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COPD.Pal: Using a person-based approach to develop a self-management app for people with COPD 慢性阻塞性肺病。Pal:使用以人为本的方法开发COPD患者的自我管理应用程序
Pub Date : 2021-09-05 DOI: 10.1183/13993003.congress-2021.oa2739
L. Knox, R. Gemine, S. Rees, S. Bowen, Phil Groom, David Taylor, Ian Bond, K. Lewis
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引用次数: 0
Respiratory upskilling training sessions for redeployed clinical staff in the COVID-19 pandemic 为COVID-19大流行期间重新部署的临床工作人员提供呼吸技能培训课程
Pub Date : 2021-09-05 DOI: 10.1183/13993003.congress-2021.oa2744
N. Smallcombe, A. Sweeney, Filitsa Allwright, Rachel Crisp, H. Mills, R. Gill, W. Ricketts
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引用次数: 0
The assessment of physicians’ knowledge of community-acquired pneumonia basics: KNOCAP study 医生对社区获得性肺炎基本知识的评估:KNOCAP研究
Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa1483
R. Bontsevich, A. Gavrilova, G. Prozorova, O. Myronenko, T. M. Shagieva, O. Kompaniets, V. Barysheva, G. Ketova, E. Luchinina, E. Miliutina, T. Filinichenko, O. Osipova
Objective: To assess physicians’ level of knowledge in clinical picture, diagnosis and treatment of community-acquired pneumonia (CAP) and its comparison with national clinical standards. Material and Methods: Multicenter research (KNOCAP study) was conducted in Russian and Ukrainian cities Belgorod, Saratov, Dnipro, Voronezh, Chelyabinsk, Tambov, Lipetsk and Kuban’ Region during 2017-2018. We assessed 255 physicians in the knowledge of CAP basics by asking them to complete a questionnaire (14 questions). Results: The average level of correct answers totaled 49.6%, and varied from 39.9% to 58.2% in different centers. The most difficult questions were related to an optimal time for control (repeated) X-ray examination on top of positive dynamics of CAP treatment (20.5% of correct answers), CAP main diagnostic character (38.2%), optimal initial CAP therapy in patients without risk factors (24.9%) and patients with risk factors (17.5%); only 34.9% of the physicians surveyed correctly reported typical mistakes in the treatment of a non-severe CAP. The maximum numbers of correct answers were given on the following questions: postpone reasons for CAP antibiotic therapy (85.8%), the efficiency of pneumococcal and influenza vaccination (82.9%), CAP main pathogens (63.8%) and “inaccurate/ amphibolic” diagnosis of CAP in the absence of X-ray examination (62.6%). Conclusions: The results gained in the survey revealed the insufficient level of physicians’ knowledge in management of patients with CAP. On the one hand, a number of issues need to be considered more carefully, on the other hand, educational activities have to be conducted among physicians of medical and preventive treatment facilities.
目的:了解临床医师对社区获得性肺炎(CAP)的临床知识、诊治知识及与国家临床标准的比较。材料和方法:多中心研究(KNOCAP研究)于2017-2018年在俄罗斯和乌克兰城市别尔哥罗德、萨拉托夫、第聂伯罗、沃罗涅日、车里雅宾斯克、坦波夫、利佩茨克和库班地区进行。我们通过要求255名医生完成一份问卷(14个问题)来评估他们对CAP基础知识的了解。结果:平均答对率为49.6%,不同中心答对率在39.9% ~ 58.2%之间。最难回答的问题为:在CAP治疗积极动态的基础上进行对照(重复)x线检查的最佳时间(20.5%)、CAP主要诊断特征(38.2%)、无危险因素患者的最佳初始CAP治疗(24.9%)和有危险因素患者的最佳初始CAP治疗(17.5%);仅34.9%的受访医师正确报告了非严重CAP治疗中的典型错误,正确回答最多的是以下问题:延迟CAP抗生素治疗的原因(85.8%)、肺炎球菌和流感疫苗接种的效率(82.9%)、CAP主要病原体(63.8%)和在没有x线检查的情况下对CAP的“不准确/模棱两可”诊断(62.6%)。结论:调查结果显示,医生在CAP患者管理方面的知识水平不足,一方面需要认真考虑一些问题,另一方面需要对医疗和预防治疗机构的医生进行教育活动。
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引用次数: 5
Improving the standard of practical pleural procedures teaching for junior doctors: A quality improvement project 提高初级医师胸膜实务教学水平:一项质量改进工程
Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa1472
Junyi Zhang, Adam Loveridge, S. Mahendran
