scholarly journals Fusion iENA Scholar Study: Sensor-Navigated I-124-PET/US Fusion Imaging versus Conventional Diagnostics for Retrospective Functional Assessment of Thyroid Nodules by Medical Students

Sensors ◽  
2020 ◽  
Vol 20 (12) ◽  
pp. 3409
Author(s):  
Martin Freesmeyer ◽  
Thomas Winkens ◽  
Luis Weissenrieder ◽  
Christian Kühnel ◽  
Falk Gühne ◽  
...  

In conventional thyroid diagnostics, the topographical correlation between thyroid nodules (TN) depicted on ultrasound (US) in axial or sagittal orientation and coronally displayed scintigraphy images can be challenging. Sensor-navigated I-124-PET/US fusion imaging has been introduced as a problem-solving tool for ambiguous cases. The purpose of this study was to investigate the results of multiple unexperienced medical students (MS) versus multiple nuclear medicine physicians (MD) regarding the overvalue of I-124-PET/US in comparison to conventional diagnostics (CD) for the functional assessment of TN. Methods: Out of clinical routine, cases with ambiguous findings on CD were selected for I-124-PET/US fusion imaging. Sixty-eight digital patient case files (PCF) of 34 patients (CDonly and CD+PET/US PCF) comprising 66 TN were provided to be retrospectively evaluated by 70 MD and 70 MS, respectively. A total of 2174 ratings (32.9 per TN) were carried out: 555 ratings (8.4 per TN) for CDonly and 532 ratings (8.1 per TN) for CD+PET/US by each MD and MS. Results: Functional assessment revealed 8.5%/11.7% (n.s.) (16.4%/25.8% (p = 0.0002)), 41.8%/28.5% (p < 0.0001) (23.9%/17.9% (p = 0.0193)), 36.0%/30.5% (n.s.) (57.3%/53.9% (n.s.)), and 13.7%/29.4% (p < 0.0001) (2.4%/2.4% (n.s.)) hyperfunctioning, indifferent, hypofunctioning, and not rateable TNs for CDonly (CD+PET/US) and MD/MS, respectively. The respective rating confidence was indicated as absolute certain, quite certain, equivocal, uncertain, and not rateable in 11.7/3.4% (p < 0.0001) (44.9%/38.9% (p = 0.0541), 51.9%/26.7% (p < 0.0001) (46.2%/41.5% (n.s.)), 21.6%/29.0% (p = 0.0051) (6.2%/14.8% (p < 0.0001)), 1.1%/11.5% (p < 0.0001) (0.2%/2.3% (p = 0.0032)), and 13.7%/29.4% (p < 0.0001) (2.4%/2.4% (n.s.)) by MD/MS, respectively. There was a significant difference in the diversity of the observers’ functional assessment of TN (MD 0.84 vs. MS 1.02, p = 0.0006) and the respective confidence in functional assessment (MD 0.93 vs. MS 1.16, p < 0.0001) between MD and MS on CDonly, whereas CD+PET/US revealed weaker differences for both groups (MD 0.48 vs. MS 0.47, p = 0.57; and MD 0.66 vs. MS 0.83, p = 0.0437). With the additional application of I-124-PET/US, the rating diversity of both MD and MS markedly tends towards more consistency (p < 0.0001 in each case). Conclusion: The additional application of sensor-navigated I-124-PET/US fusion imaging significantly influenced the functional assessment of TN positively, especially for unexperienced observers.

2019 ◽  
Vol 58 (06) ◽  
pp. 434-442 ◽  
Author(s):  
Thomas Winkens ◽  
Philipp Seifert ◽  
Christian Hollenbach ◽  
Christian Kühnel ◽  
Falk Gühne ◽  
...  

Abstract Aim To investigate the value of I-124 positron emission tomography (PET) / ultrasound (US) fusion imaging in comparison to conventional diagnostics (CD) of Thyroid nodules (TN) by multiple observers. Methods Digital patient case files (PCF) of patients that received CD and I-124-PET/US in clinical routine were prepared containing cine-loops of the examinations. All physicians with nuclear medicine specialty from Germany, Austria, and Switzerland were invited to participate. 106 acquired observers completed 7.2 ± 1.8 (median: 8, range: 4–14) randomly assigned PCF (CD only or CD+PET/US). They assessed the TN function, stated their confidence in functional assessment, and suggested a treatment course for each TN. Results 68 PCF of 34 patients comprising 66 TN ≥ 1 cm (= 1.94 TN/patient) were created. A total of 748 (11.2/TN), and 751 ratings (11.4/TN) were recorded for CD only, and CD+PET/US, respectively. The functional assessment revealed more hyper- or hypofunctioning (524 vs. 320, p < 0.0001) and less indifferent or not rateable (209 vs. 428, p < 0.0001) TN in CD+PET/US vs. CD only. The observers’ confidence in functional assessment was superior in CD+PET/US (p < 0.0001). Furthermore, the ratings were carried out more homogeneous in CD+PET/US (p < 0.0001). Fewer suggestion of follow up (p < 0.0001), and more (p < 0.0001) suggestion of invasive treatments (fine-needle aspiration & surgery) was observed in CD+PET/US. Radioiodine therapy was more often (p = 0.0036), and thyroid medication less often (p = 0.0167) advised in CD+PET/US. Conclusion Functional assessment of equivocal TN shows frequent failures in CD, underestimating the incidence of hyper- and hypofunctioning lesions. Confidence in functional assessment significantly increases with additional PET/US. This influences the proposed treatment course.


