USAGE OF ANESTHESIA INFORMATION MANAGEMENT SYSTEMS IN EUROPEAN COUNTRIES IN 2020 – A SHORT SURVEY

The theoretical aspects and benefits of Anesthesia Information Management Systems (AIMS) are well described in literature already. However, certain existing systems are much less researched with most studies concentrating on the USA. In our study, we sent a link to a Google questionnaire to 403 European hospitals and to 382 European authors who have published in the last five years in a renowned anesthesiologic journal. We have not researched AIMS usage in the Czech Republic, as we have covered this topic in our previous study. We asked responders for information on their AIMS (name, vendor, length of use) or to explain why they do not use one. We received 14 responses from the hospitals and 38 responses directly from the authors. With the return rate of 8 per cent we evaluated our study in qualitative terms. Among the 23 respondents that use AIMS there are 12 different systems including two self-developed systems. A number of these systems have not previously been mentioned in the literature. Most use their systems longer than five years but only three respondents are implementing AIMS at the moment. Both these findings show slower progress in this field than in the USA. Typical reasons given from non-users were financial constraints and inability to recognize benefits of AIMS. Incompatibilities with other medical software and medical devices in use were also mentioned. The heterogeneity of AIMS used and perceived barriers corroborate our previous study from the Czech Republic

25th International Congress of the European Association for Endoscopic Surgery (EAES) Frankfurt, Germany, 14-17 June 2017 : Oral Presentations

Introduction: Ouyang has recently proposed hiatal surface area (HSA) calculation by multiplanar multislice computer tomography (MDCT) scan as a useful tool for planning treatment of hiatus defects with hiatal hernia (HH), with or without gastroesophageal reflux (MRGE). Preoperative upper endoscopy or barium swallow cannot predict the HSA and pillars conditions. Aim to asses the efficacy of MDCT’s calculation of HSA for planning the best approach for the hiatal defects treatment. Methods: We retrospectively analyzed 25 patients, candidates to laparoscopic antireflux surgery as primary surgery or hiatus repair concomitant with or after bariatric surgery. Patients were analyzed preoperatively and after one-year follow-up by MDCT scan measurement of esophageal hiatus surface. Five normal patients were enrolled as control group. The HSA’s intraoperative calculation was performed after complete dissection of the area considered a triangle. Postoperative CT-scan was done after 12 months or any time reflux symptoms appeared. Results: (1) Mean HSA in control patients with no HH, no MRGE was cm2 and similar in non-complicated patients with previous LSG and cruroplasty. (2) Mean HSA in patients candidates to cruroplasty was 7.40 cm2. (3) Mean HSA in patients candidates to redo cruroplasty for recurrence was 10.11 cm2. Discussion. MDCT scan offer the possibility to obtain an objective measurement of the HSA and the correlation with endoscopic findings and symptoms. The preoperative information allow to discuss with patients the proper technique when a HSA[5 cm2 is detected. During the follow-up a correlation between symptoms and failure of cruroplasty can be assessed. Conclusions: MDCT scan seems to be an effective non-invasive method to plan hiatal defect treatment and to check during the follow-up the potential recurrence. Future research should correlate in larger series imaging data with intraoperative findings

Surgeons’ perspectives on artificial intelligence to support clinical decision-making in trauma and emergency contexts: results from an international survey

Background: Artificial intelligence (AI) is gaining traction in medicine and surgery. AI-based applications can offer tools to examine high-volume data to inform predictive analytics that supports complex decision-making processes. Time-sensitive trauma and emergency contexts are often challenging. The study aims to investigate trauma and emergency surgeons’ knowledge and perception of using AI-based tools in clinical decision-making processes. Methods: An online survey grounded on literature regarding AI-enabled surgical decision-making aids was created by a multidisciplinary committee and endorsed by the World Society of Emergency Surgery (WSES). The survey was advertised to 917 WSES members through the society’s website and Twitter profile. Results: 650 surgeons from 71 countries in five continents participated in the survey. Results depict the presence of technology enthusiasts and skeptics and surgeons’ preference toward more classical decision-making aids like clinical guidelines, traditional training, and the support of their multidisciplinary colleagues. A lack of knowledge about several AI-related aspects emerges and is associated with mistrust. Discussion: The trauma and emergency surgical community is divided into those who firmly believe in the potential of AI and those who do not understand or trust AI-enabled surgical decision-making aids. Academic societies and surgical training programs should promote a foundational, working knowledge of clinical AI

