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  1. Article ; Online: Response to case comparisons and a new definition of disease-free status.

    Duggan, Nicole M / Wilcox, Susan R

    The American journal of emergency medicine

    2020  Volume 46, Page(s) 747

    MeSH term(s) COVID-19/epidemiology ; COVID-19/virology ; DNA, Viral/analysis ; Humans ; Pandemics ; SARS-CoV-2/genetics
    Chemical Substances DNA, Viral
    Keywords covid19
    Language English
    Publishing date 2020-10-02
    Publishing country United States
    Document type Letter
    ZDB-ID 605890-5
    ISSN 1532-8171 ; 0735-6757
    ISSN (online) 1532-8171
    ISSN 0735-6757
    DOI 10.1016/j.ajem.2020.09.071
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Artificial Intelligence to Determine Fetal Sex.

    Frisch, Emily H / Jain, Anant / Jin, Mike / Duhaime, Erik P / Malshe, Amol / Corey, Steve / Allen, Robert / Duggan, Nicole M / Fischetti, Chanel E

    American journal of perinatology

    2024  

    Abstract: Objective:  This proof-of-concept study assessed how confidently an artificial intelligence (AI) model can determine the sex of a fetus from an ultrasound image.: Study design:  Analysis was performed using 19,212 ultrasound image slices from a high- ... ...

    Abstract Objective:  This proof-of-concept study assessed how confidently an artificial intelligence (AI) model can determine the sex of a fetus from an ultrasound image.
    Study design:  Analysis was performed using 19,212 ultrasound image slices from a high-volume fetal sex determination practice. This dataset was split into a training set (11,769) and test set (7,443). A computer vision model was trained using a transfer learning approach with EfficientNetB4 architecture as base. The performance of the computer vision model was evaluated on the hold out test set. Accuracy, Cohen's Kappa and Multiclass Receiver Operating Characteristic area under the curve (AUC) were used to evaluate the performance of the model.
    Results:  The AI model achieved an Accuracy of 88.27% on the holdout test set and a Cohen's Kappa score 0.843. The ROC AUC score for Male was calculated to be 0.896, for Female a score of 0.897, for Unable to Assess a score of 0.916, and for Text Added a score of 0.981 was achieved.
    Conclusion:  This novel AI model proved to have a high rate of fetal sex capture that could be of significant use in areas where ultrasound expertise is not readily available.
    Key points: · This is the first proof-of-concept AI model to determine fetal sex.. · This study adds to the growing research in ultrasound AI.. · Our findings demonstrate AI integration into obstetric care..
    Language English
    Publishing date 2024-03-01
    Publishing country United States
    Document type Journal Article
    ZDB-ID 605671-4
    ISSN 1098-8785 ; 0735-1631
    ISSN (online) 1098-8785
    ISSN 0735-1631
    DOI 10.1055/a-2265-9177
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 1929: Show issues Location:
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  3. Article ; Online: Ultrasound-guided nerve blocks in emergency medicine practice: 2022 updates.

    Goldsmith, Andrew J / Brown, Joseph / Duggan, Nicole M / Finkelberg, Tomer / Jowkar, Nick / Stegeman, Joseph / Riscinti, Matthew / Nagdev, Arun / Amini, Richard

    The American journal of emergency medicine

    2024  Volume 78, Page(s) 112–119

    Abstract: Objectives: In the Emergency Department (ED), ultrasound-guided nerve blocks (UGNBs) have become a cornerstone of multimodal pain regimens. We investigated current national practices of UGNBs across academic medical center EDs, and how these trends have ...

    Abstract Objectives: In the Emergency Department (ED), ultrasound-guided nerve blocks (UGNBs) have become a cornerstone of multimodal pain regimens. We investigated current national practices of UGNBs across academic medical center EDs, and how these trends have changed over time.
    Methods: We conducted a cross-sectional electronic survey of academic EDs with ultrasound fellowships across the United States. Twenty-item questionnaires exploring UGNB practice patterns, training, and complications were distributed between November 2021-June 2022. Data was manually curated, and descriptive statistics were performed. The survey results were then compared to results from Amini et al. 2016 UGNB survey to identify trends.
    Results: The response rate was 80.5% (87 of 108 programs). One hundred percent of responding programs perform UGNB at their institutions, with 29% (95% confidence interval (CI), 20%-39%) performing at least 5 blocks monthly. Forearm UGNB are most commonly performed (96% of programs (95% CI, 93%-100%)). Pain control for fractures is the most common indication (84%; 95% CI, 76%-91%). Eighty-five percent (95% CI, 77%-92%) of programs report at least 80% of UGNB performed are effective. Eighty-five percent (95% CI, 66%-85%) of programs have had no reported complications from UGNB performed by emergency providers at their institution. The remaining 15% (95% CI, 8%-23%) report an average of 1 complication annually.
    Conclusions: All programs participating in our study report performing UGNB in their ED, which is a 16% increase over the last 5 years. UGNB's are currently performed safely and effectively in the ED, however practice improvements can still be made. Creating multi-disciplinary committees at local and national levels can standardize guidelines and practice policies to optimize patient safety and outcomes.
    MeSH term(s) Humans ; United States ; Cross-Sectional Studies ; Nerve Block/methods ; Ultrasonography ; Emergency Service, Hospital ; Pain ; Ultrasonography, Interventional/methods ; Emergency Medicine
    Language English
    Publishing date 2024-01-12
    Publishing country United States
    Document type Journal Article
    ZDB-ID 605890-5
    ISSN 1532-8171 ; 0735-6757
    ISSN (online) 1532-8171
    ISSN 0735-6757
    DOI 10.1016/j.ajem.2023.12.043
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Why pretest probability matters when we do point-of-care ultrasound.

