Category Archives: Anesthesiology

Anesthesiology

AI-driven alerts improve patient care escalation and survival rates in hospitals – News-Medical.Net

Deploying and evaluating a machine learning intervention to improveclinical care and patient outcomes is a key step in moving clinical deterioration models from byte to bedside, according to a June 13 editorial in Critical Care Medicine that comments on a Mount Sinai study published in the same issue. The main study found that hospitalized patients were 43 percent more likely to have their care escalated and significantly less likely to die if their care team received AI-generated alerts signaling adverse changes in their health.

We wanted to see if quick alerts made by AI and machine learning, trained on many different types of patient data, could help reduce both how often patients need intensive care and their chances of dying in the hospital. Traditionally, we have relied on older manual methods such as the Modified Early Warning Score (MEWS) to predict clinical deterioration. However, our study shows automated machine learning algorithm scores that trigger evaluation by the provider can outperform these earlier methods in accurately predicting this decline. Importantly, it allows for earlier intervention, which could save more lives."

Matthew A. Levin, MD, lead study author, Professor of Anesthesiology, Perioperative and Pain Medicine, and Genetics and Genomic Sciences, at Icahn Mount Sinai, and Director of Clinical Data Science at The Mount Sinai Hospital

The non-randomized, prospective study looked at 2,740 adult patients who were admitted to four medical-surgical units at The Mount Sinai Hospital in New York. The patients were split into two groups: one that received real-time alerts based on the predicted likelihood of deterioration, sent directly to their nurses and physicians or a "rapid response team" of intensive care physicians, and another group where alerts were created but not sent. In the units where the alerts were suppressed, patients who met standard deterioration criteria received urgent interventions from the rapid response team.

Additional findings in the intervention group demonstrated that patients:

"Our research shows that real-time alerts using machine learning can substantially improve patient outcomes," says senior study author David L. Reich, MD, President of The Mount Sinai Hospital and Mount Sinai Queens, the Horace W. Goldsmith Professor of Anesthesiology, and Professor of Artificial Intelligence and Human Health at Icahn Mount Sinai. "These models are accurate and timely aids to clinical decision-making that help us bring the right team to the right patient at the right time. We think of these as 'augmented intelligence' tools that speed in-person clinical evaluations by our physicians and nurses and prompt the treatments that keep our patients safer. These are key steps toward the goal of becoming a learning health system."

The study was terminated early due to the COVID-19 pandemic. The algorithm has been deployed on all stepdown units within The Mount Sinai Hospital, using a simplified workflow. A stepdown unit is a specialized area in the hospital where patients who are stable but still require close monitoring and care are placed. It's a step between the intensive care unit (ICU) and a general hospital area, ensuring that patients receive the right level of attention as they recover.

A team of intensive care physicians visits the 15 patients with the highest prediction scores every day and makes treatment recommendations to the doctors and nurses caring for the patient. As the algorithm is continually retrained on larger numbers of patients over time, the assessments by the intensive care physicians serve as the gold standard of correctness, and the algorithm becomes more accurate through reinforcement learning.

In addition to this clinical deterioration algorithm, the researchers have developed and deployed 15 additional AI-based clinical decision support tools throughout the Mount Sinai Health System.

The Mount Sinai paper is titled "Real-Time Machine Learning Alerts to Prevent Escalation of Care: A Nonrandomized Clustered Pragmatic Clinical Trial." The remaining authors of the paper, all with Icahn Mount Sinai except where indicated, are Arash Kia, MD, MSc; Prem Timsina, PhD; Fu-yuan Cheng, MS; Kim-Anh-Nhi Nguyen, MS; Roopa Kohli-Seth, MD; Hung-Mo Lin, ScD (Yale University); Yuxia Ouyang, PhD; and Robert Freeman, RN, MSN, NE-BC.

Source:

Journal reference:

Levin, M. A., et al. (2024). Real-Time Machine Learning Alerts to Prevent Escalation of Care: A Nonrandomized Clustered Pragmatic Clinical Trial.Critical Care Medicine. doi.org/10.1097/CCM.0000000000006243.

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AI-driven alerts improve patient care escalation and survival rates in hospitals - News-Medical.Net

Anesthesiology

Hospitals with higher ratio of female surgeons, anaesthetists have better patient outcomes: Study – University of Toronto

Greater sex diversity in hospital anaesthesia-surgery teams is associated with better post-operative outcomes for patients, according to a study fromICES,Sunnybrook Research Instituteand the University of Toronto.

The study, published in theBritish Journal of Surgery, found that teams with more than 35 per cent female anesthesiologists and surgeons were associated with a three per cent reduction in odds of post-operative complications in the three months following surgery.

This is one of the first studies to focus on sex diversity of operating room teams, building on past work that has compared the impact of individual surgeon and anesthesiologist characteristics on patient outcomes.

