Artificial intelligence outperforms human students in conducting neurosurgical audits.

Abstract:

OBJECTIVES:Neurosurgical audits are an important part of improving the safety, efficiency and quality of care but require considerable resources, time, and funding. To that end, the advent of the Artificial Intelligence-based algorithms offered a novel, more economically viable solution. The aim of the study was to evaluate whether the algorithm can indeed outperform humans in that task. PATIENTS & METHODS:Forty-six human students were invited to inspect the clinical notes of 45 medical outliers on a neurosurgical ward. The aim of the task was to produce a report containing a quantitative analysis of the scale of the problem (e.g. time to discharge) and a qualitative list of suggestions on how to improve the patient flow, quality of care, and healthcare costs. The Artificial Intelligence-based Frideswide algorithm (FwA) was used to analyse the same dataset. RESULTS:The FwA produced 44 recommendations whilst human students reported an average of 3.89. The mean time to deliver the final report was 5.80 s for the FwA and 10.21 days for humans. The mean relative error for factual inaccuracy for humans was 14.75 % for total waiting times and 81.06 % for times between investigations. The report produced by the FwA was entirely factually correct. 13 out of 46 students submitted an unfinished audit, 3 out of 46 made an overdue submission. Thematic analysis revealed numerous internal contradictions of the recommendations given by human students. CONCLUSION:The AI-based algorithm can produce significantly more recommendations in shorter time. The audits conducted by the AI are more factually accurate (0 % error rate) and logically consistent (no thematic contradictions). This study shows that the algorithm can produce reliable neurosurgical audits for a fraction of the resources required to conduct it by human means.

journal_name

Clin Neurol Neurosurg

authors

Brzezicki MA,Bridger NE,Kobetić MD,Ostrowski M,Grabowski W,Gill SS,Neumann S

doi

10.1016/j.clineuro.2020.105732

subject

Has Abstract

pub_date

2020-05-01 00:00:00

pages

105732

eissn

0303-8467

issn

1872-6968

pii

S0303-8467(20)30075-5

journal_volume

192

pub_type

杂志文章
  • Spinal meningioma: chronicles of contemporary neurosurgical diagnosis and management.

    abstract::Spinal meningiomas are uncommon entities that fortunately burden only a small minority of patients. Notwithstanding their overwhelmingly benign propensity, the occurrence of extramedullary meningioma may nonetheless cause significant morbidity and possible mortality. The consideration therefore, of spinal meningioma i...

    journal_title:Clinical neurology and neurosurgery

    pub_type: 杂志文章,评审

    doi:10.1016/j.clineuro.2008.10.018

    authors: Saraceni C,Harrop JS

    更新日期:2009-04-01 00:00:00

  • Cerebral proliferative angiopathy with papilledema.

    abstract::A young female presented with intermittent blurring of vision and mild to moderate headache for three months. Fundus examination revealed bilateral papilledema with secondary optic atrophy (right more than left). Computed tomography scan of brain showed a diffuse intraparenchymal vascular malformation in right parieto...

    journal_title:Clinical neurology and neurosurgery

    pub_type: 杂志文章

    doi:10.1016/j.clineuro.2015.08.032

    authors: Kumar S,Srivastava T,Tejwani S,Khilnani K

    更新日期:2015-12-01 00:00:00

  • Primary decompressive craniectomy for poor-grade middle cerebral artery aneurysms with associated intracerebral hemorrhage.

    abstract:OBJECTIVE:Aggressive surgery seems mandatory for poor-grade middle cerebral artery (MCA) aneurysm with associated intracerebral hemorrhage (ICH). However, primary decompressive craniectomy (DC) is controversial. We performed a case control study to define the role of primary DC. MATERIALS AND METHODS:We analyzed data ...

    journal_title:Clinical neurology and neurosurgery

    pub_type: 杂志文章,多中心研究

    doi:10.1016/j.clineuro.2015.03.009

    authors: Zhao B,Zhao Y,Tan X,Cao Y,Wu J,Zhong M,Wang S

    更新日期:2015-06-01 00:00:00

  • Risk factors of young ischemic stroke in Qatar.

    abstract:OBJECTIVES:There is limited information about risk factors of young ischemic stroke in Qatar. The aim of this study was to describe the risk factors and subtypes of young ischemic stroke among Qatari and non-Qatari residents. PATIENTS AND METHODS:Hospital based prospective observational study involving all young adult...

    journal_title:Clinical neurology and neurosurgery

    pub_type: 杂志文章

    doi:10.1016/j.clineuro.2007.07.006

    authors: Khan FY

    更新日期:2007-11-01 00:00:00

  • The differential yet concurrent contributions of motor, cognitive and affective disturbance to freezing of gait in Parkinson's disease.

