Author: Jason Curtis

Educating for Accuracy: Improving ENT Abbreviation Recognition (2025)

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Type of publication:

Service improvement case study

Author(s):

*Dr. Saarah Talha; *Dr. Karola Meunier; *Dr. Ayesha Khan; *Dr. Emma Richards; *Mr. Salil Sood

Citation:

SaTH Improvement Hub, July 2025

Aims:

To evaluate the understanding of commonly used clinical abbreviations among the multi-disciplinary
team. To assess the effectiveness of a structured educational intervention in improving abbreviation recognition and overall communication within the clinical team.

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Heparin-Induced Thrombocytopenia Following Tinzaparin Administration: A Case Report (2025)

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Type of publication:

Journal article

Author(s):

*Khallaf, Laila; *Katarki, Praveenkumar; *Ahmad, Nawaid; *Govindagowda, Thimmegowda.

Citation:

Cureus. 17(9):e93248, 2025 Sep.

Abstract:

Heparin-induced thrombocytopenia (HIT), a severe immune-mediated reaction, presents a significant diagnostic challenge, particularly with atypical symptoms like syncope or when induced by low-molecular-weight heparin (LMWH). This report describes the case of a 77-year-old male who developed severe thrombocytopenia following tinzaparin administration for bridging therapy after an elective endovascular aneurysm repair (EVAR). The patient presented to the emergency department with syncope, an uncommon manifestation of HIT. Initial investigations revealed isolated thrombocytopenia, and a high clinical suspicion based on a 4Ts score of 6 prompted the immediate discontinuation of tinzaparin and initiation of fondaparinux. The diagnosis was subsequently confirmed by a positive HIT antibody screening test. The patient's platelet counts improved in a few days, and he was successfully transitioned to warfarin without complications. This case highlights the critical importance of maintaining a high index of suspicion for HIT in any patient exposed to Heparin products, including LMWH, who develops thrombocytopenia, even when the clinical presentation is atypical. Early recognition and prompt management with alternative anticoagulants are essential to prevent life-threatening thromboembolic complications.

DOI: 10.7759/cureus.93248

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Comparative Diagnostic Accuracy of Clinical Assessment, Computed Tomography (CT), and Magnetic Resonance Imaging With Magnetic Resonance Cholangiopancreatography (MRI/MRCP) in Evaluating Common Bile Duct Stones (2025)

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Type of publication:

Journal article

Author(s):

*Al-Dulaimi, Mina; *Ibraheem, Mustafa; *Abdulkareem, Mustafa; Al-Dujaili, Aaisha; Abdulkareem, Ameer.

Citation:

Cureus. 17(10):e94572, 2025 Oct.

Abstract:

PURPOSE: To determine the most effective method for diagnosing common bile duct (CBD) stones, this research retrospectively compares the diagnostic accuracy of initial clinical evaluation, computed tomography (CT), and magnetic resonance imaging with magnetic resonance cholangiopancreatography (MRI/MRCP). The goal is to identify the optimal non-invasive strategy to guide patient management and prevent unnecessary invasive procedures such as endoscopic retrograde cholangiopancreatography (ERCP). An accurate diagnosis of choledocholithiasis is essential for proper patient care.

MATERIALS AND METHODS: This single-center, retrospective analysis involved 691 adult patients who were under evaluation for suspected choledocholithiasis. The effectiveness of clinical assessment, multidetector CT, and MRI/MRCP was measured against definitive diagnoses obtained from surgical or procedural findings. For each diagnostic method, the study calculated sensitivity, specificity, accuracy, and the area under the receiver operating characteristic curve (AUC).

RESULTS: CBD stones were present in 311 of the 691 patients, a prevalence of 45%. MRI/MRCP was the most effective diagnostic tool, with a sensitivity of 92.7%, a specificity of 91.9%, and an accuracy of 92.3%. In comparison, CT scans yielded a sensitivity of 73.2%, a specificity of 82.9%, and an accuracy of 78.3%. Clinical assessment resulted in a sensitivity of 71.1%, a specificity of 87.1%, and an accuracy of 80%. The AUC for MRI/MRCP (0.95) was markedly higher than that for both CT (0.83; p<0.001) and clinical assessment (0.81; p<0.001). There was no significant difference in the diagnostic performance between CT and clinical assessment (p=0.45).