Surgeons' perspectives on artificial intelligence to support clinical decision-making in trauma and emergency contexts: results from an international survey

Background Artificial intelligence (AI) is gaining traction in medicine and surgery. AI-based applications can offer tools to examine high-volume data to inform predictive analytics that supports complex decision-making processes. Time-sensitive trauma and emergency contexts are often challenging. The study aims to investigate trauma and emergency surgeons’ knowledge and perception of using AI-based tools in clinical decision-making processes. Methods An online survey grounded on literature regarding AI-enabled surgical decision-making aids was created by a multidisciplinary committee and endorsed by the World Society of Emergency Surgery (WSES). The survey was advertised to 917 WSES members through the society’s website and Twitter profile. Results 650 surgeons from 71 countries in five continents participated in the survey. Results depict the presence of technology enthusiasts and skeptics and surgeons' preference toward more classical decision-making aids like clinical guidelines, traditional training, and the support of their multidisciplinary colleagues. A lack of knowledge about several AI-related aspects emerges and is associated with mistrust. Discussion The trauma and emergency surgical community is divided into those who firmly believe in the potential of AI and those who do not understand or trust AI-enabled surgical decision-making aids. Academic societies and surgical training programs should promote a foundational, working knowledge of clinical AI

The Anesthesia Continuing Education Market and the Value Creation From a Sustainable Unified Platform

Practicing anesthesia professionals in the United States are all governed by various profession-specific regulatory bodies that mandate continuing education (CE) requirements. To date, no unified resource exists for anesthesia professionals (i.e., Anesthesiologists, Certified Registered Nurse Anesthetists, and Anesthesiologist Assistants) to explore the CE offerings available within the marketplace. This study endeavored to convey the potential value of a unified anesthesia CE resource. It investigated how to cultivate a sustainable platform to potentially improve how anesthesia professionals search available CE offerings and to potentially enhance how anesthesia CE providers reach anesthesia professionals. This qualitative study was conducted utilizing an integrative review of the literature. The key concepts identified and investigated were network effect, segmentation, first to market, best of breed, search costs, transaction costs, minimally viable product, evolutionary phases of platforms, platform theory, platform business model, platform economy, and types of platforms. Inductive content analysis was chosen as the organizational method for the resultant qualitative data. The goal of the analysis was to create a conceptual, practical, and strategically applicable platform paradigm for the anesthesia CE marketplace driven by the insights and amalgamations from the literature. The analyzed concepts, dimensions, and indicators of platform successes and their applications potentially facilitate anesthesia professionals’ CE explorations and CE providers’ marketing efforts, as well as contextualize the overarching impacts and implications onto the anesthesia CE industry and beyond. The conclusion portrays these impacts and implications

Building trust - from television to the internet : crowds, trust and digital engagement

In the late 1960s, American democracy entered a crisis of trust and declining civic engagement. Policy makers interested in rebuilding trust with the people have often resorted to new communication technologies, but the impact of these technologies is sometimes unclear. The research presented here found that the impact of novel communication technologies is sometimes over-rated and that too much significance has been placed on leadership charisma. Sound strategic and tactical plans are critical to a successful outcome of any trust building activity, as trust is not necessarily created and sustained through the same means. Second, such plans must regularly be revised, and require competent expert support to execute strategic goals. This work concludes that – at all levels of public leadership – a change in thinking about digital technology is required, and that such technologies should be approached as opportunities rather than threats. Such an approach helps identify and deploy creative solutions, and speaks to younger generations who are more likely to embrace new technologies.Public Polic

