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15. Accuracy of visual estimation of ejection fraction in patients with heart failure using augmented reality glasses

Author

Choi, Sungwoo, Nah, Sangun, Cho, Young Soon, Moon, Inki, Lee, Jae Wook, Ah Lee, Choung, Moon, Ji Eun, and Han, Sangsoo

Abstract

ObjectiveLeft ventricular ejection fraction (LVEF) is measured to assess haemodynamic status and cardiac function. It may be difficult to accurately measure in patients with heart failure (HF) as they are often poorly echogenic. The augmented reality (AR) technology is expected to provide real-time guidance that will enable more accurate measurements.MethodsA prospective, randomised, case-crossover simulation study was conducted to confirm the effect of AR glasses on echocardiographic interpretation in patients with HF. 22 emergency physicians participated. The participants were randomly assigned to two groups. Group A estimated the visual ejection fraction of echocardiographic video clips without the AR glasses, while group B estimated them with glasses. After a washout period, the two groups crossed over. The estimates were then compared with the ejection fraction measurements obtained by echocardiologists; intraclass correlation coefficient (ICC) was calculated.ResultsThe ICC with glasses (0.969, 95% CI 0.966 to 0.971) was higher than without glasses (0.705, 95% CI 0.681 to 0.727) among all participants. In the subgroup analysis, the first-year and second-year residents showed the most significant difference, with an ICC of 0.568 (95% CI 0.508 to 0.621) without glasses compared with 0.963 (95% CI 0.958 to 0.968) with glasses. For the third-year and fourth-year residents group, the ICC was 0.754 (95% CI 0.720 to 0.784) without glasses and 0.972 (95% CI 0.958 to 0.968) with glasses. Among the group of attending physicians, the ICC was 0.807 (95% CI 0.775 to 0.834) without glasses and 0.973 (95% CI 0.969 to 0.977) with glasses.ConclusionsAR glasses could be helpful in measuring LVEF and could be more helpful to those with little visual estimation experience.

Published
2024
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23. Framework Development of Non-Face-to-Face Training of Basic Life Support for Laypersons: A Multi-Method Study.

Author

Han, Sangsoo, Lee, Choung Ah, Jeong, Won Jung, Park, JuOk, and Park, Hang A

Subjects
ONLINE education, RESEARCH methodology, BYSTANDER CPR, CURRICULUM, MANN Whitney U Test, CONCEPTUAL structures, RESEARCH funding, CARDIAC arrest, STATISTICAL sampling, DATA analysis software, DELPHI method
Abstract

The spread of infectious diseases has accelerated the transition from face-to-face (F2F) to non-F2F (NF2F) education. To maintain the effect of successful NF2F education in cardiopulmonary resuscitation, reorganizing the curriculum to suit the NF2F educational environment is necessary. We propose an appropriate learning curriculum for NF2F basic life support (BLS) training for laypersons based on expert surveys and learners' performance outcomes. This study included three stages and used multiple methods. A draft curriculum was created through a literature review and three-round Delphi approach, and then applied as a test for actual education. After the training, the final curriculum of the NF2F BLS training for laypersons was proposed by reflecting on the performance outcomes of learners and expert opinions. NF2F theoretical education was simplified into five content items: concept of chain of survival, legal protection for first aiders, importance of bystander cardiopulmonary resuscitation, how to recognize a patient in cardiac arrest and activate the emergency medical services system, and reduced training time. In the hands-on skills session, it was recommended to practice chest compressions using a simple intuitive feedback device and to use automated external defibrillators step-by-step more than in F2F training. In conclusion, NF2F training is a suitable option for BLS training methods in situations where F2F training is difficult. [ABSTRACT FROM AUTHOR]

Published
2023
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39. Characteristics of injuries according to types of personal mobility devices in a multicenter emergency department from 2011 to 2017

Author

Kim, Joo Yeong, Lee, Seung Chul, Lee, Sanghun, Lee, Choung Ah, Ahn, Ki Ok, and Park, Ju Ok

Subjects
Adult, Male, Adolescent, injury, electronic board, Observational Study, Young Adult, Sex Factors, Risk Factors, Republic of Korea, Humans, Off-Road Motor Vehicles, Child, Retrospective Studies, electronic balancing wheel, Age Factors, Middle Aged, Cross-Sectional Studies, electronic scooter, Wounds and Injuries, Female, Head Protective Devices, personal mobility device, Emergency Service, Hospital, Research Article
Abstract

