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Maintenance and updating of the information contained in the Orthodose application.

Executive Summary

Orthodose developed MedLight srl by represents a significant advance in medical applications dedicated to palliative care and pain management. Initially created in 2010 by a doctor specializing in palliative care, it offers healthcare professionals useful, accurate and actionable information on palliative care pain management and relevant conversion calculations. Orthodose stands as an indispensable tool for improving palliative care quality worldwide.

In a landscape awash with varying information, Orthodose stands out by providing information fuelled by Evidence Based Medicine, yet practical, peer-used practical information, facilitating enlightened therapeutic decisions. It is important to emphasize that Orthodose provides theoretical information for professional use, devoid of patient-specific diagnostics or treatment options, underscoring the necessity for healthcare professionals to tailor application advice to individual patient contexts.

Procedure to Ensure Up-to-Date and Accurate Medical App Information

In order to constantly maintain the accuracy and relevance of Orthodose, we have developed a specific procedure to ensure that the medical information in the application remains up-to-date and accurate. This history underscores the application’s enduring commitment to quality, security, and patient safety, making it a trusted resource in the palliative care community.

Content Review Cycle

A rigorous content review cycle involves clinical expert in palliative care and explicitly includes supervision by a medical doctor. It ensures that updates and assessments of the app’s medical content are overseen by a qualified healthcare professional, reinforcing the app’s credibility and reliability. This cycle is designed to incorporate the latest clinical guidelines, research findings, and evidence-based practices, with updates occurring annually or more frequently as needed. This cycle explicitly acknowledges the balance between the application’s practicality and the necessity for it to remain secure and up to date, ensuring that decisions to update are informed not only by the latest articles but also by their applicability and safety in clinical use.

User Feedback Integration

The mechanism for integrating user feedback, collected through the app and website, is detailed further to emphasize its effectiveness. This process, conducted monthly, involves reviewing feedback to identify scientific references and prioritize updates, reinforcing the app’s responsiveness to user needs and enhancing its practical utility. The inclusion of user feedback in the literature review process, and the decision not to list all sources in the bibliography due to the long-standing nature of this review (commencing 15 years ago), are new additions. This approach ensures a relatively concise yet comprehensive bibliography.

Literature and Guidelines Monitoring

The ongoing monitoring of scientific literature, clinical guidelines, and regulatory updates is crucial. This process involves continuous scanning of new information relevant to pain management in palliative care, ensuring that the app remains a current and practical resource for healthcare professionals. This monitoring explicitly includes the criteria of quality, practicality and security in the evaluation of new information for app integration, ensuring that updates not only reflect the latest scientific findings but are also viable and safe for clinical application.

Quality Assurance and Validation

The quality assurance and validation section has been expanded to detail the testing process by “testers”, including medical doctors, ensuring that updates do not compromise the app’s functionality or reliability. Users interested in participating as testers are encouraged to apply through the Orthodose contact page, fostering a community-driven approach to app development and quality assurance.

Change Log and Version Control

With the detailed background of Orthodose’s creation and MEDLIGHT SRL’s stewardship, the application has undergone significant enhancements to solidify its position as a reliable, effective, and compliant tool for palliative care professionals. MEDLIGHT’s approach, incorporating rigorous update cycles, user feedback integration, continuous monitoring of scientific literature, and comprehensive quality assurance, builds a robust foundation for trust among users. This commitment to excellence and patient safety is now further emphasized in our change log version notes, reflecting our dedication to maintaining Orthodose as a premier resource for healthcare professionals. By incorporating these detailed procedures, MEDLIGHT SRL ensures that Orthodose continues to be a dependable and efficient tool for target information, fostering greater trust and demonstrating a steadfast commitment to quality and patient safety in palliative care.

Bibliography

The bibliography will be selectively compiled to reflect the extensive literature review spanning over 15 years, emphasizing key references that inform the app’s content, such as:

  • Cherny, Nathan I., and others (eds), Oxford Textbook of Palliative Medicine, 6 edn (Oxford, 2021; online edn, Oxford Academic, 1 Aug. 2021), https://doi.org/10.1093/med/9780198821328.001.0001, accessed 1 Apr. 2024.