    Duggan, Nicole M / Selame, Lauren A / Shokoohi, Hamid

    Journal of the American College of Emergency Physicians open

    2020  Volume 1, Issue 6, Page(s) 1778

    Language English
    Publishing date 2020-12-17
    Publishing country United States
    Document type Journal Article
    ISSN 2688-1152
    ISSN (online) 2688-1152
    DOI 10.1002/emp2.12331
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Clinical Features vs CT Findings to Estimate Need for Surgery in Small Bowel Obstruction.

    Schulwolf, Sara / Brower, Charles / Karam, Alessandra / Havens, Joaquim / Shokoohi, Hamid / Duggan, Nicole M / Goldsmith, Andrew J

    JAMA network open

    2023  Volume 6, Issue 11, Page(s) e2341376

    MeSH term(s) Humans ; Intestinal Obstruction/diagnostic imaging ; Intestinal Obstruction/surgery ; Intestine, Small/diagnostic imaging ; Intestine, Small/surgery ; Tomography, X-Ray Computed
    Language English
    Publishing date 2023-11-01
    Publishing country United States
    Document type Journal Article
    ISSN 2574-3805
    ISSN (online) 2574-3805
    DOI 10.1001/jamanetworkopen.2023.41376
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Diaphragmatic Excursion as a Novel Objective Measure of Serratus Anterior Plane Block Efficacy: A Case Series.

    Lentz, Brian / Kharasch, Sigmund / Goldsmith, Andrew J / Brown, Joseph / Duggan, Nicole M / Nagdev, Arun

    Clinical practice and cases in emergency medicine

    2022  Volume 6, Issue 4, Page(s) 276–279

    Abstract: Introduction: Pain scales are often used in peripheral nerve block studies but are problematic due to their subjective nature. Ultrasound-measured diaphragmatic excursion is an easily learned technique that could provide a much-needed objective measure ... ...

    Abstract Introduction: Pain scales are often used in peripheral nerve block studies but are problematic due to their subjective nature. Ultrasound-measured diaphragmatic excursion is an easily learned technique that could provide a much-needed objective measure of pain control over time with serial measurements.
    Case series: We describe three cases where diaphragmatic excursion was used as an objective measure of decreased pain and improved respiratory function after serratus anterior plane block in emergency department patients with anterior or lateral rib fractures.
    Conclusion: Diaphragmatic excursion may be an ideal alternative to pain scores to evaluate serratus anterior plane block efficacy. More data will be needed to determine whether this technique can be applied to other ultrasound-guided nerve blocks.
    Language English
    Publishing date 2022-11-25
    Publishing country United States
    Document type Journal Article
    ISSN 2474-252X
    ISSN (online) 2474-252X
    DOI 10.5811/cpcem.2022.7.57457
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: POCUS-first for nephrolithiasis: A Monte Carlo simulation illustrating cost savings, LOS reduction, and preventable radiation.

    Barton, Michael F / Brower, Charles H / Barton, Brenna L / Duggan, Nicole M / Baugh, Christopher W / Haleblian, George E / Goldsmith, Andrew J

    The American journal of emergency medicine

    2023  Volume 74, Page(s) 41–48

    Abstract: Objectives: Non-contrast computed tomography (NCCT) is the gold standard for nephrolithiasis evaluation in the emergency department (ED). However, Choosing Wisely guidelines recommend against ordering NCCT for patients with suspected nephrolithiasis who ...