Gastrostomy

The gastrostomy placement is a method of providing nutrition to the patients who are unable to eat. In this book you can find chapters focused on the use of gastrostomy in children, patients with neurological impairment and patients with head and neck tumours. Home enteral nutrition is suitable for all of these groups of patients and is far easier with gastrostomy. The new indications (especially in very young children) required new techniques such as: laparoscopic gastrostomy, laparoscopy assisted endoscopic gastrostomy with/without fundoplication, ultrasonography assisted gastronomy. All information about these techniques can be found in this book. This book does not serve as a basic textbook, but as an interesting reading material and as an aid for physicians who are already familiar with the indication for gastrostomy and want to know more

Information Technology's Role in Global Healthcare Systems

Over the past few decades, modern information technology has made a significant impact on people’s daily lives worldwide. In the field of health care and prevention, there has been a progressing penetration of assistive health services such as personal health records, supporting apps for chronic diseases, or preventive cardiological monitoring. In 2020, the range of personal health services appeared to be almost unmanageable, accompanied by a multitude of different data formats and technical interfaces. The exchange of health-related data between different healthcare providers or platforms may therefore be difficult or even impossible. In addition, health professionals are increasingly confronted with medical data that were not acquired by themselves, but by an algorithmic “black box”. Even further, externally recorded data tend to be incompatible with the data models of classical healthcare information systems.From the individual’s perspective, digital services allow for the monitoring of their own health status. However, such services can also overwhelm their users, especially elderly people, with too many features or barely comprehensible information. It therefore seems highly relevant to examine whether such “always at hand” services exceed the digital literacy levels of average citizens.In this context, this reprint presents innovative, health-related applications or services emphasizing the role of user-centered information technology, with a special focus on one of the aforementioned aspects

Perceptions of Acupuncture and Acupressure by Anesthesia Providers

BACKGROUND: Randomized controlled trials show acupuncture and acupressure support anesthesia management by decreasing anxiety, opioid requirements and treating post-operative nausea and vomiting. Acupuncture and acupressure have demonstrated clinical usefulness and received governmental support (NIH, PPACA, WHO, U.S. Military), but have not yet diffused into mainstream anesthesia practice. This study examined US anesthesia providers\u27 perceptions of acupuncture and acupressure. METHODS: Ninety-six anesthesiology departments stratified by geographic region (Northeast, South, West, and Midwest) and institution type (university medical centers, community hospitals, children’s hospitals, and VA hospitals) were selected for participation in an anonymous, online survey. The target sample was 1,728 providers of which N = 292 (54% anesthesiologists, 44% CRNAs, 2% AAs) responded yielding an overall 17% response rate. RESULTS: Spearman’s correlation coefficient revealed a statistically significant correlation between acupuncture and geographic region, with the West having the highest predisposition toward acupuncture use (rs = 0.159, p = 0.007). Females are more likely to use acupuncture than men (rs = -.188, p = 0.002). Age yielded a moderate effect size with providers between the ages of 31-50 years old experiencing the best outcomes administering acupuncture (rs = 0.65, 95% CI = 2.79, 3.06). A strong effect size exists between acupuncture and country of pre-anesthesia training (rs = 1.00, 95% CI = 1.08, 1.16). Some providers have used acupuncture (27%) and acupressure (18%) with positive outcomes, however the majority of providers have not used these modalities, but would consider using them (54%, SD = 1.44 acupuncture; 60%, SD = 1.32 acupressure). Seventy-six percent of respondents would like acupuncture education and 74% would like acupressure education (SD = 0.43, SD = 0.44, respectively). Lack of scientific evidence (79%, SD = 0.73) and unavailability of credentialed providers (71%, SD = 0.92) were the primary barriers. CONCLUSIONS: While most U.S. anesthesia providers have not used these modalities, they still report a favorable perception of acupuncture/acupressure’s role as part of an anesthetic and the majority of providers express an interest in receiving education. This study adds to the body of acupuncture and acupressure research by providing insight into anesthesia providers’ perceptions of these alternative medicine modalities