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1
Curry, Reva A. "Neurosonology—Who Should Perform the Study?" Journal of Child Neurology 4, nr 1_suppl (styczeń 1989): S5—S7. http://dx.doi.org/10.1177/0883073889004001s03.
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Neurosonology is a rapidly growing field of imaging which demands a highly skilled imaging professional. Sonographers are imagers trained to produce sonographic images of one or more of the following specialty areas: abdomen, obstetrics/ gynecology, adult echocardiography, pediatric echocardiography, opthalmology, vascular technology, and neurosonology. There are short and long term training programs for sonographers which vary in scope and the number of specialty areas offered. Some sonographers do not receive formal training and learn OTJ (on-the-job). Any training program in neurosonology should encompass anatomy, basic pathology, sonographic appearance of normal and abnormal structures, and physics/instrumentation. There is presently a sonographer shortage due to the rapid increase in sonographer positions nationwide. It is therefore beneficial to the neurosonology department to allow ample time to recruit and/or train a sonographer. The Society of Diagnostic Medical Sonographers, the American Registry of Diagnostic Medical Sonographers, and the American Institute of Ultrasound in Medicine are valuable resources in providing information on training opportunities and recruitment strategies for sonographers. (J Child Neurol 1989;4:S5-S7).
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Naomi, Clay. "Strategies for Eliminating the Sonographer Shortage". Journal of Diagnostic Medical Sonography 20, nr 6 (listopad 2004): 408–13. http://dx.doi.org/10.1177/8756479304269838.
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Hagen-Ansert, Sandra, i Kristen Billick. "The Challenges of Educating a Cardiac Sonography Workforce". Journal of Diagnostic Medical Sonography 39, nr 4 (24.06.2023): 414–20. http://dx.doi.org/10.1177/87564793231168776.
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Objective: Cardiac sonographers are challenged on a daily basis to provide excellent frontline care for a variety of patients. They face challenges of promoting quality over quantity and continued support for education and training efforts. Echocardiography requires an operator-dependent sonographer with independent judgement and critical thinking skills to obtain and integrate diagnostic information during the echo examination. The growth of echocardiographic procedures has increased the demand for qualified cardiac sonographers to cover the workload. Materials and Methods: Occupational employment and wage statistics, educational opportunities, simulation labs and clinical sites, national registries, and ASE standards for a quality echo educational environment are discussed. Results: The national curriculum for echocardiography is extensive and requires adequate clinical hands-on training to promote an opportunity for the student to become a competent cardiac sonographer. Credentialing in echocardiography demonstrates to the patients, healthcare professionals, and employers of medical facilities that the cardiac sonographer is a dedicated professional in their respective field. Conclusions: Additional accredited cardiovascular programs with active credentialed clinical sites to fulfill this shortage. The skillset has increased with new procedures requiring training in advanced imaging techniques such as three-dimensional imaging, strain, tissue Doppler, and contrast-enhanced imaging.
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Witt, Sandy. "The Sonographer Shortage: A Misguided Debate or the Real Deal?" Journal of the American Society of Echocardiography 18, nr 5 (maj 2005): A25—A26. http://dx.doi.org/10.1016/j.echo.2005.03.036.
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Waring, Lorelei, Paul K. Miller, Charles Sloane i Gareth Bolton. "Charting the practical dimensions of understaffing from a managerial perspective: The everyday shape of the UK’s sonographer shortage". Ultrasound 26, nr 4 (12.05.2018): 206–13. http://dx.doi.org/10.1177/1742271x18772606.
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Introduction Across the last two decades, ultrasound services in many healthcare sectors have become increasingly pressurised as a consequence of upsurging demand and difficulties in recruiting viable clinicians. Indeed by 2013, the UK government’s Migration Advisory Committee had listed sonography as an official ‘shortage specialty’. Comparatively little research has to date, however, explored the impacts of this situation upon the departments themselves, and the individuals working therein. The core purpose of this study is, thus, to lend qualitative depth to current understandings of the frontline situation in the UK’s ultrasound units, many of which are understaffed, from the perspective of their managers. Methods Using a thematic analysis informed by a Straussian model of Grounded Theory, N = 20 extended accounts provided by ultrasound department leads in public ( n = 18) and private ( n = 2) units were explored. Results Four global themes emerged from the analysis of which the first two (the broadly sociological matters) are described in this paper. Theme 1 addresses how a lack of staff in the broader ultrasound economy has created a troublesome migratory system in contemporary UK ultrasound. Theme 2 addresses how this economy works chiefly to the advantage of the most junior and the most senior clinicians, often leaving mid-career professionals in the borderline impossible situation of having to concurrently occupy both junior and senior roles. Conclusions The findings ideally open up debate on some key practical contingencies of the UK’s sonographer shortage, and reflect upon literature regarding the nuanced aspects of a shifting healthcare workplace constitution.
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Sawitsky, Leah. "Ongoing Challenges in Clinical Precepting: Exploring Solutions for the Shortage of Clinical Practicum Placements for Diagnostic Medical Sonography Students in Canada". Canadian Journal of Medical Sonography 16, nr 1 (1.01.2025): 8–13. https://doi.org/10.3138/cjms-2024-0010.
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There continues to be an ongoing shortage of diagnostic medical sonographers in Canada. While much focus has been placed on educational institutions opening more spots in their competitive entry programs, this priority ignores a critical piece of the puzzle—the availability of clinical preceptors required to provide the mandatory clinical training for these students to obtain their Canadian Clinical Skills Assessment (CCSA) competencies. Students must obtain their CCSAs to be eligible to write the Sonography Canada written examinations and gain entry-to-practie in the field. To continue to train competent sonographers and open more clinical practicum placements in Canada, clinical preceptors require increased support and training, both from educational institutions and the facilities they work for. The lack of adequate professional training in teaching skills, a lack of scanning time, and minimal support for clinical preceptors has led to a scarcity of clinical spots for sonography students, undermining students’ training and impeding their ability to acquire essential hands-on scanning experience required to meet the Sonography Canada entry-to-practise requirements.
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Craig, Marveen. "Sonographer Shortages:". Journal of Diagnostic Medical Sonography 19, nr 4 (lipiec 2003): 261–71. http://dx.doi.org/10.1177/8756479303253946.
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Craig, Marveen. "Sonographer Shortages: A Day Late and a Dollar Short?" Journal of Diagnostic Medical Sonography 19, nr 3 (maj 2003): 199. http://dx.doi.org/10.1177/8756479303019003013.
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Lichtenberg, Gerson S. "Sonographer Shortages: A Day Late and a Dollar Short?" Journal of Diagnostic Medical Sonography 19, nr 3 (maj 2003): 199–200. http://dx.doi.org/10.1177/8756479303019003014.
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Schneider, Sharon. "Sonographer Shortages: A Day Late and a Dollar Short?" Journal of Diagnostic Medical Sonography 19, nr 3 (maj 2003): 200. http://dx.doi.org/10.1177/8756479303019003015.
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Pantaleo, Jean. "Sonographer Shortages: A Day Late and a Dollar Short?" Journal of Diagnostic Medical Sonography 19, nr 3 (maj 2003): 200–201. http://dx.doi.org/10.1177/8756479303019003016.
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Karol, Sandra M. "Sonographer Shortages: A Day Late and a Dollar Short?" Journal of Diagnostic Medical Sonography 19, nr 3 (maj 2003): 201. http://dx.doi.org/10.1177/8756479303019003017.
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Brennan, Kevin. "Sonographer Shortages: A Day Late and a Dollar Short?" Journal of Diagnostic Medical Sonography 19, nr 3 (maj 2003): 201. http://dx.doi.org/10.1177/8756479303019003018.
