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AI Improves Fracture Detection on Whole-Body Trauma CT

By MedImaging International staff writers
Posted on 11 Oct 2022

$Image: AI algorithm can help to avoid missed fractures on whole-body trauma CT exams (Photo courtesy of Pexels)$

Image: AI algorithm can help to avoid missed fractures on whole-body trauma CT exams (Photo courtesy of Pexels)

The emergency department is an environment with a potential risk for diagnostic errors during trauma care, particularly for fractures. In the primary management of patients with multiple traumas, whole-body CT scanning is recommended as a standard of care. It is well established that CT scanning is superior to plain radiographs in the evaluation of fractures. Nonetheless, missed diagnoses are common. Convolutional neural network (CNN) deep learning methods are now widely used in medicine because they improve diagnostic accuracy, decrease misinterpretation, and improve efficiency. Now, a new study has found that with CNN model assistance, surgeons showed improved sensitivity for detecting fractures and the time of reading and interpreting CT scans was reduced, especially for less experienced orthopedic surgeons. The findings suggest that application of the CNN model may lead to reductions in missed fractures from whole-body CT images and to faster workflows and improved patient care through efficient diagnosis in polytrauma patients.

In the study, researchers at Chiba University (Chiba, Japan) investigated whether automatic localization and classification using CNN could be applied to pelvic, rib, and spine fractures. They also examined whether this fracture detection algorithm could help physicians in fracture diagnosis. A total of 7664 whole-body CT axial slices (chest, abdomen, pelvis) from 200 patients were used. Out of this, 5,217 images from 181 patients were used for training and validation, while 2,447 images from 19 patients were set aside for a test dataset. The test dataset included 5.8% with pelvic fractures, 5.5% with spine fractures, and 3.6% with rib fractures.

The researchers found that on its own, the algorithm produced a sensitivity of 78.6%, precision of 64.8%, and an F1 score of 0.711. The researchers then assessed the performance of three orthopedic surgeons on the test set with as well as without the help of AI. Two orthopedic surgeons had three years of experience, while the third orthopedic surgeon had eight years of experience. The researchers found that AI sharply reduced the time to diagnosis from 278.4 seconds to 162.3 seconds for one surgeon, from 205.2 seconds to 144.5 seconds for the second surgeon, and from 233.7 seconds to 155.5 seconds for the third surgeon. All differences were statistically significant (p < 0.0001). Based on the findings, the researchers concluded that the CNN could serve as a triage system in a busy emergency department and the use of AI can also lead to shorter reading times.

"Even though each examination takes just a few minutes, a reduction in reading time has a significant impact for emergency staff who make multiple clinical decisions each day," the authors wrote. "Emergency physicians and radiologists on long shifts may experience fatigue and oculomotor strain, resulting in a reduced ability to focus and to detect fractures. Fracture recognition using CNN is not only able to detect subtle findings that are difficult for inexperienced physicians to diagnose but also prevents cognitive errors due to human fatigue and biased image interpretation."

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67 (812.05368041992): select jos_linkedin.link from jos_linkedin where cat=10

68 (!!!!! 3296.8521118164): SELECT fid FROM jos_deeppockets WHERE id=294794903 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294794903 AND published='1' LIMIT 1

69 (425.81558227539): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=215 ORDER BY `ordering`

70 (684.97657775879): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294794903 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (!!!!! 3941.0591125488): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294794903 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (46.014785766602): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

73 (586.03286743164): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (138.0443572998): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (43.869018554688): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (689.02969360352): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (532.86552429199): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (389.09912109375): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (347.85270690918): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (191.92695617676): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (332.11708068848): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (227.92816162109): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (247.00164794922): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (205.99365234375): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (!!!!! 1111.9842529297): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294794903 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (211.95411682129): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294794903 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (!!!!! 1920.9384918213): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

90 (63.896179199219): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (221.96769714355): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (148.05793762207): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (123.02398681641): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (118.97087097168): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (118.97087097168): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (133.03756713867): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (123.02398681641): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (820.15991210938): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794903 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294794903 AND published='1' LIMIT 1

