Publications
573 results found
Naik R, Kogkas A, Ashrafian H, et al., 2022, The Measurement of Cognitive Workload in Surgery Using Pupil Metrics: A Systematic Review and Narrative Analysis, JOURNAL OF SURGICAL RESEARCH, Vol: 280, Pages: 258-272, ISSN: 0022-4804
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- Citations: 4
Zhang J, Budhdeo S, Ashrafian H, 2022, Failing IT infrastructure is undermining safe healthcare in the NHS, BMJ-BRITISH MEDICAL JOURNAL, Vol: 379, ISSN: 0959-535X
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- Citations: 2
Ravindran S, Thomas-Gibson S, Bano M, et al., 2022, National census of UK endoscopy services 2021, FRONTLINE GASTROENTEROLOGY, Vol: 13, Pages: 463-470, ISSN: 2041-4137
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- Citations: 5
Acharya A, Judah G, Ashrafian H, et al., 2022, Investigating the implementation of mobile messaging in population screening programmes: a modified Delphi study, LANCET, Vol: 400, Pages: 15-15, ISSN: 0140-6736
Acharya A, Judah G, Ashrafian H, et al., 2022, Investigating the implementation of mobile messaging in population screening programmes: a modified Delphi study., Lancet, Vol: 400 Suppl 1
BACKGROUND: Mobile messaging is an increasingly important health-care communication tool. Screening programmes pose unique challenges because of the large, diverse populations invited, who might have not interacted with services previously. This study aimed to provide guidance on how screening programmes in England can effectively implement mobile messaging services. METHODS: Experts based in England, from public health, policy, screening provision, communications, and academia were recruited to this Delphi study. Recommendations were derived from an evidence synthesis involving a literature review, expert scoping questionnaire, public consultation, and discussion with relevant national organisations. Experts voted upon the importance and feasibility of recommendations across two consensus rounds, using a five-point Likert scale. Items reaching consensus, defined a priori at 70%, on importance and feasibility formed core recommendations. Those reaching this threshold on importance only, were labelled desirable. All items were discussed at an expert meeting to determine suitability. Ethical approval was obtained (20IC6088), and participants provided informed consent. FINDINGS: 33 experts representing all 11 screening programmes were enrolled, with 100% retention across rounds. Of the initial 101 items, 23 (23%) reached consensus. These core recommendations were divided across six domains: message content, timing, delivery, evaluation, security, and research. They included the use of general practitioner endorsement and limiting message length to 320 characters. A further 17 items were considered desirable; for example, introducing greater functionality such as bidirectional and tailored messaging. INTERPRETATION: Findings will facilitate the effective use of mobile messaging across screening and will form national guidance for services. This guidance will enable programmes to overcome implementation challenges and facilitate uptake of screening invitations. As repres
Penney N, Yeung K, Garcia Perez I, et al., 2022, Multi-omic phenotyping reveals host-microbe responses to bariatric surgery, glycaemic control and obesity, communications medicine, Vol: 2, Pages: 1-18, ISSN: 2730-664X
Background: Resolution of type 2 diabetes (T2D) is common following bariatric surgery, particularly Roux-en-Y gastric bypass. However, the underlying mechanisms have not been fully elucidated.Methods: To address this we compare the integrated serum, urine and faecal metabolic profiles of participants with obesity +/- T2D (n=80, T2D=42) with participants who underwent Roux-en-Y gastric bypass or sleeve gastrectomy (pre and 3-months post-surgery; n=27), taking diet into account. We co-model these data with shotgun metagenomic profiles of the gut microbiota to provide a comprehensive atlas of host-gut microbe responses to bariatric surgery, weight-loss and glycaemic control at the systems level.Results: Here we show that bariatric surgery reverses several disrupted pathways characteristic of T2D. The differential metabolite set representative of bariatric surgery overlaps with both diabetes (19.3% commonality) and body mass index (18.6% commonality). However, the percentage overlap between diabetes and body mass index is minimal (4.0% commonality), consistent with weight-independent mechanisms of T2D resolution. The gut microbiota is more strongly correlated to body mass index than T2D, although we identify some pathways such as amino acid metabolism that correlate with changes to the gut microbiota and which influence glycaemic control.Conclusion: We identify multi-omic signatures associated with responses to surgery, body mass index, and glycaemic control. Improved understanding of gut microbiota - host co-metabolism may lead to novel therapies for weight-loss or diabetes. However, further experiments are required to provide mechanistic insight into the role of the gut microbiota in host metabolism and establish proof of causality.