    abstract:OBJECTIVES:We sought to concurrently examine the specific motor, cognitive and affective contributions to self-reported FOG symptoms. PATIENTS AND METHODS:Ninety-six patients with Parkinson's disease completed the validated freezing of gait questionnaire and had their motor function scored on section three of the Unif...

    journal_title:Clinical neurology and neurosurgery

    pub_type: 杂志文章

    doi:10.1016/j.clineuro.2012.06.027

    authors: Shine JM,Naismith SL,Lewis SJ

    更新日期:2013-05-01 00:00:00

  • Hypothalamic Hamartomas: A Comprehensive Review of Literature - Part 3: Updates on Radiotherapy Management.

    abstract::Hypothalamic hamartomas (HH) are rare, non-neoplastic heterotopic tissues which contains normal neurons and glia including oligodendrocytes and fibrillary astrocytes but in an abnormal distribution. They arise from the floor of the third ventricle, tuber cinereum, or mammillary bodies. Estimated incidence ranges from ...

    journal_title:Clinical neurology and neurosurgery

    pub_type: 杂志文章,评审

    doi:10.1016/j.clineuro.2020.106077

    authors: Alomari SO,El Houshiemy MN,Bsat S,Moussalem CK,Allouh M,Omeis IA

    更新日期:2020-10-01 00:00:00

  • Acute ischemic stroke in the very elderly Chinese: risk factors, hospital management and one-year outcome.

    abstract:BACKGROUND:Little information is available on Asian patients over 80 years with stroke. We aimed to investigate characteristics of the very elderly ischemic stroke hospitalized patients in China. METHODS:We prospectively enrolled consecutive patients with acute ischemic stroke from March, 2002 to October, 2008 into th...

    journal_title:Clinical neurology and neurosurgery

    pub_type: 杂志文章

    doi:10.1016/j.clineuro.2011.01.005

    authors: Wang D,Hao Z,Tao W,Kong F,Zhang S,Wu B,Lin S,Liu M

    更新日期:2011-07-01 00:00:00

  • Direct measurement of patient's entrance skin dose during neurointerventional procedure to avoid further radiation-induced skin injuries.

    abstract::Although several cases of radiation-induced skin injury (RSI) have been reported in association with neurointerventional procedures such as endovascular embolization for cerebral aneurysm, cerebral arteriovenous malformation, and dural arteriovenous fistula, in most cases the absorbed doses are not measured directly; ...

    journal_title:Clinical neurology and neurosurgery

    pub_type: 杂志文章

    doi:10.1016/j.clineuro.2010.03.019

    authors: Hayakawa M,Moritake T,Kataoka F,Takigawa T,Koguchi Y,Miyamoto Y,Akahane K,Matsumaru Y

    更新日期:2010-07-01 00:00:00

  • The prevalence of neglect: superiority of neuropsychological over clinical methods of estimation.

    abstract::As anatomical studies have suggested that neglect might occur more frequently than is presently realized, and since pilot studies with dopamine agonists have suggested a possible therapy, we examined whether simple neuropsychological tests could detect neglect in the presence of a negative clinical examination. We fou...

    journal_title:Clinical neurology and neurosurgery

    pub_type: 杂志文章

    doi:10.1016/0303-8467(90)90025-z

    authors: Stam CJ,Bakker M

    更新日期:1990-01-01 00:00:00

  • Chronic opioid use is associated with increased postoperative urinary retention, length of stay and non-routine discharge following lumbar fusion surgery.

    abstract:BACKGROUND:The incidence of chronic opioid use (COU) is increasing with health related complications impacting both patients and healthcare services. OBJECTIVE:The aim of this study was to identify the impact of COU on postoperative urinary retention (PUR) in patients following lumbar fusion surgery as well as its imp...

    journal_title:Clinical neurology and neurosurgery

    pub_type: 杂志文章

    doi:10.1016/j.clineuro.2020.106161

    authors: Doherty RJ,Wahood W,Yolcu YU,Zreik J,Goyal A,Gazelka HM,Habermann EB,Sebastian A,Bydon M

    更新日期:2020-10-01 00:00:00

  • Spinal cord stimulation in the treatment of complex regional pain syndrome type 1: Is trial truly required?

    abstract:OBJECTIVE:Spinal cord stimulation has been proven highly effective in the treatment of Complex Regional Pain Syndrome (CRPS). The definitive implantation of a neurostimulator is usually preceded by a therapeutic test (trial), which has the purpose of identifying whether the patient would respond positively to neuromodu...