Author(s):  
Cassidy M. Johnston ◽  
Huixian Pan ◽  
Robert Sorrells ◽  
Damianne Brand-Eubanks ◽  
Emily Darst ◽  
...  

Introduction: The effective delivery of patient care is a complex venture, often requiring efficient collaboration among varied healthcare professions. Not surprisingly, research continues to indicate collaboration between these diverse professionals can be challenging. Early exposure of health professions students to interprofessional education (IPE) offers a promising way to improve this collaboration and, in turn, improve patient care and service delivery. Objectives: This study examines the impact of an innovative IPE cocurricular event on knowledge, understanding, and attitudes, regarding future healthcare delivery between medical and pharmacy students. Method: Students developed and conducted an IPE cocurricular event involving medical students of a dermatology-interest club, and pharmacy students of a compounding-interest club. Medical students introduced a patient case, delivered in a standardized-patient format. This was followed by a pharmacy student presentation representing compounding the prescriptions needed for the patient case and writing accurate prescriptions. Following both presentations, students from each program were paired.  Each interprofessional pair then communicated and compounded two medications for the case, working collaboratively.  Pre- and post-questionnaires were designed with rating scales and open-ended questions for data collection.  Results: Both parametric and nonparametric tests revealed significant differences between the pretests and posttests. There was no significant difference in responding between the groups. Inspection of the open-ended questions revealed changes in attitudes regarding collaboration and learning. Conclusions: This study found students of both professions reported significant improvements in their level of knowledge, understanding, and interest in interprofessional collaboration. The open-ended questions revealed both groups of students began the event with different expectations regarding cooperation and interprofessional activities but left the session with very similar perspectives. By including similar IPE activities in early healthcare education, medical students will gain an understanding of the knowledge, skills, and services that a compounding pharmacist can offer in personalized patient care, and pharmacy students will acquire clinical reasoning based on patient presentations. Both factors promote collaboration between professions and ultimately show promise in improving outcomes in patient care.


2020 ◽  
Vol 11 (1) ◽  
Author(s):  
Chi-Tung Cheng ◽  
Chih-Chi Chen ◽  
Chih-Yuan Fu ◽  
Chung-Hsien Chaou ◽  
Yu-Tung Wu ◽  
...  

Abstract Background With recent transformations in medical education, the integration of technology to improve medical students’ abilities has become feasible. Artificial intelligence (AI) has impacted several aspects of healthcare. However, few studies have focused on medical education. We performed an AI-assisted education study and confirmed that AI can accelerate trainees’ medical image learning. Materials We developed an AI-based medical image learning system to highlight hip fracture on a plain pelvic film. Thirty medical students were divided into a conventional (CL) group and an AI-assisted learning (AIL) group. In the CL group, the participants received a prelearning test and a postlearning test. In the AIL group, the participants received another test with AI-assisted education before the postlearning test. Then, we analyzed changes in diagnostic accuracy. Results The prelearning performance was comparable in both groups. In the CL group, postlearning accuracy (78.66 ± 14.53) was higher than prelearning accuracy (75.86 ± 11.36) with no significant difference (p = .264). The AIL group showed remarkable improvement. The WithAI score (88.87 ± 5.51) was significantly higher than the prelearning score (75.73 ± 10.58, p < 0.01). Moreover, the postlearning score (84.93 ± 14.53) was better than the prelearning score (p < 0.01). The increase in accuracy was significantly higher in the AIL group than in the CL group. Conclusion The study demonstrated the viability of AI for augmenting medical education. Integrating AI into medical education requires dynamic collaboration from research, clinical, and educational perspectives.


2021 ◽  
Vol 8 ◽  
pp. 238212052098418
Author(s):  
William Beedham ◽  
Kasun Wanigasooriya ◽  
Georgia R Layton ◽  
Ley Taing Chan ◽  
Adnan Darr ◽  
...  