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Corbett, Margaret. "Sonographer Shortages: A Day Late and a Dollar Short?" Journal of Diagnostic Medical Sonography 19, nr 3 (maj 2003): 201–2. http://dx.doi.org/10.1177/8756479303019003019.
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Perko, Connie. "Sonographer Shortages: A Day Late and a Dollar Short?" Journal of Diagnostic Medical Sonography 19, nr 3 (maj 2003): 202–3. http://dx.doi.org/10.1177/8756479303019003020.
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Lawson, Mark. "Sonographer Shortages: A Day Late and a Dollar Short?" Journal of Diagnostic Medical Sonography 19, nr 3 (maj 2003): 203–4. http://dx.doi.org/10.1177/8756479303019003021.
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Blume, Gretchen Lee. "Sonographer Shortages: A Day Late and a Dollar Short?" Journal of Diagnostic Medical Sonography 19, nr 3 (maj 2003): 204. http://dx.doi.org/10.1177/8756479303019003022.
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Milburn, Don. "Sonographer Shortages: A Day Late and a Dollar Short?" Journal of Diagnostic Medical Sonography 19, nr 3 (maj 2003): 204–5. http://dx.doi.org/10.1177/8756479303019003023.
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Dempsey, Ann, i Sie Mens. "Sonographer Shortages: A Day Late and a Dollar Short?" Journal of Diagnostic Medical Sonography 19, nr 3 (maj 2003): 205–6. http://dx.doi.org/10.1177/8756479303019003024.
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Spitz, Jean Lea. "Sonographer Shortages: A Day Late and a Dollar Short?" Journal of Diagnostic Medical Sonography 19, nr 3 (maj 2003): 206–7. http://dx.doi.org/10.1177/8756479303019003025.
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Płotka, Szymon, Adam Klasa, Aneta Lisowska, Joanna Seliga-Siwecka, Michał Lipa, Tomasz Trzciński i Arkadiusz Sitek. "Deep learning fetal ultrasound video model match human observers in biometric measurements". Physics in Medicine & Biology 67, nr 4 (16.02.2022): 045013. http://dx.doi.org/10.1088/1361-6560/ac4d85.
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Abstract Objective. This work investigates the use of deep convolutional neural networks (CNN) to automatically perform measurements of fetal body parts, including head circumference, biparietal diameter, abdominal circumference and femur length, and to estimate gestational age and fetal weight using fetal ultrasound videos. Approach. We developed a novel multi-task CNN-based spatio-temporal fetal US feature extraction and standard plane detection algorithm (called FUVAI) and evaluated the method on 50 freehand fetal US video scans. We compared FUVAI fetal biometric measurements with measurements made by five experienced sonographers at two time points separated by at least two weeks. Intra- and inter-observer variabilities were estimated. Main results. We found that automated fetal biometric measurements obtained by FUVAI were comparable to the measurements performed by experienced sonographers The observed differences in measurement values were within the range of inter- and intra-observer variability. Moreover, analysis has shown that these differences were not statistically significant when comparing any individual medical expert to our model. Significance. We argue that FUVAI has the potential to assist sonographers who perform fetal biometric measurements in clinical settings by providing them with suggestions regarding the best measuring frames, along with automated measurements. Moreover, FUVAI is able perform these tasks in just a few seconds, which is a huge difference compared to the average of six minutes taken by sonographers. This is significant, given the shortage of medical experts capable of interpreting fetal ultrasound images in numerous countries.
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Balthazaar, Shane J. T., Sandra Taves Bhutto i Jaclyn Lam. "Ongoing Challenges in Clinical Precepting". Canadian Journal of Medical Sonography 16, nr 2 (1.01.2025): 29–33. https://doi.org/10.3138/cjms-2025-0003.
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A recent review published in CJMS highlights the pressing shortage of clinical preceptors for diagnostic medical sonography students in Canada and its impact on entry-to-practice requirements. While the author focuses on the challenges faced by clinical preceptors, we wish to approach the discussion from a broader systemic perspective. Solutions to this issue should include both structural changes and systemic incentives, such as creating dedicated roles for clinical educators, promoting collaborative learning ecosystems, and exploring innovative simulation technologies to supplement hands-on training.
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Rachmatullah, M. N., Siti Nurmaini, A. I. Sapitri, A. Darmawahyuni, B. Tutuko i Firdaus Firdaus. "Convolutional neural network for semantic segmentation of fetal echocardiography based on four-chamber view". Bulletin of Electrical Engineering and Informatics 10, nr 4 (1.08.2021): 1987–96. http://dx.doi.org/10.11591/eei.v10i4.3060.
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The acute shortage of trained and experienced sonographers causes the detection of congenital heart defects (CHDs) extremely difficult. In order to minimize this difficulty, an accurate fetal heart segmentation to the early location of such structural heart abnormalities prior to delivery is essential. However, the segmentation process is not an easy task due to the small size of the fetal heart structure. Moreover, the manual task for identifying the standard cardiac planes, primarily based on a four-chamber view, requires a well-trained clinician and experience. In this paper, a CNN method using U-Net architecture was proposed to automate fetal cardiac standard planes segmentation from ultrasound images. A total of 519 fetal cardiac images was obtained from three videos. All data is divided into training and testing data. The testing data consist of 106 slices of the four-chamber segmentation tasks, i.e. atrial septal defect (ASD), ventricular septal defect (VSD), and normal. The segmentation of the post-processing method is needed to enhanced the segmentation result. In this paper, a combination technique with U-Net and Otsu thresholding gives the best performances with 99.48%-pixel accuracy, 96.73% mean accuracy, 94.92% mean intersection over union, and 0.21% segmentation error. In the future, the implementation of Deep Learning in the study of CHDs holds significant potential for identifying novel CHDs in heterogeneous fetal hearts.
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Iida, Tatsuto, Shunsuke Kiya, Kosuke Kubota, Takashi Jin, Akitoshi Seiyama i Yasutomo Nomura. "Monte Carlo Modeling of Shortwave-Infrared Fluorescence Photon Migration in Voxelized Media for the Detection of Breast Cancer". Diagnostics 10, nr 11 (17.11.2020): 961. http://dx.doi.org/10.3390/diagnostics10110961.
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Recent progress regarding shortwave-infrared (SWIR) molecular imaging technology has inspired another modality of noninvasive diagnosis for early breast cancer detection in which previous mammography or sonography would be compensated. Although a SWIR fluorescence image of a small breast cancer of several millimeters was obtained from experiments with small animals, detailed numerical analyses before clinical application were required, since various parameters such as size as well as body hair differed between humans and small experimental animals. In this study, the feasibility of SWIR was compared against visible (VIS) and near-infrared (NIR) region, using the Monte Carlo simulation in voxelized media. In this model, due to the implementation of the excitation gradient, fluorescence is based on rational mechanisms, whereas fluorescence within breast cancer is spatially proportional to excitation intensity. The fluence map of SWIR simulation with excitation gradient indicated signals near the upper surface of the cancer, and stronger than those of the NIR. Furthermore, there was a dependency on the fluence signal distribution on the contour of the breast tissue, as well as the internal structure, due to the implementation of digital anatomical data for the Visible Human Project. The fluorescence signal was observed to become weaker in all regions including the VIS, the NIR, and the SWIR region, when fluorescence-labeled cancer either became smaller or was embedded in a deeper area. However, fluorescence in SWIR alone from a cancer of 4 mm diameter was judged to be detectable at a depth of 1.4 cm.
