Smartphone apps to support laypersons in bystander CPR are of ambivalent benefit: a controlled trial using medical simulation

Abstract Background Bystander-initiated resuscitation is essential for surviving out-of-hospital cardiac arrest. Smartphone apps can provide real-time guidance for medical laypersons in these situations. Are these apps a beneficial addition to traditional resuscitation training? Methods In this controlled trial, we assessed the impact of app use on the quality of resuscitation (hands-off time, assessment of the patient’s condition, quality of chest compression, body and arm positioning). Pupils who have previously undergone a standardised resuscitation training, encountered a simulated cardiac arrest either (i) without an app (control group); (ii) with facultative app usage; or (iii) with mandatory app usage. Measurements were compared using generalised linear regression. Results 200 pupils attended this study with 74 pupils in control group, 65 in facultative group and 61 in mandatory group. Participants who had to use the app significantly delayed the check for breathing, call for help, and first compression, leading to longer total hands-off time. Hands-off time during chest compression did not differ significantly. The percentage of correct compression rate and correct compression depth was significantly higher when app use was mandatory. Assessment of the patient’s condition, and body and arm positioning did not differ. Conclusions Smartphone apps offering real-time guidance in resuscitation can improve the quality of chest compression but may also delay the start of resuscitation. Provided that the app gives easy-to-implement, guideline-compliant instructions and that the user is familiar with its operation, we recommend smartphone-guidance as an additional tool to hands-on CPR-training to increase the prevalence and quality of bystander-initiated CPR.

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Smartphone Apps to Support Laypersons in Bystander CPR Are of Ambivalent Benefit: a Randomized Controlled Trial Using Medical Simulation

10.21203/rs.3.rs-152565/v1 ◽

2021 ◽

Author(s):

Camilla Metelmann ◽

Bibiana Metelmann ◽

Louisa Schuffert ◽

Klaus Hahnenkamp ◽

Peter Brinkrolf

Keyword(s):

Randomized Controlled Trial ◽

Cardiac Arrest ◽

Real Time ◽

Controlled Trial ◽

Control Group ◽

Smartphone Apps ◽

Chest Compressions ◽

Randomized Controlled ◽

Resuscitation Training

Abstract Background: Bystander initiated resuscitation is essential. To encourage medical laypersons to perform resuscitation smartphone apps providing real-time guidance were invented. Are these apps a beneficial addition to traditional resuscitation training?Methods: In a randomized controlled trial impact of app usage on quality of resuscitation in a standardised simulated cardiac arrest scenario was assessed. In a previous study the app “HELP Notfall” was selected for this purpose. Six weeks after a standardised resuscitation training pupils encountered a simulated cardiac arrest (i) without app (control group); (ii) with facultative app usage (facultative group); (iii) with mandatory app usage (mandatory group).Results: 200 pupils attended this study with 74 pupils (37%) in control group, 65 (32,5%) in facultative group and 61 (30,5%) in mandatory group. Participants using the app in mandatory group had a significantly higher percentage of chest compressions with the correct compression rate (65.4% vs. 43.8%; p<0.01) and with correct compression depth (47.6% vs. 24.4%; p=0.001) than pupils of the control group. Participants of the mandatory group had a significant delay compared with control group regarding time until check for breathing (23 sec. vs. 12 sec., p<0.001), call for help (35 sec. vs. 20 sec., p<0.001) and first compression (68 sec. vs. 29 sec., p<0.001). Hands-off-time during compression tended to be shorter in mandatory group (0.5 sec.) compared with control group (1.5 sec.), (p=0.36).Conclusions: Smartphone apps offering real-time guidance in resuscitation are of mixed benefits. An improved quality of chest compression is countered by a delayed start of chest compressions. Both aspects have to be considered before recommending smartphone apps to support laypersons in bystander resuscitation as an addition to traditional hands-on training.

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A Proposal of an innovative program for informal caregivers of patients with mood disorders

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.943 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S603-S603

Author(s):

J. Cabral ◽

C. Barreto Carvalho ◽

P. Castilho Freitas ◽

C. Pato

Keyword(s):

