Speech technology for medical reporting : consequences for the correction process

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Epidural steroid compared to placebo injection in sciatica: a systematic review and meta-analysis

Purpose The purpose of this systematic review and meta-analysis was to determine whether epidural steroid injections (ESI) are superior to epidural or non-epidural placebo injections in sciatica patients. Methods The PubMed, Embase, Cochrane Library, and Web of science databases were searched for trials comparing ESI to epidural or non-epidural placebo. Risk of bias was assessed using the Cochrane RoB 2 tool. The primary outcome measures were pooled using a random-effects model for 6-week, 3-month, and 6-month follow-up. Secondary outcomes were described qualitatively. Quality of evidence was graded using GRADE classification. Results Seventeen out of 732 articles were included. ESI was superior compared to epidural placebo at 6 weeks (- 8.6 [- 13.4; - 3.9]) and 3 months (- 5.2 [- 10.1; - 0.2]) for leg pain and at 6 weeks for functional status (- 4.1 [- 6.5; - 1.6]), though the minimally clinical important difference (MCID) was not met. There was no difference in ESI and placebo for back pain, except for non-epidural placebo at 3 months (6.9 [1.3; 12.5]). Proportions of treatment success were not different. ESI reduced analgesic intake in some studies and complication rates are low. Conclusion The literature indicates that ESI induces larger improvements in pain and disability on the short term compared to epidural placebo, though evidence is of low to moderate quality and MCID is not met. Strong conclusions for longer follow-up or for comparisons with non-epidural placebo cannot be drawn due to general low quality of evidence and limited number of studies. Epidural injections can be considered a safe therapy.Neuro Imaging Researc

The influence of time on error-detection

Secretaries are needed to type out the reports dictated by medical specialists. Even with a large transcription department it takes more than a day before a dictated report is ready to be sent to the people concerned. The use of automatic speech recognition (ASR) can shorten this time interval. A disadvantage is that ASR systems still make errors. As reports must be error-free a lot depends on the pathologists' correction capabilities. The correction procedure that pathologists currently use may not be adequate for correcting ASR errors. To be able to correct the reports pathologists must be able to recollect the structure and contents of their dictation. Their recollection is likely to be better with less time between dictation and correction. In this paper correction performance on the same day as dictation is compared with correction the day after. To be able to make this comparison, errors were artificially introduced into the pathologists' reports. No difference between the conditions was observed, but it was found that pathologists had great difficulty correcting the reports. It is concluded that their current correction procedure is inadequate to correct ASR errors and may be inadequate altogether

Speech interfacing for diagnosis reporting systems : an overview

Automatic speech recognition has since long been seen as an ideal method for innovation in diagnosis reporting. Speech technology now seems on the verge of introducing (commercially) attractive systems. The selection of a good speech recogniser is only one consideration in system design. Interface aspects, error handling, reporting method and implementation in the daily working routine are interwoven with the selection of an appropriate speech recognition technique, and should therefore be determined first

The Outcome of Epidural Injections in Lumbar Radiculopathy Is Not Dependent on the Presence of Disc Herniation on Magnetic Resonance Imaging: Assessment of Short-Term and Long-Term Efficacy

OBJECTIVE: Lumbar radiculopathy is a condition with major physical, social, and economic consequences. Despite its favorable prognosis, the burden can be significant. In this study, we aimed to determine the value of magnetic resonance imaging (MRI) and the efficacy of transforaminal epidural injections (TEIs) in patients with lumbar radiculopathy secondary to lumbar disc herniation (LDH) and other causes (non-LDH).METHODS: Patients with lumbar radiculopathy were reviewed for radiologic diagnosis based on MRI. For patients receiving TEI therapy, response after 6-8 weeks (short-term) and 16 weeks (long-term), number of injections, subsequent surgery, and patient outcome were evaluated. Treatment response was assessed by patient-reported symptom relief and numeric rating scale pain scores.RESULTS: Overall, 66% of MRI examinations showed a clinically relevant LDH. A total of 486 of 1824 patients received TEI, of whom one third did not show LDH. Of patients, 70% reported a short-term effect with significant pain reduction and 44% reported a long-term effect. No significant differences were observed between the LDH and non-LDH groups. Of patients, 59% required multiple injections and reported similar efficacy compared with patients treated with a single injection.CONCLUSIONS: A considerable part of MRI examinations in patients with lumbar radiculopathy do not show a clinically relevant LDH. Regardless of the radiologic diagnosis, most patients treated with TEI benefit in both the short-term and the long-term after a single-injection or multiple-injection regime. Subsequent injections are advisable if the effect from the first injection is unsatisfactory or wears off. MRI examination before TEI therapy may be redundant, which allows for expedition of this treatment.Scientific Assessment and Innovation in Neurosurgical Treatment Strategie