scholarly journals Automated Morphometric Analysis of the Femur on Large Anatomical Databases with Highly Accurate Correspondence Detection

2014 ◽  
Vol 1 (1) ◽  
pp. 15-22 ◽  
Author(s):  
Manuel Schröder ◽  
Heiko Gottschling ◽  
Nils Reimers ◽  
Matthias Hauschild ◽  
Rainer Burgkart
Keyword(s):  
Medical Applications ◽  
Detailed Knowledge ◽  
Morphometric Measurements ◽  
Data Set ◽  
Specific Patient ◽  
Novel Approach ◽  
Patient Groups ◽  
Ct Segmentation ◽  
Correspondence Mapping

For a variety of medical applications, detailed knowledge on the statistical distribution of morphometric characteristics among specific patient groups is required. We present a novel approach for performing automated morphometric measurements on the surface of anatomical bone samples obtained from CT segmentation. The system developed supports various types of measurements (distances, angles, radii) on several kinds of features (points, lines, planes or circles), which are performed automatically for every bone sample in a given data set. The desired features can be specified by the user in two ways, either by marking them on a standardized template that is mapped to all samples via a correspondence mapping, or by hierarchically building new features from existing features. The system was implemented and tested on a database containing about 1200 segmented femur. The quality of the automated matching was assessed through a study comparing the performance of the system with results obtained from manual labeling by medical experts. It was found that the deviation between the two methods was generally less than 2mm.

Optimising the use of virtual and conventional simulation: a clinical and economic analysis

2007 ◽  
Vol 6 (2) ◽  
pp. 83-91 ◽  
Author(s):  
M. McJury ◽  
B. Foran ◽  
J. Conway ◽  
S. Dixon ◽  
K. Wilcock ◽  
...  
Keyword(s):  
Treatment Process ◽  
Virtual Simulation ◽  
Treatment Episode ◽  
Specific Patient ◽  
Registration Data ◽  
Significant Difference ◽  
Patient Groups ◽  
Set Up ◽  
Costing Analysis

AbstractBackground and purpose: Currently, optimal use of virtual simulation for all treatment sites is not entirely clear. This study presents data to identify specific patient groups for whom conventional simulation may be completely eliminated and replaced by virtual simulation.Sampling and method: Two hundred and sixty patients were recruited from four treatment sites (head and neck, breast, pelvis, and thorax). Patients were randomly assigned to be treated using the usual treatment process involving conventional simulation, or a treatment process differing only in the replacement of conventional plan verification with virtual verification. Data were collected on set-up accuracy at verification, and the number of unsatisfactory verifications requiring a return to the conventional simulator. A micro-economic costing analysis was also undertaken, whereby data for each treatment process episode were also collected: number and grade of staff present, and the time for each treatment episode.Results: The study shows no statistically significant difference in the number of returns to the conventional simulator for each site and study arm. Image registration data show similar quality of verification for each study arm. The micro-costing data show no statistical difference between the virtual and conventional simulation processes.Conclusions: At our institution, virtual simulation including virtual verification for the sites investigated presents no disadvantage compared to conventional simulation.

Cost Analysis of Dialysis Modalities in Italy

2001 ◽  
Vol 14 (1) ◽  
pp. 9-17 ◽  
Author(s):  
F. Tediosi ◽  
G. Bertolini ◽  
F. Parazzini ◽  
G. Mecca ◽  
L. Garattini
Keyword(s):  
Cost Analysis ◽  
Specific Patient ◽  
Rational Allocation ◽  
Italian National Health Service ◽  
Related Quality ◽  
Health Related ◽  
Italian National Health ◽  
Patient Groups ◽  
The Cost

This study analyses management and costs of dialysis in the Italian National Health Service (NHS). Information on efficacy and health-related quality of life (HRQOL) based on the existing literature also is presented. The clinical differences between the dialysis modalities seem to be related to their appropriateness to specific patient groups. Efficacy rates are similar and the only differences are in complications and HRQOL. Traditional haemodialysis (THD) can be done by Italian patients in dialysis centres or in hospital. High-flux haemodialysis (HFHD) is generally only done in hospital. Peritoneal dialysis (PD) is usually done at home. The cost analysis was performed on a sample of Italian dialysis centres and hospitals, according to the full cost method. As expected, HFHD was more expensive than THD and PD, but no marked differences emerged among the different HFHD modalities. THD modalities in dialysis centres were less costly than in hospitals. Automated PD (APD) was much more expensive (almost twice) than continuous ambulatory PD (CAPD), the cheapest method in absolute terms. This study confirms that dialysis is costly and that it is very difficult to assess the cost-effectiveness of the different approaches. Although this study has limits, it should provide sufficient analytical information to local healthcare managers for more rational allocation of financial resources to dialysis services.

