Current Medical Environment Research Articles

Exploring Unprofessional Behaviors and Biased Perceptions in the Clinical Environment: Students’ Perspectives

Professionalism stands as a fundamental cornerstone within the realm of physician training, representing a core competency that holds significant importance. It entails creating workplaces that are physically and psychologically safe within the health care system. Positive role modeling from health professionals is important in creating a learning environment that fosters diversity, equity, and inclusion for all. Using the mixed-methods sequential design, this study investigated unprofessional behaviors and biased perceptions demonstrated by health professionals as perceived and experienced by medical students during their clinical rotations at one medical school. Seventy-three M3 students and 37 M4 students responded to the survey, followed by three focus groups (n = 11) to further examine unprofessionalism and biases as well as impacts on performance, learning opportunities, and well-being. The results from both the quantitative and qualitative data demonstrate the presence of unprofessionalism and biases within the current medical education environment. These issues include a lack of respect and compassion, a lack of commitment to professional duties, malfunctioning teamwork, and a lack of sensitivity towards individuals regardless of their group affiliations. The unprofessional behaviors and biased perceptions have detrimental impacts on students’ performance, learning, and well-being. The reasons behind unprofessionalism and bias are multifaceted, influenced by societal and local environmental factors that extend beyond individual beliefs and values. By collecting empirical data on students’ experiences and perceptions, the study sheds light on the areas that need improvement and offers insights into adopting strategies to decrease unprofessional conducts and foster a respectful and inclusive learning environment.

Categorization, Identification, and Management of Stakeholders in University Hospital of China Based on Public Value Theory

Public hospitals, particularly university hospitals, as the primary suppliers of high-quality healthcare services in China, play an indispensable role in encouraging the development of a healthy China. In the new historical period, university hospitals are faced with the challenge of the continuous development and change of the external environment, as well as the internal structure. The primary cause for this is a lack of understanding of the connotation and definition of hospital stakeholders, as well as neglecting stakeholder requests and failing to build and form a strategic awareness of improving stakeholder management in university hospital. This paper focuses on the stakeholders of university hospitals in China, investigates the classification and identification of stakeholders, five university hospitals designated as "Grade A tertiary hospitals" was carried out. Semi-Interviews were conducted with 33 participants including experts, university hospital leadership level, and basic level. The study revealed that there are ten (10) stakeholders influencing the development of university hospitals in China and discussed the importance of stakeholders for hospital management and operation in the current medical environment and doctor-patient relationship in China. The study revealed that certain stakeholders drive university hospitals to shift their development strategies. The classification and identification of stakeholders in the pattern of interactions is critical for understanding the complexity and dynamics inherent in stakeholder relationship management. A systemic vision is required to address the university hospital issue's complexity from a broader perspective, engage the system's numerous stakeholders, and allow long-term decision-making.

2023 China Alzheimer’s disease: facts and figures

In China, the aging population and the increasing incidence of Alzheimer's disease (AD) and other dementias have emerged as major medical concerns. Extensive research and new technologies on AD have provided possibilities for early intervention, including emerging biomarkers for detection and new drugs with disease-modifying therapy. This report includes a large amount of facts and figures to describe the understanding of patients and their families about the disease, discuss the problems they encounter in the current medical environment, and outline potential difficulties in clinical diagnosis and treatment status. Furthermore, people’s concerns, the overall effect on caregivers, and the development of AD treatment are presented in this report. Overall, to increase public awareness of the disease, this report suggests early detection, screening, and intervention for AD while calling on all sectors to work together to help AD patients.

Role of Nurse Practitioners in Shared Decision Making: Examples of Heart Failure Patients in Rural Hospital

