Objective To investigate the development and appl ication of the computer aided surgery systems in the joint surgery field. Methods The l iteratures were extensively reviewed to analysis the usefulness of current active, semi-active and passive computer aided surgery systems in solving the cl inical problems of joint surgery. Results Several computer aided surgery systems have met the high technique demands, such as the precision of anatomical position and orientation, the accuracy of normal l imb al ignment restoration, the optimum of instrumentation control in arthroplasty, peri-articular osteotomy and minimally invasive procedure. Conclusion Computer aided joint surgery systems facil itate precise surgical techniques to achieve ideal operative outcome.
With the development of computer and digital technology, the application of computer-aided technology has become a new trend in the field of oral implant. Computer-guided oral implant surgery has the advantages of being safer and more accurate than traditional implant surgery, and it can truly realize the concept of restoration-oriented implant. However, computer-guided oral implant surgery has various steps which cause deviations accumulation, so that some clinicians remain sceptical about the accuracy of the technology. Currently, due to the lack of a quantitative system for evaluating the accuracy of computer-guided oral implantation, the implant deviation in each step is still inconclusively in the stage of research and debate. The purpose of this paper is to summarize the advantages and disadvantages, research progress, accuracy and influencing factors of computer-guided oral implantation, aiming to provide a reference for improving implant accuracy and guiding clinical design and surgery.
Objective To compare and evaluate the sensitivity, specificity, accuracy, negative and positive predictive values, negative and positive likelihood ratios of colposcopically directed biopsy and diagnostic cone biopsy in patients with cervical intraepithelial neoplasia. Methods We searched PubMed, CBMdisc, CMCC, CNKI, and VIP to March 2004, and Cochrane Library (Issue 4, 2003). Related journals published from 1970 to 2003 and unpublished papers were hansearched. Diagnostic studies which employed colposcopically directed biopsy or diagnostic cone biopsy and compared with golden standard (pathological diagnosis of specimens obtained through therapeutic conization or hysterectomy) were included and meta-analysis was performed. Participants were clinically suspected of pre-cancerous cervical lesions. Quality of studies was assessed, and SROC curve by Diagnostic and Screening Group of the Cochrane Collaboration was used to perform meta-analysis. Parameters were sensitivity, specificity, accuracy, predictive values, and likelihood ratio. Results Twenty six studies (3 376 patients ranging from 2 to 604 patients/per study) met the inclusion criteria. The quality of studies was generally poor.Before sensitivity analysis, superiority of diagnostic cone biopsy (sensitivity and specificity: 0.83) was shown over colposcopically directed biopsy (sensitivity and specificity: 0.76) (P＜0.001); while after sensitivity analysis the results reversed (sensitivity of diagnostic cone biopsy was 0.58 and its specificity was 0.61; sensitivity and specificity of colposcopically directed biopsy increased to 0.84) (Plt;0.001). Conclusions No definite conclusioncan be drawn as to which method is superior. To make further analysis, more studies with high quality are needed.
The Standards for reporting diagnostic accuracy studies (STARD) 2015 is a revision of the STARD 2003 on the checklist and flow chart, on the basis of the new evidences of potential bias and applicability, to better guide the application of diagnostic test in clinical practices. Currently, the interpretation and application in China is still based on STARD 2003. This review will describe the application status of the original version and introduce the updated standards for reporting diagnostic accuracy studies.
ObjectiveTo systematically review the accuracy of different stroke-associated pneumonia (SAP) assessment tools. MethodsThe PubMed, Cochrane Library, Embase, Web of Science, CNKI, VIP, WanFang Data, and CBM databases were electronically searched to collect studies related to the objectives from inception to January 2024. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. A network meta-analysis was then performed by using Meta-disc 1.4 and Stata 17.0 software. ResultsA total of 20 studies were included, involving 6 SAP assessment tools. The results of network meta-analysis showed that the sensitivity of AIS-APS was higher than that of A2DS2, and the specificity of A2DS2 was higher than that of PANTHERIS, and the difference was statistically significant. The sensitivity SUCRA values from high to low were: AIS-APS (95.6%) > PANTHERIS (46.7%) > Kwon (44.1%) > A2DS2 (40.5%) > Chumbler (37.3%) > ISAN (35.8%). The specificity SUCRA values from high to low were: A2DS2 (84.0%) > Chumbler (66.0%) > ISAN (59.5%) > AIS-APS (41.4%) > Kwon (37.0%) > PANTHERIS (12.1%) ConclusionAmong the common stroke-associated pneumonia screening tools used to screen patients with ischemic stroke, AIS-APS has the highest sensitivity and A2DS2 has the highest specificity.
