Continuous monitoring tools for pediatric surgical outcomes: an example using biliary atresia

Sibanda, Nokuthaba; Lewsey, James; Meulen, Jan van der; Stringer, Mark D.

doi:10.1016/j.jpedsurg.2007.07.023

Cited by 15 publications

(7 citation statements)

References 28 publications

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“…PE is a rarely performed and a complicated operative procedure. In many centers only one or two surgeons perform the operations for BA (3,9,12). Even though the results of centralization to larger centers have been addressed, no particular studies have examined how the experience of the individual surgeon influences outcome of PE.…”

Section: Discussionmentioning

confidence: 99%

Outcome for biliary atresia patients treated at a low-volume centre

Björnland

Hinna

Aksnes

et al. 2018

Scandinavian Journal of Gastroenterology

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Section: Discussionmentioning

confidence: 99%

Outcome for biliary atresia patients treated at a low-volume centre

Björnland

Hinna

Aksnes

et al. 2018

Scandinavian Journal of Gastroenterology

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“…Sequential analysis is used mainly in experimental clinical trials. However, it could be applied in other conditions as to quality assurance, surveillance of vaccine safety, double-blind allergen-exposure tests, dosefinding, the optimal ventilation technique in preterm neonates [25][26][27], hearing testing [28,29], metabolic screening, computerized testing of human examinees as a termination criterion in a variable-length computerized classification test (CCT) [30], detection of anomalous medical outcomes [31], and monitoring the performance of doctors, surgeons and other medical practitioners in such a way as to give early warning of potentially anomalous results. Another important use that merits particular attention is a cumulative metaanalysis and trial sequential analysis of randomized trials in systematic reviews [32,33].…”

Section: Applications Of Sequential Designmentioning

confidence: 99%

The world is waiting, use sequential analysis and get us the evidence-based treatment we need for COVID-19

Taguri

Nasef

2020

Libyan Journal of Medicine

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“…In the medical area, the SPRT has been previously applied to the performance monitoring of clinical teams [26][27][28][29][30] (to continually monitor the surgical outcome rate and ensure it does not deviate from the expected success rate), routine surveillance of drug safety 31 (to continually monitor whether a new vaccine is safe over a period of time), and determination of early stopping criteria of clinical trials 32,33 (to allow the trial to be stopped as soon as the information accumulated is considered sufficient to reach a conclusion). Our results demonstrated that the SPRT may be effective for continual physiological monitoring, in the reduction of false-alarm-affected patients (36% fewer patients than the time-averaging method) and overall decision changes (75% fewer decision changes).…”

Section: Insufficiency Of Standard Test Characteristics For Describinmentioning

confidence: 99%

Are Standard Diagnostic Test Characteristics Sufficient for the Assessment of Continual Patient Monitoring?

et al. 2012

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Background. For diagnostic processes involving continual measurements from a single patient, conventional test characteristics, such as sensitivity and specificity, do not consider decision consistency, which might be a distinct, clinically relevant test characteristic. Objective. The authors investigated the performance of a decision-support classifier for the diagnosis of traumatic injury with blood loss, implemented with three different data-processing methods. For each method, they computed standard diagnostic test characteristics and novel metrics related to decision consistency and latency. Setting. Prehospital air ambulance transport. Patients. A total of 557 trauma patients. Design. Continually monitored vital-sign data from 279 patients (50%) were randomly selected for classifier development, and the remaining were used for testing. Three data-processing methods were evaluated over 16 min of patient monitoring: a 2-min moving window, time averaging, and postprocessing with the sequential probability ratio test (SPRT). Measurements. Sensitivity and specificity were computed. Consistency was quantified through cumulative counts of decision changes over time and the fraction of patients affected by false alarms. Latency was evaluated by the fraction of patients without a decision. Results. All 3 methods showed very similar final sensitivities and specificities. Yet, there were significant differences in terms of the fraction of patients affected by false alarms, decision changes through time, and latency. For instance, use of the SPRT led to a 75% reduction in the number of decision changes and a 36% reduction in the number of patients affected by false alarms, at the expense of 3% unresolved final decisions. Conclusion. The proposed metrics of decision consistency and decision latency provided additional information beyond what could be obtained from test sensitivity and specificity and are likely to be clinically relevant in some applications involving temporal decision making.

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Continuous monitoring tools for pediatric surgical outcomes: an example using biliary atresia

Cited by 15 publications

References 28 publications

Outcome for biliary atresia patients treated at a low-volume centre

Outcome for biliary atresia patients treated at a low-volume centre

The world is waiting, use sequential analysis and get us the evidence-based treatment we need for COVID-19

Are Standard Diagnostic Test Characteristics Sufficient for the Assessment of Continual Patient Monitoring?

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