scholarly journals What to choose and why to use – a critical review on the clinical relevance of rASRM, EFI and Enzian classifications of endometriosis

2021 ◽  
Vol 13 (4) ◽  
pp. 331-338 ◽  
Author(s):  
G Hudelist ◽  
L Valentin ◽  
E Saridogan ◽  
G Condous ◽  
M Malzoni ◽  
...  
Keyword(s):  
Classification System ◽  
Classification Systems ◽  
Future Research ◽  
Junctional Zone ◽  
Disease Extent ◽  
Deep Endometriosis ◽  
Imaging Methods ◽  
Advantages And Disadvantages ◽  
Surgical Complexity ◽  
American Society

Background: Endometriosis is a common benign gynaecological disease that affects pelvic structures and causes adhesions. Endometriosis outside the pelvis exists but is rarer. Deep endometriosis may affect organs such as the urinary bladder, ureters, bowel and sacral roots. Adenomyosis (growth of endometrium in the myometrium, sometimes explained by disruption of the uterine junctional zone) frequently co-exists with deep endometriosis. Over the past decades, multiple attempts have been made to describe the anatomical extent of endometriosis. Out of approximately 20 classification systems suggested and published so far, three have gained widespread acceptance. These are the rASRM (American Society of Reproductive Medicine) classification, the Endometriosis Fertility Index (EFI) and the Enzian classification. Ideally, a classification system should be useful both for describing disease extent based on surgical findings and results of imaging methods (ultrasound, magnetic resonance imaging). Objectives: To highlight the advantages and disadvantages of the three classification systems. Methods: This is a narrative review based on selected publications and experience of the authors. We discuss the current literature on the use of the rASRM, EFI and Enzian classification systems for describing disease extent with imaging methods and for prediction of fertility, surgical complexity, and risk of surgical complications. We underline the need for one universally acceptable terminology to describe the extent of endometriosis. Conclusions: A useful classification system for endometriosis should describe the sites and extent of the disease, be related to surgical complexity and to disease-associated symptoms, including subfertility and should satisfy needs of both, imaging specialists for pre-operative classification and surgeons. The need for such a system is obvious and is provided by the #Enzian classification. Future research is necessary to test its validity.

CLASSIFICATION OF HAND SPLINTING

Hand Surgery ◽  
2002 ◽  
Vol 07 (02) ◽  
pp. 209-213 ◽  
Author(s):  
Simon K. M. Wong
Keyword(s):  
Environmental Factors ◽  
Classification System ◽  
Single System ◽  
Logical Deduction ◽  
Advantages And Disadvantages ◽  
American Society ◽  
Set Up ◽  
New System ◽  
Rote Memory

The terminology in describing splint or orthosis has been reviewed but there is no one single system adopted universally. Joint efforts by doctors, therapists and orthotists had been set up to review the classification of splint. Four ways of classifying hand splints have been introduced: namely, eponym, acronym, descriptive classification system and the classification system proposed by the American Society of Hand Therapists. These systems include the use of rote memory or logical deduction in grouping of splints. This paper describes the advantages and disadvantages of each classification system. Neither one of the systems stands out to be the best. A combination of the advantages of different systems, such as precision and logical deduction, may be an option for developing a new system. Moreover, communication, documentation and other environmental factors should also be considered.

scholarly journals Currently available classification systems for lower cervical spine injuries. Part 1. Overview of the most popular scales and classifications

2019 ◽  
Vol 21 (1) ◽  
pp. 90-102 ◽  
Author(s):  
A. A. Grin ◽  
I. S. Lvov ◽  
S. L. Arakelyan ◽  
A. E. Talypov ◽  
A. Yu. Kordonsky ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Classification System ◽  
Injury Severity ◽  
Scoring Systems ◽  
Classification Systems ◽  
Spine Injury ◽  
Lower Cervical Spine ◽  
Cervical Spine Injuries ◽  
Advantages And Disadvantages ◽  
Spine Injuries

This article provides a detailed illustrated description of currently available classification and scoring systems for lower cervical spine injuries (including Allen–Fergusson, J. Harris et al., C. Argenson et al., and AOSpine classifications, Subaxial Injury Classification System and Cervical Spine Injury Severity Score). The present review primarily aims to discuss the advantages and disadvantages of each classification system. 