Wei J, Monfort Sanchez E, Avery J, et al., 2022, Non-invasive assessment of intestinal permeability in healthy volunteers using transcutaneous fluorescence spectroscopy, Methods and Applications in Fluorescence, Vol: 10, Pages: 1-9, ISSN: 2050-6120
The permeability of the intestinal barrier is altered in a multitude of gastrointestinal conditions such as Crohn's and coeliac disease. However, the clinical utility of gut permeability is currently limited due to a lack of reliable diagnostic tests. To address this issue, we report a novel technique for rapid, non-invasive measurement of gut permeability based on transcutaneous ('through-the-skin') fluorescence spectroscopy. In this approach, participants drink an oral dose of a fluorescent dye (fluorescein) and a fibre-optic fluorescence spectrometer is attached to the finger to detect permeation of the dye from the gut into the blood stream in a non-invasive manner. To validate this technique, clinical trial measurements were performed in 11 healthy participants. First, after 6 h of fasting, participants ingested 500 mg of fluorescein dissolved in 100 ml of water and fluorescence measurements were recorded at the fingertip over the following 3 h. All participants were invited back for a repeat study, this time ingesting the same solution but with 60 g of sugar added (known to transiently increase intestinal permeability). Results from the two study datasets (without and with sugar respectively) were analysed and compared using a number of analysis procedures. This included both manual and automated calculation of a series of parameters designed for assessment of gut permeability. Calculated values were compared using Student's T-tests, which demonstrated significant differences between the two datasets. Thus, transcutaneous fluorescence spectroscopy shows promise in non-invasively discriminating between two differing states of gut permeability, demonstrating potential for future clinical use.
Zhang J, Budhdeo S, William W, et al., 2022, Moving towards vertically integrated artificial intelligence development, npj Digital Medicine, Vol: 5, Pages: 1-9, ISSN: 2398-6352
Substantial interest and investment in clinical artificial intelligence (AI) research has not resulted in widespread translation to deployed AI solutions. Current attention has focused on bias and explainability in AI algorithm development, external validity and model generalisability, and lack of equity and representation in existing data. While of great importance, these considerations also reflect a model-centric approach seen in publishedclinical AI research, which focuses on optimising architecture and performance of an AI model on best available datasets. However, even robustly built models using state-of-the-art algorithms may fail once tested in realistic environments due to unpredictability of real-world conditions, out-of-dataset scenarios, characteristics of deployment infrastructure, and lack ofadded value to clinical workflows relative to cost and potential clinical risks. In this perspective, we define a vertically integrated approach to AI development that incorporates early, cross-disciplinary, consideration of impact evaluation, data lifecycles, and AI production, and explore its implementation in two contrasting AI development pipelines: a scalable “AI factory” (Mayo Clinic, Rochester, United States), and an end-to-end cervicalcancer screening platform for resource poor settings (Paps AI, Mbarara, Uganda). We provide practical recommendations for implementers, and discuss future challenges and novel approaches (including a decentralised federated architecture being developed in the NHS (AI4VBH, London, UK)). Growth in global clinical AI research continues unabated, and introduction of vertically integrated teams and development practices can increase thetranslational potential of future clinical AI projects.
