ABSTRACT
Osteoporotic vertebral fractures (OVFs) are often not reported by radiologists on routine chest radiographs. This study aims to investigate the clinical value of a newly developed artificial intelligence (AI) tool, Ofeye 1.0, for automated detection of OVFs on lateral chest radiographs in post-menopausal women (>60 years) who were referred to undergo chest x-rays for other reasons. A total of 510 de-identified lateral chest radiographs from three clinical sites were retrieved and analysed using the Ofeye 1.0 tool. These images were then reviewed by a consultant radiologist with findings serving as the reference standard for determining the diagnostic performance of the AI tool for the detection of OVFs. Of all the original radiologist reports, missed OVFs were found in 28.8% of images but were detected using the AI tool. The AI tool demonstrated high specificity of 92.8% (95% CI: 89.6, 95.2%), moderate accuracy of 80.3% (95% CI: 76.3, 80.4%), positive predictive value (PPV) of 73.7% (95% CI: 65.2, 80.8%), and negative predictive value (NPV) of 81.5% (95% CI: 79, 83.8%), but low sensitivity of 49% (95% CI: 40.7, 57.3%). The AI tool showed improved sensitivity compared with the original radiologist reports, which was 20.8% (95% CI: 14.5, 28.4). The new AI tool can be used as a complementary tool in routine diagnostic reports for the reduction in missed OVFs in elderly women.
ABSTRACT
Introducción: La principal causa de morbi-mortalidad pediátrica incluye el compromiso de la vía aérea, por lo que una correcta intubación salva la vida del paciente. El objetivo de este estudio fue determinar las variables predictivas de diámetro y longitud de inserción de tubo endotraqueal en niños intubados en el área de terapia Intensiva del Hospital Vicente Corral Moscoso, Cuenca-Ecuador. Métodos: En el presente estudio observacional con una muestra no probabilística tipo censo, se determinó el diámetro del tubo endotraqueal (DTE) utilizado y la profundidad de inserción mediante rayos x para determinar la Longitud del Tubo Endotraqueal (LTE). Se utiliza correlación y regresión lineal para predecir DTE y LTE en base a Edad, Peso y Talla de niños de 1 a 120 meses de edad. Se utiliza estadística no paramétrica. Resultados: Fueron 102 casos que constituyeron una frecuencia de intubación del 30.6 %, el motivo más frecuente fue patología respiratoria. La ecuación de predicción del DTE=3.54+0.14*(edad años) + 0.04*(Peso kg). R2=0.65, P=0.0001, para LTE=10.36+0.31*(edad años) + 0.18*(Peso kg). R2=0.65, P=0.0001. Conclusiones: El diámetro y longitud del tubo endotraqueal se correlacionan con variables propias de cada paciente como edad y peso
Introduction: The main cause of morbidity and mortality in pediatrics includes the compromise of the airway and ventilation, proper intubation will save the patient's life, being therefore transcendent to consider age, height, weight and sex. Objective: To determine the predictive variables of diameter and length of endotracheal tube insertion in children aged 1 to 120 months admitted to the Intensive Care area of Vicente Corral Moscoso Hospital. Methods: Correlational study, with a sample of 102 intubated patients, determined the size of the tube used and the depth of insertion using x-rays; For qualitative variables descriptive statistics were used, for the quantitative Kolmogorov-Smirnov test, in the bivariate analysis the Mann Whitney U and Spearman correlation was used. Subsequently, the multivariate linear regression analysis was executed, the final equation was modeled and Pearson coefficients were obtained, finally ANOVA analysis was performed. Results: The frequency of intubation was 30.6%, the most frequent reason was respiratory pathology. The diameter of the tube can be predicted individually using age, weight and height, and by combining age and weight the prediction increases to 64.9%. To estimate the depth of the tube, weight (63.4%), age and height are useful, and combining age and weight increases the accuracy to 65.2%. There is no correlation between diameter, insertion length and sex. Conclusions: The diameter and length of the endotracheal tube correlate with each patient's own variables such as age and weight
Subject(s)
Humans , Intensive Care Units, Pediatric , Child , Intubation, Intratracheal , Trachea , Radiography, ThoracicABSTRACT
BACKGROUND: The structured diagnosis of chest radiographs is an important basic competence in radiology and will be required in the student teaching with the implementation of the National Competency-Based Learning Catalog Medicine (NKLM) in Germany. AIM: The aim was to evaluate the extent to which second-year students gain confidence in the diagnosis of chest radiographs through a new curricular training for the diagnosis of chest radiographs with subsequent objective structured clinical examination (OSCE) and how confident they feel about meeting the expectations of the supervising medical colleagues during the clinical clerkship. METHODS: The training included four lectures and ten commented instructional films on the diagnosis of radiographs. Two years later, the students were asked how often and in what form they had contact with chest radiographs in their clinical clerkship. They were also asked how confident they felt in dealing in different areas. The students with training were also asked to what extent the lectures and the instructional films were helpful. The results of students in the last year without and the first year with training and OSCE were compared using the Mann-Whitney U test for independent samples. RESULTS: The frequency of dealing with chest radiographs was comparably high among students with and without training. The students with training and OSCE felt more confident and better prepared in dealing with chest radiographs than the students without training (varying between pâ¯< 0.001 and pâ¯= 0.148). They rated the educational films as more helpful than the lectures (mean 2.85⯱ 0.76 vs. 3.41⯱ 0.68 on a four-point scale). DISCUSSION: With early training, students' confidence in dealing with chest radiographs can be sustainably increased.
Subject(s)
Clinical Competence , Educational Measurement , Radiography, Thoracic , Feasibility Studies , Follow-Up Studies , Germany , Humans , Surveys and Questionnaires , X-RaysABSTRACT
We prospectively studied the feasibility and effectiveness of sputum induction in obtaining good quality sputum and its subsequent bacterial yield in children with clinically suspected acute lower-respiratory-tract infection (aLRTI). Good quality sputum was collected in 89/98 (91%) patients. Sputum cultures revealed ≥1 bacterial pathogens in 22 cases (25%). Adverse events were infrequent and mild (6%). Sputum induction is feasible in young children and leads to an increased number of etiological diagnoses of aLRTI.
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Objective To analyze the imaging characteristics of thoracic LDRD(Low-dose directly Digital Radiographic Device) and its artifacts.Methods 188 patients were performed with LDRD and common thoracic X-ray film respectively in our hospital during two weeks.Results Among the 188 cases,1.60%(3/188) showed thoracic motion artifacts.46.8%(88/188) appeared as tentorial prominence along left heart edge and 2.6%(5/188) along the right one.1 artifact was in aorta-pulmonary artery window(0.53%).Conclusion(1)Less than 0.5 should be taken as reference in podoid enlargement diagnosis.(2)Pseudomorph from heart motion may result from cardio-phase,cardiac contraction,heart rate,arrhythmia,local abnormal pulse of left heart edge,different enlarged velocity of cardiac cavity during heart beat,etc.(3)The motion artifacts in thoracic LDRD has no important influence in clinical diagnosis and therapy.