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Article ; Online: Point-of-care ultrasound for the diagnosis of Fournier gangrene.

Chen, Fiona / Neill, Emily / Graglia, Sally

2023 Volume 40, Issue 9, Page(s) 682–685

MeSH term(s)	Male ; Humans ; Fournier Gangrene/diagnostic imaging ; Point-of-Care Systems ; Point-of-Care Testing ; Ultrasonography
Language	English
Publishing date	2023-07-25
Publishing country	England
Document type	Journal Article
ZDB-ID	2040124-3
ISSN	1472-0213 ; 1472-0205
ISSN (online)	1472-0213
ISSN	1472-0205
DOI	10.1136/emermed-2023-213262
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Article ; Online: BiRD: Using Bidirectional Rotation Gain Differences to Redirect Users during Back-and-forth Head Turns in Walking.

Xu, Sen-Zhe / Chen, Fiona Xiao Yu / Gong, Ran / Zhang, Fang-Lue / Zhang, Song-Hai

IEEE transactions on visualization and computer graphics

2024 Volume 30, Issue 5, Page(s) 2693–2702

Abstract: Redirected walking (RDW) facilitates user navigation within expansive virtual spaces despite the constraints of limited physical spaces. It employs discrepancies between human visual-proprioceptive sensations, known as gains, to enable the remapping of ... ...

Abstract	Redirected walking (RDW) facilitates user navigation within expansive virtual spaces despite the constraints of limited physical spaces. It employs discrepancies between human visual-proprioceptive sensations, known as gains, to enable the remapping of virtual and physical environments. In this paper, we explore how to apply rotation gain while the user is walking. We propose to apply a rotation gain to let the user rotate by a different angle when reciprocating from a previous head rotation, to achieve the aim of steering the user to a desired direction. To apply the gains imperceptibly based on such a Bidirectional Rotation gain Difference (BiRD), we conduct both measurement and verification experiments on the detection thresholds of the rotation gain for reciprocating head rotations during walking. Unlike previous rotation gains which are measured when users are turning around in place (standing or sitting), BiRD is measured during users' walking. Our study offers a critical assessment of the acceptable range of rotational mapping differences for different rotational orientations across the user's walking experience, contributing to an effective tool for redirecting users in virtual environments.
MeSH term(s)	Humans ; Animals ; Computer Graphics ; Walking ; Orientation ; Environment ; Birds
Language	English
Publishing date	2024-04-19
Publishing country	United States
Document type	Journal Article
ISSN	1941-0506
ISSN (online)	1941-0506
DOI	10.1109/TVCG.2024.3372094
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Article ; Online: Recalcitrant plunging ranulas: a new approach to salivary tissue localization using prostate-specific membrane antigen positron emission tomography.

Chen, Fiona / Barber, Thomas W / Tudge, Stephen

ANZ journal of surgery

2020 Volume 90, Issue 11, Page(s) E108–E109

MeSH term(s)	Humans ; Male ; Positron-Emission Tomography ; Prostate ; Prostatic Neoplasms/diagnostic imaging ; Ranula ; Sublingual Gland
Language	English
Publishing date	2020-03-21
Publishing country	Australia
Document type	Journal Article
ZDB-ID	2050749-5
ISSN	1445-2197 ; 1445-1433 ; 0004-8682
ISSN (online)	1445-2197
ISSN	1445-1433 ; 0004-8682
DOI	10.1111/ans.15824
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Article ; Online: Association between disability status and dental attendance patterns in Australian children: A national survey.

Sawhney, Seerat / Vu, Theresa / Chen, Fiona / Wong, Kingsley / Zafar, Sobia / Lopez Silva, Claudia Patricia

Community dentistry and oral epidemiology

2022 Volume 51, Issue 3, Page(s) 443–451

Abstract: Objectives: This study investigated the dental attendance patterns of Australian children with and without disabilities using data from Growing up in Australia: The Longitudinal Study of Australian Children.: Methods: Data on 6470 participants within ...

