Готові списки джерел за темами / Clinical interpretation

Зміст

Статті в журналах
Дисертації
Книги
Частини книг
Тези доповідей конференцій
Звіти організацій

Добірка наукової літератури з теми "Clinical interpretation"

Автор: Grafiati

Опубліковано: 12 квітня 2025

Оформте джерело за APA, MLA, Chicago, Harvard та іншими стилями

Оберіть тип джерела:

Ознайомтеся зі списками актуальних статей, книг, дисертацій, тез та інших наукових джерел на тему "Clinical interpretation".

Біля кожної праці в переліку літератури доступна кнопка «Додати до бібліографії». Скористайтеся нею – і ми автоматично оформимо бібліографічне посилання на обрану працю в потрібному вам стилі цитування: APA, MLA, «Гарвард», «Чикаго», «Ванкувер» тощо.

Також ви можете завантажити повний текст наукової публікації у форматі «.pdf» та прочитати онлайн анотацію до роботи, якщо відповідні параметри наявні в метаданих.

Статті в журналах з теми "Clinical interpretation"

Bahcall, Orli. "Clinical genome interpretation." Nature Genetics 46, no. 5 (April 28, 2014): 423. http://dx.doi.org/10.1038/ng.2975.

Повний текст джерела

Стилі APA, Harvard, Vancouver, ISO та ін.

Triggs, E. J. "Clinical interpretation of data: Guide to clinical interpretation of data." Medical Journal of Australia 147, no. 6 (September 1987): 299. http://dx.doi.org/10.5694/j.1326-5377.1987.tb133471.x.

Повний текст джерела

Стилі APA, Harvard, Vancouver, ISO та ін.

Wagner, Edward H. "Causal versus clinical interpretation." Journal of General Internal Medicine 1, no. 6 (November 1986): 420–21. http://dx.doi.org/10.1007/bf02596431.

Повний текст джерела

Стилі APA, Harvard, Vancouver, ISO та ін.

Nias, A. H. W., and O. C. A. Scott. "Interpretation of clinical trials." British Journal of Radiology 58, no. 686 (February 1985): 189. http://dx.doi.org/10.1259/0007-1285-58-686-189-a.

Повний текст джерела

Стилі APA, Harvard, Vancouver, ISO та ін.

Freedman, L. S. "Interpretation of clinical trials." British Journal of Radiology 58, no. 686 (February 1985): 189. http://dx.doi.org/10.1259/0007-1285-58-686-189-b.

Повний текст джерела

Стилі APA, Harvard, Vancouver, ISO та ін.

Bates, Thelma D. "Interpretation of clinical trials." British Journal of Radiology 58, no. 691 (July 1985): 686. http://dx.doi.org/10.1259/0007-1285-58-691-686-a.

Повний текст джерела

Стилі APA, Harvard, Vancouver, ISO та ін.

Freedman, L. S. "Interpretation of clinical trials." British Journal of Radiology 58, no. 691 (July 1985): 686. http://dx.doi.org/10.1259/0007-1285-58-691-686-b.

Повний текст джерела

Стилі APA, Harvard, Vancouver, ISO та ін.

Wingate, D. "Gastrointestinal symptoms: clinical interpretation." Gut 32, no. 11 (November 1, 1991): 1430–31. http://dx.doi.org/10.1136/gut.32.11.1430-b.

Повний текст джерела

Стилі APA, Harvard, Vancouver, ISO та ін.

Everaert, Jonas, Michael V. Bronstein, Tyrone D. Cannon, and Jutta Joormann. "Looking Through Tinted Glasses: Depression and Social Anxiety Are Related to Both Interpretation Biases and Inflexible Negative Interpretations." Clinical Psychological Science 6, no. 4 (January 19, 2018): 517–28. http://dx.doi.org/10.1177/2167702617747968.

Повний текст джерела

Анотація:

Interpretation bias is often theorized to play a critical role in depression and social anxiety. To date, it remains unknown how interpretation bias exerts its toxic effects. Interpretation inflexibility may be an important determinant of how distorted interpretations affect emotional well-being. This study investigated interpretation bias and inflexibility in relation to depression severity and social anxiety. Participants ( N = 212) completed a novel cognitive task that simultaneously measured bias and inflexibility in the interpretation of unfolding ambiguous situations. Depression severity was associated with increased negative and decreased positive interpretation biases. Social anxiety was associated with increased negative interpretation bias. Critically, both symptom types were related to reduced revision of negative interpretations by disconfirmatory positive information. These findings suggest that individuals with more severe depression or social anxiety make more biased and inflexible interpretations. Future work examining cognitive risk for depression and anxiety could benefit from examining both these factors.

Стилі APA, Harvard, Vancouver, ISO та ін.

Eagle, Morris N. "Interpreting Interpretation." Journal of the American Psychoanalytic Association 71, no. 6 (December 2023): 1175–210. http://dx.doi.org/10.1177/00030651241238325.

Повний текст джерела

Анотація:

Interpretation of the latent meaning of manifest content is the core of the traditional approach to psychoanalytic treatment. The main purpose of such interpretation is to enhance the patient’s self-knowledge, in particular his or her awareness of unconscious wishes and their embeddedness in inner conflicts. An assumption of classical psychoanalysis is that veridical interpretations—as Freud put it, interpretations that tally with what is real in the patient—will be especially effective therapeutically. These basic assumptions have been called into question, as reflected in such concepts as “narrative truth” and the overriding importance of the patient’s “assured conviction” regarding interpretations. Also called into question is the therapeutic value of “deep” interpretations intended to uncover repressed impulses. To an important extent, these have been replaced by interpretations of defensive processes just below the surface of consciousness, and interpretations that make connections among different experiences, both of which are intended to help the patient understand how his or her mind works. There is also an increased emphasis on nonsemantic aspects of interpretation, as well as some degree of skepticism toward the therapeutic value of interpretation itself, along with an increased emphasis on the implicit interpretive aspects of the therapeutic relationship. Finally, representative research is presented on the relation between transference interpretation and therapeutic outcome.

Стилі APA, Harvard, Vancouver, ISO та ін.

Більше джерел

Дисертації з теми "Clinical interpretation"

Memon, Ameer Afzal. "Helicobacter pylori virulence tests : interpretation and clinical significance." Thesis, University of Nottingham, 2012. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.580532.

Повний текст джерела

Анотація:

