Evidence map›Paper›PMID 41068530›Full record

Observational studyJournal of medical systems2025

Real-Time Identification of Cricothyrotomy Landmarks in Emergency Care and Obstetric Patients Using Wireless Handheld Ultrasound and Edge-Computing Artificial Intelligence: A Prospective Observational Study.

Cheng-Yi Wu, Jia-Da Li, Po-Yuan Shih, Cheng-Chia Huang, Hsiao-Liang Cheng, Chun-Yu Wu, Joyce Tay, Meng-Che Wu, Chih-Hung Wang, Chu-Song Chen and 1 more

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Journal of medical systems, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. Article
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

11 authors.

Cheng-Yi Wu *Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Jia-Da Li *NTU Joint Research Center for AI Technology and All Vista Healthcare, National Taiwan University, Taipei, Taiwan.
Po-Yuan ShihDepartment of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan.
Cheng-Chia HuangDepartment of Computer Science and Information Engineering, National Taiwan University, No. 1, Sec. 4, Roosevelt Rd., Taipei 106, Taipei, Taiwan.
Hsiao-Liang ChengDepartment of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan.
Chun-Yu WuDepartment of Anesthesiology, College of Medicine, National Taiwan University Hsinchu Branch, National Taiwan University, Taipei, Taiwan.
Joyce TayDepartment of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Meng-Che WuDepartment of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Chih-Hung Wang *Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan. chwang1981@ntu.edu.tw.
Chu-Song Chen *Department of Computer Science and Information Engineering, National Taiwan University, No. 1, Sec. 4, Roosevelt Rd., Taipei 106, Taipei, Taiwan. chusong@csie.ntu.edu.tw.
Chien-Hua HuangDepartment of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan.

Funding

National Science and Technology Council 113-2326-B-002 -009 -MY3National Taiwan University Hospital,Taiwan 114-SS0019
6 · The paper itself

Abstract

This study aimed to develop machine learning-based algorithms to assist physicians in ultrasound-guided localization of the cricoid cartilage (CC), thyroid cartilage (TC), and cricothyroid membrane (CTM) for cricothyroidotomy. Adult female participants presenting to the emergency department with dyspnea or to the obstetrics and gynecology department for a scheduled cesarean section between August 2022 and July 2024 were prospectively recruited. Ultrasonographic images were collected using a wireless handheld ultrasound device connected to an edge computing tablet. Three You Only Look Once (YOLO) model variants-v5n6, v8n, and v10n-were selected for development and evaluation. A total of 608 participants (median age: 58.0 years, interquartile range [IQR]: 40.0-73.0; median body mass index: 23.2 kg/m², IQR: 20.2-26.5) contributed 117,094 ultrasonographic frames. All three YOLO-based models demonstrated high accuracy in detecting CC, TC, and CTM, with area under the receiver operating characteristic curve values exceeding 0.88. In correctly identified frames, the models effectively localized CC (IOU values: YOLOv5n6, 0.713 [95% confidence interval (CI): 0.698-0.726]; YOLOv8n, 0.718 [95% CI: 0.702-0.733]; YOLOv10n, 0.718 [95% CI: 0.701-0.734]; p value: 0.03) and TC (YOLOv5n6, 0.700 [95% CI: 0.683-0.717]; YOLOv8n, 0.706 [95% CI: 0.687-0.725]; YOLOv10n, 0.703 [95% CI: 0.783-0.721] ; p value: 0.037), though localization accuracy was lower for CTM (YOLOv5n6, 0.364 [95% CI: 0.333-0.394]; YOLOv8n, 0.363 [95% CI: 0.331-0.394]; YOLOv10n, 0.354 [95% CI: 0.325-0.381] ; p value: 0.053). The mean frames per second for YOLOv5n6, YOLOv8n, and YOLOv10n were 3.67, 13.83, and 14.13, respectively, when deployed on the handheld ultrasound platform. YOLO-based models demonstrated high accuracy in detecting and localizing CC, TC, and CTM. YOLOv8n and YOLOv10n achieved clinically acceptable real-time imaging performance when deployed on a wireless handheld ultrasound device with an edge computing tablet. Further studies are needed to assess whether this favorable performance translates into actual clinical benefits.

Indexed as

Anatomic LandmarksArtificial IntelligenceCricoid CartilageThyroid CartilageAdultAgedAlgorithmsCesarean SectionEmergency Service, HospitalFemaleHumansMachine LearningMiddle AgedPregnancyProspective StudiesUltrasonographyCricoid CartilageCricothyroid MembraneCricothyroidotomyMachine LearningObject DetectionThyroid CartilageUltrasound

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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.