Introduction: Junior doctors in the UK are required to gain pleural procedural competencies during their 2-3 year core training program, but their exposure to these are highly variable and they struggle to meet their curriculum requirements. Objectives: By scheduling attendance at pleural clinics for our trainees, we aimed to formalise and improve the overall quality of pleural procedural teaching and increase their confidence at performing and caring for patients undergoing these procedures. Action: All 11 core trainees at Kingston Hospital were invited to attend consultant delivered pleural clinics between February and August 2018. Questionnaires were completed pre and post intervention to measure the trainees’ experience and their confidence level regarding various aspects of pleural procedural management. Outcome: Pre intervention, 0 of the 11 trainees had received regular bedside teaching of pleural procedures and only 2 trainees felt their training requirements had been met adequately by their exposure so far. Post intervention, all trainees felt their training requirements for pleural procedures had been met. Their self reported confidence levels across all aspects of medical pleural procedures had increased; including pleural procedure indications, equipment use, procedural skills and management of complications. Conclusion: Through this simple intervention we have successfully improved the confidence of our trainees in performing and caring for patients undergoing practical pleural procedures. This intervention was effective, cost-neutral and can be easily adapted to other practical procedures and services in which a daycase or outpatient service is already established.
简介:在英国,初级医生需要在2-3年的核心培训计划中获得胸膜手术能力,但他们对这些技能的接触是高度可变的,他们很难满足课程要求。目的:通过安排学员到胸膜诊所就诊,我们旨在规范和提高胸膜手术教学的整体质量,提高他们在执行和照顾接受这些手术的患者方面的信心。行动:2018年2月至8月期间,金斯敦医院的所有11名核心受训人员都被邀请参加顾问提供的胸膜门诊。在干预前和干预后完成问卷调查,以衡量受训者对胸膜手术管理各方面的经验和信心水平。结果:干预前,11名受训者中有0人接受了定期的胸膜手术床边教学,只有2名受训者认为他们的培训要求得到了充分的满足。干预后,所有受训者都感到他们对胸膜手术的训练要求已得到满足。他们自我报告的胸膜手术各方面的信心水平有所提高;包括胸膜手术指征,设备使用,手术技巧和并发症的处理。结论:通过这个简单的干预,我们成功地提高了我们的学员在执行和护理实际胸膜手术患者的信心。这种干预是有效的,成本中性的,可以很容易地适应于其他实际的程序和服务,其中日间病例或门诊服务已经建立。
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引用次数: 0
Medical registrar experience of chest drains - a stab in the dark? 注册医生胸部引流的经验-在黑暗中捅刀子?
Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.oa5347
F. Conway
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引用次数: 0
Improving education through a national blended learning program for caregivers and informal caregivers of home mechanical ventilation patients in the Netherlands. National Education Program for Home Mechanical Ventilation in the Netherlands 通过荷兰家庭机械通气患者护理人员和非正式护理人员的国家混合学习计划改善教育。荷兰家庭机械通气国家教育计划
Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.oa5345
S. Steijns, M. Gol, N. Kalkman, C. J. Roosekrans, M. Thió, A. Veldhorst, I. Sinnema
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引用次数: 0
Team Based Learning is a helpful strategy for teaching respiratory guidelines to Trainee Medical Doctors 以团队为基础的学习是向实习医生教授呼吸指南的有效策略
Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa1488
D. Draicchio, A. Choudhury, J. Alcolado
Background: Compliance with clinical practice guidelines is sub-optimal. Guidelines are often taught in a didactic method that does not favour a greater depth of understanding. Team Based Learning (TBL) is a five step educational strategy which aims to promote greater retention of knowledge. Methods: Two Respiratory guidelines of key clinical importance were chosen as the teaching subject matter - The BTS guidelines for Oxygen use in adults 2017 and the BTS/SIGN Asthma guidelines 2016. Teaching was delivered via two one-hour sessions to Foundation Year two Doctors. Preparatory reading materials were sent out in advance. Trainees were split into small working groups and asked to complete two attempts of a 20 MCQ test (individually and then in groups). Answers were given through a facilitator led slide presentation with open participant discussion. Deeper learning was facilitated through a detailed case summary with critique of four potential management plans. Results: Feedback was collated from an immediate post-session questionnaire and then afterwards using a Likert rating scale. 100% of participants felt that the objectives of the session were identified and met and that delivery was effective. Doctors were asked to identify any advantages to using the TBL methodology - 42% stated increased session engagement in their free text answers. The same question was asked for disadvantages – the most common theme (35.7% of answers) was increased time of the session. Conclusions: TBL was felt by trainees to be a positive way to learn and embed new knowledge. Further research is needed to see if TBL methods increase the likelihood of guideline adherence in clinical practice.