scholarly journals State of advance care planning research: A descriptive overview of systematic reviews

2018 ◽  
Vol 17 (2) ◽  
pp. 234-244 ◽  
Author(s):  
Geronimo Jimenez ◽  
Woan Shin Tan ◽  
Amrit K. Virk ◽  
Chan Kee Low ◽  
Josip Car ◽  
...  
Keyword(s):  
Advance Care Planning ◽  
Systematic Reviews ◽  
Care Planning ◽  
Specific Patient ◽  
Cochrane Reviews ◽  
Overview Of Systematic Reviews ◽  
Patient Groups ◽  
Advance Care ◽  
State Of Research

AbstractObjectiveTo provide an overview of the current state of research of advance care planning (ACP), highlighting most studied topics, publication time, quality of studies and reported outcomes, and to identify gaps to improve ACP receptivity, utilization, implementation, and outcomes.MethodCochrane methodology for conducting overviews of systematic reviews. Study quality was assessed using a modified version of the Assessing the Methodological Quality of Systematic Reviews tool. The following databases were searched from inception to April 2017: MEDLINE, EBM Reviews, Cochrane Reviews, CINAHL, Global Health, PsycINFO, and EMBASE. Searches were supplemented with gray literature and manual searches.ResultEighty systematic reviews, covering 1,662 single articles, show that ACP-related research focuses on nine main topics: (1) ACP as part of end-of-life or palliative care interventions, (2) care decision-making; (3) communication strategies; (4) factors influencing ACP implementation; (5) ACP for specific patient groups, (6) ACP effectiveness; (7) ACP experiences; (8) ACP cost; and (9) ACP outcome measures. The majority of this research was published since 2014, its quality ranges from moderate to low, and reports on documentation, concordance, preferences, and resource utilization outcomes.Significance of resultsDespite the surge of ACP research, there are major knowledge gaps about ACP initiation, timeliness, optimal content, and impact because of the low quality and fragmentation of the available evidence. Research has mostly focused on discrete aspects within ACP instead of using a holistic evaluative approach that takes into account its intricate working mechanisms, the effects of systems and contexts, and the impacts on multilevel stakeholders. Higher quality studies and innovative interventions are needed to develop effective ACP programs and address research gaps.

scholarly journals Evidence-Based Infection Control Planning Based on National Healthcare-Associated Infection Prevalence Data

2009 ◽  
Vol 30 (2) ◽  
pp. 187-189 ◽  
Author(s):  
Jacqueline Reilly ◽  
Sally Stewart ◽  
Gwen Allardice ◽  
Shona Cairns ◽  
Lisa Ritchie ◽  
...  
Keyword(s):  
Infection Control ◽  
Infection Prevalence ◽  
Healthcare Associated Infection ◽  
Prevalence Survey ◽  
Data Set ◽  
Prevalence Data ◽  
Specific Patient ◽  
High Prevalence ◽  
Patient Groups ◽  
Healthcare Associated

This study identifies factors associated with a high prevalence of healthcare-associated infection (HAI) in the Scottish inpatient population, on the basis of the Scotland National HAI Prevalence Survey data set. The multivariate models developed can be used to predict HAI prevalence in specific patient groups to help with planning and policy in infection control.

scholarly journals Onco-Cardiology: Consensus Paper of the German Cardiac Society, the German Society for Pediatric Cardiology and Congenital Heart Defects and the German Society for Hematology and Medical Oncology

2020 ◽  
Vol 109 (10) ◽  
pp. 1197-1222 ◽  
Author(s):  
Tienush Rassaf ◽  
◽  
Matthias Totzeck ◽  
Johannes Backs ◽  
Carsten Bokemeyer ◽  
...  
Keyword(s):  
Side Effects ◽  
Heart Defects ◽  
German Society ◽  
Tumour Therapy ◽  
Specific Patient ◽  
Treatment Groups ◽  
Consensus Paper ◽  
Patient Groups ◽  
Therapy Strategies

Abstract The acute and long-lasting side effects of modern multimodal tumour therapy significantly impair quality of life and survival of patients afflicted with malignancies. The key components of this therapy include radiotherapy, conventional chemotherapy, immunotherapy and targeted therapies. In addition to established tumour therapy strategies, up to 30 new therapies are approved each year with only incompletely characterised side effects. This consensus paper discusses the risk factors that contribute to the development of a potentially adverse reaction to tumour therapy and, in addition, defines specific side effect profiles for different treatment groups. The focus is on novel therapeutics and recommendations for the surveillance and treatment of specific patient groups.

