CHEST pulmonary最新文献

{"title":"Cardiopulmonary Exercise Testing in Patients With Long COVID","authors":"Lotte Sørensen PhD ,&nbsp;Camilla Lundgren Pedersen PT ,&nbsp;Mads Jønsson Andersen MD, PhD ,&nbsp;Johannes Martin Schmid MD, PhD ,&nbsp;Lisa Gregersen Oestergaard PhD ,&nbsp;Berit Schiøttz-Christensen MD ,&nbsp;Søren Sperling MD","doi":"10.1016/j.chpulm.2024.100036","DOIUrl":"10.1016/j.chpulm.2024.100036","url":null,"abstract":"<div><h3>Background</h3><p>After COVID-19, some patients present with ongoing symptoms (eg, breathlessness, exercise limitations), even after mild acute infection.</p></div><div><h3>Research Question</h3><p>What is the exercise capacity of patients diagnosed with long COVID and does it change from baseline to 1-year follow-up?</p></div><div><h3>Study Design and Methods</h3><p>This retrospective case series included patients with persistent symptoms after a confirmed diagnosis of COVID-19. Exercise capacity was examined by cardiopulmonary exercise testing (CPET), and parameters related to performance, ventilation, circulation, and gas exchange were compared with predicted values. A subgroup of patients was retested 1 year after baseline, and self-reported physical fitness was assessed at follow-up.</p></div><div><h3>Results</h3><p>In total, 169 patients completed baseline CPET and 41 patients completed 1-year follow-up. Mean maximum workload was 172 W (95% CI, 161-182), with 19% not achieving at least 84% predicted workload. Mean peak oxygen uptake was 24.4 mL/kg/min (95% CI, 23.1-25.7), and 36% had a value below % predicted. Oxygen uptake/workload slope below the normal threshold of 8.4 mL/min/W was observed in 54% of patients. The 1-year follow-up results showed no statistically significant changes in any of the CPET parameters, which correspond to lack of improvement in self-reported physical fitness.</p></div><div><h3>Interpretation</h3><p>Patients with long COVID demonstrated lowered peak oxygen uptake, oxygen uptake/workload slope, and/or ventilatory equivalent for carbon dioxide, but different parameters were lowered in different patients, illustrating a heterogeneous study population. No improvements in any parameters were found at 1-year follow-up.</p></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949789224000023/pdfft?md5=9e470b0313c45124451b2141b1a32449&pid=1-s2.0-S2949789224000023-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139635900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Employment of the Envisia Genomic Classifier in Conjunction With Cryobiopsy in Patients With Undiagnosed Interstitial Lung Disease","authors":"Fayez Kheir MD ,&nbsp;Ramsy Abdelghani MD ,&nbsp;Diana Espinoza MD ,&nbsp;Regina Villalobos MD ,&nbsp;David Becnel MD ,&nbsp;Rachel Herr MD ,&nbsp;Alejandro Aragaki MD ,&nbsp;J.P. Uribe Becerra MD ,&nbsp;Justin M. Oldham MD ,&nbsp;Joseph Lasky MD","doi":"10.1016/j.chpulm.2023.100034","DOIUrl":"https://doi.org/10.1016/j.chpulm.2023.100034","url":null,"abstract":"<div><h3>Background</h3><p>The Envisia Genomic Classifier (EGC) is a clinically validated molecular diagnostic test identifying usual interstitial pneumonia (UIP), increasing the diagnostic confidence for idiopathic pulmonary fibrosis in patients with interstitial lung disease (ILD).</p></div><div><h3>Research Question</h3><p>What is the association of the EGC and lung cryobiopsy on clinical management decisions in patients with fibrotic ILD?</p></div><div><h3>Study Design and Methods</h3><p>Retrospective analysis of patients at multimedical centers. We assessed the change in management strategy after EGC and cryobiopsy. We evaluated the association between genomic UIP classification and disease progression using the American Thoracic Society definition of progressive pulmonary fibrosis (method 1), or combined end point of death from any cause, lung transplant, or ≥ 10% relative decline in FVC (method 2).