CHEST pulmonary最新文献_第2页

Adapting the Tools of Our Trade 改造我们的行业工具：艾滋病毒感染者肺癌筛查的共同决策辅助工具

CHEST pulmonary Pub Date : 2024-09-01 DOI: 10.1016/j.chpulm.2024.100048

引用次数: 0

Tackling Comprehensive Asthma Education for Providers One Breath at a Time 一次呼吸，解决医疗工作者的哮喘综合教育问题：哮喘在线继续医学教育项目评估

CHEST pulmonary Pub Date : 2024-09-01 DOI: 10.1016/j.chpulm.2024.100061

{"title":"Tackling Comprehensive Asthma Education for Providers One Breath at a Time","authors":"","doi":"10.1016/j.chpulm.2024.100061","DOIUrl":"10.1016/j.chpulm.2024.100061","url":null,"abstract":"<div><h3>Background</h3><p>Exponential growth of knowledge in asthma has advanced the diagnosis and treatment of personalized, phenotype- and endotype-driven care in asthma leading to improved clinical outcomes. However, many knowledge and practice gaps persist among health care professionals. Microlearning has demonstrated efficacy in educational outcomes but is often limited by fragmentation and incomplete information. To integrate the benefits of microlearning into a comprehensive asthma curriculum that addresses knowledge gaps in this rapidly growing field, we built an extensive curriculum in bite-sized, “one breath at a time” portions for physicians managing asthma.</p></div><div><h3>Research question</h3><p>Is creating an asthma curriculum online educational program with modules of microlearning feasible and useful in improving knowledge of clinicians?</p></div><div><h3>Study Design and Methods</h3><p>The CHEST Curriculum Pathway for Asthma was published online on the American College of Chest Physicians (CHEST) learning management site in September 2022. It was derived from existing asthma education at the CHEST organization and was vetted by asthma experts. Pretests and posttests, satisfaction surveys, and user engagement data were collected.</p></div><div><h3>Results</h3><p>In the first 6 months, 523 participants engaged with the CHEST Curriculum Pathway for Asthma. Participant satisfaction was high, and participants answered 68% of the knowledge pretest correctly and 82% of the posttest correctly. Participants completed 82.8% of the individual videos that they opened. Completion rates for each asthma chapter ranged from 22.6% to 57.9%.</p></div><div><h3>Interpretation</h3><p>This educational program is, to our knowledge, the first comprehensive microlearning online curriculum issued by a medical association on asthma. Our results suggest that the CHEST Curriculum Pathway for Asthma was effective in improving knowledge and had high user satisfaction. Comprehensive online educational programs broken into microlearning components may be useful in other topics in pulmonary medicine.</p></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"2 3","pages":"Article 100061"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949789224000278/pdfft?md5=36d1504b247ffeaf3e7dae6225b345e4&pid=1-s2.0-S2949789224000278-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141035240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Dynamic Digital Radiography Pulmonary Function Testing 动态数字射线肺功能测试：机器学习肺部研究替代方案

CHEST pulmonary Pub Date : 2024-09-01 DOI: 10.1016/j.chpulm.2024.100052

{"title":"Dynamic Digital Radiography Pulmonary Function Testing","authors":"","doi":"10.1016/j.chpulm.2024.100052","DOIUrl":"10.1016/j.chpulm.2024.100052","url":null,"abstract":"<div><h3>Background</h3><p>Common diagnostic tests for pulmonary disorders include chest radiography and pulmonary function tests (PFTs). Although essential, these tests only offer a static assessment. Chest dynamic digital radiography (DDR) integrates lung and diaphragm motion in one study with limited radiation exposure. DDR is relatively easy to obtain, but barriers to its clinical adoption include time-consuming manual analysis and unclear correlation with PFTs.</p></div><div><h3>Research Question</h3><p>Can a machine learning pipeline automate DDR analysis? What is the strength of the relationship between PFT measures and automated DDR-based lung area measurements?</p></div><div><h3>Study Design and Methods</h3><p>PFT and DDR studies were obtained in 55 participants. We developed an analysis pipeline using convolutional neural networks capable of quantifying lung areas in DDR images to generate DDR-based PFTs (dPFTs). PFT and dPFT measures were correlated in patients with normal, obstructive, and restrictive lung physiology.</p></div><div><h3>Results</h3><p>We observed statistically significant (<em>P</em> < 1 × 10<sup>-6</sup>), strong correlations between dPFT areas and PFT volumes, including total lung capacity (<em>r</em> = 0.764), FEV<sub>1</sub> (<em>r</em> = 0.591), vital capacity (<em>r</em> = 0.763), and functional residual capacity (<em>r</em> = 0.756). Automated DDR and lung shape tracking revealed differences between normal, restrictive, and obstructive physiology using diaphragm curvature indices and strain analysis measurements. Linear regressions allowed for derivation of PFT values from dPFT measurements.</p></div><div><h3>Interpretation</h3><p>Statistically significant correlations found between dPFTs and PFTs suggest that dPFTs can act as a surrogate to PFTs when these are not available or unable to be performed. This study contributes to the potential integration of DDR as a reliable alternative to PFTs.</p></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"2 3","pages":"Article 100052"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949789224000187/pdfft?md5=9d2d97c098696dc1a1baf8a3c6ae782b&pid=1-s2.0-S2949789224000187-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140400217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