<p>醫療自主權於現今醫療環境中日趨重要，以病人為中心照護的重要環節，就是鼓勵病患積極參與醫療決策，以提升照護品質與滿度度。台灣衛生福利部自2016年開始推行醫病共享決策（shared decision making, SDM），期望促使病人積極參與醫療決策，以提升醫病關係、醫療品質及病人安全。推動至今，共享決策已廣泛運用於臨床實務中。但是，偏鄉及高齡長者，其就醫習慣、喜好、價值觀和醫療新知取得與都市居民有極大的差異。傳統以「醫生」作決策的觀念深植，參與SDM之意願以及推廣策略，值得探討。因此，本文將從專科護理師之角色去探討共享決策於偏鄉醫院推動影響因素，推行過程所遇到困境與經驗，綜整考量偏鄉居民特質及觀念，因應出不同之SDM推行之道。</p> <p> </p><p>The importance of patient autonomy is increasing in current complex medical environment as well as the promotion of patient-centered care. One key aspect of patient-centered care is to encourage patients to actively participate in medical decision-making in order to improve the quality and sat-isfaction of care. Since 2016, the Ministry of Health and Welfare of Taiwan has promoted shared decision-making (SDM), aimed at facilitating patient participation in medical decision-making and enhancing doctor-patient relationships for medical quality and patient safety. Since then, SDM has been widely applied in clinical practice. However, rural and elderly patients have significant deviations from urban residents in their health-seeking habits, preferences, values and access to medical informa-tion. The traditional concept of “doctor” as sole decision maker is deeply rooted in rural and elderly patients’ mind, and their willingness to participate in SDM and how to promote it are worth exploring. Therefore, the aim of this paper is to discuss from nurse practitioners’ point of view of about the chal-lenges and factors that influence the experiences of the implementation of SDM in rural hospitals. The results of this synthesis will contribute to proper implementation of SDM in low health literacy areas in the future.</p> <p> </p>

Risk Analysis and Countermeasures for Wearable Mobile Medical Devices

With peoples attention to health, wearable mobile medical devices have gradually entered people's vision in recent years. With its convenient and fast functions, it is expected to im-prove the current medical environment. A wearable mobile health device is a portable de-vice that is worn directly on the body or integrated into the user's clothing or accessories. Wearable devices are not only hardware devices but also perform powerful functions through software support, data interaction, and cloud interaction. Wearable devices will bring great changes to our lives and perceptions. This chapter will explain the technology, development, device form, market performance, and other aspects of wearable devices.

Noninvasive Skin Respiration (CO2) Measurement Based on Quartz-Enhanced Photoacoustic Spectroscopy.

A noninvasive method for disease diagnosis that does not require complex specialized laboratory facilities and chemical reagents is particularly attractive in the current medical environment. Here, we develop a noninvasive skin respiration sensor based on quartz-enhanced photoacoustic spectroscopy (QEPAS) that can monitor the skin elimination rate of carbon dioxide (CO2). A 3.8 mW distributed feedback laser emitting at 2.0 μm is used as an excitation source, and a three-dimensional (3D)-printed acoustic detection module is designed to apply to the skin as a sensor head. The performance of the noninvasive skin respiration sensor is assessed in terms of detection sensitivity, linearity, long-term stability, and water effect. A minimum detection limit of 35 ppb is achieved at the optimal integration time of 670 s. The skin respiration measurements from eight healthy volunteers are recorded, and the real-time results are analyzed.

Current health resources required for the management of ankylosing spondylitis in developing areas of China.

Current health resources required for the management of ankylosing spondylitis in developing areas of China.

Implementation of art therapy assisted by the internet of medical things based on blockchain and fuzzy set theory

This work aims to improve the stability and efficiency of the Internet of Medical Things (IoMT), strengthen the security and privacy of personal information, and create a healthy and safe network environment. First, art therapy in the current medical environment is discussed, and the security defenses of the IoMT supporting art therapy are studied. Then, a security defense method for IoMT is proposed by combining basic Blockchain knowledge with the Fuzzy Sets Theory. Specifically, a Density-awarded Fuzzy C-means (DFCM) algorithm is developed to solve the clustering issue of unbalanced data sets. Besides, the Fuzzy Support Vector Machine (FSVM) model is used to classify data points far from the sample center to increase classification accuracy. In the simulation experiment, the DFCM algorithm achieves a pleasing clustering effect on the four data sets, involving the data sets with density changes and imbalanced sample points within the cluster. Moreover, the combination of DFCM and FSVM (DFCM-FSVM) for attack detection in the Internet of Things (IoT) realizes the optimal accuracy in the detection of different behaviors compared with similar algorithms; the detection accuracy of normal behavior, scheduled attack, gray hole attack, and black hole attack is 99.8%, 89.8%, 99.4%, and 91.5%, respectively. This work creatively proposes a hybrid intrusion detection method based on fuzzy theory. As the second line of defense in security protection, it plays a critical role and is suitable for the network environment of the perception layer. In conclusion, the attack detection method based on Blockchain combined with the Fuzzy Sets Theory can precisely identify potential attacks in abnormal data, which has important practical value for maintaining data security and the regular operation of the IoMT.

Narrative medicine in surgery: necessity or hindrance?

Narrative medicine in surgery: necessity or hindrance?

