Medical education, web and internet最新文献_第4页

The importance of inhaler technique education in asthma and COPD: a long-term follow-up 哮喘和慢性阻塞性肺病患者吸入器技术教育的重要性:长期随访

Medical education, web and internet Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa1479

T. Klemmeier, Luc H. Steenhuis, S. Schokker

{"title":"The importance of inhaler technique education in asthma and COPD: a long-term follow-up","authors":"T. Klemmeier, Luc H. Steenhuis, S. Schokker","doi":"10.1183/13993003.congress-2019.pa1479","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa1479","url":null,"abstract":"Background: Our randomised controlled trial (RCT) evaluating the value of an inhaler-specific visual aid as adjunct to standard inhaler technique education, showed beneficial short-term (after 6-8 weeks) effects. Correct inhaler technique improved from 8% to 70% of patients with asthma or COPD. Aim: To evaluate the long-term effects of inhaler technique education in asthma or COPD. Methods: Patients who participated in our RCT and completed both visits (n=98) were invited for a 1-year follow-up (FU) visit as part of routine care. All patients had completed inhaler technique education, including the use of the visual aid at short-term FU. During long-term FU inhaler technique was (re)assessed using inhaler-specific checklists. Results: Inhaler technique was evaluated in 56 patients (mean age 64±12yrs, 52% male) with asthma (45%) or COPD (55%). Reasons for not attending long-term FU were: referral to primary care (n=13), unwilling (n=6), deceased (n=4), lost to follow-up (n=19). Inhaler technique was adequate in 37 patients (66%). The most common mistakes with incorrect technique (n=19) were: no complete exhalation before inhalation (n=10, DPI), no 5 times in- and exhaling through the mouthpiece (n=5, MDI with spacer). Incorrect technique occurred more in COPD (48%) as compared to asthma (16%). Patients with incorrect technique were significantly older (69yrs) as compared to patients with adequate technique (62yrs). Conclusion: This study demonstrates positive long-term effects of thorough inhaler technique education. Yet, the number of patients who inhaled incorrectly stresses the importance of monitoring and (repeatedly) educating correct inhaler technique, particularly in older COPD patients.","PeriodicalId":228043,"journal":{"name":"Medical education, web and internet","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116969341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Students’ knowledge of bronchial asthma: ASSA-1 and ASSA-2 results comparison 学生支气管哮喘知识:ASSA-1与ASSA-2结果比较

Medical education, web and internet Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa1477

R. Bontsevich, A. Mikhno, K. Shchurovskaya, N. Goncharova, G. Batisheva, V. Barysheva, G. Ketova, O. Myronenko, G. M. Bikkinina, Zhanna Zhdanova, T. Pokrovskaia

{"title":"Students’ knowledge of bronchial asthma: ASSA-1 and ASSA-2 results comparison","authors":"R. Bontsevich, A. Mikhno, K. Shchurovskaya, N. Goncharova, G. Batisheva, V. Barysheva, G. Ketova, O. Myronenko, G. M. Bikkinina, Zhanna Zhdanova, T. Pokrovskaia","doi":"10.1183/13993003.congress-2019.pa1477","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa1477","url":null,"abstract":"The Aim: of study is to assess the dynamics of medical undergraduates’ knowledge of bronchial asthma (BA) basics. Materials and Methods: Following up our multicenter research ASSA-1 (‘14-‘15, 7 cities, 521 medical majors), we started ASSA-2 project in 2017. Currently, we obtained the results from 249 undergraduates tested in 8 Russian and Ukrainian centers. The knowledge of BA basics such as definition, pathogenesis, diagnostics and treatment was evaluated by applying the 12 single-choice questions survey. Results: The average level of correct answers in both groups (ASSA-1 and ASSA-2) was not significantly increased (74.0%-72.6%), and varied from 56.8%-49.2% to 93.9%-90.0% in different questions. The most difficult questions were still related to exact BA definition in both groups (ASSA-1 and ASSA-2) 56.8%-49.2%, p The groups did not demonstrate any significant dynamics in the following questions: pathogenesis (70.8%-66.3%), instrumental and laboratory markers (65.6%-65.7%), main diagnosis methods (85.6%-87.6%), severity levels (80.6%-77.1%), self-control over BA (74.5%-71.9%), status asthmaticus definition (93.9%-90.0%), asthma attack therapy (78.9%-77.7%), fixed combination drugs (61.4%-60.2%). The knowledge of BA baseline therapy had significantly increased among ASSA-2 group in comparison to ASSA-1 (75.9%-64.5%, p Conclusion: It was revealed that despite the availability of plenty training and scientific literature in the area of bronchial asthma, the level of knowledge remains unsatisfactory. Thus, BA subject should be studied more thoroughly in higher schools.","PeriodicalId":228043,"journal":{"name":"Medical education, web and internet","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117172428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Lowering the p value threshold in recently published Respiratory Medicine RCTs 降低最近发表的呼吸医学随机对照试验的p值阈值

