The Experts below are selected from a list of 8574 Experts worldwide ranked by ideXlab platform
Mohammad F Madhoun - One of the best experts on this subject based on the ideXlab platform.
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impact of fellowship Training Level on colonoscopy quality and efficiency metrics
Gastrointestinal Endoscopy, 2018Co-Authors: Hussein Bitar, Muhammad H Bashir, Pratyusha Parava, Muhammad Z Hanafi, William M Tierney, Mohammad F MadhounAbstract:Abstract Background & Aims Previous studies have described variable effects of fellow involvement on the adenoma detection rate (ADR), but few have stratified this effect by Level of Training. We aimed to evaluate the "fellow effect" on multiple procedural metrics including a newly defined adenoma management efficiency index, which may have a role in documenting colonoscopy proficiency for trainees. We also describe the impact of Level of Training on moderate sedation use. Methods We performed a retrospective review of 2024 patients (mean age 60.9 ± 10. 94% males) who underwent outpatient colonoscopy between June 2012 and December 2014 at our Veterans Affairs Medical Center. Colonoscopies were divided into 5 groups. The first 2 groups were first year fellows in the first 6 months and last 6 months of the Training year. Second and third year fellows and attending only procedures accounted for one group each. We collected data on doses of sedatives used, frequency of adjunctive agent use, procedural times as well as location, size and histology of polyps. We defined the adenoma management efficiency index as average time required per adenoma resected during withdrawal. Results 1675 colonoscopies involved a fellow. 349 were performed by the attending alone. There was no difference in ADR between fellows according to Level of Training (P=0.8), or between fellows compared with attending-only procedures (P=0.67). Procedural times decreased consistently during Training, and declined further for attending only procedures. This translated into improvement in the adenoma management efficiency index (fellow groups by ascending Level of Training 23.5 minutes vs 18.3 minutes vs 13.7 minutes vs 13.4 minutes vs attending group 11.7 minutes; P Conclusions ADR was similar at different stages of fellowship Training and comparable with the attending group. Efficiency of detecting and resecting polyps improved throughout Training without reaching attending Level. Fellow involvement led to greater use of moderate sedation, which may relate to a longer procedure duration and an evolving experience in endoscopic technique.
Carla M. Pugh - One of the best experts on this subject based on the ideXlab platform.
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Combining Metrics From Clinical Simulators and Sensorimotor Tasks Can Reveal the Training Background of Surgeons
IEEE Transactions on Biomedical Engineering, 2019Co-Authors: Felix C. Huang, Hossein Mohamadipanah, Ferdinando A. Mussa-ivaldi, Carla M. PughAbstract:Background: Skill assessment in surgery traditionally has relied on the expert observation and qualitative scoring. Our novel study design demonstrates how analysis of performance in sensorimotor tasks and bench-top surgical simulators can provide inferences about the technical proficiency as well as the Training history of surgeons. Methods: We examined metrics for basic sensorimotor tasks in a virtual reality interface as well as motion metrics in clinical scenario simulations. As indicators of the Training Level, we considered survey responses from surgery residents, including the number of postgraduation years (PGY, four Levels), research years (RY, three Levels), and clinical years (CY, three Levels). Next, we performed a linear discriminant analysis with cross-validation (90% Training, 10% testing) to relate the Training Levels to the selected metrics. Results: Using combined metrics from all stations, we found greater than chance predictions for each survey category, with an overall accuracy of 43.4 ± 2.9% for identifying the Level for post-graduate years, 79.1 ± 1.0% accuracy for research Training years, and 64.2 ± 1.0% for clinical Training years. Our main finding was that combining metrics from all stations resulted in more accurate predictions than using only sensorimotor or clinical scenario tasks. In addition, we found that metrics related to the ability to cope with changes in the task environment were the most important predictors of Training Level. Conclusions: These results suggest that each simulator-type provided crucial information for evaluating surgical proficiency. The methods developed in this paper could improve evaluations of a surgeon's clinical proficiency as well as Training potential in terms of basic sensorimotor ability.
Hussein Bitar - One of the best experts on this subject based on the ideXlab platform.