Li E, Clarke J, Ashrafian H, et al., 2022, Impact of electronic health record interoperability on safety and quality of care in high-income countries: A systematic review, Journal of Medical Internet Research, Vol: 24, Pages: 1-15, ISSN: 1438-8871
Background: Electronic health records (EHR) and poor systems interoperability are well-known issues in the use of health information technologies worldwide in most high-income countries. Despite the abundance of literature exploring their relationship, its practical implications on patient safety and quality of care remain unclear.Objective: To examine how EHR interoperability affects patient safety, or other dimensions of care quality, in high-income healthcare settings. Methods: A systematic search was conducted using four online medical journal repositories and grey literature sources. Publications included were published in English between 2010-2022, pertaining to EHR use, interoperability, and patient safety or care quality in high-income settings. Screening was completed by three researchers in accordance with the Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines. Risk of bias assessments was performed using the Risk Of Bias In Non-randomised Studies - of Interventions (ROBINS-I) and the Cochrane Risk of Bias 2 (RoB2) tools. Findings were presented as a narrative synthesis and mapped based on the Institute of Medicine’s framework for healthcare quality.Results: Twelve studies met the inclusion criteria to be included in our review. Findings were categorised into six common outcome measure categories: patient safety events, medication safety, data accuracy and errors, care effectiveness, productivity, and cost-savings. EHR interoperability was found to positively influence medication safety, reduce patient safety events, and lower costs. Improvements to time-savings and clinical workflow are mixed. However, true measures of effect are difficult to determine with certainty due to the heterogeneity in outcome measures used and notable variation in study quality.Conclusion: The benefits of EHR interoperability on the quality and safety of care remain unclear and reflect the extensive heterogeneity in the interventions, designs, and outcome
Fletcher E, Thompson A, Ashrafian H, et al., 2022, The measurement and modification of hypoxia in colorectal cancer: overlooked but not forgotten, Gastroenterology Report, Vol: 10, Pages: 1-13, ISSN: 2052-0034
Tumour hypoxia is the inevitable consequence of a tumour’s rapid growth and disorganised, inefficient vasculature. The compensatory mechanisms employed by tumours, and indeed the absence of oxygen itself, hinder the ability of all treatment modalities. The clinical consequence is poorer overall survival, disease-free survival, and locoregional control. Recognising this, clinicians have been attenuating the effect of hypoxia, primarily with hypoxic modification or with hypoxia activated pro-drugs, and notable success has been demonstrated. However, in the case of colorectal cancer (CRC), there is a general paucity of knowledge and evidence surrounding the measurement and modification of hypoxia, and this is possibly due to the comparative inaccessibility of such tumours. We specifically review the role of hypoxia in CRC, and focus on: the current evidence for the existence of hypoxia in CRC, the majority of which originates from indirect positron emission topography (PET) imaging with hypoxia selective radiotracers; the evidence correlating CRC hypoxia with poorer oncological outcome, which is largely based on the measurement of Hypoxia Inducible Factor (HIF) in correlation with clinical outcome; the evidence of hypoxic modification in CRC, of which no direct evidence exists, but is reflected in a number of indirect markers; the prognostic and monitoring implications of accurate CRC hypoxia quantification and its potential in the field of precision oncology; and the present and future imaging tools and technologies being developed for the measurement of CRC hypoxia, including the use of blood oxygen level dependent (BOLD) MRI imaging and diffuse reflectance spectroscopy.
Wallace W, Chan C, Chidambaram S, et al., 2022, 471 Assessing the Accuracy and Bias of Digital Symptom Checkers with Myocardial Infarction Patients, ASiT Surgical Conference, Publisher: OXFORD UNIV PRESS, ISSN: 0007-1323
Wallace W, Chan C, Chidambaram S, et al., 2022, The diagnostic and triage accuracy of digital and online symptom checker tools: a systematic review, npj Digital Medicine, Vol: 5, ISSN: 2398-6352
Digital and online symptom checkers are an increasingly adopted class of health technologies that enable patients to input their symptoms and biodata to produce a set of likely diagnoses and associated triage advice. However, concerns regarding the accuracy and safety of these symptom checkers have been raised. This systematic review evaluates the accuracy of symptom checkers in providing diagnoses and appropriate triage advice. MEDLINE and Web of Science were searched for studies that used either real or simulated patients to evaluate online or digital symptom checkers. The primary outcomes were the diagnostic and triage accuracy of the symptom checkers. The QUADAS-2 tool was used to assess study quality. Of the 177 studies retrieved, 10 studies met the inclusion criteria. Researchers evaluated the accuracy of symptom checkers using a variety of medical conditions, including ophthalmological conditions, inflammatory arthritides and HIV. 50% of the studies recruited real patients, while the remainder used simulated cases. The diagnostic accuracy of the primary diagnosis was low across included studies (range: 19% to 37.9%) and varied between individual symptom checkers, despite consistent symptom data input. Triage accuracy (range: 48.8% to 90.1%) was typically higher than diagnostic accuracy. Overall, the diagnostic and triage accuracy of symptom checkers are variable and of low accuracy. Given the increasing push towards adopting this class of technologies across numerous health systems, this study demonstrates that reliance upon symptom checkers could pose significant patient safety hazards. Large scale primary studies, based upon real world data, are warranted to demonstrate adequate performance of these technologies in a manner that is and non-inferior to current best practice. Moreover, an urgent assessment of how these systems are regulated and implemented is required.
