scholarly journals Feasibility of Asynchronous and Automated Telemedicine in Otolaryngology: Prospective Cross-Sectional Study

10.2196/23680 ◽  
2020 ◽  
Vol 8 (10) ◽  
pp. e23680
Author(s):  
Dongchul Cha ◽  
Seung Ho Shin ◽  
Jungghi Kim ◽  
Tae Seong Eo ◽  
Gina Na ◽  
...  
Keyword(s):  
Medical Records ◽  
Clinical Manifestations ◽  
Cross Sectional Study ◽  
Interrater Agreement ◽  
Diagnostic Model ◽  
Sectional Study ◽  
Perfect Agreement ◽  
Cross Sectional ◽  
Machine Learning Model ◽  
Community Transmission

Background COVID-19 often causes respiratory symptoms, making otolaryngology offices one of the most susceptible places for community transmission of the virus. Thus, telemedicine may benefit both patients and physicians. Objective This study aims to explore the feasibility of telemedicine for the diagnosis of all otologic disease types. Methods A total of 177 patients were prospectively enrolled, and the patient’s clinical manifestations with otoendoscopic images were written in the electrical medical records. Asynchronous diagnoses were made for each patient to assess Top-1 and Top-2 accuracy, and we selected 20 cases to conduct a survey among four different otolaryngologists to assess the accuracy, interrater agreement, and diagnostic speed. We also constructed an experimental automated diagnosis system and assessed Top-1 accuracy and diagnostic speed. Results Asynchronous diagnosis showed Top-1 and Top-2 accuracies of 77.40% and 86.44%, respectively. In the selected 20 cases, the Top-2 accuracy of the four otolaryngologists was on average 91.25% (SD 7.50%), with an almost perfect agreement between them (Cohen kappa=0.91). The automated diagnostic model system showed 69.50% Top-1 accuracy. Otolaryngologists could diagnose an average of 1.55 (SD 0.48) patients per minute, while the machine learning model was capable of diagnosing on average 667.90 (SD 8.3) patients per minute. Conclusions Asynchronous telemedicine in otology is feasible owing to the reasonable Top-2 accuracy when assessed by experienced otolaryngologists. Moreover, enhanced diagnostic speed while sustaining the accuracy shows the possibility of optimizing medical resources to provide expertise in areas short of physicians.

scholarly journals Feasibility of Asynchronous and Automated Telemedicine in Otolaryngology: Prospective Cross-Sectional Study (Preprint)

2020 ◽  
Author(s):  
Dongchul Cha ◽  
Seung Ho Shin ◽  
Jungghi Kim ◽  
Tae Seong Eo ◽  
Gina Na ◽  
...  
Keyword(s):  
Medical Records ◽  
Clinical Manifestations ◽  
Cross Sectional Study ◽  
Interrater Agreement ◽  
Diagnostic Model ◽  
Sectional Study ◽  
Perfect Agreement ◽  
Cross Sectional ◽  
Machine Learning Model ◽  
Community Transmission

BACKGROUND COVID-19 often causes respiratory symptoms, making otolaryngology offices one of the most susceptible places for community transmission of the virus. Thus, telemedicine may benefit both patients and physicians. OBJECTIVE This study aims to explore the feasibility of telemedicine for the diagnosis of all otologic disease types. METHODS A total of 177 patients were prospectively enrolled, and the patient’s clinical manifestations with otoendoscopic images were written in the electrical medical records. Asynchronous diagnoses were made for each patient to assess Top-1 and Top-2 accuracy, and we selected 20 cases to conduct a survey among four different otolaryngologists to assess the accuracy, interrater agreement, and diagnostic speed. We also constructed an experimental automated diagnosis system and assessed Top-1 accuracy and diagnostic speed. RESULTS Asynchronous diagnosis showed Top-1 and Top-2 accuracies of 77.40% and 86.44%, respectively. In the selected 20 cases, the Top-2 accuracy of the four otolaryngologists was on average 91.25% (SD 7.50%), with an almost perfect agreement between them (Cohen kappa=0.91). The automated diagnostic model system showed 69.50% Top-1 accuracy. Otolaryngologists could diagnose an average of 1.55 (SD 0.48) patients per minute, while the machine learning model was capable of diagnosing on average 667.90 (SD 8.3) patients per minute. CONCLUSIONS Asynchronous telemedicine in otology is feasible owing to the reasonable Top-2 accuracy when assessed by experienced otolaryngologists. Moreover, enhanced diagnostic speed while sustaining the accuracy shows the possibility of optimizing medical resources to provide expertise in areas short of physicians.