</p></div><div><h3>Results</h3><p>In patients that were EGC positive for UIP (gcUIP+), 78.6% were diagnosed with idiopathic pulmonary fibrosis. Cryobiopsy and EGC test results changed management strategy for 59.5% of patients in the cohort that were gcUIP+, and 21.4% of patients that had indeterminate cryobiopsy interpretations were gcUIP+, leading to a change in treatment strategy of an additional 16.7%. There was a decrease in follow-up without treatment from 64.3% to 11.9% (<em>P</em> &lt; .001). Utilization of immunosuppressive drugs decreased from 23.8% to 9.5% (<em>P</em> = .06), and there was an increase in treatment with antifibrotics drugs from 11.9% to 71.4% (<em>P</em> &lt; .001). A Kaplan-Meier curve of disease progression did not reach statistical significance on multivariable analysis (method 1: hazard ratio, 1.4; 95% CI, 0.4-4.2; <em>P</em> = .55; method 2: hazard ratio, 1.3; 95% CI, 0.8-2.1; <em>P</em> = .29). In analysis of EGC positivity for UIP, patients who were not prescribed antifibrotics showed disease progression compared with patients who were EGC negative for UIP (hazard ratio, 1.8; 95% CI, 0.99-3.4; <em>P</em> = .053)</p></div><div><h3>Interpretation</h3><p>This study suggests that combined EGC and cryobiopsy are associated with change in therapeutic strategy in patients with undiagnosed ILD. The EGC might serve as a predictor for disease progression in patients not treated with antifibrotics.</p></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S294978922300034X/pdfft?md5=3a31e647a9df7ad6aaacd911645e1704&pid=1-s2.0-S294978922300034X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140551629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thymoma as a Potential Risk Factor for Nontuberculous Mycobacterial Pulmonary Disease","authors":"Marie Yan MD, MSc ,&nbsp;Sarah K. Brode MD, MSc ,&nbsp;Theodore K. Marras MD, MSc","doi":"10.1016/j.chpulm.2023.100032","DOIUrl":"10.1016/j.chpulm.2023.100032","url":null,"abstract":"","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949789223000326/pdfft?md5=ac77814e7af987814b077d89c5ad9c25&pid=1-s2.0-S2949789223000326-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138617894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Managing Pulmonary Complications in Adults With Cerebral Palsy","authors":"Brinda Desai MD ,&nbsp;Daniel J. Lesser MD ,&nbsp;Bernie Y. Sunwoo MBBS","doi":"10.1016/j.chpulm.2023.100025","DOIUrl":"10.1016/j.chpulm.2023.100025","url":null,"abstract":"<div><p>Cerebral palsy is the most common motor disability in childhood with increasing survival rates into adulthood. Pulmonary complications are a leading cause of morbidity and mortality in this population. However, adult pulmonologists are rarely trained on how to receive these patients into their practice, including how best to identify and manage pulmonary complications. Quality studies on pulmonary complications in cerebral palsy, both in the adult and pediatric population, are lacking, but we review the available literature to provide an approach for the adult pulmonologist in identifying risk factors for pulmonary complications including aspiration, impaired airway clearance, airways disease, neuromuscular scoliosis and restrictive chest wall disease, sleep-disordered breathing, and hypoventilation. We provide a framework to help manage these pulmonary complications and plan and organize successful multidisciplinary transition of pulmonary care from adolescence to adulthood, largely extrapolating from small pediatric studies, studies on neurodevelopmental disorders in general, international guidelines, and clinical experiences, until more quality studies on this topic are available.</p></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949789223000259/pdfft?md5=1932c9aead8e0aee90fcf8ffdd5fbeb3&pid=1-s2.0-S2949789223000259-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135654719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protocol for the Veterans Affairs Cooperative Studies Program Study Number 2005","authors":"Drew Moghanaki MD, MPH ,&nbsp;Tomer Karas MD ,&nbsp;Robert D. Timmerman MD ,&nbsp;Robert B. Cameron MD ,&nbsp;Timothy A. Ritter PhD ,&nbsp;Hairong Shi PhD ,&nbsp;Matthew K. Leiner MS ,&nbsp;Hua Feng PhD ,&nbsp;Vicki L. Skinner RN, MSN ,&nbsp;Lisa Robin MA ,&nbsp;Cheryl Odle MBA ,&nbsp;Tom Sindowski BS ,&nbsp;Amanda J. Snodgrass PharmD ,&nbsp;Grant D. Huang MPH, PhD ,&nbsp;Domenic J. Reda PhD ,&nbsp;David H. Harpole MD ,&nbsp;Veterans Affairs Lung Cancer Surgery or Stereotactic Radiotherapy Study Team","doi":"10.1016/j.chpulm.2023.100024","DOIUrl":"10.1016/j.chpulm.2023.100024","url":null,"abstract":"<div><h3>Background</h3><p>Standard-of-care treatment options for stage I non-small cell lung cancer (NSCLC) include surgery and stereotactic body radiation therapy (SBRT). Notwithstanding a lack of prospective evidence demonstrating superior long-term survival with either of these treatments, evidence-based guidelines currently recommend only surgery for patients with operable disease and to limit SBRT for patients with inoperable disease.