scholarly journals Az interdiszciplináris kommunikáció jelentősége az állcsonti cysták megfelelő kórismézésében

2021 ◽  
Vol 162 (12) ◽  
pp. 458-467
Author(s):  
Gábor Cserni ◽  
Dorottya Cserni ◽  
Tamás Zombori ◽  
Zoltán Baráth
Keyword(s):  
Clinical Data ◽  
Clinical Information ◽  
Odontogenic Cysts ◽  
Radicular Cyst ◽  
Jaw Cysts ◽  
Good Communication ◽  
Pathological Correlation ◽  
Proper Diagnosis ◽  
And Gender ◽  
Parallel Evaluation

Összefoglaló. Bevezetés: Az állcsonti cysták helytálló diagnosztikája a klinikai, radiológiai és patológiai leletek együttes értékelésével lehetséges. Korábbi munkánk során többször tapasztaltuk a klinikoradiopatológiai kommunikáció és korreláció hiányát, és ez olykor inadekvát diagnózisok felállításához vezetett. Célkitűzés: Célunk ezen kommunikációs probléma mértékének becslése és annak bemutatása, hogy ez a hiányosság hogyan befolyásolhatja a diagnosztikát. Módszer: Korábbi, más célú retrospektív elemzés újraértékelése történt a klinikai (radiológiai) adatközlés, a revízió kapcsán módosuló diagnózisok számszerűsítése céljából, valamint további 3 egyetemi patológiai intézet 10-10 anonimizált leletének vizsgálata az adatközlések vonatkozásában. Eredmények: 2 intézményben 85 odontogen cysta diagnózisakor csupán a betegek életkora, neme volt 100%-osan ismert. A lokalizációra vonatkozó adekvát információ 62%-ban, a méretre vonatkozó csupán 29%-ban fordult elő a szövettani kérőlapokon. Összességében a diagnózist segítő releváns információt csak 52%-ban adtak meg. Az utólagos klinikoradiopatológiai korrelációra törekvő revízió során 38/85 esetben (45%) módosult a végső diagnózis kisebb vagy nagyobb mértékben. A megküldött leletek alapján a klinikai/radiológiai adatok közlése <50% és 100% közöttinek becsülhető más intézetekben is. Az 5 intézmény közül csak az egyikben utalt specializációra az, hogy minden leletet egy patológus véleményezett, általában sok patológus (n = 25) valamelyike véleményezte a kevés tömlőt (n = 105). A diagnózis kommunikáció hiányán alapuló kisiklásának lehetőségét 5 példával illusztráljuk: cysta radicularisként leletezett paradentalis, lobos follicularis és lateralis periodontalis cysta, ductus nasopalatinus cysta és radicularis cysta differenciáldiagnosztikáját példázó tömlő, valamint botryoid odontogen cysta kerül bemutatásra. Következtetés: Az odontogen tömlők precíz diagnosztikája mind a klinikai, mind a patológiai oldalról javítást igényel, amelynek egyik része az ilyen irányú képzés lehet. Orv Hetil. 2021; 162(12): 458–467. Summary. Introduction: Proper diagnosis of jaw cysts requires the parallel evaluation of clinical, radiological and histopathological findings. Lack of clinico-radio-pathological correlation can lead to inconsistent diagnoses. Objective: To evaluate the rate of lacking clinico-pathological communication and demonstrate how this may influence diagnostics. Method: Data of a former retrospective analysis were re-evaluated to quantify the lack of clinical data communicated to pathologists and estimate the rate of final diagnoses requiring alteration after review of all available clinical data. 10 anonymized reports on odontogenic cysts from 3 university pathology departments each were analysed for the lack of relevant clinical information. Results: Only the age and gender of patients were documented in 100% for 85 jaw cysts diagnosed in 2 departments of pathology. Adequate information about cyst localization and size were communicated in 62% and 29%, respectively. Overall, information relevant to the diagnosis was given in 52% of the cases. Revision based on clinico-radio-pathological correlation led to alterations of the diagnosis in 38/85 cases (45%). Based on reports from other institutions, the communication of clinical data is estimated to be between <50% and 100%. 25 pathologists were involved in reporting 105 cysts. 5 cases illustrate how diagnosis may fail without good communication: a paradental, an inflamed dentigerous and a lateral periodontal cyst, each misdiagnosed as radicular cyst; a cyst raising the differential diagnosis of nasopalatine duct versus radicular cyst; a botryoid odontogenic cyst. Conclusion: Proper diagnosis of jaw cysts requires improvements from both pathological and clinical sides, and could probably be improved through education. Orv Hetil. 2021; 162(12): 458–467.