scholarly journals Clinical and Para-clinical Features of Brucellosis With and Without Spondylodiscitis

2021 ◽  
Vol 8 (2) ◽  
pp. 39-44
Author(s):  
Fariba Keramat ◽  
Seyyed Hamid Hashemi ◽  
Farzaneh Esna-ashari ◽  
Kaveh Kaseb
Keyword(s):  
Back Pain ◽  
Medical Records ◽  
Clinical Manifestations ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Significant Difference ◽  
Vertebral Involvement ◽  
Spinal Mri ◽  
The Mean

Background: Brucellosis is a common zoonotic disease with protean clinical manifestations. Osteoarticular involvement is the most common complication of the disease. This study aimed to compare the clinical and para-clinical manifestations of brucellosis among the patients with and without spondylodiscitis. Methods: In this comparative and cross-sectional study, 135 patients having brucellosis with and without spondylodiscitis and admitted to Sina hospital in Hamadan, Iran from March 2009 to March 2014 were included. Clinical and para-clinical data of the patients were obtained from their medical records in the hospital based on a designed checklist. Results: Thirty-five patients having brucellar spondylodiscitis (BS) with the mean age of 55.60±14.31 years, and 100 patients having brucellosis without BS with the mean age of 43.27±18.35 years were examined. A significant difference was found between the mean age of the patients with spondylodiscitis and that of those without spondylodiscitis (P<0.001). All patients with spondylodiscitis complained of back pain and vertebral tenderness, while 60% of the patients without BS suffered from back pain but experienced no vertebral tenderness (P=0.003). The most common vertebral involvement in spinal MRI of the patients with BS was L4-L5 (45.7%). Patients with spondylodiscitis had more increased ESR and CRP than those without spondylodiscitis (P<0.001). Conclusion: It is recommended that Brucellar spondylodiscitis be considered in the differential diagnosis of the patients with prolonged fever, back pain, and vertebrae tenderness in the endemic areas.

Etiologies, Clinical Manifestations, and Factors Associated with Severe Symptomatic Hyponatremia among Hospitalized Hyponatremia Patients

2020 ◽  
Vol 103 (5) ◽  
pp. 465-471
Keyword(s):  
Clinical Manifestations ◽  
Cross Sectional Study ◽  
Hospitalized Patients ◽  
Sectional Study ◽  
Close Attention ◽  
Cross Sectional ◽  
Factors Associated ◽  
Present Cross Sectional Study ◽  
Important Health ◽  
Baseline Characteristics

Background: Hyponatremia is associated with unfavorable outcomes in many cases. The mainstay of hyponatremia treatment depends on its symptoms and etiology. However, etiologies, clinical manifestations, and factors associated with severe symptomatic hyponatremia have been rarely reported. Objective: To analyze and report etiologies, clinical manifestations, and factors associated with severe symptomatic hyponatremia. Materials and Methods: In the present cross-sectional study, the authors enrolled hospitalized patients with hyponatremia who had consulted a nephrologist between October 1, 2017, and October 31, 2018. Their baseline characteristics and clinical manifestations were recorded. Etiologies were confirmed by the attending nephrology staff. Factors associated with severe symptomatic hyponatremia were evaluated using logistic regression analysis. Results: One hundred patients were included in this study. The syndrome of inappropriate antidiuresis (SIAD), hypovolemia, and hydrochlorothiazide use were the leading hyponatremia etiologies. Hyponatremia etiologies differed between patients with community-acquired hyponatremia (n=50) and those with hospital-associated hyponatremia (n=50). Patients with communityacquired hyponatremia were older, presented with a higher frequency of severe symptomatic hyponatremia, and showed lower SNa-levels. Low SNa-levels were significantly associated with severe symptomatic hyponatremia (p=0.014). Conclusion: Hyponatremia remains an important health problem. SIAD, hypovolemia, and hydrochlorothiazide use are among the leading etiologies of hyponatremia. Low SNa-levels are associated with severe symptomatic hyponatremia; thus, physicians should pay close attention to low SNa-levels in hospitalized patients. Keywords: Hyponatremia, Symptomatic Hyponatremia, Community-acquired hyponatremia, Hospital-associated hyponatremia