背景:临床实践指南的依从性是次优的。指导方针通常是以一种说教式的方法教授的,这种方法不利于更深入的理解。基于团队的学习(TBL)是一种旨在提高知识留存率的五步教育策略。方法:选取具有重要临床意义的两份呼吸系统指南——《BTS成人氧气使用指南2017》和《BTS/SIGN哮喘指南2016》作为教学主题。教学通过两个一小时的课程提供给预科二年级的医生。预备阅读材料已提前发出。受训者被分成几个工作小组,并被要求完成两次20 MCQ的测试(单独完成,然后分组完成)。答案是通过主持人主持的幻灯片演示和公开的参与者讨论给出的。通过详细的案例总结和对四种潜在管理计划的批评,促进了更深入的学习。结果:反馈整理从立即会后的问卷调查,然后使用李克特评定量表。100%的参与者认为会议的目标得到了确定和满足,并且交付是有效的。医生被要求确定使用TBL方法的任何优势- 42%的人在他们的免费文本回答中表示增加了会话参与度。同样的问题被问及缺点——最常见的主题(35.7%的答案)是增加了会议时间。结论:学员认为TBL是一种积极的学习和嵌入新知识的方式。需要进一步的研究来确定TBL方法是否增加了临床实践中遵循指南的可能性。
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引用次数: 0
Late Breaking Abstract - Training thoracic ultrasound skills: a multicentre, blinded, randomized controlled trial of simulation-based training versus training on healthy figurants 摘要-训练胸部超声技能:一项多中心、盲法、随机对照试验,基于模拟的训练与健康人的训练
Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.oa5341
P. Pietersen, Rasmus Jørgensen, O. Graumann, L. Konge, S. Skaarup, H. H. L. Schultz, C. Laursen
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引用次数: 0
Artificial Intelligence applied to asthma biomedical research: a systematic review 人工智能在哮喘生物医学研究中的应用:系统综述
Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa1482
A. Malva, F. Arpinelli, G. Recchia, C. Micheletto, Robert Alexander
Introduction: A major application of Artificial Intelligence (AI) is to uncover relevant information from big data. This technology could play major roles in medicine, such as identification of new targets, discovery of new molecules, diagnostics, therapy selection, risk prediction and stratifying disease. Aims and Objective: To provide a review of existing algorithms for the application of AI in research and medical management of asthma. Methods: We performed a systematic review of English scientific articles, using the PubMed database, until Dec. 2018. Search terms included AI, machine learning, deep learning in single combination with asthma term. We included papers focused on human asthma, based on machine learning algorithms. Results: We selected 136 papers on 253 found after excluding duplicated and papers which did not meet inclusion criteria. 52 (40%) regarded the application of AI in asthma pathway analysis, phenotype and biomarker identification, 77 (56%) involved AI in asthma diagnosis, early prediction of exacerbations and predicting control, 7 (5%) are related to AI as support to the management and personalization of the treatment. Conclusions: Standard validation method of these technologies has not been established and data used in each work originate from different sources. Hence it is impossible to perform a direct outcome comparison of selected articles for each application. Evidences of AI confirmed proof of concept, but in order to transfer AI to clinical practice a systematic evaluation of properties, effects, and impacts of health technology is needed.
