Performance and clinical applicability of machine learning in liver computed tomography imaging: a systematic review.

Objectives: Machine learning (ML) for medical imaging is emerging for several organs and image modalities. Our objectives were to provide clinicians with an overview of this field by answering the following questions: (1) How is ML applied in liver computed tomography (CT) imaging? (2) How well do ML systems perform in liver CT imaging? (3) What are the clinical applications of ML in liver CT imaging?

Methods: A systematic review was carried out according to the guidelines from the PRISMA-P statement. The search string focused on studies containing content relating to artificial intelligence, liver, and computed tomography.

Group-based multimodal physical therapy in women with chronic pelvic pain: A randomized controlled trial.

Introduction: Chronic pelvic pain in women is a complex condition, and physical therapy is recommended as part of a broader treatment approach. The objective of this study was to compare structured group-based multimodal physical therapy in a hospital setting (intervention group) with primary-care physical therapy (comparator group) for women with chronic pelvic pain.

Material And Methods: Women aged 20-65 years with pelvic pain ≥6 months and referred for physical therapy were eligible.

Using anchors from free text in electronic health records to diagnose postoperative delirium.

Objectives: Postoperative delirium is a common complication after major surgery among the elderly. Despite its potentially serious consequences, the complication often goes undetected and undiagnosed. In order to provide diagnosis support one could potentially exploit the information hidden in free text documents from electronic health records using data-driven clinical decision support tools.

Analysis of free text in electronic health records for identification of cancer patient trajectories.

With an aging patient population and increasing complexity in patient disease trajectories, physicians are often met with complex patient histories from which clinical decisions must be made. Due to the increasing rate of adverse events and hospitals facing financial penalties for readmission, there has never been a greater need to enforce evidence-led medical decision-making using available health care data. In the present work, we studied a cohort of 7,741 patients, of whom 4,080 were diagnosed with cancer, surgically treated at a University Hospital in the years 2004-2012.

Predicting colorectal surgical complications using heterogeneous clinical data and kernel methods.

Objective: In this work, we have developed a learning system capable of exploiting information conveyed by longitudinal Electronic Health Records (EHRs) for the prediction of a common postoperative complication, Anastomosis Leakage (AL), in a data-driven way and by fusing temporal population data from different and heterogeneous sources in the EHRs.

Material And Methods: We used linear and non-linear kernel methods individually for each data source, and leveraging the powerful multiple kernels for their effective combination. To validate the system, we used data from the EHR of the gastrointestinal department at a university hospital.

What device should be used for telementoring? Randomized controlled trial.

Background And Objective: The paper analyzes behavioral patterns of mentors while using different mentoring devices to demonstrate the feasibility of multi-platform mentoring. The fundamental differences of devices supporting telementoring create threats for the perception and interpretation of the transmitted video, highlighting the necessity of exploring hardware usability aspects in a safety critical surgical mentoring scenario.

Materials And Methods: Three types of devices, based on the screen size, formed the arms for the randomized controlled trial.

Nationwide improvement of rectal cancer treatment outcomes in Norway, 1993-2010.

Background: The Norwegian Rectal Cancer Project was initated in 1993 with the aims of improving surgery, decreasing local recurrence rates, improving survival, and establishing a national rectal cancer registry. Here we present results from the Norwegian Colorectal Cancer Registry (NCCR) from 1993 to 2010.

Material And Methods: A total of 15 193 patients were diagnosed with rectal cancer in Norway 1993-2010, and were registered with clinical data regarding diagnosis, treatment, locoregional recurrences and distant metastases.

Data-driven Temporal Prediction of Surgical Site Infection.

Analysis of data from Electronic Health Records (EHR) presents unique challenges, in particular regarding nonuniform temporal resolution of longitudinal variables. A considerable amount of patient information is available in the EHR - including blood tests that are performed routinely during inpatient follow-up. These data are useful for the design of advanced machine learning-based methods and prediction models.

Support Vector Feature Selection for Early Detection of Anastomosis Leakage From Bag-of-Words in Electronic Health Records.

The free text in electronic health records (EHRs) conveys a huge amount of clinical information about health state and patient history. Despite a rapidly growing literature on the use of machine learning techniques for extracting this information, little effort has been invested toward feature selection and the features' corresponding medical interpretation. In this study, we focus on the task of early detection of anastomosis leakage (AL), a severe complication after elective surgery for colorectal cancer (CRC) surgery, using free text extracted from EHRs.

Implementation of an electronic surgical referral service. Collaboration, consensus and cost of the surgeon - general practitioner Delphi approach.

Background: Poor coordination between levels of care plays a central role in determining the quality and cost of health care. To improve patient coordination, systematic structures, guidelines, and processes for creating, transferring, and recognizing information are needed to facilitate referral routines.

Methods: Prospective observational survey of implementation of electronic medical record (EMR)-supported guidelines for surgical treatment.

Telementoring in education of laparoscopic surgeons: An emerging technology.

Laparoscopy, minimally invasive and minimal access surgery with more surgeons performing these advanced procedures. We highlight in the review several key emerging technologies such as the telementoring and virtual reality simulators, that provide a solid ground for delivering surgical education to rural area and allow young surgeons a safety net and confidence while operating on a newly learned technique.

A prospective analysis of false positive events in a National Colon Cancer Surveillance Program.