Medical education, web and internet Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa1484

A. Malhotra, K. Grice, N. Shah

{"title":"Lowering the p value threshold in recently published Respiratory Medicine RCTs","authors":"A. Malhotra, K. Grice, N. Shah","doi":"10.1183/13993003.congress-2019.pa1484","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa1484","url":null,"abstract":"Introduction: The use and misuse of p values remains controversial, with increasing support for lowering the threshold of statistical significance from 0.05 to 0.005, to reduce false positive results. A recent evaluation of randomised controlled trials (RCTs) determined that 70% would maintain significance if the p value threshold was Methods: RCTs published in the American Journal of Respiratory and Critical Care Medicine (AJRCCM), European Respiratory Journal (ERJ), Chest, Lancet Respiratory Medicine and Thorax (2017-2018) were identified. Pooled analyses and RCTs using Bayesian or noninferiority analyses were excluded. Data extracted included whether each RCT was multicentre, multinational, a drug trial and sample size. Results: 125 studies were included. 62/125 (49.6%) reported a significant primary end point with p value Discussion: Of statistically significant primary end points published in respiratory medicine RCTs, only 50% would maintain statistical significance with a threshold of 0.005. This may be because treatment effects are not large enough to be assessed at this level of significance. Lowering the p value threshold would have an important impact on the clinical applicability of RCT findings and alternative methods such as Bayesian analysis should be explored as potential solutions to the controversy of p values. Reference: [1] JAMA. 2016;315(11):1141-1148.","PeriodicalId":228043,"journal":{"name":"Medical education, web and internet","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129619004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

A new patient-centered classification system for adverse drug reactions 一种新的以患者为中心的药物不良反应分类系统

Medical education, web and internet Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa1478

F. Rahaghi, S. Tunnicliffe, Vianca Reeves, Starlet Harrimon, William Kernan

{"title":"A new patient-centered classification system for adverse drug reactions","authors":"F. Rahaghi, S. Tunnicliffe, Vianca Reeves, Starlet Harrimon, William Kernan","doi":"10.1183/13993003.congress-2019.pa1478","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa1478","url":null,"abstract":"Introduction: Long term medication adherence is often determined by patients’ perceptions of a drug’s effectiveness and potential adverse reactions. Adverse drug reactions are now listed in manufacturing package inserts in a manner that does not emphasize either the expected incidence or risk level. Aims and Objectives: We discuss and propose a new format for listing adverse drug reactions to be in a more patient centered classification system. Methods: We explored a variety of communication methods observed for illustration of risk in medical literature. Results: We found the methodology of risk disclosure used by many institutional review boards designed for full disclosure of potential presenting adverse effects in research may be generalized to clinical communication of approved medications. This takes the form of grid with risk and probability as the axis (Table1). Providers and patients should be more aware of what adverse reactions would be expected or likely to occur versus a simple listing of reactions with incidences. This allows to focus on discussing interventions to protect against the likely/expected adverse effects, while allaying fears of occurrence of less likely effects. Conclusions: We believe this would lead to improved provider and patient understanding of a medications adverse reactions and ultimately to improved patient adherence and outcomes.","PeriodicalId":228043,"journal":{"name":"Medical education, web and internet","volume":"72 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124456247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Do UK postgraduate medical trainees prefer to do mentor supported respiratory quality improvement projects compared to traditional audit? 与传统审核相比，英国医学研究生实习生是否更喜欢导师支持的呼吸质量改善项目?

