Comparison of Woven EndoBridge device sizing with conventional measurements and virtual simulation using the Sim&Size software: a multicenter experience

BackgroundSelection of the appropriate device size mandatory during aneurysm treatment with a Woven EndoBridge (WEB). We aimed to investigate if virtual simulation with Sim&Size software may have an impact on technical, angiographic, and clinical outcomes after WEB treatment.MethodsData from two large-volume centers were collected and compared (January 2017–January 2020). Virtual simulation was systematically adopted in one center, while conventional sizing was used in the other one. Outcomes were the duration of intervention, the radiation dose (in milligrays, the number of corrective interventions for inappropriate WEB size, the number of WEBs not deployed, angiographic occlusion, and complications. Univariate and multivariate linear models were adopted.ResultsA total of 186 aneurysms were treated with WEB (109 with and 77 without virtual simulation). Patient characteristics and aneurysm features were comparable among virtual and conventional sizing, except for mean age (62.2±11.8 years and 56.2±10.1 years, P=0.0004) and median aspect ratio (1.6, IQR=1.2–2 and 1.2, IQR=1–1.6, P=0.0001). Years of operator experience were comparable. Virtual simulation was independently associated with shorter intervention time (45 min, IQR=33–63.5 min vs 63.5 min, IQR=41–84.7 min, P=0.0001), lower radiation dose (1051 mGy, IQR=815–1399 mGy vs 1207 mGy, IQR=898–2084 mGy, P=0.0001), and lower number of WEBs not deployed (26/77=33.7% vs 8/109=7.3%, P=0.0001). The need for additional maneuvers was significantly lower in the virtual simulation group (5/109=4.6% vs 12/77=15.6%, P=0.021). Angiographic outcomes and complications were comparable.ConclusionsIn this multicenter experience, virtual simulation with Sim&Size software seems to facilitate the selection of the appropriate WEB device for aneurysm treatment, reducing the time of intervention, the radiation dose, the number of devices not deployed, and the need for corrective interventions.Trial registration numberclinicaltrials.gov Identifier: NCT04621552.

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Radiation Minimisation and Outcome Maximisation in Cardiac Computed Tomograpy

European Cardiology Review ◽

10.15420/ecr.2010.6.1.15 ◽

2010 ◽

Vol 6 (1) ◽

pp. 15

Author(s):

James P Earls ◽

Jonathon A Leipsic ◽

◽

Keyword(s):

Radiation Dose ◽

Dose Reduction ◽

New Technologies ◽

Cardiac Computed Tomography ◽

Substantial Reduction ◽

Radiation Doses ◽

Tube Current ◽

Prospective Triggering ◽

Effective Radiation ◽

Selection Of

Recent reports have raised general awareness that cardiac computed tomography (CT) has the potential for relatively high effective radiation doses. While the actual amount of risk this poses to the patient is controversial, the increasing concern has led to a great deal of research on new CT techniques capable of imaging the heart at substantially lower radiation doses than was available only a few years ago. Methods of dose reduction include optimised selection of user-defined parameters, such as tube current and voltage, as well as use of new technologies, such as prospective triggering and iterative reconstruction. These techniques have each been shown to lead to substantial reduction in radiation dose without loss of diagnostic accuracy. This article will review the most frequently used and widely available methods for radiation dose reduction in cardiac CT and give practical advice on their use and limitations.

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Doubly multivariate linear models with block exchangeable distributed errors and site-dependent covariates

Journal of Applied Statistics ◽

10.1080/02664763.2021.1959529 ◽

2021 ◽

pp. 1-18

Author(s):

Timothy Opheim ◽

Anuradha Roy

Keyword(s):

Linear Models ◽

Multivariate Linear Models

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Comparing Patient Characteristics, Clinical Outcomes, and Biomarkers of Severe Asthma Patients in Taiwan

Biomedicines ◽

10.3390/biomedicines9070764 ◽

2021 ◽

Vol 9 (7) ◽

pp. 764

Author(s):

Shih-Lung Cheng ◽

Kuo-Chin Chiu ◽

Hsin-Kuo Ko ◽

Diahn-Warng Perng ◽

Hao-Chien Wang ◽

...

Keyword(s):