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Noguchi, I., i K. Oda. "AB1122 BENEFIT OF JOINT ULTRASONOGRAPHY IN RHEUMATOID CARE PATIENT SATISFACTION SURVEY WITH NPS® USING POCUS (POINT OF CARE ULTRASOUND)". Annals of the Rheumatic Diseases 79, Suppl 1 (czerwiec 2020): 1850.1–1850. http://dx.doi.org/10.1136/annrheumdis-2020-eular.3074.
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Background:The roles of rheumatologists include patient education and information provision, and there is a report that patient care led by nurses gives high satisfaction. In addition, it has been reported that rheumatologists will no longer provide sufficient care for rheumatism and nurses may make up for the shortage (1). In order for patients to deal with diseases for a long time, it is necessary to communicate with patients through team approach to healthcare including nurses specialized in rheumatology, and to make efforts to further improve patient satisfaction.Objectives:The satisfaction of patients who had undergone joint ultrasound (MSKUS) by rheumatologist nurses who had been registered as sonographers by the Japan College of Rheumatology was evaluated using a net promoter score (NPS®) to investigate whether medical intervention by nurses improved patient satisfaction.Methods:A questionnaire survey was performed in 103 RA patients who visited our department. The contents were 2 points, and (1) MSKUS’s level of patient satisfaction and (2) MSKUS’s level of recommendation to others were investigated. In (1), whether or not (1) the echo test was good, (2) whether the test was done with peace of mind, (3) whether the time of the test was appropriate, and (4) whether or not the disease status was better understood after the test, and (5) whether or not the patient wished to undergo the echo test periodically, were asked on a 5 point scale (high evaluation to low evaluation, 1 ~ 5). Regarding (2), the doctor said “Would you like to recommend the joint echo test to other patients? This question was evaluated using NPS®, which is said to have strong correlation with patient satisfaction, growth, and business performance in various industries.Measurement method of NPS®The customer with the 9 ~ 10 point score is classified as a “recommendation” the customer with the 7 ~ 8 point score is classified as a “neutral person” and the customer with the 0 ~ 6 point score is classified as a “critical person” The value of NPS® is the value that comes out after subtracting the percentage of a critical person (%) from the percentage of a recommended person (%).Results:Questionnaires were administered to 103 RA patients and responses were obtained from all.(1) For the 5 items of patient satisfaction, 85% or more of the patients had high scores (1 and 2) for all the questions.(2) NPS® score was high at 67. The NPS® score was even higher in the group of patients without progression of joint destruction (Stage 1 and 2) at 79.Conclusion:It was suggested that when the nurse who usually coaches explained the symptoms immediately using POCUS, the patient’s satisfaction would be improved, and a sense of security would be provided for the test. In addition, NPS® is a unified questioning method and said to be highly correlated with customer satisfaction, and it was considered that POCUS leads to benefits in medical management.References:[1]Fusama M et al. Mod Rheumatol. 2017 Sep;27(5):886-893.; Survey on attitudes regarding EULAR recommendations for the role of nurses involved in medical care of patients with chronic inflammatory arthritis in Japan.Disclosure of Interests:None declared
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Won, Daniel, James Walker, Russ Horowitz, Sandeep Bharadwaj, Edward Carlton i Helena Gabriel. "Sound the Alarm: The Sonographer Shortage is Echoing Across Healthcare". Journal of Ultrasound in Medicine, 27.03.2024. http://dx.doi.org/10.1002/jum.16453.
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ObjectivesThe growth in ultrasound usage necessitates concurrent growth in the number of sonographers. Despite the increasing importance of ultrasound, there is a shortage of sonographers in the United States that has never been specifically quantified. This study examines recent trends in the number of ultrasound exams, sonography graduates, open sonographer positions, and wages.MethodsThis retrospective study uses public databases and surveys including the Medical Expenditure Panel Survey (MEPS), Bureau of Labor Statistics (BLS), Integrated Postsecondary Education Data System (IPEDS), and Zippia, a human resources platform to determine metrics. These metrics include the number of ultrasound exams conducted in the United States (excluding inpatient setting), number of sonographers and sonographer wages, sonography graduates, and open sonographer positions.ResultsUltrasound exams in the United States from 2011 to 2021 increased from 38.6 million to 59.8 million (+55.1%,) while the number of sonographers (2011–2021) increased from 54,760 to 78,640 (+43.6%). There was a significant difference between supply and demand of sonographers with the number of sonography graduates (2011–2021) increasing from 4,386 to 5,393 (+23.0%) while the number of open sonographer positions (2012–2021) increased from 18,462 to 25,162 (+36.3%).ConclusionsFrom 2011 to 2021, the increase in the number of ultrasound exams has significantly outpaced the increase in the number of sonographers. Furthermore, the increase in demand for sonographers has grown significantly faster than the supply, leading to a shortage and consequent strain on the healthcare system. To address the shortage, the number of sonography school openings should be increased, and the attendant challenges addressed.
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Clark, Amy, Narelle Kennedy, Paula Brown i Liza Thomas. "Professional recognition and parity: A necessity for New South Wales sonographers". Sonography, 2.06.2024. http://dx.doi.org/10.1002/sono.12452.
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AbstractAccredited Medical Sonographers are highly specialised healthcare professionals who have specific knowledge, competence, and responsibility. While the profession of sonography is evolving in terms of career pathways and regulation, sonographers in NSW are divided according to pay, working conditions, career progression, and gender pay inequality. To retain quality staff amidst a national sonographer shortage, urgent award reform is needed. Professional equality and unification of sonographers along with career diversity and satisfaction is crucial to ensure NSW patients receive the highest quality healthcare.
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Gomes, Ryan G., Bellington Vwalika, Chace Lee, Angelica Willis, Marcin Sieniek, Joan T. Price, Christina Chen i in. "A mobile-optimized artificial intelligence system for gestational age and fetal malpresentation assessment". Communications Medicine 2, nr 1 (11.10.2022). http://dx.doi.org/10.1038/s43856-022-00194-5.
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Abstract Background Fetal ultrasound is an important component of antenatal care, but shortage of adequately trained healthcare workers has limited its adoption in low-to-middle-income countries. This study investigated the use of artificial intelligence for fetal ultrasound in under-resourced settings. Methods Blind sweep ultrasounds, consisting of six freehand ultrasound sweeps, were collected by sonographers in the USA and Zambia, and novice operators in Zambia. We developed artificial intelligence (AI) models that used blind sweeps to predict gestational age (GA) and fetal malpresentation. AI GA estimates and standard fetal biometry estimates were compared to a previously established ground truth, and evaluated for difference in absolute error. Fetal malpresentation (non-cephalic vs cephalic) was compared to sonographer assessment. On-device AI model run-times were benchmarked on Android mobile phones. Results Here we show that GA estimation accuracy of the AI model is non-inferior to standard fetal biometry estimates (error difference −1.4 ± 4.5 days, 95% CI −1.8, −0.9, n = 406). Non-inferiority is maintained when blind sweeps are acquired by novice operators performing only two of six sweep motion types. Fetal malpresentation AUC-ROC is 0.977 (95% CI, 0.949, 1.00, n = 613), sonographers and novices have similar AUC-ROC. Software run-times on mobile phones for both diagnostic models are less than 3 s after completion of a sweep. Conclusions The gestational age model is non-inferior to the clinical standard and the fetal malpresentation model has high AUC-ROCs across operators and devices. Our AI models are able to run on-device, without internet connectivity, and provide feedback scores to assist in upleveling the capabilities of lightly trained ultrasound operators in low resource settings.
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Pereira de Sousa, L. A., V. Tostes Carvalho, W. Wagner de Oliveira, M. V. Lins de Barros, T. Guimarães Teixeira, L. Alcantara de Abreu de Rosa i AL Pinho Ribeiro. "Screening Echocardiography in a Developing Country". European Journal of Public Health 30, Supplement_5 (1.09.2020). http://dx.doi.org/10.1093/eurpub/ckaa166.073.