导读:人工智能(AI)的一个主要应用是从大数据中发现相关信息。这项技术可以在医学中发挥重要作用,例如识别新靶点、发现新分子、诊断、治疗选择、风险预测和疾病分层。目的与目的:综述人工智能在哮喘研究和医疗管理中的应用。方法:我们使用PubMed数据库对英文科学文章进行了系统回顾,直到2018年12月。搜索词包括人工智能,机器学习,深度学习与哮喘词的单一组合。我们收录了基于机器学习算法的关于人类哮喘的论文。结果:剔除重复和不符合纳入标准的论文后,我们筛选出253篇论文中的136篇。52例(40%)认为人工智能应用于哮喘通路分析、表型和生物标志物鉴定,77例(56%)认为人工智能应用于哮喘诊断、急性加重早期预测和预测控制,7例(5%)认为人工智能支持管理和个性化治疗。结论:这些技术的标准验证方法尚未建立,各工作中使用的数据来源不同。因此,不可能对每个应用程序的选定文章进行直接的结果比较。人工智能的证据证实了概念的证明,但为了将人工智能应用于临床实践,需要对卫生技术的特性、效果和影响进行系统评估。
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引用次数: 1
Pulmonary hypertension – an unmet need in undergraduate medical education 肺动脉高压——本科医学教育未满足的需求
Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa1489
N. Hill, N. Bascon, N. Barnes, B. Madden
Introduction: Pulmonary hypertension (PH) is a fascinating subject which interdigitates with many specialities as the classification of the condition into five groups testifies. Knowledge of the condition is, in our experience, poor among medical students. As doctors, this subject is relevant regardless of future career direction. To address this gap, we have arranged a formal training programme for medical students each term at St George’s University of London. Aim: To improve knowledge in PH among our medical students Methods: For over 10 years medical students have been performing specialist subject modules (SSM) in PH over a term. This involves weekly meetings with Professor Brendan Madden, opportunities to attend Right Heart Catheterisation lists, Computed Tomography scanning, lung function testing, cardiac MRI, PH outpatient clinics, multidisciplinary team meetings and ward rounds. At the end of the study period, each student prepares a 4,000 word PH related project and gives a 5 minute presentation; and provides feedback on the course. The grade attained contributes towards their end of year grade. Results: For the past 10 years, 200 second year medical students (10 students each term, for two terms a year), participated in this course. All rated their experience very useful and reported that the lessons learnt helped them with their future medical cases. Patient feedback was also positive. 70% attained an honours grade. None failed. 7 students presented their work at international scientific meetings. Conclusion: We believe that PH is poorly taught at medical school and projects such as ours helps to address this.
肺动脉高压(PH)是一个引人入胜的主题,它与许多专业交叉,分为五组的条件证明。根据我们的经验,医学生对这种情况的了解很少。作为医生,无论未来的职业方向如何,这门学科都是相关的。为了弥补这一差距,我们每学期在伦敦圣乔治大学为医科学生安排了一个正式的培训方案。目的:提高医学生对PH的认识方法:十多年来,医学生在一个学期内完成了PH的专业学科模块(SSM)。这包括每周与Brendan Madden教授会面,参加右心导管检查清单,计算机断层扫描,肺功能测试,心脏MRI, PH门诊,多学科团队会议和查房。在学习结束时,每位学生准备一份4000字的PH相关项目,并做5分钟的演讲;并对课程提供反馈。取得的成绩会影响他们的年终成绩。结果:10年来,共有200名二年级医学生(每学期10人,每年两学期)参加了本课程。所有人都认为他们的经历非常有用,并报告说,从中吸取的教训对他们今后的医疗案件有帮助。病人的反馈也是积极的。70%的学生获得荣誉等级。没有失败。7名学生在国际科学会议上展示了他们的工作。结论:我们认为PH在医学院的教学很差,我们的项目有助于解决这个问题。
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引用次数: 0
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Medical education, web and internet
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