Background: Starting work as a junior doctor can be daunting for any medical student. There are numerous aspects of the hidden curriculum which many students fail to acquire during their training. Objectives: To evaluate the effectiveness of a novel foundation year one (FY1) doctor preparation course focusing on certain core topics, practical tips and components of the hidden curriculum. The primary objective was to improve the confidence level and knowledge of final year medical students transitioning to FY1 doctors. Method: A 2-day, practical course titled ‘Preparation 2 Practice’ delivering hands-on, small-group and lecture-based teaching, covering core medical student undergraduate curriculum topics in medicine and surgery. The course content spanned therapeutics, documentation skills and managing acute clinical tasks encountered by FY1 doctors during an on-call shift. A pre- and post-course survey and knowledge assessment were carried out to assess the effectiveness of the course. The assessment was MCQ-based, derived from topics covered within our course. The 20-question test and a short survey were administered electronically. Results: Twenty students from a single UK medical school attended the course. 100% participation was observed in the pre- and post-course test and survey. The median post-course test result was 22 (IQR 20.25-23.75) which was higher than the median pre-course test score of 18.75 (IQR 17-21.75). A Wilcoxon sign rank test revealed a statistically significant difference between the pre- and post-course test results ( P = .0003). The self-reported confidence score of delegates on starting work as a junior doctor was also significantly higher following the course ( P = .004). Conclusion: The results show a significant improvement in perceived confidence and knowledge on core curriculum topics amongst final year medical students having attended our FY1 doctor preparation course. We conclude that there is scope for similar supplementary courses as an adjunct to the undergraduate medical curriculum.


2021 ◽  
Vol 8 ◽  
pp. 238212052110164
Author(s):  
Abbie West ◽  
Cara Cawley ◽  
Elizabeth Crow ◽  
Alexis M. Stoner ◽  
Natalie M. Fadel ◽  
...  

Objective: Approximately 1 in 6 adults 60 and older have experienced a form of abuse in the past year. Many cases remain under-reported due to lack of knowledge and awareness. This study created an educational program on elder abuse for medical students to determine if participation would increase knowledge and awareness of elder abuse. Methods: This study used a pre and post survey methodology to evaluate students’ knowledge and awareness of elder abuse before and after participating in this educational program. Sixty first and second year osteopathic medical students at the Edward Via College of Osteopathic Medicine, Carolinas Campus participated in this study. Students were emailed a pre-survey to evaluate their pre-existing knowledge and awareness. The survey was, previously created by the Student Training on Preventing Domestic Violence (STOP-DV) team using validated measures. Participants then attended educational events about various forms of elder abuse and recognizing its associated signs, and afterward completed the post-survey. The results were compared using t-tests to determine if there was a significant difference. Results: First and second year students differed significantly in pre-survey results of knowledge but not post-survey results. The results showed a significant difference in overall mean knowledge ( P-value < .001) and awareness scores ( P-value < .001) in all students. Conclusion: These results suggest education on elder abuse can enable future physicians to better recognize, understand, and support older adults regarding elder maltreatment.


2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 3055-3055
Author(s):  
Yuntao Song ◽  
Jie Liu ◽  
Weiran Wang ◽  
Tonghui Ma

3055 Background: Ultrasound and ultrasound-guided fine needle aspiration (US-FNA) are the first choice for judging benign and malignant thyroid nodules. This study will report on the differences of US-FNA BSRTC class, postoperative pathology and mutation landscape of thyroid nodules between China and other countries. Methods: We conducted a prospective study containing 383 FNA samples of thyroid nodules. For most of these FNA samples, genomic DNA and RNA were extracted and sequenced with FSZ-Thyroid NGS Panel V1, and postoperative pathology were followed up. Moreover, we also compared results of this study with those of West China Hospital in China, Yamashita Thyroid Hospital in Japan, and Cleveland Clinic in the United States. Results: Among the 383 FNA samples, the proportions of BSRTC class I to VI were 10.7%, 6.3%, 18.8%, 3.7%, 12.3%, and 48.3% respectively. Compared with study in other countries, the proportion of class II was significantly lower than that in Japan and the United States. Meanwhile, the proportion of class V and VI were significantly higher than the above two countries. Subsequently, 232 thyroid nodules were surgically removed. Postoperative pathology showed that the proportion of malignant tumors (85.3%) was also significantly higher than reported in Japan and the United States. But compared with other studies in China, there was no significant difference. Most of the malignant tumors were papillary thyroid cancer (PTC, 96%), accompanied with 2 follicular thyroid cancer (FTC), 3 medullary cancer (MTC) and 3 anaplastic thyroid cancer (ATC). Compared with study in the United States, the proportion of PTC and FTC were elevated (96% vs. 85.3%) and reduced (1% vs. 9.3%) respectively. At last, we also analysis the mutation landscape of 180 malignant tumors. Compared with TCGA study, the frequency of BRAF V600E in PTC in our study was significantly higher than that of TCGA (73.3% vs. 58%), and the frequency of RAS mutation was significantly lower (1.2% vs. 12.6%). And compared with an institutional experience of ThyroSeq v3 for Bethesda III and IV at the University of Pittsburgh Medical Center, the frequency of BRAF V600E and RAS mutation in Bethesda III-IV malignant tumors was also significantly higher (45.8% vs. 1.4%) and lower (8.3% vs. 47.1%). Conclusions: There were significant differences in BSRTC class and postoperative pathology between China and other countries, such as Japan and the United States. The possible reasons included that the indications for FNA in China were different. For example, most of patients who underwent FNA in this study had suspicious clinical/ultrasound features. So the proportion of BSRTC class V and VI as well as the malignant rate were elevated. On the other hand, more BRAF V600E and less RAS mutations were detected in malignant tumors in this study which might result from racial differentiation and discrepancy in proportion of PTC and FTC.