</p></div><div><h3>Research Question</h3><p>Do surgery or SBRT lead to superior survival rates for operable stage I NSCLC?</p></div><div><h3>Study Design and Methods</h3><p>A phase 3 randomized clinical trial was designed to compare the overall survival (OS) rates after surgery or SBRT for stage I NSCLC. Eligible participants must have biopsy-confirmed NSCLC measuring ≤ 5 cm in maximum diameter located &gt; 1 cm from the trachea, proximal bronchial tree, esophagus, and spinal cord. Participants must be staged with fluorodeoxyglucose PET scans with mandatory biopsies of all radiographic areas concerning for regional or distant metastatic disease. The planned accrual is 670 patients to detect a 10% absolute benefit in 5-year OS with surgery or SBRT. Secondary outcome measures include patient-reported quality of life, respiratory function, health state utilities, patterns of lung cancer relapse, and causes of mortality by independent adjudication.</p></div><div><h3>Results</h3><p>The study was initiated in April 2017 with a planned ramp-up phase at six Veterans Affairs medical centers. Adapted recruitment interventions contributed to overcoming historical barriers to randomizing eligible participants between surgery and SBRT, and the study was expanded to 16 sites in May 2019. As of July 5, 2023, 280 of 670 planned participants have been enrolled.</p></div><div><h3>Interpretation</h3><p>The final results are expected to clarify the role of SBRT in lieu of surgery for patients with operable stage I NSCLC and to facilitate more informed discussions about these treatment options.</p></div><div><h3>Trial Registry</h3><p>ClinicalTrials.gov; No.: NCT02984761; URL: <span>www.clinicaltrials.gov</span><svg><path></path></svg></p></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949789223000247/pdfft?md5=c61f19856ae17cebb90a23eea4287320&pid=1-s2.0-S2949789223000247-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134936296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multilevel Risk Factors for Sleep-Disordered Breathing-Related Symptom Burden in an Urban Pediatric Community-Based Sample","authors":"Seyni Gueye-Ndiaye MD ,&nbsp;Marissa Hauptman MD, MPH ,&nbsp;Xinting Yu MD, PhD ,&nbsp;Le Li MS ,&nbsp;Michael Rueschman MPH ,&nbsp;Cecilia Castro-Diehl DrPH ,&nbsp;Tamar Sofer PhD ,&nbsp;Judith Owens MD, MPH ,&nbsp;Diane R. Gold MD, MPH ,&nbsp;Gary Adamkiewicz PhD, MPH ,&nbsp;Nervana Metwali PhD ,&nbsp;Peter S. Thorne PhD ,&nbsp;Wanda Phipatanakul MD ,&nbsp;Susan Redline MD, MPH","doi":"10.1016/j.chpulm.2023.100019","DOIUrl":"10.1016/j.chpulm.2023.100019","url":null,"abstract":"<div><h3>Background</h3><p>Pediatric sleep-disordered breathing (SDB) disproportionately affects children with low socioeconomic status (SES). The multilevel risk factors that drive these associations are not well understood.</p></div><div><h3>Research Question</h3><p>What are the associations between SDB risk factors, including individual health conditions (obesity, asthma, and allergies), household SES (maternal education), indoor exposures (environmental tobacco smoke [ETS] and pests), and neighborhood characteristics (neighborhood disadvantage), and pediatric SDB symptoms?</p></div><div><h3>Study Design and Methods</h3><p>Cross-sectional analyses were performed on 303 children (aged 6-12 years) enrolled in the Environmental Assessment of Sleep Youth study from 2018 to 2022. Exposures were determined by caregiver reports, assays of measured settled dust from the child’s bedroom, and neighborhood-level Census data (deriving the Childhood Opportunity Index to characterize neighborhood disadvantage). The primary outcome was the SDB-related symptom burden assessed by the OSA-18 questionnaire total score. Using linear regression models, we calculated associations between exposures and SDB-related symptom burden, adjusting for sociodemographic factors, then health conditions, indoor environment, and neighborhood factors.