scholarly journals Optimizing Clinical Decision Making in Acute Traumatic Spinal Cord Injury

2017 ◽  
Vol 34 (20) ◽  
pp. 2841-2842 ◽  
Author(s):  
Michael G. Fehlings ◽  
Vanessa K. Noonan ◽  
Derek Atkins ◽  
Anthony S. Burns ◽  
Christiana L. Cheng ◽  
...  
Keyword(s):  
Decision Making ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Traumatic Spinal Cord Injury ◽  
Cord Injury

scholarly journals Clinical decision-making on spinal cord injury-associated pneumonia: a nationwide survey in Germany

Spinal Cord ◽  
2020 ◽  
Vol 58 (8) ◽  
pp. 873-881 ◽  
Author(s):  
Claudia Druschel ◽  
Ramin R. Ossami Saidy ◽  
Ulrike Grittner ◽  
Claus P. Nowak ◽  
Andreas Meisel ◽  
...  
Keyword(s):  
Decision Making ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Clinical Decision Making ◽  
Nationwide Survey ◽  
Clinical Decision ◽  
Cord Injury

scholarly journals Towards a Mobile Gait Analysis for Patients with a Spinal Cord Injury: A Robust Algorithm Validated for Slow Walking Speeds

Sensors ◽  
2021 ◽  
Vol 21 (21) ◽  
pp. 7381
Author(s):  
Charlotte Werner ◽  
Chris Awai Awai Easthope ◽  
Armin Curt ◽  
László Demkó
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Gait Analysis ◽  
Clinical Decision Making ◽  
Inertial Sensors ◽  
Clinical Decision ◽  
Cord Injury ◽  
Spatio Temporal ◽  
The Individual ◽  
Walking Speeds

Spinal cord injury (SCI) patients suffer from diverse gait deficits depending on the severity of their injury. Gait assessments can objectively track the progress during rehabilitation and support clinical decision making, but a comprehensive gait analysis requires far more complex setups and time-consuming protocols that are not feasible in the daily clinical routine. As using inertial sensors for mobile gait analysis has started to gain ground, this work aimed to develop a sensor-based gait analysis for the specific population of SCI patients that measures the spatio-temporal parameters of typical gait laboratories for day-to-day clinical applications. The proposed algorithm uses shank-mounted inertial sensors and personalized thresholds to detect steps and gait events according to the individual gait profiles. The method was validated in nine SCI patients and 17 healthy controls walking on an instrumented treadmill while wearing reflective markers for motion capture used as a gold standard. The sensor-based algorithm (i) performed similarly well for the two cohorts and (ii) is robust enough to cover the diverse gait deficits of SCI patients, from slow (0.3 m/s) to preferred walking speeds.

scholarly journals Correlational Dueling Bandits with Application to Clinical Treatment in Large Decision Spaces

2017 ◽  
Author(s):  
Yanan Sui ◽  
Joel W. Burdick
Keyword(s):  
Decision Making ◽  
Spinal Cord ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Sequential Decision Making ◽  
Sequential Decision ◽  
Decision Space ◽  
Cord Injury ◽  
Effectiveness And Efficiency ◽  
Comparative Feedback

We consider sequential decision making under uncertainty, the optimization over large decision space with noisy comparative feedback. This problem can be formulated as a K-armed Dueling Bandits problem where K is the total number of decisions. When K is very large, existing dueling bandits algorithms suffer huge cumulative regret before converging on the optimal arm. This paper studies the dueling bandits problem with a large number of dependent arms. Our problem is motivated by a clinical decision making process in large decision space. We propose an efficient algorithm CorrDuel for the problem which makes decisions to simultaneously deliver effective therapy and explore the decision space. Many sequential decision making problems with large and structured decision space could be facilitated by our algorithm. After evaluated the fast convergence of CorrDuel in analysis and simulation experiments, we applied it on a live clinical trial of therapeutic spinal cord stimulation. It is the first applied algorithm towards spinal cord injury treatments and experimental results show the effectiveness and efficiency of our algorithm.

Neurological Recovery in Traumatic Spinal Cord Injury Patient with Delayed Surgical Intervention

2018 ◽  
Vol 1 (2) ◽  
pp. 34
Author(s):  
Mochamad Targib Alatas
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Surgical Intervention ◽  
Case Series ◽  
Spinal Cord Injury Patient ◽  
Traumatic Spinal Cord Injury ◽  
Best Interest ◽  
Score Improvement ◽  
Cord Injury ◽  
Injury Patient

Early surgical treatment for traumatic spinal cord injury (SCI) patients has been proven to yield better improvement on neurological state, and widely practiced among surgeons in this field. However, it is not always affordable in every clinical setting. It is undeniable that surgery for chronic SCI has more challenges as the malunion of vertebral bones might have initiated, thus requires more complex operating techniques. In this case series, we report 7 patients with traumatic SCI whose surgical intervention is delayed due to several reasons. Initial motoric scores vary from 0 to 3, all have their interval periods supervised between outpatient clinic visits. On follow up they demonstrate significant neurological development defined by at least 2 grades motoric score improvement. Physical rehabilitation also began before surgery was conducted. These results should encourage surgeons to keep striving for the patient’s best interest, even when the injury has taken place weeks or even months before surgery is feasible because clinical improvement for these patients is not impossible. 

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