Quality Of Life ◽

Mood Disorders ◽

Negative Impact ◽

Controlled Trial ◽

Informal Caregivers ◽

Well Being ◽

Control Group ◽

Compassion Focused Therapy ◽

The Impact

IntroductionIntervention with informal caregivers (IC) of psychiatric patients is internationally recognized as relevant and a priority. However, the existing responses in this area are still insufficient, especially regarding caregivers of individuals with mood disorders (MD). Mindfulness and compassion focused therapy have proven to be an effective approach in stress reduction and in improving emotional and social well-being of caregivers of patients with other conditions. However, no studies testing these new approaches in IC of patients with MD have been carried out. The objective of this work is to present a research project that aims to develop, implement and empirically test the effectiveness of an innovative group program to help informal caregivers of individuals with mood disorders to cope with the negative impact of the disease and reduce caregiver burdens.MethodsThe design of this experimental study to test the program's efficacy is a non-randomised controlled trial (nrct) with 12 months follow-up, with a mixed assessment methodology (quantitative and qualitative analysis). A sample of 60 informal caregivers of individuals with chronic MD will be constituted (n = 30 Control group; n= 30 Experimental group).ResultsWe expect the program to promote significant changes in participants in terms of several emotional variables (eg: burden, stress, resilience, compassion and quality of life).ConclusionsFurther efforts to continue studying the impact of interventions in caregivers should be carried out, as a way to improve the quality of life of caregivers and their ability to provide informal care to MD patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Harnessing Telehealth to Mitigate the Impact of the COVID-19 Pandemic on Sleep and Well-being: A Randomized Controlled Trial (Preprint)

10.2196/preprints.34409 ◽

2021 ◽

Author(s):

Kathleen P. O'Hora ◽

Raquel A. Osorno ◽

Dena Sadeghi-Bahmani ◽

Mateo Lopez ◽

Allison Morehouse ◽

...

Keyword(s):

Quality Of Life ◽

Randomized Controlled Trial ◽

Early Treatment ◽

Controlled Trial ◽

Well Being ◽

Control Group ◽

Randomized Controlled ◽

The Impact ◽

Insomnia Symptoms

BACKGROUND The COVID-19 Pandemic led to drastic increases in the prevalence and severity of insomnia symptoms. These increases in insomnia complaints have been paralleled by significant decreases in well-being, including increased symptoms of depression, anxiety, and suicidality and decreased quality of life. However, the efficacy and impact of early treatment of insomnia symptoms on future sleep and well-being remains unknown. OBJECTIVE Here, we present the framework and protocol for a novel study that aims to investigate whether a brief telehealth insomnia intervention targeting new insomnia that developed during the pandemic prevents deterioration of well-being, including symptoms of insomnia, depression, anxiety, suicidality, and quality of life. METHODS The protocol details a two-arm randomized controlled trial to investigate the efficacy of a brief, telehealth-delivered, early treatment of insomnia and evaluate its potential to prevent a deterioration of well-being. Participants with clinically significant insomnia symptoms that began during the pandemic are randomized to either a treatment group or a 28-week waitlist control group. Treatment consists of 4 telehealth sessions of Cognitive Behavioral Therapy for Insomnia (CBT-I) delivered over 5 weeks. All participants will complete assessments of insomnia symptom severity, well-being, and daily habits checklist at baseline (week 0), and at weeks 1-6, 12, 28, and 56. RESULTS The trial began enrollment June 3, 2020 and closed enrollment June 17, 2021. As of October 2021, 49 participants have been randomized to either immediate treatment or a 28-week waitlist. 23 participants are still active in the protocol. CONCLUSIONS To our knowledge, this protocol would be represent the first study to test an early sleep intervention for improving insomnia that emerged during the COVID-19 Pandemic. The findings of this study could provide information about the utility of CBT-I for symptoms that emerge in the context of other stressors before they develop a chronic course and deepen understanding of the relationship between sleep and well-being. CLINICALTRIAL NCT04409743

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Effect of an intensive patient educational programme on the quality of bowel preparation for colonoscopy: a single-blind randomised controlled trial

BMJ Open Gastroenterology ◽

10.1136/bmjgast-2020-000376 ◽

2020 ◽

Vol 7 (1) ◽

pp. e000376

Author(s):

Sivakami Janahiraman ◽

Chan Yen Tay ◽

Jie Min Lee ◽

Wen Ling Lim ◽

Chun Hoe Khiew ◽

...