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Abstract Background The use of tele-echocardiograms could be useful for improving access of patients to echocardiographic evaluation in places where there is a shortage of trained physicians. It was evaluated the agreement between a physician sonographer and another health professional with basic training to acquire transthoracic images, assessed by a remote echocardiographer. Methods 174 patients underwent echocardiography by a physician level III training in Echo. A moving image protocol (MPEG format, 3 cycles for each image) was stored: 2D parasternal long axis, apical four chambers with and without color. Soon after, a nurse with 20 hours of training in Echo, unaware of the result of the report, acquired the same protocol. The exams were randomized and sent to a remote observer, another echocardiographer level III, blinded to the sonographer's status, to recognize the presence of the any of the following abnormalities: left ventricular enlargement, hypertrophy and systolic dysfunction; right ventricular enlargement, left atrium enlargement and left sided valvopathy at least moderate. Agreement was evaluated by kappa concordance. Results It was analyzed 108 females and 66 males, median age= 61 y [P.25=50-P.75=72]; LV ejection fraction= 64 % [58-69] and body mass index= 27.6 kg/m2 [24.5-32.5]. There was a good concordance between the evaluators. All the indices analyzed showed agreement above 0.55 and statistic significance (left ventricular enlargement - 0.84; left ventricular hypertrophy - 0.84; systolic left ventricular dysfunction - 0.82; right ventricle enlargement - 0.72; left atrial enlargement - 0.80; valvopathy - 0.56). Conclusions The image acquisition by a tele-echocardiogram screening may be acquired by non-physician professionals with minimum training. Key messages Echocardiography. Remote.
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Soemantoro, Raska, Attila Kardos, Gilbert Tang i Yifan Zhao. "An AI-powered navigation framework to achieve an automated acquisition of cardiac ultrasound images". Scientific Reports 13, nr 1 (11.09.2023). http://dx.doi.org/10.1038/s41598-023-42263-2.
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AbstractEchocardiography is an effective tool for diagnosing cardiovascular disease. However, numerous challenges affect its accessibility, including skill requirements, workforce shortage, and sonographer strain. We introduce a navigation framework for the automated acquisition of echocardiography images, consisting of 3 modules: perception, intelligence, and control. The perception module contains an ultrasound probe, a probe actuator, and a locator camera. Information from this module is sent to the intelligence module, which grades the quality of an ultrasound image for different echocardiography views. The window search algorithm in the control module governs the decision-making process in probe movement, finding the best location based on known probe traversal positions and image quality. We conducted a series of simulations using the HeartWorks simulator to assess the proposed framework. This study achieved an accuracy of 99% for the image quality model, 96% for the probe locator model, and 99% for the view classification model, trained on an 80/20 training and testing split. We found that the best search area corresponds with general guidelines: at the anatomical left of the sternum between the 2nd and 5th intercostal space. Additionally, the likelihood of successful acquisition is also driven by how long it stores past coordinates and how much it corrects itself. Results suggest that achieving an automated echocardiography system is feasible using the proposed framework. The long-term vision is of a widely accessible and accurate heart imaging capability within hospitals and community-based settings that enables timely diagnosis of early-stage heart disease.
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CADTH. "General Ultrasound Examination Volumes per Sonographer 8-Hour Workday". Canadian Journal of Health Technologies 4, nr 2 (27.02.2024). http://dx.doi.org/10.51731/cjht.2024.841.
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The average number of general ultrasound examinations performed by a sonographer in an 8-hour workday is not well reported in the literature. Through an informal survey, we estimate that the average general ultrasound examination volume across Canada per 8-hour workday is 11.25, with a range of 9 to 14.
Understanding ultrasound examination data volumes provides information to help understand productivity. Decision-makers can also use the examination volume data and factors affecting sonographer examination throughput to create strategies to enhance efficiency in clinic and hospital departments.
Factors that may influence the average examination rate include examination time, the age of equipment, resource availability, staffing shortages, and sonographer’s work-related musculoskeletal disorders and stress.
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CDA-AMC. "Comparative Effectiveness of Real-Time Teleultrasound Versus In-Person Ultrasound". Canadian Journal of Health Technologies 5, nr 3 (17.03.2025). https://doi.org/10.51731/cjht.2025.1097.
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What Is the Issue? Ultrasound imaging requires highly trained professionals for accurate diagnostic exams and interpretation. Ultrasound is more affordable and portable than CT and MRI and does not expose patients to radiation. This makes ultrasound the preferred method for real-time assessment and soft tissue imaging. For more detailed or complex imaging, or when clinically indicated, CT and MRI may be more appropriate. In Canada, less than 28% of rural hospitals have in-house access to ultrasound, leading to patient transfers. Ultrasound exams are often conducted by sonographers, and there is a notable shortage of sonographers both in Canada and worldwide. Limited access to skilled ultrasound professionals has led to the development of teleultrasound (TUS), which supports remote clinical decision-making. TUS can be delivered in real time with remote guidance from a sonographic expert. TUS can be used by a variety of health care professionals with minimal ultrasound training. However, as the use of real-time TUS continues to expand to different clinical areas, its clinical effectiveness compared with traditional in-person ultrasound remains unclear. What Did We Do? We received a request related to the use of real-time TUS to support policy decision-making. A literature search was conducted to identify studies examining the clinical effectiveness of real-time TUS compared with conventional in-person ultrasound and any evidence-based guidelines for TUS use in clinical practice. We also report some of the advantages and challenges of TUS as described in the literature. What Did We Find? Real-time TUS was comparable to conventional in-person ultrasound for exam image quality and diagnostic consistency. Exams took, on average, more than 25% (or 6 minutes) longer to complete compared with in-person ultrasound. Real-time TUS was associated with high clinician satisfaction for comfortability, telecommunication quality, exam duration and quality, and accessibility. Several studies reported transient safety-related complications (e.g., increased pressure, pain), patient discomfort or fear, and technical difficulties during 10% of robotic-assisted TUS exams. Real-time TUS was studied in a wide range of clinical indications in various settings, highlighting its growing role and potential for expanded application in clinical practice. No evidence-based guidelines were identified for the use of TUS in clinical practice.
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Yang, Chaoran, Shanshan Liao, Zeyu Yang, Jiaqi Guo, Zhichao Zhang, Yingjian Yang, Yingwei Guo, Shaowei Yin, Caixia Liu i Yan Kang. "RDHCformer: Fusing ResDCN and Transformers for Fetal Head Circumference Automatic Measurement in 2D Ultrasound Images". Frontiers in Medicine 9 (29.03.2022). http://dx.doi.org/10.3389/fmed.2022.848904.
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Fetal head circumference (HC) is an important biological parameter to monitor the healthy development of the fetus. Since there are some HC measurement errors that affected by the skill and experience of the sonographers, a rapid, accurate and automatic measurement for fetal HC in prenatal ultrasound is of great significance. We proposed a new one-stage network for rotating elliptic object detection based on anchor-free method, which is also an end-to-end network for fetal HC auto-measurement that no need for any post-processing. The network structure used simple transformer structure combined with convolutional neural network (CNN) for a lightweight design, meanwhile, made full use of powerful global feature extraction ability of transformer and local feature extraction ability of CNN to extract continuous and complete skull edge information. The two complement each other for promoting detection precision of fetal HC without significantly increasing the amount of computation. In order to reduce the large variation of intersection over union (IOU) in rotating elliptic object detection caused by slight angle deviation, we used soft stage-wise regression (SSR) strategy for angle regression and added KLD that is approximate to IOU loss into total loss function. The proposed method achieved good results on the HC18 dataset to prove its effectiveness. This study is expected to help less experienced sonographers, provide help for precision medicine, and relieve the shortage of sonographers for prenatal ultrasound in worldwide.