Cost analysis of dialysis modalities in Italy

2001 ◽  
Vol 14 (1) ◽  
pp. 9-17 ◽  
Author(s):  
F. Tediosi ◽  
G. Bertolini ◽  
F. Parazzini ◽  
G. Mecca ◽  
L. Garattini
Keyword(s):  
Cost Analysis ◽  
Specific Patient ◽  
Rational Allocation ◽  
Italian National Health Service ◽  
Related Quality ◽  
Health Related ◽  
Italian National Health ◽  
Patient Groups ◽  
The Cost

This study analyses management and costs of dialysis in the Italian National Health Service (NHS). Information on efficacy and health-related quality of life (HRQOL) based on the existing literature also is presented. The clinical differences between the dialysis modalities seem to be related to their appropriateness to specific patient groups. Efficacy rates are similar and the only differences are in complications and HRQOL. Traditional haemodialysis (THD) can be done by Italian patients in dialysis centres or in hospital. High-flux haemodialysis (HFHD) is generally only done in hospital. Peritoneal dialysis (PD) is usually done at home. The cost analysis was performed on a sample of Italian dialysis centres and hospitals, according to the full cost method. As expected, HFHD was more expensive than THD and PD, but no marked differences emerged among the different HFHD modalities. THD modalities in dialysis centres were less costly than in hospitals. Automated PD (APD) was much more expensive (almost twice) than continuous ambulatory PD (CAPD), the cheapest method in absolute terms. This study confirms that dialysis is costly and that it is very difficult to assess the cost-effectiveness of the different approaches. Although this study has limits, it should provide sufficient analytical information to local healthcare managers for more rational allocation of financial resources to dialysis services.

scholarly journals One Song, Many Voices: Dementia and The Power of Music

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 775-775
Author(s):  
Debra Sheets ◽  
Stuart MacDonald ◽  
Andre Smith
Keyword(s):  
High School Students ◽  
Social Inclusion ◽  
Positive Impact ◽  
Social Connections ◽  
Social Connection ◽  
School Students ◽  
Choral Singing ◽  
Novel Approach ◽  
Care Partners

Abstract Choral singing is a novel approach to reduce dementia stigma and social isolation while offering participants a sense of purpose, joy and social connection. The pervasiveness of stigma surrounding dementia remains one of the biggest barriers to living life with dignity following a diagnosis (Alzheimer Society of Canada, 2018). This paper examines how a social inclusion model of dementia care involving an intergenerational choir for people living with dementia, their care partners and high school students can reduce stigma and foster social connections. Multiple methodologies are used to investigate the effects of choir participation on cognition, stress levels, social connections, stigma, and quality of life. Results demonstrate the positive impact of choir participation and indicate that this socially inclusive intervention offers an effective, non-pharmacological alternative for older adults living with dementia in the community. Discussion focuses on the importance of instituting meaningful and engaging dementia-friendly activities at the community level.

scholarly journals Calling for improved quality in the registration of traditional Chinese medicine during the public health emergency: a survey of trial registries for COVID-19, H1N1, and SARS

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Zhuoran Kuang ◽  
◽  
Xiaoyan Li ◽  
Jianxiong Cai ◽  
Yaolong Chen ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Clinical Trials ◽  
Chinese Medicine ◽  
Traditional Chinese Medicine ◽  
Secondary Outcome ◽  
Specific Information ◽  
Clinical Trial Registry ◽  
Data Set ◽  
Diagnosis Criteria

Abstract Objective To assess the registration quality of traditional Chinese medicine (TCM) clinical trials for COVID-19, H1N1, and SARS. Method We searched for clinical trial registrations of TCM in the WHO International Clinical Trials Registry Platform (ICTRP) and Chinese Clinical Trial Registry (ChiCTR) on April 30, 2020. The registration quality assessment is based on the WHO Trial Registration Data Set (Version 1.3.1) and extra items for TCM information, including TCM background, theoretical origin, specific diagnosis criteria, description of intervention, and outcomes. Results A total of 136 records were examined, including 129 severe acute respiratory syndrome coronavirus 2 (COVID-19) and 7 H1N1 influenza (H1N1) patients. The deficiencies in the registration of TCM clinical trials (CTs) mainly focus on a low percentage reporting detailed information about interventions (46.6%), primary outcome(s) (37.7%), and key secondary outcome(s) (18.4%) and a lack of summary result (0%). For the TCM items, none of the clinical trial registrations reported the TCM background and rationale; only 6.6% provided the TCM diagnosis criteria or a description of the TCM intervention; and 27.9% provided TCM outcome(s). Conclusion Overall, although the number of registrations of TCM CTs increased, the registration quality was low. The registration quality of TCM CTs should be improved by more detailed reporting of interventions and outcomes, TCM-specific information, and sharing of the result data.