scholarly journals Inadequate Gestational Weight Gain and Exposure to Second-Hand Smoke during Pregnancy Increase the Risk of Low Birth Weight: A Cross-Sectional Study among Full-Term Infants

2021 ◽  
Vol 18 (3) ◽  
pp. 1068
Author(s):  
Muliana Edi ◽  
Yit Chin ◽  
Fui Woon ◽  
Geeta Appannah ◽  
Poh Lim ◽  
...  
Keyword(s):  
Weight Gain ◽  
Birth Weight ◽  
Pregnant Women ◽  
Medical Records ◽  
Cross Sectional Study ◽  
Second Hand Smoke ◽  
Sectional Study ◽  
Cross Sectional ◽  
Shs Exposure ◽  
At Home

Despite the advancement of the healthcare system, low birth weight (LBW) remains as one of the leading causes of under-five mortality. This cross-sectional study aimed to determine the prevalence of LBW and its associated factors among 483 third trimester pregnant women recruited from six selected public health clinics in the Federal Territory of Kuala Lumpur and the state of Selangor, Malaysia. Pregnant women were interviewed for information on socio-demographic characteristics, smoking behaviour, and second-hand smoke (SHS) exposure at home and in the workplace. Information on the obstetrical history and prenatal care visits history were retrieved from the maternal medical records, while infant’s birth outcomes were retrieved from infant medical records. The prevalence of LBW (<2.5 kg) in infants was 10.4%, with a mean birth weight of 3.0 [standard deviation (SD) 0.4] kg. Results from the multivariable logistic regression model showed that inadequate weight gained during pregnancy [odds ratio (OR) = 2.41, 95% confidence interval (CI) = 1.18–4.90] and exposure to SHS at home (OR = 1.92, 95% CI = 1.03–3.55) were significantly associated with LBW. In conclusion, pregnant women should monitor their rate of weight gain throughout pregnancy and avoid SHS exposure at home to reduce the risk of delivering LBW infants.

Ophthalmologists and WhatsApp: Teleophthalmology is already here

2021 ◽  
pp. 112067212110026
Author(s):  
Edward Barayev ◽  
Ofri Vorobichik Berar ◽  
Gad Dotan ◽  
Alon Skaat ◽  
Orly Gal-Or ◽  
...  
Keyword(s):  
Medical Records ◽  
Cross Sectional Study ◽  
Work Hours ◽  
Clinical Settings ◽  
Sectional Study ◽  
Cross Sectional ◽  
Policy Makers ◽  
Media Messages ◽  
Rapid Responses ◽  
Wide Availability

Purpose: To estimate the extent of WhatsApp utilization using text and media messages for inter-physician consultations among ophthalmologists (residents and specialists) at various clinical settings and its perceived benefits for ophthalmologists and their patients. We also aimed to detect obstacles that concern ophthalmologists when using WhatsApp as a consultation platform. Methods: This was a cross-sectional study using a self-administered survey through Google Forms, which was sent to 660 practicing ophthalmologists during April to May 2020. Results: One hundred and ninety-two ophthalmologists completed the questionnaire, 151 of which (78.6%) were specialists and 41 (21.4%) were residents. Most ophthalmologists reported using WhatsApp at least once a day for both personal and professional use. Residents reported lower rates of contacting patients using WhatsApp than specialists (1.51 ± 0.98 vs 2.72 ± 1.32, p < 0.001). Respondents reported WhatsApp consultations frequently replaced referrals of patients to other physicians, with a median of once a week. 97.8% of residents and 91.4% of specialists reported the ability to share media is a major advantage of WhatsApp over other medias, followed by rapid responses for consultations. Conclusion: Many ophthalmologists already use WhatsApp as a tool for professional consultations with other providers, mainly thanks to its simplicity and wide availability. Residents use it more frequently than specialists, and ranked it higher when asked how much WhatsApp has improved the clinical setting. Policy makers should address concerns brought up by physicians, such as documentation in medical records and proper compensation for consulting ophthalmologists during and after work hours.

