5 research outputs found
The use of privacy-protected computer vision to measure the quality of healthcare worker hand hygiene
© 2018 The Author(s). Objectives: (i) To demonstrate the feasibility of automated, direct observation and collection of hand hygiene data, (ii) to develop computer visual methods capable of reporting compliance with moment 1 (the performance of hand hygiene before touching a patient) and (iii) to report the diagnostic accuracy of automated, direct observation of moment 1. Design: Observation of simulated hand hygiene encounters between a healthcare worker and a patient. Setting: Computer laboratory in a university. Participants: Healthy volunteers. Main outcome measures: Sensitivity and specificity of automatic detection of the first moment of hand hygiene. Methods: We captured video and depth images using a Kinect camera and developed computer visual methods to automatically detect the use of alcohol-based hand rub (ABHR), rubbing together of hands and subsequent contact of the patient by the healthcare worker using depth imagery. Results: We acquired images from 18 different simulated hand hygiene encounters where the healthcare worker complied with the first moment of hand hygiene, and 8 encounters where they did not. The diagnostic accuracy of determining that ABHR was dispensed and that the patient was touched was excellent (sensitivity 100%, specificity 100%). The diagnostic accuracy of determining that the hands were rubbed together after dispensing ABHR was good (sensitivity 83%, specificity 88%). Conclusions: We have demonstrated that it is possible to automate the direct observation of hand hygiene performance in a simulated clinical setting. We used cheap, widely available consumer technology and depth imagery which potentially increases clinical application and decreases privacy concerns
CASE REPORT - CEREBELLAR ATAXIA DUE TO ISOLATED VITAMIN E DEFICIENCY
Ataxia is a common and important neurological finding in medical practice. Severe deficiency of Vitamin E can profoundly affect the central nervous system and can cause ataxia and peripheral neuropathy resembling Friedreich's ataxia. Vitamin E deficiency can occur with abetalipoproteinemia, cholestatic liver disease or fat malabsorption. Ataxia with isolated Vit E deficiency (AVED) is an Autosomal Recessive genetic disorder with a mutation in the alpha tocopherol transfer protein gene (TTPA). This condition responds to high dose of Vit E and is one of the important causes of treatable ataxia. We report a young patient with Ataxia with isolated Vit E deficiency (AVED) who responded partially to replacement of Vitamin E
ORIGINAL CONTRIBUTIONS - GREEK STROKE SCORE, SIRIRAJ SCORE AND ALLEN SCORE IN CLINICAL DIAGNOSIS OF INTRACEREBRAL HEMORRHAGE AND INFARCT: VALIDATION AND COMPARISON STUDY
AIM: To compare Greek stroke score with available previous two stroke
scores for the diagnosis of cerebral ischemia and hemorrhage in acute
stroke patients, and validate the Greek stroke score. SETTING: A
tertiary hospital in India. MATERIALS AND METHODS: In a prospective
study acute stroke patients were evaluated with Greek stroke score,
Allen score and Siriraj stroke score. Comparability (Kappa Statistics)
and validity (sensitivity, specificity, negative predictive value and
positive predictive value) of the Greek stroke score and previous
scores were tested. RESULT: Out of the 91 patients enrolled in the
study, 47 patients had cerebral infarction and 44 patients had
hemorrhage by CT scan. Allen score was uncertain / equivocal in 39
patients, Siriraj Stroke score in 22 and Greek stroke score in 47
patients. Sensitivity, Specificity, positive predictive value, negative
predictive value for Allen score were 0.5(95% CI:0.34,0.58), 0.94(95%
CI:0.86,0.98), 0.81(95% CI:0.56,0.95), 0.78(95% CI: 0.71,0.81) for
Siriraj score were 0.75(95% CI: 0.63,0.84), 0.81(95% CI: 0.71,0.89),
0.77(95% CI: 0.65,0.86), 0.78(95% CI 0.69,0.86) and for Greek Score
were 0.42(95% CI: 0.23,0.53), 0.93(95% CI: 0.87,0.98), 0.71(95%
CI:0.39,0.91), 0.81(95% CI:0.75,0.85) respectively. Greek stroke score
was compared with previous scores using kappa statistics which revealed
substantial strength of agreement between the Allen Score for certain
results. CONCLUSION: The overall comparability of Greek stroke score
and Allen score was better as compared to Greek stroke score and
Siriraj stroke score. Greek Stroke score was more specific in
diagnosing hemorrhage as compared to Siriraj score. However, all these
stroke scores lack accuracy hence could not be applied safely to guide
the physician in management of stroke