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Item Accuracy of Orthodontic Soft Tissue Prediction Software between Different Ethnicities(2019) Stewart, Kelton; Patel, Pranali; Eckert, George; Rigsbee III, OH; Hughes, Jay; Utreja, AchintObjective: The objective of this study was to assess the accuracy of the soft tissue prediction module of Dolphin Imaging Software (DIS) in patients requiring extractions as part of the orthodontic treatment plan and compare its accuracy between different ethnicities. Materials and Methods: Initial and final records of 57 patients from three ethnic groups (African Americans, Caucasians, and Hispanics) who completed orthodontic treatment were included for assessment. The identified cases were managed non-surgically with dental extractions. A predictive profile was generated using DIS and compared to post-treatment lateral photographs. Actual and predictive profile photographs were compared using five designated parameters. The assessment parameters were evaluated using a manual protractor. ANOVA was used to compare differences between actual and predicted parameters between the specified groups and ICC was used to assess correlations between the data. Results: Neither ethnicity nor gender had a significant effect on the difference between predicted and final values. No significant difference was noted between the predicted and final images for the nasolabial angle. Significant differences were observed for the mentolabial fold, upper lip to E-line, and lower lip to E-line between predicted and actual images. Additionally, soft tissue convexity was significantly different (p=0.019). Additionally, a clinically significant difference was found for the mentolabial fold. Conclusion: Ethnicity and gender had no impact on the accuracy of predicted and actual image parameters. Overall, DIS demonstrated acceptable accuracy when simulating soft tissue changes after extraction therapy. Additional research on the accuracy of the software is warranted.Item Effect of a point-of-care ultrasound (POCUS) curriculum on emergency department soft tissue management(Springer, 2022-10-21) Nti, Benjamin K.; Phillips, Whitney; Sarmiento, Elisa; Russell, Frances; Emergency Medicine, School of MedicineBackground: Pediatric emergency department (ED) visits for superficial skin and soft tissue infections (SSTI) have steadily been increasing and point-of-care ultrasound (POCUS) continues to be an effective modality to improve management and shorter ED length of stays (LOS). Objective: We sought to determine the impact of a soft tissue POCUS curriculum on POCUS utilization, ED LOS, and cost-effectiveness. Methods: This was a retrospective pre- and post-interventional study of pediatric patients aged 0 to 17 years. Patients presenting to ED with international classification of disease 9 or 10 code for abscess or cellulitis were included. Data were collected a year before and after curriculum implementation with a 1-year washout training period. Training included continuing medical education, greater than 25 quality assured examinations, and a post-test. We compared diagnostic imaging type, ED LOS, and mean charges in patients with SSTI. Results: We analyzed data on 119 total patients, 38 pre- and 81 post-intervention. We found a significant increase in the total number of POCUS examinations performed pre- to post-curriculum intervention, 26 vs. 59 (p = 0.0017). Mean total charges were significantly decreased from $3,762 (± 270) to $2,622 (± 158; p = 0.0009). There was a significant trend towards a decrease in average ED LOS 282 (standard error of mean [SEM] ± 19) vs 185 (± 13) minutes (p = 0.0001). Conclusions: Implementation of a soft tissue POCUS curriculum in a pediatric ED was associated with increased POCUS use, decreased LOS, and lower cost. These findings highlight the importance of POCUS education and implementation in the management of pediatric SSTI.