Cost effective use of free to use apps (FAN) in neurosurgery in developing countries: from clinical decision making to educational courses, strengthening the health care delivery

Thapa, Amit; Kc, Bidur; Shakya, Bikram

doi:10.3126/jssn.v18i3.15299

Cited by 4 publications

(4 citation statements)

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“…The choice of the surgical approach is very important. The common approaches reported in the literature include the transtriangular, transfrontal, and transoccipital approaches [21] . It is di cult to remove a hematoma in the anterior horn of the lateral ventricle through the triangular and occipital approaches, which cannot unblock the interventricular foramen effectively, the lateral or prone position is often required, and the placement of the body position is time-consuming and cumbersome.…”

Section: Discussionmentioning

confidence: 99%

Clinical Efficacy and Safety of Neuroendoscopic Surgery for Severe Ventricular Thalamic Hemorrhage

Zhou

Jiang

Wang

et al. 2021

Preprint

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Objective To summarize and analyze the clinical efficacy and safety of neuroendoscopic surgery in the treatment of patients with severe ventricular thalamic hemorrhage. Methods Eight-three patients with severe ventricular thalamic hemorrhage were treated in the Neurosurgery Department of Anqing Hospital Affiliated to Anhui Medical University from July 2019 to August 2021. Of the 83 patients, 41 underwent neuroendoscopic surgery and 42 underwent simple extraventricular drainage. The hospital stay, GCS scores on the 1st and 14th days postoperatively, the incidence of intracranial infections, and the clearance of postoperative hematomas were compared and analyzed between the two groups. The patients were followed up to 6 months. The prognosis was evaluated by the activity of daily living (ADL) score. A head CT or MRI was obtained to determine whether there was hydrocephalus, cerebral infarction, or other related complications. Results The postoperative hospital stay was 17.42±1.53 days, the GCS score was 6.56±0.21 points on day 1 and 10.83±0.36 points on day 14, intracranial infections occurred in three patients (7.31%) and the hematoma clearance rate was 83.6±5.18% in the neuroendoscopy group, all of which were significantly better than the simple extraventricular drainage group (P < 0.05). After 6 months of follow-up, 28 patients (68.29%) had a good prognosis, 5 patients (12.19%) died, and 4 patients(9.75%)had hydrocephalus in the neuroendoscopy group. In the extraventricular drainage group, the prognosis was good in 15 patients (35.71%), death in 12 patients (28.57%), and hydrocephalus in 17 patients (40.47%). The follow-up results showed that the good prognosis, mortality, and incidence of hydrocephalus in the neuroendoscopy group were significantly better than the extraventricular drainage group (P < 0.05). Conclusion Compared with traditional ventricular-puncture drainage, simultaneous endoscopic sinus surgery for severe ventricular thalamic hemorrhage had a higher hematoma clearance rate, fewer intracranial infections, and hydrocephalus, which together improve the clinical prognosis, and is thus recommended for clinical use.

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Section: Discussionmentioning

confidence: 99%

Clinical Efficacy and Safety of Neuroendoscopic Surgery for Severe Ventricular Thalamic Hemorrhage

Zhou

Jiang

Wang

et al. 2021

Preprint

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“…20 Thapa et al instead studied the use of multiple smartphone applications through the neurosurgical pathway. 26 Here, the authors concluded these tools to aid quick reliable decision making, allowing for instantaneous communication, storing data and knowledge exchange, though they brought with them increased risk of data misuse and increased discrepancies in clinical image interpretation.…”

Section: Smartphone Applicationsmentioning

confidence: 98%

“…13 Importantly, however, this is not uniformly the case when adopting digital platforms and a number of studies, including those by Thapa et al and Macyszyn et al, have demonstrated considerable net savings. 19,26 This has typically been through either low upfront costs associated with communication tools or organisational savings attributed to improved clinical outcomes or preventing the need for duplicate investigations, as is often the case in current clinical practice.…”

Section: Barriers To Implementationmentioning

confidence: 99%

Digital Technology: Digital tools in neurosurgical pathways: considerations for the future