Perception of Medical Students on Current Medical Education in Bangladesh

Introduction A modernized and relevant medical curriculum is the backbone of an effective medical education. A healthy and efficient medical academic environment is crucial for effective implementation of any medical curriculum. This study was performed with the aims and objectives of determining medical students’ perception of ongoing medical curriculum, teaching and learning methodologies and academic resources. Methodology: A cross sectional descriptive analytical study was conducted with a self-administered questionnaire to determine the perception of medical students about current medical curriculum, teaching-assessment methodology and learning academic environment. A total of n= 268 medical students from 4 different medical colleges participated in the study. The questionnaire consisted of 5 questions. The first two questions (Q1 and Q2) addressed students’ views ongoing medical curriculum and each were Likert type on a 1 to 5 scale (from strongly disagree to strongly agree). There were 6 items under Q1 and 4 items under Q2. Views were recorded on Likert scale ranging from 1 to 5 (No idea to strongly agreed). The third question was on preference for duration of lecture class. The last two questions (Q4 and Q5) were multiple- response-test-based questions for determining the preferred responses on factors affecting medical exam results/scores and medical curriculum contents. Results: The majority of the students for the Q1, poorly rated the first item labeled as,” your own college standard is at par with international standard” with a mean ±SD of 2.9±.97 and the third item as,” Current teaching practices is sufficient to prepare for international exams (USMLE, PLAB)” with a mean ±SD of 2.7±0.83. Most of the students under Q2 predominantly chose the statement “agree” or “disagree” and the item score mean ±SD is ≥ 4.5±0.5 for each of the four items. Regarding major preference of lecture duration, 126 (47.0%) opined for 45 minutes followed by 107 (39.9%) for 60 minutes and 35(13.1%) for 30 minutes lecture. For Q4, the multiple response test, the majority of the responses (31.4%) was for betterment of lectures and for more practical classes (30.3%). To the Q5 multiple response test, the majority of responses (18.3%) was for increased motivation, 16.3% for provision of well-equipped library and laboratories as well as 16.1% for increased hands-on-skill training. There was also statistically significant difference between the public and private medical colleges on opinion regarding the factors, “decreased student teacher ratio” (31.7% vs 18.7%) with a χ 2 = 10.08, d =1 and p=0.001& for factor, “research training in curriculum” (29.5% vs 19.8%) with χ 2 =4.40, df=1 and p=0.03. Conclusion: This study has elicited the perception of medical students on various issues related to curriculum, and academic environment and resources and methods reflecting the areas that needs to be addressed for improvement. It is imperative that every country focus on building and implementing curriculum and exam system that amplifies professional competence and social values, expands setting for efficacious and sustainable medical education programs, trains the medical teachers as educators and encourages life-long self-learning practices. Bangladesh Journal of Medical Education Vol.13(2) July 2022: 13-25

A Study on the Role of Intelligent Medical Simulation Systems in Teaching First Aid Competence in Anesthesiology.

Anesthesiology is a subject with strong practicality and application. Undergraduate anesthesiology teaching needs to strike a balance between theoretical knowledge, clinical skill training, and clinical thinking development. Clinical probation and practice are an important part of undergraduate anesthesia teaching. Traditional clinical teaching uses real patients for demonstration and training, but as patients become more self-protective and less cooperative, there are not enough patients for clinical skill training. Simulation is to teach medical scenes in real life under the control of standardized technical guidelines and parameters. Since then, with the rapid development of computer technology, simulation technology and simulation teaching have been greatly developed and are more and more used in clinical teaching, skill evaluation, and scientific research. This study explores the effective methods of clinical teaching in anesthesiology by comparing the effectiveness of traditional teaching methods and simulation teaching methods in undergraduate clinical teaching. It is difficult to combine theory and practice in first aid, which does not allow them to directly receive and deal with emergency medical treatment and resuscitation. In China's current medical environment and patients' high demand for medical services, it is imperative to vigorously carry out simulated medical education. In the eastern part of Inner Mongolia, according to the advantages of teaching hospitals, our hospital took the lead in carrying out the simulation education project, which is still in the exploratory stage and not systematic enough. This study will help us to better carry out simulation teaching and improve the clinical skills of medical students in the future. Methods. The student group and class took the advanced simulator training as the experimental group, applied the advanced integrated simulator and other systems of the Norwegian company, referred to the international guidelines for cardiopulmonary resuscitation and cardiovascular first aid in 2005, and practiced in the emergency department during the clinical internship and “emergency clinical simulation training” course. The course includes basic life support, advanced life support, and comprehensive training of CPR (cardiopulmonary resuscitation) and endotracheal intubation. Results. The passing rate of simulated first aid practice was 94.4%; 100% of the students think it is necessary to set up the course, 91% of the students think it is practical, 91% of the students think the course content is reasonable and perfect, and 77%–100% of the students think the course has improved their first aid operation ability, comprehensive application of knowledge, and clinical thinking ability. Conclusion. Carrying out the course of “clinical simulated first aid training” through the advanced simulator system can effectively improve the interns' clinical first aid operation ability, teamwork ability, and self-confidence, improve the students' clinical thinking and judgment ability, and improve the service level to patients.