Unless treated, Helicobacter pylori persists as a chronic lifelong infection in the gastric mucosa of almost half the human population. Peptic ulcer disease or gastric cancer result in a small proportion of cases, thus it is important to develop effective methods to identify those patients at high risk of developing disease. The studies in this thesis aimed firstly to develop more accurate serological tests for non-invasive diagnosis of a H. pylori infection; secondly, to develop tests to identify virulence markers of disease-associated H. pylori strains; and thirdly, to determine implications of these tests for disease pathogenesis. Methods: Gastric biopsies and blood samples were collected from patients undergoing a routine upper gastrointestinal endoscopy at the Nottingham University Hospital NHS Trust- Queen's Medical Centre Campus, Nottingham. In addition, a panel of H. pylori isolates from Belgian population, including patients with duodenal ulcer, gastric cancer and, an age and gender matched gastric cancer control group with non-ulcer dyspepsia, was also characterised. ELISA assays were developed using serial dilution methods to accurately and quantitatively measure anti-H. pylori and anti-CagA IgG titres. PCR genotyping was carried out on H. pylori isolates for vacA region polymorphisms, cagA status and determination of the number of cagA EPIY A-C motifs. cagA mRNA levels in gastric biopsy tissues and cultured H. pylori strains were assessed using real- time RT-PCR. Naturally occurring polymorphic differences in the cagA promoter regions were identified by sequence analysis. Results and conclusions: The ELISA assays developed in this study allowed reliable detection of H. pylori infection and its virulence factor CagA. These assays performed well to overcome previously reported limitations of serological methods. Antibody titres closely associated with the severity of inflammation in the gastric mucosa but not with gastric atrophy. The relationship between anti-CagA IgG responses and numbers of EPIY A-C motifs was investigated and surprisingly patients infected with less virulent cagA types were found to have significantly higher titres. These strains were also found to express significantly higher cagA transcript levels both in vivo and in vitro. Sequence analysis of the cagA promoter region identified few potential naturally occurring polymorphisms. Polymorphic differences at position -54 within the inverted repeat of the cagA promoter region were found to be important in determining cagA transcription and site directed mutagenesis confirmed this. Genotyping analysis of the Belgian samples showed that vacA s l and il-type H pylori strains were closely associated with DU and ,GC and there was also a good concordance with cagA status. However, these strains were not significantly associated with mononuclear cell infiltration and neutrophil infiltration. In conclusion, serological detection of H pylori and its virulence factor CagA is a useful diagnostic tool and the intensity of the immune response in patients infected with these virulent strains is a good indicator of inflammatory process in the gastric mucosa. It was observed that a complex interaction between H pylori virulence and host exists, and that the cagA+ strains are likely to modulate their virulence potential possibly by regulating their gene expression. This has important implications and could explain why only some CagA strains cause disease. Although, vacA sl- and il-type strains are good markers of disease, determination of an independent virulence marker of H pylori- associated disease is difficult.

Стилі APA, Harvard, Vancouver, ISO та ін.

Zayed, Richard S. "Interpretation in psychotherapy: An empirical phenomenological-hermeneutic study." Thesis, University of Ottawa (Canada), 2006. http://hdl.handle.net/10393/29326.

Повний текст джерела

Анотація:

As a psychotherapeutic intervention, interpretation has an extensive history dating back to the beginnings of psychotherapy itself. It has been theoretically expounded as the essence of psychotherapy by some theorists, and rejected as unnecessary by others. However, as the major theoretical orientations have begun to converge, interpretation has entered into their contemporary discourses in one form or another. Empirically, interpretation has been addressed extensively, particularly in the psychodynamic and process psychotherapy literatures. However, few qualitative studies have been conducted on the phenomenon as it presents itself in actual therapy sessions, and these qualitative studies have presented with significant limitations. The present dissertation conducted a phenomenological study of interpretation in psychotherapy by examining the manner in which it presents itself through three sessions of self-identified psychodynamic, humanistic-existential, and cognitive behavioural therapists. These sessions were followed by separate interviews with the therapists and the patients regarding their experiences of the interpretations within the sessions. The three sessions and six interviews were analyzed by using the phenomenological method. The resulting general meaning structure indicated that interpretation was a core therapeutic intervention in all three sessions, and presented as a highly complex phenomenon. Its deeply interrelated main features indicated that interpretation is a highly dialogical phenomenon immersed in therapist and patient contexts and intentions, as well as pre-interpretive and post-interpretive contexts. Both the therapists and patients contributed to the evolution of interpretations in the interpretive dialogue, and in fact patients were found to initiate some of the interpretations. The dialogical nature of interpretation also implied that, through their interrelationship, the therapist and patient dialogued with the interpreted material as a presence beyond their relationship, giving rise to the actual interpretations. Interpretive threads interweaved throughout the sessions as the interpretations formed layers of thematic development and increased in complexity. These interpretations involved greater or lesser degrees of intuition or reflection. Intuition and reflection counterbalanced each other; the former reflecting the interpretation's grounding in understanding the patient's experiencing, and the latter reflecting the interpretation's abstraction, complexity, and/or explanatory focus. Through its temporal dimension, interpretation unfolded in the present of the therapeutic dialogue, but reached back into the past and thrust forward into the future, even beyond the session itself. Finally, the present dissertation addressed specific and general patient responses to interpretation, and suggested a novel typology of interpretation.

Стилі APA, Harvard, Vancouver, ISO та ін.

Dodd, Dorian R. "Attaining Imperfection: An Interpretation Bias Intervention Targeting Clinical Perfectionism." Miami University / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=miami159545061793484.

Повний текст джерела

Стилі APA, Harvard, Vancouver, ISO та ін.

Macdonald, Morag M. "Craft knowledge in medicine : an interpretation of teaching and learning in apprenticeship." N.p, 1997. http://ethos.bl.uk/.

Повний текст джерела

Стилі APA, Harvard, Vancouver, ISO та ін.

Puccini, Cecilia. "Interpretation of Nonverbal Communication by Individuals Exhibiting Schizotypal Traits." W&M ScholarWorks, 1991. https://scholarworks.wm.edu/etd/1539625699.

Повний текст джерела

Стилі APA, Harvard, Vancouver, ISO та ін.

Zhao, Bo. "Towards semantic interpretation of clinical narratives with ontology-based text mining." Thesis, Cardiff University, 2016. http://orca.cf.ac.uk/93447/.

Повний текст джерела

Анотація:

In the realm of knee pathology, magnetic resonance imaging (MRI) has the advantage of visualising all structures within the knee joint, which makes it a valuable tool for increasing diagnostic accuracy and planning surgical treatments. Therefore, clinical narratives found in MRI reports convey valuable diagnostic information. A range of studies have proven the feasibility of natural language processing for information extraction from clinical narratives. However, no study focused specifically on MRI reports in relation to knee pathology, possibly due to the complexity of knee anatomy and a wide range of conditions that may be associated with different anatomical entities. In this thesis, we describe KneeTex, an information extraction system that operates in this domain. As an ontology-driven information extraction system, KneeTex makes active use of an ontology to strongly guide and constrain text analysis. We used automatic term recognition to facilitate the development of a domain-specific ontology with sufficient detail and coverage for text mining applications. In combination with the ontology, high regularity of the sublanguage used in knee MRI reports allowed us to model its processing by a set of sophisticated lexico-semantic rules with minimal syntactic analysis. The main processing steps involve named entity recognition combined with coordination, enumeration, ambiguity and co-reference resolution, followed by text segmentation. Ontology-based semantic typing is then used to drive the template filling process. We adopted an existing ontology, TRAK (Taxonomy for RehAbilitation of Knee conditions), for use within KneeTex. The original TRAK ontology expanded from 1,292 concepts, 1,720 synonyms and 518 relationship instances to 1,621 concepts, 2,550 synonyms and 560 relationship instances. This provided KneeTex with a very fine-grained lexicosemantic knowledge base, which is highly attuned to the given sublanguage. Information extraction results were evaluated on a test set of 100 MRI reports. A gold standard consisted of 1,259 filled template records with the following slots: finding, finding qualifier, negation, certainty, anatomy and anatomy qualifier. KneeTex extracted information with precision of 98.00%, recall of 97.63% and F-measure of 97.81%, the values of which are in line with human-like performance. To demonstrate the utility of formally structuring clinical narratives and possible applications in epidemiology, we describe an implementation of KneeBase, a web-based information retrieval system that supports complex searches over the results obtained via KneeTex. It is the structured nature of extracted information that allows queries that encode not only search terms, but also relationships between them (e.g. between clinical findings and anatomical locations). This is of particular value for large-scale epidemiology studies based on qualitative evidence, whose main bottleneck involves manual inspection of many text documents. The two systems presented in this dissertation, KneeTex and KneeBase, operate in a specific domain, but illustrate generic principles for rapid development of clinical text mining systems. The key enabler of such systems is the existence of an appropriate ontology. To tackle this issue, we proposed a strategy for ontology expansion, which proved effective in fast–tracking the development of our information extraction and retrieval systems.