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Huang, Weiting, Tracy Koh, Jasper Tromp, Chanchal Chandramouli, See Hooi Ewe, Choon Ta Ng, Audry Shan Yin Lee i in. "Point-of-care AI-enhanced novice echocardiography for screening heart failure (PANES-HF)". Scientific Reports 14, nr 1 (12.06.2024). http://dx.doi.org/10.1038/s41598-024-62467-4.
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AbstractThe increasing prevalence of heart failure (HF) in ageing populations drives demand for echocardiography (echo). There is a worldwide shortage of trained sonographers and long waiting times for expert echo. We hypothesised that artificial intelligence (AI)-enhanced point-of-care echo can enable HF screening by novices. The primary endpoint was the accuracy of AI-enhanced novice pathway in detecting reduced LV ejection fraction (LVEF) < 50%. Symptomatic patients with suspected HF (N = 100, mean age 61 ± 15 years, 56% men) were prospectively recruited. Novices with no prior echo experience underwent 2-weeks’ training to acquire echo images with AI guidance using the EchoNous Kosmos handheld echo, with AI-automated reporting by Us2.ai (AI-enhanced novice pathway). All patients also had standard echo by trained sonographers interpreted by cardiologists (reference standard). LVEF < 50% by reference standard was present in 27 patients. AI-enhanced novice pathway yielded interpretable results in 96 patients and took a mean of 12 min 51 s per study. The area under the curve (AUC) of the AI novice pathway was 0.880 (95% CI 0.802, 0.958). The sensitivity, specificity, positive predictive and negative predictive values of the AI-enhanced novice pathway in detecting LVEF < 50% were 84.6%, 91.4%, 78.5% and 94.1% respectively. The median absolute deviation of the AI-novice pathway LVEF from the reference standard LVEF was 6.03%. AI-enhanced novice pathway holds potential to task shift echo beyond tertiary centres and improve the HF diagnostic workflow.
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Wang, Yijie, Zihao Xu, Ruilong Dan, Chunlei Yao, Ji Shao, Yiming Sun, Yaqi Wang i Juan Ye. "Automated classification of multiple ophthalmic diseases using ultrasound images by deep learning". British Journal of Ophthalmology, 18.10.2023, bjo—2022–322953. http://dx.doi.org/10.1136/bjo-2022-322953.
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BackgroundUltrasound imaging is suitable for detecting and diagnosing ophthalmic abnormalities. However, a shortage of experienced sonographers and ophthalmologists remains a problem. This study aims to develop a multibranch transformer network (MBT-Net) for the automated classification of multiple ophthalmic diseases using B-mode ultrasound images.MethodsUltrasound images with six clinically confirmed categories, including normal, retinal detachment, vitreous haemorrhage, intraocular tumour, posterior scleral staphyloma and other abnormalities, were used to develop and evaluate the MBT-Net. Images were derived from five different ultrasonic devices operated by different sonographers and divided into training set, validation set, internal testing set and temporal external testing set. Two senior ophthalmologists and two junior ophthalmologists were recruited to compare the model’s performance.ResultsA total of 10 184 ultrasound images were collected. The MBT-Net got an accuracy of 87.80% (95% CI 86.26% to 89.18%) in the internal testing set, which was significantly higher than junior ophthalmologists (95% CI 67.37% to 79.16%; both p<0.05) and lower than senior ophthalmologists (95% CI 89.45% to 92.61%; both p<0.05). The micro-average area under the curve of the six-category classification was 0.98. With reference to comprehensive clinical diagnosis, the measurements of agreement were almost perfect in the MBT-Net (kappa=0.85, p<0.05). There was no significant difference in the accuracy of the MBT-Net across five ultrasonic devices (p=0.27). The MBT-Net got an accuracy of 82.21% (95% CI 78.45% to 85.44%) in the temporal external testing set.ConclusionsThe MBT-Net showed high accuracy for screening and diagnosing multiple ophthalmic diseases using only ultrasound images across mutioperators and mutidevices.
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Pascoe, Suean. "G.O.O.S.E.: Introducing a novel five‐stage structured framework for the early phases of teaching and learning ultrasound". Sonography, 25.10.2024. http://dx.doi.org/10.1002/sono.12481.
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AbstractThe sonography profession faces a critical global workforce shortage, particularly pronounced in Australia, due to insufficient clinical training opportunities and an ageing workforce. The financial burden and increased scan times associated with training exacerbate this issue. Innovative approaches, such as intensive ultrasound courses and pair scanning protocols, have shown promise in addressing these challenges. The GOOSE framework (Get the window, Optimise the view, Optimise the image, Select the image, Explain the findings) offers a structured, step‐by‐step approach to practical sonography training. This framework deconstructs complex ultrasound skills into manageable tasks, optimises cognitive load management, and provides explicit guidance for novice learners. The GOOSE framework is designed to enhance the efficiency of teaching and learning by simplifying complex skills into clear, actionable steps, supported by checklists that guide both instructors and students through the training process. The GOOSE framework offers a systematisation of knowledge transfer that, combined with deliberate practice and structured feedback, ensures learners progressively build their skills with focused, goal‐directed activities. While this model is yet to be validated, initial implementations have shown promising results in improving trainee performance, reducing supervision workload, and standardising instructional methods. This article outlines the principles of the GOOSE framework, its development, and its application in a specialised training facility, proposing it as a standardised model to enhance practical ultrasound education and improve teaching and learning efficiency.
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Mubuuke, Aloysius G., Geoffrey Erem, Rita Nassanga i Elsie Kiguli-Malwadde. "Point of care obstetric ultrasound training for midwives and nurses: implementation and experiences of trainees at a rural based hospital in Sub-saharan Africa: a qualitative study". BMC Research Notes 16, nr 1 (24.10.2023). http://dx.doi.org/10.1186/s13104-023-06569-8.
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Abstract Background Point of care ultrasound training has been successfully implemented in some settings. This has been done due to a shortage of radiology human resource gap especially in the rural areas of low-resource settings. The purpose of the study was to implement a point of care obstetric ultrasound training program for midwives and nurses and explore their experiences following the training at a rural based hospital in Uganda. Methods It was an exploratory qualitative study with some elements of implementation research design involving midwives and nurses that had undergone obstetric ultrasound training at Kiwoko hospital, a rural-based hospital in Uganda. Purposive sampling was used to select twenty-five midwives and nurses. These participants underwent a 6-weeks training in point of care obstetric ultrasound. Following the training, in-depth interviews were conducted to obtain the experiences of the participants. Results The training was conducted by qualified radiologists and sonographers and it involved both didactic sessions and rigorous practical and clinical demonstrations and eventually real-time scanning of the women. Three key themes emerged from the interviews: (1) Gaining important obstetric ultrasound skills, (2) Improving management of pregnant women and (3) Positive for task-shifting. Conclusion The point of care obstetric ultrasound training program was successfully implemented at Kiwoko Hospital. The trainees reported positive experiences from the training and while only conducted at one rural health facility, the overwhelmingly positive experience from trainees underscores the importance of point of care obstetric ultrasound in delivering imaging services.
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Anne Aspler, Fraser Kegel, Temesgen Beyene, Tigist Zewdu, Berhanu Tesfaye, Alexandra McKnight, Eileen Cheung, Jennifer Bryan i Claire Acton. "Establishing a Self-sustaining Emergency Medicine Point-of-Care Ultrasound Curriculum in an Academic Teaching Hospital in Ethiopia". Ethiopian Journal of Health Sciences 32, nr 3 (1.05.2022). http://dx.doi.org/10.4314/ejhs.v32i3.8.