Keyword(s):

Randomised Controlled Trial ◽

Bowel Preparation ◽

Controlled Trial ◽

Tertiary Hospital ◽

Educational Programme ◽

Control Group ◽

Randomised Controlled ◽

The Impact ◽

Experimental Group

ObjectivePreprocedural bowel preparation is necessary for optimal colonoscopy visualisation. However, it is challenging to achieve high-quality bowel preparation among patients scheduled for colonoscopy. This study aims to evaluate the impact of an intensive patient educational programme on the quality of bowel preparation.DesignAn accessor-blinded randomised controlled trial was carried out at the outpatient surgical clinic of a tertiary hospital. Patients were randomly assigned to the control group (received standard written and verbal instructions) or the experimental group (received an intensive and structured educational programme). All subjects completed a questionnaire before colonoscopy to assess their compliance, acceptability, and tolerability towards bowel preparation regime. Quality of bowel preparation was determined using the Boston Bowel Preparation Scale (BBPS).ResultsA total of 300 subjects who fulfilled the inclusion criteria were recruited. The experimental group had a significantly higher proportion of good quality bowel preparation than the control group (98.7% vs 52.3%, p<0.001). The median total BBPS score was also significantly higher in the experimental group (8 vs 5, p<0.001). Factors associated with good quality of bowel preparation included educational programme (OR: 22.79, 95% CI: 4.23 to 122.85, p<0.001), compliance to bowel cleansing agent (OR: 24.98, 95% CI 3.12 to 199.71, p<0.001), very difficult acceptability of preparation (OR: 0.11, 95% CI 0.03 to 0.38, p<0.001), tolerability towards bowel preparation (OR: 4.98, 95% CI 1.44 to 17.20, p<0.011) and hypomotility drugs (OR: 3.03, 95% CI 0.12 to 0.91, p<0.05).ConclusionAn intensive patient educational programme can significantly improve the quality of bowel preparation for colonoscopy.

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Pain Squad+ smartphone app to support real-time pain treatment for adolescents with cancer: protocol for a randomised controlled trial

BMJ Open ◽

10.1136/bmjopen-2020-037251 ◽

2020 ◽

Vol 10 (3) ◽

pp. e037251

Author(s):

Lindsay Jibb ◽

Paul C Nathan ◽

Vicky Breakey ◽

Conrad Fernandez ◽

Donna Johnston ◽

...

Keyword(s):

Real Time ◽

Pain Treatment ◽

Controlled Trial ◽

Qualitative Interviews ◽

Randomised Trial ◽

Control Group ◽

Management Support ◽

Scientific Meetings ◽

Randomised Controlled ◽

The Impact

IntroductionPain negatively affects the health-related quality of life (HRQL) of adolescents with cancer. The Pain Squad+ smartphone-based application (app), has been developed to provide adolescents with real-time pain self-management support. The app uses a validated pain assessment and personalised pain treatment advice with centralised decision support via a registered nurse to enable real-time pain treatment in all settings. The algorithm informing pain treatment advice is evidence-based and expert-vetted. This trial will longitudinally evaluate the impact of Pain Squad+, with or without the addition of nurse support, on adolescent health and cost outcomes.Methods and analysisThis will be a pragmatic, multicentre, waitlist controlled, 3-arm parallel-group superiority randomised trial with 1:1:1 allocation enrolling 74 adolescents with cancer per arm from nine cancer centres. Participants will be 12 to 18 years, English-speaking and with ≥3/10 pain. Exclusion criteria are significant comorbidities, end-of-life status or enrolment in a concurrent pain study. The primary aim is to determine the effect of Pain Squad+, with and without nurse support, on pain intensity in adolescents with cancer, when compared with a waitlist control group. The secondary aims are to determine the immediate and sustained effect over time of using Pain Squad+, with and without nurse support, as per prospective outcome measurements of pain interference, HRQL, pain self-efficacy and cost. Linear mixed models with baseline scores as a covariate will be used. Qualitative interviews with adolescents from all trial arms will be conducted and analysed.Ethics and disseminationThis trial is approved by the Hospital for Sick Children Research Ethics Board. Results will provide data to guide adolescents with cancer and healthcare teams in treating pain. Dissemination will occur through partnerships with stakeholder groups, scientific meetings, publications, mass media releases and consumer detailing.Trial registration numberNCT03632343(ClinicalTrials.gov).

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A Brief Mindfulness-Based Intervention for Primary Care Physicians: A Pilot Randomized Controlled Trial

American Journal of Lifestyle Medicine ◽

10.1177/1559827616629121 ◽

2016 ◽

Vol 12 (1) ◽

pp. 83-91 ◽

Cited By ~ 29

Author(s):

David A. Schroeder ◽

Elizabeth Stephens ◽

Dharmakaya Colgan ◽

Matthew Hunsinger ◽

Dan Rubin ◽

...