Стилі APA, Harvard, Vancouver, ISO та ін.

Piper, K. "Interpretation of clinical imaging examinations by radiographers : a programme of research." Thesis, Canterbury Christ Church University, 2014. http://create.canterbury.ac.uk/13316/.

Повний текст джерела

Анотація:

Background Studies which have investigated the interpretation of plain skeletal examinations by radiographers have demonstrated encouraging findings, however, the studies have not extended beyond this area of practice and radiographers' diagnostic performance for other more complex investigations has not been established. Comparisons of performance between groups of healthcare practitioners to date, has also been limited. Aim This research programme aimed to investigate the interpretation of clinical imaging examinations by radiographers, and other healthcare practitioners, in the provision of initial interpretations and/or definitive reports of plain imaging ( skeletal and chest) and crosssectional ( magnetic resonance imaging [MRI] – lumbar/thoracic spine, knees and internal auditory meati [IAM]) investigations. Methods The eight studies utilised a variety of methodological approaches and included quasiexperimental and observational studies. One quasi-experimental study compared the performance of radiographers, nurses and junior doctors in initial image interpretation and another similar study included a training intervention; both utilised alternate free-response receiver operating characteristic curve (AFROC) methodology. Three of the observational studies investigated the ability of radiographers to provide definitive reports on a wide range of clinical examinations, including chest and MRI investigations, in a controlled environment. One large multi-centre observational study investigated the performance of radiographers, in clinical practice (A/E: skeletal examinations) during the implementation of a radiographic reporting service. The agreement between consultant radiologists' MRI reports of lumbar/thoracic spine, knee and IAM examinations was investigated in another observational study. The final study compared the reports of trained radiographers and consultant radiologists, with those of an index radiologist, when reporting on MRI examinations of the knee and lumbar spine, as part of a prospective pre-implementation agreement study. Results The first AFROC study demonstrated statistically significant improvements after training, for radiographers (A1=0.55 - 0.72) and nurses (A1=0.65 - 0.63), although the radiographers maintained a better overall performance post training (p=0.004) in providing an initial image interpretation of trauma radiographs of the appendicular skeleton. Radiographers also achieved statistically higher (p<0.01) AUC values (A1=0.75) than nurses (A1=0.58) and junior doctors (A1=0.54) in the second AFROC study. Three studies, which examined 11155 reports, were conducted under controlled conditions in an academic setting and provided evidence of radiographers’ high levels of accuracy in reporting of skeletal A/E (93.9%); skeletal non A/E (92.5%); chest (89.0%); MRI lumbar/thoracic spine (87.2%), knees (86.3%) and IAM (98.4%) examinations. In the multi-centre clinical study, the mean accuracy, sensitivity and specificity rates of the radiographers reports (n=7179) of plain examinations of the skeletal system in the trauma setting was found to be 99%, 98% and 99%, respectively. The considerable range of values for agreement, between consultant radiologists reports of MRI examinations of the thoracic/lumbar spine (k=0 – 0.8), knee (k=0.3 – 0.8) and IAM (k=1.0) was similar to other studies and resulted in a reasonable estimation of the performance, in the UK, of an average non specialist consultant radiologist in MRI reporting. In the final study, radiographers reported in clinical practice conditions, on a prospective random sample of knee and lumbar spine MRI examinations, to a level of agreement comparable with non-musculoskeletal consultant radiologists (Mean difference in observer agreement <1%, p=0.86). Less than 10% of observers' reports (radiographers and consultant radiologists) were found to be sufficiently discordant to be clinically important. Conclusion The outcomes of this research programme demonstrate that radiographers can provide initial interpretations of radiographic examinations of the appendicular skeleton, in the trauma setting, to a higher level of accuracy than A/E practitioners. The findings also provide evidence that selected radiographers with appropriate education and training can provide definitive reports on plain clinical examinations (A/E and non A/E referral sources) of the skeletal system and the chest; and MRI examinations of the knee, lumbar/thoracic spine and IAM to a level of performance comparable to the average non specialist consultant radiologist. Wider implementation of radiographer reporting is therefore indicated and future multi-centre research, including economic evaluations, to further inform practice at a national level, is recommended.

Стилі APA, Harvard, Vancouver, ISO та ін.

Schön, Joan. "Elements of dream interpretation: laying the foundation of a basic model for clinical practice." Thesis, Rhodes University, 2001. http://hdl.handle.net/10962/d1002559.

Повний текст джерела

Анотація:

The study addresses certain paradoxes evident in the theory and practice of dream interpretation. These relate to the considerable value afforded to dreams in psychoanalytic thinking, compared with (1) the surprising dearth of literature, research, and training on dream interpretation in clinical practice, (2) the difficulties voiced by clinicians regarding dream interpretation, and (3) the diversity of keys employed by different schools to unlock the ‘truth’ of dreams. The intention of the study is to examine these paradoxes in order to develop a model fordream interpretation which falls within the ambit of psychodynamic psychotherapy. It is argued that there have been few insights over the century to match the seminal work of Freud (1900/1976), except perhaps the work of Carl Jung. As a result of the 1914 rift between these two, Jung’s insights have been largely ignored in mainstream psychoanalytic thinking and the focus on dreams has given way to other areas of development, such as, unconscious thinking, symbol formation, and interpretation in a general sense. These, it is argued, have contributed to a more comprehensive understanding of dreams and their interpretation. Thus a model would need to consider both Freud and Jung’s work, and later salient developments. It would also need to be informed by local, contemporary practice. The method used in this thesis is one of breaking down the process of dream interpretation into component parts, in order to examine useful contributions from different sources and to compare work with dreams to work with other material. The literature review examines the major theoretical contributions in relation to four elements of dreams interpretation: the nature and function of dreams, methods of dream interpretation, the meaning of dreams, and the goals of dream interpretation. A model which accommodates diverse theories without resorting to eclecticism is then proposed. Dream interpretation is further examined in the light of a multiphase clinical study, designed to provide different perspectives on the topic. The study yielded findingscompatible with the literature reviewed, as well as certain problems in relation to the proposed model. These included shortcomings of the elements used in the literature review, particularly the sequence of these elements, and caveats about affording dreams a special focus in the consulting room. Thus a second configuration was posited, namely the idea of viewing dream-work as a triangular situation, comprising the dream, the dreamer, and the dream interpreter. The final model which is the outcome of the study provides two interrelated methods of addressing dream interpretation which accommodate the theory/practice dichotomy. In the first, the elements of dreams and their interpretation are considered sequentially. This method provides a framework for considering theoretical contributions on dreams, as well as issues of technique, without recourse to the introduction of theory in the consulting room. In the second, dream interpretation is regarded as a triangular situation, comprising the interchange between therapist and patient in relation to the patient’s dream-life. This structure accommodates the alliance which is discernible in practice and draws on Segal’s (1957/1986) notion that the process of symbol formation is a triangular situation. The value of regarding ‘dream-work’ in the consulting room as a triangular situation is threefold: (1) it is akin to symbol formation in terms of the meaning reached; (2) dreams cannot be accurately interpreted in isolation from the contributions of both therapist and patient; and (3) it provides ‘dream-work’ in practice with its own structure, highlighting a perspective that dreams are an element of clinical practice, rather than a focus, a subtext within the broader framework of psychodynamic psychotherapy.

Стилі APA, Harvard, Vancouver, ISO та ін.

Nikolaenko, E. M., Вікторія Едуардівна Проняєва, Виктория Эдуардовна Проняева, and Viktoriia Eduardivna Proniaieva. "New joint initiative to explore clinical interpretation of molecular tests for cancer." Thesis, Sumy State University, 2016. http://essuir.sumdu.edu.ua/handle/123456789/45978.