Abstract	Objectives: This study investigated the dental attendance patterns of Australian children with and without disabilities using data from Growing up in Australia: The Longitudinal Study of Australian Children. Methods: Data on 6470 participants within two groups (B cohort [aged 12-13]: n = 3381; K cohort [aged 16-17]: n = 3089) were used for the study. Binomial regression models were fitted to examine the association between disability status and dental attendance. The models were adjusted for gender, parent's country of birth, region of residence, highest parental education and household weekly income, and multiple imputations was used for handling missing data. Results: Children with disabilities constituted 2.4% and 3.8% of the study sample in the B and K cohort, respectively. The unadjusted risk ratio of irregular (vs. regular) dental attendance between children with and without disabilities was 1.07 (95% CI 0.78-1.46) in the B cohort and 1.15 (95% CI 0.93-1.42) in the K cohort. After adjustment and imputation, the risk ratios were 1.03 (95% CI 0.76-1.41) and 1.10 (95% CI 0.89-1.36) in the B and K cohort, respectively. Conclusions: Dental attendance pattern was positively, but minimally, associated with disabilities in older children, and factors including region of residence, parental education and household income were related to disability status and dental attendance. Further studies are required to clarify the association and ascertain key factors that affect the health and wellbeing of children with disabilities.
MeSH term(s)	Humans ; Child ; Longitudinal Studies ; Australia/epidemiology ; Educational Status ; Parents
Language	English
Publishing date	2022-06-14
Publishing country	Denmark
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	189172-8
ISSN	1600-0528 ; 0301-5661
ISSN (online)	1600-0528
ISSN	0301-5661
DOI	10.1111/cdoe.12755
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Article ; Online: A Deep Learning Algorithm to Identify Anatomical Landmarks on Computed Tomography of the Temporal Bone.

Hasan, Zubair / Key, Seraphina / Lee, Michael / Chen, Fiona / Aweidah, Layal / Esmaili, Aaron / Sacks, Raymond / Singh, Narinder

The journal of international advanced otology

2023 Volume 19, Issue 5, Page(s) 360–367

Abstract: Background: Petrous temporal bone cone-beam computed tomography scans help aid diagnosis and accurate identification of key operative landmarks in temporal bone and mastoid surgery. Our primary objective was to determine the accuracy of using a deep ... ...

Abstract	Background: Petrous temporal bone cone-beam computed tomography scans help aid diagnosis and accurate identification of key operative landmarks in temporal bone and mastoid surgery. Our primary objective was to determine the accuracy of using a deep learning convolutional neural network algorithm to augment identification of structures on petrous temporal bone cone-beam computed tomography. Our secondary objective was to compare the accuracy of convolutional neural network structure identification when trained by a senior versus junior clinician. Methods: A total of 129 petrous temporal bone cone-beam computed tomography scans were obtained from an Australian public tertiary hospital. Key intraoperative landmarks were labeled in 68 scans using bounding boxes on axial and coronal slices at the level of the malleoincudal joint by an otolaryngology registrar and board-certified otolaryngologist. Automated structure identification was performed on axial and coronal slices of the remaining 61 scans using a convolutional neural network (Microsoft Custom Vision) trained using the labeled dataset. Convolutional neural network structure identification accuracy was manually verified by an otolaryngologist, and accuracy when trained by the registrar and otolaryngologist labeled datasets respectively was compared. Results: The convolutional neural network was able to perform automated structure identification in petrous temporal bone cone-beam computed tomography scans with a high degree of accuracy in both axial (0.958) and coronal (0.924) slices (P < .001). Convolutional neural network accuracy was proportionate to the seniority of the training clinician in structures with features more difficult to distinguish on single slices such as the cochlea, vestibule, and carotid canal. Conclusion: Convolutional neural networks can perform automated structure identification in petrous temporal bone cone-beam computed tomography scans with a high degree of accuracy, with the performance being proportionate to the seniority of the training clinician. Training of the convolutional neural network by the most senior clinician is desirable to maximize the accuracy of the results.
MeSH term(s)	Deep Learning ; Australia ; Algorithms ; Tomography, X-Ray Computed ; Temporal Bone/diagnostic imaging ; Image Processing, Computer-Assisted/methods
Language	English
Publishing date	2023-10-02
Publishing country	Turkey
Document type	Journal Article
ZDB-ID	2561231-1
ISSN	2148-3817 ; 1308-7649 ; 2148-3817
ISSN (online)	2148-3817
ISSN	1308-7649 ; 2148-3817
DOI	10.5152/iao.2023.231073
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Article ; Online: A Computer Vision Algorithm to Classify Pneumatization of the Mastoid Process on Temporal Bone Computed Tomography Scans.