Deighton¹,

Chhatwal

2022

Future Healthcare Journal

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With aspects of neurosurgery becoming increasingly digitised, there is a need to understand both the prevalence and impact of digital tools on clinical and organisational outcomes. Consequently, we sought to evaluate evidence of the use of digital tools in neurosurgical settings. We systematically searched three public databases for relevant articles: 283 articles were screened using inclusion/exclusion criteria, with 26 selected for further analysis. Many studies reported on the use of simulation, smartphones, telemedicine and robotics in neurosurgical pathways from education through to postoperative care. Though generally beneficial for both patient and organisational outcomes, a number of considerations were highlighted. Many referred to protection of patient data, cost and requirements to ensure socially disadvantaged groups are not further excluded by the move to digital services. Fortunately, with further innovation, many of these limitations look set to dissipate over coming years, paving the way for a more streamlined neurosurgical pathway.

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“…Moreover, whilst certain institutions may be early adopters with exposure to digital neurosurgical simulation technologies, others may be unable to gain the required exposure due to organisational financial constraints. In fact, various teams have highlighted that the costs of neurosurgical simulation can be high and hence have developed further methods like app-based communication platforms to reduce costs [26,28,31,61,75,79,113]. Study designs for centres with established track records and budgets for neurosurgical simulation differ from centres with financial constraints undertaking an initial study into its usefulness for their trainees.…”

Section: Comparison With Other Studiesmentioning

confidence: 99%

Simulation for skills training in neurosurgery: a systematic review, meta-analysis, and analysis of progressive scholarly acceptance

et al. 2020

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At a time of significant global unrest and uncertainty surrounding how the delivery of clinical training will unfold over the coming years, we offer a systematic review, meta-analysis, and bibliometric analysis of global studies showing the crucial role simulation will play in training. Our aim was to determine the types of simulators in use, their effectiveness in improving clinical skills, and whether we have reached a point of global acceptance. A PRISMA-guided global systematic review of the neurosurgical simulators available, a meta-analysis of their effectiveness, and an extended analysis of their progressive scholarly acceptance on studies meeting our inclusion criteria of simulation in neurosurgical education were performed. Improvement in procedural knowledge and technical skills was evaluated. Of the identified 7405 studies, 56 studies met the inclusion criteria, collectively reporting 50 simulator types ranging from cadaveric, low-fidelity, and part-task to virtual reality (VR) simulators. In all, 32 studies were included in the meta-analysis, including 7 randomised controlled trials. A random effects, ratio of means effects measure quantified statistically significant improvement in procedural knowledge by 50.2% (ES 0.502; CI 0.355; 0.649, p < 0.001), technical skill including accuracy by 32.5% (ES 0.325; CI − 0.482; − 0.167, p < 0.001), and speed by 25% (ES − 0.25, CI − 0.399; − 0.107, p < 0.001). The initial number of VR studies (n = 91) was approximately double the number of refining studies (n = 45) indicating it is yet to reach progressive scholarly acceptance. There is strong evidence for a beneficial impact of adopting simulation in the improvement of procedural knowledge and technical skill. We show a growing trend towards the adoption of neurosurgical simulators, although we have not fully gained progressive scholarly acceptance for VR-based simulation technologies in neurosurgical education.

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Cost effective use of free to use apps (FAN) in neurosurgery in developing countries: from clinical decision making to educational courses, strengthening the health care delivery

Abstract: Materials and Methods: Results:Conclusion:

Cited by 4 publications

References 0 publications

Clinical Efficacy and Safety of Neuroendoscopic Surgery for Severe Ventricular Thalamic Hemorrhage

Clinical Efficacy and Safety of Neuroendoscopic Surgery for Severe Ventricular Thalamic Hemorrhage

Digital Technology: Digital tools in neurosurgical pathways: considerations for the future

Simulation for skills training in neurosurgery: a systematic review, meta-analysis, and analysis of progressive scholarly acceptance

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