    Abstract Objectives: Non-contrast computed tomography (NCCT) is the gold standard for nephrolithiasis evaluation in the emergency department (ED). However, Choosing Wisely guidelines recommend against ordering NCCT for patients with suspected nephrolithiasis who are <50 years old with a history of kidney stones. Our primary objective was to estimate the national annual cost savings from using a point-of-care ultrasound (POCUS)-first approach for patients with suspected nephrolithiasis meeting Choosing Wisely criteria. Our secondary objectives were to estimate reductions in ED length of stay (LOS) and preventable radiation exposure.
    Methods: We created a Monte Carlo simulation using available estimates for the frequency of ED visits for nephrolithiasis and eligibility for a POCUS-first approach. The study population included all ED patients diagnosed with nephrolithiasis. Based on 1000 trials of our simulation, we estimated national cost savings in averted advanced imaging from this strategy. We applied the same model to estimate the reduction in ED LOS and preventable radiation exposure.
    Results: Using this model, we estimate a POCUS-first approach for evaluating nephrolithiasis meeting Choosing Wisely guidelines to save a mean (±SD) of $16.5 million (±$2.1 million) by avoiding 159,000 (±18,000) NCCT scans annually. This resulted in a national cumulative decrease of 166,000 (±165,000) annual bed-hours in ED LOS. Additionally, this resulted in a national cumulative reduction in radiation exposure of 1.9 million person-mSv, which could potentially prevent 232 (±81) excess cancer cases and 118 (±43) excess cancer deaths annually.
    Conclusion: If adopted widely, a POCUS-first approach for suspected nephrolithiasis in patients meeting Choosing Wisely criteria could yield significant national cost savings and a reduction in ED LOS and preventable radiation exposure. Further research is needed to explore the barriers to widespread adoption of this clinical workflow as well as the benefits of a POCUS-first approach in other patient populations.
    MeSH term(s) Humans ; Middle Aged ; Length of Stay ; Cost Savings ; Monte Carlo Method ; Kidney Calculi ; Emergency Service, Hospital ; Ultrasonography/methods ; Neoplasms
    Language English
    Publishing date 2023-09-20
    Publishing country United States
    Document type Journal Article
    ZDB-ID 605890-5
    ISSN 1532-8171 ; 0735-6757
    ISSN (online) 1532-8171
    ISSN 0735-6757
    DOI 10.1016/j.ajem.2023.09.025
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 2005: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  9. Article: Artificial Intelligence to Determine Fetal Sex

    Frisch, Emily H. / Jain, Anant / Jin, Mike / Duhaime, Erik P. / Malshe, Amol / Corey, Steve / Allen, Robert / Duggan, Nicole M. / Fischetti, Chanel E.

    American Journal of Perinatology

    2024  

    Abstract: Objective: This proof-of-concept study assessed how confidently an artificial intelligence (AI) model can determine the sex of a fetus from an ultrasound image.: Study Design: Analysis was performed using 19,212 ultrasound image slices from a high- ... ...

    Abstract Objective: This proof-of-concept study assessed how confidently an artificial intelligence (AI) model can determine the sex of a fetus from an ultrasound image.
    Study Design: Analysis was performed using 19,212 ultrasound image slices from a high-volume fetal sex determination practice. This dataset was split into a training set (11,769) and test set (7,443). A computer vision model was trained using a transfer learning approach with EfficientNetB4 architecture as base. The performance of the computer vision model was evaluated on the hold out test set. Accuracy, Cohen's Kappa and Multiclass Receiver Operating Characteristic area under the curve (AUC) were used to evaluate the performance of the model.
    Results: The AI model achieved an Accuracy of 88.27% on the holdout test set and a Cohen's Kappa score 0.843. The ROC AUC score for Male was calculated to be 0.896, for Female a score of 0.897, for Unable to Assess a score of 0.916, and for Text Added a score of 0.981 was achieved.
    Conclusion: This novel AI model proved to have a high rate of fetal sex capture that could be of significant use in areas where ultrasound expertise is not readily available.
    Key Points: This is the first proof-of-concept AI model to determine fetal sex. This study adds to the growing research in ultrasound AI. Our findings demonstrate AI integration into obstetric care.
    Keywords artificial intelligence ; machine learning ; ultrasound ; fetal sex
    Language English
    Publishing date 2024-02-09
    Publisher Thieme Medical Publishers, Inc.
    Publishing place Stuttgart ; New York
    Document type Article
    ZDB-ID 605671-4
    ISSN 1098-8785 ; 0735-1631
    ISSN (online) 1098-8785
    ISSN 0735-1631
    DOI 10.1055/a-2265-9177
    Database Thieme publisher's database

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  10. Article: Lung Ultrasound in Children with Respiratory Tract Infections: Viral, Bacterial or COVID-19? A Narrative Review.

    Kharasch, Sigmund / Duggan, Nicole M / Cohen, Ari R / Shokoohi, Hamid

    Open access emergency medicine : OAEM

    2020  Volume 12, Page(s) 275–285

    Abstract: Respiratory tract infections (RTIs) are common complaints among patients presenting to the pediatric emergency department. In the diagnostic assessment of children with RTIs, many patients ultimately undergo imaging studies for further evaluation. Point- ... ...

    Abstract Respiratory tract infections (RTIs) are common complaints among patients presenting to the pediatric emergency department. In the diagnostic assessment of children with RTIs, many patients ultimately undergo imaging studies for further evaluation. Point-of-care lung ultrasound (LUS) can be used safely and with a high degree of accuracy in differentiating etiologies of RTIs in pediatric patients. Ultrasonographical features such as an irregular pleural line, subpleural consolidations, focal and lobar consolidation and signs of interstitial involvement can be used to distinguish between several pathologies. This work offers a comprehensive overview of pediatric LUS in cases of the most common pediatric RTIs including bacterial and viral pneumonia, bronchiolitis, and COVID-19.
    Keywords covid19
    Language English
    Publishing date 2020-10-14
    Publishing country New Zealand
    Document type Journal Article ; Review
    ZDB-ID 2520704-0
    ISSN 1179-1500
    ISSN 1179-1500
    DOI 10.2147/OAEM.S238702
    Database MEDical Literature Analysis and Retrieval System OnLINE

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