CONCLUSION: For the non-invasive identification of CBD stones, MRI/MRCP provides superior diagnostic accuracy compared to both CT and clinical evaluation. It is recommended as the top imaging choice for patients with suspected choledocholithiasis.

DOI: 10.7759/cureus.94572

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Accuracy and Timeliness of Prehospital Global Triage System Protocols in Mass Disasters (2025)

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Type of publication:

Journal article

Author(s):

Shaltout, Amr Essam; Elfatih Elbadri, Mohammed; Kaur, Kiranjot; Alsharif, Mohammed M; Alkhazendar, Aliaa H; *Hassouba, Omar Nasr; Ahmad, Muhammad Nabeel; Osman, Mazin; Zahid, Areeba; Banjamin, Shaun.

Citation:

Cureus. 17(9):e92796, 2025 Sep.

Abstract:

This systematic review evaluated the accuracy and timeliness of global prehospital triage systems in mass disasters, following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020
guidelines. A comprehensive search of PubMed/MEDLINE, Embase, Scopus, and Cochrane Library up to June 2025 identified 344 records, of which four studies met eligibility criteria after screening and full-text assessment. Included studies analyzed conventional systems such as Simple Triage and Rapid Treatment (START), JumpSTART, Sort, Assess, Lifesaving Interventions, Treatment/Transport (SALT), and Modified Physiological Triage Tool (MPTT), as well as artificial intelligence (AI)-assisted approaches and diagnostic adjuncts like portable ultrasound. Sample sizes ranged from targeted reviews of 30-60 studies (systematic and evidence-based reviews) to practical evaluations of triage innovations involving prehospital and emergency responders. Data extraction captured accuracy, timeliness, and resource allocation, while risk of bias was assessed using the A Measurement Tool to Assess Systematic Reviews version 2 (AMSTAR-2) and the Scale for the Assessment of Narrative Review Articles (SANRA), with ratings ranging from low to moderate. Results demonstrated that traditional systems such as START and SALT provide rapid categorization but remain prone to over- and under-triage depending on responder training and situational factors. AI-driven models and portable diagnostic technologies significantly improved decision speed, diagnostic precision, and prioritization of life-saving interventions, reducing delays in critical care. Overall, while no single algorithm proved universally superior, integration of training, simulation-based preparedness, and emerging AI-supported tools was consistently associated with improved triage performance in chaotic, resource-limited disaster environments.

DOI: 10.7759/cureus.92796

Link to full-text [open access - no password required]

Introducing a falls trolley to ward 28 (2025)

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Type of publication:

Service improvement case study

Author(s):

*Karen Forrest; *Debbie Pearce

Citation:

SaTH Improvement Hub, June 2025

SMART Aim:

To reduce the number of falls on ward 28 by 10% by the end of April 2025. Ward 28 aimed to increase their compliance with neurological observations to 100% by April 2025.

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    Personalised Care on the Head and Neck Pathway (2025)

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    Type of publication:

    Service improvement case study

    Author(s):

    *Jennifer Hall

    Citation:

    SaTH Improvement Hub, June 2025

    SMART Aim:

    To increase and standardise the offer and completion of Heath Needs assessments (HNAs) and end of treatment summaries to ensure consistent and high-quality personalised care for all patients on the head and neck pathway. Data will be reviewed by 31st December 2024.

    Link to PDF poster

    Investigating how to increase the Potential of Homegrown Research Projects at SaTH (2025)

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    Type of publication:

    Service improvement case study

    Author(s):

    *Jo Sawyer

    Citation:

    SaTH Improvement Hub, June 2025

    SMART Aim:

    Increase the amount of homegrown research projects applying for the £10K R&I charity funding pot by December 2024, as evidenced by 10 projects being submitted and funding being allocated by Jan 2025.

    Link to PDF poster