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BACKGROUND: Point-of-care ultrasound (POCUS) training has become a standard component of Canadian emergency medicine (EM) residency programs. In resource-limited contexts, including Ethiopia, there is a critical shortage of local clinicians who can perform and teach POCUS. Our aim was to establish an introductory POCUS rotation within the EM residency program at Addis Ababa University (AAU) through The Toronto Addis Ababa Academic Collaboration in Emergency Medicine (TAAACEM).METHODS: Through stakeholder engagement, the authors completed a quality improvement initiative and conducted a survey of AAU EM faculty and residents to understand which POCUS scans should be included in a core residency POCUS curriculum, "POCUS1".RESULTS: 17 residents completed the POCUS1 program and 16 residents completed the written survey. Focused assessment with sonography for trauma, inferior vena cava, and lung (pneumothorax, pleural effusions, and interstitial syndrome) were identified as core introductory topics. Seventeen residents completed the initial POCUS1 program. Three program graduates were supported to become “POCUS1 Master Instructors” to continue the program during the SARS-CoV-2 global pandemic.CONCLUSION: The authors identified the highest yield POCUS scans through a written survey, successfully introduced a sustainable core POCUS curriculum at AAU for EM residents, and graduated three master instructors for curriculum continuation. We outline the structure and materials for implementation of POCUS programs for EM trainees and staff in similar low- and middle-income countries.
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Tefera, Maleda, Haymanot Mezmur, Mohammed Jemal i Nega Assefa. "Midwives’ experiences of performing obstetric ultrasounds in antenatal care in eastern Ethiopia: Qualitative exploratory study". Women's Health 20 (styczeń 2024). http://dx.doi.org/10.1177/17455057241228135.
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Background: In 2016, the World Health Organization recommended inclusion of an ultrasound scan as part of routine antenatal care to improve pregnancy outcomes. However, most rural women in Ethiopia do not have access to ultrasound scanning as part of their routine antenatal care. Recently, ultrasonography services were introduced at health centers in Harar, Kersa, and Haramaya districts in Eastern Ethiopia. This expoloratory study aimed to examine experiences of pregnancy surveillance midwives in the Child Health and Mortality Prevention Surveillance (CHAMPS) who performed ultrasonography at health centers that are in the catchment area of Health and Demographic Surveillance Systems, in Eastern Ethiopia. Objective: To explor midwives’ experiences across 14 health centers in Eastern Ethiopia, located in the Kersa, Haramaya, and Harar Health and Demographic Surveillance Systems from February to April 2022 Design: Exploratory qualitative study. Methods: The methods used were based on the Standards for Reporting Qualitative Research framework. Purposeful sampling was used to explore experiences of midwives who performed ultrasonography at selected health centers. The Midwives are recurited, trained and stationed at the health ceners to do ultrasound scanning and other activities by the Child Helath and Mortality Prevention Surveillance (CHAMPS) pregancny surveillance activities. Among 17 midwives who had undergone ultrasonography training and who were actively involved in ultrasound scanning at health centers in Kersa, Haramaya, and Harar Health and Demographic Surveillance Systems, three midwives who worked at health centers with no power or near a hospital were excluded. Using tape recordings and note-taking, data were collected through in-depth interviews based on a semi-structured interview guide. Thematic analysis used for data categorization, and the trustworthiness of data was kept throughout the procedure using credibility, dependability, confirmability, and transferability. Results: In this study, we identified five main themes: Ultrasonography positively impacts midwives trained as sonographers; performing ultrasound scans enhances the skills and confidence of midwives, improving their professional development, Individual perception of self-efficacy; midwives’ belief in their abilities to perform ultrasound scans effectively influences their job satisfaction and motivation, Provision of care; integrating ultrasound into antenatal care enhances the quality, therapeutic communication, and personalized nature of care provided to pregnant women, Barriers to providing ultrasonography services; challenges such as shortage of ultrasonography-trained staff and workload can hinder the delivery of ultrasound services in rural areas, Community acceptance; the level of community understanding, trust, and support towards ultrasound technology and midwives as sonographers impacts the successful implementation and sustainability of ultrasound services. Conclusion: Ultrasonography performed by midwives at rural health centers had a considerable impact on antenatal care services and incareased confidence of midwives.
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Arends, B., M. Vessies, W. Van Amsterdam, A. Teske, P. Van Der Harst, D. Van Osch i R. Van Es. "Preventing unnecessary echocardiograms in de novo patients referred to the cardiology outpatient clinic using electrocardiogram-based deep learning". European Heart Journal 45, Supplement_1 (październik 2024). http://dx.doi.org/10.1093/eurheartj/ehae666.3486.
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Abstract Introduction The growing demand on European echocardiography labs, driven by the rise in structural heart disease (SHD), is further complicated by a shortage of skilled sonographers, necessitating resource optimisation strategies. Electrocardiogram (ECG)-based deep learning models may assist in streamlining the echocardiography workflow. Purpose This study sought to develop a deep learning model capable of identifying patients at very low risk of SHD in a population of de novo patients referred to the cardiology outpatient clinic. Methods We identified all adult patients who underwent a 12-lead ECG and echocardiogram at a Dutch academic teaching hospital between 2011 and August 2023. Echocardiogram outcomes were extracted from reports, including left ventricular systolic dysfunction (LVSD), left ventricular dilatation (LVD), aortic stenosis (AS), aortic regurgitation (AR), mitral regurgitation (MR), and tricuspid regurgitation (TR), from which a composite outcome label was derived. A cohort of patients newly referred to our cardiology outpatient clinic with a primary complaint of chest pain, dyspnea, palpitations, dizziness, a murmur, or an abnormal ECG was held out as a test set, while the remaining dataset was split patient-wise into training (90%) and validation (10%) sets. A convolutional neural network was trained using only the ECG tracing as input and the composite label as outcome. Results We included 92,210 ECG-echo pairs from 44,785 patients (19,717 female) with 25,543 (27.7%) abnormal ECG-echo pairs. Among 2724 newly referred patients in the test set, 210/1389 males (15.1%) and 201/1335 females (15.1%) were diagnosed with SHD. In the test set, the model for predicting composite outcome demonstrated an area-under-the-curve, negative predictive value, and specificity of 0.74 (95% confidence interval [CI] 0.71-0.79), 0.94 (95% CI 0.92-0.95), and 0.47 (95% CI 0.45-0.49), respectively. Conclusion This study demonstrates the feasibility of employing deep learning models based solely on electrocardiogram (ECG) data to identify patients at very low risk of structural heart disease (SHD). Further validation and prospective studies are warranted to confirm the generalizability and clinical utility of our findings in diverse patient populations and healthcare settings.
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Mubuuke, Aloysius G., i Rita Nassanga. "Point of care obstetric ultrasound knowledge retention among mid-wives following a training program: a prospective cohort pilot study". BMC Pregnancy and Childbirth 23, nr 1 (9.02.2023). http://dx.doi.org/10.1186/s12884-023-05429-4.