Hasan, Zubair / Lee, Michael / Chen, Fiona / Key, Seraphina / Habib, Al-Rahim / Aweidah, Layal / Sacks, Raymond / Singh, Narinder

The journal of international advanced otology

2023 Volume 19, Issue 3, Page(s) 217–222

Abstract: Background: Pneumatization of the mastoid process is variable and of significance to the operative surgeon. Surgical approaches to the temporal bone require an understanding of pneumatization and its implications for surgical access. This study aims to ... ...

Abstract	Background: Pneumatization of the mastoid process is variable and of significance to the operative surgeon. Surgical approaches to the temporal bone require an understanding of pneumatization and its implications for surgical access. This study aims to determine the feasibility of using deep learning convolutional neural network algorithms to classify pneumatization of the mastoid process. Methods: De-identified petrous temporal bone images were acquired from a tertiary hospital radiology picture archiving and communication system. A binary classification mode in the pretrained convolutional neural network was used to investigate the utility of convolutional neural networks in temporal bone imaging. False positive and negative images were reanalyzed by the investigators and qualitatively assessed to consider reasons for inaccuracy. Results: The overall accuracy of the model was 0.954. At a probability threshold of 65%, the sensitivity of the model was 0.860 (95% CI 0.783-0.934) and the specificity was 0.989 (95% CI 0.960-0.999). The positive predictive value was 0.973 (95% CI 0.904-0.993) and the negative predictive value was 0.935 (95% CI 0.901-0.965). The false positive rate was 0.006. The F1 number was 0.926 demonstrating a high accuracy for the model. Conclusion: The temporal bone is a complex anatomical region of interest to otolaryngologists. Surgical planning requires high-resolution computed tomography scans, the interpretation of which can be augmented with machine learning. This initial study demonstrates the feasibility of utilizing machine learning algorithms to discriminate anatomical variation with a high degree of accuracy. It is hoped this will lead to further investigation regarding more complex anatomical structures in the temporal bone.
MeSH term(s)	Mastoid/diagnostic imaging ; Temporal Bone/diagnostic imaging ; Tomography, X-Ray Computed ; Algorithms ; Computers
Language	English
Publishing date	2023-06-05
Publishing country	Turkey
Document type	Journal Article
ZDB-ID	2561231-1
ISSN	2148-3817 ; 1308-7649 ; 2148-3817
ISSN (online)	2148-3817
ISSN	1308-7649 ; 2148-3817
DOI	10.5152/iao.2023.22958
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Article: Evaluating Large Language Models for Drafting Emergency Department Discharge Summaries.

Williams, Christopher Y K / Bains, Jaskaran / Tang, Tianyu / Patel, Kishan / Lucas, Alexa N / Chen, Fiona / Miao, Brenda Y / Butte, Atul J / Kornblith, Aaron E

medRxiv : the preprint server for health sciences

2024

Abstract: Importance: Large language models (LLMs) possess a range of capabilities which may be applied to the clinical domain, including text summarization. As ambient artificial intelligence scribes and other LLM-based tools begin to be deployed within ... ...

Abstract	Importance: Large language models (LLMs) possess a range of capabilities which may be applied to the clinical domain, including text summarization. As ambient artificial intelligence scribes and other LLM-based tools begin to be deployed within healthcare settings, rigorous evaluations of the accuracy of these technologies are urgently needed. Objective: To investigate the performance of GPT-4 and GPT-3.5-turbo in generating Emergency Department (ED) discharge summaries and evaluate the prevalence and type of errors across each section of the discharge summary. Design: Cross-sectional study. Setting: University of California, San Francisco ED. Participants: We identified all adult ED visits from 2012 to 2023 with an ED clinician note. We randomly selected a sample of 100 ED visits for GPT-summarization. Exposure: We investigate the potential of two state-of-the-art LLMs, GPT-4 and GPT-3.5-turbo, to summarize the full ED clinician note into a discharge summary. Main outcomes and measures: GPT-3.5-turbo and GPT-4-generated discharge summaries were evaluated by two independent Emergency Medicine physician reviewers across three evaluation criteria: 1) Inaccuracy of GPT-summarized information; 2) Hallucination of information; 3) Omission of relevant clinical information. On identifying each error, reviewers were additionally asked to provide a brief explanation for their reasoning, which was manually classified into subgroups of errors. Results: From 202,059 eligible ED visits, we randomly sampled 100 for GPT-generated summarization and then expert-driven evaluation. In total, 33% of summaries generated by GPT-4 and 10% of those generated by GPT-3.5-turbo were entirely error-free across all evaluated domains. Summaries generated by GPT-4 were mostly accurate, with inaccuracies found in only 10% of cases, however, 42% of the summaries exhibited hallucinations and 47% omitted clinically relevant information. Inaccuracies and hallucinations were most commonly found in the Plan sections of GPT-generated summaries, while clinical omissions were concentrated in text describing patients' Physical Examination findings or History of Presenting Complaint. Conclusions and relevance: In this cross-sectional study of 100 ED encounters, we found that LLMs could generate accurate discharge summaries, but were liable to hallucination and omission of clinically relevant information. A comprehensive understanding of the location and type of errors found in GPT-generated clinical text is important to facilitate clinician review of such content and prevent patient harm.
Language	English
Publishing date	2024-04-04
Publishing country	United States
Document type	Preprint
DOI	10.1101/2024.04.03.24305088
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Article ; Online: Non-diagnostic sonography may reduce negative appendicectomy rate in women when combined with abbreviated Alvarado score.