Повний текст джерела

Анотація:

New life requirements enforce doctors navigate one of the most important scientific questions faced by the cancer community could help improve survival rates for patients. A joint initiative of UNICANCER, ESMO and Cancer Research UK, the meeting on Molecular Analysis for Personalised therapy (MAP) will explore clinical interpretation of molecular tests for cancers that have spread.

Стилі APA, Harvard, Vancouver, ISO та ін.

Macdonald, Morag M. "Craft knowledge in medicine : an interpretation of teaching and learning in apprenticeship." Thesis, Open University, 1998. http://oro.open.ac.uk/56460/.

Повний текст джерела

Анотація:

The diagnosis and management of patients requires professional know-how or medical craft knowledge. To explain how this knowledge is acquired, this research asked 'How do medical experts pass on their craft?' Other questions arose through successive data collections and progressive focusing on what medical experts did well in their work and teaching. The programme comprised: pilot interviews with three expert physicians; a case study in a hospital medical unit; and paired consultant/SHO interviews. Participant observation, interviews, and expert-novice comparisons explored clinical work, teaching, and learning in apprenticeship. Data analysis of participants' responses and ward round discussions allowed identified categories to cluster within three inter-related constructs instrumental to the acquisition of medical knowledge: gaining experience in the experiential process of clinical practice (1); and the products of experience which manifest as experts' clinical expertise (2) and teaching/learning expertise (3). These constructs can be located within a model of apprenticeship based on Spady's (1973) analysis of authority in effective teaching containing two frames of reference: the social, 'traditional-legal'; and the individual, 'expert-charismatic'. The medical apprenticeship is associated with similar perspectives: the 'traditional-experiential' represents the professional process of learning through patient care with its infrastructure of clinical methods in presentation, discourse, and commentary; and the 'expert-charismatic' represents clinical and teaching expertise coupled with vocational enthusiasm. Experienced experts synthesised two repertoires of knowledge and skills derived from the craft knowledge of medicine and pedagogy, respectively. Both crafts are required for effective clinical education. While apprenticeship accommodates a range of teaching/learning experiences, in postgraduate education experts pass on knowledge through the deliberate engagement of junior doctors in diagnosis and management. The skills involved in this process were largely unrecognised by most senior and junior doctors and were not perceived as 'clinical teaching' although learning was structured through service-based work.

Стилі APA, Harvard, Vancouver, ISO та ін.

Більше джерел

Книги з теми "Clinical interpretation"

Berk, J. Edward. Gastrointestinal symptoms: Clinical interpretation. Philadelphia: B.C. Decker, 1991.

Знайти повний текст джерела

Стилі APA, Harvard, Vancouver, ISO та ін.

1910-, Kaplan Alex, and Kaplan Alex 1910-, eds. Clinical chemistry: Interpretation and techniques. 4th ed. Baltimore: Williams & Wilkins, 1995.

Знайти повний текст джерела

Стилі APA, Harvard, Vancouver, ISO та ін.

Farrukh, Iqbal. Slide interpretation in clinical medicine. New Delhi, India: Jaypee Brothers Medical Publishers, 2008.

Знайти повний текст джерела

Стилі APA, Harvard, Vancouver, ISO та ін.

L, Szabo LaVerne, and Opheim Kent E, eds. Clinical chemistry: Interpretation and techniques. 3rd ed. Philadelphia: Lea & Febiger, 1988.

Знайти повний текст джерела

Стилі APA, Harvard, Vancouver, ISO та ін.

Fraser, C. G. Interpretation of clinical chemistry laboratory Data. Oxford: Blackwell Scientific, 1986.

Знайти повний текст джерела

Стилі APA, Harvard, Vancouver, ISO та ін.

Fraser, C. G. Interpretation of clinical chemistry laboratory data. Oxford: Blackwell Scientific, 1986.

Знайти повний текст джерела

Стилі APA, Harvard, Vancouver, ISO та ін.

Ryan, Leo Robert. Clinical interpretation of the FIRO-B. 3rd ed. Palo Alto, CA (3803 E. Bayshore Rd., Palo Alto 94303): Consulting Psychologists Press, 1989.

Знайти повний текст джерела

Стилі APA, Harvard, Vancouver, ISO та ін.

Bert, Spilker, ed. Guide to clinical interpretation of data. New York: Raven Press, 1986.

Знайти повний текст джерела

Стилі APA, Harvard, Vancouver, ISO та ін.

A, Sacher Ronald, McPherson Richard A, Campos Joseph M, and Widmann Frances K. 1935-, eds. Widmann's clinical interpretation of laboratory tests. Philadelphia: Davis, 2000.

Знайти повний текст джерела

Стилі APA, Harvard, Vancouver, ISO та ін.

A, McPherson Richard, Campos Joseph M, and Widmann Frances K. 1935-, eds. Widmann's clinical interpretation of laboratory tests. Philadelphia: F.A. Davis, 1991.

Знайти повний текст джерела

Стилі APA, Harvard, Vancouver, ISO та ін.

Більше джерел

Частини книг з теми "Clinical interpretation"

Wheeler, Robert. "Interpretation." In Clinical Law for Clinical Practice, 75–76. First edition. | Boca Raton : CRC Press, 2020.: CRC Press, 2020. http://dx.doi.org/10.1201/9780429320583-31.

Повний текст джерела

Стилі APA, Harvard, Vancouver, ISO та ін.

Moore, Nathanael D., Parastou Ghazi, and Eliezer M. Van Allen. "Clinical Interpretation." In Precision Cancer Medicine, 33–48. Cham: Springer International Publishing, 2019. http://dx.doi.org/10.1007/978-3-030-23637-3_3.

Повний текст джерела

Стилі APA, Harvard, Vancouver, ISO та ін.

Okutucu, Sercan, and Ali Oto. "ECG Rhythm Interpretation." In In Clinical Practice, 19–43. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-90557-0_2.

Повний текст джерела

Стилі APA, Harvard, Vancouver, ISO та ін.

O’Toole, Anita Werner, and Sheila Rouslin Welt. "Interpretation of Clinical Observations." In Hildegard E. Peplau, Selected Works, 149–63. London: Macmillan Education UK, 1994. http://dx.doi.org/10.1007/978-1-349-13441-0_11.

Повний текст джерела

Стилі APA, Harvard, Vancouver, ISO та ін.

Yin, Henry H. "Interpretation of Clinical Symptoms." In The Integrative Functions of The Basal Ganglia, 281–300. Boca Raton: CRC Press, 2023. http://dx.doi.org/10.1201/9780429154461-14.

Повний текст джерела

Стилі APA, Harvard, Vancouver, ISO та ін.

Rana, Abdul Qayyum, Ali T. Ghouse, and Raghav Govindarajan. "Interpretation of EEG." In Neurophysiology in Clinical Practice, 11–21. Cham: Springer International Publishing, 2016. http://dx.doi.org/10.1007/978-3-319-39342-1_2.

Повний текст джерела

Стилі APA, Harvard, Vancouver, ISO та ін.

Pocock, Stuart J. "Publication and Interpretation of Findings." In Clinical Trials, 234–47. West Sussex, England: John Wiley & Sons Ltd,., 2013. http://dx.doi.org/10.1002/9781118793916.ch15.

Повний текст джерела

Стилі APA, Harvard, Vancouver, ISO та ін.

Pennell, Dudley J., S. Richard Underwood, Durval C. Costa, and Peter J. Ell. "Image Interpretation." In Thallium Myocardial Perfusion Tomography in Clinical Cardiology, 31–43. London: Springer London, 1992. http://dx.doi.org/10.1007/978-1-4471-1857-2_5.

