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Examining Ultrasound Diagnostic Performance Improvement with Utilization of Maternal-Fetal Medicine Tele-Interpretation.

Am J Obstet Gynecol MFM 2021 May 3:100389. Epub 2021 May 3.

Maternal and Child Health Research Center, Department of Obstetrics & Gynecology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.

Background: Telemedicine can extend essential health services to under-resourced settings and improve level and quality of obstetric care. Specifically, evaluation and management of fetal anomalies often requires perinatal subspecialists, rendering prenatal diagnosis essential, and may benefit from telemedicine platforms to improve access to care.

Objective: This study examines the impact of a maternal-fetal medicine (MFM) tele-ultrasound program on diagnostic accuracy of fetal anomalies when deployed within practices where ultrasounds are otherwise interpreted by general obstetricians or family medicine physicians. Read More

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Does Advanced Trauma Life Support Training work? 10-Year Follow Up of Advanced Trauma Life Support India Program.

J Am Coll Surg 2021 Apr 28. Epub 2021 Apr 28.

- Sharda Hospital, Greater Noida, Uttar Pradesh, India, & Advanced Trauma Life Support, India.

Background: Studies evaluating the efficacy of ATLS in Low & Middle-income countries (LMICs) are limited. We followed up ATLS providers certified by ATLS India program over a decade (2008-2018), aiming at measuring the benefits, if any, in knowledge, skills & attitude (KSA) from ATLS, and attrition over time.

Methods: Survey instrument was developed taking a cue from published literature on ATLS and improvised using the Delphi method. Read More

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Ultrasound-guided regional anesthesia in the emergency department: an argument for multidisciplinary collaboration to increase access while maintaining quality and standards.

Reg Anesth Pain Med 2021 May 5. Epub 2021 May 5.

Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.

The practice of ultrasound-guided regional anesthesia (UGRA) by emergency medicine physicians in the emergency department (ED) is increasing. The need for effective alternatives to opioid analgesia in the acute care setting likely exceeds the current capacity of UGRA-trained anesthesia teams. In this daring discourse, we outline several matters of relevance to be considered as protocols are put into place to facilitate the practice of UGRA by emergency medicine physicians in the ED. Read More

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Hospital staff, volunteers' and patients' perceptions of barriers and facilitators to communication following stroke in an acute and a rehabilitation private hospital ward: a qualitative description study.

BMJ Open 2021 May 5;11(5):e043897. Epub 2021 May 5.

School of Medical and Health Sciences, Edith Cowan University, Joondalup, Perth, Australia.

Objectives: To explore barriers and facilitators to patient communication in an acute and rehabilitation ward setting from the perspectives of hospital staff, volunteers and patients following stroke.

Design: A qualitative descriptive study as part of a larger study which aimed to develop and test a Communication Enhanced Environment model in an acute and a rehabilitation ward.

Setting: A metropolitan Australian private hospital. Read More

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Dignity-conserving palliative care in a diverse population: A qualitative study of physicians' perspective.

Palliat Support Care 2021 May 6:1-7. Epub 2021 May 6.

Department of Public & Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands.

Background: Preserving personal dignity is an important aim of palliative care. Little is known about how physicians perceive and preserve dignity of patients from non-western migration backgrounds. Insight in this is important given the increased demand for culturally sensitive palliative care. Read More

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Knowledge, attitude, and practice regarding atrial fibrillation among primary care physicians: the potential role of postgraduate training.

Malays Fam Physician 2021 Mar 7;16(1):39-49. Epub 2021 Feb 7.

MFamMed (UM), FRACGP, FAMM. Professor, Department of Family Medicine, International Medical University, Seremban Campus, Seremban, Negeri Sembilan, Malaysia.

Introduction: Atrial fibrillation (AF) is known to lead to stroke and thromboembolism, causing a five-fold increase in the risk of stroke and almost doubling the mortality rate. Optimal anticoagulant therapy is effective in reducing AF-related death. However, prescription of anticoagulants in AF in East Asian countries has been low, ranging from 0. Read More

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Assessment of an AI Aid in Detection of Adult Appendicular Skeletal Fractures by Emergency Physicians and Radiologists: A Multicenter Cross-sectional Diagnostic Study.

Radiology 2021 May 4:203886. Epub 2021 May 4.