Bappayya, Shaneel / Chen, Fiona / Alderuccio, Megan / Xu, Edward / Vootukuru, Nikil / Lee, James C

ANZ journal of surgery

2021 Volume 91, Issue 4, Page(s) 609–615

Abstract: Background: The diagnosis of acute appendicitis (AA) remains a clinical one, with selective use of adjunct imaging. Patients with equivocal clinical presentation often undergo a diagnostic laparoscopy. To help reduce negative appendicectomy rates in ... ...

Abstract	Background: The diagnosis of acute appendicitis (AA) remains a clinical one, with selective use of adjunct imaging. Patients with equivocal clinical presentation often undergo a diagnostic laparoscopy. To help reduce negative appendicectomy rates in women, we aimed to develop a simple scoring system based on the Alvarado score (AS) and ultrasound scan (US), as a diagnostic aid for AA in females. Methods: All patients who underwent appendicectomy for AA at The Alfred Hospital Melbourne between 1 July 2012 and 30 June 2017 were included for this case-control study. Logistic regression was used to identify pre-operative parameters predictive of AA. Histopathological identification of AA was interpreted as the gold standard. Statistical analysis was performed using IBM SPSS Statistics V26. Results: A total of 1194 patients were included, with 26% negative appendicectomy rate in women. Of the 8 parameters in the AS, logistic regression identified migratory pain, leukocytosis and leukocyte left shift as most significant predictors for AA. These three parameters were used in a 3-point test which carried a sensitivity of 92.1% and specificity of 28.7%. In women, a negative or non-diagnostic US improved the negative predictive value of the 3-point test from 57% to 82%. Conclusion: The 3-point abbreviated AS in combination with US may be clinically useful in women to exclude appendicitis without diagnostic laparoscopy. Further large-scale prospective studies are required to validate the utility across different subgroups.
MeSH term(s)	Acute Disease ; Appendectomy ; Appendicitis/diagnostic imaging ; Appendicitis/surgery ; Case-Control Studies ; Female ; Humans ; Prospective Studies ; Sensitivity and Specificity ; Ultrasonography
Language	English
Publishing date	2021-01-21
Publishing country	Australia
Document type	Journal Article
ZDB-ID	2050749-5
ISSN	1445-2197 ; 1445-1433 ; 0004-8682
ISSN (online)	1445-2197
ISSN	1445-1433 ; 0004-8682
DOI	10.1111/ans.16588
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Article ; Online: Caseload distribution of general surgeons in regional Australia: is there a role for a rural surgery sub-specialization?

Bappayya, Shaneel / Chen, Fiona / Alderuccio, Megan / Schwalb, Heinrich

ANZ journal of surgery

2018 Volume 89, Issue 6, Page(s) 672–676

Abstract: Background: Rural and regional Australia presents a unique challenge in the delivery of surgical services by virtue of its geographical vastness and low population density. While up to 33% of Australians live in rural or regional areas, only 14.8% of ... ...