Fadel M, Fehervari M, Lairy A, et al., 2022, CLINICAL OUTCOMES OF SINGLE-STAGE VERSUS TWO-STAGE LAPAROSCOPIC ROUX-EN-Y GASTRIC BYPASS IN THE MANAGEMENT OF SUPER OBESITY: A RETROSPECTIVE COHORT STUDY Multidisciplinary care (primary care, medical management), Publisher: SPRINGER, Pages: 108-108, ISSN: 0960-8923
Yeung K, Penney N, Whiley L, et al., 2022, SERUM AMINO ACID RATIOS AS PROXIES TO MECHANISMS CONTRIBUTING TO IMPROVED METABOLIC HEALTH AFTER BARIATRIC SURGERY Basic science and research in bariatric surgery, 25th IFSO World Congress, Publisher: SPRINGER, Pages: 483-483, ISSN: 0960-8923
Yeung K, Whiley L, Penney N, et al., 2022, SERUM LIPIDOMIC SIGNATURES OF TYPE 2 DIABETES AND EARLY SURGICAL DIABETES RESOLUTION Basic science and research in bariatric surgery, Publisher: SPRINGER, Pages: 485-485, ISSN: 0960-8923
Wallace W, Chan C, Chidambaram S, et al., 2022, The diagnostic and triage accuracy of digital and online symptom checker tools: a systematic review, Publisher: MedArxiv
<h4>ABSTRACT</h4> <h4>Objective</h4> To evaluate the accuracy of digital and online symptom checkers in providing diagnoses and appropriate triage advice. <h4>Design</h4> Systematic review. <h4>Data sources</h4> Medline and Web of Science were searched up to 15 February 2021. <h4>Eligibility criteria for study selection</h4> Prospective and retrospective cohort, vignette, or audit studies that utilised an online or application-based service designed to input symptoms and biodata in order to generate diagnoses, health advice and direct patients to appropriate services were included. <h4>Main outcome measures</h4> The primary outcomes were (1) the accuracy of symptom checkers for providing the correct diagnosis and (2) the accuracy of subsequent triage advice given. <h4>Data extraction and synthesis</h4> Data extraction and quality assessment (using the QUADAS-2 tool) were performed by two independent reviewers. Owing to heterogeneity of the studies, meta-analysis was not possible. A narrative synthesis of the included studies and pre-specified outcomes was completed. <h4>Results</h4> Of the 177 studies retrieved, nine cohort studies and one cross-sectional study met the inclusion criteria. Symptom checkers evaluated a variety of medical conditions including ophthalmological conditions, inflammatory arthritides and HIV. 50% of the studies recruited real patients, while the remainder used simulated cases. The diagnostic accuracy of the primary diagnosis was low (range: 19% to 36%) and varied between individual symptom checkers, despite consistent symptom data input. Triage accuracy (range: 48.8% to 90.1%) was typically higher than diagnostic accuracy. Of note, one study found that 78.6% of emergency ophthalmic cases were under-triaged. <h4>Conclusions</h4> The diagnostic and triage accuracy of symptom checkers are variable and of low accuracy. Given the increasin
Iqbal F, Joshi M, Khan S, et al., 2022, Key Stakeholder Barriers and Facilitators to Implementing Remote Monitoring Technologies: Protocol for a Mixed Methods Analysis, JMIR Research Protocols, Vol: 11, ISSN: 1929-0748
Background: The implementation of novel digital solutions within the National Health Service has historically been challenging. Since the start of the COVID-19 pandemic, there has been a greater push for digitization and for operating remote monitoring solutions. However, the implementation and widespread adoption of this type of innovation have been poorly studied.Objective: We aim to investigate key stakeholder barriers and facilitators to implementing remote monitoring solutions to identify factors that could affect successful adoption.Methods: A mixed methods approach will be implemented. Semistructured interviews will be conducted with high-level stakeholders from industry and academia and health care providers who have played an instrumental role in, and have prior experience with, implementing digital solutions, alongside the use of an adapted version of the Technology Acceptance Model questionnaire.Results: Enrollment is currently underway, having started in February 2022. It is anticipated to end in July 2022, with data analysis scheduled to commence in August 2022.Conclusions: The results of our study may highlight key barriers and facilitators to implementing digital remote monitoring solutions, thereby allowing for improved widespread adoption within the National Health Service in the future.Trial Registration: ClinicalTrials.gov NCT05321004; https://clinicaltrials.gov/ct2/show/NCT05321004
