Objective: The Open Payments Program (OPP) was a database started in 2013 by the US government to report payments made by the medical device and pharmaceutical industry to physicians. Neurosurgery is a technologically advanced field that relies heavily on the latest innovations for complex treatment of its patient population. This study sought to explore the financial relationship between academic neurosurgeons and the industry.
View Article and Find Full Text PDFIntroduction: The use of extended reality (XR) technologies, including virtual, augmented, and mixed reality, has increased within surgical and procedural training programs. Few studies have assessed experiential learning- and patient-based outcomes using XR compared with standard training methods.
Methods: As a working group for the Society for Simulation in Healthcare, we used Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and a PICO strategy to perform a systematic review of 4238 articles to assess the effectiveness of XR technologies compared with standard training methods.
Aim: To investigate the impact of obesity on postoperative morbidity and mortality in patients who underwent anterior cervical discectomy and fusion (ACDF).
Material And Methods: The American College of Surgeons' National Surgical Quality Improvement Project (NSQIP) files from 2006 to 2019 were queried for all patients who underwent an ACDF. Fisher exact tests were used in analyzing univariate differences in preoperative comorbidities and postoperative morbidity and mortality between patients with and without obesity (BMI ?30 kg/ m < sup > 2 < /sup > ).
Interact Cardiovasc Thorac Surg
July 2022
The next chapter of the robotics revolution is well underway with the deployment of robots for a broad range of commercial use cases. Even in a myriad of applications and environments, there exists a common vocabulary of components that robots share-the need for a modular, scalable, and reliable architecture; sensing; planning; mobility; and autonomy. The Robot Operating System (ROS) was an integral part of the last chapter, demonstrably expediting robotics research with freely available components and a modular framework.
View Article and Find Full Text PDFBackground: Minimally invasive anatomic sublobar resection is increasingly being considered as an alternative to lobectomy in selected cases. However, this remains a technically challenging procedure and only 5 studies evaluating learning curves have been published to date. The aim of this study was to evaluate a single surgeon's learning curve for completely thoracoscopic anatomic sublobar resection.
View Article and Find Full Text PDFCumulative sum (CUSUM) plots and methods have wide-ranging applications in healthcare. We review and discuss some issues related to the analysis of surgical learning curve (LC) data with a focus on three types of CUSUM statistical approaches. The underlying assumptions, benefits, and weaknesses of each approach are given.
View Article and Find Full Text PDFSocial networks have become ubiquitous in modern society, which makes social network monitoring a research area of significant practical importance. Social network data consist of social interactions between pairs of individuals that are temporally aggregated over a certain interval of time, and the level of such temporal aggregation can have substantial impact on social network monitoring. There have been several studies on the effect of temporal aggregation in the process monitoring literature, but no studies on the effect of temporal aggregation in social network monitoring.
View Article and Find Full Text PDFObjective: This study evaluated a new insulin delivery system designed to reduce insulin delivery when trends in continuous glucose monitoring (CGM) glucose concentrations predict future hypoglycemia.
Research Design And Methods: Individuals with type 1 diabetes ( = 103, age 6-72 years, mean HbA 7.3% [56 mmol/mol]) participated in a 6-week randomized crossover trial to evaluate the efficacy and safety of a Tandem Diabetes Care t:slim X2 pump with Basal-IQ integrated with a Dexcom G5 sensor and a predictive low-glucose suspend algorithm (PLGS) compared with sensor-augmented pump (SAP) therapy.
Background: As the deployment of electronic medical records (EMR) expands, so is the availability of long-term datasets that could serve to enhance public health surveillance. We hypothesized that EMR-based surveillance systems that incorporate seasonality and other long-term trends would discover outbreaks of acute respiratory infections (ARI) sooner than systems that only consider the recent past.
Methods: We simulated surveillance systems aimed at discovering modeled influenza outbreaks injected into backgrounds of patients with ARI.
The purpose of this study was to assess impact of operator positioning on the development of musculoskeletal disorders (MSDs) and workforce issues among practicing dental hygienists in the state of Mississippi. The sample consisted of all dental hygienists (n=1,553) licensed in the state of Mississippi. A modified 47 item, online version of the Standardized Nordic Questionnaire was used to document the following: types of MSDs, practice history, operator positioning, ergonomic work habits and the impact of MSDs on workforce issues.
View Article and Find Full Text PDFMethodology Issue: The traditional implementation of the risk-adjusted Bernoulli cumulative sum (CUSUM) chart for monitoring surgical outcome quality requires waiting a pre-specified period of time after surgery before incorporating patient outcome information.
