Defensive medicine is widespread and practiced the world over, with serious consequences for patients, doctors, and healthcare costs. Even students and resi-dents are exposed to defensive medicine practices and taught...Defensive medicine is widespread and practiced the world over, with serious consequences for patients, doctors, and healthcare costs. Even students and resi-dents are exposed to defensive medicine practices and taught to take malpractice liability into consideration when making clinical decisions. Defensive medicine is generally thought to stem from physicians' perception that they can easily be sued by patients or their relatives who seek compensation for presumed medical errors. However, in our view the growth of defensive medicine should be seen in the context of larger changes in the conception of medicine that have taken place in the last few decades, undermining the patient–physician trust, which has traditionally been the main source of professional satisfaction for physicians. These changes include the following: time directly spent with patients has been overtaken by time devoted to electronic health records and desk work; family doctors have played a progressively less central role; clinical reasoning is being replaced by guidelines and algorithms; the public at large and a number of young physicians tend to believe that medicine is a perfect science rather than an imperfect art, as it continues to be; and modern societies do not tolerate the inevitable morbidity and mortality. To finally reduce the increasing defensive behavior of doctors around the world, the decriminalization of medical errors and the assurance that they can be dealt with in civil courts or by medical organizations in all countries could help but it would not suffice. Physicians and surgeons should be allowed to spend the time they need with their patients and should give clinical reasoning the importance it deserves. The institutions should support the doctors who have experienced adverse patient events, and the media should stop reporting with excessive evidence presumed medical errors and subject physicians to "public trials" before they are eventually judged in court.展开更多
针对图像分割中的困难样本,提出了一种对像素区域细分计算的Generalized Region Loss的新的代价函数;首先通过引入一项参数,改变了以往代价函数主要通过设置权重或Focal等关注困难样本的方法,其次通过对标签图像和预测图像进行区域划分...针对图像分割中的困难样本,提出了一种对像素区域细分计算的Generalized Region Loss的新的代价函数;首先通过引入一项参数,改变了以往代价函数主要通过设置权重或Focal等关注困难样本的方法,其次通过对标签图像和预测图像进行区域划分,并且对划分四区域的困难样本分类关注,最后分别计算其四区域绝对损失,进而进行加权组合;为验证算法性能,使用CamVid数据集作为实验数据,该代价函数在FCN和U-Net两种图像分割网络上得到验证,同当前图像分割领域常用的12种代价函相比,IoU指标分别提高1.93%和2.99%,由此证明此代价函数优于大多数图像分割代价函数;最终实验结果表明,提出的基于像素区域细分计算的代价函数能够有效提高图像分割精度,为图像分割的研究提供借鉴。展开更多
文摘Defensive medicine is widespread and practiced the world over, with serious consequences for patients, doctors, and healthcare costs. Even students and resi-dents are exposed to defensive medicine practices and taught to take malpractice liability into consideration when making clinical decisions. Defensive medicine is generally thought to stem from physicians' perception that they can easily be sued by patients or their relatives who seek compensation for presumed medical errors. However, in our view the growth of defensive medicine should be seen in the context of larger changes in the conception of medicine that have taken place in the last few decades, undermining the patient–physician trust, which has traditionally been the main source of professional satisfaction for physicians. These changes include the following: time directly spent with patients has been overtaken by time devoted to electronic health records and desk work; family doctors have played a progressively less central role; clinical reasoning is being replaced by guidelines and algorithms; the public at large and a number of young physicians tend to believe that medicine is a perfect science rather than an imperfect art, as it continues to be; and modern societies do not tolerate the inevitable morbidity and mortality. To finally reduce the increasing defensive behavior of doctors around the world, the decriminalization of medical errors and the assurance that they can be dealt with in civil courts or by medical organizations in all countries could help but it would not suffice. Physicians and surgeons should be allowed to spend the time they need with their patients and should give clinical reasoning the importance it deserves. The institutions should support the doctors who have experienced adverse patient events, and the media should stop reporting with excessive evidence presumed medical errors and subject physicians to "public trials" before they are eventually judged in court.
文摘针对图像分割中的困难样本,提出了一种对像素区域细分计算的Generalized Region Loss的新的代价函数;首先通过引入一项参数,改变了以往代价函数主要通过设置权重或Focal等关注困难样本的方法,其次通过对标签图像和预测图像进行区域划分,并且对划分四区域的困难样本分类关注,最后分别计算其四区域绝对损失,进而进行加权组合;为验证算法性能,使用CamVid数据集作为实验数据,该代价函数在FCN和U-Net两种图像分割网络上得到验证,同当前图像分割领域常用的12种代价函相比,IoU指标分别提高1.93%和2.99%,由此证明此代价函数优于大多数图像分割代价函数;最终实验结果表明,提出的基于像素区域细分计算的代价函数能够有效提高图像分割精度,为图像分割的研究提供借鉴。