    journal_title:Clinical neurology and neurosurgery

    pub_type: 杂志文章

    doi:10.1016/j.clineuro.2018.06.014

    authors: Risson EG,Serpa AP,Berger JJ,Koerbel RFH,Koerbel A

    更新日期:2018-08-01 00:00:00

  • Serum AGR2 as a useful biomarker for pituitary adenomas.

    abstract:OBJECTIVE:This study aims to evaluate whether the serum Anterior Gradient-2 (AGR2) can be used as a potential biomarker screening in the diagnosis of Pituitary adenomas(PAs). PATIENTS AND METHODS:The serum AGR2 protein levels were preoperatively measured in 163 PA patients, 43 patients with other sellar lesions exclud...

    journal_title:Clinical neurology and neurosurgery

    pub_type: 杂志文章

    doi:10.1016/j.clineuro.2017.01.004

    authors: Tohti M,Li J,Tang C,Wen G,Abdujilil A,Yizim P,Ma C

    更新日期:2017-03-01 00:00:00

  • Role of comorbidities and in-hospital complications in short-term status epilepticus outcome.

    abstract:OBJECTIVE:pre-morbid patient conditions and hospitalization complications possibly play a role in status epilepticus short-term outcome, although evidence is incomplete and non-conclusive. The study's aim was to define whether comorbidities and in-hospital complications arising after status epilepticus affect its progn...

    journal_title:Clinical neurology and neurosurgery

    pub_type: 杂志文章

    doi:10.1016/j.clineuro.2016.12.017

    authors: Belluzzo M,Furlanis G,Stragapede L,Monti F

    更新日期:2017-03-01 00:00:00

  • Is there a difference in outcomes of patients with idiopathic intracranial hypertension with the choice of cerebrospinal fluid diversion site: a single centre experience.

    abstract:UNLABELLED:The visual and headache outcomes in patients with idiopathic intracranial hypertension (IIH) undergoing cerebrospinal fluid diversion with a lumboperitoneal (LPS) or ventriculoperitoneal shunting (VPS) have not been well reported. The aims of this study were to: (a) to assess outcomes of CSF diversion in IIH...

    journal_title:Clinical neurology and neurosurgery

    pub_type: 杂志文章

    doi:10.1016/j.clineuro.2011.02.008

    authors: Tarnaris A,Toma AK,Watkins LD,Kitchen ND

    更新日期:2011-07-01 00:00:00

  • The impacts of acute carbon monoxide poisoning on the brain: Longitudinal clinical and 99mTc ethyl cysteinate brain SPECT characterization of patients with persistent and delayed neurological sequelae.

    abstract:OBJECTIVE:Acute carbon monoxide (CO) poisoning poses a significant threat to the central nervous system. It can cause brain injury and diverse neurological deficits including persistent neurological sequelae (PNS) and delayed neurological sequelae (DNS). The study aimed to investigate the long-term impacts of acute CO ...

    journal_title:Clinical neurology and neurosurgery

    pub_type: 杂志文章

    doi:10.1016/j.clineuro.2014.01.005

    authors: Tsai CF,Yip PK,Chen SY,Lin JC,Yeh ZT,Kung LY,Wang CY,Fan YM

    更新日期:2014-04-01 00:00:00

  • Pharmacologic considerations in patients with osteoporosis undergoing lumbar interbody fusion: A systematic review.

    abstract:OBJECTIVE:As the ageing population continues to grow, the incidence of osteoporosis continues to rise. Patients with osteoporosis are often managed pharmacologically. It is unclear the impact of these medications on osteoporotic patients requiring lumbar interbody fusion, and whether differences exist with respect to p...

    journal_title:Clinical neurology and neurosurgery

    pub_type: 杂志文章,评审

    doi:10.1016/j.clineuro.2020.106030

    authors: Soldozy S,Sarathy D,Skaff A,Montgomery SR Jr,Young S,Desai B,Sokolowski JD,Buchholz AL,Shaffrey ME,Syed HR

    更新日期:2020-09-01 00:00:00

  • Clinical characteristics of headache or facial pain prior to the development of acute herpes zoster of the head.

    abstract:OBJECTIVES:When physicians encounter patients with headache or facial pain (preeruptive pain) associated with acute herpes zoster of the head, especially before the appearance of characteristic skin eruptions (preeruptive phase), they typically find it difficult to make clinical impressions and apply appropriate diagno...

