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A Visual Decision Support Tool for Appendectomy Care

  • Systems-Level Quality Improvement
  • Published:
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Abstract

Appendectomy is the most common abdominal surgical procedure performed in children in the United States. In order to assist care providers in creating treatment plans for the postoperative management of pediatric appendicitis, we have developed a predictive statistical model of outcomes on which we have built a prototype decision aid application. The model, trained on 3724 anonymized care records and evaluated on a separate set of 2205 cases from a tertiary care center, achieves 97.0% specificity, 25.1% true sensitivity, and 58.8% precision. We have also built an interactive decision support tool augmented with simple visualization techniques designed for clinicians to use in the course of making care decisions (e.g., discharge) and in patient/stakeholder communication. Its focus is on end-user ease of use and integration into existing clinician workflows, and is designed to evolve its predictions as more and better data become available.

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Acknowledgements

This work was conducted under Georgia Tech Institutional Review Board (IRB) Protocol H15340 and Emory IRB Protocol 00077519 and supported by the joint Georgia Tech/Children’s Healthcare of Atlanta Quick Wins grant program.

Funding

This study was funded by a grant from the Emory+Children’s Healthcare of Atlanta Pediatric Research Alliance to Mehul Raval.

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Authors and Affiliations

  1. Electro-Optical Systems Lab, Georgia Tech Research Institute, 925 Dalney St., Atlanta, GA, 30332-0834, USA

    Edward Clarkson & Jason Zutty

  2. Division of Pediatric Surgery, Department of Surgery, Emory University School of Medicine and Children’s Healthcare of Atlanta, Atlanta, GA, 30322, USA

    Mehul V. Raval

Authors
  1. Edward Clarkson
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  2. Jason Zutty
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  3. Mehul V. Raval
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Corresponding author

Correspondence to Edward Clarkson.

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Conflict of Interest

Edward Clarkson and Jason Zutty have received research support from the United States Centers of Disease Control and Department of Defense in addition to the Emory+Children’s Healthcare of Atlanta Pediatric Research Alliance. Mehul Raval has research support from the Emory+Children’s Healthcare of Atlanta Pediatric Research Alliance, the Emory University Department of Surgery, and the Agency for Healthcare Research and Quality.

Ethical Approval

This article does not contain any studies with animals performed by any of the authors. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The data analysis was conducted according to and approved by Emory IRB protocol #00077519 and Georgia Tech IRB H15340. For this type of study formal consent is not required.

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This article is part of the Topical Collection on Systems-Level Quality Improvement

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Clarkson, E., Zutty, J. & Raval, M.V. A Visual Decision Support Tool for Appendectomy Care. J Med Syst 42, 52 (2018). https://doi.org/10.1007/s10916-018-0906-9

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  • DOI: https://doi.org/10.1007/s10916-018-0906-9

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