Telementorable "just-in-time" lung ultrasound on an iPhone
Notice bibliographique
Résumé
Sir, Pleural and lung ultrasound (PLUS) is increasingly used in the bedside management of pulmonary pathology such as with the EFAST and BLUE protocols.[12] As ultrasound is operator-dependent, however, there are challenges to ensure that clinicians have adequate training. With a current explosion in the availability of ultrasound machines, we believe there is a need to optimize ultrasound availability to patients, yet ensure quality and avoidance of misinformation from erroneous exams. The National Aeronautics and Space Administration has addressed this challenge by examining the concept of remote telementored telesonography (RTMTS), wherein just-in-time users onboard the International Space Station are guided to capture meaningful images by remote terrestrial experts using elaborate informatics.[3] The World Health Organization also recognizes that communication technologies have the potential to address challenges in both developed and developing countries in providing accessible, cost-effective, and high-quality healthcare services, especially for rural and underserved communities in developing countries.[4] Thus, we endeavored to provide RTMTS using markedly simpler informatics.[5] We investigated the provision of RTMS by allowing remote experts in Aberdeen to view real-time PLUS images displayed on a smartphone (iPhone-4, Apple, Cupertino, CA). A portable ultrasound (Sonosite 180, Sonosite, Bothell, WA) in Calgary was interfaced to a laptop computer (Aspire 5741, Acer, Kuala Lumpur, Malaysia) via an analogue-to-digital converter (VC-211V, ActionStar LinXcel, Taiwan) [Figure on-line supplement]. Xsplit Broadcaster (SplitMediaLabs ltd, Hong Kong) allowed video-streaming of both an inexpensive head-mounted webcam (LifeCam VX-2000, Microsoft, Washington) and ultrasound over Skype (Skype, Luxembourg), easily viewed on any smartphone. The remote experts were thereafter able to easily view both the Calgary examiners hands and probe and resultant ultrasound images and to audibly bidirectionally communicate during the conducting of PLUS, with the iphone images deemed of diagnostic quality demonstrating clear evidence of real-time lung sliding [Figure 1]. While best appreciated real-time, the color-power Doppler function also documented this movement as the “Power-slide,”[6] confirming and documenting respiration and pneumothorax absence.Figure 1: iPhone image as viewed in Aberdeen demonstrating the “Power slide” confirming pleural sliding with imbedded image of remote examiner holding US probe in CalgaryWhile ultrasound images have been previously viewed over smartphones, we believe this is the first utilization of this ever more-prevalent technology to allow cost-minimal telementoring in lung telesonography. Therefore, despite the myriad of challenges for global health improvements, we believe that as the globe is shrunk by informatics, remote experts in developed nations could increasingly assist with education and clinical care delivery using affordable technologies that are likely to be already in our coat pockets.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».