Severe Asthma ◽

Clinical Characteristics ◽

Linear Models ◽

Patient Characteristics ◽

Emergency Department Visits ◽

Receiver Operating Characteristic Curves ◽

Increased Risk ◽

Significant Difference ◽

Asthma Patients ◽

Patients At Risk

Purpose: To understand the association between biomarkers and exacerbations of severe asthma in adult patients in Taiwan. Materials and Methods: Demographic, clinical characteristics and biomarkers were retrospectively collected from the medical charts of severe asthma patients in six hospitals in Taiwan. Exacerbations were defined as those requiring asthma-specific emergency department visits/hospitalizations, or systemic steroids. Enrolled patients were divided into: (1) those with no exacerbations (non-exacerbators) and (2) those with one or more exacerbations (exacerbators). Receiver operating characteristic curves were used to determine the optimal cut-off value for biomarkers. Generalized linear models evaluated the association between exacerbation and biomarkers. Results: 132 patients were enrolled in the study with 80 non-exacerbators and 52 exacerbators. There was no significant difference in demographic and clinical characteristics between the two groups. Exacerbators had significantly higher eosinophils (EOS) counts (367.8 ± 357.18 vs. 210.05 ± 175.24, p = 0.0043) compared to non-exacerbators. The optimal cut-off values were 292 for EOS counts and 19 for the Fractional exhaled Nitric Oxide (FeNO) measure. Patients with an EOS count ≥ 300 (RR = 1.88; 95% CI, 1.26–2.81; p = 0.002) or FeNO measure ≥ 20 (RR = 2.10; 95% CI, 1.05–4.18; p = 0.0356) had a significantly higher risk of exacerbation. Moreover, patients with both an EOS count ≥ 300 and FeNO measure ≥ 20 had a significantly higher risk of exacerbation than those with lower EOS count or lower FeNO measure (RR = 2.16; 95% CI, 1.47–3.18; p = < 0.0001). Conclusions: Higher EOS counts and FeNO measures were associated with increased risk of exacerbation. These biomarkers may help physicians identify patients at risk of exacerbations and personalize treatment for asthma patients.

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COMPARISON OF RADIATION DOSE IN FEMORAL AND RADIAL ARTERIAL ACCESS CORONARY PROCEDURES; THE EFFECT OF OPERATOR EXPERIENCE.

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(10)61334-4 ◽

2010 ◽

Vol 55 (10) ◽

pp. A142.E1333

Author(s):

Johanne Neill ◽

Hannah Douglas ◽

Niall Herity

Keyword(s):

Radiation Dose ◽

Operator Experience ◽

Arterial Access ◽

Coronary Procedures

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Instrument Relevance in Multivariate Linear Models

Review of Economics and Statistics ◽

10.1162/rest.1999.81.3.550 ◽

1999 ◽

Vol 81 (3) ◽

pp. 550-552 ◽

Cited By ~ 37

Author(s):

Leslie G. Godfrey

Keyword(s):

Linear Models ◽

Multivariate Linear Models

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M-Methods in multivariate linear models

Journal of Multivariate Analysis ◽

10.1016/0047-259x(85)90077-6 ◽

1985 ◽

Vol 17 (2) ◽

pp. 168-184 ◽

Cited By ~ 27

Author(s):

Julio Motta Singer ◽

Pranab Kumar Sen

Keyword(s):

Linear Models ◽

Multivariate Linear Models

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Asymptotic Theory of Likelihood Ratio and Rank Order Tests in Some Multivariate Linear Models

The Annals of Mathematical Statistics ◽

10.1214/aoms/1177697191 ◽

1970 ◽

Vol 41 (1) ◽

pp. 87-100 ◽

Cited By ~ 20

Author(s):

Pranab Kumar Sen ◽

Madan Lal Puri

Keyword(s):

Likelihood Ratio ◽

Asymptotic Theory ◽

Linear Models ◽

Rank Order ◽

Multivariate Linear Models

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Criterios y modelos estadísticos de eficacia escolar

Revista de Investigación Educativa ◽

10.6018/rie.417881 ◽

2020 ◽

Vol 38 (2) ◽

pp. 311-327

Author(s):

Luis Lizasoain Hernández

Keyword(s):

Effective Schools ◽

School Effectiveness ◽

Linear Models ◽

Basque Country ◽

Outcome Variable ◽

Multilevel Regression ◽

School Effectiveness Research ◽

Regression Techniques ◽

Pais Vasco ◽

Selection Of

El objetivo de este artículo es presentar los criterios y modelos estadísticos empleados en un estudio de eficacia escolar desarrollado en la Comunidad Autónoma del País Vasco empleando como variable criterio los resultados en matemáticas, comprensión lectora en lengua castellana y en lengua vasca, resultantes de las evaluaciones de Diagnóstico aplicadas en cinco años. Se definen cuatro criterios de eficacia escolar: puntuaciones extremas, residuos extremos, crecimiento de puntuaciones y crecimiento de residuos. Para ello se han aplicado técnicas de regresión multinivel empleando modelos jerárquicos lineales. Los resultados permiten una selección de centros tanto de alta como de baja eficacia que se basa en cuatro enfoques distintos y complementarios de la eficacia (o ineficacia) escolar. The aim of this paper is to present the statistical criteria and models used in a school effectiveness research carried out in the Basque Country Autonomous Community using as outcome variable the mathematics, spanish language and basque language scores. These scores come from the Diagnosis Assessments applied for five years. Four school effectiveness criteria are defined: extreme scores, extreme residuals, scores growth and residuals growth. Multilevel regression techniques have been applied using hierarchical linear models (HLM). Results have permitted a selection of both high and low effective schools based on four different and complementary school effectiveness approaches.

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