From the Department of Radiology, Hôpital Fondation A. de Rothschild, 25 rue Manin, 75019 Paris, France (L.D.); Faculty of Medicine, Université de Paris, Paris, France (L.D., A. Feydy); Gleamer, Paris, France (A.D., C.A., N.C., Z.Z., N.N., E.L., A.P., N.E.R.); Department of Biostatistics, CHU Rouen, Rouen, France (A.G.); Department of Radiology, Hôpital Hôtel-Dieu, Assistance Publique-Hôpitaux de Paris, Paris, France (J.L.); Department of Radiology, Hôpital Ambroise-Paré, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt, France (A. Felter); Department of Radiology, Hôpital Raymond-Poincaré, Assistance Publique-Hôpitaux de Paris, Garches, France (A. Felter); and Department of Radiology B, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France (L.L., N.E.R., A. Feydy).

Background The interpretation of radiographs suffers from an ever-increasing workload in emergency and radiology departments, while missed fractures represent up to 80% of diagnostic errors in the emergency department. Purpose To assess the performance of an artificial intelligence (AI) system designed to aid radiologists and emergency physicians in the detection and localization of appendicular skeletal fractures. Materials and Methods The AI system was previously trained on 60 170 radiographs obtained in patients with trauma. Read More

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News Sentiment Informed Time-series Analyzing AI (SITALA) to curb the spread of COVID-19 in Houston.

Expert Syst Appl 2021 Apr 29:115104. Epub 2021 Apr 29.

Address: Rice University, 6100 Main St, MS-321, Houston, TX 77005, USA.

Coronavirus disease (COVID-19) has evolved into a pandemic with many unknowns. Houston, located in the Harris County of Texas, is becoming the next hotspot of this pandemic. With a severe decline in international and inter-state travel, a model at the county level is needed as opposed to the state or country level. Read More

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Artificial intelligence improves the accuracy of residents in the diagnosis of hip fractures: a multicenter study.

BMC Musculoskelet Disord 2021 May 3;22(1):407. Epub 2021 May 3.

Nonprofit Organization (NPO) Nagoya Orthopedic Regional Healthcare Support Center, AI Research Division, Meitohonmachi 2-22-1, Meito-ward, Nagoya, Japan.

Background: Less experienced clinicians sometimes make misdiagnosis of hip fractures. We developed computer-aided diagnosis (CAD) system for hip fractures on plain X-rays using a deep learning model trained on a large dataset. In this study, we examined whether the accuracy of the diagnosis of hip fracture of the residents could be improved by using this system. Read More

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Feasibility of fast cardiovascular magnetic resonance strain imaging in patients presenting with acute chest pain.

PLoS One 2021 3;16(5):e0251040. Epub 2021 May 3.

Department of Cardiology, Angiology and Pneumology, University of Heidelberg, Heidelberg, Germany.

Background: Cardiovascular magnetic resonance (CMR) is the current reference standard for the quantitative assessment of ventricular function. Fast Strain-ENCoded (fSENC)-CMR imaging allows for the assessment of myocardial deformation within a single heartbeat. The aim of this pilot study was to identify obstructive coronary artery disease (oCAD) with fSENC-CMR in patients presenting with new onset of chest pain. Read More

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Convolutional Neural Networks for Automated PET/CT Detection of Diseased Lymph Node Burden in Patients with Lymphoma.

Radiol Artif Intell 2020 Sep 2;2(5):e200016. Epub 2020 Sep 2.

Department of Medical Physics, University of Wisconsin-Madison, Madison Wis (A.J.W., R.J.); Department of Radiology, Wisconsin Institutes for Medical Research, University of Wisconsin-Madison, 1111 Highland Ave, Room 1005, Madison, WI 53705 (M.W.K., S.B.P., T.J.B.); Department of Hematology, Rigshospitalet, Copenhagen, Denmark (M.H.); Faculty of Mathematics and Physics, University of Ljubljana, Ljubljana, Slovenia (R.J.); and Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, Va (L.K.).

Purpose: To automatically detect lymph nodes involved in lymphoma on fluorine 18 (F) fluorodeoxyglucose (FDG) PET/CT images using convolutional neural networks (CNNs).

Materials And Methods: In this retrospective study, baseline disease of 90 patients with lymphoma was segmented on F-FDG PET/CT images (acquired between 2005 and 2011) by a nuclear medicine physician. An ensemble of three-dimensional patch-based, multiresolution pathway CNNs was trained using fivefold cross-validation. Read More

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September 2020

Convolutional Neural Networks for Automatic Risser Stage Assessment.

Radiol Artif Intell 2020 May 27;2(3):e180063. Epub 2020 May 27.

Department of Software and IT Engineering, Ecole de Technologie Supérieure, 1100 rue Notre-Dame Ouest, Montréal, QC, Canada H3C 1K3 (H.K., L.D.); Division of Orthopedics, Sainte-Justine Hospital, Montréal, Canada (J.J., C.B., I.N., O.C., S.P., G.G., H.L.); and Department of Surgery, Université de Montréal, Montréal, Canada (M.L.N., S.P., G.G., H.L.).