scholarly journals Chronic stress, work-related daily challenges and medicolegal investigations: a cross-sectional study among German general practitioners

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Christine Kersting ◽  
Lena Zimmer ◽  
Anika Thielmann ◽  
Birgitta Weltermann
Keyword(s):  
Regression Model ◽  
General Practitioners ◽  
Chronic Stress ◽  
Medical Records ◽  
High Strain ◽  
Well Being ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Work Related

Abstract Background The prevalence of chronic stress among German general practitioners (GPs) was shown to be twice as high as in the general population. Because chronic stress negatively influences well-being and poor physician well-being is associated with poor patient outcomes, targeted strategies are needed. This analysis focuses on work-related factors associated with high chronic stress in GPs. Methods This cross-sectional study measured chronic stress among German GPs using the validated and standardized Trier Inventory for the Assessment of Chronic Stress (TICS-SSCS). Based on the TICS, GPs were categorized as either having low strain (≤ 25th percentile) or high strain (≥ 75th percentile) due to chronic stress. Questions on work-related challenges assessed the frequency and the subjectively perceived strain of single challenges. For exploratory analyses, these items were combined to dichotomous variables reflecting challenges that are common and that cause high strain. Variables significant in bivariate analyses were included in a multivariate logistic regression model analyzing their association with high chronic stress. Results Data of 109 GPs categorized as having low strain (n = 53) or high strain (n = 56) due to chronic stress were analyzed. Based on bivariate analyses, challenges regarding personnel matters, practice software, complexity of patients, difficult patients, care facilities, scheduling of appointments, keeping medical records up-to-date, fee structures, and expectations versus reality of care were included in the regression model. Keeping medical records up-to-date had the strongest association with high chronic stress (odds ratio 4.95, 95% confidence interval 1.29–19.06). A non-significant trend showed that medicolegal investigations were more common among GPs with high chronic stress. Conclusions This exploratory research shows that chronic stress is predominantly associated with administrative challenges. Treatment documentation, which represents a legal safeguard and is closely linked to existential concerns, has the strongest influence.

scholarly journals Profile of medicines used via oral and gastrointestinal catheter in a Walk-in Service

2018 ◽  
Vol 52 (0) ◽  
Author(s):  
Moara Avila de Jesus Moreira ◽  
Paula Pereira de Figueiredo ◽  
Rosemary Silva da Silveira ◽  
Valdecir Zavarese da Costa ◽  
Eliana Cardia de Pinho ◽  
...  
Keyword(s):  
Medical Records ◽  
Drug Class ◽  
Cross Sectional Study ◽  
Oral Route ◽  
Descriptive Statistics ◽  
University Hospital ◽  
Care Practice ◽  
Sectional Study ◽  
Cross Sectional ◽  
Pharmaceutical Form

ABSTRACT Objective: To identify the profile of drugs prescribed via oral and gastrointestinal catheter in a Walk-in Service of a University Hospital. Method: Quantitative cross-sectional study in which data were collected from the medical records of hospitalized patients using medication via oral or gastrointestinal catheter at least once a day between April and October 2015. The analysis was performed through descriptive statistics. Results: Out of 568 prescriptions (total), there were 143 different medications. The pharmaceutical form with the greatest number of prescriptions was solid (95.8%), of which 46.1% were simple tablets. The oral route had the highest number of administrations (97.3%). The most prescribed drug class was of anti-infectives (25.9%), but the Omeprazole drug was the most prescribed in the study (40%). Conclusion: There are indications that enable rethinking the care practice and establishing criteria and norms for contributing to the safety and efficacy of services provided in healthcare, especially regarding the preparation and administration of medications via gastrointestinal catheter.

