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The Journal of Thoracic and... Jun 2018
Topics: Thoracic Surgery; Thoracic Surgical Procedures
PubMed: 29776297
DOI: 10.1016/j.jtcvs.2018.01.054 -
The Journal of Thoracic and... Jan 2022
Topics: Education, Medical, Graduate; Thoracic Surgery; Thoracic Surgical Procedures
PubMed: 33461812
DOI: 10.1016/j.jtcvs.2020.12.072 -
The Journal of Thoracic and... Aug 2018
Topics: Curriculum; Internet; Learning; Thoracic Surgery; Thoracic Surgical Procedures
PubMed: 29753508
DOI: 10.1016/j.jtcvs.2018.04.009 -
The Journal of Thoracic and... Nov 2020
Topics: Education, Medical, Graduate; Hospitals, General; Humans; Internship and Residency; Ontario; Surgeons; Thoracic Surgery; Thoracic Surgical Procedures
PubMed: 32417062
DOI: 10.1016/j.jtcvs.2020.02.112 -
The Journal of Thoracic and... Apr 2016The time interval for the doubling of medical knowledge continues to decline. Physicians, patients, administrators, government officials, and payors are struggling to... (Review)
Review
The time interval for the doubling of medical knowledge continues to decline. Physicians, patients, administrators, government officials, and payors are struggling to keep up to date with the waves of new information and to integrate the knowledge into new patient treatment protocols, processes, and metrics. Guidelines, Consensus Guidelines, and Consensus Statements, moderated by seasoned content experts, offer one method to rapidly distribute new information in a timely manner and also guide minimal standards of treatment of clinical care pathways as they are developed as part of bundled care programs. These proposed Consensus Guidelines advance The American Association for Thoracic Surgery's mission of leading in cardiothoracic health care, education, innovation, and modeling excellence.
Topics: Clinical Competence; Consensus; Diffusion of Innovation; Education, Medical, Graduate; Evidence-Based Medicine; Guideline Adherence; Humans; Practice Guidelines as Topic; Practice Patterns, Physicians'; Societies, Medical; Thoracic Surgery; Thoracic Surgical Procedures
PubMed: 26892077
DOI: 10.1016/j.jtcvs.2015.09.138 -
European Journal of Cardio-thoracic... Jan 2022Machine learning (ML) has great potential, but there are few examples of its implementation improving outcomes. The thoracic surgeon must be aware of pertinent ML... (Review)
Review
OBJECTIVES
Machine learning (ML) has great potential, but there are few examples of its implementation improving outcomes. The thoracic surgeon must be aware of pertinent ML literature and how to evaluate this field for the safe translation to patient care. This scoping review provides an introduction to ML applications specific to the thoracic surgeon. We review current applications, limitations and future directions.
METHODS
A search of the PubMed database was conducted with inclusion requirements being the use of an ML algorithm to analyse patient information relevant to a thoracic surgeon and contain sufficient details on the data used, ML methods and results. Twenty-two papers met the criteria and were reviewed using a methodological quality rubric.
RESULTS
ML demonstrated enhanced preoperative test accuracy, earlier pathological diagnosis, therapies to maximize survival and predictions of adverse events and survival after surgery. However, only 4 performed external validation. One demonstrated improved patient outcomes, nearly all failed to perform model calibration and one addressed fairness and bias with most not generalizable to different populations. There was a considerable variation to allow for reproducibility.
CONCLUSIONS
There is promise but also challenges for ML in thoracic surgery. The transparency of data and algorithm design and the systemic bias on which models are dependent remain issues to be addressed. Although there has yet to be widespread use in thoracic surgery, it is essential thoracic surgeons be at the forefront of the eventual safe introduction of ML to the clinic and operating room.
Topics: Algorithms; Artificial Intelligence; Humans; Reproducibility of Results; Thoracic Surgery; Thoracic Surgical Procedures
PubMed: 34601587
DOI: 10.1093/ejcts/ezab422 -
Anaesthesia Apr 2023This review of 19 studies (39,783 patients) of atrial fibrillation after thoracic surgery addresses the pathophysiology, incidence, and consequences of atrial... (Review)
Review
This review of 19 studies (39,783 patients) of atrial fibrillation after thoracic surgery addresses the pathophysiology, incidence, and consequences of atrial fibrillation in this population, as well as its prevention and management. Interestingly, atrial fibrillation was most often identified in patients not previously known to have the disease. Rhythm control with amiodarone was the most commonly used treatment and nearly all patients were discharged in sinus rhythm. Major predictors were age; male sex; history of atrial fibrillation; congestive heart failure; left atrial enlargement; elevated brain natriuretic peptide level; and the invasiveness of procedures. Overall, patients with atrial fibrillation stayed 3 days longer in hospital. We also discuss the importance of standardising research on this subject and provide recommendations that might mitigate the impact postoperative atrial fibrillation on hospital resources.
Topics: Humans; Male; Atrial Fibrillation; Anti-Arrhythmia Agents; Thoracic Surgery; Amiodarone; Thoracic Surgical Procedures
PubMed: 36632006
DOI: 10.1111/anae.15957 -
The Annals of Thoracic Surgery Aug 2020
Topics: Humans; Pandemics; Thoracic Surgery; Thoracic Surgical Procedures
PubMed: 32278753
DOI: 10.1016/j.athoracsur.2020.03.006 -
Minerva Anestesiologica Nov 2023Accidental or surgically induced thoracic trauma is responsible for significant pain that can impact patient outcomes. One of the main objectives of its pain management... (Review)
Review
Accidental or surgically induced thoracic trauma is responsible for significant pain that can impact patient outcomes. One of the main objectives of its pain management is to promote effective coughing and early mobilization to reduce atelectasis and ventilation disorders induced by pulmonary contusion. The incidence of chronic pain can affect more than 35% of patients after both thoracotomy and thoracoscopy as well as after chest trauma. As the severity of acute pain is associated with the incidence of chronic pain, early and effective pain management is very important. In this narrative review, we propose to detail systemic and regional analgesia techniques to minimize postoperative pain, while reducing transitional pain, surgical stress response and opioid side effects. We provide the reader with practical recommendations based on both literature and clinical practice experience in a referral level III thoracic trauma center.
Topics: Humans; Pain Management; Thoracic Surgery; Chronic Pain; Thoracic Surgical Procedures; Thoracoscopy; Pain, Postoperative; Thoracotomy
PubMed: 37671536
DOI: 10.23736/S0375-9393.23.17291-9 -
Regionalization for thoracic surgery: Economic implications of regionalization in the United States.The Journal of Thoracic and... May 2021
Topics: Hospital Planning; Humans; Thoracic Surgery; United States
PubMed: 33323196
DOI: 10.1016/j.jtcvs.2020.10.132