Purpose: To develop an automatic method for the assessment of the Risser stage using deep learning that could be used in the management panel of adolescent idiopathic scoliosis (AIS).

Materials And Methods: In this institutional review board approved-study, a total of 1830 posteroanterior radiographs of patients with AIS (age range, 10-18 years, 70% female) were collected retrospectively and graded manually by six trained readers using the United States Risser staging system. Each radiograph was preprocessed and cropped to include the entire pelvic region. Read More

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Automatic Hip Fracture Identification and Functional Subclassification with Deep Learning.

Radiol Artif Intell 2020 Mar 25;2(2):e190023. Epub 2020 Mar 25.

Departments of Orthopaedic Surgery (J.D.K., K.M.H., P.T., E.G.M., E.J.G., M.Z.), Emergency Medicine (B.F.D., K.A.P.), and Radiology and Biomedical Imaging (K.C.M., R.P., J.H.S., A.W., E.O., S.M., V.P.), University of California, San Francisco, 6945 Geary Blvd, San Francisco, CA 94121; and Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, Berkeley, Calif (K.V.C.).

Purpose: To investigate the feasibility of automatic identification and classification of hip fractures using deep learning, which may improve outcomes by reducing diagnostic errors and decreasing time to operation.

Materials And Methods: Hip and pelvic radiographs from 1118 studies were reviewed, and 3026 hips were labeled via bounding boxes and classified as normal, displaced femoral neck fracture, nondisplaced femoral neck fracture, intertrochanteric fracture, previous open reduction and internal fixation, or previous arthroplasty. A deep learning-based object detection model was trained to automate the placement of the bounding boxes. Read More

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A National Survey of Attitudes and Practices of Physicians Relating to Therapeutic Drug Monitoring and Clinical Pharmacokinetic Service: Strategies for Enhancing Patient's Care in Saudi Arabia.

Int J Gen Med 2021 23;14:1513-1524. Epub 2021 Apr 23.

Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, 11451, Saudi Arabia.

Purpose: The aim of the study was to evaluate physicians' perception of the concept of pharmacokinetics and therapeutic drug monitoring (PK/TDM) and their use in clinical practice.

Methods: A novel, structured, self-administered questionnaire was designed, validated and distributed to physicians in 3 major cities in Saudi Arabia (Riyadh, Jeddah, Dammam) during a 4-month period. Data were collected on demographics, knowledge and practice of PK/TDM. Read More

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"We don't have up to date knowledge about the disease" Practical challenges encountered in delivery of cervical cancer screening in Iraq.

Eur J Cancer Care (Engl) 2021 May 1:e13457. Epub 2021 May 1.

School of Biomedical Sciences, Faculty of Medicine and Dentistry, University of Plymouth, Plymouth, UK.

This qualitative study aimed to explore the lived experience of medical doctors in delivering cervical cancer screening in a city in Iraq.

Methods: An applied grounded theory approach explored the reported experiences of doctors in the field. A purposive sample of 12 gynaecologists and one general practitioner (GP) working in two main hospitals participated: Semi-structured interviews took place from June to September 2015. Read More

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Pandemic response in pluralistic health systems: a cross-sectional study of COVID-19 knowledge and practices among informal and formal primary care providers in Bihar, India.

BMJ Open 2021 04 30;11(4):e047334. Epub 2021 Apr 30.

Bill and Melinda Gates Foundation India, New Delhi, Delhi, India.

Objectives: Responding to pandemics is challenging in pluralistic health systems. This study assesses COVID-19 knowledge and case management of informal providers (IPs), trained practitioners of Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy (AYUSH) and Bachelor of Medicine, Bachelor of Surgery (MBBS) medical doctors providing primary care services in rural Bihar, India.

Design: This was a cross-sectional study of primary care providers conducted via telephone between 1 and 15 July 2020. Read More

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Laterality and severity of nasal obstruction does not correlate between physicians and patients, nor among physicians.

Am J Otolaryngol 2021 Apr 24;42(6):103039. Epub 2021 Apr 24.

Boston University School of Medicine, Boston, MA, United States of America. Electronic address:

Background: Nasal obstruction is a common patient complaint and has a variety of etiologies, and a specific anatomical abnormality can often be found within the nasal cavity on physical examination. In practice, this observed pathology does not always correlate with the laterality, severity, and exact intranasal site of the patients' perceived obstruction.

Objectives: We seek to answer the following questions: 1) Does a physician's evaluation of nasal obstruction correlate with subjective patient complaints? 2) Is there reasonable correlation between physicians of similar training in the routine evaluation of nasal obstruction?