POINT: Liquid Markers for Risk Stratification of Pulmonary Nodules, Ready for Prime Time? Yes! 用于肺结节风险分层的液体标记物，准备好了吗？是的！

CHEST pulmonary Pub Date : 2024-09-01 DOI: 10.1016/j.chpulm.2024.100071

引用次数: 0

Critical Analysis of Hemodynamic Risk Assessment 血流动力学风险评估的关键分析：肺动脉高压热稀释法与直接菲克法的对比透视

CHEST pulmonary Pub Date : 2024-09-01 DOI: 10.1016/j.chpulm.2024.100085

Arif Albulushi MD , Rawan Al Bulushi MD

引用次数: 0

Response 对 "血流动力学风险评估的关键分析：对肺动脉高压热稀释法与直接菲克法的见解"

CHEST pulmonary Pub Date : 2024-09-01 DOI: 10.1016/j.chpulm.2024.100086

Adam J. Brownstein, Christopher B. Cooper, Sonia Jasuja, Alexander E. Sherman, Rajan Saggar, Richard Channick

引用次数: 0

Does the Presence of Lung Incidental Findings on Low-Dose CT for Lung Cancer Screening Lead to Additional Testing? 用于肺癌筛查的低剂量 CT 出现肺部意外发现是否会导致额外的检查？

CHEST pulmonary Pub Date : 2024-08-17 DOI: 10.1016/j.chpulm.2024.100096

Jeffrey Larson MD , Hyun Joo Kim MD , Rebecca Freese MS , Abbie Begnaud MD

引用次数: 0

A Collaborative, Interinstitutional Program to Improve the Care of Patients With Chronic Thromboembolic Pulmonary Hypertension 改善慢性血栓栓塞性肺动脉高压患者护理的机构间合作计划

CHEST pulmonary Pub Date : 2024-08-13 DOI: 10.1016/j.chpulm.2024.100092

Bryan A. Kelly DO , Vikas Aggarwal MD , Prachi P. Agarwal MD , Samuel Allen DO , Rana Awdish MD , Wael Berjaoui MD , Domingo J. Franco-Palacios MD , Reda E. Girgis MD , Gillian Grafton DO , Jonathan W. Haft MD , Brandon Hooks DO , Reem Ismail NP , Sheila Krishnan DO , Scott Visovatti MD , Vallerie V. McLaughlin MD, FACC , Victor M. Moles MD

{"title":"A Collaborative, Interinstitutional Program to Improve the Care of Patients With Chronic Thromboembolic Pulmonary Hypertension","authors":"Bryan A. Kelly DO , Vikas Aggarwal MD , Prachi P. Agarwal MD , Samuel Allen DO , Rana Awdish MD , Wael Berjaoui MD , Domingo J. Franco-Palacios MD , Reda E. Girgis MD , Gillian Grafton DO , Jonathan W. Haft MD , Brandon Hooks DO , Reem Ismail NP , Sheila Krishnan DO , Scott Visovatti MD , Vallerie V. McLaughlin MD, FACC , Victor M. Moles MD","doi":"10.1016/j.chpulm.2024.100092","DOIUrl":"10.1016/j.chpulm.2024.100092","url":null,"abstract":"<div><div>Chronic thromboembolic pulmonary hypertension (CTEPH), a subcategory of pulmonary hypertension and chronic sequela of acute pulmonary embolism, is often underdiagnosed due to nonspecific symptoms. Pulmonary endarterectomy remains the optimal, potentially curative therapy; however, determination of operability is based on multiple factors that may be relatively unique to each patient and largely based on physician expertise. Patients with CTEPH should be referred to CTEPH centers for comprehensive confirmatory diagnostics and operability assessments by multidisciplinary teams. Because CTEPH center experience and expertise are key to improving clinical outcomes, challenges arise when they are not available or easily accessible to patients. This article describes the Michigan Multi-Center CTEPH Collaboration, a multidisciplinary, interinstitutional collaboration program developed by health care centers in Michigan. Pulmonary hypertension and pulmonary embolism teams from centers across the state share expertise and clinical opinions in a monthly virtual conference. This collaborative approach tackles the two main challenges in the treatment of CTEPH head on: accurate diagnosis and patient access to CTEPH centers. Our collaboration model can be used as a best practice across the nation to benefit patients, multidisciplinary teams, and CTEPH centers.</div></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"2 4","pages":"Article 100092"},"PeriodicalIF":0.0,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142706134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Looking to Philadelphia for Trends in Lung Cancer Risk and Screening Adherence Among Asian American Patients 从费城看亚裔美国患者的肺癌风险和筛查依从性趋势