Medical education, web and internet Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa1481

A. Choudhury, J.C. Alcolado

{"title":"Do UK postgraduate medical trainees prefer to do mentor supported respiratory quality improvement projects compared to traditional audit?","authors":"A. Choudhury, J.C. Alcolado","doi":"10.1183/13993003.congress-2019.pa1481","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa1481","url":null,"abstract":"Aim: To explore views of postgraduate doctors of performing mentor supported respiratory quality improvement (QI) projects compared to audit. Background: Two respiratory QI projects took place on 2 acute 30-bedded chest wards in an acute hospital in Essex, UK. 9 FY doctors and a CMT undertook the QI projects. 6 trainees improved the 48-hour antimicrobial stewardship on drug charts (Hobday et al, BHJM 2018), and 4 trainees improved oxygen prescribing and delivery (Choudhury et al, BMJOQ 2018). Both achieved their desired patient outcomes. Methods: A qualitative study was conducted to explore doctors’s views on participating in mentor-supported respiratory QI projects. All 10 participants attended structured focus-group interviews. Analysis was performed using open/category codes and formulated into major themes. One emergent theme was the medical trainee’s view on performing mentor supported respiratory QI programmes compared to audits. Results: Trainee collaboration was a highlight. The were able to “share learning between each other”, and foster “shared responsibility”. Active learning through QI practicum were described; “Everybody who comes through QI, learns from it, and that’s a powerful effect” and “the hands-on experience of QI…was pivotal”. Tradition audit was viewed as “just data collection” and a “big waste of time”. Audit supervisors’ roles were also negatively appraised as “always very personal” with a ”view to publishing stuff’\". Conclusions: Trainees reflected positively towards their respiratory QI projects. Their experience of audit was less favourable, questioning both their educational validity and clinical usefulness.","PeriodicalId":228043,"journal":{"name":"Medical education, web and internet","volume":"62 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132387824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Effects of programed education for chronic obstructive pulmonary disease on tertiary teaching hospital 慢性阻塞性肺疾病程序化教育在三级教学医院的效果

Medical education, web and internet Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa1474

J. Jang, J. Chung, K. Shin, E. Choi, H. Jin, J. Ahn, Kwanyole Lee

引用次数: 0

Clinical effect on asthma control using a novel digital self-management solution: a physician blinded randomized controlled crossover trial 新型数字化自我管理解决方案对哮喘控制的临床效果:一项医生盲法随机对照交叉试验

Medical education, web and internet Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.oa5343

H. Ljungberg, Anna Carleborg, B. Nordlund

引用次数: 1

Developing a successful medical team using WhatsApp(TM) and social media (1 year follow up) 利用WhatsApp(TM)和社交媒体建立一支成功的医疗团队(1年跟进)

Medical education, web and internet Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa1473

