: In the first round of the survey, 61% of eligible patients and caregivers and 82% of eligible clinicians participated; the combined response rate was 69%; 89% of the patients and caregivers and 93% of the clinicians who participated in the first round also participated in the second round. The combined response rate was 90% in the second round.

PreviousNext
Back to top

In this issue

CMAJ Open: 8 (1)
Vol. 8, Issue 1
1 Jan 2020
  • Table of Contents
  • Index by author

Article tools

Respond to this article
Print
Download PDF
Article Alerts
To sign up for email alerts or to access your current email alerts, enter your email address below:
Email Article

Thank you for your interest in spreading the word on CMAJ Open.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
A research agenda to improve patients’ experience of knee replacement surgery: a patient-oriented modified Delphi study of patients of South Asian origin in British Columbia
(Your Name) has sent you a message from CMAJ Open
(Your Name) thought you would like to see the CMAJ Open web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
A research agenda to improve patients’ experience of knee replacement surgery: a patient-oriented modified Delphi study of patients of South Asian origin in British Columbia
Stirling Bryan, Laurie J. Goldsmith, Nitya Suryaprakash, Richard Sawatzky, Marilyn Mulldoon, Moira Le Mercier, David Moorthy, Rajiv Gandhi, Satwinder Kaur Bains, Linda C. Li, Mary Doyle-Waters, Sean Brown
Jan 2020, 8 (1) E226-E233; DOI: 10.9778/cmajo.20190128

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
A research agenda to improve patients’ experience of knee replacement surgery: a patient-oriented modified Delphi study of patients of South Asian origin in British Columbia
Stirling Bryan, Laurie J. Goldsmith, Nitya Suryaprakash, Richard Sawatzky, Marilyn Mulldoon, Moira Le Mercier, David Moorthy, Rajiv Gandhi, Satwinder Kaur Bains, Linda C. Li, Mary Doyle-Waters, Sean Brown
Jan 2020, 8 (1) E226-E233; DOI: 10.9778/cmajo.20190128
Digg logo Reddit logo Twitter logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like

Related Articles

  • PubMed
  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

Similar Articles

Collections

  • Clinical
    • Surgery
      • Orthopedic & trauma surgery
    • Patient-oriented research
  • Nonclinical
    • Patients
      • Patients' views

Content

  • Current issue
  • Past issues
  • Collections
  • Alerts
  • RSS

Authors & Reviewers

  • Overview for Authors
  • Preparing manuscripts
  • Manuscript Submission Checklist
  • Publication Fees
  • Forms
  • Editorial Policies
  • Editorial Process
  • Patient-Oriented Research
  • Submit a manuscript
  • Manuscript Progress
  • Submitting a letter
  • Information for Reviewers

About

  • General Information
  • Staff
  • Editorial Board
  • Contact Us
  • Advertising
  • Media
  • Reprints
  • Copyright and Permissions
  • Accessibility
  • CMA Civility Standards
CMAJ Group

Copyright 2023, CMA Impact Inc. or its licensors. All rights reserved. ISSN 2291-0026

All editorial matter in CMAJ OPEN represents the opinions of the authors and not necessarily those of the Canadian Medical Association or its subsidiaries.

To receive any of these resources in an accessible format, please contact us at CMAJ Group, 500-1410 Blair Towers Place, Ottawa ON, K1J 9B9; p: 1-888-855-2555; e: [email protected].

View CMA's Accessibility policy.

 

Powered by HighWire