scholarly journals Proteinuria and malaria parasite counts in children

2013 ◽  
Vol 53 (6) ◽  
pp. 295 ◽  
Author(s):  
Mahrani Lubis ◽  
Rusdidjas Rusdidjas ◽  
Rafita Ramayati ◽  
Oke Rina Ramayani ◽  
Rosmayanti S Siregar ◽  
...  
Keyword(s):  
Malaria Parasite ◽  
Clinical Manifestations ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Urine Dipstick ◽  
Weak Association ◽  
Blood Smears ◽  
Moderate Malnutrition ◽  
Peripheral Blood Smears

Background Malaria-induced proteinuria has been observed insevere cases of malaria. Few studies have been done to assess foran association between proteinuria and malaria parasite countsbefore the disease becomes severe.Objective To investigate a possible association between proteinuriaand malaria parasite counts in children .Methods A cross-sectional study was conducted on school-agedchildren in Panyabungan, Mandailing Natal, between Septemberto November 2010. Malaria was diagnosed by microscopicexamination of peripheral blood smears. Children with malariaunderwent proteinuria t ests by urine dipstick method. Anassociation between proteinuria and malaria parasite counts wasanalyzed using linear regression test.Results Of 181 participants with Plasmodium fak:iparum malaria,53.6% were female and had a mean age of 7.8 years. Subjects'nutritional status were as follows: 50.8% normoweight, 28.2%mild malnutrition, 3 .3% moderate malnutrition, and 17. 7% severemalnutrition. Clinical manifestations showed 36.5% suffered fromsubfebrile temperatures and 29.8% had pallor. Proteinuria occurredin 45.9% participants and there was a weak association betweenproteinuria and malaria parasite counts (raa .261, Paa .0001).Conclusion There is a weak association between proteinuria andmalaria parasite counts in children.

scholarly journals Potential Incompatibility Problem of Intravenous Drugs’ Administration among Intensive Care Unit (ICU) Patients at PKU Muhammadiyah Yogyakarta Hospital

2019 ◽  
Vol 9 (4) ◽  
pp. 238
Author(s):  
Ardhanarishwari Umi Salamah ◽  
Fita Rahmawati ◽  
Fivy Kurniawati
Keyword(s):  
Medical Records ◽  
Dosage Form ◽  
Electrolyte Solutions ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Inclusion Criteria ◽  
Cross Sectional ◽  
Icu Patients ◽  
Injectable Drugs ◽  
Intravenous Drugs

Drugs’ administration among hospitalized patients in ICU commonly is given intravenously. Mixing the intravenous drugs may result in incompatibility problem that might affect the drugs’ stability and bioavailability. The aim of the study was to investigate the potential incompatibility problem of  intravenous mixing drugs’ administration among ICU patients at PKU Muhammadiyah Yogyakarta Hospital. This study was a cross-sectional study in which design and data was obtained from ICU patients’ medical record retrospectively with purposive sampling in order to observe the pattern of intravenous drug’s combination. The potential incompatibility problem was analyzed using Handbook on Injectable Drugs. There were 79 out of 119 medical records which fulfilled sample inclusion criteria taken in this study. Parenteral dosage form was commonly used rather than non parenteral (62.06%) among ICUs’ patients. The potential incompatibility pattern consisted of incompatibility of intravenous drugs, electrolyte solutions/parenteral nutritions in mixture form, and the electrolyte solutions/parenteral nutritions, which are administrated simultaneously. Potential incompatibility of intravenous dosage was found in 50 events out of 79 patients (0.63 events per patients), which consisted of 8 events (8.51%) in using of drugs administrated simultaneously, 10 events (19.23%) in using of electrolyte solutions/parenteral nutritions in mixture form, and 32 events (11.72%) in using of electrolyte solutions/parenteral nutritions administrated simultaneously. Common potential incompatibilities types were precipitation of drugs and drug’s adsorption to packaging materials.

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