    journal_title:Clinical neurology and neurosurgery

    pub_type: 杂志文章

    doi:10.1016/j.clineuro.2016.12.004

    authors: Lee HL,Yeo M,Choi GH,Lee JY,Kim JS,Shin DI,Lee SS,Lee SH

    更新日期:2017-01-01 00:00:00

  • Diagnostic utility of skin biopsy in dystrophinopathies.

    abstract:AIMS:Muscle biopsy is an important diagnostic modality and screening test for the diagnosis of dystrophinopathies. Sometimes muscle biopsies are needed for the diagnosis when genetic tests are inconclusive and are also useful for immunoblotting assay of the dystrophin protein. However, the procedure is painful, require...

    journal_title:Clinical neurology and neurosurgery

    pub_type: 杂志文章

    doi:10.1016/j.clineuro.2009.01.011

    authors: Tanveer N,Sharma MC,Sarkar C,Gulati S,Kalra V,Singh S,Bhatia R

    更新日期:2009-07-01 00:00:00

  • Recurrent forms of sporadic brachial plexus neuropathy. A report of two cases.

    abstract::Two patients presenting a relapsing form of sporadic brachial plexus neuropathy, the so-called Parsonage Turner syndrome, are reported. The diagnosis is based on clinical and electromyographic features. Recurrent attacks, although infrequently encountered, have been well described in the past. Sporadic cases of this s...

    journal_title:Clinical neurology and neurosurgery

    pub_type: 杂志文章

    doi:10.1016/s0303-8467(88)80014-3

    authors: Michotte A,Dierckx R,Deleu D,Herregodts P,Schmedding E,Bruyland M,Ebinger G

    更新日期:1988-01-01 00:00:00

  • Subacute aseptic meningitis as neurological manifestation of primary Sjögren's syndrome.

    abstract::Sjögren's syndrome (SS) is an autoimmune disease characterized by inflammatory infiltration and secondary chronic dysfunction of exocrine glands. Systemic (extraglandular) manifestations of the disease occur in one-third of the patients, including a wide spectrum of peripheral and central neurological disorders. We re...

    journal_title:Clinical neurology and neurosurgery

    pub_type: 杂志文章

    doi:10.1016/j.clineuro.2005.05.015

    authors: Rossi R,Valeria Saddi M

    更新日期:2006-10-01 00:00:00

  • Outcome and complications of chronically implanted subdural electrodes for the treatment of medically resistant epilepsy.

    abstract:BACKGROUND:Surgery for medically resistant epilepsy is safe and effective. However, when noninvasive techniques are insufficient, then consideration is given to invasive electrocorticography (EcoG). OBJECTIVE:The aim of the study was to analyze results and complications of subdural electrodes placement in the treatmen...

    journal_title:Clinical neurology and neurosurgery

    pub_type: 杂志文章

    doi:10.1016/j.clineuro.2012.10.007

    authors: Vale FL,Pollock G,Dionisio J,Benbadis SR,Tatum WO

    更新日期:2013-07-01 00:00:00

  • Anatomico-radiologic study of the distribution of the suboccipital artery of Salmon.

    abstract:OBJECTIVES:The frequency of suboccipital injections to treat headaches has increased. The third segment of the vertebral artery is located in the suboccipital triangle and its main muscular branch, the suboccipital artery of Salmon (SAS), supplies blood to the suboccipital muscles. The purpose of this study was to radi...

    journal_title:Clinical neurology and neurosurgery

    pub_type: 杂志文章

    doi:10.1016/j.clineuro.2013.11.020

    authors: Macchi V,Porzionato A,Morra A,D'Antoni AV,Tubbs RS,De Caro R

    更新日期:2014-02-01 00:00:00

  • Trends in the incidence of primary malignant brain tumors in Taiwan and correlation with comorbidities: A population-based study.

    abstract:OBJECTIVE:Primary malignant brain tumors are relatively uncommon, and their incidence and survival rates have seldom been reported. PATIENTS AND METHODS:We identified all patients with malignant brain tumors in Taiwan between 1997 and 2012 using the National Health Insurance database. We estimated the stratified incid...

    journal_title:Clinical neurology and neurosurgery

    pub_type: 杂志文章

    doi:10.1016/j.clineuro.2017.05.021

    authors: Lin YJ,Chiu HY,Chiou MJ,Huang YC,Wei KC,Kuo CF,Hsu JT,Chen PY

    更新日期:2017-08-01 00:00:00

  • Glossopharyngeal schwannoma, an uncommon posterior fossa tumor: diagnostical and therapeutical aspects: a case report.

