Expert review of medical devices最新文献

Background: The mental health chatbot is dedicated to providing assistance to individuals grappling with the complexities of depression and anxiety.

Objective: The study aimed to evaluate the effectiveness of the mental health chatbot in alleviating symptoms of depression and anxiety among adolescents and young adults.

Methods: A systematic review framework was employed with a protocol pre-registered on Prospero (CRD42023418877). Databases were systematically searched, including PubMed, ACM Digital Library, Embase, Cochrane and IEEE. Data synthesis was conducted narratively, and meta-analysis was performed by pooling data from the original studies.

Results: Ten randomized controlled trials focused on an acute population, mainly females and university students. Chatbots designed for daily conversations and mood monitoring, using cognitive behavioral therapy techniques, showed efficacy in treating depression (95% CI = -1.09 to -0.23; p = .003). However, it is essential to highlight that these interventions utilizing chatbots for mental health were not found to be efficacious in managing symptoms of anxiety (95% CI = -0.56 to 0.4; p = .74).

Conclusions: Evidence supports the effectiveness of mental health chatbots in treating depression, but further exploration and refinement are needed to optimize their efficacy in managing anxiety.

Introduction: Traditional spine surgery is frequently impeded by a number of challenges, including the complexity of the underlying anatomy, the depth of the surgical locations, and the limited visibility. These factors can collectively result in prolonged operation times and a reduction in the precision. The advent of robot-assisted spine surgery has brought about a transformative solution, particularly in the context of screw placement. Robot-assisted spine surgery has the potential to enhance accuracy and safety while minimizing soft tissue damage.

Areas covered: This article presents a review of the current state of robot systems in spine surgery. The principal advantages of robot-assisted technology include high precision in screw placement, robust imaging capabilities, reduced surgeon fatigue, and the potential for remote operation, thereby addressing disparities in healthcare access. Clinical studies indicate that robot-assisted techniques significantly improve the accuracy of screw placement and may reduce the incidence of postoperative complications. Challenges such as cost, technology limitations, and the need for comprehensive clinical guidelines persist.

Expert opinion: It is anticipated that future advancements in surgical navigation, artificial intelligence integration and the expansion of robot functions will further enhance the efficacy of robot-assisted spine surgery, with the potential to improve patient outcomes and facilitate broader adoption in clinical practice.

Introduction: Endovascular repair for thoracoabdominal aortic aneurysms (TAAAs) has changed treatment paradigm over the past decades. However for urgent cases, there are not many options available. The E-nside (Artivion, Georgia, U.S.A.) endograft is one of the three off-the-shelf-aortic endografts available on the market. Its unique design with four inner branches and other special features offer more versatility, so more patients could be minimally invasively treated.

Areas covered: We present a descriptive review based on market analysis on the available devices and a pubmed literature research on the E-nside endograft. The aim of this article is to present its unique structure, deployment method, cannulation methods and discuss its applicability, indications, associated concerns and an overview of the available alternative devices.

Expert opinion: The implantation of the E-nside endograft is a promising technique for treating not only TAAAs but also complex abdominal aortic aneurysm. Unlike FEVAR or BEVAR, which require precise planning and have the disadvantage of long manufacturing time. We think that with the off-the-shelf feature from E-nside endograft this can be obviated, and through its flexible planning along with its simple use, more patients could benefit and so favorable results can be achieve.

Introduction: Wearables are electronic devices worn on the body to collect health data. These devices, like smartwatches and patches, use sensors to gather information on various health parameters. This review highlights the current use and the potential benefit of wearable technology in patients with inflammatory bowel disease (IBD).

Areas covered: In this review, we explore the current use of wearable technology in healthcare and the studies applying this technology in patients with IBD. We also discuss the limitations of using digital health data in general and wearable technology in particular in the current clinical paradigm and predict a path forward in how to rationally and effectively apply this technology to improve the care of patients with IBD. A comprehensive search of all suitable studies was conducted using the databases of PubMed, MEDLINE, Embase, and Scopus from inception to August 2024.

Expert opinion: Currently, wearable technology is applied to the monitoring of IBD and prediction of flares using devices and sensors. Future applications include early disease detection using biosensors, advanced data collection through ingestible devices, gut microbiome monitoring, and integration with machine learning. These advancements promise to revolutionize disease management, including IBD, by enabling early diagnosis, personalized treatment, and improved patient outcomes.

Introduction: Amblyopia, the leading cause of monocular childhood vision loss, affects millions and is projected to increase. Early detection and treatment are crucial for preventing vision impairment.

Areas covered: This commentary reviews the current state and opportunities for improvement in amblyopia screening strategy and technology focused primarily within the United States. A review of current guidelines from organizations and a literature review of innovations between 1999 and 2024 informed this commentary. Organizations recommend routine vision screening for children, starting in infancy and continuing through adolescence. However, the variations in screening devices, components, timelines, and requirements leave room for improving outcomes. An exploration of instrument-based screening which has emerged as an alternative to traditional optotype testing will be investigated, and the risks of these instruments with high sensitivity and varying specificity will be acknowledged. Finally, new approaches to directly identify amblyopia and search for innovative biomarkers that indicate amblyopia risk or amblyopia itself will be discussed.

Expert opinion: Improving the treatment of amblyopia necessitates the reimagination of current practices in connecting patients to care. Technologies that incorporate novel diagnostic approaches, like the consideration of specific biomarkers or the use of artificial intelligence, hold promise to identify cases of amblyopia rather than its risk factors.

Introduction: Since the mid-1900s, techniques in the repair of aortic arch and thoracoabdominal aortic pathologies have drastically evolved. Open aortic surgical repair was once the sole option for both simple and complex aneurysmal degeneration. Today, a number of minimally invasive and hybrid approaches are now available to assist both the surgeon and patient in tackling this challenging problem.

Areas covered: In this review, we discuss the most current techniques in the repair of these complex pathologies as well as new advances. These include aortic arch and abdominal aortic debranching with endovascular repair, branched stent graft repair, parallel grafting techniques, fenestration techniques, and a hybrid approach to the aforementioned. In addition, we discuss comparative outcomes of these techniques spanning disciplines of both cardiac and vascular surgery.

Expert opinion: The most vital part of the treatment of complex aortic aneurysms is the tailoring of the treatment plan to each patient's unique anatomic and physiologic attributes.