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  • Caraceni, A., Hanks, G., Kaasa, S., Bennett, M. I., Brunelli, C., Cherny, N., Dale, O., De Conno, F., Fallon, M., Hanna, M., Haugen, D. F., Juhl, G., King, S., Klepstad, P., Laugsand, E. A., Maltoni, M., Mercadante, S., Nabal, M., Pigni, A., Radbruch, L., … European Association for Palliative Care (EAPC) (2012). Use of opioid analgesics in the treatment of cancer pain: evidence-based recommendations from the EAPC. The Lancet. Oncology13(2), e58–e68. https://doi.org/10.1016/S1470-2045(12)70040-2

  • Ofoegbu, A., & B Ettienne, E. (2021). Pharmacogenomics and Morphine. Journal of clinical pharmacology61(9), 1149–1155. https://doi.org/10.1002/jcph.1873

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  • Watanabe, S., Pereira, J., Tarumi, Y., Hanson, J., & Bruera, E. (2008). A randomized double-blind crossover comparison of continuous and intermittent subcutaneous administration of opioid for cancer pain. Journal of palliative medicine11(4), 570–574. https://doi.org/10.1089/jpm.2007.0176

  • De Gregori, S., De Gregori, M., Ranzani, G. N., Allegri, M., Minella, C., & Regazzi, M. (2012). Morphine metabolism, transport and brain disposition. Metabolic brain disease27(1), 1–5. https://doi.org/10.1007/s11011-011-9274-6

  • Takahashi, M., Ohara, T., Yamanaka, H., Shimada, A., Nakaho, T., & Makoto, Y. (2003). The oral-to-intravenous equianalgesic ratio of morphine based on plasma concentrations of morphine and metabolites in advanced cancer patients receiving chronic morphine treatment. Palliative medicine17(8), 673–678. https://doi.org/10.1191/0269216303pm824oa

  • Hagen, N. A., & Babul, N. (1997). Comparative clinical efficacy and safety of a novel controlled-release oxycodone formulation and controlled-release hydromorphone in the treatment of cancer pain. Cancer79(7), 1428–1437.

  • Lasheen, W., Walsh, D., Mahmoud, F., Sarhill, N., Rivera, N., Davis, M., Lagman, R., & Legrand, S. (2010). The intravenous to oral relative milligram potency ratio of morphine during chronic dosing in cancer pain. Palliative medicine24(1), 9–16. https://doi.org/10.1177/0269216309346595

  • Poulain, P., Berleur, M. P., Lefki, S., Lefebvre, D., Chvetzoff, G., Serra, E., Tremellat, F., Derniaux, A., Filbet, M., & EQUIMETH2 Study Group (2016). Efficacy and Safety of Two Methadone Titration Methods for the Treatment of Cancer-Related Pain: The EQUIMETH2 Trial (Methadone for Cancer-Related Pain). Journal of pain and symptom management52(5), 626–636.e1. https://doi.org/10.1016/j.jpainsymman.2016.05.022

  • Link, B., Haschke, M., Grignaschi, N., Bodmer, M., Aschmann, Y. Z., Wenk, M., & Krähenbühl, S. (2008). Pharmacokinetics of intravenous and oral midazolam in plasma and saliva in humans: usefulness of saliva as matrix for CYP3A phenotyping. British journal of clinical pharmacology66(4), 473–484. https://doi.org/10.1111/j.1365-2125.2008.03201.x

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  • Scott, L. J., Lyseng-Williamson, K. A., & Garnock-Jones, K. P. (2012). Oromucosal midazolam: a guide to its use in paediatric patients with prolonged acute convulsive seizures. CNS drugs26(10), 893–897. https://doi.org/10.2165/11209350-000000000-00000

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  • Kaiko, R. F., Wallenstein, S. L., Rogers, A., Grabinski, P., & Houde, R. W. (1981). Relative analgesic potency of intramuscular heroin and morphine in cancer patients with postoperative pain and chronic pain due to cancer. NIDA research monograph34, 213–219.

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  • Other :
    https://www.benzoinfo.com
    https://www.benzo.org.uk/index.htm
    https://www.sciencedirect.com/book/9780323847025
    https://www.pharmaceuticalpress.com/products/palliative-care-formulary/
    https://cbip.be/fr/
    https://www.fda.gov
    Adult Drug Information Handbook, 32 th edition, American Pharmacists Association (APhA), Wolters Kluwer Edition.

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