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- W4316095969 abstract "Difficult and traumatic neuraxial blocks and procedures are not uncommon. Although score-based prediction has been attempted, the practical application of those has remained limited for various reasons. The aim of this study was to develop a clinical scoring system from the strong predictors of failed spinal-arachnoid puncture procedures assessed previously using artificial neural network (ANN) analysis and analyze the score's performance on the index cohort.The present study is based on the ANN model analyzing 300 spinal-arachnoid punctures (index cohort) performed in an academic institute in India. For the development of the score, i.e., Difficult Spinal-Arachnoid Puncture (DSP) Score, the coefficient estimates of the input variables, which showed a Pr(>|z|) value of <0.01, were considered. The resultant DSP Score was then applied to the index cohort for receiver operating characteristic (ROC) analysis, Youden's J point determination for best sensitivity and specificity, and diagnostic statistical analysis for the cut-off value for predicting the difficulty.A DSP Score incorporating spine grades, performers' experience, and positioning difficulty was developed; the minimum and maximum scores were 0 and 7, respectively. The area under the ROC curve for the DSP Score was 0.858 (95% confidence interval 0.811-0.905), Youden's J point for cut-off was at 2, which showed a specificity and sensitivity of 98.15% and 56.5%, respectively.The ANN model-based DSP Score developed for predicting the difficult spinal-arachnoid puncture procedure showed an excellent area under the ROC curve. At the cut-off value 2, the score had a sensitivity plus specificity of approximately 155%, indicating that the tool can be useful as a diagnostic (predictive) tool in clinical practice." @default.
- W4316095969 created "2023-01-14" @default.
- W4316095969 creator A5003331150 @default.
- W4316095969 date "2023-01-14" @default.
- W4316095969 modified "2023-10-03" @default.
- W4316095969 title "Difficult Spinal-Arachnoid Puncture (DSP) Score: Development and Performance Analysis" @default.
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- W4316095969 doi "https://doi.org/10.7759/cureus.33760" @default.
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- W4316095969 hasPublicationYear "2023" @default.
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