Повний текст джерела

Стилі APA, Harvard, Vancouver, ISO та ін.

Crane, Jack. "Injury Interpretation." In A Physician’s Guide to Clinical Forensic Medicine, 99–116. Totowa, NJ: Humana Press, 2000. http://dx.doi.org/10.1007/978-1-59259-022-3_4.

Повний текст джерела

Стилі APA, Harvard, Vancouver, ISO та ін.

Trendelenburg, Ch. "Chapter 3.8. Expert Systems in Clinical Chemistry." In Data Presentation / Interpretation, edited by H. Keller and Ch Trendelenburg, 381–402. Berlin, Boston: De Gruyter, 1989. http://dx.doi.org/10.1515/9783110869880-018.

Повний текст джерела

Стилі APA, Harvard, Vancouver, ISO та ін.

Тези доповідей конференцій з теми "Clinical interpretation"

Krishna, Gautham, Manoj Kumar Pathak, and Meenakshi Dheer. "Interpretable Machine Learning Algorithms for Interpretation of Clinical Data." In 2024 15th International Conference on Computing Communication and Networking Technologies (ICCCNT), 1–7. IEEE, 2024. http://dx.doi.org/10.1109/icccnt61001.2024.10724476.

Повний текст джерела

Стилі APA, Harvard, Vancouver, ISO та ін.

Xu, Lingfeng, Kimberly D. Mueller, Julie Liss, and Visar Berisha. "The Impact of Decorrelation on Transformer Interpretation Methods: Applications to Clinical Speech AI." In ICASSP 2025 - 2025 IEEE International Conference on Acoustics, Speech and Signal Processing (ICASSP), 1–5. IEEE, 2025. https://doi.org/10.1109/icassp49660.2025.10889946.

Повний текст джерела

Стилі APA, Harvard, Vancouver, ISO та ін.

Yin, Mi, Yuchen Pei, and Yutao Ma. "Human-Machine Integration to Enhance Clinical Typing and Fine-Grained Interpretation of Cervical OCT Images." In 2024 IEEE International Conference on Bioinformatics and Biomedicine (BIBM), 2787–94. IEEE, 2024. https://doi.org/10.1109/bibm62325.2024.10822370.

Повний текст джерела

Стилі APA, Harvard, Vancouver, ISO та ін.

Worship, Asbury, Gawthrop, and Gray. "Towards Automatic Clinical Sign Interpretation." In Proceedings of the Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE, 1992. http://dx.doi.org/10.1109/iembs.1992.592662.

Повний текст джерела

Стилі APA, Harvard, Vancouver, ISO та ін.

Worship, G. R., A. J. Asbury, P. J. Gawthrop, and W. M. Gray. "Towards automatic clinical sign interpretation in anaesthesia." In 1992 14th Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE, 1992. http://dx.doi.org/10.1109/iembs.1992.5761461.

Повний текст джерела

Стилі APA, Harvard, Vancouver, ISO та ін.

Garrett-Mayer, E. "Abstract ES03-3: Clinical 101: Clinical trial endpoints: Selection, analysis and interpretation." In Abstracts: Thirty-Sixth Annual CTRC-AACR San Antonio Breast Cancer Symposium - Dec 10-14, 2013; San Antonio, TX. American Association for Cancer Research, 2013. http://dx.doi.org/10.1158/0008-5472.sabcs13-es03-3.

Повний текст джерела

Стилі APA, Harvard, Vancouver, ISO та ін.

Snegireva, Ekaterina, Grigory R. Khazankin, and Igor Mikheenko. "ECG printout interpretation system for clinical decision support." In 2020 Cognitive Sciences, Genomics and Bioinformatics (CSGB). IEEE, 2020. http://dx.doi.org/10.1109/csgb51356.2020.9214740.

Повний текст джерела

Стилі APA, Harvard, Vancouver, ISO та ін.

Joshi, V., C. Agurto, ES Barriga, S. Nemeth, and P. Soliz. "Clinical utilization of automated image analysis software for improving retinal reader's performance." In 2016 IEEE Southwest Symposium on Image Analysis and Interpretation (SSIAI). IEEE, 2016. http://dx.doi.org/10.1109/ssiai.2016.7459196.

Повний текст джерела

Стилі APA, Harvard, Vancouver, ISO та ін.

Lay-Ekuakille, Aime, Giuseppe Vendramin, Amerigo Trotta, Marta De Rinaldis, and Antonio Trabacca. "Processing EEG signals for Clinical Interpretation in Seizure-Suspected Patients." In 2007 IEEE International Workshop on Medical Measurement and Applications. IEEE, 2007. http://dx.doi.org/10.1109/memea.2007.4285157.

Повний текст джерела

Стилі APA, Harvard, Vancouver, ISO та ін.

Van Allen, Eliezer M. "Abstract SY16-02: Clinical whole exome interpretation for precision cancer medicine." In Proceedings: AACR 106th Annual Meeting 2015; April 18-22, 2015; Philadelphia, PA. American Association for Cancer Research, 2015. http://dx.doi.org/10.1158/1538-7445.am2015-sy16-02.

Повний текст джерела

Стилі APA, Harvard, Vancouver, ISO та ін.

Звіти організацій з теми "Clinical interpretation"

Walker, Alex, Brian MacKenna, Peter Inglesby, Christopher Rentsch, Helen Curtis, Caroline Morton, Jessica Morley, et al. Clinical coding of long COVID in English primary care: a federated analysis of 58 million patient records in situ using OpenSAFELY. OpenSAFELY, 2021. http://dx.doi.org/10.53764/rpt.3917ab5ac5.

Повний текст джерела

Анотація:

This OpenSAFELY report is a routine update of our peer-review paper published in the British Journal of General Practice on the Clinical coding of long COVID in English primary care: a federated analysis of 58 million patient records in situ using OpenSAFELY. It is a routine update of the analysis described in the paper. The data requires careful interpretation and there are a number of caveats. Please read the full detail about our methods and discussionis and the full analytical methods on this routine report are available on GitHub. OpenSAFELY is a new secure analytics platform for electronic patient records built on behalf of NHS England to deliver urgent academic and operational research during the pandemic. You can read more about OpenSAFELY on our website.

Стилі APA, Harvard, Vancouver, ISO та ін.

Surendra G, Dr Prasad, Dr Bhuyan Ashok K, Dr Baro Abhamon, Dr Saikia Uma K, and Dr Kumar Angad. CLINICAL AND METABOLIC CHARACTERISTICS OF PRIMARY HYPERPARATHYROIDISM IN DIFFERENT AGE GROUPS- A TERTIARY CENTRE EXPERIENCE. World Wide Journals, February 2023. http://dx.doi.org/10.36106/ijar/6005490.

Повний текст джерела

Анотація:

Background and Objectives- Symptomatic Primary Hyperparathyroidism (PHPT) is common in India in comparison to the western population. But there is very little data on the inuence of age on the presentation of PHPT. In the present study we aimed to analyse the clinical and metabolic prole among different age groups of symptomatic primary hyperparathyroidism. Methods: This retrospective analysis was done in PHPT patients who attended Department of Endocrinology, Gauhati Medical college and Hospital. Thirty-one PHPT subjects who presented to us over a period of last ve years were divided into three different age groups i.e, children and adolescents <18yrs, adults ≥18-50 years, and older group >50years. All major clinical, metabolic and imaging parameters were compared among these groups. Appropriate statistical methods were used to compare different variables. The age distribution ranged from 13 to Results: 72 years with mean age of 38.6±16.3years and with equal female to male ratio. Bony deformity (Rickets) as initial manifestation was seen in three adolescents and bone pain was common in adolescents(p=0.05). Prevalence of renal stones were higher in adult group(p=0.002), gastrointestinal manifestations were higher in older group (p=0.02). There was no signicant difference in fracture rate(P=0.17), brown tumours(P=0.56) and other symptoms among different age groups. Alkaline phosphatase(p=0.006) and iPTH(p=0.01) were signicantly higher in adolescent group. There was no signicant difference in serum calcium, phosphate, 25(OH)Vitamin-D3 and haemoglobin levels among different age groups. Age has substantial inuence on PHPT presentation. Bone Interpretation & Conclusion: pain and deformity was common in adolescents, while renal stones and gastrointestinal manifestations were common in middle aged and elderly group respectively

Стилі APA, Harvard, Vancouver, ISO та ін.