    abstract::Among posterior fossa tumors, schwannomas arising from glossopharyngeal nerve are rare; only about 30 cases of glossopharyngeal neuroma have been described. Though a typical 'jugular foramen syndrome' has been described for tumors of this region, the clinical onset may often closely resemble that of acoustic neuromas ...

    journal_title:Clinical neurology and neurosurgery

    pub_type: 杂志文章

    doi:10.1016/s0303-8467(97)00016-4

    authors: Rapanà A,Lamaida E,Bracale C,Lepore P,Pizza V,Graziussi G

    更新日期:1997-08-01 00:00:00

  • Provocative tests in different stages of carpal tunnel syndrome.

    abstract::The frequency of positive results of four conventional provocative tests (Phalen sign, Tinel sign, wrist extension and pressure provocation test) was evaluated in 179 patients with clinical and electrophysiological findings consistent with idiopathic carpal tunnel syndrome (CTS), 147 control subjects and 39 patients w...

    journal_title:Clinical neurology and neurosurgery

    pub_type: 临床试验,杂志文章

    doi:10.1016/s0303-8467(01)00140-8

    authors: Mondelli M,Passero S,Giannini F

    更新日期:2001-10-01 00:00:00

  • Subarachnoid hemorrhage in systemic lupus erythematosus: systematic review and report of three cases.

    abstract:OBJECTIVE:Systemic lupus erythematosus (SLE) is an autoimmune disorder of multifactorial etiology with a broad range of clinical manifestations. Cerebral disorders such as psychosis, seizures and cerebrovascular accidents are commonly described in SLE patients. Subarachnoid hemorrhage (SAH) presents a higher incidence ...

    journal_title:Clinical neurology and neurosurgery

    pub_type: 杂志文章,评审

    doi:10.1016/j.clineuro.2014.10.018

    authors: Torné R,Rodríguez-Hernández A,Bernard T,Arikan Abelló F,Vilalta Castan J,Sahuquillo J

    更新日期:2015-01-01 00:00:00

  • Supine catch sign--a simple clinical test to differentiate between true and false (pseudo) radial nerve palsy.

    abstract::Patients at times present with neurological symptoms and signs for which at times extensive investigation fails to identify any structural or organic pathology within the nervous system. These pseudo neurological syndromes can mimic almost any organic disease of the central and peripheral nervous system. Some such as ...

    journal_title:Clinical neurology and neurosurgery

    pub_type: 杂志文章

    doi:10.1016/j.clineuro.2010.01.005

    authors: Sethi NK,Sethi PK,Torgovnick J

    更新日期:2010-06-01 00:00:00

  • Involvement of disregulated c-myc but not c-sis/PDGF in atypical and anaplastic meningiomas.

    abstract::We investigated the expression of c-myc and c-sis/PDGF mRNA and protein products in 20 cases of meningiomas of various grades: 10 benign, 5 atypical and 5 anaplastic meningiomas. All cases of atypical and anaplastic meningiomas were positive for c-myc protein and mRNA by immunohistochemistry and in situ hybridisation,...

    journal_title:Clinical neurology and neurosurgery

    pub_type: 杂志文章

    doi:10.1016/s0303-8467(00)00119-0

    authors: Nagashima G,Aoyagi M,Yamamoto S,Wakimoto H,Tamaki M,Yamamoto K,Fujimoto T,Hirakawa K

    更新日期:2001-04-01 00:00:00

  • Pregnancy and multiple sclerosis: the influence on long term disability.

    abstract::We studied 200 female patients with multiple sclerosis (MS) to investigate whether pregnancy after the onset of disease influences long term disability. As an index of progression, we used the time between disease onset and wheelchair dependence. Patients who had at least one pregnancy after onset were wheelchair depe...

    journal_title:Clinical neurology and neurosurgery

    pub_type: 杂志文章

    doi:10.1016/0303-8467(94)90027-2

    authors: Verdru P,Theys P,D'Hooghe MB,Carton H

    更新日期:1994-02-01 00:00:00

  • Miller Fisher syndrome associated with Mycoplasma pneumoniae infection: report of a case.

    abstract::We report a 38-year-old male patient who developed a Miller Fisher syndrome following a respiratory tract disorder associated with a serologically proven Mycoplasma pneumoniae infection. Although several neurologic manifestations have been reported after Mycoplasma pneumonia infection, Miller Fisher syndrome has not b...

    journal_title:Clinical neurology and neurosurgery

    pub_type: 杂志文章

    doi:10.1016/0303-8467(94)90038-8

    authors: Merkx H,De Keyser J,Ebinger G

    更新日期:1994-02-01 00:00:00