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impact of fellowship Training Level on colonoscopy quality and efficiency metrics
Gastrointestinal Endoscopy, 2018Co-Authors: Hussein Bitar, Muhammad H Bashir, Pratyusha Parava, Muhammad Z Hanafi, William M Tierney, Mohammad F MadhounAbstract:Abstract Background & Aims Previous studies have described variable effects of fellow involvement on the adenoma detection rate (ADR), but few have stratified this effect by Level of Training. We aimed to evaluate the "fellow effect" on multiple procedural metrics including a newly defined adenoma management efficiency index, which may have a role in documenting colonoscopy proficiency for trainees. We also describe the impact of Level of Training on moderate sedation use. Methods We performed a retrospective review of 2024 patients (mean age 60.9 ± 10. 94% males) who underwent outpatient colonoscopy between June 2012 and December 2014 at our Veterans Affairs Medical Center. Colonoscopies were divided into 5 groups. The first 2 groups were first year fellows in the first 6 months and last 6 months of the Training year. Second and third year fellows and attending only procedures accounted for one group each. We collected data on doses of sedatives used, frequency of adjunctive agent use, procedural times as well as location, size and histology of polyps. We defined the adenoma management efficiency index as average time required per adenoma resected during withdrawal. Results 1675 colonoscopies involved a fellow. 349 were performed by the attending alone. There was no difference in ADR between fellows according to Level of Training (P=0.8), or between fellows compared with attending-only procedures (P=0.67). Procedural times decreased consistently during Training, and declined further for attending only procedures. This translated into improvement in the adenoma management efficiency index (fellow groups by ascending Level of Training 23.5 minutes vs 18.3 minutes vs 13.7 minutes vs 13.4 minutes vs attending group 11.7 minutes; P Conclusions ADR was similar at different stages of fellowship Training and comparable with the attending group. Efficiency of detecting and resecting polyps improved throughout Training without reaching attending Level. Fellow involvement led to greater use of moderate sedation, which may relate to a longer procedure duration and an evolving experience in endoscopic technique.
K Klausen - One of the best experts on this subject based on the ideXlab platform.
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development of muscle strength in relation to Training Level and testosterone in young male soccer players
Journal of Applied Physiology, 1999Co-Authors: Lone Hansen, Jens Bangsbo, J W R Twisk, K KlausenAbstract:Isometric and functional strength of ninety-eight 11-yr-old male soccer players at an elite (E) and nonelite (NE) Level were determined (3–4 times) through a 2-yr period, and the changes were relat...
Muhammad H Bashir - One of the best experts on this subject based on the ideXlab platform.
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impact of fellowship Training Level on colonoscopy quality and efficiency metrics
Gastrointestinal Endoscopy, 2018Co-Authors: Hussein Bitar, Muhammad H Bashir, Pratyusha Parava, Muhammad Z Hanafi, William M Tierney, Mohammad F MadhounAbstract:Abstract Background & Aims Previous studies have described variable effects of fellow involvement on the adenoma detection rate (ADR), but few have stratified this effect by Level of Training. We aimed to evaluate the "fellow effect" on multiple procedural metrics including a newly defined adenoma management efficiency index, which may have a role in documenting colonoscopy proficiency for trainees. We also describe the impact of Level of Training on moderate sedation use. Methods We performed a retrospective review of 2024 patients (mean age 60.9 ± 10. 94% males) who underwent outpatient colonoscopy between June 2012 and December 2014 at our Veterans Affairs Medical Center. Colonoscopies were divided into 5 groups. The first 2 groups were first year fellows in the first 6 months and last 6 months of the Training year. Second and third year fellows and attending only procedures accounted for one group each. We collected data on doses of sedatives used, frequency of adjunctive agent use, procedural times as well as location, size and histology of polyps. We defined the adenoma management efficiency index as average time required per adenoma resected during withdrawal. Results 1675 colonoscopies involved a fellow. 349 were performed by the attending alone. There was no difference in ADR between fellows according to Level of Training (P=0.8), or between fellows compared with attending-only procedures (P=0.67). Procedural times decreased consistently during Training, and declined further for attending only procedures. This translated into improvement in the adenoma management efficiency index (fellow groups by ascending Level of Training 23.5 minutes vs 18.3 minutes vs 13.7 minutes vs 13.4 minutes vs attending group 11.7 minutes; P Conclusions ADR was similar at different stages of fellowship Training and comparable with the attending group. Efficiency of detecting and resecting polyps improved throughout Training without reaching attending Level. Fellow involvement led to greater use of moderate sedation, which may relate to a longer procedure duration and an evolving experience in endoscopic technique.