scholarly journals EQUSUM: Endometriosis QUality and grading instrument for SUrgical performance: proof of concept study for automatic digital registration and classification scoring for r-ASRM, EFI and Enzian

2020 ◽  
Vol 2020 (4) ◽  
Author(s):  
J Metzemaekers ◽  
P Haazebroek ◽  
M J G H Smeets ◽  
J English ◽  
M D Blikkendaal ◽  
...  
Keyword(s):  
Group Versus ◽  
Mental Effort ◽  
Classification Systems ◽  
Future Research ◽  
Proof Of Concept ◽  
Surgical Performance ◽  
Deep Endometriosis ◽  
Concept Study ◽  
System Usability Scale

Abstract STUDY QUESTION Is electronic digital classification/staging of endometriosis by the EQUSUM application more accurate in calculating the scores/stages and is it easier to use compared to non-digital classification? SUMMARY ANSWER We developed the first digital visual classification system in endometriosis (EQUSUM). This merges the three currently most frequently used separate endometriosis classification/scoring systems (i.e. revised American Society for Reproductive Medicine (rASRM), Enzian and Endometriosis Fertility Index (EFI)) to allow uniform and adequate classification and registration, which is easy to use. The EQUSUM showed significant improvement in correctly classifying/scoring endometriosis and is more user-friendly compared to non-digital classification. WHAT IS KNOWN ALREADY Endometriosis classification is complex and until better classification systems are developed and validated, ideally all women with endometriosis undergoing surgery should have a correct rASRM score and stage, while women with deep endometriosis (DE) should have an Enzian classification and if there is a fertility wish, the EFI score should be calculated. STUDY DESIGN, SIZE, DURATION A prospective endometriosis classification proof of concept study under experts in deep endometriosis was conducted. A comparison was made between currently used non-digital classification formats for endometriosis versus a newly developed digital classification application (EQUSUM). PARTICIPANTS/MATERIALS, SETTING, METHODS A hypothetical operative endometriosis case was created and summarized in both non-digital and digital form. During European endometriosis expert meetings, 45 DE experts were randomly assigned to the classic group versus the digital group to provide a proper classification of this DE case. Each expert was asked to provide the rASRM score and stage, Enzian and EFI score. Twenty classic forms and 20 digital forms were analysed. Questions about the user-friendliness (system usability scale (SUS) and subjective mental effort questionnaire (SMEQ)) of both systems were collected. MAIN RESULTS AND THE ROLE OF CHANCE The rASRM stage was scored completely correctly by 10% of the experts in the classic group compared to 75% in the EQUSUM group (P < 0. 01). The rASRM numerical score was calculated correctly by none of the experts in the classic group compared with 70% in the EQUSUM group (P < 0.01). The Enzian score was correct in 60% of the classic group compared to 90% in the EQUSUM group (P = 0.03). EFI scores were calculated correctly in 25% of the classic group versus 85% in the EQUSUM group (P < 0.01). Finally, the usability measured with the SUS was significantly better in the EQUSUM group compared to the classic group: 80.8 ± 11.4 and 61.3 ± 20.5 (P < 0.01). Also the mental effort measured with the SMEQ was significant lower in the EQUSUM group compared to the classic group: 52.1 ± 18.7 and 71.0 ± 29.1 (P = 0.04). Future research should further develop and confirm these initial findings by conducting similar studies with larger study groups, to limit the possible role of chance. LIMITATIONS, REASONS FOR CAUTION These first results are promising, however it is important to note that this is a preliminary result of experts in DE and needs further testing in daily practice with different types (complex and easy) of endometriosis cases and less experienced gynaecologists in endometriosis surgery. WIDER IMPLICATIONS OF THE FINDINGS This is the first time that the rASRM, Enzian and EFI are combined in one web-based application to simplify correct and automatic endometriosis classification/scoring and surgical registration through infographics. Collection of standardized data with the EQUSUM could improve endometriosis reporting and increase the uniformity of scientific output. However, this requires a broad implementation. STUDY FUNDING/COMPETING INTEREST(S) To launch the EQUSUM application, a one-time financial support was provided by Medtronic to cover the implementation cost. No competing interests were declared. TRIAL REGISTRATION NUMBER N/A.