We wanted to challenge the binary approach of comparing female and male clinicians and rather highlight the importance of diversity as a team asset or bonus in enhancing quality care, sayslead authorJulie Hallet, a scientist with ICES and Sunnybrook Research Institute, and associate professor ofsurgeryat U of Ts Temerty Faculty of Medicine.

The study includes population-based, health-care data on 709,899 adult patients undergoing major in-patient surgeries in Ontario between 2009 and 2019.

Sex diversity of surgical teams was defined as the percentage of female anesthesiologists and surgeons among all anesthesiologists and surgeons working in the hospital each year. The primary outcome was 90-day major morbidity, which the researchers analyzed with a standardized classification scale to identify severe post-surgical complications.

The findings showed that reaching a critical mass of more than 35 per cent female anesthesiologists and surgeons was linked to lower odds of severe complications.

The association between greater sex diversity and reduced post-surgical complications was even greater for patients treated by female anesthesiologists and female surgeons which aligns with previous studies comparing outcomes of male to female surgeons.

These results are the start of an important shift in understanding the way in which diversity contributes to better quality care around the time of surgery, says Hallet. Ensuring a critical mass of female anesthesiologists and surgeons in operative teams is crucial to performance. Below a critical mass, female clinicians may withhold their perspectives, such that the benefits of diversity can only be achieved once minimum representation is reached.

One limitation of the study is that the data did not include gender as a social construct. It is possible that gender roles, behaviours and attitudes would have influenced the strength of the association.

The studys authors noted further research is also needed to explore diversity based on other sociodemographic variables, including but not limited to race and ethnicity.

Nevertheless, this study is the first to show a robust positive association between team sex diversity, patient outcomes and quality care.

We hope that these results will encourage hospitals to intentionally foster sex diversity in operating room teams to reduce poor health outcomes, which, in turn, can improve patient satisfaction and promote sustainability of health systems,saysGianni Lorello, staff anesthesiologist atToronto Western Hospital, University Health Network and an associate professor in Temerty Medicinesdepartment of anesthesiology and pain medicine.

Ensuring sex diversity in operative teams will require intentional effort for recruitment and retainment policies for female physicians, structural interventions such as minimum representation on teams, and monitoring and reporting of teams composition to build institutional accountability in existing systems. The research was supported by the Sunnybrook Alternate Funding Plan Innovation Fund.

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Hospitals with higher ratio of female surgeons, anaesthetists have better patient outcomes: Study - University of Toronto

Anesthesiology

Anesthesiology house officers present research at GME Symposium – University of Nebraska Medical Center

Anesthesiology residents and fellows presented their research including both poster and oral formats at the sixth annual Graduate Medical Education Research Symposium on Monday, April 22.

The symposium provides the opportunity for house officers to present their research in all areas, including clinical outcomes, basic science, education, business, health policy and humanities.

Peter Ricci Pellegrino, MD, PhD, received an award for his oral presentation on Sympathetic Vasomotion Correlates With the Magnitude of Hemorrhage in Conscious Rabbits.

Chandra Are, MBBS, the UNMC College of Medicines associate dean of Graduate Medical Education, said close to 120 research abstracts were presented at the event, nearly 50 more than when the symposium first premiered in 2018.

UNMC Department of Anesthesiology presenters at the event included:

Patrick Barone, MD, pediatric anesthesiology fellow Incompatible Batteries With Potential Hazard in MRI Environment

Mark Cheney, MD, critical care anesthesiology fellow Mind the Gap! Unexpected Euglycemic Ketoacidosis in a Case of Apparent Volume Overload

Nate Goergen, MD, PhD, resident NextSTAT: A Low-Cost Lot Based Paging Solution to Request Urgent Help in the or Using Amazon AWS Cloud A Novel, In-House, Rapid Response Solution to a Critical Supply Crisis Affecting Hyperbaric Oxygen Therapy Centers Nationwide Jenkins: An Anesthesia Intra-Op Voice Assistant to Improve Patient Outcomes and Situational Awareness in the OR

Peter Ricci Pellegrino, MD, PhD, pain medicine fellow Sympathetic Vasomotion Correlates With the Magnitude of Hemorrhage in Conscious Rabbits

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Anesthesiology house officers present research at GME Symposium - University of Nebraska Medical Center

Anesthesiology

Anesthesiology resident inducted into the Alpha Omega Alpha Medical Honor Society – University of Nebraska Medical Center

Theodore (Teddy) Black, MD, a UNMC Department of Anesthesiology resident, was inducted into the Alpha Omega Alpha Medical Honor Society in April.

Founded in 1902,Alpha Omega Alpha is dedicated to the belief that in the profession of medicine, we will improve care for all by:

Members may be elected throughout their career and epitomize professionalism, leadership, academic and clinical excellence, research, community service and being worthy to serve the suffering.