Acharya A, Ashrafian H, Cunnignham D, et al., 2022, Evaluating the impact of a novel behavioural science informed animation upon breast cancer screening uptake: protocol for a randomised controlled trial, BMC Public Health, Vol: 22, ISSN: 1471-2458
BackgroundBreast cancer screening is estimated to save 1300 lives annually in the United Kingdom. Despite this, uptake of invitations has fallen over the past decade. Behavioural science-informed interventions addressing the determinants of attendance behaviour have shown variable effectiveness. This may be due to the narrow repertoire of techniques trialled, and the difficulties of implementation at a population-scale. The aim of this study is to evaluate the impact on breast screening uptake of a novel behavioural video intervention which can contain more complex combinations of behavioural change techniques. MethodsA 3-armed randomised controlled trial will be undertaken in London comparing the impact of (1) the usual care SMS reminder, to (2) a behavioural plain text SMS reminder and (3) a novel video sent as a link within the behavioural plain text SMS reminder. A total of 8391 participants (2797 per group) will be allocated to one of the three trial arms using a computer randomisation process, based upon individuals’ healthcare identification numbers. The novel video has been co-designed with a diverse range of women to overcome the barriers faced by underserved communities and the wider population. The behavioural SMS content has also been co-designed through the same process as the video. Messages will be sent through the current reminder system used by the London screening programmes, with reminders 7 days and 2 days prior to a timed appointment. The primary outcome is attendance at breast cancer screening within 3 months of the initial invitation. Secondary outcomes will include evaluating the impact of each message amongst socio-demographic groups and according to the appointment type e.g. first invitation or recall. DiscussionIn addition to general declining trends in attendance, there is also concern of increasing healthcare inequalities with breast cancer screening in London. The current novel intervention, designed with underserved groups and t
Acharya A, Ashrafian H, Cunnigham D, et al., 2022, Evaluating the impact of a novel behavioural science informed animation upon breast cancer screening uptake: protocol for a randomised controlled trial, BMC Public Health, ISSN: 1471-2458
Joshi M, Ashrafian H, Arora S, et al., 2022, A pilot study to investigate real time digital alerting from wearable sensors in surgical patients, Pilot and Feasibility Studies, Vol: 8, ISSN: 2055-5784
Background Continuous vital sign monitoring may identify changes sooner than current standard monitoring. Objective To investigate if the use of real time digital alerts sent to healthcare staff can improve the time taken to identify unwell patients and those with sepsis. DesignA prospective cohort study design. Setting West Middlesex University Hospital, UK. Participants 50 acutely unwell surgical patients admitted to hospital. Intervention Patients wore a lightweight wearable sensor measuring heart rate (HR), respiratory rate (RR) and temperature every 2 minutes whilst standard intermittent ward monitoring of vital signs was performed by nurses. Digital alerts were sent to healthcare staff from the sensor to a smartphone device. All alerts were reviewed for recruited patients to identify the exact time on the sensor in which deterioration occurred. The time to acknowledgement was then reviewed for each action and an average time to acknowledgement calculated.Results There were 50 patients recruited in the pilot study, of which there were vital sign alerts in 18 patients (36%). The total number of vital sign alerts generated in these 18 patients was 51. Of these 51 alerts there 7 alerts for high HR (13.7%), 33 for RR (64.7%) and 11 for temperature (21.6%). Out of the 27 acknowledged alerts there were 2 alerts for HR, 17 for RR and 8 for temperature. The average time to staff acknowledgement of the notification for all alerts was 154 minutes (2.6 hours). There were some patients which had shown signs of deterioration in the cohort. The frequency of routine observation monitoring was increased in 2 cases, 3 patients were referred to a senior clinician and 2 patients were initiated on the sepsis pathway. Conclusion This study demonstrates the evaluation of digital alerts to nurses in real-time. Although not all alerts were acknowledged, deterioration on the ward observations was detected and actions were taken accordingly. Patients were started on the sepsis pathw