Simple Index to Assess the Calibration Quality of Safety Performance Functions Based on Multiple Goodness-of-Fit Metrics

2021 ◽  
pp. 036119812110088
Author(s):  
Raul E. Avelar ◽  
Karen Dixon ◽  
Boniphace Kutela ◽  
Sam Klump ◽  
Beth Wemple ◽  
...  
Keyword(s):  
Goodness Of Fit ◽  
Synthetic Data ◽  
Calibration Procedure ◽  
Safety Performance ◽  
Absolute Deviation ◽  
Data Set ◽  
Safety Database ◽  
Simple Index ◽  
Safety Performance Functions

The calibration of safety performance functions (SPFs) is a mechanism included in the Highway Safety Manual (HSM) to adjust SPFs in the HSM for use in intended jurisdictions. Critically, the quality of the calibration procedure must be assessed before using the calibrated SPFs. Multiple resources to aid practitioners in calibrating SPFs have been developed in the years following the publication of the HSM 1st edition. Similarly, the literature suggests multiple ways to assess the goodness-of-fit (GOF) of a calibrated SPF to a data set from a given jurisdiction. This paper uses the calibration results of multiple intersection SPFs to a large Mississippi safety database to examine the relations between multiple GOF metrics. The goal is to develop a sensible single index that leverages the joint information from multiple GOF metrics to assess overall quality of calibration. A factor analysis applied to the calibration results revealed three underlying factors explaining 76% of the variability in the data. From these results, the authors developed an index and performed a sensitivity analysis. The key metrics were found to be, in descending order: the deviation of the cumulative residual (CURE) plot from the 95% confidence area, the mean absolute deviation, the modified R-squared, and the value of the calibration factor. This paper also presents comparisons between the index and alternative scoring strategies, as well as an effort to verify the results using synthetic data. The developed index is recommended to comprehensively assess the quality of the calibrated intersection SPFs.

scholarly journals Non-medical risk factors associated with postponing elective surgery: a prospective observational study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Julia Becker ◽  
Gerald Huschak ◽  
Hannes-Caspar Petzold ◽  
Volker Thieme ◽  
Sebastian Stehr ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Low Socioeconomic Status ◽  
Elective Surgery ◽  
Nursing Home Residents ◽  
Hospital Staff ◽  
Data Management System ◽  
Electronic Patient Records ◽  
Specific Patient ◽  
Emergency Procedures ◽  
Patient Groups

Abstract Background Operation room (OR) planning is a complex process, especially in large hospitals with high rates of unplanned emergency procedures. Postponing elective surgery in order to provide capacity for emergency operations is inevitable at times. Elderly patients, residents of nursing homes, women, patients with low socioeconomic status and ethnic minorities are at risk for undertreatment in other contexts, as suggested by reports in the medical literature. We hypothesized that specific patient groups could be at higher risk for having their elective surgery rescheduled for non-medical reasons. Methods In this single center, prospective observational trial, we analysed 2519 patients undergoing elective surgery from October 2018 to May 2019. A 14-item questionnaire was handed out to illicit patient details. Additional characteristics were collected using electronic patient records. Information on the timely performance of the scheduled surgery was obtained using the OR’s patient data management system. 6.45% of all planned procedures analysed were postponed. Association of specific variables with postponement rates were analysed using the Mann–Whitney U test and Fisher's exact test/χ2-test. Results Significantly higher rates of postponing elective surgery were found in elderly patients. No significant differences in postponing rates were found for the variables gender, nationality (Germany, EU, non-EU), native language, professional medical background and level of education. Significantly lower rescheduling rates were found in patients with ties to hospital staff and in patients with a private health insurer. Conclusions Elderly patients, retirees and nursing home residents seem to be at higher risk for having their elective surgery rescheduled. However, owing to the study design, causality could not be proven. Our findings raise concern about possible undertreatment of these patient groups and provide data on short-term postponement of elective surgery. Trial registration DRKS00015836. Retrospectively registered.

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