Novel Arthroscopic Classification of Osteochondritis Dissecans of the Knee

2016 ◽  
Vol 44 (7) ◽  
pp. 1694-1698 ◽  
Author(s):  
James L. Carey ◽  
Eric J. Wall ◽  
Nathan L. Grimm ◽  
Theodore J. Ganley ◽  
Eric W. Edmonds ◽  
...  
Keyword(s):  
Osteochondritis Dissecans ◽  
Classification System ◽  
Interobserver Reliability ◽  
Intraclass Correlation ◽  
Intraobserver Reliability ◽  
Classification Systems ◽  
Future Research ◽  
Multicenter Studies ◽  
Level Of Evidence ◽  
Surgical Evaluation

Background: Several systems have been proposed for classifying osteochondritis dissecans (OCD) of the knee during surgical evaluation. No single classification includes mutually exclusive categories that capture all of the salient features of stability, chondral fissuring, and fragment detachment. Furthermore, no study has assessed the reliability of these classification systems. Purpose: To determine the intra- and interobserver reliability of a novel, comprehensive arthroscopic classification system with mutually exclusive OCD lesion types. Study Design: Cohort study (diagnosis); Level of evidence, 3. Methods: The Research in OsteoChondritis of the Knee (ROCK) study group developed a classification system for arthroscopic evaluation of OCD of the knee that includes 6 arthroscopic categories—3 immobile types and 3 mobile types. To optimize comprehensibility and applicability, each was developed with a memorable name, a brief description, a line diagram corresponding to the archetypal arthroscopic appearance, and an arthroscopic photograph depicting this archetype. Thirty representative arthroscopic videos were evaluated by 10 orthopaedic surgeon raters, who classified each lesion. After 4 weeks, the raters again classified the OCD lesions depicted in the 30 videos in a new, randomly selected order. Reliability was assessed via the intraclass correlation coefficient (ICC). Results: The interobserver reliability of this novel arthroscopy classification was estimated by an ICC of 0.94 (95% CI, 0.91-0.97) for the first round and 0.95 (95% CI, 0.93-0.98) for the second round. According to the standards for the magnitude of the reliability coefficient of Altman, these ICCs indicate that interobserver reliability was very good. The intraobserver reliability was estimated by an ICC of 0.96 (95% CI, 0.95-0.97), which indicates that the intraobserver reliability was similarly very good. Conclusion: The ROCK OCD knee arthroscopy classification system demonstrated excellent intra- and interobserver reliability. In light of this reliability, this classification system may be used clinically and to facilitate future research, including multicenter studies for OCD.

A Review of Drug Side Effect Identification Methods

2020 ◽  
Vol 26 (26) ◽  
pp. 3096-3104 ◽  
Author(s):  
Shuai Deng ◽  
Yige Sun ◽  
Tianyi Zhao ◽  
Yang Hu ◽  
Tianyi Zang
Keyword(s):  
Side Effects ◽  
Future Research ◽  
Drug Side Effects ◽  
Important Indicator ◽  
Advantages And Disadvantages ◽  
Key Points ◽  
Network Methods ◽  
Future Research Directions ◽  
The One ◽  
Approved Drugs

Drug side effects have become an important indicator for evaluating the safety of drugs. There are two main factors in the frequent occurrence of drug safety problems; on the one hand, the clinical understanding of drug side effects is insufficient, leading to frequent adverse drug reactions, while on the other hand, due to the long-term period and complexity of clinical trials, side effects of approved drugs on the market cannot be reported in a timely manner. Therefore, many researchers have focused on developing methods to identify drug side effects. In this review, we summarize the methods of identifying drug side effects and common databases in this field. We classified methods of identifying side effects into four categories: biological experimental, machine learning, text mining and network methods. We point out the key points of each kind of method. In addition, we also explain the advantages and disadvantages of each method. Finally, we propose future research directions.