Ravindran S, Thomas-Gibson S, Bano M, et al., 2022, The national census of UK endoscopy services 2021., Future Healthc J, Vol: 9, Pages: 16-17, ISSN: 2514-6645
Iqbal F, Joshi M, Fox R, et al., 2022, Outcomes of vital sign monitoring of an acute surgical cohort with wearable sensors and digital alerting systems: a pragmatically designed cohort study and propensity-matched analysis, Frontiers in Bioengineering and Biotechnology, Vol: 10, ISSN: 2296-4185
Background: The implementation and efficacy of wearable sensors and alerting systems in acute secondary care have been poorly described. Objectives: to pragmatically test one such system and its influence on clinical outcomes in an acute surgical cohort.Methods: In this pragmatically designed, pre-post implementation trial, participants admitted to the acute surgical unit at our institution were recruited. In the pre-implementation phase (September 2017 to May 2019), the SensiumVitals™ monitoring system, which continuously measures temperature, heart, and respiratory rates, was used for monitoring alongside usual care (intermittent monitoring in accordance with the National Early Warning Score 2 [NEWS 2] protocol) without alerts being generated. In the post-implementation phase (May 2019 to March 2020), alerts were generated when pre-established thresholds for vital parameters were breached, requiring acknowledgement from healthcare staff on provided mobile devices. Hospital length of stay, intensive care use, and 28-day mortality were measured. Balanced cohorts were created with 1:1 ‘optimal’ propensity score logistic regression models.Results: The 1:1 matching method matched the post-implementation group (n = 141) with the same number of subjects from the pre-implementation group (n = 141). The median age of the entire cohort was 52 (range: 18-95) years and the median duration of wearing the sensor was 1.3 (interquartile range: 0.7-2.0) days. The median alert acknowledgement time was 111 (range: 1-2146) minutes. There were no significant differences in critical care admission (planned or unplanned), hospital length of stay, or mortality.Conclusion: This study offered insight into the implementation of digital health technologies within our institution. Further work is required for optimisation of digital workflows, particularly given their more favourable acceptability in the post pandemic era.Clinical trials registration information: Cli
Ravindran S, Matharoo M, Healey C, et al., 2022, ENDOSCOPY SAFETY INCIDENTS REPORTED IN A NATIONAL DATA SET - A HUMAN FACTORS ANALYSIS, Publisher: BMJ PUBLISHING GROUP, Pages: A134-A135, ISSN: 0017-5749
Ravindran S, Healey C, Coleman M, et al., 2022, VALIDATION OF THE TEAM-ENTS (TEAMWORK IN ENDOSCOPY ASSESSMENT MODULE FOR ENDOSCOPIC NON-TECHNICAL SKILLS) FRAMEWORK, Publisher: BMJ PUBLISHING GROUP, Pages: A135-A136, ISSN: 0017-5749
Hanna L, Lam K, Agbeko AE, et al., 2022, Coverage of the Coeliac Artery During Thoracic Endovascular Aortic Repair: A Systematic Review and Meta-Analysis, EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY, Vol: 63, Pages: 828-837, ISSN: 1078-5884
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Ravindran S, Matharoo M, Healey C, et al., 2022, THE ENDOSCOPY SAFETY ATTITUDES QUESTIONNAIRE (ENDO-SAQ): VALIDATION AND RESULTS, Annual Meeting of the British Society of Gastroenterology (BSG), Publisher: BMJ PUBLISHING GROUP, Pages: A136-A137, ISSN: 0017-5749
Ravindran S, Marshall S, Healey C, et al., 2022, THE NATIONAL CENSUS OF UK ENDOSCOPY SERVICES 2021, Annual Meeting of the British-Society-of-Gastroenterology (BSG), Publisher: BMJ PUBLISHING GROUP, Pages: A136-A136, ISSN: 0017-5749
Chidambaram S, Maheswaran Y, Chan C, et al., 2022, Misinformation about the human gut microbiome in YouTube videos: cross-sectional study, JMIR Formative Research, Vol: 6, ISSN: 2561-326X