Methods: First, we asked patients presenting to the otolaryngology clinic with a primary complaint of nasal obstruction to fill out a modified NOSE survey. Read More

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Capacity Building in Mental Health for Bihar: Overview of the 1-Year Blended Training Program for Nonspecialist Medical Officers.

J Neurosci Rural Pract 2021 Apr 23;12(2):329-334. Epub 2021 Apr 23.

University of New Mexico School of Medicine, Albuquerque, New Mexico, United States.

 The aim of this study is to give an experiential overview of a 1-year blended training program for nonspecialist medical officers (primary care doctors; PCDs) of Bihar State of India. The training program was aimed to enable PCDs identify, diagnose, and treat commonly presenting psychiatric disorders in primary care  PCDs had a brief onsite orientation program to psychiatric practice at National Institute of Mental Health and Neuro-Sciences (NIMHANS), followed by 10 months of online blended training. The online program followed the NIMHANS Virtual Knowledge- Extension for Community Healthcare Outcomes (ECHO) model, that is, a hub and spokes model of training  Twenty-two PCDs participated in this program. Read More

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Intelligent Diagnosis of Thyroid Ultrasound Imaging Using an Ensemble of Deep Learning Methods.

Medicina (Kaunas) 2021 Apr 19;57(4). Epub 2021 Apr 19.

Department of Medical Informatics and Biostatistics, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania.

: At present, thyroid disorders have a great incidence in the worldwide population, so the development of alternative methods for improving the diagnosis process is necessary. : For this purpose, we developed an ensemble method that fused two deep learning models, one based on convolutional neural network and the other based on transfer learning. For the first model, called 5-CNN, we developed an efficient end-to-end trained model with five convolutional layers, while for the second model, the pre-trained VGG-19 architecture was repurposed, optimized and trained. Read More

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A Novel Deep Learning Method for Recognition and Classification of Brain Tumors from MRI Images.

Diagnostics (Basel) 2021 Apr 21;11(5). Epub 2021 Apr 21.

Data Science and Cyber Analytics Research Group, Edinburgh Napier University, Edinburgh EH11 4DY, UK.

A brain tumor is an abnormal growth in brain cells that causes damage to various blood vessels and nerves in the human body. An earlier and accurate diagnosis of the brain tumor is of foremost important to avoid future complications. Precise segmentation of brain tumors provides a basis for surgical planning and treatment to doctors. Read More

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Evaluating the Practice of Preventive Behaviors and the Fear of COVID-19 among Dentists in Oradea Metropolitan Area after the First Wave of Pandemic; a Cross-Sectional Study.

Healthcare (Basel) 2021 Apr 9;9(4). Epub 2021 Apr 9.

Faculty of Psychology and Education Sciences, "Alexandru Ioan Cuza" University, 700554 Iasi, Romania.

Dental clinics were suspected to be a hotspot for nosocomial transmission of COVID-19 due to the easy spread of the virus. The study investigated the preventive behaviors applied in dentistry settings and the level of fear of COVID-19 infection among dentists. A total of 83 respondents (34. Read More

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Physician and nurses' perception of paediatric trauma care in Israeli emergency departments.

Nurs Crit Care 2021 Apr 29. Epub 2021 Apr 29.

Department of Health Systems Management, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.

Background: Treatment of paediatric trauma requires specialized infrastructure, medical equipment, medical staff and ancillary support personnel that have been specifically trained for such tasks.

Aims And Objectives: To examine the perceptions and attitudes of physicians and nurses in general and paediatric emergency departments (PEDs) on training, confidence, and management of paediatric trauma in order to facilitate the establishment of an optimal model for admitting and treating paediatric trauma patients.

Design: Drawing on published literature and a previously conducted qualitative study that explored the provision of medical care to paediatric trauma patients, we conducted an attitude survey. Read More

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[Home infusion therapy for Pompe disease: Recommendations for German-speaking countries].

Fortschr Neurol Psychiatr 2021 Apr 27. Epub 2021 Apr 27.

Friedrich-Baur- Institut der Neurologischen Klinik , Klinikum der Universität München, Deutschland.

Background: Pompe disease is a lysosomal multisystem disorder with predominant proximal myopathy. Treatment with enzyme replacement therapy (ERT) is available requiring life-long biweekly infusions of recombinant α-glucosidase. To minimize the burden of ERT patients ask for home infusion therapy. Read More

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MADGAN: unsupervised medical anomaly detection GAN using multiple adjacent brain MRI slice reconstruction.

BMC Bioinformatics 2021 Apr 26;22(Suppl 2):31. Epub 2021 Apr 26.

