The effect of transmission bandwidth on diagnostic accuracy in remote fetal ultrasound scanning

1997 ◽  
Vol 3 (4) ◽  
pp. 209-214 ◽  
Author(s):  
R. Wootton ◽  
J. Dornan ◽  
N. M. Fisk ◽  
A. Harper ◽  
C. Barry-Kinsella ◽  
...  

Six subspecialists with considerable experience in fetal ultrasound viewed a selection of pre-recorded ultrasound scans. Scans from 18 patients recorded on VHS video-tape were supplied from five centres in the UK and Ireland, each made on a high-resolution ultrasound machine by an experienced sonologist at a referral centre. Each observer viewed the scans on a large display monitor in an individual viewing booth. The scans were viewed in random order, at randomly selected bandwidths. Observers, who were blinded to both recording and bandwidth, assessed the technical quality on a five-point Likert scale. They also recorded their diagnosis. The six observers each carried out 32 viewing sessions, which gave a total of 192 viewings. There was no significant difference in the perceived technical quality of the scans between the two bandwidths used P 0.09 . Of the 84 recordings transmitted at 1920 kbit s, 71 85 were diagnosed correctly or half correctly' and 13 15 were misdiagnosed. Of the 95 recordings transmitted at 384 kbit s, 66 69 were diagnosed correctly or half correctly' and 29 31 were misdiagnosed. This difference was significant P 0.03. The results indicate that although there were no perceived differences in technical quality between recordings transmitted at 384 or 1920 kbit s, diagnostic accuracy was marginally worse at the lower bandwidth. This suggests that the higher bandwidth conveys more detail and information to the observer, which in turn enables more accurate diagnosis. However, further work is required before a definitive choice can be made about the optimum transmission bandwidth for remote fetal ultrasound studies.

2016 ◽  
Vol 2 (3) ◽  
pp. 00103-2015 ◽  
Author(s):  
Nicola J. Barker ◽  
Heather Elphick ◽  
Mark L. Everard

Dysfunctional breathing is a significant cause of morbidity, adversely affecting an individual's quality of life. There is currently no data from paediatric centres on the impact of breathing retraining for dysfunctional breathing.Symptoms and quality of life were measured in 34 subjects referred sequentially for breathing retraining to the first dedicated paediatric dysfunctional breathing clinic in the UK. Data were obtained prior to the first intervention (time point 1), at discharge (time point 2) and by post 6 months later (time point 3).The mean (interquartile range) age of participants was 13.3 (9.1–16.3) years, with 52% female. Data were obtained at time points 2 and 3 in 23 and 13 subjects, respectively.Statistically significant improvements were observed in symptom scores, child quality of life and parental proxy quality of life between time points 1 and 2 (p<0.0001), while there was no significant difference in the data at time point 3 as compared with time point 2.This study suggests that physiotherapist-led breathing retraining offers significant benefit to young people with dysfunctional breathing which is maintained for at least 6 months after treatment is completed. Future studies will provide more information on the long-term effects of interventions for dysfunctional breathing.


2016 ◽  
Vol 10 (2) ◽  
pp. 133-136 ◽  
Author(s):  
Mathew Westergreen-Thorne ◽  
Sook Yan Lee ◽  
Kunle Babawale ◽  
Catherine Lovegrove ◽  
John Brewer ◽  
...  