Keyword(s):

Primary Care ◽

Randomized Controlled Trial ◽

Primary Care Physicians ◽

Controlled Trial ◽

Well Being ◽

Control Group ◽

Randomized Controlled ◽

Patient Reported ◽

The Impact

Primary care physicians experience high rates of burnout, which results in diminished quality of life, poorer quality of care, and workforce attrition. In this randomized controlled trial, our primary aim was to examine the impact of a brief mindfulness-based intervention (MBI) on burnout, stress, mindfulness, compassion, and resilience among physicians. A total of 33 physicians completed the baseline assessment and were randomized to the Mindful Medicine Curriculum (MMC; n = 17) or waitlist control group (n = 16). Participants completed self-report measures at baseline, post-MBI, and 3-month follow-up. We also analyzed satisfaction with doctor communication (DCC) and overall doctor rating (ODR) data from patients of the physicians in our sample. Participants in the MMC group reported significant improvements in stress (P < .001), mindfulness (P = .05), emotional exhaustion (P = .004), and depersonalization (P = .01) whereas in the control group, there were no improvements on these outcomes. Although the MMC had no impact on patient-reported DCC or ODR, among the entire sample at baseline, DCC and ODR were significantly correlated with several physician outcomes, including resilience and personal achievement. Overall, these findings suggest that a brief MBI can have a positive impact on physician well-being and potentially enhance patient care.

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Sudden cardiac arrest pharmacotherapy with preﬁlled syringes improves adherence to Advanced Life Support protocol in understaffed resuscitation pre-hospital care teams

10.22514/sv.2020.16.0098 ◽

2020 ◽

Keyword(s):

Cardiac Arrest ◽

Simulation Study ◽

Life Support ◽

Sudden Cardiac Arrest ◽

Advanced Life Support ◽

Control Group ◽

Performance Quality ◽

Prefilled Syringes ◽

The Impact

Every procedural facilitation or a change in available equipment in treatment of out-of-hospital arrest (OHCA) by two-person teams may significantly enhance their performance quality. The aim of this study was to assess the impact of adrenaline in prefilled syringes on improving the adherence to Advanced Life Support protocol by understaffed teams. The research was based on a randomized cross-over high-fidelity simulation study. Two-person teams took part in two 10-minute simulation scenarios featuring sudden cardiac arrest in ventricular fibrillation (VF). The control group (group C) had at its disposal standard ampoules, whereas the experimental group (group E) prefilled syringes. The execution times of CPR start, defibrillation shocks, intravenous (IV) access, epinephrine and amiodarone doses were measured. Additionally, the chest compression fraction (CCF) was calculated. The designed two-minute loops were considerably prolonged in group C. Nineteen teams (31.1%) in group C but 49 (80.3%) in group E carried out the fifth defibrillation (P < 0.001). After two minutes of CPR nobody in group C switched to perform chest compressions. IV access was obtained significantly earlier in group E (114.7 ± 52.2 sec) than in group C (150.2 ± 68.6 sec)(P = 0.002). Two doses of adrenaline were administered in group E, whereas its second dose only by 12 teams in group C. The simulation study has proved that for understaffed teams a use of prefilled syringes not only did enhance the flow of ALS procedure, but it also improved the quality of cardiopulmonary resuscitation.

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Randomised controlled trial of WISENSE, a real-time quality improving system for monitoring blind spots during esophagogastroduodenoscopy

Gut ◽

10.1136/gutjnl-2018-317366 ◽

2019 ◽

Vol 68 (12) ◽

pp. 2161-2169 ◽

Cited By ~ 61

Author(s):

Lianlian Wu ◽

Jun Zhang ◽

Wei Zhou ◽

Ping An ◽

Lei Shen ◽

...

Keyword(s):

Real Time ◽

Controlled Trial ◽

Blind Spot ◽

Control Group ◽

Health Examination ◽

Spot Rate ◽

Deep Convolutional Neural Networks ◽

Gastrointestinal Lesions ◽

Blind Spots

ObjectiveEsophagogastroduodenoscopy (EGD) is the pivotal procedure in the diagnosis of upper gastrointestinal lesions. However, there are significant variations in EGD performance among endoscopists, impairing the discovery rate of gastric cancers and precursor lesions. The aim of this study was to construct a real-time quality improving system, WISENSE, to monitor blind spots, time the procedure and automatically generate photodocumentation during EGD and thus raise the quality of everyday endoscopy.DesignWISENSE system was developed using the methods of deep convolutional neural networks and deep reinforcement learning. Patients referred because of health examination, symptoms, surveillance were recruited from Renmin hospital of Wuhan University. Enrolled patients were randomly assigned to groups that underwent EGD with or without the assistance of WISENSE. The primary end point was to ascertain if there was a difference in the rate of blind spots between WISENSE-assisted group and the control group.ResultsWISENSE monitored blind spots with an accuracy of 90.40% in real EGD videos. A total of 324 patients were recruited and randomised. 153 and 150 patients were analysed in the WISENSE and control group, respectively. Blind spot rate was lower in WISENSE group compared with the control (5.86% vs 22.46%, p<0.001), and the mean difference was −15.39% (95% CI −19.23 to −11.54). There was no significant adverse event.ConclusionsWISENSE significantly reduced blind spot rate of EGD procedure and could be used to improve the quality of everyday endoscopy.Trial registration numberChiCTR1800014809; Results.