Research Center for Medical Big Data, National Institute of Informatics, Tokyo, Japan.

Background: Unsupervised learning can discover various unseen abnormalities, relying on large-scale unannotated medical images of healthy subjects. Towards this, unsupervised methods reconstruct a 2D/3D single medical image to detect outliers either in the learned feature space or from high reconstruction loss. However, without considering continuity between multiple adjacent slices, they cannot directly discriminate diseases composed of the accumulation of subtle anatomical anomalies, such as Alzheimer's disease (AD). Read More

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A Deep Learning Approach for Automatic Seizure Detection in Children With Epilepsy.

Front Comput Neurosci 2021 8;15:650050. Epub 2021 Apr 8.

Department of Electrical and Computer Engineering, University of Louisiana at Lafayette, Lafayette, LA, United States.

Over the last few decades, electroencephalogram (EEG) has become one of the most vital tools used by physicians to diagnose several neurological disorders of the human brain and, in particular, to detect seizures. Because of its peculiar nature, the consequent impact of epileptic seizures on the quality of life of patients made the precise diagnosis of epilepsy extremely essential. Therefore, this article proposes a novel deep-learning approach for detecting seizures in pediatric patients based on the classification of raw multichannel EEG signal recordings that are minimally pre-processed. Read More

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Knowledge and Associated Factors of Medical Students Regarding Radiation Exposure from Common Diagnostic Imaging Procedures at the University of Gondar, Ethiopia.

Ethiop J Health Sci 2020 Jul;30(4):589-598

Department of Environmental and Occupational Health & Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P.O. Box, 196, Gondar, Ethiopia.

Background: Physicians' knowledge about radiation exposure and risks was previously reported as inadequate. Therefore, the aim of this study was to assess knowledge and associated factors regarding radiation exposure among medical students from common diagnostic imaging procedures at the University of Gondar.

Methods: A cross-sectional study was conducted to assess knowledge and associated factors regarding radiation exposure among medical students. Read More

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An impact of a digitally driven primary care psychiatry program on the integration of psychiatric care in the general practice of primary care doctors.

Indian J Psychiatry 2020 Nov-Dec;62(6):690-696. Epub 2020 Dec 12.

Department of Psychiatry, Tele Medicine Centre, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.

Introduction: The prevalence of psychiatric disorders among the general population is 10.6%. Primary care doctors (PCDs) are often the first contact for patients with common psychiatric disorders, but the majority of them are ill equipped to handle the same leading to symptomatic treatment. Read More

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December 2020

A deep learning pipeline for automatic analysis of multi-scan cardiovascular magnetic resonance.

J Cardiovasc Magn Reson 2021 04 26;23(1):47. Epub 2021 Apr 26.

Centre for Translational MR Research (TMR), National University of Singapore, Singapore, 117549, Singapore.

Background: Cardiovascular magnetic resonance (CMR) sequences are commonly used to obtain a complete description of the function and structure of the heart, provided that accurate measurements are extracted from images. New methods of extraction of information are being developed, among them, deep neural networks are powerful tools that showed the ability to perform fast and accurate segmentation. Iq1n order to reduce the time spent by reading physicians to process data and minimize intra- and inter-observer variability, we propose a fully automatic multi-scan CMR image analysis pipeline. Read More

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Deep learning to detect acute respiratory distress syndrome on chest radiographs: a retrospective study with external validation.

Lancet Digit Health 2021 Apr 20. Epub 2021 Apr 20.

Department of Emergency Medicine, University of Michigan Medical School, Ann Arbor, MI, USA; Michigan Center for Integrative Research in Critical Care; Ann Arbor, MI, USA; Michigan Institute for Data Science, University of Michigan, Ann Arbor, MI, USA.

Background: Acute respiratory distress syndrome (ARDS) is a common, but under-recognised, critical illness syndrome associated with high mortality. An important factor in its under-recognition is the variability in chest radiograph interpretation for ARDS. We sought to train a deep convolutional neural network (CNN) to detect ARDS findings on chest radiographs. Read More

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Assessment of functional somatic disorders in epidemiological research: Self-report questionnaires versus diagnostic interviews.

J Psychosom Res 2021 Apr 16;146:110491. Epub 2021 Apr 16.

The Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, Aarhus C, Denmark.

Objective: Self-reported symptom questionnaires are often used for identifying individuals with functional somatic disorders (FSD) in epidemiological research. Studies on their validity in establishing clinically valid cases are, however, lacking. We aimed to compare and dissect the processes of identifying participants with FSD with symptom questionnaires and FSD diagnoses established by diagnostic interviews. Read More

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