FDG-PET/CT SUV for Response to Cancer Therapy, Clinically Feasible Profile. Chair Nathan Hall and Jeffrey Yap. Radiological Society of North America (RSNA) / Quantitative Imaging Biomarkers Alliance (QIBA), June 2023. http://dx.doi.org/10.1148/qiba/20230615.

Повний текст джерела

Анотація:

This QIBA Profile documents specifications and requirements to provide comparability and consistency for quantitative FDG-PET across scanners in oncology. It can be applied to both clinical trial use as well as individual patient management. This document organizes acquisition, reconstruction and post-processing, analysis and interpretation as steps in a pipeline that transforms data to information to knowledge. The document, developed through the efforts of the QIBA FDG-PET Biomarker Committee, has shared content with the FDG-PET UPICT protocol, as well as additional material focused on the devices used to acquire and analyze the FDG-PET data. The QIBA acquisition protocol is largely derived from the FDG-PET UPICT protocol for FDG-PET imaging in clinical trials. In the UPICT protocol, there is a carefully developed hierarchy with tiered levels of protocol compliance. This reflects the recognition that there are valid reasons to perform trials using different levels of rigor, even for the same disease/intervention combination. For example, a high level of image measurement precision may be needed in small, early-phase trials whereas a less rigorous level of precision may be acceptable in large, late-phase trials of the same drug in the same disease setting. This Profile defines the behavioral performance levels and quality control specifications for whole-body FDG-PET/CT scans used in single- and multi-center clinical trials of oncologic therapies. While the emphasis is on clinical trials, this process is also intended to apply for clinical practice. The specific claims for accuracy are detailed in the Claims section. A motivation for the development of this Profile is that while a typical PET/CT scanner measurement system (including all supporting devices) may be stable over days or weeks, this stability cannot be expected over the time that it takes to complete a clinical trial. In addition, there are well known differences between scanners and or the operation of the same type of scanner at different imaging sites. The intended audiences of this document include: Technical staff of software and device manufacturers who create products for this purpose Biopharmaceutical companies, oncologists, and clinical trial scientists designing trials with imaging endpoints Clinical research professionals Radiologists, nuclear medicine physicists, technologists, physicists and administrators at healthcare institutions (1) considering specifications for procuring new PET/CT equipment, (2) designing PET/CT acquisition protocols, (3) making quantitative measurements from PET/CT images Regulators, nuclear medicine physicians, oncologists, and others making decisions based on quantitative image measurements

Стилі APA, Harvard, Vancouver, ISO та ін.

MR (Diffusion-Weighted Imaging (DWI) of the Apparent Diffusion Coefficient (ADC), Clinically Feasible Profile. Chair Michael Boss, Dariya Malyarenko, and Daniel Margolis. Radiological Society of North America (RSNA) / Quantitative Imaging Biomarkers Alliance (QIBA), December 2022. http://dx.doi.org/10.1148/qiba/20221215.

Повний текст джерела

Анотація:

The goal of a QIBA Profile is to help achieve a useful level of performance for a given biomarker. The Claim (Section 2) describes the biomarker performance and is derived from the body of scientific literature meeting specific requirements, in particular test-retest studies. The Activities (Section 3) contribute to generating the biomarker. Requirements are placed on the Actors that participate in those activities as necessary to achieve the Claim. Assessment Procedures (Section 4) for evaluating specific requirements are defined as needed to ensure acceptable performance. Diffusion-Weighted Imaging (DWI) and the Apparent Diffusion Coefficient (ADC) are being used clinically as qualitative (DWI) and quantitative (ADC) indicators of disease presence, progression or response to treatment. Use of ADC as a robust quantitative biomarker with finite confidence intervals places additional requirements on Sites, Acquisition Devices and Protocols, Field Engineers, Scanner Operators (MR Technologists, Radiologists, Physicists and other Scientists), Image Analysts, Reconstruction Software and Image Analysis Tools. Additionally, due to the intrinsic dependence of measured ADC values on biophysical tissue properties, both the Profile Claims and the associated scan protocols (Section 3.6.2) are organ-specific. All of these are considered Actors involved in Activities of Acquisition Device Pre-delivery and Installation, Subject Handling, Image Data Acquisition, Reconstruction, Registration, ADC map generation, Quality Assurance (QA), Distribution, Analysis, and Interpretation. The requirements addressed in this Profile are focused on achieving ADC values with minimal systematic bias and measurement variability. DISCLAIMER: Technical performance of the MRI system can be assessed using a phantom having known diffusion properties, such as the QIBA DWI phantom. The clinical performance target is to achieve a 95% confidence interval for measurement of ADC with a variable precision depending on the organ being imaged and assuming adequate technical performance requirements are met. While in vivo DWI/ADC measurements have been performed throughout the human body, this Profile focused on four organ systems, namely brain, liver, prostate, and breast as having high clinical utilization of ADC with a sufficient level of statistical evidence to support the Profile Claims derived from the current peer-reviewed literature. In due time, new DWI technologies with proven greater performance levels, as well as more organ systems will be incorporated in future Profiles. This document is intended to help a variety of users: clinicians using this biomarker to aid patient management; imaging staff generating this biomarker; MRI system architects developing related products; purchasers of such products; and investigators designing clinical trials utilizing quantitative diffusion-based imaging endpoints. Note that this document only states requirements specific to DWI to achieve the claim, not requirements that pertain to clinical standard of care. Conforming to this Profile is secondary to proper patient care.

Стилі APA, Harvard, Vancouver, ISO та ін.

Luo, Minjing, Yilin Li, Yingqiao Wang, Jinghan Huang, Zhihan Liu, Yicheng Gao, Qianyun Chai, Yuting Feng, Jianping Liu, and Yutong Fei. The Fragility of Statistically Significant Findings from Depression Randomized Controlled Trials. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, April 2023. http://dx.doi.org/10.37766/inplasy2023.4.0086.

Повний текст джерела

Анотація:

Review question / Objective: The Fragility of Statistically Significant Findings from Depression Randomized Controlled Trials. Condition being studied: Depression is a mental disorder characterized by a range of symptoms, including loss of memory and sleep, decreased energy, feelings of guilt or low mood, disturbed appetite, poor concentration, and an increased risk of suicide. According to a systematic analysis of the Global Burden of Disease Study 2019, depression is recognized as the leading cause of disease burden for mental disorders, accounting for the largest proportion of disability-adjusted life years (DALYs) at 37.3%. The fragility index (FI), which is the minimum number of changes from events to non-events resulting in loss of statistical significance, has been suggested as a means to aid the interpretation of trial results, as the potential inadequacy about robustness of threshold P-value as a tool for reporting binary outcomes in clinical trials. In this systematic review, we want to calculate the FI of randomized controlled trials (RCTs) in depression.

Стилі APA, Harvard, Vancouver, ISO та ін.

