Is computer-assisted telephone triage safe? A prospective surveillance study in walk-in patients with non-life-threatening medical conditions

2010 ◽  
Vol 29 (2) ◽  
pp. 124-128 ◽  
Author(s):  
Andreas Meer ◽  
Thomas Gwerder ◽  
Lutz Duembgen ◽  
Niki Zumbrunnen ◽  
Heinz Zimmermann
Keyword(s):  
Surveillance Study ◽  
Computer Assisted ◽  
Medical Conditions ◽  
Telephone Triage ◽  
Prospective Surveillance ◽  
Life Threatening

scholarly journals A Review of Biophysiological and Biochemical Indicators of Stress for Connected and Preventive Healthcare

Diagnostics ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 556
Author(s):  
Talha Iqbal ◽  
Adnan Elahi ◽  
Pau Redon ◽  
Patricia Vazquez ◽  
William Wijns ◽  
...  
Keyword(s):  
Cardiovascular Events ◽  
Medical Conditions ◽  
Review Of The Literature ◽  
Stress Monitoring ◽  
Preventive Healthcare ◽  
Connected Health ◽  
Root Cause ◽  
Chemical Indicators ◽  
Life Threatening ◽  
Assessment Of Stress

Stress is a known contributor to several life-threatening medical conditions and a risk factor for triggering acute cardiovascular events, as well as a root cause of several social problems. The burden of stress is increasing globally and, with that, is the interest in developing effective stress-monitoring solutions for preventive and connected health, particularly with the help of wearable sensing technologies. The recent development of miniaturized and flexible biosensors has enabled the development of connected wearable solutions to monitor stress and intervene in time to prevent the progression of stress-induced medical conditions. This paper presents a review of the literature on different physiological and chemical indicators of stress, which are commonly used for quantitative assessment of stress, and the associated sensing technologies.

Cardiac Arrhythmia Detection using Dual Tree Wavelet Transform and Convolutional Neural Network

2021 ◽  
Author(s):  
K Reddy Madhavi ◽  
Padmavathi kora ◽  
L Venkateswara Reddy ◽  
J Avanija ◽  
KLS Soujanya ◽  
...  
Keyword(s):  
Neural Network ◽  
Wavelet Transform ◽  
Cardiac Cells ◽  
P Wave ◽  
Computer Assisted ◽  
Ecg Signals ◽  
Coronary Diseases ◽  
Life Saving ◽  
Life Threatening ◽  
Assisted Diagnosis

Abstract The non-stationary ECG signals are used as a key tools in screening coronary diseases. ECG recording is collected from millions of cardiac cells’ and depolarization and re-polarization conducted in a synchronized manner as: The P-wave occurs first, followed by the QRScomplex and the T-wave, which will repeat in each beat. The signal is altered in a cardiac beat period for different heart conditions. This change can be observed in order to diagnose the patient’s heart status. There are life-threatening (critical) and non-life - threatening (noncritical) arrhythmia (abnormal Heart). Critical arrhythmia gives little time for surgery, whereas non-critical needs additional life-saving care. Simple naked eye diagnosis can mislead the detection. At that point, Computer Assisted Diagnosis (CAD) is therefore required. In this paper Dual Tree Wavelet Transform (DTWT) used as a feature extraction technique along with Convolution Neural Network (CNN) to detect abnormal Heart. The findings of this research and associated studies are without any cumbersome artificial environments. The CAD method proposed has high generalizability; it can help doctors efficiently identify diseases and decrease misdiagnosis.

PP23 Accuracy of emergency medical services (EMS) telephone triage in identifying acute coronary syndrome (ACS) for chest pain patients. A systematic review abstract

2021 ◽  
Vol 38 (9) ◽  
pp. A10.2-A10
Author(s):  
Ahmed Alotaibi ◽  
Abdulrhman Alghamdi ◽  
Charles Reynard ◽  
Richard Body
Keyword(s):  
Systematic Review ◽  
Acute Coronary Syndrome ◽  
Chest Pain ◽  
Prediction Models ◽  
Meta Analysis ◽  
Final Diagnosis ◽  
Telephone Triage ◽  
Coronary Syndrome ◽  
Life Threatening ◽  
Pain Patients

IntroductionChest pain is one of the most common reasons for ambulance callouts and presentation to Emergency Departments (EDs). Differentiating patients with serious conditions (e.g. acute coronary syndrome [ACS]) from the majority, who have self-limiting, non-cardiac conditions is extremely challenging. This causes over-triage and over-use of healthcare resources. We aimed to systematically review existing evidence on the accuracy of emergency telephone triage to detect ACS or life-threatening conditions associated with chest pain.MethodsWe conducted a systematic review in accordance with PRISMA guidelines. Two independent investigators searched the Embase, Medline, and Cinahl databases for relevant papers. We included retrospective and prospective cohort studies written in English and investigating EMS telephone triage for chest pain patients linked with final diagnosis of ACS. Studies were summarised in a narrative format as the data were not suitable for meta-analysis.ResultIn total, 553 studies were identified from the literature search and cross-referencing. After excluding 550 studies, three were eligible for inclusion. Among those 3 studies, there are different prediction models developed by authors with variation in variables to detect ACS. The result showed that dispatch triage tools have good sensitivity to detect ACS and life-threatening conditions although they are used to triage sign and symptoms rather than diagnosing the patients. On the other hand, prediction models were built to detect ACS and life-threatening conditions and therefore it showed better sensitivity and NPV.ConclusionEMS dispatch systems accuracy for ACS and life-threatening conditions associated with chest pain is good. Since the dispatch tools were built to triage ambulance response priority based on sign and symptoms, this led to over triage among non-life-threatening chest pain patients. Over triage were slightly reduced by deriving prediction models and showed better sensitivity.