CHEST pulmonary Pub Date : 2024-08-08 DOI: 10.1016/j.chpulm.2024.100090

Travis L. Dotson MD, Christina R. Bellinger MD

引用次数: 0

Demographic and Clinical Factors Associated With Diagnostic Confidence in Interstitial Lung Disease 与间质性肺病诊断可信度相关的人口统计学和临床因素：肺纤维化基金会患者登记处的调查结果

CHEST pulmonary Pub Date : 2024-07-15 DOI: 10.1016/j.chpulm.2024.100084

Mary Beth Scholand MD , Sachin Gupta MD , Kevin R. Flaherty MD , Rosalinda V. Ignacio MS , Zhongze Li MS , Ayodeji Adegunsoye MD

{"title":"Demographic and Clinical Factors Associated With Diagnostic Confidence in Interstitial Lung Disease","authors":"Mary Beth Scholand MD , Sachin Gupta MD , Kevin R. Flaherty MD , Rosalinda V. Ignacio MS , Zhongze Li MS , Ayodeji Adegunsoye MD","doi":"10.1016/j.chpulm.2024.100084","DOIUrl":"10.1016/j.chpulm.2024.100084","url":null,"abstract":"<div><h3>Background</h3><div>Accurate diagnosis of interstitial lung disease (ILD) can be challenging. Accordingly, clinicians may attribute a diagnostic certainty based on guideline criteria and clinical judgment. However, further research is needed to refine this approach and improve diagnostic clarity.</div></div><div><h3>Research Question</h3><div>What are the real-world factors associated with diagnostic confidence in fibrotic ILD?</div></div><div><h3>Study Design and Methods</h3><div>Data were included from all patients enrolled in the Pulmonary Fibrosis Foundation Patient Registry from March 2016 to August 2018. Baseline demographic and clinical characteristics were collected at enrollment, or at the test date closest to the date of consent for longitudinal measures. Descriptive analyses were performed separately for all participants, and for subgroup participants with idiopathic pulmonary fibrosis (IPF) and participants with non-IPF ILD, stratified by the level of investigator diagnostic confidence (high vs medium/low) assigned at registry enrollment. Adjusted ORs and 95% CIs were calculated using multivariable logistic regression, with the aforementioned characteristics as predictors.</div></div><div><h3>Results</h3><div>Data up to April 2022 from 1,992 participants were included. In adjusted logistic regression analyses among all participants, antifibrotic use (OR, 1.51; 95% CI, 1.09-2.07), longer time since diagnosis (OR, 0.94; 95% CI, 0.89-0.98) at the research unit of 365 days, and diabetes (OR, 2.56; 95% CI, 1.01-6.44) were significantly associated with higher diagnostic confidence, and non-IPF idiopathic interstitial pneumonia (vs IPF; OR, 0.36; 95% CI, 0.24-0.55), insurance - other (OR, 0.65; 95% CI, 0.43-0.97), and Hispanic ethnicity (OR, 0.54; 95% CI, 0.31-0.94) were significantly associated with lower diagnostic confidence. Factors associated with diagnostic confidence in the IPF and/or non-IPF ILD groups included age, male sex, region, immunomodulatory medication use, multidisciplinary team discussion, surgical lung biopsy, and definite high-resolution CT pattern.</div></div><div><h3>Interpretation</h3><div>These findings suggest that certain demographic and clinical factors may influence physicians’ confidence in diagnosis of IPF and non-IPF ILD. Tailored physician education may help to reduce biases and improve consistency in diagnosis.</div></div>","PeriodicalId":94286,"journal":{"name":"CHEST pulmonary","volume":"2 4","pages":"Article 100084"},"PeriodicalIF":0.0,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141709263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0