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Lian gong as a Therapeutic Treatment Option in Primary Care for Patients with Dizziness: A Randomized Controlled Trial

International Archives of Otorhinolaryngology ◽

10.1055/s-0040-1718956 ◽

2020 ◽

Author(s):

Aline Lamas Lopes ◽

Stela Maris Aguiar Lemos ◽

Pedro Henrique Scheidt Figueiredo ◽

Denise Utsch Gonçalves ◽

Juliana Nunes Santos

Keyword(s):

Quality Of Life ◽

Health Care ◽

Primary Health Care ◽

Fear Of Falling ◽

Controlled Trial ◽

Treatment Method ◽

Control Group ◽

Primary Health ◽

The Impact

Abstract Introduction Dizziness is one of the most common reasons for seeking primary health care. Vestibular rehabilitation (VR) is a conventional treatment method for peripheral balance disorders that effectively decreases symptoms. Lian gong [LG] is believed to benefit patients with dizziness and to reduce the impact of the condition on quality of life by stimulating visual fixation, attention, body balance, and neuroplasticity. Objective The present study aimed to evaluate the effects of LG on the impact of dizziness on quality of life and fear of falling in primary health care patients. Methods This was a two-arm, parallel randomized clinical trial that included 36 patients with dizziness not caused by central changes. After specific medical evaluations and indications for treatment, the participants were randomly assigned to 3 groups: the LG group (n = 11), the VR group (n = 11), and the control group (n = 14). The interventions were conducted collectively over a period of 12 weeks. Results Lian gong reduced the influence of dizziness on quality of life in physical (1.8 points, 95% confidence interval [CI]: 0.2–3.4), functional (4.0 points, 95% CI: 2.1–5.9), and emotional domains of quality of life (4.4 points, 95% CI: 1.7–7.2), with no differences compared with VR. There were similar concerns among the groups about the risk of falling. Conclusion Lian gong was shown to be an effective balance rehabilitation strategy to reduce the impact of dizziness on quality of life, with similar results to those of VR.

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Sailing Can Improve Quality of Life of People with Severe Mental Disorders: Results of a Cross Over Randomized Controlled Trial

Clinical Practice and Epidemiology in Mental Health ◽

10.2174/1745017901410010080 ◽

2014 ◽

Vol 10 (1) ◽

pp. 80-86 ◽

Cited By ~ 12

Author(s):

Mauro Giovanni Carta ◽

Federica Maggiani ◽

Laura Pilutzu ◽

Maria Francesca Moro ◽

Gioia Mura ◽

...

Keyword(s):

Quality Of Life ◽

Mental Disorders ◽

Controlled Trial ◽

Rehabilitation Program ◽

Control Group ◽

Severe Mental Disorders ◽

Rehabilitation Protocols ◽

The Impact

The aim of this study was to evaluate the impact of a sailing rehabilitation program on the quality of life (QoL) in a sample of patients with severe mental disorders. The study adopted a randomized, crossover, waiting-list controlled design. The participants enrolled in the study were outpatients diagnosed with severe chronic mental disorders. The participants (N=40) exposed to rehabilitation with sailing took part in a series of supervised cruises near the gulf of Cagliari, South Sardinia, and showed a statistically significant improvement of their quality of life compared to the control group. This improvement was comparable to the improvement in psychopathologic status and social functioning as shown in a previous report of the same research project. The improvement was maintained at follow-up only during the trial and for a few months later: after 12 months, patients returned to their baseline values and their quality of life showed a worsening trend. This is the first study to show that rehabilitation with sailing may improve the quality of life of people with severe chronic mental disorders. In all likelihood, a program grounded on learning how to manage a sailing vessel - during which patients perform cruises that emphasize the exploration of the marine environment by sailing - might be interesting enough and capture the attention of the patients so as to favour greater effectiveness of standard rehabilitation protocols, but this should be specifically tested.

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