Objective: The objective of this article is to test whether there is a significant difference in diagnostic accuracy between hospital and community-based ultrasound (US) for the detection of urinary calculi in the United Kingdom (UK). Materials and methods: A 30-month, single-blind, retrospective cohort study of all patients referred to Kent and Canterbury Hospital urology multidisciplinary meeting for suspected urinary calculi was conducted. Only those investigated with US and non-contrast computed tomography (NCCT, the gold standard) for their calculi were included. Concordance of US and NCCT was stratified by US location: i.e. either the hospital or community setting (e.g. the latter via general practitioners (GPs) or independent radiographers). Fisher’s exact test was subsequently utilised to test for any significant difference between these two patient groups. Results: Of 2464 patients referred, 257 had both ultrasound and NCCT in their diagnostic workup. Of these, 150 and 107 patients had their US performed in hospital and community settings, respectively. No significant difference in the accuracy of US was detected between the two groups for the detection of urinary calculi when compared with NCCT. Conclusion: US carried out by independent radiographers and GPs in the community is just as accurate as US carried out by hospital sonographers for the detection of urinary calculi in the UK. Greater use of community US for the diagnosis of urinary calculi may promote greater patient/GP satisfaction and reduce hospital attendance without loss of diagnostic accuracy.


Author(s):  
Ehsan Tavakoli ◽  
Jale Shafiei Sabet ◽  
Mahjube Entezarghaem ◽  
Fatemeh Nadaf ◽  
Elahe Shafiei Rad

Objectives: The aim of this study was to determine the effect of different scan delays and different kVps on the diagnostic accuracy of inter-proximal caries detection in photostimulable phosphor plates (PSPs). Materials and Methods: 45 non-cavitated extracted human posterior teeth were radiographed using the DIGORA® PSPs (Soredex Corporation, Helsinki, Finland). The plates were exposed at 60 kVp and 70 kVp were scanned immediately, 10 min, 30 min, 1h, 6 h, 24 h and 48 h after exposure. In between the exposure and the scan period, the plates were stored in light-tight boxes. The true presence of caries was determined by sectioning the teeth mesiodistally. The accuracy was expressed as the area under ROC curve (AZ). The AZs were compared using SPSS version17 software and repeated measurement test. Kappa was used to measure inter and intra observer agreement. Results: There was no significant difference between caries detection AZs of the images that were scanned immediately and within 30 min after exposure at 60 kVp and 70 kVp (P >0.05). The immediately scanned AZ at 60 kVp was significantly higher than the AZs with 6 h, 24 h and 48 h scan delays (P <0.05). the immediately scanned AZ at 70Kvp was significantly higher than the AZs of 1 h, 6 h, 24 h and 48 h (P <0.05). Conclusions: PSP scanning should not be delayed higher than 30 min in order to have an accurate proximal caries detection. Longer delays may cause loss of quality of images.


2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Reem M. Barakat ◽  
Manal Matoug-Elwerfelli ◽  
Rahaf A. Almohareb ◽  
Hanan A. Balto

Objectives. The aim of this study was to investigate the influence of exposure to additional preclinical endodontic training on undergraduate students’ technical quality of root canal treatment and overall confidence levels in endodontics. Methods. Technical quality of root canal treatment performed clinically by fifth-year undergraduate students was evaluated and divided into two groups: Group 1, teeth treated by students who had attended both a preclinical endodontic block course and an elective preclinical course. Group 2: teeth treated by students who had not attended the elective preclinical course. All students were also invited to participate in a survey to rate their undergraduate endodontic training and confidence levels performing endodontic treatment. Statistical analysis of data was performed using Person chi-square test, Fisher Freeman Halton exact test, and t-test. A p -value <0.05 was considered statistically significant. Results. There was no significant difference between the two groups in overall obturation quality ( p = 0.619 ). However, more teeth treated by attendees were of adequate obturation length ( p = 0.015 ) and lacked procedural errors ( p = 0.004 ). Significantly more elective course attendees rated their undergraduate endodontic training as adequate ( p = 0.002 ), but there was no significant difference in the level of confidence between the attendees and the non-attendees. Conclusion. Within the limitations of this study, additional preclinical training showed minimal effect on overall quality of root canal treatment performed clinically by undergraduate students and did not enhance their confidence levels; however, it was associated with more satisfaction with their undergraduate endodontic education.


