Barriers and facilitators of artificial intelligence conception and implementation for breast imaging diagnosis in clinical practice: a scoping review.

OBJECTIVE: Although artificial intelligence (AI) has demonstrated promise in enhancing breast cancer diagnosis, the implementation of AI algorithms in clinical practice encounters various barriers. This scoping review aims to identify these barriers and facilitators to highlight key considerations for developing and implementing AI solutions in breast cancer imaging. METHOD: A literature search was conducted from 2012 to 2022 in six databases (PubMed, Web of Science, CINHAL, Embase, IEEE, and ArXiv). The articles were included if some barriers and/or facilitators in the conception or implementation of AI in breast clinical imaging were described. We excluded research only focusing on performance, or with data not acquired in a clinical radiology setup and not involving real patients. RESULTS: A total of 107 articles were included. We identified six major barriers related to data (B1), black box and trust (B2), algorithms and conception (B3), evaluation and validation (B4), legal, ethical, and economic issues (B5), and education (B6), and five major facilitators covering data (F1), clinical impact (F2), algorithms and conception (F3), evaluation and validation (F4), and education (F5). CONCLUSION: This scoping review highlighted the need to carefully design, deploy, and evaluate AI solutions in clinical practice, involving all stakeholders to yield improvement in healthcare. CLINICAL RELEVANCE STATEMENT: The identification of barriers and facilitators with suggested solutions can guide and inform future research, and stakeholders to improve the design and implementation of AI for breast cancer detection in clinical practice. KEY POINTS: • Six major identified barriers were related to data; black-box and trust; algorithms and conception; evaluation and validation; legal, ethical, and economic issues; and education. • Five major identified facilitators were related to data, clinical impact, algorithms and conception, evaluation and validation, and education. • Coordinated implication of all stakeholders is required to improve breast cancer diagnosis with AI.

Prevalence and incidence of venous leg ulcers-A systematic review and meta-analysis.

Venous leg ulcers (VLU) represent a major public health challenge. Little is known about the prevalence and incidence of VLU internationally. Published studies are usually reporting different estimates because of disparities in study designs and measurement methods. Therefore, we conducted a systematic literature review and meta-analysis to identify the prevalence and incidence of VLU internationally and to characterise the population as reported in these studies. Studies were identified from searches in Medline (PubMed), CINAHL Complete (EBSCOhost), Embase, Scopus, Web of Science, LiSSa (Littérature Scientifique en Santé), Google Scholar and Cochrane Database of Systematic Reviews up to November 2022. Studies were included if their primary outcomes were reported as a period prevalence or point prevalence or cumulative incidence or incidence VLU rate. Fourteen studies met the inclusion criteria, 10 reporting estimates of prevalence, three reporting both prevalence and incidence estimates and one incidence. All were included in meta-analyses. The results show a pooled prevalence of 0.32% and a pooled incidence of 0.17%. Our results highlighted an extreme heterogeneity across effect sizes for both prevalence and incidence, which prevent a meaningful interpretation of pooled indexes and argue for further studies with specific prevalence-type reported and target population under study.

Effectiveness of high vs lower enteral protein intake, considering energy intake, on clinical outcomes in critically ill children: a systematic review protocol.

OBJECTIVE: The objective of this review is to evaluate the effectiveness of high vs lower enteral protein intake, considering energy intake, on clinical and nutritional outcomes in critically ill children hospitalized in the pediatric intensive care unit. INTRODUCTION: Over- and undernutrition increases the risk of morbidity and mortality in critically ill children. The impact of high vs lower enteral protein intake on clinical outcomes, considering energy intake, still needs to be investigated in children of different ages. INCLUSION CRITERIA: This review will consider studies of critically ill children (aged between ≥ 37 weeks gestational age and < 18 years) admitted to the pediatric intensive care unit for a minimum of 48 hours and receiving enteral nutrition. Randomized controlled trials comparing high vs lower enteral protein intake, considering energy intake, will be eligible. Primary outcomes will include clinical and nutritional outcomes, such as length of stay in the pediatric intensive care unit and nitrogen balance. METHODS: Using the JBI methodology for systematic reviews of effectiveness, we will search for randomized controlled trials published in English, French, Italian, Spanish, and German in electronic databases, including MEDLINE, CINAHL Complete, Embase, and the Cochrane Library, from database inception until the present. We will also search clinical trial registers and, if required, contact authors. Two independent reviewers will screen and select studies for inclusion, data extraction, and assessment of methodological quality. A third reviewer will be consulted if necessary. A statistical meta-analysis will be performed if feasible. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42022315325.

Nurse-led patient education for persons suffering from a venous leg ulcer in outpatient's clinics and homecare settings: A scoping review.

AIM OF THIS STUDY: To provide an overview of the available nurse-led individualized educational interventions, for persons with Venous Leg Ulcer (VLUs) in an outpatient or homecare settings. MATERIALS AND METHODS: For this scoping review, a search was performed between December 2019 and January 2020. To identify sources of evidence a systematic search was conducted in PubMed, CINAHL, Embase, PsychINFO, Web of Science and LiSSa as well as in clinical trial registers to identify sources of evidence. All types of evidence associated with a nurse led-intervention were included. RESULTS: Fifteen sources of evidence met the inclusion criteria. Educational sessions varied in modality, content and duration. Education sessions were face to face and supported by written materiel. The content focused on compression therapy and exercises. The duration and numbers of sessions varied. The most reported health related outcomes was wound healing. CONCLUSION: This scoping review provides a broad overview of the available evidence and ongoing research for individualized nurse-led education persons with VLUs. Variability in the literature was found, which suggests that more intervention studies are needed to test and evaluate efficacy of nurse-led patient education.