Telementoring platforms can help transfer surgical expertise remotely. However, most telementoring platforms are not designed to assist in austere, pre-hospital settings. This paper evaluates the system for telementoring with augmented reality (STAR), a portable and self-contained telementoring platform based on an augmented reality head-mounted display (ARHMD). The system is designed to assist in austere scenarios: a stabilized first-person view of the operating field is sent to a remote expert, who creates surgical instructions that a local first responder wearing the ARHMD can visualize as three-dimensional models projected onto the patient’s body. Our hypothesis evaluated whether remote guidance with STAR could lead to performing a surgical procedure better, as opposed to remote audio-only guidance. Remote expert surgeons guided first responders through training cricothyroidotomies in a simulated austere scenario, and on-site surgeons evaluated the participants using standardized evaluation tools. The evaluation comprehended completion time and technique performance of specific cricothyroidotomy steps. The analyses were also performed considering the participants’ years of experience as first responders, and their experience performing cricothyroidotomies. A linear mixed model analysis showed that using STAR was associated with higher procedural and non-procedural scores, and overall better performance. Additionally, a binary logistic regression analysis showed that using STAR was associated to safer and more successful executions of cricothyroidotomies. This work demonstrates that remote mentors can use STAR to provide first responders with guidance and surgical knowledge, and represents a first step towards the adoption of ARHMDs to convey clinical expertise remotely in austere scenarios.
Abstract. Predicting landslide displacement is challenging, but accurate predictions can prevent casualties and economic losses. Many factors can affect the deformation of a landslide, including the geological conditions, rainfall and reservoir water level. Time series analysis was used to decompose the cumulative displacement of landslide into a trend component and a periodic component. Then the least-squares support vector machine (LSSVM) model and genetic algorithm (GA) were used to predict landslide displacement, and we selected a representative landslide with episodic movement deformation as a case study. The trend component displacement, which is associated with the geological conditions, was predicted using a polynomial function, and the periodic component displacement which is associated with external environmental factors, was predicted using the GA-LSSVM model. Furthermore, based on a comparison of the results of the GA-LSSVM model and those of other models, the GA-LSSVM model was superior to other models in predicting landslide displacement, with the smallest root mean square error (RMSE) of 62.4146 mm, mean absolute error (MAE) of 53.0048 mm and mean absolute percentage error (MAPE) of 1.492 % at monitoring station ZG85, while these three values are 87.7215 mm, 74.0601 mm and 1.703 % at ZG86 and 49.0485 mm, 48.5392 mm and 3.131 % at ZG87. The results of the case study suggest that the model can provide good consistency between measured displacement and predicted displacement, and periodic displacement exhibited good agreement with trends in the major influencing factors.
Introduction
Point-of-injury (POI) care requires immediate specialized assistance but delays and expertise lapses can lead to complications. In such scenarios, telementoring can benefit health practitioners by transmitting guidance from remote specialists. However, current telementoring systems are not appropriate for POI care. This article clinically evaluates our System for Telementoring with Augmented Reality (STAR), a novel telementoring system based on an augmented reality head-mounted display. The system is portable, self-contained, and displays virtual surgical guidance onto the operating field. These capabilities can facilitate telementoring in POI scenarios while mitigating limitations of conventional telementoring systems.
Methods
Twenty participants performed leg fasciotomies on cadaveric specimens under either one of two experimental conditions: telementoring using STAR; or without telementoring but reviewing the procedure beforehand. An expert surgeon evaluated the participants’ performance in terms of completion time, number of errors, and procedure-related scores. Additional metrics included a self-reported confidence score and postexperiment questionnaires.
Results
STAR effectively delivered surgical guidance to nonspecialist health practitioners: participants using STAR performed fewer errors and obtained higher procedure-related scores.
Conclusions
This work validates STAR as a viable surgical telementoring platform, which could be further explored to aid in scenarios where life-saving care must be delivered in a prehospital setting.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.