Objective To analyze the current state, evaluate the accuracy, and determine the influencing factors of diabetes-related subscriptions on the WeChat platform. Methods The top 100 WeChat platforms on the "China WeChat Platform New Rank Annual List 2020" were searched using the term "diabetes". We identified diabetes-related subscriptions published from June 1, 2021 to August 31, 2021. The accuracy of subscriptions was analyzed according to the consistency with clinical practice guidelines, and was independently assessed by two specialists. SPSS 22.0 software was used for data analysis. Results Sixty-eight subscriptions from 26 WeChat platforms were included. Twenty-five (36.8%) subscriptions were evaluated as inconsistent. The numbers of "wow" per thousand reads and "like" per thousand reads of inconsistent diabetic subscriptions were statistically higher than those of consistent diabetic subscriptions (P<0.05). Subscriptions with expert support (80.8% vs. 52.4%) and evidence support (91.7% vs. 57.1%) shared a higher consistency (P<0.05). Subscriptions with commercial promotion (16.7% vs. 67.7%) had a lower consistency (P=0.02). Conclusion Although some content is inconsistent with guidelines, diabetes-related subscriptions have a certain dissemination ability on the WeChat platform. Moreover, readers are more likely to "wow" or "like" for inconsistent subscriptions. Diabetes-related subscriptions on the WeChat public platform need supervision and can be further regulated by providing evidence support and regulating commercial promotion.
It is a challenge for clinicians and diagnostic systematic reviewers to determine the best test in clinical diagnosis and screening. Meanwhile, it also becomes the new chance and challenge for diagnostic test meta-analysis. Network meta-analysis has been commonly used in intervention systematic reviews, which can compare the effect size of all available interventions and to choose the best intervention. Network meta-analysis of diagnostic test can be defined as comparing all available diagnostic technologies in the same conditions based on the common reference tests. In order to provide the guide for diagnostic systematic reviewers, we aims to introduce four methods of conducting diagnostic test accuracy network meta-analysis, and to explore two ranking methods of network meta-analysis of diagnostic test accuracy.
Objective To investigate the short-term effectiveness of percutaneous pedicle screw (PPS) guided with photoelectric navigation for thoracolumbar fractures. Methods Between May 2013 and June 2015, the clinical data of 39 patients with thoracolumbar fractures in accordance with the selection criteria were retrospectively analyzed. The patients were divided into photoelectric navigation PPS group (trial group, 20 cases) and C-arm X-ray guidance PPS group (control group, 19 cases). There was no significant difference in gender, age, injury cause, fracture vertebrae, AO classification, operation time after injury, visual analogue scale (VAS) score, and vertebral compression ratio (VCR) between 2 groups (P > 0.05). The operation time, bleeding amount, perspective times, VAS score, and one-time success rate (OSR) of screw placement were recorded; VCR and endplate-screw angle (ESA) were measured; and pedicle-screw relationship (PSR) was assessed by Ringel’s method in radiographic result. Results Differences in operation time and bleeding amount were not significant between 2 groups (P > 0.05); perspective times of control group was significantly more than t hat of trial group (t=-15.658, P=0.000). The OSR of trial group (95.60%, 87/91) was significantly better than that of control group (86.75%, 72/83) (χ2=4.323, P=0.038). The patients were followed up 6-11 months (mean, 7.6 months) in trial group, and 7-11 months (mean, 7.8 months) in control group. No neurovascular complications associated with screw insertion occurred. Difference was not significant in VAS score at 7 days and 6 months after operation between 2 groups (P > 0.05), but VAS scores at 7 days and 6 months were significantly improved when compared with preoperative score in 2 groups (P < 0.05), and significant difference in VAS score was shown between at 7 days and 6 months in 2 groups (P < 0.05). VCR of trial group and control group were significantly improved to 94.75%±5.10% and 92.40%±5.09% at 6 months after operation from preoperative 71.97%±5.66% and 73.50%±5.97% (t=11.865, P=0.000; t=11.359, P=0.000), but there was no significant difference between 2 groups (t=1.442, P=0.158). ESA of trial group and control group were (1.82±1.13)° and (3.36±2.43)° at 6 months after operation, showing significant difference (t=5.421, P=0.000). At 6 months after operation, according to PSR classification, 83 screws rated as grade I, 6 as grade II, and 2 as grade III, and excellent and good rate of screw replacement was 97.80% in trial group; 54 screws were rated as grade I, 19 as grade II, 7 as grade III, and 3 as grade IV, and excellent and good rate of screw replacement was 87.95% in control group; difference was significant between 2?groups (χ2=18.347, P=0.000). Conclusion Application of photoelectric navigation can guide screws placement by the two-dimensional multi pl ane dynamic image, has better accuracy of screws position in thoracolumbar fractures, reduces the introperative X-ray perspective times, maintains good reduction of vertebral body, and achieves satisfactory effectiveness.