Background: The survival benefits of colon cancer surveillance programs are well delineated, but less is known about the magnitude of false positive testing. The objective of this study was to estimate the false positive rate and positive predictive value of testing as part of a surveillance program based on national guidelines, and to estimate the degree of testing and resource use needed to identify a curable recurrence.

Methods: Analysis of clinically significant events leading to suspicion of cancer recurrence, false positive events, true cancer recurrences, time to confirmation of diagnosis, and resource use (radiology, blood samples, colonoscopies, consultations) among patients included in a randomised colon cancer surveillance trial.

Telemedical technologies in urological cancer care: past, present and future applications.

Since the initial development of telegraphy by Sir Charles Wheatstone in 1837 and the telephone by Alexander Graham Bell in 1875, doctors have been able to convey medical information across great distances. The exchange and sharing of medical information has evolved and adapted to suit the vast array of today's medicine. Early adopters of telemedicine within clinical practice have gained significant health economic benefits.

Cost-effectiveness and quality of life in surgeon versus general practitioner-organised colon cancer surveillance: a randomised controlled trial.

Objective: To assess whether colon cancer follow-up can be organised by general practitioners (GPs) without a decline in the patient's quality of life (QoL) and increase in cost or time to cancer diagnoses, compared to hospital follow-up.

Design: Randomised controlled trial.

Setting: Northern Norway Health Authority Trust, 4 trusts, 11 hospitals and 88 local communities.

Surgical telementoring in knowledge translation--clinical outcomes and educational benefits: a comprehensive review.

Background: Surgical telementoring has been reported for decades. However, there exists limited evidence of clinical outcome and educational benefits.

Objective: To perform a comprehensive review of surgical telementoring surveys published in the past 2 decades.

Sacral nerve stimulation.

Background: Sacral nerve stimulation implies electrical stimulation of a sacral nerve root by an electrode and a pacemaker. Within the past few years, sacral nerve stimulation has become a possible treatment option for selected patients with urinary retention, urinary incontinence, anal incontinence and constipation. The method is furthermore being tested for several other conditions.

International trends in surgical treatment of rectal cancer.

Background: Surgical technique might influence rectal cancer survival, yet international practices for surgical treatment of rectal cancer are poorly described.

Methods: We performed a cross-sectional survey in a cohort of experienced colorectal surgeons representing 123 centers.

Results: Seventy-one percent responded, 70% are from departments performing more than 50 proctectomies annually.

[Overactive pelvic floor syndrome].

Background: The etiology of the overactive pelvic floor syndrome is not fully understood and no gold standards are available for diagnosis or treatment. The article presents an overview of literature, and discusses diagnostics and treatment.

Material And Methods: Literature was identified through a non-systematic search in PubMed, and discussed in light of the authors' clinical experience with the patient group.

International preoperative rectal cancer management: staging, neoadjuvant treatment, and impact of multidisciplinary teams.

Background: Little is known regarding variations in preoperative treatment and practice for rectal cancer (RC) on an international level, yet practice variation may result in differences in recurrence and survival rates.

Methods: One hundred seventy-three international colorectal centers were invited to participate in a survey of preoperative management of rectal cancer.

Results: One hundred twenty-three (71%) responded, with a majority of respondents from North America, Europe, and Asia.

A standardized technique for laparoscopic rectal resection.

Introduction: Laparoscopic rectal resection (LRR) has not gained the same acceptance as laparoscopic segmental colonic resection because of technical challenges, increased operating time and costs, and concerns about the oncological outcome.

Discussion: One way to overcome these challenges is by standardizing the laparoscopic technique in the same way as has been done with the open rectal cancer surgery. We have established a standardized, stepwise laparoscopic procedure for rectal resections that enhances the transformation of laparoscopic skills, identifies indications for conversion early in the operation, and makes the operation predictable and reproducible for the whole surgical team.

Chronic abdominal wall pain--a diagnostic challenge for the surgeon.

Background: Chronic abdominal wall pain (CAWP) occurs in about 30% of all patients presenting with chronic abdominal pain.

Methods: The authors review the literature identified in a PubMed search regarding the abdominal wall as the origin of chronic abdominal pain.

Results: CAWP is frequently misinterpreted as visceral or functional abdominal pain.

Overcoming distance: video-conferencing as a clinical and educational tool among surgeons.

Background: Since the 1960s, there has been substantial development in the uses of video-conferencing (VC) among medical personnel, including surgeons who have adopted the technology.

Methods: A report on our own experience with VC was combined with a comprehensive PubMed search with the key words telepresence, video-conferencing, video-teleconferencing, telementoring and surgery, trauma, follow-up, education, and multidisciplinary teams. A search through two peer-reviewed telemedicine journals -- Journal of Telemedicine and Telecare and Telemedicine and e-Health Journal -- and references of all included papers and identified additional reports was conducted.

Laparoscopic rectal resections and fast-track surgery: what can be expected?

Background: We present the results of combining protocols of standardized laparoscopic rectal resection (LRR) and perioperative fast track care.

Methods: Patients undergoing LRRs were identified from a prospectively maintained, institutional review board-approved database. Perioperative fast track care and laparoscopic operations were performed according to a standardized system.

Validation of a novel postoperative quality-of-life scoring system.

Background: No specific scoring system exists for the assessment of postoperative quality of life (QOL) after major abdominal surgery. This study prospectively validates PQL, a novel prospective scoring system in patients having laparoscopic or open major abdominal colorectal surgery.

Methods: Six experienced surgeons developed the questionnaire.