scholarly journals A Review of Dynamic Balancing for Robotic Mechanisms

Robotica ◽  
2020 ◽  
Vol 39 (1) ◽  
pp. 55-71 ◽  
Author(s):  
Bin Wei ◽  
Dan Zhang
Keyword(s):  
Future Research ◽  
Dynamic Balancing ◽  
Advantages And Disadvantages

SUMMARYThe authors summarize the main dynamic balancing methods of robotic mechanisms in this paper. The majority of dynamic balancing methods have been presented, and there may be other dynamic balancing methods that are not included in this paper. Each of the balancing methods is reviewed and discussed. The advantages and disadvantages of each method are presented and compared. The goal of this paper is to provide an overview of recent research in balancing. The authors hope that this study can provide an informative reference for future research in the direction of dynamic balancing of robotic mechanisms.

scholarly journals Validity of the Gender Dysphoria diagnosis and incidence trends in Sweden: a nationwide register study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Malin Indremo ◽  
Richard White ◽  
Thomas Frisell ◽  
Sven Cnattingius ◽  
Alkistis Skalkidou ◽  
...  
Keyword(s):  
Gender Dysphoria ◽  
Age Groups ◽  
Medical Intervention ◽  
Future Research ◽  
Advantages And Disadvantages ◽  
Incidence Trends ◽  
Interaction Terms ◽  
Definition Of ◽  
The Individual ◽  
Nationwide Register Study

AbstractThe aim of this study was to examine the validity of the Gender Dysphoria (GD) diagnoses in the Swedish National Patient Register (NPR), to discuss different register-based definitions of GD and to investigate incidence trends. We collected data on all individuals with registered GD diagnoses between 2001 and 2016 as well as data on the coverage in the NPR. We regarded gender confirming medical intervention (GCMI) as one proxy for a clinically valid diagnosis and calculated the positive predictive value (PPV) for receiving GCMI for increasing number of registered GD diagnoses. We assessed crude and coverage-adjusted time trends of GD during 2004–2015 with a Poisson regression, using assigned sex and age as interaction terms. The PPV for receiving GCMI was 68% for ≥ 1 and 79% for ≥ 4 GD-diagnoses. The incidence of GD was on average 35% higher with the definition of ≥ 1 compared to the definition of ≥ 4 diagnoses. The incidence of GD, defined as ≥ 4 diagnoses increased significantly during the study period and mostly in the age categories 10–17 and 18–30 years, even after adjusting for register coverage. We concluded that the validity of a single ICD code denoting clinical GD in the Swedish NPR can be questioned. For future research, we propose to carefully weight the advantages and disadvantages of different register-based definitions according to the individual study’s needs, the time periods involved and the age-groups under study.

scholarly journals Involvement of Probiotics and Postbiotics in the Immune System Modulation

Biologics ◽  
2021 ◽  
Vol 1 (2) ◽  
pp. 89-110
Author(s):  
Neslihan Yeşilyurt ◽  
Birsen Yılmaz ◽  
Duygu Ağagündüz ◽  
Raffaele Capasso
Keyword(s):  
Immune System ◽  
Pharmaceutical Industry ◽  
Intestinal Microbiota ◽  
Health Benefits ◽  
The Body ◽  
Future Research ◽  
Immune Systems ◽  
Advantages And Disadvantages ◽  
Immune System Modulation ◽  
Molecular Patterns

Intestinal microbiota interacts with other systems, especially the immune system, which is responsible for protecting the body by recognizing “stranger” (pathogen associated molecular patterns-PAMPs) and “danger” (damage-associated molecular patterns-DAMPs) molecular motifs. In this manner, it plays an important role in the pathogenesis of various diseases and health. Despite the use of probiotics that modulate the intestinal microbiota in providing health benefits and in the treatment of diseases, there are some possible concerns about the possibility of developing adverse effects, especially in people with suppressed immune systems. Since probiotics provide health benefits with bioactive compounds, studies are carried out on the use of products containing non-living probiotic microorganisms (paraprobiotics) and/or their metabolites (postbiotics) instead of probiotic products. It is even reported that these microbial compounds have more immunomodulatory activities than living microorganisms via some possible mechanism and eliminates some disadvantages of probiotics. Considering the increasing use of functional foods in health and disease, further studies are needed with respect to the benefits and advantages of parabiotic and/or postbiotic use in the food and pharmaceutical industry as well as immune system modulation. Although probiotics have been extensive studied for a long time, it seems that postbiotics are promising tools for future research and applications according to the recent literature. This review aimed to evaluate the interaction of probiotics and postbiotics with the immune systems and also their advantages and disadvantages in the area of food-pharmaceutical industry and immune system modulation.