</p></div><div><h3>Results</h3><p>The sample included 303 children (39% Hispanic, Latino, Latina, or Spanish origin; 30% Black or African American; 22% White; and 11% other). Increasing OSA-18 total scores were associated with low household SES after adjustment for demographic factors, and with asthma, allergies, ETS, pests (mouse, cockroach, and rodents), and an indoor environmental index (sum of the presence of pests and ETS; 0-2) after adjusting for sociodemographic factors. Even after further adjusting for asthma, allergies, and neighborhood disadvantage, ETS and pest exposure were associated with OSA-18 (ETS: β = 12.80; 95% CI, 7.07-18.53, also adjusted for pest; pest exposure: β = 3.69; 95% CI, 0.44-6.94, also adjusted for ETS).</p></div><div><h3>Interpretation</h3><p>In addition to associations with ETS, a novel association was observed for indoor pest exposure and SDB symptom burden. Strategies to reduce household exposure to ETS and indoor allergens should be tested as approaches for reducing sleep health disparities.</p></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949789223000193/pdfft?md5=91aa07089927f75d999f540745cff438&pid=1-s2.0-S2949789223000193-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135249489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short of Breath and Teary-Eyed","authors":"Bilal Al Kalaji MD,&nbsp;Saad Khan MD,&nbsp;Abdelraouf Salah MD,&nbsp;Ahmad Harb MD,&nbsp;Grace Ying DO,&nbsp;Alok Patel MD","doi":"10.1016/j.chpulm.2023.100015","DOIUrl":"10.1016/j.chpulm.2023.100015","url":null,"abstract":"<div><h3>Case Presentation</h3><p>A 78-year-old man is admitted to the ICU for acute respiratory distress requiring endotracheal intubation. The patient was in his usual state of health and had seen his primary care physician earlier that day for a routine visit and influenza immunization. Later in the evening, the patient developed acutely worsening shortness of breath. He had no fever or chills, worsening cough, purulent sputum, wheezing, stridor, chest pain, palpitation, or known sick contacts. Family members noted that his face looked puffy, but he did not have lip or tongue swelling, difficulty swallowing, odynophagia, or a new rash. On ambulance arrival, the patient was noted to have significant respiratory distress. He was subsequently intubated at the scene and transferred to the hospital for further evaluation and management. The patient was known to have paroxysmal atrial fibrillation and COPD requiring 2 to 4 L of oxygen via nasal cannula at baseline. Social history was notable for prior use of tobacco. Family history was negative for allergies, pulmonary disease, and malignancy. The patient was last hospitalized for COPD exacerbation &gt; 1 year prior to this admission. Otherwise, he remained adequately adherent to his COPD treatment.</p></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949789223000156/pdfft?md5=57d56e2d786eeccc3e16c1de148eea11&pid=1-s2.0-S2949789223000156-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135255414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulmonary Manifestations of Inflammatory Bowel Disease and Treatment Strategies","authors":"Subha Ghosh MD, MBA ,&nbsp;Himanshu Deshwal MD ,&nbsp;Rebecca Haraf MD ,&nbsp;Shine Raju MD ,&nbsp;Mnahi Bin Saeedan MBBS, MPH ,&nbsp;Pralay Sarkar MD, FCCP ,&nbsp;Thomas Gildea MD ,&nbsp;Carol F. Farver MD ,&nbsp;Atul C. Mehta MD, FCCP","doi":"10.1016/j.chpulm.2023.100018","DOIUrl":"10.1016/j.chpulm.2023.100018","url":null,"abstract":"<div><h3>Topic Importance</h3><p>Ulcerative colitis and Crohn’s disease are multisystem illnesses that primarily affect the gut, but present with various extraintestinal manifestations. The pathogenesis behind these clinical features is poorly understood, and pulmonary manifestations of inflammatory bowel disease (IBD) are no exception. Research has suggested an intricate interplay between the mucosal immune system and the microbiotic environment between the gut and the lung, often termed the <em>gut-lung axis</em>. This dysregulated communication is demonstrated in a wide range of pulmonary complications involving the large and small airways, lung parenchyma, serosal tissues, and pulmonary vasculature; fistulous connection between the gastrointestinal tract and thoracic cavity; and drug toxicities. Most of these diseases have been well documented in case reports to respond to corticosteroid treatment regimens. However, a notable lack of treatment recommendations guiding the dosage and duration of steroid use and managing the disease refractory to therapy are available. In addition, the progressive and debilitating disease often remains a therapeutic challenge.