scholarly journals Clinicopathological Evaluation of Odontogenic Jaw Cysts

2016 ◽  
Vol 5 (2) ◽  
pp. 30-39 ◽  
Author(s):  
Mohammad Kamrujjaman ◽  
Sajid Hasan ◽  
ASM Didar Alam Khan ◽  
Hasan Tareq Bin Noor ◽  
Abul Hasnat
Keyword(s):  
Clinical Diagnosis ◽  
Cystic Lesion ◽  
Dentigerous Cyst ◽  
Maxillofacial Surgery ◽  
Odontogenic Cyst ◽  
Odontogenic Cysts ◽  
Cystic Lesions ◽  
Radicular Cyst ◽  
Maxillofacial Region ◽  
Jaw Cysts

Background: Odontogenic cysts are the most common form of cystic lesions affecting the maxillofacial region and one of the main causes of the damage of these bones.Objective: To determine the frequency of different types of odontogenic jaw cysts diagnose among the Bangladeshi population.Study design: A descriptive observational study was made of 62 patients.Study setting and period: The study was done in the Department of Oral & Maxillofacial Surgery, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka-1000 from 1st March’ 2010 to 28th February’2011.Participants: Sixty-two patients with cystic lesions in the maxillofacial region were selected for the study.Methods: Patients who attended in the Oral & Maxillofacial Surgery Department of BSMMU during the study period with suspective cystic lesion in the maxillofacial region were included in the study. After clinical diagnosis with odontogenic cysts all the patients were treated surgically either under local anesthesia or under general anesthesia if required. Cystic lining was then sent for histopathological confirmation. Data were collected from a total of 76 patients with a clinical diagnosis of odontogenic jaw cysts. Of those, data of 14 patients were not included in the analysis (Histopathology showed no cystic lesion in 6 patients and non odontogenic cyst in 8 patients). Therefore data of a total of 62 patients were analyzed for the purpose of the study. The study protocol was explained to the patients in detail before obtaining the informed consent from the patients. Patients were allocated for the study.Outcome Variable: The following variable were recorded: gender, age, site of the lesion, swelling, tooth mobility, carious tooth, discolored tooth, missing tooth, radiological features, impacted tooth and correlation with histological types.Results: Out of 76 histopathology reports analyzed, odontogenic cyst found in 62 cases (82%). The mean patient age was 28.06 years. The cysts were slightly more prevalent in females (52%). Radicular cyst was the most prevalent histological type (56%), followed by dentigerous cyst (21%), odontogenic keratocysts (15%) and residual cysts (8%). The most common location of the odontogenic cysts were in the maxilla (n=35) than mandible (n=27).Conclusion: The most frequently occurring lesion was radicular cyst and the site was the anterior region of the maxilla. The dentigerous cyst and odontogenic keratocyst were the next most common lesions and preferred site was in the ramus and angular region of the mandible.Update Dent. Coll. j: 2015; 5 (2): 30-39

scholarly journals Combining a convolutional neural network with autoencoders to predict the survival chance of COVID-19 patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Fahime Khozeimeh ◽  
Danial Sharifrazi ◽  
Navid Hoseini Izadi ◽  
Javad Hassannataj Joloudari ◽  
Afshin Shoeibi ◽  
...  
Keyword(s):  
Clinical Data ◽  
Data Augmentation ◽  
Clinical Information ◽  
Ct Images ◽  
Classification Performance ◽  
Survival Chance ◽  
Average Accuracy ◽  
Novel Method ◽  
Aided Diagnosis ◽  
Augmentation Procedure

AbstractCOVID-19 has caused many deaths worldwide. The automation of the diagnosis of this virus is highly desired. Convolutional neural networks (CNNs) have shown outstanding classification performance on image datasets. To date, it appears that COVID computer-aided diagnosis systems based on CNNs and clinical information have not yet been analysed or explored. We propose a novel method, named the CNN-AE, to predict the survival chance of COVID-19 patients using a CNN trained with clinical information. Notably, the required resources to prepare CT images are expensive and limited compared to those required to collect clinical data, such as blood pressure, liver disease, etc. We evaluated our method using a publicly available clinical dataset that we collected. The dataset properties were carefully analysed to extract important features and compute the correlations of features. A data augmentation procedure based on autoencoders (AEs) was proposed to balance the dataset. The experimental results revealed that the average accuracy of the CNN-AE (96.05%) was higher than that of the CNN (92.49%). To demonstrate the generality of our augmentation method, we trained some existing mortality risk prediction methods on our dataset (with and without data augmentation) and compared their performances. We also evaluated our method using another dataset for further generality verification. To show that clinical data can be used for COVID-19 survival chance prediction, the CNN-AE was compared with multiple pre-trained deep models that were tuned based on CT images.