scholarly journals Toward the Development of a Comprehensive Clinically Oriented Patient Profile: A Systematic Review of the Purpose, Characteristic, and Methodological Quality of Classification Systems of Adult Spinal Deformity

Neurosurgery ◽  
2021 ◽  
Author(s):  
Kenny Yat Hong Kwan ◽  
J Naresh-Babu ◽  
Wilco Jacobs ◽  
Marinus de Kleuver ◽  
David W Polly ◽  
...  
Keyword(s):  
Systematic Review ◽  
Decision Making ◽  
Classification System ◽  
Methodological Quality ◽  
Literature Search ◽  
Adult Spinal Deformity ◽  
Classification Systems ◽  
Systematic Literature Search ◽  
Patient Profile

Abstract BACKGROUND Existing adult spinal deformity (ASD) classification systems are based on radiological parameters but management of ASD patients requires a holistic approach. A comprehensive clinically oriented patient profile and classification of ASD that can guide decision-making and correlate with patient outcomes is lacking. OBJECTIVE To perform a systematic review to determine the purpose, characteristic, and methodological quality of classification systems currently used in ASD. METHODS A systematic literature search was conducted in MEDLINE, EMBASE, CINAHL, and Web of Science for literature published between January 2000 and October 2018. From the included studies, list of classification systems, their methodological measurement properties, and correlation with treatment outcomes were analyzed. RESULTS Out of 4470 screened references, 163 were included, and 54 different classification systems for ASD were identified. The most commonly used was the Scoliosis Research Society-Schwab classification system. A total of 35 classifications were based on radiological parameters, and no correlation was found between any classification system levels with patient-related outcomes. Limited evidence of limited quality was available on methodological quality of the classification systems. For studies that reported the data, intraobserver and interobserver reliability were good (kappa = 0.8). CONCLUSION This systematic literature search revealed that current classification systems in clinical use neither include a comprehensive set of dimensions relevant to decision-making nor did they correlate with outcomes. A classification system comprising a core set of patient-related, radiological, and etiological characteristics relevant to the management of ASD is needed.

scholarly journals A Systematic Literature Review of Multi-Criteria Decision-Making Methods for Sustainable Selection of Insulation Materials in Buildings

2021 ◽  
Vol 13 (2) ◽  
pp. 737
Author(s):  
Indre Siksnelyte-Butkiene ◽  
Dalia Streimikiene ◽  
Tomas Balezentis ◽  
Virgilijus Skulskis
Keyword(s):  
Decision Making ◽  
Literature Review ◽  
Systematic Literature Review ◽  
Energy Demand ◽  
Energy Performance ◽  
Future Research ◽  
Multi Criteria Decision Making ◽  
Insulation Materials ◽  
Advantages And Disadvantages ◽  
Selection Of

The European Commission has recently adopted the Renovation Wave Strategy, aiming at the improvement of the energy performance of buildings. The strategy aims to at least double renovation rates in the next ten years and make sure that renovations lead to higher energy and resource efficiency. The choice of appropriate thermal insulation materials is one of the simplest and, at the same time, the most popular strategies that effectively reduce the energy demand of buildings. Today, the spectrum of insulation materials is quite wide, and each material has its own specific characteristics. It is recognized that the selection of materials is one of the most challenging and difficult steps of a building project. This paper aims to give an in-depth view of existing multi-criteria decision-making (MCDM) applications for the selection of insulation materials and to provide major insights in order to simplify the process of methods and criteria selection for future research. A systematic literature review is performed based on the Search, Appraisal, Synthesis and Analysis (SALSA) framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. In order to determine which MCDM method is the most appropriate for different questions, the main advantages and disadvantages of different methods are provided.

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