scholarly journals Telemedicine-Based Specialized Care Improves the Outcome of Anticoagulated Individuals with Venous Thromboembolism—Results from the thrombEVAL Study

2020 ◽  
Vol 9 (10) ◽  
pp. 3281
Author(s):  
Karsten Keller ◽  
Sebastian Göbel ◽  
Vincent ten Cate ◽  
Marina Panova-Noeva ◽  
Lisa Eggebrecht ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Vitamin K Antagonists ◽  
Computer Assisted ◽  
Thromboembolic Events ◽  
Specialized Care ◽  
Life Threatening ◽  
Multi Center Study ◽  
Reported Data ◽  
Mortality Hazard Ratio

Venous thromboembolism (VTE) is a life-threatening disease with risk of recurrence. Oral anticoagulation (OAC) with vitamin K antagonists (VKA) is effective to prevent thromboembolic recurrence. We aimed to investigate the quality of OAC of VTE patients in regular medical care (RMC) compared to a telemedicine-based coagulation service (CS). The thrombEVAL study (NCT01809015) is a prospective, multi-center study to investigate OAC treatment (recruitment: January 2011–March 2013). Patients were evaluated using clinical visits, computer-assisted personal interviews, self-reported data and laboratory measurements according to standard operating procedures. Overall, 360 patients with VTE from RMC and 254 from CS were included. Time in therapeutic range (TTR) was higher in CS compared to RMC (76.9% (interquartile range [IQR] 63.2–87.1%) vs. 69.5% (52.3–85.6%), p < 0.001). Crude rate of thromboembolic events (rate ratio [RR] 11.33 (95% confidence interval [CI] 1.85–465.26), p = 0.0015), clinically relevant bleeding (RR 6.80 (2.52–25.76), p < 0.001), hospitalizations (RR 2.54 (1.94–3.39), p < 0.001) and mortality under OAC (RR 5.89 (2.40–18.75), p < 0.001) were consistently higher in RMC compared with CS. Patients in RMC had higher risk for primary outcome (clinically relevant bleedings, thromboembolic events and mortality, hazard ratio [HR] 5.39 (95%CI 2.81–10.33), p < 0.0001), mortality (HR 5.54 (2.22–13.84), p = 0.00025), thromboembolic events (HR 6.41 (1.51–27.24), p = 0.012), clinically relevant bleeding (HR 5.31 (1.89–14.89), p = 0.0015) and hospitalization (HR 1.84 (1.34–2.55), p = 0.0002). Benefits of CS care were still observed after adjusting for comorbidities and TTR. In conclusion, anticoagulation quality and outcome of VTE patients undergoing VKA treatment was significantly better in CS than in RMC. Patients treated in CS had lower rates of adverse events, hospitalizations and lower mortality. CS was prognostically relevant, beyond providing advantages of improved international ratio (INR) monitoring.

Bilateral, independent juvenile nasopharyngeal angiofibroma: case report

2015 ◽  
Vol 129 (10) ◽  
pp. 1032-1035 ◽  
Author(s):  
M-L Mørkenborg ◽  
M Frendø ◽  
T Stavngaard ◽  
C Von Buchwald
Keyword(s):  
Case Report ◽  
Contralateral Side ◽  
Growth Patterns ◽  
Sinus Surgery ◽  
Juvenile Nasopharyngeal Angiofibroma ◽  
Computer Assisted ◽  
Nasopharyngeal Angiofibroma ◽  
Operative Planning ◽  
Life Threatening ◽  
One Step

AbstractBackground:Juvenile nasopharyngeal angiofibroma is a benign, vascular tumour that primarily occurs in adolescent males. Despite its benign nature, aggressive growth patterns can cause potential life-threatening complications. Juvenile nasopharyngeal angiofibroma is normally unilateral, originating from the sphenopalatine artery, but bilateral symptoms can occur if a large tumour extends to the contralateral side of the nasopharynx. This paper presents the first reported case of true bilateral extensive juvenile nasopharyngeal angiofibroma involving clinically challenging pre-surgical planning and surgical strategy.Case report:A 21-year-old male presented with increasing bilateral nasal obstruction and discharge. Examination revealed tumours bilaterally and imaging demonstrated non-contiguous tumours. Pre-operative angiography showed strictly ipsilateral vascular supplies requiring bilateral embolisation. Radical removal performed as one-step, computer-assisted functional endoscopic sinus surgery was performed. The follow-up period was uncomplicated.Conclusion:This case illustrates the importance of suspecting bilateral juvenile nasopharyngeal angiofibroma in patients presenting with bilateral symptoms. Our management, including successful pre-operative planning, enabled one-step total removal of both tumours and rapid patient recovery.

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