scholarly journals Provider and patient satisfaction with the integration of ambulatory and hospital EHR systems

2018 ◽  
Vol 25 (8) ◽  
pp. 1054-1063 ◽  
Author(s):  
Chad D Meyerhoefer ◽  
Susan A Sherer ◽  
Mary E Deily ◽  
Shin-Yi Chou ◽  
Xiaohui Guo ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
System Integration ◽  
Clinical Information ◽  
Access To Information ◽  
Work Processes ◽  
Automatic Data ◽  
Provider Satisfaction ◽  
Good Communication ◽  
Care Experience ◽  
Healthcare Network

Abstract Objective The installation of EHR systems can disrupt operations at clinical practice sites, but also lead to improvements in information availability. We examined how the installation of an ambulatory EHR at OB/GYN practices and its subsequent interface with an inpatient perinatal EHR affected providers’ satisfaction with the transmission of clinical information and patients’ ratings of their care experience. Methods We collected data on provider satisfaction through 4 survey rounds during the phased implementation of the EHR. Data on patient satisfaction were drawn from Press Ganey surveys issued by the healthcare network through a standard process. Using multivariable models, we determined how provider satisfaction with information transmission and patient satisfaction with their care experience changed as the EHR system allowed greater information flow between OB/GYN practices and the hospital. Results Outpatient OB/GYN providers became more satisfied with their access to information from the inpatient perinatal triage unit once system capabilities included automatic data flow from triage back to the OB/GYN offices. Yet physicians were generally less satisfied with how the EHR affected their work processes than other clinical and non-clinical staff. Patient satisfaction dropped after initial EHR installation, and we find no evidence of increased satisfaction linked to system integration. Conclusions Dissatisfaction of providers with an EHR system and difficulties incorporating EHR technology into patient care may negatively impact patient satisfaction. Care must be taken during EHR implementations to maintain good communication with patients while satisfying documentation requirements.

Necessity of Clinical Information in Surgical Pathology

1999 ◽  
Vol 123 (7) ◽  
pp. 615-619 ◽  
Author(s):  
Raouf E. Nakhleh ◽  
Gordon Gephardt ◽  
Richard J. Zarbo
Keyword(s):  
Clinical Data ◽  
Clinical Information ◽  
The United States ◽  
Surgical Pathology ◽  
Lower Percentage ◽  
Malignant Neoplasms ◽  
Anatomic Site ◽  
Improvement Program ◽  
Additional Information ◽  
Inadequate Information

Abstract Objectives.—To examine the frequency and nature of problems caused by inadequate clinical data provided on surgical pathology requisition forms. Design.—Participants in the 1996 Q-Probes voluntary quality improvement program of the College of American Pathologists were asked to document prospectively all surgical pathology cases with inadequate information. Inadequate clinical information was defined as the pathologist's need for additional clinical information before a diagnosis could be rendered, regardless of the amount of information already present on the requisition slip. Cases that had no clinical information on a requisition slip were not counted if the lack of history did not hinder diagnosis. The study concluded when 3 months had elapsed or 40 surgical pathology cases were documented. The following data were recorded for each case: anatomic site, type of procedure, nature of disease, method of obtaining additional information, importance of obtained information, and the length of delay in the final diagnosis. Participants.—Three hundred forty-one laboratories, 322 of which were from the United States. Results.—A total of 5594 cases (0.73%) required additional clinical information for diagnosis (10th through 90th percentile range, 3.01% to 0.08%). Institutions with greater average occupied bedsize, a greater number of cases accessioned per year, and a greater number of pathologists had a lower percentage of cases with inadequate clinical data (P &lt; .05). Sixty-eight percent of these cases had no delay in completion of a case, 16.2% had a delay of 1 day or less, and 15.1% of cases were delayed more than 1 day. In 59.4% of cases, the additional clinical information obtained confirmed the initial diagnostic impression. In 25.1%, the information was not relevant to the pathologic diagnosis. In 6.1% there was a substantial change in the diagnosis or a revised report was issued, and in 2.2% no additional information could be obtained. Specific anatomic sites that correlated with a higher rate of changed diagnoses or revised reports in cases with inadequate information included the small bowel, the bronchus/lung, and the ovary. Resection specimens were also significantly associated with a higher rate of changed diagnoses or revised reports when additional information was obtained, as were malignant neoplasms and therapy-induced changes. Conclusions.—This study establishes an aggregate rate of cases with inadequate clinical information for diagnosis (0.73%) and documents the extent of problems caused by inadequate clinical information. The criticality of appropriate clinical information provided to the pathologist is identified for specific anatomic sites and disease processes and is reflected in changed diagnoses or revised reports.