105 (196.93374633789): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794903 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294794903 AND published='1' LIMIT 1

106 (380.03921508789): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294794903 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (531.91184997559): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294794903 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (!!!!! 1020.1930999756): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794903 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294794903 AND published='1' LIMIT 1

109 (252.96211242676): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794903 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294794903 AND published='1' LIMIT 1

110 (!!!!! 1143.9323425293): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294794903 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (838.9949798584): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294794903 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (648.97537231445): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

113 (378.84712219238): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

114 (84.877014160156): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794903 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294794903 AND published='1' LIMIT 1

115 (66.995620727539): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794903 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294794903 AND published='1' LIMIT 1

116 (94.890594482422): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794903 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294794903 AND published='1' LIMIT 1

117 (41.007995605469): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794903 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294794903 AND published='1' LIMIT 1

118 (51.021575927734): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794903 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294794903 AND published='1' LIMIT 1

119 (38.862228393555): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794903 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294794903 AND published='1' LIMIT 1

120 (263.92936706543): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

121 (!!!!! 72127.103805542): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

122 (193.11904907227): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794903 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294794903 AND published='1' LIMIT 1

123 (81.062316894531): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794903 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294794903 AND published='1' LIMIT 1

124 (552.17742919922): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294794903 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294794903 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 1493510.0078583): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

126 (!!!!! 822139.97840881): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

127 (396.0132598877): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

128 (251.05476379395): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

129 (348.09112548828): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

130 (!!!!! 1156.0916900635): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

131 (308.99047851562): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

132 (36.954879760742): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

133 (!!!!! 1977.9205322266): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794903 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

134 (!!!!! 1868.9632415771): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294794903 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

135 (756.97898864746): SELECT name FROM jos_deeppockets WHERE id=215

136 (932.21664428711): SELECT name FROM jos_deeppockets WHERE id=215

137 (818.01414489746): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))215((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

138 (!!!!! 1502.9907226562): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))215((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

139 (!!!!! 4487.0376586914): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794903 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294794903 AND published='1' LIMIT 1

140 (244.140625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794903 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294794903 AND published='1' LIMIT 1

141 (!!!!! 13038.873672485): TRUNCATE TABLE jos_trademed_module

142 (447.98851013184): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294794903 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

143 (581.97975158691): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294794903 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

144 (!!!!! 2948.0457305908): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794903 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

145 (997.06649780273): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794903 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

146 (!!!!! 4385.9481811523): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794903 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294794903 AND published='1' LIMIT 1

147 (479.93659973145): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794903 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294794903 AND published='1' LIMIT 1

148 (!!!!! 1760.0059509277): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

149 (!!!!! 2547.025680542): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794903 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294794903 AND published='1' LIMIT 1

150 (135.89859008789): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794903 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294794903 AND published='1' LIMIT 1

151 (!!!!! 1016.8552398682): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294794903 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294794903 AND type='deeppockets_item' AND published='1' LIMIT 1

152 (80.108642578125): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=215 or channel_id is null)

153 (327.82554626465): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=215 or channel_id is null)

154 (502.10952758789): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

155 (!!!!! 5372.0474243164): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794903 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294794903 AND published='1' LIMIT 1

156 (570.05882263184): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294794903 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294794903 AND published='1' LIMIT 1

157 (226.02081298828): select jos_twitters.link from jos_twitters where cat=10

158 (33.855438232422): select jos_facebook.link from jos_facebook where cat=10

159 (114.91775512695): select jos_google_plus.link from jos_google_plus where cat=10

160 (270.12825012207): select jos_linkedin.link from jos_linkedin where cat=10

161 (!!!!! 1013.9942169189): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

162 (!!!!! 3779.8881530762): insert into jos_banners_delta values (14615,'2025-04-30 18:27:59','3.145.42.128','view'),(14202,'2025-04-30 18:27:59','3.145.42.128','view'),(14203,'2025-04-30 18:27:59','3.145.42.128','view')

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