Proposed Solution: We propose a simple but powerful implementation of the risk-adjusted Bernoulli CUSUM chart that incorporates outcome information as soon as it is available, rather than waiting a pre-specified period of time after surgery.
Evaluation: A simulation study is presented that compares the performance of the traditional implementation of the risk-adjusted Bernoulli CUSUM chart to our improved implementation.
For a patient who has survived a surgery, there could be several levels of recovery. Thus, it is reasonable to consider more than two outcomes when monitoring surgical outcome quality. The risk-adjusted cumulative sum (CUSUM) chart based on multiresponses has been developed for monitoring a surgical process with three or more outcomes.
View Article and Find Full Text PDFBackground And Objectives: To improve hospital to home transitions, a 4-element pediatric patient-centered transition bundle was developed, including: a transition readiness checklist; predischarge teach-back education; timely and complete written handoff to the primary care provider; and a postdischarge phone call. The objective of this study was to demonstrate the feasibility of bundle implementation and report initial outcomes at 4 pilot sites. Outcome measures included postdischarge caregiver ability to teach-back key home management information and 30-day reuse rates.
View Article and Find Full Text PDFBackground: There is considerable recent interest in the monitoring of individual surgeon or hospital surgical outcomes. If one aggregates data over time and assesses performance with a funnel plot, then the detection of any process deterioration or improvement could be delayed. The variable life adjusted display (VLAD) is widely used for monitoring on a case-by-case basis, but we show that use of the risk-adjusted Bernoulli cumulative sum (RA-CUSUM) chart leads to much better performance.
View Article and Find Full Text PDFThe risk-adjusted Bernoulli cumulative sum (CUSUM) chart developed by Steiner et al. (2000) is an increasingly popular tool for monitoring clinical and surgical performance. In practice, however, the use of a fixed control limit for the chart leads to a quite variable in-control average run length performance for patient populations with different risk score distributions.
View Article and Find Full Text PDFInt J Qual Health Care
February 2015
Objective: This research is designed to examine the impact of varying patient population distributions on the in-control performance of the risk-adjusted Bernoulli CUSUM chart.
Design: The in-control performance of the chart is compared based on sampling the Parsonnet scores with replacement from five realistic subsets of a given distribution.
Settings: Five patient mixes with different Parsonnet score distributions are created from a real patient population.
Context: Young adult smokers have the highest smoking prevalence among all US age groups but are least likely to use evidence-based cessation counseling or medication to quit.
Objective: Use and effectiveness of nicotine patch were explored in a randomized trial evaluating smoking cessation interventions with this population.
Participants: Smokers aged 18 to 30 (n = 3094) were recruited through online and off-line methods and from telephone quit lines and analyzed.
Background: The University of California, Irvine Blood Donor Center operates a plateletpheresis donor program utilizing the Amicus Cell Separator. Plateletpheresis donors may donate one or more apheresis platelet (PLT) units per collection event. This study seeks to characterize UC Irvine's donor pool by identifying biometric and demographic attributes predictive of double product (DP) collections.
View Article and Find Full Text PDFInt J Inj Contr Saf Promot
February 2015
This paper quantitatively motivates the need for active monitoring of occupational safety incident data through the use of cumulative sum (CUSUM) control charts. The frequency of incidents within a subset of historical accident data is analysed. The performance of Poisson CUSUM and exponential CUSUM (time-between-events) charts is compared in an illustrative example to show that shorter periods of aggregation and time-between-events monitoring lead to more timely indications of increased accident frequency.
View Article and Find Full Text PDFObjective: The primary purpose of this study was to identify the practitioner competencies that occupational therapists perceive as important for handwriting evaluation and intervention in school-aged children. A secondary purpose was to compare the practitioner perceptions of those in school-based practice with those from other primary practice settings.
Method: A stratified random sample of 376 occupational therapists recruited from a national professional organization database participated by completing a survey instrument containing 80 competency items.
Health surveillance involves collecting public health data on chronic and infectious diseases to detect changes in disease incidence rates in order to improve public health. Timely detection of disease clusters is essential in prospective public health surveillance. Most existing health surveillance research is based on the assumption that observations from different regions are independent.
View Article and Find Full Text PDFIn this paper we examine some of the methodologies implemented by the Centers for Disease Control and Prevention's (CDC) BioSense program. The program uses data from hospitals and public health departments to detect outbreaks using the Early Aberration Reporting System (EARS). The EARS method W2 allows one to monitor syndrome counts (W2count) from each source and the proportion of counts of a particular syndrome relative to the total number of visits (W2rate).
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