Status Quo of Occupational Identity of Nursing Staff in Rehabilitation Department and Its Relationship with Work Stressors.

Due to the continuous progress of social economy, medical and health technology and the development of disciplines have shown a trend of rapid development. In the current medical environment, quality nursing services are constantly promoted. Nursing staff are dedicated to their work to the best of their ability. Meanwhile, they should be rewarded with corresponding happiness and joy in their work. This study starts from the perspective of nursing management and psychology. On this basis, it investigates the occupational identity and work stress status of nursing staff. At the same time, the data are analyzed, and the relationship between occupational identity and work pressure is analyzed. This article provides a certain theoretical basis and support for the decision-making of relevant nursing managers, and also makes efforts to improve the professional identity and work happiness of nursing staff. In this study, which surveyed 596 rehabilitation nurses, the nurses' total occupational stress score was 74.52, with an average score of 2.12 points. The overall score for professional identity was 102.00, with an average score of 3.40 points. This belonged to the medium level. It showed that the occupational pressure of nurses should be paid attention to by relevant managers. Two of the five dimensions with the highest scores were occupational social support and occupational self-reflection. A negative correlation was found between occupational stress and its dimensions and occupational identity and its dimensions (P < 0.01).

Promoting Culture Change Within Organizations.

Promoting Culture Change Within Organizations.

Advanced Abdominal Pregnancy (AAP) after 20 Weeks of Gestation in Japan: A Retrospective Review.

Background An advanced abdominal pregnancy (AAP) rarely continues to a live birth, but sometimes, a live birth may occur. In developed countries, women with AAP who have not been diagnosed preoperatively are expected to be diagnosed quickly, and the pregnant woman and the fetus will be saved. After careful examination of the past cases, we sought to derive what is the best diagnosis and treatment choice in the current medical environment. Materials and Methods We retrospectively studied AAP cases in Japan. We examined diagnosis of AAP before fetal delivery and placental treatment at the time of delivery. AAP was well documented in 10 cases. We contacted the AAP authors, who reported 10 AAP cases in Japan, directly to confirm any unclear points. Results Two cases were diagnosed with AAP before laparotomy, one was diagnosed after IUFD, and seven were diagnosed at the time of laparotomy. The two most recent cases were diagnosed with AAP preoperatively by ultrasound and MRI. Six cases were described for preoperative diagnosis. There were two cases of placenta previa, one of a bicornuate uterus, one of breech presentation, one of a combination of uterine cervical fibroids and placenta previa, and one of a combination of presentation and placental abnormality with uterine fibroids. In five cases, the placenta was removed at the time of laparotomy. Simultaneous removal of the placenta during laparotomy could not be performed because of intra-amniotic infection with a macerated fetus in an IUFD case. Among eight cases, excluding 20-week and 21-week gestation with no expectation of viable newborns, there were one male and seven female fetuses. The birth weight ranged from 1765 to 3520 g, with a median birth weight of 2241 g. Combined malformations were described in six of the seven live births. Clubfoot, torticollis, joint contracture, and bone deformity were transient because intrauterine compression quickly improved. Conclusion In recent cases, AAP has been diagnosed by MRI and ultrasound. MRI should be performed if abdominal pregnancy is suspected. Postoperative infections may occur if the placenta is not removed at the time of delivery. We recommend placental resection with the help of an anesthesiologist, a gynecologist, a urologist, and a surgeon in the current medical environment.

Effects of a Short Emotional Management Program on Inpatients with Schizophrenia: A Pilot Study.