R. Crișan-Dabija, A. Cernomaz, T. Mihăescu, Dumitru Filipeanu

{"title":"Developing a successful medical team using WhatsApp(TM) and social media (1 year follow up)","authors":"R. Crișan-Dabija, A. Cernomaz, T. Mihăescu, Dumitru Filipeanu","doi":"10.1183/13993003.congress-2019.pa1473","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa1473","url":null,"abstract":"Social media and internet availability on more and more affordable smartphones encourage doctors to communicate more across specialties, to consult and offer realtime insights on cases, dramatically shortening the time until an investigation is prescribed or a therapeutic decision is made. Followingup a small study regarding resident doctors in Clinic of Pulmonary Diseases in Iasi and their use of WhatsAppO messaging smartphone app we extended our questionnaire to doctors and nurses from a wider range of age, specialization and social media messagingapp preference using the same 3 items questionnaire as previously presented (ERJ 52, suppl 62). Our result showed that 85% of doctors and nurses use social media to communicate professionally when caring a patient with complex pathology. 68% of doctors over 45 years prefer telephone calls while 32% send images and tests results via social media apps to consult with colleagues from other speciality. 91% of doctors between 25 and 45 years use social media apps (preferably WhatsApp(TM)) to ask for other colleagues opinion but only 26% of nurses use social media to ask for indications when communicating with doctors. Although social media messaging apps like WhatsApp(TM), which seems to be preferred in professional communications between doctors and nurses, are still in a “greyarea”, the need for a dedicated medical app to fulfil this clear need of rapid consultations while preserving patient sensitive data, seems clear and neccessary.","PeriodicalId":228043,"journal":{"name":"Medical education, web and internet","volume":"150 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116368395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Multidisciplinary diagnosis of interstitial lung disease: a retrospective analysis 间质性肺疾病的多学科诊断:回顾性分析

Medical education, web and internet Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa1487

A. Magalhães, I. Moreira, A. Borba, J. Cardoso

{"title":"Multidisciplinary diagnosis of interstitial lung disease: a retrospective analysis","authors":"A. Magalhães, I. Moreira, A. Borba, J. Cardoso","doi":"10.1183/13993003.congress-2019.pa1487","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa1487","url":null,"abstract":"Background: The accurate diagnosis of interstitial lung disease (ILD) can be a challenging process. Guidelines highlight the importance of a multidisciplinary discussion (MD) between experts but there is few data regarding its role in a real-life setting. Aim: To evaluate the diagnostic ability of our center’s MD. Methods: Retrospective analysis of patients (pts) referred for discussion at a tertiary hospital in Lisbon between 2015 and 2018. Results: 181 cases were referred for diagnostic discussion in the mentioned period. Mean age was 64, 51% were female. The MD established a definite diagnosis in 111 pts (61%); in 70 pts (39%) the MD was unable to provide a diagnosis but suggestions for further work up were given. 78 pts (43%) had a definite diagnosis of ILD, the most common being: idiopathic pulmonary fibrosis (n=21), hipersensitivity pneumonitis (n=15) and connective tissue associated ILD (n=12). 33 pts (18%) were diagnosed with diseases other than ILD. 106 pts (59%) had a pre discussion diagnosis provided by the the referring physician: in 42 (40%) this diagnosis was confirmed by the MD; in the majority of cases the MD resulted in a change of diagnosis (in 23% a different diagnosis was made; 37% had non classified ILD, in need for further work up). 75 pts had no preliminary diagnosis or multiple differential diagnoses pre discussion. The MD was able to establish a diagnosis in 44 (59%) of these. Conclusion: The MD was able to establish a definite diagnosis in 61% of the cases, including a modification in diagnosis in 60% of the pts with a previous diagnosis of ILD and a diagnosis in 59% of the pts with no diagnosis pre discussion, illustrating the importance of the multidisciplinary assessment.","PeriodicalId":228043,"journal":{"name":"Medical education, web and internet","volume":"127 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124588352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Development of an online resource to support paedaitric asthma management: www.beatasthma.co.uk 开发支持儿童哮喘管理的在线资源:www.beatasthma.co.uk

Medical education, web and internet Pub Date : 2018-09-15 DOI: 10.1183/13993003.congress-2018.pa3134

J. Townshend, L. Hayes, S. Hails, Austin Toombs, Madeline Balaam

引用次数: 0