Objective To evaluate the accuracy of newer-generation home blood glucose meter (Accu-Check? Integra) in patients with impaired glucose regulation (IGR) and newly-diagnosed type 2 diabetes mellitus. Methods A cross-sectional study was performed on 109 cases with newly-diagnosed type 2 diabetes or IGR who were asked to take oral glucose tolerance test (OGTT), while paired samples, that were Accu-Check? Integra in capillary blood glucose (CBG) and laboratory glucose in venous plasma glucose (VPG ), were taken simultaneously. Taking VPG as the reference value, the accuracy of the home glucose meter was assessed according to the international standardization organization (ISO), including, the accuracy was studied by means of Median absolute difference (Median AD) and Median absolute relative difference (Median RAD), the consistency of CBG and VPG was studied by Clarke Error Grid analysis, the correlation of CBG and VPG was analyzed according to liner regression analysis, and the sensitivity and specificity for hyperglycemia were also calculated. Results There were 292 VPG values paired with CBG values, among which 93.49% of CBG values met ISO home glucose meter criteria, the median AD was 7.2 mg/dL, and the median RAD was 4.76%. Paired glucose measurements from the Accu-Check Integra meter and laboratory glucose measurement demonstrated that 100% of paired points in the overall subject population fell in zones A and B of the Clarke Error Grid. The CBG value was well correlated to VPG value in the overall level, and the sensitivity and specificity were 94.6% and 95.7% respectively for hyperglycemia. Conclusion The newer-generation home blood glucose meter (Accu-Check? Integra) demonstrates a high degree of accuracy, and it can precisely report the real value of blood glucose.
Objective To evaluate the deviation between actual and simulated screw placement after cervical pedicle screw placement assisted by 3D printed navigation template, and analyze the correlation between screw placement deviation and navigation pipe length. Methods A total of 40 patients undergoing cervical 1-7 pedicle screw insertion assisted by 3D printed navigation template in Zigong Fourth People’s Hospital between February 2018 and August 2020 were included in this prospective study. These patients were divided into 3 groups randomly, including 12 patients with a 5-mm pipe length (5 mm group), 13 patients with a 10-mm pipe length (10 mm group), and 15 patients with a 15-mm pipe length (15 mm group). Three-dimensional modeling was performed on preoperative cervical CT images of these patients and simulated pedicle screw was placed. Individualized pedicle screw navigation templates were designed according to the position and direction of simulated pedicle screws, and 3D printing was performed on the cervical model and navigation templates. Preoperative 3D printed model and navigation templates were used to simulate the surgical process to confirm the safety of screws. During the operation, pedicle screw placement was performed according to the preoperative design and simulated surgical process. The postoperative CT images were registered with the preoperative CT images in 3D model. The safety of screw placement was evaluated by the postoperative screw placement Grade, and the accuracy of screw placement was evaluated by measuring the deviation of screw placement point and the deviation of screw placement direction in horizontal plane (inclination angle) and sagittal plane (head inclination angle). The influence of different navigation pipe lengths on the safety and accuracy of screw placement was analyzed. Results A total of 164 pedicle screws were inserted with navigation template assistance, including 48 screws (38 in Grade 0 and 10 in Grade 1) in the 5 mm group, 52 screws in the 10 mm group (all in Grade 0), and 64 screws (52 in Grade 0 and 12 in Grade 1) in the 15 mm group, and the difference in the grade among the three groups was statistically significant (P<0.05). When the navigation pipe length was 5, 10, and 15 mm, respectively, the screw entry point deviation was (1.87±0.63), (1.44±0.63), and (1.66±0.54) mm, respectively, the inclination angle deviation was (2.72±0.25), (0.90±0.21), and (1.84±0.35)°, respectively, and the head inclination angle deviation was (8.63±1.83), (7.15±1.38), and (8.24±1.52)°, respectively. The deviations in the 10 mm group were all significantly less than those in the other two groups (P<0.05). Conclusions In the cervical pedicle screw placement assisted by navigation template, all the screws were Grade 0 or Grade 1, with high safety. The mean deviation of the screw entry point is within 2 mm, with high accuracy. When the length of navigation pipe is 10 mm, the safety and accuracy of screw placement can be fully guaranteed.