scholarly journals Confidentiality and security of clinical information in mental health practice

2002 ◽  
Vol 8 (4) ◽  
pp. 291-296 ◽  
Author(s):  
Roy McClelland ◽  
Victoria Thomas
Keyword(s):  
Mental Health ◽  
Social Services ◽  
Information And Communication Technologies ◽  
New Technologies ◽  
Personal Information ◽  
Health Sector ◽  
Clinical Information ◽  
Health Care Organisation ◽  
Good Communication ◽  
The Impact

‘Security holds the key’ was the title of a newspaper article concerned with e-commerce (D. Sumner-Smith, The Sunday Times, 6 February, 2000, p. 3.13). However, it applies just as readily to the health sector. The need to safeguard the confidentiality of information that patients share with clinicians is as fundamental as the principle of consent. This issue has come to the fore in the context of the rapid developments and applications of information and communication technologies within society in general and within the health sector in particular. There are also changing societal expectations regarding access to information, confidentiality and disclosure. The emerging scenarios present significant challenges in relation to the traditional methods used to deal with the privacy and confidentiality of personal information (Anderson, 1995). In addition to the impact of new technologies, consideration also needs to be given to the impact of changes in health care organisation and practice, for example multidisciplinary and multi-agency working. Mental health services are in many respects at the vanguard of these changes, where the ideals of community care, shared care and seamless care depend fundamentally on good communication and information sharing. Failures in communicating information, particularly across sectoral boundaries, have led to significant problems in patient care, as revealed in several recent enquiries into homicides (Northamptonshire Health Authority & Northamptonshire Social Services, 1999)

An Ontology-based Mediator of Clinical Information for Decision Support Systems

2008 ◽  
Vol 47 (06) ◽  
pp. 549-559 ◽  
Author(s):  
K. Ohe ◽  
Y. Kawazoe
Keyword(s):  
Decision Support ◽  
Decision Support System ◽  
Clinical Data ◽  
Support System ◽  
Adverse Drug Events ◽  
Clinical Information ◽  
Temporal Information ◽  
Temporal Abstraction ◽  
Alert System ◽  
Data Repositories

Summary Objective: We have been developing a decision support system that uses electronic clinical data and provides alerts to clinicians. However, the inference rules for such a system are difficult to write in terms of representing domain concepts and temporal reasoning. To address this problem, we have developed an ontologybased mediator of clinical information for the decision support system. Methods: Our approach consists of three steps: 1) development of an ontology-based mediator that represents domain concepts and temporal information; 2) mapping of clinical data to corresponding concepts in the mediator; 3) temporal abstraction that creates high-level, interval-based concepts from time-stamped clinical data. As a result, we can write a concept-based rule expression that is available for use in domain concepts and interval-based temporal information. The proposed approach was applied to a prototype of clinical alert system, and the rules for adverse drug events were executed on data gathered over a 3-month period. Results: The system generated 615 alerts. 346 cases (56%) were considered appropriate and 269 cases (44%) were inappropriate. Of the false alerts, 192 cases were due to data inaccuracy and 77 cases were due to insufficiency of the temporal abstraction. Conclusion: Our approach enabled to represent a concept-based rule expression that was available for the prototype of a clinical alert system. We believe our approach will contribute to narrow the gaps of information model between domain concepts and clinical data repositories.

scholarly journals Transthoracic Echocardiography: Impact on Diagnosis and Management in Tertiary Care Intensive Care Units

2005 ◽  
Vol 33 (4) ◽  
pp. 492-496 ◽  
Author(s):  
L. K. Stanko ◽  
E. Jacobsohn ◽  
J. W. Tam ◽  
C. J. De Wet ◽  
M. Avidan
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Clinical Data ◽  
Transthoracic Echocardiography ◽  
Clinical Information ◽  
Management Plan ◽  
Surgical Intensive Care Unit ◽  
Surgical Intensive Care ◽  
Diagnosis And Management ◽  
Referring Physicians

