I appreciate the opportunity to respond to the letter submitted by Dr Figurski.
I believe that the lack of a control group for patient satisfaction, lack of randomization, and differences between the study and control group were adequately addressed under “Study limitations” published in the paper.
In three cases, I scheduled additional appointments as clinically required. I did not consider these appointments, two electronic and one in person, as “unscheduled care.” For the study purposes, I only considered visits to the emergency department or walk-in initiated by the patient without my knowledge as “unscheduled.”
Responding to a patient using the Medeo platform on my iPhone took approximately 2 minutes per instance, including billing the MSP fee code 10006 (Specialist Email Patient Management/Follow-Up) using a separate Accuro iPhone app.
This research was conducted without any funding from any source. Transparency and academic integrity is very important to me in terms of conflict of interest. I felt so strongly on this point that, on my own accord, I sold all of my shares in QHR before this paper was accepted for publication by the BCMJ. The BCMJ has a conflict-of-interest declaration process for peer-reviewed papers. It is noteworthy that subsequent to acceptance of the paper, QHR was acquired by Loblaw on 22 August 2016 with a significant increase in the QHR share price. I can confidently declare that I currently have no financial interest in QHR or its subsidiaries. I am, however, an unapologetically enthusiastic user of QHR’s products, Accuro and Medeo, and a proponent for the use of novel technology to improve patient care. As I concluded in the paper, I hope my research can be used to help develop a more rigorous, multicentre, randomized controlled study by institutions that have the resources to conduct this kind of research. The Vernon Jubilee Hospital does not fall into this category.
—Hamish Hwang, MD, FRCSC, FACS
Above is the information needed to cite this article in your paper or presentation. The International Committee
of Medical Journal Editors (ICMJE) recommends the following citation style, which is the now nearly universally
accepted citation style for scientific papers:
Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.
About the ICMJE and citation styles
The ICMJE is small group of editors of general medical journals who first met informally in Vancouver, British Columbia, in 1978 to establish guidelines for the format of manuscripts submitted to their journals. The group became known as the Vancouver Group. Its requirements for manuscripts, including formats for bibliographic references developed by the U.S. National Library of Medicine (NLM), were first published in 1979. The Vancouver Group expanded and evolved into the International Committee of Medical Journal Editors (ICMJE), which meets annually. The ICMJE created the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.
An alternate version of ICMJE style is to additionally list the month an issue number, but since most journals use continuous pagination, the shorter form provides sufficient information to locate the reference. The NLM now lists all authors.
BCMJ standard citation style is a slight modification of the ICMJE/NLM style, as follows:
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For more information on the ICMJE Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals, visit www.icmje.org