2010 ◽  
Vol 197 (S53) ◽  
pp. s32-s40 ◽  
Author(s):  
L. Howard ◽  
C. Flach ◽  
M. Leese ◽  
S. Byford ◽  
H. Killaspy ◽  
...  

BackgroundWomen's crisis houses have been developed in the UK as a less stigmatising and less institutional alternative to traditional psychiatric wards.AimsTo examine the effectiveness and cost-effectiveness of women's crisis houses by first examining the feasibility of a pilot patient-preference randomised controlled trial (PP–RCT) design (ISRCTN20804014).MethodWe used a PP–RCT study design to investigate women presenting in crisis needing informal admission. The four study arms were the patient preference arms of women's crisis house or hospital admission, and randomised arms of women's crisis house or hospital admission.ResultsForty-one women entered the randomised arms of the trial (crisis house n = 19, wards n = 22) and 61 entered the patient-preference arms (crisis house n = 37, ward n = 24). There was no significant difference in outcomes (symptoms, functioning, perceived coercion, stigma, unmet needs or quality of life) or costs for any of the groups (randomised or preference arms), but women who obtained their preferred intervention were more satisfied with treatment.ConclusionsAlthough the sample sizes were too small to allow definite conclusions, the results suggest that when services are able to provide interventions preferred by patients, those patients are more likely to be satisfied with treatment. This pilot study provides some evidence that women's crisis houses are as effective as traditional psychiatric wards, and may be more cost-effective.


Endoscopy ◽  
2021 ◽  
Author(s):  
Mihai Ciocirlan ◽  
Anca Gheorghiu ◽  
Dana Bilous ◽  
Miruna Cruceru ◽  
Georgiana Mănăilă ◽  
...  

Background and study aims. EUS FNA is recommended for diagnosis of solid pancreatic masses. We aimed to evaluate if a high needle movement acceleration value during puncture increases diagnostic accuracy. Patients and methods. EUS FNA needle acceleration was measured using a PocketLab accelerometer connected by Bluetooth to a smartphone. Two passes (fast and slow) with higher and respectively lower than 1g needle acceleration values were performed in random order. Sample cellularity and quality were measured by semiquantitative scales. Results. 51 patients were included (32 women, mean age 63). Mean acceleration values were 1.59 ± 0.66g for fast pass and 0.32 ± 0.19g for slow pass, p < 10-3. Fast pass yielded significantly higher EUS FNA accuracy (84.3% vs. 68.6%, p = 0.021) and adequate quality scores (94.1% vs. 76.5%, p = 0.007). High cellularity score frequencies were similar (15.7% vs. 11.8%, p = 0.317). Conclusions. A higher than 1g EUS FNA needle acceleration may increase diagnostic accuracy and specimen quality of pancreatic solid lesions.