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Abstract Background Obstetric ultrasound has become a routine part of antenatal care in many parts of the world including low income settings. However, there is a shortage of radiologists and sonographers to perform routine obstetric scans in many areas especially in the rural settings of low income countries, despite having equipment available to do this. As a result, Point of care ultrasound (POCUS) has been suggested to bridge this gap by training other health workers such as midwives to perform basic obstetric ultrasound as part of their clinical care. Methods It was a prospective cohort pilot study in which trained midwives in point of care obstetric ultrasound were followed up at 6 months post training to assess their knowledge retention. Eleven trained midwives were purposively selected and followed up for knowledge retention. These were trained for 6 weeks and were given a knowledge assessment immediately after training, then given an assessment at 6 months following training. Data was analyzed using SPSS. Wilcoxon signed rank test was used to compare assessments and perceived knowledge as well as Spearman correlation to test the relationship between the number of scans performed and exam assessments, knowledge and exam assessments, and number of scans and knowledge. Results There were eleven midwives, all female with an average age of 42.3 years. The mean exam score (out of 50) was 44.2 at the end of the training and 42.9 at 6-months follow up. The midwives demonstrated higher perceived knowledge at the end of the training when compared to the 6-months follow up. However, this perceived higher knowledge was not statistically significant when correlated with the exam scores either at the end of the training or at the follow up of 6 months. Conclusion This pilot study has demonstrated that training midwives in point of care obstetric ultrasound can result into acceptable levels of knowledge retention that assist the midwives to apply this knowledge when making routine clinical decisions in relation to pregnant women.
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Antolin, Andreu, Nuria Roson, Marina Planes, Mar Castillo, Anna Alberti i Manuel Escobar. "Validation of a tele-robotic ultrasound system for abdomen and thyroid gland explorations: a comparison with standard ultrasound". Ultrasound Journal 17, nr 1 (13.01.2025). https://doi.org/10.1186/s13089-025-00408-6.
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Abstract Background Tele-robotic ultrasound (US) is a novel technique that might help overcome the current shortage of radiologists and poor access to radiologists and/or sonographers in remote or rural areas. Despite the promising results of this technology in the past two decades, there is still insufficient data about its advantages and limits, as well as the implementation in routine clinical practice and the learning curve for the user. The purpose of this prospective cohort-based study is to evaluate the performance of a 5G-based tele-robotic US system for abdominal and thyroid gland assessment in a cohort of healthy volunteers and outpatients, as well as assessing the learning curve and patient satisfaction. Results 64 participants (23 male, 41 female) were consecutively included during the recruitment period, for a total of 51 abdominal and 37 thyroid gland US studies. The mean age was 45.23 ± 18.90 years old, and the body mass index of the abdominal cohort was 22.97 ± 2.95 kg/m2. The learning curve estimated a minimum of 20 patients for abdominal tele-robotic US training, being almost non-existent in the thyroid gland cohort. All the variables showed no-statistical differences between standard US and tele-robotic US in the abdominal post-trained cohort except the visualization of the left kidney short axis and its interpolar length. Thyroid gland variables showed no statistical differences. The mean time of exploration for the tele-robotic US for abdomen and thyroid gland examinations were 18.33 ± 6.26 min and 4.64 ± 0.97 min respectively. Most participants (> 70%) felt comfortable and safe while being examined by the tele-robotic US. Conclusion Tele-robotic US achieves equal performance in comparison with the standard US when evaluating abdominal structures in this cohort of patients, as well as a relatively fast learning curve and good patient satisfaction. The performance when assessing the thyroid gland is almost identical to the standard US, which makes it a strong first candidate for a future clinical implementation.
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Ofoegbu, Okechukwu Uche, Nicholas Irurhe, Tersur Terry Saalu, Oluwaseun Emmanuel Familusi, Charity Opeoluwapo Maduagu, Lucky Enajite Tietie, Olaniyi Araotan Kusamotu i Ochuwa Adiketu Babah. "Accuracy of ultrasonographic transcerebellar diameter for dating in third trimester of pregnancy in Nigerian women: a cross-sectional study". BMC Medical Imaging 25, nr 1 (25.03.2025). https://doi.org/10.1186/s12880-025-01634-z.
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Abstract Background Accurate prediction of foetal gestational age is of critical importance as it can positively affect the outcome of pregnancy. Routine sonographic estimation of gestational age using biparietal diameter, head circumference, abdominal circumference and femur length is popular but has limitations especially when used as a singly or in late pregnancy. Often pregnant women in low-middle-income countries like Nigeria register for antenatal care late in pregnancy, necessitating the need for a single, cost-effective parameter that requires minimal skills to measure gestational age accurately in late pregnancies. This study examined the accuracy of ultrasonographic transcerebellar diameter compared to other foetal biometric parameters for dating in third trimester of pregnancy. Methodology An analytic cross-sectional study conducted at Lagos University Teaching Hospital, Idi-Araba, Lagos, on 110 pregnant women in their third trimester. Data was collected using an interviewer administered questionnaire. Transabdominal ultrasound scan was done to determine the gestational age by measuring the biparietal diameter, head circumference, abdominal circumference, femur length and transcerebellar diameter. Spearman’s correlation coefficient was used to determine the correlation between the biometric measurements; Accuracy was determine using gestational age from menstrual date as gold standard and comparisons made using Chi square test. Results Mean age of participants was 31.5 ± 5.8 years; mean gestational age 236 ± 25 days. Compared to biparietal diameter, head circumference, abdominal circumference, and femur length, transcerebellar diameter correlates best with gestational age (r = 0.8837, p < 0.001). At an error margin of ± 2weeks, transcerebellar diameter had a high predictive accuracy of 84.6%, though significantly less than that for abdominal circumference alone, 86.4% (p = 0.003), and also less than that for all four well known foetal biometric parameters (biparietal diameter, head circumference, abdominal circumference, and femur length) combined, 85.5% (p < 0.001). Conclusion Transcerebellar diameter has a better correlation with gestational age than other routine foetal biometric parameters and has high predictive accuracy for dating in third trimester of pregnancy. It may thus play a relevant role in low resource settings where there is shortage of staff and limited skills in obstetric ultrasonography. Clinical trial number Not applicable for this study.
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Becker, Betsy, Kelsey Rutt, Allyson Huntley, Harlan Sayles i Kim Michael. "Student and Faculty Perceptions of Live Synchronous Distance Education for Allied Health Students Following Program Expansion to a Rural Campus". Internet Journal of Allied Health Sciences and Practice, 2018. http://dx.doi.org/10.46743/1540-580x/2018.1777.
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Background & Purpose: Distance education (DE) is a means to meet allied health workforce needs in rural locations where healthcare worker shortages are apparent. Five allied health programs were expanded to a rural campus teaching synchronously using distance education technology. The purpose of this convergent parallel mixed methods study was to explore perceptions of allied health students and faculty at two campus locations. Methods: Quantitative and qualitative information were collected through a survey of students and faculty (physical therapy, physician assistant, and medical imaging [diagnostic medical sonography, radiography, magnetic resonance imaging] programs). Both campuses served as live and distance sites depending on instructor location and area of content expertise. For example, morning courses may be taught live from one campus, and afternoon classes taught live from the other campus. Only one program, physical therapy, offered labs by distance education. Response distributions were compared for questions by campus using Cochran-Armitage trend tests and analyzed de-identified qualitative comments using constant comparisons to establish themes. Results: Student (n=121) and faculty (n=19) mostly agreed distance education technology was effective for teaching and learning. Significant differences were found in student opinions about receiving a similar educational experience between the two campuses. More students at the Main campus somewhat or strongly disagreed (n=34, 37%) it was similar compared to the Rural campus (n= 5, 17%, p=0.024). There were no comments specifically related to the physical therapy lab experience. Open-ended comment themes included training, purposeful engagement of both campus locations, and setting clear expectations. Conclusions: Although differences in learning experiences exist between the main and rural campus locations; the results indicated using distance education technology is an effective means to deliver the curriculum. Both students and faculty commented about the lack of experience with the educational technology before implementation. Synchronous, distance education offers the opportunity for program expansion and effective delivery of curriculum content. Using the results of this study can enhance future education in allied health professions using synchronous distance education technology.