Abstract	Background: Rural and regional Australia presents a unique challenge in the delivery of surgical services by virtue of its geographical vastness and low population density. While up to 33% of Australians live in rural or regional areas, only 14.8% of surgeons work in a rural or regional area. Data regarding the caseload distribution of general surgeons working in a regional setting in Australia remain scarce. In order to better examine the training needs of rural general surgeons, this study aims to examine the caseload distribution of general surgeons working in regional Australia. Methods: A retrospective review of surgical procedures carried out by general surgeons at Albury Base Hospital between September 2006 and December 2014 was carried out. Surgical procedures were grouped according to the classifications of the Royal Australasian College of Surgeons Morbidity and Audit Logbook Tool. Results: During the study period, 21 652 procedures were carried out by general surgeons. A total of 58.7% (12711) of these procedures consisted of general surgical procedures and 35.9% (7763) were endoscopic procedures. A total of 5.4% of procedures carried out by general surgeons fell outside the scope of traditional general surgery, including cardiothoracic, orthopaedic, ear, nose and throat, neurosurgical, vascular and urological procedures. All general surgeons performed operations in surgical specialities outside of general surgery. Conclusion: This study adds weight to the value of a broad skill set in provision of surgical services in a rural setting.
MeSH term(s)	Australia ; General Surgery/statistics & numerical data ; Humans ; Retrospective Studies ; Rural Health Services/organization & administration ; Specialization ; Surgical Procedures, Operative/statistics & numerical data ; Workload/statistics & numerical data
Language	English
Publishing date	2018-06-05
Publishing country	Australia
Document type	Journal Article
ZDB-ID	2050749-5
ISSN	1445-2197 ; 1445-1433 ; 0004-8682
ISSN (online)	1445-2197
ISSN	1445-1433 ; 0004-8682
DOI	10.1111/ans.14680
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Article ; Online: Hypotension in Posterior Retroperitoneoscopic Versus Transperitoneal Laparoscopic Adrenalectomy.

Chen, Fiona / Adhami, Mohammadmehdi / Tan, MinTing / Grodski, Simon / Serpell, Jonathan / Orr, Annabel / Stark, Anthony / Lee, James C

The Journal of surgical research

2022 Volume 275, Page(s) 87–95

Abstract: Introduction: Despite preoperative optimization, hemodynamic instability can be a major challenge during adrenalectomy. Even brief episodes of intraoperative hypotension can be associated with ischemia-reperfusion injury. This study aimed to compare ... ...

Abstract	Introduction: Despite preoperative optimization, hemodynamic instability can be a major challenge during adrenalectomy. Even brief episodes of intraoperative hypotension can be associated with ischemia-reperfusion injury. This study aimed to compare intraoperative hemodynamic parameters between posterior retroperitoneoscopic adrenalectomy (PRA) and transperitoneal laparoscopic adrenalectomy (TPA). Methods: This is a retrospective study of patients undergoing PRA and TPA without conversion or concomitant intraabdominal pathology from 2008 to 2019. The primary outcome was intraoperative hypotension defined by mean arterial pressure <60 mm Hg or the need for ≥1 intravenous vasopressors at least 30 min after anesthetic induction. Results: Overall, 108 patients met the inclusion criteria; 33 (30.6%) had pheochromocytoma, 26 (24.1%) had aldosterone excess, 8 (7.4%) had corticosteroid excess, and 41 (38.0%) had nonfunctioning adrenal tumors. Of these, 68 (63.0%) underwent PRA and 40 (37.0%) underwent TPA. Age, sex, body mass index, preinduction blood pressure, number of preoperative antihypertensives, and histopathological diagnosis were similar in the two groups. Tumor size was greater in the TPA group. The presence of pheochromocytoma was an independent risk factor for hypotension. Multivariate analysis revealed that PRA was associated with a higher risk of experiencing a mean arterial pressure <60 mm Hg (odds ratio 4.44, 95% confidence interval 1.27-15.54, P = 0.02) and the need for ≥1 intravenous vasopressors (odds ratio 9.97, 95% confidence interval 3.34-29.78, P < 0.001) compared with TPA. Conclusions: Although PRA offers several advantages over TPA, it carries a greater risk of intraoperative hypotension. A prospective trial is required to validate these findings. Nevertheless, institution of risk reduction strategies is encouraged to be considered for individuals undergoing PRA.
MeSH term(s)	Adrenal Gland Neoplasms/pathology ; Adrenal Gland Neoplasms/surgery ; Adrenalectomy/adverse effects ; Humans ; Hypotension/epidemiology ; Hypotension/etiology ; Laparoscopy/adverse effects ; Pheochromocytoma/surgery ; Prospective Studies ; Retrospective Studies
Language	English
Publishing date	2022-03-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	80170-7
ISSN	1095-8673 ; 0022-4804
ISSN (online)	1095-8673
ISSN	0022-4804
DOI	10.1016/j.jss.2022.01.013
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