scholarly journals Cervical Spine Computed Tomography Imaging Artifact Affecting Clinical Decision-Making in the Traumatized Patient

2014 ◽  
Vol 8 (1) ◽  
pp. 372-374 ◽  
Author(s):  
Aaron C Coats ◽  
Matthew S Nies ◽  
David Rispler
Keyword(s):  
Computed Tomography ◽  
Decision Making ◽  
Cervical Spine ◽  
Clinical Decision Making ◽  
Ct Scanning ◽  
Clinical Decision ◽  
Trauma Patients ◽  
Advanced Imaging ◽  
X Ray ◽  
Ct Artifact

CT scanning is an important tool in the evaluation of trauma patients. We review a case involving a trauma patient in which a cervical spine computed tomography (CT) artifact affected decision-making by physicians. The CT artifact mimicked bilateral dislocated facets (51-B1.1). On the basis of CT findings, the patient was transferred to a different hospital for evaluation. Discrepancy between the primary CT scan and patient physical exam prompted secondary CT scans and X-ray evaluation; neither of these studies showed osseous abnormalities. This case reinforces the necessity for physicians to formulate their diagnosis based upon multiple areas of information including physical examination, plain x-ray and subsequent advanced imaging, rather than relying solely on advanced imaging.

The Use of Artificial Intelligence Systems for Support of Medical Decision-Making

2011 ◽  
pp. 1017-1029
Author(s):  
William Claster ◽  
Nader Ghotbi ◽  
Subana Shanmuganathan
Keyword(s):  
Artificial Intelligence ◽  
Decision Making ◽  
Statistical Analysis ◽  
Medical Records ◽  
Clinical Decision Making ◽  
Ct Scanning ◽  
Clinical Decision ◽  
Radiology Department ◽  
Self Organizing Map ◽  
One Year

There is a treasure trove of hidden information in the textual and narrative data of medical records that can be deciphered by text-mining techniques. The information provided by these methods can provide a basis for medical artificial intelligence and help support or improve clinical decision making by medical doctors. In this paper we extend previous work in an effort to extract meaningful information from free text medical records. We discuss a methodology for the analysis of medical records using some statistical analysis and the Kohonen Self-Organizing Map (SOM). The medical data derive from about 700 pediatric patients’ radiology department records where CT (Computed Tomography) scanning was used as part of a diagnostic exploration. The patients underwent CT scanning (single and multiple) throughout a one-year period in 2004 at the Nagasaki University Medical Hospital. Our approach led to a model based on SOM clusters and statistical analysis which may suggest a strategy for limiting CT scan requests. This is important because radiation at levels ordinarily used for CT scanning may pose significant health risks especially to children.

scholarly journals Return to Play after Cervical Spine Injuries: A Consensus of Opinion

2016 ◽  
Vol 6 (8) ◽  
pp. 792-797 ◽  
Author(s):  
John C. France ◽  
Michael Karsy ◽  
James S. Harrop ◽  
Andrew T. Dailey
Keyword(s):  
Decision Making ◽  
Cervical Spine ◽  
Clinical Decision Making ◽  
Clinical Symptoms ◽  
Clinical Decision ◽  
Return To Play ◽  
Spine Injury ◽  
Cervical Cord ◽  
Clinical Scenarios ◽  
Cord Injury

Study Design Survey. Objective Sports-related spinal cord injury (SCI) represents a growing proportion of total SCIs but lacks evidence or guidelines to guide clinical decision-making on return to play (RTP). Our objective is to offer the treating physician a consensus analysis of expert opinion regarding RTP that can be incorporated with the unique factors of a case for clinical decision-making. Methods Ten common clinical scenarios involving neurapraxia and stenosis, atlantoaxial injury, subaxial injury, and general cervical spine injury were presented to 25 spine surgeons from level 1 trauma centers for whom spine trauma is a significant component of their practice. We evaluated responses to questions about patient RTP, level of contact, imaging required for a clinical decision, and time to return for each scenario. The chi-square test was used for statistical analysis, with p < 0.05 considered significant. Results Evaluation of the surgeons’ responses to these cases showed significant consensus regarding return to high-contact sports in cases of cervical cord neurapraxia without symptoms or stenosis, surgically repaired herniated disks, and nonoperatively healed C1 ring or C2 hangman's fractures. Greater variability was found in recommendations for patients showing persistent clinical symptomatology. Conclusion This survey suggests a consensus among surgeons for allowing patients with relatively normal imaging and resolution of symptoms to return to high-contact activities; however, patients with cervical stenosis or clinical symptoms continue to be a challenge for management. This survey may serve as a basis for future clinical trials and consensus guidelines.

scholarly journals Lymphoepithelioma-Like Carcinoma of the Lung: An Unusual Case and Literature Review

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Yuan-Chun Huang ◽  
Ching Hsueh ◽  
Shang-Yun Ho ◽  
Chiung-Ying Liao
Keyword(s):  
Computed Tomography ◽  
Decision Making ◽  
Unusual Case ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Shortness Of Breath ◽  
Lung Mass ◽  
Postoperative Adjuvant Chemotherapy ◽  
Chest Computed Tomography ◽  
Initial Symptoms

We described a case of lymphoepithelioma-like carcinoma (LELC) of the lung of a 65-year-old man with initial symptoms of intermittent chest pain and mild shortness of breath for 2 weeks. A right-lung mass was noted on chest computed tomography (CT) scan and was proved histopathologically as LELC of lung after video-assisted thorascopic lobectomy. He was successfully treated with lobectomy with postoperative adjuvant chemotherapy and is alive without signs of recurrence for 36 months after the diagnosis. It is important for clinicians, pathologists, and radiologists to understand the clinical, pathological, and radiological presentations of this neoplasm to avoid improper clinical decision making and misdiagnosis.

Cost-effective clinical decision making

PEDIATRICS ◽  
1977 ◽  
Vol 60 (5) ◽  
pp. 756-759
Author(s):  
Duncan Neuhauser
Keyword(s):  
Decision Making ◽  
Hospital Stay ◽  
Clinical Decision Making ◽  
Cost Effective ◽  
Clinical Decision ◽  
Inappropriate Therapy ◽  
X Ray ◽  
Scarce Resources ◽  
Chest X Ray ◽  
The Cost

Are pediatric preoperative chest x-ray examinations worth doing? Sane et al. (p. 669) conclude that they are "medically and economically justified and essential." To answer this question requires at least the following information. What is the cost of the examination (dollars, radiation exposure, cost of further testing and perhaps inappropriate therapy resulting therefrom, and possible prolongation of hospital stay)? What is the benefit? What percent of patients have unsuspected findings; of these, the percent with modified treatment; and of these, what percent benefited therefrom? What was the cost per unit of benefit received? Is there some other use of these scarce resources that would have yielded greater benefits?

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