Evidence map›Paper›PMID 30051244›Full record

ArticleAnnals of biomedical engineering2018

Clinical Translation of the LevelCheck Decision Support Algorithm for Target Localization in Spine Surgery.

Amir Manbachi, Tharindu De Silva, Ali Uneri, Matthew Jacobson, Joseph Goerres, Michael Ketcha, Runze Han, Nafi Aygun, David Thompson, Xiaobu Ye and 9 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of biomedical engineering, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Accuracy in spinal level determination, including transitional vertebrae: an ASReview supported systematic review.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026
    Review
  2. Preventing Wrong-Level Spine Surgery.Acta neurochirurgica. Supplement · 2025
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Amir ManbachiDepartment of Biomedical Engineering, Johns Hopkins University, 3400 N. Charles Street, Wyman Park Building, Suite 400 West, Baltimore, MD, 21218, USA.
Tharindu De SilvaDepartment of Biomedical Engineering, Johns Hopkins University, 3400 N. Charles Street, Wyman Park Building, Suite 400 West, Baltimore, MD, 21218, USA.
Ali UneriDepartment of Biomedical Engineering, Johns Hopkins University, 3400 N. Charles Street, Wyman Park Building, Suite 400 West, Baltimore, MD, 21218, USA.
Matthew JacobsonDepartment of Biomedical Engineering, Johns Hopkins University, 3400 N. Charles Street, Wyman Park Building, Suite 400 West, Baltimore, MD, 21218, USA.
Joseph GoerresDepartment of Biomedical Engineering, Johns Hopkins University, 3400 N. Charles Street, Wyman Park Building, Suite 400 West, Baltimore, MD, 21218, USA.
Michael KetchaDepartment of Biomedical Engineering, Johns Hopkins University, 3400 N. Charles Street, Wyman Park Building, Suite 400 West, Baltimore, MD, 21218, USA.
Runze HanDepartment of Biomedical Engineering, Johns Hopkins University, 3400 N. Charles Street, Wyman Park Building, Suite 400 West, Baltimore, MD, 21218, USA.
Nafi AygunRussell H. Morgan Department of Radiology, Johns Hopkins University, The Johns Hopkins Hospital, 1800 Orleans Street, Baltimore, MD, 21287, USA.
David ThompsonArmstrong Institute for Patient Safety and Quality, Johns Hopkins University School of Medicine, 750 E Pratt St, 15th Floor, Baltimore, MD, 21202, USA.
Xiaobu YeDepartment of Neurosurgery, Johns Hopkins University School of Medicine, The Johns Hopkins Hospital, 1800 Orleans Street, Baltimore, MD, 21287, USA.
Sebastian VogtSiemens Healthineers, Henkestraße 127, 91052, Erlangen, Germany.
Gerhard KleinszigSiemens Healthineers, Henkestraße 127, 91052, Erlangen, Germany.
Camilo MolinaDepartment of Neurosurgery, Johns Hopkins University School of Medicine, The Johns Hopkins Hospital, 1800 Orleans Street, Baltimore, MD, 21287, USA.
Rajiv IyerDepartment of Neurosurgery, Johns Hopkins University School of Medicine, The Johns Hopkins Hospital, 1800 Orleans Street, Baltimore, MD, 21287, USA.
Tomas Garzon-MuvdiDepartment of Neurosurgery, Johns Hopkins University School of Medicine, The Johns Hopkins Hospital, 1800 Orleans Street, Baltimore, MD, 21287, USA.
Michael R RaberDepartment of Neurosurgery, Johns Hopkins University School of Medicine, The Johns Hopkins Hospital, 1800 Orleans Street, Baltimore, MD, 21287, USA.
Mari GrovesDepartment of Neurosurgery, Johns Hopkins University School of Medicine, The Johns Hopkins Hospital, 1800 Orleans Street, Baltimore, MD, 21287, USA.
Jean-Paul WolinskyDepartment of Neurosurgery, Johns Hopkins University School of Medicine, The Johns Hopkins Hospital, 1800 Orleans Street, Baltimore, MD, 21287, USA.
Jeffrey H SiewerdsenDepartment of Biomedical Engineering, Johns Hopkins University, 3400 N. Charles Street, Wyman Park Building, Suite 400 West, Baltimore, MD, 21218, USA. jeff.siewerdsen@jhu.edu.

Funding

Intraoperative Imaging for Guidance, Patient Safety, and OR Quality AssuranceR01EB017226 · NIBIB · JOHNS HOPKINS UNIVERSITY · PI SIEWERDSEN, JEFFREY H · 2014 to 2017
$2.1M
NIBIB NIH HHS R01 EB017226Siemens academic-industry partnership with Siemens Healthineers (XP DivisionSiemens ErlangenSiemens Germany).
6 · The paper itself

Abstract

Recent work has yielded a method for automatic labeling of vertebrae in intraoperative radiographs as an assistant to manual level counting. The method, called LevelCheck, previously demonstrated promise in phantom studies and retrospective studies. This study aims to: (#1) Analyze the effect of LevelCheck on accuracy and confidence of localization in two modes: (a) Independent Check (labels displayed after the surgeon's decision) and (b) Active Assistant (labels presented before the surgeon's decision). (#2) Assess the feasibility and utility of LevelCheck in the operating room. Two studies were conducted: a laboratory study investigating these two workflow implementations in a simulated operating environment with 5 surgeons, reviewing 62 cases selected from a dataset of radiographs exhibiting a challenge to vertebral localization; and a clinical study involving 20 patients undergoing spine surgery. In Study #1, the median localization error without assistance was 30.4% (IQR = 5.2%) due to the challenging nature of the cases. LevelCheck reduced the median error to 2.4% for both the Independent Check and Active Assistant modes (p < 0.01). Surgeons found LevelCheck to increase confidence in 91% of cases. Study #2 demonstrated accuracy in all cases. The algorithm runtime varied from 17 to 72 s in its current implementation. The algorithm was shown to be feasible, accurate, and to improve confidence during surgery.

Indexed as

AlgorithmsDecision Making, Computer-AssistedHumansNeurosurgical ProceduresSpinal CordTranslational Research, BiomedicalClinical translationImage-guided surgeryIntraoperative imagingLevelCheckSpine surgerySurgical workflow

Identifiers

PMID30051244
PMCPMC9107073

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.