Accuracy of physicians’ intuitive risk estimation in the diagnostic management of pulmonary embolism: an individual patient data meta-analysis
Rosanne van MaanenEmily S.L. MartensToshihiko TakadaPierre‐Marie RoyKerstin de WitSameer ParpiaNoémie KraaijpoelMenno V. HuismanPhilip S. WellsGrégoire Le GalMarc RighiniYonathan FreundJavier GalipienzoNick van EsJeanet W. BlomKarel G.M. MoonsFrans H. RuttenMaarten van SmedenFrederikus A. KlokGeert‐Jan GeersingKim Luijken
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In patients clinically suspected of having pulmonary embolism (PE), physicians often rely on intuitive estimation ("gestalt") of PE presence. Although shown to be predictive, gestalt is criticized for its assumed variation across physicians and lack of standardization.To assess the diagnostic accuracy of gestalt in the diagnosis of PE and gain insight into its possible variation.We performed an individual patient data meta-analysis including patients suspected of having PE. The primary outcome was diagnostic accuracy of gestalt for the diagnosis of PE, quantified as risk ratio (RR) between gestalt and PE based on 2-stage random-effect log-binomial meta-analysis regression as well as gestalts' sensitivity and specificity. The variability of these measures was explored across different health care settings, publication period, PE prevalence, patient subgroups (sex, heart failure, chronic lung disease, and items of the Wells score other than gestalt), and age.We analyzed 20 770 patients suspected of having PE from 16 original studies. The prevalence of PE in patients with and without a positive gestalt was 28.8% vs 9.1%, respectively. The overall RR was 3.02 (95% CI, 2.35-3.87), and the overall sensitivity and specificity were 74% (95% CI, 68%-79%) and 61% (95% CI, 53%-68%), respectively. Although variation was observed across individual studies (I2, 90.63%), the diagnostic accuracy was consistent across all subgroups and health care settings.A positive gestalt was associated with a 3-fold increased risk of PE in suspected patients. Although variation was observed across studies, the RR of gestalt was similar across prespecified subgroups and health care settings, exemplifying its diagnostic value for all patients suspected of having PE.Modern Theories of Gestalt Perception. This paper examines four modem theories that address the problem of how holistic contextual effects might occur in the perception of simple geometric figures. These modem theories are all closely related to the original ideas of Gestalt theorists. The first three theories attempt to specify the simtulus factors that produce the emergent structure characteristic of Gestalt phenomena. The fourth theoretical approach is a much more speculative attempt to specify a mechanism for Gestalt effect in the form of dynamic "connexionist" networks. It is argued that these modem theories offer a promising approach for constructing new theories to account for Gestalt phenomena.
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The subject of this study is the study of the effects of Gestalt principles in logotype design. For this purpose, perception in Gestalt visual perception theory, perceptual organization laws and the relation of logotype, one of the graphic design products, are discussed in terms of design principles and design elements. Descriptive method was used in the research. The universe of the research was formed by the determination of the effects of gestalt visual perception theory in logotype design. Examples of the research include the determination of the effects of gestalt visual perception theory on logotype designs. The effects of the perceptual organization laws of Gestalt theory such as Figure-Ground relation, similarity, proximity, symmetry and completion principles on the perception of designs in the sample design applications in the logotype design areas are examined. It has been determined that the principles of Gestalt theory, which constitute the law of perceptual organization, positively affect perception in logotype design.
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In this study, basic design concepts related to Gestalt principles were examined. In the first phase of the work, the principles that Gestalt theory developed in the field of visual perception are introduced and the basic design principles are explained by various abstract examples. In the second phase, gestalt principles have been tested with concrete examples of the various existing implementations. As a study area; In Turkey, various examples of religious architectural buildings were selected. These types of structures; Early and classical mosque, medrese and tomb examples. As a result of the analysis of the religious architecture samples taken into consideration; The types of structures are expressed in basic design principles, which are related to guttal theory. After all; The importance of implementing design concepts related to gestalt principles in the construction has been emphasized.
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Recent studies have indicated higher risk of fractures among coffee drinkers. To quantitatively assess the association between coffee consumption and the risk of fractures, we conducted this meta-analysis.We searched MEDLINE and EMBASE for prospective studies reporting the risk of fractures with coffee consumption. Quality of included studies was assessed with the Newcastle Ottawa scale. We conducted a meta-analysis and a cumulative meta-analysis of relative risk (RR) for an increment of one cup of coffee per day, and explored the potential dose-response relationship. Sensitivity analysis was performed where statistical heterogeneity existed.We included 10 prospective studies covering 214,059 participants and 9,597 cases. There was overall 3.5% higher fracture risk for an increment of one cup of coffee per day (RR = 1.035, 95% CI: 1.019-1.052). Pooled RRs were 1.049 (95% CI: 1.022-1.077) for women and 0.910 (95% CI: 0.873-0.949) for men. Among women, RR was 1.055 (95% CI: 0.999-1.114) for younger participants, and 1.047 (95% CI: 1.016-1.080) for older ones. Cumulative meta-analysis indicated that risk estimates reached a stabilization level (RR = 1.035, 95% CI: 1.019-1.052), and it revealed a positive dose-response relationship between coffee consumption and risk of fractures either for men and women combined or women specifically.This meta-analysis suggests an overall harm of coffee intake in increasing the risk of fractures, especially for women. But current data are insufficient to reach a convincing conclusion and further research needs to be conducted.
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Thesis URL http://hxa3529.cias.rit.edu/thesis The term Gestalt literally means “form” in German. In the early 20th century, the Gestalt Principles of Perception were developed by German psychologists from the Berlin School. These principles describe the different ways the human mind organizes visual elements into groups or unified wholes. The definition of Gestalt in relation to these principles is “unified whole.” This thesis is an endeavor to examine the five major principles of Gestalt perception through the use of short animations and illustrated examples, presented in a website. It will also allow the user to test the knowledge provided through a short multiple-choice quiz and an experimental workshop section. The website will essentially be an educational tool for students and teachers alike, helping establish a strong visual and aesthetic awareness and improvement in design choices.
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Abstract Gestalt principles of perception are those aspects of perception that cannot be defined in terms of smaller, constituent elements. Gestalt is a German word which translates in English as whole, configuration, or pattern.
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