The US Medical Licensing Examination (USMLE) and Orthopaedic In-Training (OITE) are commonly used to select medical students or residents, respectively. Knowing how well these examinations predict performance on the American Board of Surgery (ABOS) Part I certifying examination is important provide evaluations for residents. Previous studies comparing OITE scores with ABOS 1 have been limited one program.Therefore, we compared USMLE Step those using data from four ACGME approved residency...

Hospital occupancy, nurse staffing levels, weekend admission, and seasonal influenza have all been shown to be associated with in-hospital mortality. Yet, no study has simultaneously compared the strength of associations these 4 factors mortality.To compare risk mortality conferred by high hospital occupancy on increased influenza.Retrospective cohort 166,920 patients admitted 39 Michigan hospitals between 2003 2006. Participants were adults, age > or = 65 years, through emergency department...

Background: Surgical quality improvement has received increasing attention in recent years, but it is not clear where orthopaedic surgeons should focus their efforts for the greatest impact on perioperative safety and quality. We sought to guide these by prioritizing procedures according those that generate number of adverse events. Methods: used data from American College Surgeons National Quality Improvement Program (ACS NSQIP) identify all patients who had undergone an surgical procedure...

Increasing obesity within the general population has been accompanied by rising rates of diabetes. The extent to which increased among people with diabetes is unknown, as are potential consequences for outcomes.Community medical records (hospital and ambulatory) all Rochester, Minnesota, residents aged > or =30 years who first met standardized research criteria from 1970 1989 (n = 1,306) were reviewed obtain data on BMI related characteristics identification date (+/-3 months). Vital status...

To evaluate femoral radius of curvature in a large sample computed tomography scans to definitively determine the relationship between and length, age, gender, ethnicity, body mass index cortical thickness.A retrospective review was conducted electronic medical records advanced imaging 1961 patients who underwent pulmonary embolism protocol December 1999 March 2010. The were imported from clinical picture archiving communication system archive into research image analysis system. Each scan...

Introduction: Clinicians use imaging studies to help gauge the degree which structural factors within knee account for patients' pain and symptoms. We aimed determine commonly used features predict a patient's Methods: Using Osteoarthritis Initiative data, 10-year study of 4,796 patients with osteoarthritis (KOA), participants' KOA was characterized by radiographs MRI scans knee. Salient were quantified two established grading systems: (1) individual radiographic (IRFs) (2) Knee Scores...

Background: Artificial intelligence (AI) technologies have recently exploded in both accessibility and applicability, including health care. Although studies demonstrated its ability to adequately answer simple patient issues or multiple-choice questions, capacity for deeper complex decision making within care is relatively untested. In this study, we aimed delve into AI's integrate multiple clinical data sources produce a reasonable assessment plan, specifically the setting of an...

Background: Comparing outcomes across providers requires risk-adjustment models that account for differences in case mix. The burden of data collection from the clinical record can make risk-adjusted difficult to measure. purpose this study was develop hip fracture repair (HFR), total arthroplasty (THA), and knee (TKA) weigh adequacy risk adjustment against data-collection burden. Methods: We used American College Surgeons National Surgical Quality Improvement Program create derivation...

Patients requiring bilateral total knee arthroplasties may have both joints replaced simultaneously during one hospitalization (one-stage) or two separate hospitalizations (two-stage). The goals of the current study were to retrospectively analyze discharge patterns for 91 patients who had one-stage and 32 two-stage surgeries, quantify their inhospital costs if discharged from hospital an inpatient unit. having surgery similar in age, gender, severity illness (as measured by American Society...

Clinical outcomes of autograft and allograft anterior cruciate ligament (ACL) reconstructions are mixed, with some reports excellent to good other early graft failure or significant donor site morbidity.To determine if there is a difference in functional outcomes, rates, stability between ACL reconstructions.Medline, Cochrane Central Register Controlled Trials (Evidence Based Medicine Reviews Collection), Database Systematic Reviews, Web Science, CINAHL, SPORTDiscus were searched for...

The ankle medial clear space (MCS) is frequently measured to evaluate stability after an injury. However, controversy exists regarding a threshold size that distinguishes normal MCS from abnormal MCS. A retrospective radiographic review of mortise radiographs in the uninjured was performed, with goal defining relationship among patient height, sex, and Forty-nine patients information on height available electronic medical chart were identified for inclusion. For men, mean±standard deviation...

In the not-so-distant future, orthopaedic surgeons will be exposed to machines that begin automatically "read" medical imaging studies using a technology called deep learning.Deep learning has demonstrated remarkable progress in analysis of across range modalities are commonly used orthopaedics, including radiographs, computed tomographic scans, and magnetic resonance scans.There is growing body evidence showing clinical utility for musculoskeletal radiography, as evidenced by use achieve an...

The value of the Internet to deliver preoperative education would increase if there was variability in questions patients want answered. This study's goal have consulting an orthopedic surgeon about undergoing either a total hip arthroplasty (THA) or knee (TKA) rate importance different concerning their care. We assembled might joint replacement surgery by analyzing literature and querying pilot group surgeons. Twenty-nine considering THA 19 TKR completed written survey asking them 30...

There is increasing recognition that lower nurse staffing levels are associated with higher morbidity and mortality among medical surgical patients. The degree to which this applies elderly patients hip fractures unclear.We conducted a pilot study using administrative data as an initial step in investigating the relationship between in-hospital fractures.We retrospectively reviewed for 13,343 65 years or older primary diagnosis of fracture admitted 39 Michigan hospitals 2003 2006. We used...

Polymer optics are widely used in various applications, replacing traditional glass lenses. The ability to create free-form and micro-structured optics, as well fast replication, gives them major advantages over However, the fabrication of complex optical components requires full process control understanding influencing factors on quality polymer parts. In this work, a curved diffractive element (DOE) is fabricated using injection compression molding. Different gate designs were evaluated...

The production of injection-molding prototypes, e.g., molded interconnect devices (MID) can be costly and time-consuming due to the process-specific inability replace durable steel tooling with quicker fabricated aluminum tooling. Instead, additively manufactured soft is a solution for small quantities but producing complex parts with, undercuts, avoided necessity additional components. integration automated slides into has not yet been investigated poses challenge design endurance presented...

As digital radiography becomes more prevalent, several systems for preoperative planning have become available. The purpose of this study was to evaluate the accuracy and efficiency an inexpensive, cloud-based templating system, which is comparable with acetate templating. However, substantially faster convenient than or locally installed software. Although a practical solution particular medical application, regulatory changes are necessary before tremendous advantages storage computing can...

William Osler, a founding father of modern medicine, emphasized the importance good patient history by saying, “Listen to your patient, he's telling you diagnosis.” This adage is as true today it was in Dr. Osler's day, but with an interesting distinction: Our ability listen patients has never been greater than today. The data and information we are familiar undergoing revolutionary transformation that will fundamentally change way interact understand our world. One phrase increasingly used...

Despite growing interest in quality improvement, there remains uncertainty about which procedures offer the most room for improvement vascular surgery. To inform ongoing initiatives, this study assessed relative contribution of different to overall morbidity, mortality, and excess length stay surgery.Using data from ACS-NSQIP, all patients undergoing a surgery operation 2005 2006 (N = 16 096) were identified. Patients placed 29 distinct procedure categories based on CPT codes. First, we...