2021 ◽  
Author(s):  
Mohammad Nour Shashaa ◽  
Mohamad Shadi Alkarrash ◽  
Mohammad Nour Kitaz ◽  
Roaa Rhayim ◽  
Mohammed Ismail ◽  
...  

Abstract Background Sudden cardiac arrest considers one of the most leading cause for death in all over the world. It is important for all medical students to train basic life support. This study evaluated the awareness of basic life support among medical students. Methods An electronic questionnaire based cross sectional study was conducted in November 2020 among 2114 medical student in Syria, Iraq and Jordan. We evaluated BLS skills according to mean score. A chi-squared test was used to determine if there were differences between those who attended a basic life support course and those who did not. Results 1656 of the participants (78.3%) stated that they did not attend a basic life support course. There was a significant difference between the participants from different countries where the mean score in Syria, Jordan and Iraq was 18.3, 24.3 and 18.8 respectively (p < 0.05). The participants were divided into 3 level according to total score; low (0–12), moderate (13–24) and high (25–37). In total, 18.3%, 72.8% and 8.9% of participants had high, intermediate and low level respectively. Conclusions The overall knowledge of basic life support among medical students is not adequate and need significant improvements. This study showed that an attendance a basic life support course previously had an effect on knowledge level. Hence, there is an urgent need to apply basic life support courses into the pre-clinical stage at universities.


Hypertension ◽  
2017 ◽  
Vol 70 (suppl_1) ◽  
Author(s):  
Lilian S Costa ◽  
Marina C Marins ◽  
Jocasta C Ansel ◽  
Carolina P Tavares ◽  
Fernanda T Queiroz ◽  
...  

Introduction: Medical students, susceptible to sleep disorders, have irregular sleep-awake cycle, with repercussions on the quality of life and reduced academic performance, often with greater incidence of psychiatric disorders, estimated at 15% to 25% during your academic training. Objective: To evaluate the sleep habits in students of medical school in a private college of Rio de Janeiro, Brazil. Method: This subset study is a part of an observational study with cross-sectional delineation, with data collected through the application of an anonymous questionnaire, where they were asked about the number (and modification) of hours they sleep daily, in addition to reports of “stress and anxiety”. These data collected formed the basis of an instrument for assessing the quality of life on the medical students of this College. Results: We analyzed data from 481 students: 82 (17%) at the first year, 118 (24.5%) at the second year, 99 (20.6%) at the third, 64 (13.3%) and 118 (24.5%) within the fifth and sixth years. The average age was 21.7 years (16-42) and 306 (63.6%) of female gender. As for the hours of sleep, 445 students (92.5%) report 5 to 8 hours of sleep, and 216 (44.9%) a minimum of 6 hours. In the sleep of the weekends, 394 (81.9%) reported change in the number of hours and, 313 (65.1%) referred to a reduction after the entrance into college. It was reported "some level of stress and anxiety,“ not related to the least number of hours sleepping (0.07). Comparing the data obtained among the 199 students of the first and second years (62.8% female-group A) to 117 at fifth and sixth years (70.9% female-group B), we observed similarity in relation to (1) number of 5 to 8 hours sleepping (A 92.9% x 90.5% B), (2) change the hours of sleepping on the weekends (A 81.9% x 79.5% B), and (3) reduction of sleepping hours after the entrance into College (A 81.9% x 78.6% B). With regard to the report of "stress and anxiety”, we observed statistically significant difference between the groups (A 100% x 88% B, p < 0.03). Conclusion: The change in lifestyle imposed on joining a new school learning model, generates anxiety and loss of sleep hours among students. The development of resilience and adaptation to change, both individual and institutional, may have been responsible to varying degrees of stress.


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