A Systematic Review Protocol to Determine the Most Effective Strategies to Reduce Computed Tomography Usage in the Emergency Department

Elzinga, Jason L; Dunne, Cody; Vorobeichik, Allen; Keto‐Lambert, Diana; Grigat, D.; Lang, Eddy; Dowling, Shawn

doi:10.7759/cureus.9509

Cited by 3 publications

(4 citation statements)

References 23 publications

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“…The aim of the second review round will be to identify which studies meet all inclusion criteria. Researchers will utilize a standardized screening tool, adopted from Elzinga et al, to determine the inclusion eligibility of every study [10]. The tool consists of four questions, each addressing a specific inclusion/exclusion criterion.…”

Section: Abstract Reviewmentioning

confidence: 99%

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A Protocol for a Systematic Review and Meta-Analysis of Hospital Readmissions Following Acute Upper Gastrointestinal Bleeding

Kaur¹,

Dunne²,

Bresee³

2021

Cureus

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Section: Abstract Reviewmentioning

confidence: 99%

“…FIGURE 1: Overview of a standardized full-text screening tool Adapted from: Elzinga et al (2020)[10] …”

mentioning

confidence: 99%

A Protocol for a Systematic Review and Meta-Analysis of Hospital Readmissions Following Acute Upper Gastrointestinal Bleeding

Kaur¹,

Dunne²,

Bresee³

2021

Cureus

Self Cite

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“… 1 In the USA, CT radiation doses account for over half the population effective dose received from medical sources. 2 Even with this knowledge, the total number of yearly CT examinations grows. 3 , 4 Large‐scale studies have indicated the detrimental impact of ionizing radiation on human tissue, with the increased radiosensitivity of pediatric populations compared to adult populations, an area of particular concern.…”

Section: Introductionmentioning

confidence: 99%

“…Radiation doses to the patient during computed tomography (CT) procedures are among the highest in diagnostic radiology 1 . In the USA, CT radiation doses account for over half the population effective dose received from medical sources 2 . Even with this knowledge, the total number of yearly CT examinations grows 3,4 .…”

Section: Introductionmentioning

confidence: 99%

Comparison of organ and effective dose estimations from different Monte Carlo simulation‐based software methods in infant CT and comparison with direct phantom measurements

Lawson

Berk

Badawy

et al. 2022

J Applied Clin Med Phys

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Computational dosimetry software is routinely used to evaluate the organ and effective doses from computed tomography (CT) examinations. Studies have shown a significant variation in dose estimates between software in adult cohorts, and few studies have evaluated software for pediatric dose estimates. This study aims to compare the primary organ and effective doses estimated by four commercially available CT dosimetry software to thermoluminescent dosimeter (TLD) measurements in a 1-year-old phantom. Methods: One hundred fifteen calibrated LiF (Mg, Cu, P)-TLD 100-H chips were embedded within an anthropomorphic phantom representing a 1-year-old child at positions that matched the approximate location of organs within an infant. The phantom was scanned under three protocols, each with whole-body coverage. The mean absorbed doses from 25 radiosensitive organs and skeletal tissues were determined from the TLD readings. Effective doses for each of the protocols were subsequently calculated using ICRP 103 formalism. Dose estimates by the four Monte Carlo-based dose calculation systems were determined and compared to the directly measured doses. Results: Most organ doses determined by computation dosimetry software aligned to phantom measurements within 20%. Additionally, comparisons between effective doses are calculated using computational and direct measurement methods aligned within 20% across the three protocols. Significant variances were found in bone surface dose estimations among dosimetry methods, likely caused by differences in bone tissue modeling. Conclusion: All four-dosimetry software evaluated in this study provide adequate primary organ and effective dose estimations. Users should be aware, however, of the possible estimated uncertainty associated with each of the programs.

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Synchronous vs Asynchronous Telesimulation in Simulation-Based Medical Education for High-Acuity Low-Occurrence Procedures and Clinical Encounters For Physicians and Medical Trainees in Emergency Medicine: Protocol for a Systematic Review (Preprint)

Thornhill,

Jewer,

Rhodes

et al. 2023

Preprint

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BACKGROUND Proficiency in high-acuity low-occurrence (HALO) procedures and clinical encounters is important for physicians and medical trainees in emergency medicine. Simulation based medical education (SBME) offers physicians and medical trainees with learning opportunities for HALO procedures and clinical encounters. Access to SBME can be difficult. Telesimulation in SBME can help make HALO proficiency more accessible to physicians and medical trainees be challenging in remote locations. OBJECTIVE Based on this review, the research team aims to evaluate the effectiveness of SBME delivered remotely on improving learner skills in emergency medicine and to provide insights on the conditions under which synchronous versus asynchronous methods can be used effectively. METHODS A systematic review will be conducted using the electronic databases PubMed, CINAHL, Embase, and Cochrane. The search will be limited to studies published in English from 2011 to present. To be included, studies must focus on the delivery of SBME with telesimulation to teach or enhance the skills necessary for HALO procedures and clinical encounters in emergency medicine. Qualitative and quantitative studies will be analyzed. RESULTS The results of the systematic review will be available 18 months after the publication of this protocol. CONCLUSIONS The results of the systematic review could be used to develop research-led SBME for HALO procedure in emergency medicine. By investigating this topic more effective SBME sessions can be planned in the future, which has the potential to benefit the skills of practitioners and medical trainees.

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A Systematic Review Protocol to Determine the Most Effective Strategies to Reduce Computed Tomography Usage in the Emergency Department

Cited by 3 publications

References 23 publications

A Protocol for a Systematic Review and Meta-Analysis of Hospital Readmissions Following Acute Upper Gastrointestinal Bleeding

A Protocol for a Systematic Review and Meta-Analysis of Hospital Readmissions Following Acute Upper Gastrointestinal Bleeding

Comparison of organ and effective dose estimations from different Monte Carlo simulation‐based software methods in infant CT and comparison with direct phantom measurements

Synchronous vs Asynchronous Telesimulation in Simulation-Based Medical Education for High-Acuity Low-Occurrence Procedures and Clinical Encounters For Physicians and Medical Trainees in Emergency Medicine: Protocol for a Systematic Review (Preprint)

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