Incoming resident Mariah Tessin, MD, also received an award for her senior honors thesis titled, The Role of RASP Inhibitors in Preventing MAA-Modified Proteins from Initiating Pro-inflammatory Cytokines in Macrophages.

I am incredibly grateful to have found a research environment that provides me with the opportunity to navigate the entire research process from start to finish, Dr. Tessin said. It is an honor to have my thesis recognized by AOA.

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Anesthesiology resident inducted into the Alpha Omega Alpha Medical Honor Society - University of Nebraska Medical Center

Anesthesiology

Robert Stephens MD Spotlights Anesthesiologists’ Role in Patient-Centered Care – openPR

In an extensive feature published by the San Francisco Post Dr. Robert Stephens, MD, discusses the vital role of anesthesiologists in enhancing patient-centered care within the healthcare system In an extensive feature published by the San Francisco Post Dr. Robert Stephens, MD, discusses the vital role of anesthesiologists in enhancing patient-centered care within the healthcare system. The article titled "Robert Stephens MD Spotlights Anesthesiologists' Role in Patient-Centered Care" explores the comprehensive involvement of anesthesiologists in patient care, from preoperative assessment to postoperative recovery.

Dr. Stephens, a dedicated Anesthesiologist based in Southern California, emphasizes the significant yet often overlooked contributions anesthesiologists make beyond the operating room. "Our job starts long before and goes far beyond the OR," Dr. Stephens explains. "We play a crucial role in patient assessments, where we develop individualized care plans, and continue our care through vigilant intraoperative management and postoperative recovery strategies."

The feature details how anesthesiologists like Dr. Stephens prioritize effective communication with patients to demystify surgical procedures, alleviate anxiety, and enhance patient autonomy in decision-making processes. This approach not only fosters trust but also improves overall patient outcomes.

Further highlighting the multi-faceted role of anesthesiologists, the article discusses their advocacy for patient safety and involvement in implementing best practices across healthcare settings. Dr. Stephens shares insights into the evolution of anesthesiology with innovations such as non-opioid anesthetics and precision medicine, underscoring anesthesiology's pivotal role in the future of patient-centered care.

Dr. Stephens' dedication to the field and his patients is evident as he continues to push for advancements in anesthesiology to better serve patient needs and enhance the quality of care provided. His work and commitment exemplify the critical impact anesthesiologists have on the healthcare system, ensuring that patient well-being remains at the core of medical practice.

The full article can be accessed on the *San Francisco Post* website and is an essential read for healthcare professionals and anyone interested in understanding the integral role of anesthesiology in patient-centered care.

To read the full Article, click here [https://sanfranciscopost.com/robert-stephens-md-spotlights-anesthesiologists-role/].

About Dr. Robert Stephens, MD

Dr. Robert Stephens, MD, is a distinguished Anesthesiologist with over a decade of experience in the field. His dedication to patient care, continuous learning, and contribution to the evolving field of anesthesiology mark him as a leading figure in his profession. Media Contact Company Name: Robert Stephens MD Email: Send Email [http://www.universalpressrelease.com/?pr=robert-stephens-md-spotlights-anesthesiologists-role-in-patientcentered-care] City: San Diego State: California Country: United States Website: https://www.robertstephens.net/

This release was published on openPR.

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Robert Stephens MD Spotlights Anesthesiologists' Role in Patient-Centered Care - openPR

Anesthesiology

Anesthesiologist in Glenwood Springs charged with 4 counts of unlawful sexual contact – Denver 7 Colorado News

GLENWOOD SPRINGS, Colo. An anesthesiologist in Glenwood Springs has been charged with multiple counts of unlawful sexual contact.

Mark R. Young, 54, of Glenwood Springs, was arrested on three charges of unlawful sexual contact and one charge of unlawful sexual contact of an at-risk person.

On Dec. 20, 2022, officers with the Glenwood Springs Police Department took a report about a potential sexual assault that happened at APEX Ketamine Therapy. A woman reported that after more than two years of ketamine infusion treatments with Young, "he made sexually inappropriate comments and made unlawful sexual contact after administration of her medication on her last visit," the police department said. The department added that in total, five females of unknown ages were victimized in this case.

Following an investigation, an arrest warrant was issued for Young.

Denver 7+ Colorado News Latest Headlines | April 5, 11am

He was booked into the Garfield County Jail on April 1 on the four charges.

The police department said based on a multitude of factors including the location, history and more they are working to talk with anybody else who may have been victimized. Those individuals can call the police department at 970-384-6500.

According to his most recent licensing documentation from the Colorado Department of Regulatory Agencies, he is board certified in anesthesiology. That document reads that he received disciplinary action in 2012 in Colorado and a restriction or suspension in 2023, though the details on both are unknown.

No other details were immediately available.

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Anesthesiologist in Glenwood Springs charged with 4 counts of unlawful sexual contact - Denver 7 Colorado News