Background: Social media platforms such as YouTube are integral tools for disseminating information about health and wellness to the public. However, anecdotal reports have cited that the human gut microbiome has been a particular focus of dubious, misleading, and, on occasion, harmful media content. Despite these claims, there have been no published studies investigating this phenomenon within popular social media platforms.Objective: The aim of this study is to (1) evaluate the accuracy and reliability of the content in YouTube videos related to the human gut microbiome and (2) investigate the correlation between content engagement metrics and video quality, as defined by validated criteria.Methods: In this cross-sectional study, videos about the human gut microbiome were searched for on the United Kingdom version of YouTube on September 20, 2021. The 600 most-viewed videos were extracted and screened for relevance. The contents and characteristics of the videos were extracted and independently rated using the DISCERN quality criteria by 2 researchers.Results: Overall, 319 videos accounting for 62,354,628 views were included. Of the 319 videos, 73.4% (n=234) were produced in North America and 78.7% (n=251) were uploaded between 2019 and 2021. A total of 41.1% (131/319) of videos were produced by nonprofit organizations. Of the videos, 16.3% (52/319) included an advertisement for a product or promoted a health-related intervention for financial purposes. Videos by nonmedical education creators had the highest total and preferred viewership. Daily viewership was the highest for videos by internet media sources. The average DISCERN and Health on the Net Foundation Code of Conduct scores were 49.5 (SE 0.68) out of 80 and 5.05 (SE 2.52) out of 8, respectively. DISCERN scores for videos by medical professionals (mean 53.2, SE 0.17) were significantly higher than for videos by independent content creators (mean 39.1, SE 5.58; P<.001). Videos including promotional mate
Sivananthan A, Nazarian S, Ayaru L, et al., 2022, Does computer-aided diagnostic endoscopy improve the detection of commonly missed polyps? A meta-analysis, Clinical Endoscopy, Vol: 55, Pages: 355-364, ISSN: 2234-2400
Background/AimsColonoscopy is the gold standard diagnostic method for colorectal neoplasia, allowing detection and resection of adenomatous polyps; however, significant proportions of adenomas are missed. Computer-aided detection (CADe) systems in endoscopy are currently available to help identify lesions. Diminutive (≤5 mm) and nonpedunculated polyps are most commonly missed. This meta-analysis aimed to assess whether CADe systems can improve the real-time detection of these commonly missed lesions.MethodsA comprehensive literature search was performed. Randomized controlled trials evaluating CADe systems categorized by morphology and lesion size were included. The mean number of polyps and adenomas per patient was derived. Independent proportions and their differences were calculated using DerSimonian and Laird random-effects modeling.ResultsSeven studies, including 2,595 CADe-assisted colonoscopies and 2,622 conventional colonoscopies, were analyzed. CADe-assisted colonoscopy demonstrated an 80% increase in the mean number of diminutive adenomas detected per patient compared with conventional colonoscopy (0.31 vs. 0.17; effect size, 0.13; 95% confidence interval [CI], 0.09–0.18); it also demonstrated a 91.7% increase in the mean number of nonpedunculated adenomas detected per patient (0.32 vs. 0.19; effect size, 0.05; 95% CI, 0.02–0.07).ConclusionsCADe-assisted endoscopy significantly improved the detection of most commonly missed adenomas. Although this method is a potentially exciting technology, limitations still apply to current data, prompting the need for further real-time studies.
Ashrafian H, 2022, The depiction of lungs and cardiac silhouette in the Saint Francis of Assisi with Angels by Sandro Botticelli (1445-1510)., Acta Biomed, Vol: 93
The Saint Francis of Assisi with Angels is considered a worldwide masterpiece painted by renaissance artist Sandro Botticelli. The painting reveals Saint Francis of Assisi surrounded by angels in a format that directly corresponds to lung anatomy and the cardiac silhouette. Together with previous evidence in Botticelli's work, these findings add to the virtuosity and brilliance of Botticelli in depicting accurate human anatomy and highlight the role of topographical sciences and studying the human form for the presentation of both anatomical and abstract ideas in renaissance art.
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