The prevalence of schizophrenia is gradually increasing worldwide. Many patients with schizophrenia have a diminished ability to empathize and to detect their own emotions or those of others, deteriorating their social functioning and their quality of life. Nonetheless, emotional management training may improve patients’ emotion recognition, emotional expression, and negative symptoms. Developing and applying a short but effective program that reflects the current medical environment, in which hospital stays are ever-diminishing, is warranted. This one-group, pretest–posttest, quasi-experimental pilot study aimed to examine the effects of a short emotional management program (EMP-S) on 17 patients with chronic schizophrenia. Participants were patients hospitalized in the National Center for Mental Health in Korea. After the completion of a twice-a-week, eight-session, four-week long EMP-S, participants showed improvements in emotion recognition, emotional expression, and negative symptoms. Our results suggest the applicability and potential effectiveness of the EMP-S, which takes the length of psychiatric hospital stay and the inpatient environment into consideration. To minimize any barriers to social functioning in the post-discharge lives of inpatients with chronic schizophrenia and enhance their social cognition—by improving their emotion recognition, emotional expression, and negative symptoms—we suggest the periodical administration of this EMP-S to these inpatients.

Medical School to Residency: How Can We Trust the Process?

BackgroundTo say that the transition from undergraduate medical education (UME) to graduate medical education (GME) is under scrutiny would be an understatement. Findings from a panel discussion at the 2018 Association of American Medical Colleges Annual meeting entitled, “Pass-Fail in Medical School and the Residency Application Process and Graduate Medical Education Transition” addressed what and when information should be shared with residency programs, and how and when that information should be shared.Materials and MethodsOver 250 participants representing UME and GME (e.g. leadership, faculty, medical students) completed worksheets addressing these questions. During report-back times, verbal comments were transcribed in real time, and written comments on worksheets were later transcribed. All comments were anonymous. Thematic analysis was conducted manually by the research team to analyze the worksheet responses and report back comments.ResultsThemes based on suggestions of what information should be shared included the following: 1) developmental/assessment benchmarks such as demonstrating the ability/competencies to do clinical work; 2) performance on examinations; 3) grades and class ranking; 4) 360 evaluations; 5) narrative evaluations; 6) failures/remediation/gaps in training; 7) professionalism lapses; 8) characteristics of students such as resiliency/reliability; and 9) service/leadership/participation. In terms of how this information should be shared, the participants suggested enhancements to the current process of transmitting documents rather than alternative methods (e.g., video, telephonic, face-to-face discussions) and information sharing at both the time of the match and again near/at graduation to include information about post-match rotations.DiscussionConsiderations to address concerns with the transition from medical school to residency include further enhancements to the Medical Student Performance Evaluation, viewing departmental letters as ones of evaluation and not recommendation, a more meaningful educational handoff, and limits on the number of residency applications allowed for each student. The current medical education environment is ready for meaningful change in the UME to GME transition.

Looking into the life of technology-dependent children and their caregivers in Korea: lifting the burden of too many responsibilities

BackgroundThe number of technology-dependent children (TDC) is increasing in South Korea, but available healthcare services after their discharge are poor. This study aimed to examine how TDC and caregivers live at home and identify their difficulties and needs regarding home care with few services to support them.MethodsThis cross-sectional study was conducted in a tertiary hospital for children in South Korea. A self-reported questionnaire was completed by primary caregivers of TDC who were younger than 19 years and had been dependent on medical devices for more than 3 months. Technologies included home mechanical ventilation, oxygen supplementation, suction equipment, enteral feeding tube, and home total parenteral nutrition. Patterns of healthcare use and home care of TDC and caregivers’ perception toward child were assessed.ResultsA total of 74 primary caregivers of TDC completed a self-reported questionnaire. About 60% children were aged under 5 years. There were 31.1% children who required both respiratory and nutritional support. On average, caregivers took care of a child for 14.4 (±6.1) hours, slept for 5.6 (±1.6) hours, and spent 2.4 h per day on personal activities. Children used hospital services for 41.3 (±45.6) days in 6 months, and most (78.1%) were transported through private car/ambulance. Participants (75.6%) reported taking more than an hour to get to the hospital. More than 80% of caregivers responded that child care is physically very burdensome. The only statistically significant relationships was between economic status and financial burden (p = 0.026).ConclusionsCaregivers of TDC reported having significant time pressure regarding childcare-related tasks, insufficient time for personal activities, and inefficient hospital use because of inadequate medical services to support them in South Korea. Thus, it is necessary to support caregivers and develop a home care model based on current medical environment.

Potential of Mobile Technology to Relieve the Urgent Mental Health Needs in China: Web-Based Survey.