</p></div><div><h3>Review Findings</h3><p>This review sheds light on the different strategies documented to treat the spectrum of pulmonary complications of IBD, including novel therapeutic approaches using immunomodulatory therapy, and summarizes their clinical and radiologic features with pathologic correlation.</p></div><div><h3>Summary</h3><p>Although their existence is well documented, further research is needed to develop evidence-based guidelines for diagnosing, managing, and preventing pulmonary complications of IBD.</p></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949789223000181/pdfft?md5=08e6072816e229b0f88a7156fcc4b9e9&pid=1-s2.0-S2949789223000181-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135248531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acquisition of Cardiac Point-of-Care Ultrasound Images With Deep Learning","authors":"Evan Baum MD ,&nbsp;Megha D. Tandel MPH ,&nbsp;Casey Ren MD ,&nbsp;Yingjie Weng MS ,&nbsp;Matthew Pascucci MD ,&nbsp;John Kugler MD ,&nbsp;Kathryn Cardoza MD ,&nbsp;Andre Kumar MD, MEd","doi":"10.1016/j.chpulm.2023.100023","DOIUrl":"10.1016/j.chpulm.2023.100023","url":null,"abstract":"<div><h3>Background</h3><p>Point-of-care ultrasonography (POCUS) machines may use deep learning, a subfield of artificial intelligence (AI), to improve image interpretation and acquisition in real time. The impact of AI on POCUS learning is unknown.</p></div><div><h3>Research Question</h3><p>Do AI-enhanced devices equipped with deep learning aid in cardiac image acquisition and interpretation among POCUS novices?</p></div><div><h3>Study Design and Methods</h3><p>We conducted a single-center investigation from 2021 through 2022. Internal medicine trainees (N = 43) with limited POCUS experience were randomized to receive a POCUS device with (Echonous; n = 22) or without (Butterfly; n = 21) AI functionality for 2 weeks while on inpatient rotations. AI device functionality included guidance for optimal probe placement to acquire an apical four-chamber (A4C) view and ejection fraction estimations based on deep learning. Participants used the devices at their discretion for patient-related care after randomization. The primary outcome was the time to acquire A4C images on a standardized patient. Secondary outcomes included A4C image quality using a validated scale, image quiz performance, and attitudes. Measurements were performed at randomization and at 2-week follow-up using the same standardized patient.</p></div><div><h3>Results</h3><p>Both AI and non-AI groups showed similar scan times and image quality scores at baseline. At follow-up, the AI group showed faster scan times (57 s [interquartile range (IQR), 32-75 s] vs 85 s [IQR, 50-172 s]; <em>P</em> = .01), higher image quality scores (4.5 [IQR, 2-5.5] vs 2 [IQR, 1-3]; <em>P</em> &lt; .01), and more accurately identified reduced systolic function on the image quiz (85% vs 50%; <em>P</em> = .02) vs the non-AI group. The AI group used the devices more than the non-AI group (median, 5.5 times [IQR, 4-10 times] vs 2 times [IQR, 0-4 times]; <em>P</em> &lt; .01). Trust in the AI features did not change during the intervention.</p></div><div><h3>Interpretation</h3><p>POCUS devices with deep learning functionality may improve A4C image acquisition and interpretation by novices. Future studies are needed to determine the extent that AI impacts POCUS learning.</p></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949789223000235/pdfft?md5=f2f40d80c3cfa78dc9225371899bac67&pid=1-s2.0-S2949789223000235-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135434384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hurdles to Annual Low-Dose Chest CT Scan Adherence for Lung Cancer Screening Parallel Those to Initial Low-Dose Chest CT Scan Uptake","authors":"Alireza Nathani MD,&nbsp;Abbie Begnaud MD","doi":"10.1016/j.chpulm.2023.100027","DOIUrl":"10.1016/j.chpulm.2023.100027","url":null,"abstract":"","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949789223000272/pdfft?md5=14764fc267f76895870a3820b737157b&pid=1-s2.0-S2949789223000272-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135509813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}