The purpose of this study was to evaluate the utility of transthoracic echocardiography (TTE) in an intensive care unit by determining its impact on diagnosis and management. Over a six-month time period, we performed a prospective observational study on all patients admitted to either the medical or the surgical intensive care unit. Structured interviews were conducted with referring physicians before and after the TTE to determine the referring physicians’ pre-TTE diagnosis, reasons for requesting the TTE, and whether the TTE resulted in a change in diagnosis and/or management. A total of 135 TTE examinations were done in 126 patients. The referring physicians deemed that clinical information was inadequate to make a definitive diagnosis and management plan in 36/135 (27%) of the requests. In 99/135 (73%) studies, physicians indicated that there was probably sufficient clinical information to formulate a diagnosis and management plan, but ordered a TTE to corroborate their clinical findings. Overall, a change in diagnosis occurred in 39/135 (29%) of studies, and a change in management in 55/135 (41%) of studies. Diagnosis was changed in 19/99 (19%) studies with adequate clinical data, and in 20/36 (56%) studies with inadequate clinical data (P<0.001). Management was changed in 34/99 (34%) of studies with adequate clinical data and in 21/36 (58%) of studies with inadequate clinical data (P=0.017). Of the 62 management changes, 57/62 (92%) changes were minor, and 5/62 (8%) were major. In conclusion we have found that TTE frequently resulted in a change in the diagnosis and management.

scholarly journals Coagulopathy in COVID-19: Connecting the Dots Together

2020 ◽  
Vol 04 (01) ◽  
pp. 47-50 ◽  
Author(s):  
Ajay Gandhi ◽  
Klaus Görlinger
Keyword(s):  
Clinical Data ◽  
Health Care Professionals ◽  
Scientific Information ◽  
Clinical Information ◽  
Clear Understanding ◽  
Scientific Publications ◽  
Clinical Investigations ◽  
Global Concern ◽  
Connecting The Dots ◽  
Available Information

AbstractCoronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) virus has spread quickly and become a public health emergency of global concern. Originating in the Wuhan district of China, which has reportedly been declared free of it now, the rest of the world continues to struggle with its severity and spread. While a lot of scientific publications and clinical data are available, newer clinical investigations and experiences continue to evolve, thereby depicting the dynamic nature of the disease and the knowledge around it. Researchers and clinical professionals continue to collect scientific information, clinical data, and evidence to help build a knowledge pool and guidance for the health care professionals to manage those affected with this pandemic disease. As significant and new data emerge, a lot of already available information gets confirmed and updated, while some of it also getting rejected or disapproved. In this article, we aim to put together the scientific and clinical information that is proven so far and the areas where more data or evidence is needed before a clear understanding can be achieved and guidance can be developed.

Patient gender bias on the diagnosis of idiopathic pulmonary fibrosis

Thorax ◽  
2020 ◽  
Vol 75 (5) ◽  
pp. 407-412 ◽  
Author(s):  
Deborah Assayag ◽  
Julie Morisset ◽  
Kerri A Johannson ◽  
Athol U Wells ◽  
Simon L F Walsh
Keyword(s):  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Proportional Hazards ◽  
Usual Interstitial Pneumonia ◽  
Clinical Information ◽  
Cox Proportional Hazards ◽  
Diagnostic Confidence ◽  
Patient Gender ◽  
And Gender ◽  
Gender Influences

BackgroundPatient sex has clinical and prognostic implications in idiopathic pulmonary fibrosis (IPF). It is not known if sex-related and gender-related discrepancies exist when establishing a diagnosis of IPF. The aim was to determine how patient gender influences the diagnosis of IPF and the physician’s diagnostic confidence.MethodsThis study was performed using clinical cases compiled from a single centre, then scored by respiratory physicians for a prior study. Using clinical information, physicians were asked to provide up to five diagnoses, together with their diagnostic confidence. Logistic regression was used to assess the odds of receiving a diagnosis of IPF based on patient gender. Prognostic discrimination between IPF and non-IPF was used to assess diagnostic accuracy with Cox proportional hazards modelling.ResultsSixty cases were scored by 404 physicians. IPF was diagnosed more frequently in men compared with women (37.8% vs 10.6%; p<0.0001), and with greater mean diagnostic confidence (p<0.001). The odds of a male patient receiving an IPF diagnosis was greater than that of female patients, after adjusting for confounders (OR=3.05, 95% CI: 2.81 to 3.31), especially if the scan was not definite for the usual interstitial pneumonia pattern. Mortality was higher in women (HR=2.21, 95% CI: 2.02 to 2.41) than in men with an IPF diagnosis (HR=1.26, 95% CI: 1.20 to 1.33), suggesting that men were more often misclassified as having IPF.ConclusionPatient gender influences diagnosis of IPF: women may be underdiagnosed and men overdiagnosed with IPF.

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