Holmer, Haley K., Suchitra Iyer, Celia Fiordalisi, Edi Kuhn, Mary Forte, M. Hassan Murad, Zhen Wang, Amy Y. Tsou, Jeremy J. Michel, and Craig A. Umscheid. Supplementing Systematic Review Findings With Healthcare System Data: Pilot Projects From the Agency for Healthcare Research and Quality Evidence-based Practice Center Program. Agency for Healthcare Research and Quality (AHRQ), January 2025. https://doi.org/10.23970/ahrqepcwhitepapersupplementing.

Повний текст джерела

Анотація:

Objectives. The Agency for Healthcare Research and Quality (AHRQ), through the Evidence-based Practice Center (EPC) Program, aims to provide health system decision makers with the highest-quality evidence to inform clinical decisions. However, limitations in the literature may lead to inconclusive findings in EPC systematic reviews (SRs). The EPC Program conducted pilot projects to understand the feasibility, benefits, and challenges of utilizing health system data to augment SR findings to support confidence in healthcare decision making based on real-world experiences. Study Design and Setting. Three contractors (each an EPC located at a different health system) selected a recently completed systematic review conducted by their center and identified an evidence gap that electronic health record (EHR) data might address. All pilot project topics addressed clinical questions: infantile epilepsy, migraine, and hip fracture, respectively. EPCs also tracked additional resources needed to conduct supplemental analyses. The workgroup met monthly from 2022 to 2023 to discuss challenges and lessons learned from the pilot projects. Results. Two supplemental data analyses filled an evidence gap identified in the systematic reviews (raised certainty of evidence, improved applicability), and the third filled a health system knowledge gap. Project challenges fell under three themes: regulatory and logistical issues, data collection and analysis, and interpretation and presentation of findings. Limited ability to capture key clinical variables given inconsistent or missing data within the EHR was a major limitation. Conducting supplemental data analysis alongside an SR added considerable time and resources to the review process (estimated total hours to complete pilot projects ranged from 283 to 595 across EPCs), and the increased effort and resources added limited incremental value. Conclusion. Supplementing existing systematic reviews with analyses of EHR data is feasible, but resource intensive, and requires specialized skillsets throughout the process. While using EHR data for research has immense potential to generate real-world evidence and fill knowledge gaps, these data may not yet be ready for routine use alongside systematic reviews.

Стилі APA, Harvard, Vancouver, ISO та ін.

WANG, MIN, Sheng Chen, Changqing Zhong, Tao Zhang, Yongxing Xu, Hongyuan Guo, Xiaoying Wang, Shuai Zhang, Yan Chen, and Lianyong Li. Diagnosis using artificial intelligence based on the endocytoscopic observation of the gastrointestinal tumours: a systematic review and meta-analysis. InPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, February 2023. http://dx.doi.org/10.37766/inplasy2023.2.0096.

Повний текст джерела

Анотація:

Review question / Objective: With the development of endoscopic techniques, several diagnostic endoscopy methods are available for the diagnosis of malignant lesions, including magnified pigmented endoscopy and narrow band imaging (NBI).The main goal of endoscopy is to achieve the real-time diagnostic evaluation of the tissue, allowing an accurate assessment comparable to histopathological diagnosis based on structural and cellular heterogeneity to significantly improve the diagnostic rate for cancerous tissues. Endocytoscopy (ECS) is based on ultrahigh magnification endoscopy and has been applied to endoscopy to achieve microscopic observation of gastrointestinal (GI) cells through tissue staining, thus allowing the differentiation of cancerous and noncancerous tissues in real time.To date, ECS observation has been applied to the diagnosis of oesophageal, gastric and colorectal tumours and has shown high sensitivity and specificity.Despite the highly accurate diagnostic capability of this method, the interpretation of the results is highly dependent on the operator's skill level, and it is difficult to train all endoscopists to master all methods quickly. Artificial intelligence (AI)-assisted diagnostic systems have been widely recognized for their high sensitivity and specificity in the diagnosis of GI tumours under general endoscopy. Few studies have explored on ECS for endoscopic tumour identification, and even fewer have explored ECS-based AI in the endoscopic identification of GI tumours, all of which have reached different conclusions. Therefore, we aimed to investigate the value of ECS-based AI in detecting GI tumour to provide evidence for its clinical application.

Стилі APA, Harvard, Vancouver, ISO та ін.

Newman-Toker, David E., Susan M. Peterson, Shervin Badihian, Ahmed Hassoon, Najlla Nassery, Donna Parizadeh, Lisa M. Wilson, et al. Diagnostic Errors in the Emergency Department: A Systematic Review. Agency for Healthcare Research and Quality (AHRQ), December 2022. http://dx.doi.org/10.23970/ahrqepccer258.

Повний текст джерела

Анотація:

Objectives. Diagnostic errors are a known patient safety concern across all clinical settings, including the emergency department (ED). We conducted a systematic review to determine the most frequent diseases and clinical presentations associated with diagnostic errors (and resulting harms) in the ED, measure error and harm frequency, as well as assess causal factors. Methods. We searched PubMed®, Cumulative Index to Nursing and Allied Health Literature (CINAHL®), and Embase® from January 2000 through September 2021. We included research studies and targeted grey literature reporting diagnostic errors or misdiagnosis-related harms in EDs in the United States or other developed countries with ED care deemed comparable by a technical expert panel. We applied standard definitions for diagnostic errors, misdiagnosis-related harms (adverse events), and serious harms (permanent disability or death). Preventability was determined by original study authors or differences in harms across groups. Two reviewers independently screened search results for eligibility; serially extracted data regarding common diseases, error/harm rates, and causes/risk factors; and independently assessed risk of bias of included studies. We synthesized results for each question and extrapolated U.S. estimates. We present 95 percent confidence intervals (CIs) or plausible range (PR) bounds, as appropriate. Results. We identified 19,127 citations and included 279 studies. The top 15 clinical conditions associated with serious misdiagnosis-related harms (accounting for 68% [95% CI 66 to 71] of serious harms) were (1) stroke, (2) myocardial infarction, (3) aortic aneurysm and dissection, (4) spinal cord compression and injury, (5) venous thromboembolism, (6/7 – tie) meningitis and encephalitis, (6/7 – tie) sepsis, (8) lung cancer, (9) traumatic brain injury and traumatic intracranial hemorrhage, (10) arterial thromboembolism, (11) spinal and intracranial abscess, (12) cardiac arrhythmia, (13) pneumonia, (14) gastrointestinal perforation and rupture, and (15) intestinal obstruction. Average disease-specific error rates ranged from 1.5 percent (myocardial infarction) to 56 percent (spinal abscess), with additional variation by clinical presentation (e.g., missed stroke average 17%, but 4% for weakness and 40% for dizziness/vertigo). There was also wide, superimposed variation by hospital (e.g., missed myocardial infarction 0% to 29% across hospitals within a single study). An estimated 5.7 percent (95% CI 4.4 to 7.1) of all ED visits had at least one diagnostic error. Estimated preventable adverse event rates were as follows: any harm severity (2.0%, 95% CI 1.0 to 3.6), any serious harms (0.3%, PR 0.1 to 0.7), and deaths (0.2%, PR 0.1 to 0.4). While most disease-specific error rates derived from mainly U.S.-based studies, overall error and harm rates were derived from three prospective studies conducted outside the United States (in Canada, Spain, and Switzerland, with combined n=1,758). If overall rates are generalizable to all U.S. ED visits (130 million, 95% CI 116 to 144), this would translate to 7.4 million (PR 5.1 to 10.2) ED diagnostic errors annually; 2.6 million (PR 1.1 to 5.2) diagnostic adverse events with preventable harms; and 371,000 (PR 142,000 to 909,000) serious misdiagnosis-related harms, including more than 100,000 permanent, high-severity disabilities and 250,000 deaths. Although errors were often multifactorial, 89 percent (95% CI 88 to 90) of diagnostic error malpractice claims involved failures of clinical decision-making or judgment, regardless of the underlying disease present. Key process failures were errors in diagnostic assessment, test ordering, and test interpretation. Most often these were attributed to inadequate knowledge, skills, or reasoning, particularly in “atypical” or otherwise subtle case presentations. Limitations included use of malpractice claims and incident reports for distribution of diseases leading to serious harms, reliance on a small number of non-U.S. studies for overall (disease-agnostic) diagnostic error and harm rates, and methodologic variability across studies in measuring disease-specific rates, determining preventability, and assessing causal factors. Conclusions. Although estimated ED error rates are low (and comparable to those found in other clinical settings), the number of patients potentially impacted is large. Not all diagnostic errors or harms are preventable, but wide variability in diagnostic error rates across diseases, symptoms, and hospitals suggests improvement is possible. With 130 million U.S. ED visits, estimated rates for diagnostic error (5.7%), misdiagnosis-related harms (2.0%), and serious misdiagnosis-related harms (0.3%) could translate to more than 7 million errors, 2.5 million harms, and 350,000 patients suffering potentially preventable permanent disability or death. Over two-thirds of serious harms are attributable to just 15 diseases and linked to cognitive errors, particularly in cases with “atypical” manifestations. Scalable solutions to enhance bedside diagnostic processes are needed, and these should target the most commonly misdiagnosed clinical presentations of key diseases causing serious harms. New studies should confirm overall rates are representative of current U.S.-based ED practice and focus on identified evidence gaps (errors among common diseases with lower-severity harms, pediatric ED errors and harms, dynamic systems factors such as overcrowding, and false positives). Policy changes to consider based on this review include: (1) standardizing measurement and research results reporting to maximize comparability of measures of diagnostic error and misdiagnosis-related harms; (2) creating a National Diagnostic Performance Dashboard to track performance; and (3) using multiple policy levers (e.g., research funding, public accountability, payment reforms) to facilitate the rapid development and deployment of solutions to address this critically important patient safety concern.