2008 ◽  
Vol 3 (3) ◽  
pp. 61 ◽  
Author(s):  
Genevieve Gore

A Review of: Belliston, C. Jeffrey, Jared L. Howland, & Brian C. Roberts. “Undergraduate Use of Federated Searching: A Survey of Preferences and Perceptions of Value-Added Functionality.” College & Research Libraries 68.6 (Nov. 2007): 472-86. Objective – To determine whether use of federated searching by undergraduates saves time, meets their information needs, is preferred over searching databases individually, and provides results of higher quality. Design – Crossover study. Setting – Three American universities, all members of the Consortium of Church Libraries & Archives (CCLA): BYU (Brigham Young University, a large research university); BYUH (Brigham Young University – Hawaii, a small baccalaureate college); and BYUI (Brigham Young University – Idaho, a large baccalaureate college) Subjects – Ninety-five participants recruited via e-mail invitations sent to a random sample of currently enrolled undergraduates at BYU, BYUH, and BYUI. Methods – Participants were given written directions to complete a literature search for journal articles on two biology-related topics using two search methods: 1. federated searching with WebFeat® (implemented in the same way for this study at the three universities) and 2. a hyperlinked list of databases to search individually. Both methods used the same set of seven databases. Each topic was assigned in random order to one of the two search methods, also assigned in random order, for a total of two searches per participant. The time to complete the searches was recorded. Students compiled their list of citations, which were later normalized and graded. To analyze the quality of the citations, one quantitative rubric was created by librarians and one qualitative rubric was approved by a faculty member at BYU. The librarian-created rubric included the journal impact factor (from ISI’s Journal Citation Reports®), the proportion of citations from peer-reviewed journals (determined from Ulrichsweb.com™) to total citations, and the timeliness of the articles. The faculty-approved rubric included three criteria: relevance to the topic, quality of the individual citations (good quality: primary research results, peer-reviewed sources), and number of citations. Data were then analysed using ANOVA and MANOVA. Finally, librarians at the ACRL 13th National Conference Presentation were polled about their perceptions of the time savings of federated searching, whether the method meets undergraduates’ information needs, undergraduate preference for searching, and the quality of citations found. Main Results – Seventy percent of all participants preferred federated searching. For all schools combined, there was no statistically significant difference between the average time taken using federated searching (20.34 minutes) vs. non-federated searching (22.72 minutes). For all schools combined, there was a statistically significant difference in satisfaction of results favouring federated searching (5.59/7 vs. 4.80/7 for non-federated searching, α = .05). According to the librarian-created rubric, citations retrieved from federated searching were a statistically significant 6% lower in quality than citations retrieved from non-federated searching (α = .05). The faculty-approved rubric did not detect a difference in the quality of the citations retrieved using the 2 methods. Librarians’ perceptions as assessed at the ACRL 13th National Conference Presentation generally matched the authors’ findings. Conclusion – Overall, students in this study preferred federated searching, were more satisfied with the results of federated searching, and saved time (although the savings were not statistically significant). The quality of citations retrieved via both methods was judged to be similar. The study provides useful information for librarians interested in users’ experiences and perceptions of federated searching, and indicates future studies worth conducting.


2021 ◽  
Vol 8 ◽  
Author(s):  
Henri Gruwez ◽  
Stijn Evens ◽  
Tine Proesmans ◽  
David Duncker ◽  
Dominik Linz ◽  
...  

Aims: This study aims to compare the performance of physicians to detect atrial fibrillation (AF) based on photoplethysmography (PPG), single-lead ECG and 12-lead ECG, and to explore the incremental value of PPG presentation as a tachogram and Poincaré plot, and of algorithm classification for interpretation by physicians.Methods and Results: Email invitations to participate in an online survey were distributed among physicians to analyse almost simultaneously recorded PPG, single-lead ECG and 12-lead ECG traces from 30 patients (10 in sinus rhythm (SR), 10 in SR with ectopic beats and 10 in AF). The task was to classify the readings as ‘SR', ‘ectopic/missed beats', ‘AF', ‘flutter' or ‘unreadable'. Sixty-five physicians detected or excluded AF based on the raw PPG waveforms with 88.8% sensitivity and 86.3% specificity. Additional presentation of the tachogram plus Poincaré plot significantly increased sensitivity and specificity to 95.5% (P &lt; 0.001) and 92.5% (P &lt; 0.001), respectively. The algorithm information did not further increase the accuracy to detect AF (sensitivity 97.5%, P = 0.556; specificity 95.0%, P = 0.182). Physicians detected AF on single-lead ECG tracings with 91.2% sensitivity and 93.9% specificity. Diagnostic accuracy was also not optimal on full 12-lead ECGs (93.9 and 98.6%, respectively). Notably, there was no significant difference between the performance of PPG waveform plus tachogram and Poincaré, compared to a single-lead ECG to detect or exclude AF (sensitivity P = 0.672; specificity P = 0.536).Conclusion: Physicians can detect AF on a PPG output with equivalent accuracy compared to single-lead ECG, if the PPG waveforms are presented together with a tachogram and Poincaré plot and the quality of the recordings is high.


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