A137 A CANADIAN PILOT STUDY: UNSEDATED TRANS-NASAL ENDOSCOPY AND BIOPSIES IN ADOLESCENTS WITH EOSINOPHILIC ESOPHAGITIS WITH VIRTUAL REALITY DISTRACTION
Notice bibliographique
Résumé
Abstract Background Esoinophilic Esophagitis (EoE) is a chronic condition that requires endoscopy and biopsies for diagnosis and treatment evaluation. In pediatrics, anaesthesiology OR based sedation is standard practice, but it is resource intense, requires full fasting, and involves some risk. Trans-Nasal Endoscopy (TNE) with virtual reality (VR) distraction has successfully been used and evaluated at multiple Children’s Hospitals in the US. It uses thin endoscopes to obtain esophageal biopsies. This service is not available in Canada. Aims Demonstrate that unsedated TNE: - can be done safely in adolescents with EoE - can be done reasonably comfortably - tissue samples are adequate for histopathologic evaluation Methods A pilot was launched spring 2024 at BC Children’s Hospital offering TNE with VR for EoE patients. All TNE procedures were evaluated for any complications. Comfort / tolerability, was described using patient surveys including self-reported pain (Faces Pain Scale), worst pain during the procedure; anxiety (Visual Analogue Scale), VR and overall satisfaction from patients, caregivers, and staff. Heart rate was measured throughout. Biopsy samples were reviewed by a pathologist regarding size and quality. Results 7 teenage males have undergone and completed TNE, without complication. Mean procedure time was 9.6 minutes. TNE resulted in some pain, which returned to baseline levels (Table 1). Patients’ (range = 5-6), caregivers’ (range = 6-7), and staffs’ (range = 6-7) scores demonstrated satisfaction with the overall procedure. All involved were very likely to recommend VR for the same procedure (range 9-10). All patients reported that they would do TNE with VR again. Mean HR was elevated from baseline (68 BPM) compared to when the scope was inserted (78 BPM) and stayed elevated (74 BPM). Mean # of biopsies obtained was 5.7. Average biopsy size in TNE was 0.16 cm (range: 0.1-0.4) compared to the patients’ historical EoE procedures of 0.22 cm (range: 0.1-0.6). One pathologist noted that orientation in one TNE sample was poor, due to small size. Pathologists felt the need to ink the tissues to ensure embedding. No samples were lost. All pathologists found TNE samples were sufficient for evaluation with eosinophil counts reported. Conclusions Unsedated TNE with VR distraction at this early junction seems to be safe, reasonably well tolerated, and able to provide adequate specimens. Further research is needed to understand its feasibility in a more diverse sample. Funding Agencies Health Innovation Pathway Program: Minstry of Health BC; Equipment by Amacon(R)
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 machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,002 | 0,001 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,001 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| 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 source (Gemma direct ou Codex distillé), 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 ».