BackgroundWith the rapid development of information technology and mobile devices, an increasing number of mobile medical services and platforms have emerged. However, China’s current mental health situation necessitates further discussion and research on how to provide more patient-centered services in the face of many challenges and opportunities.ObjectiveThis study aims to explore the attitudes and preferences of mental health service stakeholders regarding mobile mental health services and discuss the challenges and opportunities faced by mobile technology developers in China.MethodsA web-based survey was conducted by following the Checklist for Reporting Results of Internet E-Surveys (CHERRIES) checklist. A total of 586 valid questionnaires were collected. Respondents included 184 patients or their family members, 225 mental health professionals, and 177 people from the general population. Data analysis was completed using SPSS 24.0.ResultsAmong the various problems perceived regarding the current mental health medical environment, difficulty in finding appropriate psychologists and limited visit times ranked highest. Social media (n=380/586, 64.9%) was the most preferred platform among all participants, whereas professionals showed a higher preference for smartphone apps (n=169/225, 75.1%). Professional instruction, psychological consultation, and mental health education (ranked top 3) were the most commonly identified needs. Mental health professionals generally emphasized more on treatment-related mobile mental health service needs, especially medication reminders (χ22=70.7; P<.001), symptom monitoring (χ22=24.0; P<.001), and access to mental health resources (χ22=38.6; P<.001). However, patients and their family members focused more on convenient web-based prescriptions (χ22=7.7; P=.02), with the general population interested in web-based psychological consultation (χ22=23.1; P<.001) and mental health knowledge (χ22=9.1; P=.01). Almost half of the participants regarded mobile mental health services as highly acceptable or supported their use, but less than 30% of participants thought mobile mental health services might be very helpful. Concerns about mobile mental health mainly focused on information security. Service receivers also suspected the quality and professionalism of content, and mental health professionals were worried about time and energy consumption as well as medical safety.ConclusionsIn terms of service flow, mobile services could be used to expand service time and improve efficiency before and after diagnosis. More individualized mobile mental health service content in more acceptable forms should be developed to meet the various needs of different mental health stakeholders. Multidisciplinary training and communication could be incorporated to facilitate the integration and cooperation of more well-rounded service teams. A standard medical record system and data format would better promote the development of future intelligent medical care. Issues such as ensuring service quality, solving safety risks, and better integrating mobile services with regular medical workflows also need to be addressed.

Development of a Transitional Care Model Program for Patients with Pneumonia, Asthma, and Chronic Obstructive Pulmonary Disease: In-depth Interviews with Readmitted Patients.

Community-based health management policies are needed considering societal aging. We aimed to develop a transitional care model (TCM) program for patients with pneumonia, asthma, and chronic obstructive pulmonary disease. First, we conducted in-depth interviews with patients who were hospitalized, released, and readmitted for those three conditions to identify issues with the current hospitalization/discharge system and post-discharge processes. Next, we developed a new TCM program suited to the realities of the current medical environment. Interviews revealed problems including inadequate awareness of disease and health management; insufficient information exchange between patients, caregivers, and primary medical institutions; and absence/low usage of community-based care services. The investigation applying the new TCM program to patients and following up on readmission rates and life satisfaction after discharge is ongoing. Reviewing these results and conducting further studies in the future will allow improvements to the model.

Cardiovascular Risk Assessment in Pilots.

BACKGROUND: For over 30 yr the global medical community has attempted to define the acceptable cardiovascular risk in pilots. This challenge is compounded by the ever-changing technological and medical landscape of air travel. We aimed to review the existing literature on estimating the risk of pilot cardiovascular incapacitation and determine if the current guidelines are founded in the best available evidence.METHODS: A detailed review of the guidelines and literature that supports them was completed. Relevant articles were identified by review of the source literature of the guidelines and the references of these source documents. All articles referenced were reviewed in full by both authors. Data that informed the existing recommendations were reviewed and compared to available modern data. The results of these findings were incorporated into a formula that allows for the calculation of acceptable pilot cardiovascular risk given any operator-determined set of variables.RESULTS: Among the evidence that informs current guidelines, there exists a need for further updating. A number of assumptions have been made in creating guidelines and these may no longer reflect the current technological or medical aviation environment. Incorporating the identified variables into a formula allows for the calculation of acceptable cardiovascular risk. This formula was tested using past data and reproduced existing results.DISCUSSION: Current guidelines for pilot cardiovascular risk assessment require review by the international aviation medical community. We propose a novel formula that may serve as a template for future guidelines and may be adapted as aviation technology and health data evolve.Mulloy A, Wielgosz A. Cardiovascular risk assessment in pilots. Aerosp Med Hum Perform. 2019; 90(8):730-734.