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Hopfner, Carina, Andre Jakob, Anja Tengler, Maximilian Grab, Nikolaus Thierfelder, Barbara Brunner, Alisa Thierij i Nikolaus A. Haas. "Design and 3D printing of variant pediatric heart models for training based on a single patient scan". 3D Printing in Medicine 7, nr 1 (31.08.2021). http://dx.doi.org/10.1186/s41205-021-00116-6.
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Abstract Background 3D printed models of pediatric hearts with congenital heart disease have been proven helpful in simulation training of diagnostic and interventional catheterization. However, anatomically accurate 3D printed models are traditionally based on real scans of clinical patients requiring specific imaging techniques, i.e., CT or MRI. In small children both imaging technologies are rare as minimization of radiation and sedation is key. 3D sonography does not (yet) allow adequate imaging of the entire heart for 3D printing. Therefore, an alternative solution to create variant 3D printed heart models for teaching and hands-on training has been established. Methods In this study different methods utilizing image processing and computer aided design software have been established to overcome this shortage and to allow unlimited variations of 3D heart models based on single patient scans. Patient-specific models based on a CT or MRI image stack were digitally modified to alter the original shape and structure of the heart. Thereby, 3D hearts showing various pathologies were created. Training models were adapted to training level and aims of hands-on workshops, particularly for interventional cardiology. Results By changing the shape and structure of the original anatomy, various training models were created of which four examples are presented in this paper: 1. Design of perimembranous and muscular ventricular septal defect on a heart model with patent ductus arteriosus, 2. Series of heart models with atrial septal defect showing the long-term hemodynamic effect of the congenital heart defect on the right atrial and ventricular wall, 3. Implementation of simplified heart valves and addition of the myocardium to a right heart model with pulmonary valve stenosis, 4. Integration of a constructed 3D model of the aortic valve into a pulsatile left heart model with coarctation of the aorta. All presented models have been successfully utilized and evaluated in teaching or hands-on training courses. Conclusions It has been demonstrated that non-patient-specific anatomical variants can be created by modifying existing patient-specific 3D heart models. This way, a range of pathologies can be modeled based on a single CT or MRI dataset. Benefits of designed 3D models for education and training purposes have been successfully applied in pediatric cardiology but can potentially be transferred to simulation training in other medical fields as well.
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Hsu, G., Y. Chang i C. Chang. "(535) A Novel Approach for Penile Venous Stripping Surgery and Bilateral Varicocelectomy on an Ambulatory Basis". Journal of Sexual Medicine 20, Supplement_1 (maj 2023). http://dx.doi.org/10.1093/jsxmed/qdad060.503.
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Abstract Introduction There are varied approaches for conducting varicocelectomy and penile venous surgery, which are not unified or conspicuously, being not above controversy in the later type either in methodology or routes for accessibility thus far. Objective We sought to present this innovative method in a novel combination of a physiological penile venous stripping and bilateral varicocelectomy via a single longitudinal pubic wound on an ambulatory basis. Methods From July 2012 to December 2021, 63 consecutive patients underwent this combined surgery. Primary diagnosis tools are dual cavernosography and doppler sonography. A 4-5cm longitudinal pubic incision is two-thirds above the penile pubic fold. A blunt dissection maneuver using a hemostat or finger creates a space between the Colles' and Buck's fascia. The entire penis is then released with an inside-out maneuver resulting in Buck's fascia being exposed exclusively, followed by firmed ligation of every emissary vein of the corpora cavernosa via 6-7 open-to-open schemes on Buck's fascia, subsequently stripping of the deep dorsal vein (DDV) and paired cavernosal veins (CVs). In contrast, the para-arterial veins are just ligated segmentally. Reduction of the penis is made after Buck's openings are repaired with not too tight square knots with 6-0 nylon. The stripping of the DDV and CVs is completed after 125-137 ligatures until the infra-pubic angle. Finally, the spermatic cord is hooked below the inguinal canal outlet level. On each side of the varicocele, ligation of 8-11 spermatic veins is macroscopically performed at no expense of ruining all other tissues, even the fragile lymphatic vessel. Then meticulous repair is obtained layer by layer. This novel approach is likely the most appropriate method for making a milking maneuver which is helpful in vascular differentiation on both corpora cavernosa and pampiniform plexus during the entire procedure to prevent residual veins from offensive. Results The average follow-up period is 5.3±0.5 years. There is a significant (9.6±2.7 vs. 20.9±2.3; P<0.01) between the preoperative and postoperative IIEF-5 scores. So does the EHS scale (1.6±0.3 vs. 2.9±0.3; P<0.01) between the preoperative and postoperative status. The radiopacity was unexceptionally enhanced postoperatively. Although the intracorporeal retention and erection quality improvement were unexceptional, the satisfaction rate is just 71.4% (45/63). Penile length resumed 3.5 months postoperatively, although two patients initially complained about 1-2 cm postoperative shortage. Conclusions From the physiology viewpoint, we would like to recommend this promising method with which the shortcut to express. Disclosure No
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Kumar, Amit, Harindra Kumar Goje, Nimesh Kumar Tarway i Vivek Hande. "Holmium Laser Lithotripsy in the Management of Difficult Biliary and Cystic Ductal Stones – A Case Series". Journal of Marine Medical Society, 29.02.2024. http://dx.doi.org/10.4103/jmms.jmms_176_23.
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Abstract Choledocholithiasis or common bile duct stone (CBDS) presents a unique challenge in the management of biliary stones. The clinical presentation of CBDS varies from asymptomatic CBDS, detected during the evaluation of gallstone disease to sinister presentation, like severe biliary pancreatitis. Asymptomatic liver function test abnormality, biliary colic, dilated common bile duct (CBD) on sonography for pain abdomen, and cholangitis are the part of the spectrum. Based on clinical suspicion and aided by laboratory parameters, the diagnosis is confirmed by modalities such as ultrasonography or magnetic resonance cholangiopancreatography or by endoscopic ultrasound. Endoscopic radiological cholangiopancreatography (ERCP) has evolved as a standard of care over the decades for the management of CBDS and surgical exploration of CBD is rarely resorted. ERCP is followed by laparoscopic cholecystectomy as a definitive treatment to prevent recurrence of CBDS. Multiple factors play a role in the successful extraction of CBDS. Two broad considerations are the size of stone and bilio-duodenal anatomy. Multiple studies have noted that stone size larger than 15 mm requires fragmentation for successful extraction. Mechanical lithotripsy has been cornerstone for the management of such cases. Besides size of stone, morphology and number of stones, narrow CBD (distal to stone), duodenal diverticulum and altered anatomy due to gastroduodenal surgeries pose a challenge in stone extraction and are collectively called difficult CBDS. Multiple modalities notably extracorporeal shortwave lithotripsy, holmium laser (Ho laser) lithotripsy, and electrohydraulic lithotripsy (EHL) have been studied for the fragmentation of large CBDS. Innovation in cholangioscopy and wider availability of peroral single-operator cholangioscope has brought EHL and Ho laser lithotripsy (LL) at forefront of management of difficult CBD stones. We share the experience of Ho LL for CBDS at a tertiary care hospital in Western India. The data of four patients, successfully managed with single-operator cholangioscopy (SoC)-guided Ho LL for indications ranging from large CBDS to residual large cystic duct stump stone has been discussed. These cases emphasize wider clinical application of SoC-guided Ho-LL beyond the size of the stone. Ho LL has revolutionized the management of difficult biliary stone. The major limitation is cost of care and availability of expertise.