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Patient With Pulmonary Symptoms, Dysphagia, and Raynaud Disease [Case Report]

Ghias, Aisha; Chawla, Shalinee; Agarwala, Priya
PMID: 37498616
ISSN: 1538-3598
CID: 5595262

Artificial Intelligence (AI)-Guided vs Routine Colonoscopy for Colorectal Polyps: A Meta-Analysis of Recent Randomized Controlled Trials [Meeting Abstract]

Deliwala, S; Hamid, K; Barbarawi, M; Zayed, Y; Kandel, P; Lakshman, H; Malladi, S; Singh, A; Bachuwa, G; Gurvits, G; Chawla, S
INTRODUCTION: Colorectal cancer (CRC) remains a leading cause of cancer-related death in the United States. While colonoscopy based screening is the most effective of all CRC prevention strategies, it is operator dependent and can result in missed lesions, which may contribute to interval cancer. Incorporation of artificial intelligence (AI) to routine colonoscopy has been investigated in several small studies. In this meta-analysis, we attempt to collate evidence from recent randomized controlled trials (RCTs) to further define the role of AI in colonoscopy based CRC screening.
METHOD(S): A comprehensive search of MEDLINE, EMBASE, CENTRAL, and from inception through May 2020 was completed. Pooled statistics using bivariate random-effects, odds ratio for binary outcomes, and standardized difference in means for continuous outcomes were used. Primary outcomes were Adenoma Detection Rate (ADR) and Polyp Detection Rate (PDR). Secondary outcomes were mean adenomas and polyps/procedure, withdrawal (WT) and cecal intubation times (CIT), and adequacy of bowel preparation. Post-hoc sensitivity analysis and subgroup analyses for adenomas and polyps was completed.
RESULT(S): 6 RCTs were included. Of 4996 patients, 2487 had AI-assisted, and 2509 had routine colonoscopies. Mean age was 51.99 +/- 4.43 years, 51% of males. AI had higher ADRs (P = 0.00) and PDRs (P = 0.00) [Figure 1]. Similar findings were noted for mean number of adenomas and polyps/procedure. Mean WTs favored AI when biopsy times were included. CIT and adequacy of bowel preparation were similar in both groups [Figure 2]. On subgroup analysis, AI systems had significantly better ADRs and PDRs in the transverse colon. AI had higher detection rates for adenomas < 5 mm (P = 0.00) and polyps < 10 mm (P = 0.00). However, routine colonoscopies outperformed AI in detecting pedunculated polyps (P = 0.00). PDRs had no differences based on shape. Sensitivity analysis remained unchanged for ADR, PDR, mean adenomas or polyps detected per procedure and WTs that included biopsies. Begg's funnel plots were relatively symmetrical for ADR (P - 0.25) and PDR (P - 0.20) [Figure 3].
CONCLUSION(S): The use of AI has the potential to improve the sensitivity of colonoscopy based screening. Colonoscopies using AI algorithms demonstrated significantly improved detection rates for adenomas and polyps. However, research and advancements are needed to refine the AI systems to detect pedunculated polyps and incorporate optical diagnosis into the algorithms
ISSN: 1572-0241
CID: 4720532

Outcomes of Cardiopulmonary Resuscitation in Patients Who Experience a Cardiac Arrest While on Intravenous Vasopressor Support [Meeting Abstract]

Pinto, Priya; Berger, Jeffrey; Imperato, Alexandria; Chawla, Shalinee
ISSN: 0885-3924
CID: 4305012

Complicated Silicosis Mimicking Primary Lung Malignancy on Imaging [Meeting Abstract]

Gour, A. C.; Kamath, A.; Ashraf, S.; Chawla, S.
ISSN: 1073-449x
CID: 3513272

Gemella Morbillorum: A Rare Cause of Empyema Necessitans [Meeting Abstract]

Ashraf, Sohi; Gour, Animesh; John, Santhosh; Chawla, Shalinee
ISSN: 0012-3692
CID: 3461992

Using Simulation to Conduct a Usability Study of Wearable Technology

Kutzin, Jared M.; Milligan, Zach; Chawla, Shalinee
Background: This study had two purposes. First, to assess the usability and perceived ease of use (PEU) of a head-mounted display (HMD) in the health care environment. Second, to assess whether the use of a remote teleconsultant intensivist via a HMD improves the management of a simulated cardiac arrest. The use of technology, specifically HMDs (such as Google Glass (TM)), is becoming more popular, especially in health care. However, the efficacy, usability, and PEU have not been studied to any great extent. Assessing new technology is an important step when considering potential implementation in a patient care setting. Using simulation to assess the usability and the PEU is one method that can provide insight into the viability of new technology.
ISSN: 1876-1399
CID: 3461972

Diagnostic Accuracy and Complication Rates After Implementation of an Electromagnetic Navigation Bronchoscopy Program at an Academic Teaching Hospital [Meeting Abstract]

Osahan, Deepinder; Aparnath, Malay; Desai, Anish; Kurbanov, Daniel; Salzman, Steve; Chawla, Shalinee; Spiegler, Peter; Mathew, Joseph
ISSN: 0012-3692
CID: 3461982


Coan, Amy; Desai, Anish; Gadhvi, Sonya; Milligan, Zach; Kutzin, Jared; Spiegler, Peter; Chawla, Shalinee; Mathew, Joseph
ISSN: 0090-3493
CID: 3502322

The Case | Elevated lactate and osmolar gap after levothyroxine overdose [Case Report]

Rothberger, Gary D; Desai, Anish K; Sharif, Sairah; Chawla, Shalinee A; Shirazian, Shayan
PMID: 26230209
ISSN: 1523-1755
CID: 3462092

Current controversies in the support of sepsis

Chawla, Shalinee; DeMuro, Jonas P
PURPOSE OF REVIEW/OBJECTIVE:Sepsis has a high morbidity, with a mortality rate of over 50% in the septic shock patient. This review provides a comprehensive summary of the latest Surviving Sepsis Campaign and the recent evidence since its publication. The guidelines reflect literature from the past 5 years to optimize outcomes in patients with severe sepsis and septic shock. RECENT FINDINGS/RESULTS:The most relevant changes in the latest Surviving Sepsis Campaign include the use of a protocolized resuscitation with specific physiologic targets, preference of crystalloids for volume resuscitation, preferential use of norepinephrine as the initial vasopressor, addition of lactate and its clearance as a marker of tissue hypoperfusion, reduced emphasis on corticosteroids, and removal of activated protein C therapy. Since these latest guidelines, there have been many trials published to address the various measures that are advocated. We review the recent data on fluid resuscitation, targets of resuscitation, vasopressors, and trials of protocolized care versus usual care. SUMMARY/CONCLUSIONS:Severe sepsis remains a significant cause of morbidity and mortality in hospitalized patients. The International Surviving Sepsis Guidelines provide a framework for early recognition and treatment of this condition, with the goal of an improved outcome and mortality in severe sepsis. The recent evidence suggests that early identification, adequate volume resuscitation, and assessment of adequate circulation may be the key elements to decrease morbidity from severe sepsis and septic shock.
PMID: 25340379
ISSN: 1531-7072
CID: 3462122