Personal mobility devices (PMDs) have emerged as new factors in motor vehicle accidents, and related injuries are increasing. We aimed to describe the characteristics of PMD-related injuries presented to emergency departments (EDs) through a cross-sectional study for 7 years. This study is a multicenter cross-sectional study using the Emergency Department-based Injury In-Depth Surveillance database in South Korea. We identified all PMD-related injuries from 2011 to 2017 based on text searching. We categorized them into 3 groups based on their distinguishable characteristics: electric standing scooter (E-scooter), electric self-balancing wheel (E-wheel), and electronic board (E-board). A total of 448 PMD-related injuries were observed during the observation period. E-scooter-, E-wheel-, and E-board-related injuries occurred in 284, 138, and 26 cases, respectively. Most patients were between the ages of 19 and 59 years (69.2%), men (66.3%), and injured because of leisure activity (61.2%). The mechanism of injury was mostly traffic accidents (75.2%), but regarding injuries involving E-wheel and E-board, 25.4% and 30.8% of patients slipped from the device. The most commonly injured body part was the head, which accounted for 58.1% of E-scooter injuries, 38.4% of E-wheel injuries, and 53.9% of E-board injuries. Only 6 of all patients wore a helmet at the time of accident. PMD users and PMD-sharing programs are increasing, and more accidents are expected in the future. As PMDs are convenient to move and more people are willing to use them, proper riding and safety rules based on the type of PMD are needed to reduce the risk of injury. The results of this study can be used as basic data for developing safety policies.

Published
2021

44. CDK 4/6 inhibitors are associated with a high incidence of thrombotic events in women with breast cancer in real-world practice

Author

Joseph J. Shatzel, Claire Elizabeth Powers Smith, Malinda West, Andy Kaempf, Jessica Ribkoff, Josh Lee Choung, Ramin Amirsoltani, Tia C L Kohs, Alison Palumbo, and Zahi Mitri

Subjects
Oncology, medicine.medical_specialty, Breast Neoplasms, Palbociclib, Article, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Breast cancer, Sex Factors, Risk Factors, Internal medicine, Antineoplastic Combined Chemotherapy Protocols, Outcome Assessment, Health Care, medicine, Clinical endpoint, Humans, Molecular Targeted Therapy, Abemaciclib, Protein Kinase Inhibitors, Retrospective Studies, Venous Thrombosis, Framingham Risk Score, Duration of Therapy, business.industry, Incidence, Cyclin-Dependent Kinase 4, Thrombosis, Hematology, General Medicine, Cyclin-Dependent Kinase 6, medicine.disease, Prognosis, Discontinuation, chemistry, 030220 oncology & carcinogenesis, Female, Risk Adjustment, business, CDK inhibitor, 030215 immunology
Abstract

Purpose Cyclin-dependent kinase (CDK) 4/6 inhibitors are integral treatment for advanced hormone receptor positive breast cancer; however, venous thromboembolic events (VTE) occurred in 1%-5% of clinical trial patients. Thrombosis rates in the real-world setting remain unclear. We aimed to define the rate of thromboembolic events, risk factors for thrombosis on CDK 4/6 inhibitors and evaluate the Khorana VTE risk score as a predictive tool for VTE in patients on CDK 4/6 therapy. Methods Multicenter retrospective analysis of adult breast cancer patients prescribed palbociclib, ribociclib, or abemaciclib. The primary endpoint was thrombosis during treatment or within 30 days of CDK inhibitor discontinuation. Cox regression was used to model time-to-thrombosis, starting from a patient's initiation of CDK 4/6 therapy. The extended Kaplan-Meier method and Cox modeling were used to assess the effect of time-varying thrombosis status on overall survival. Results Two hundred and sixty-six patients were included (89% on palbociclib, 14% on abemaciclib, 7% on ribociclib). Twenty-nine thrombotic events occurred in 26 (9.8%) women. Of these events, 72% were venous and 34% were arterial. The 1-year incidence of thrombosis was 10.4% overall, 10.9% on palbociclib, 8.3% on ribociclib, and 4.8% on abemaciclib. Hemoglobin less than 10 g/dL was a statistically significant predictor of thrombosis (HR 3.53, P: .014). Khorana score ranged from 0-3, with the majority between 0 and 1 and was not predictive of VTE. Thrombosis was associated with reduced overall survival (HR 1.28, P: .128, median 7.3 months) compared to not having a CDK-associated clot (median 35.7 months). Discussion VTE in our analysis is higher than reported in clinical trials and arterial thrombosis comprised over one-third of events. The highest incidence was with palbociclib, followed by ribociclib. Khorana score did not predict VTE risk. Larger, real-world studies are needed. The role for prophylactic anticoagulation is yet to be defined in this patient population.

Published
2020

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