Стилі APA, Harvard, Vancouver, ISO та ін.

Alwan, Iktimal, Dennis D. Spencer, and Rafeed Alkawadri. Comparison of Machine Learning Algorithms in Sensorimotor Functional Mapping. Progress in Neurobiology, December 2023. http://dx.doi.org/10.60124/j.pneuro.2023.30.03.

Повний текст джерела

Анотація:

Objective: To compare the performance of popular machine learning algorithms (ML) in mapping the sensorimotor cortex (SM) and identifying the anterior lip of the central sulcus (CS). Methods: We evaluated support vector machines (SVMs), random forest (RF), decision trees (DT), single layer perceptron (SLP), and multilayer perceptron (MLP) against standard logistic regression (LR) to identify the SM cortex employing validated features from six-minute of NREM sleep icEEG data and applying standard common hyperparameters and 10-fold cross-validation. Each algorithm was tested using vetted features based on the statistical significance of classical univariate analysis (p<0.05) and extended () 17 features representing power/coherence of different frequency bands, entropy, and interelectrode-based distance. The analysis was performed before and after weight adjustment for imbalanced data (w). Results: 7 subjects and 376 contacts were included. Before optimization, ML algorithms performed comparably employing conventional features (median CS accuracy: 0.89, IQR [0.88-0.9]). After optimization, neural networks outperformed others in means of accuracy (MLP: 0.86), the area under the curve (AUC) (SLPw, MLPw, MLP: 0.91), recall (SLPw: 0.82, MLPw: 0.81), precision (SLPw: 0.84), and F1-scores (SLPw: 0.82). SVM achieved the best specificity performance. Extending the number of features and adjusting the weights improved recall, precision, and F1-scores by 48.27%, 27.15%, and 39.15%, respectively, with gains or no significant losses in specificity and AUC across CS and Function (correlation r=0.71 between the two clinical scenarios in all performance metrics, p<0.001). Interpretation: Computational passive sensorimotor mapping is feasible and reliable. Feature extension and weight adjustments improve the performance and counterbalance the accuracy paradox. Optimized neural networks outperform other ML algorithms even in binary classification tasks. The best-performing models and the MATLAB® routine employed in signal processing are available to the public at (Link 1).

Стилі APA, Harvard, Vancouver, ISO та ін.

DSC-MRI Consensus QIBA Profile. Chair Ona Wu, Mark Shiroishi, and Leland Hu. Radiological Society of North America (RSNA)/Quantitative Imaging Biomarkers Alliance (QIBA), October 2020. https://doi.org/10.1148/qiba/20201022.

Повний текст джерела

Анотація:

The goal of a QIBA Profile is to help achieve a useful level of performance for a given biomarker. Profile development is an evolutionary, phased process; this Profile is in the Public Comment Resolution Draft stage. The performance claims represent expert consensus and will be empirically demonstrated at a subsequent stage. Users of this Profile are encouraged to refer to the following site to understand the document’s context: http://qibawiki.rsna.org/index.php/QIBA_Profile_Stages. The Claim (Section 2) describes the biomarker performance. The Activities (Section 3) contribute to generating the biomarker. Requirements are placed on the Actors that participate in those activities as necessary to achieve the Claim. Assessment Procedures (Section 4) for evaluating specific requirements are defined as needed. Conformance (Section 5) regroups Section 3 requirements by Actor to conveniently check Conformance. This QIBA Profile, Dynamic-Susceptibility-Contrast Magnetic Resonance Imaging (DSC-MRI), addresses the measurement of an imaging biomarker for relative Cerebral Blood Volume (rCBV) for the evaluation of brain tumor progression or response to therapy. We note here, that this profile does not claim to be measuring quantitative rCBV due to lack of existing supporting literature; it does provide claims for a biomarker that is proportional to rCBV, which is the tissue-normalized first-pass area under the contrast-agent concentration curve (AUC-TN). The AUC-TN therefore has merit as a potential biomarker for diseases or treatments that impact rCBV. This profile places requirements on Sites, Acquisition Devices, Contrast Injectors, Contrast Media, Radiologists, Physicists, Technologists, Reconstruction Software, Image Analysis Tools and Image Analysts involved in Site Conformance, Staff Qualification, Product Validation, Pre-delivery, Periodic QA, Protocol Design, Subject Handling, Image Data Acquisition, Image Data Reconstruction, Image QA, Image Distribution, Image Analysis and Image Interpretation. The requirements are focused on achieving known (ideally negligible) bias and avoiding unnecessary variability of the of the AUC-TN measurements. The clinical performance is characterized by a 95% confidence interval for the AUC-TN true change (Y2-Y1) in enhancing tumor tissue (𝑌−𝑌)±1.96× (𝑌×0.31) +(𝑌×0.31) and in normal tissue (𝑌−𝑌)±1.96× (𝑌×0.40) +(𝑌×0.40), where Y1 is the baseline measurement and Y2 is the follow-up measurement. These estimates are based on current literature values but may be updated based on future studies (see Section 2.2 for details). This document is intended to help clinicians basing decisions on this biomarker, imaging staff generating this biomarker, vendor staff developing related products, purchasers of such products and investigators designing trials with imaging endpoints. Note that this document only states requirements to achieve the claim, not “requirements on standard of care.” Conformance to this Profile is secondary to properly caring for the patient. QIBA Profiles addressing other imaging biomarkers using CT, MRI, PET and Ultrasound can be found at qibawiki.rsna.org.

Стилі APA, Harvard, Vancouver, ISO та ін.

Ми пропонуємо знижки на всі преміум-плани для авторів, чиї праці увійшли до тематичних добірок літератури. Зв'яжіться з нами, щоб отримати унікальний промокод!