Corpus overview


MeSH Disease

Human Phenotype

There are no HP terms in the subcorpus


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    The role of emergency medicine for postgraduate year one undifferentiated MESHD physician: a qualitative analysis of trainees' perspective

    Authors: Ching-Yi Shen; Chih-Chun Huang; Weide Tsai; Chen-Hao Liao; NaiHui Lin; Chih-Chun Hsu; Kuan-Chih Kuo

    doi:10.21203/ Date: 2020-08-16 Source: ResearchSquare

    Background PGY1 program was initiated in 2003 for undifferentiated MESHD physicians in Taiwan, the program aimed to improve the general competency gap exposed during the SARS epidemic breakout in physicians. Many published studies discussed the effectiveness of the program. We were interested in the learning impacts gained from the physicians' perspectives during EM rotation in the PGY1 program, and little was known regarding this subject.Methods This retrospective study used grounded theory data analysis methods. 201 PGY1 physicians rotated in the emergency department from August 2014 to July 2017 answered three open-ended post-rotation survey questions and resulted in a dataset of 603 comments. A three-member team for code development reviewed all comments and established the code themes with the consensus of the team members. A four-member coding team coded applicable comments accordingly.Results We coded 563 (96%) comments and sorted 32 themes essential to characterize the clinical experiences into two categories. Twenty-six codes were relevant to professional development; 6 were related to the emotional issue. In the professional development category, patient care (33%) was the most frequently coded domains in the sub-level of six core competencies, followed by system-based practice (25%) and interpersonal and communication skills (19%). Senses of growth and improvement were the most frequently coded theme in the emotional issue category, followed by pressure at the workplace and on-the-spot-feedback. The top 3 lessons learned by physicians' perception were decision-making, team and patient communication, and prioritize tasks.Conclusions EM rotation had a productive role in professional development for undifferentiated MESHD physicians before receiving specialty discipline training. Gaining experiences on clinical judgment and communication were the strengths of the EM PGY1 program. This model of analysis might be used as a novel way of assessment on the achievement of learning objectives from the trainee's perspective. However, a prospective standardized study protocol is needed for a further affirmative conclusion.

    Artificial intelligence driven assessment of routinely collected healthcare data is an effective screening test for COVID-19 MESHD in patients presenting to hospital

    Authors: Andrew AS Soltan; Samaneh Kouchaki; Tingting Zhu; Dani Kiyasseh; Thomas Taylor; Zaamin B Hussain; Timothy Peto; Andrew J Brent; David W Eyre; David Clifton

    doi:10.1101/2020.07.07.20148361 Date: 2020-07-08 Source: medRxiv

    The early clinical course of SARS-CoV-2 infection MESHD can be difficult to distinguish from other undifferentiated MESHD medical presentations to hospital, however viral specific real- time polymerase chain reaction (RT-PCR) testing has limited sensitivity SERO and can take up to 48 hours for operational reasons. In this study, we develop two early-detection models to identify COVID-19 MESHD using routinely collected data typically available within one hour (laboratory tests, blood SERO gas and vital signs) during 115,394 emergency presentations and 72,310 admissions to hospital. Our emergency department (ED) model achieved 77.4% sensitivity SERO and 95.7% specificity (AUROC 0.939) for COVID- 19 amongst all patients attending hospital, and Admissions model achieved 77.4% sensitivity SERO and 94.8% specificity (AUROC 0.940) for the subset admitted to hospital. Both models achieve high negative predictive values SERO (>99%) across a range of prevalences SERO (<5%), facilitating rapid exclusion during triage to guide infection control. We prospectively validated our models across all patients presenting and admitted to a large UK teaching hospital group in a two-week test period, achieving 92.3% (n= 3,326, NPV: 97.6%, AUROC: 0.881) and 92.5% accuracy (n=1,715, NPV: 97.7%, AUROC: 0.871) in comparison to RT-PCR results. Sensitivity SERO analyses to account for uncertainty in negative PCR results improves apparent accuracy (95.1% and 94.1%) and NPV (99.0% and 98.5%). Our artificial intelligence models perform effectively as a screening test for COVID-19 MESHD in emergency departments and hospital admission units, offering high impact in settings where rapid testing SERO is unavailable.

    Utility of Lung Ultrasound in COVID-19 MESHD: A Systematic Scoping Review

    Authors: Michael Trauer; Ashley Matthies; Nick Mani; Cian Brendan McDermott; Robert Jarman

    doi:10.1101/2020.06.15.20130344 Date: 2020-06-16 Source: medRxiv

    Lung ultrasound (LUS) has an established evidence base and has proven useful in previous viral epidemics. An understanding of the utility of LUS in COVID-19 MESHD is crucial to determine its most suitable role based on local circumstances. A scoping review was thus undertaken to explore the utility of LUS in COVID-19 MESHD and guide future research. 33 studies were identified which represent a rapidly expanding evidence base for LUS in COVID-19 MESHD however the quality of the included studies was relatively low. LUS certainly appears to be a highly sensitive and fairly specific test for COVID-19 MESHD in all ages TRANS and in pregnancy, however its accuracy may be influenced by various factors including disease severity, pre-existing lung disease MESHD, scanning protocol, operator experience, disease prevalence SERO and the reference standard. High quality research is needed in various fields including: diagnostic accuracy in undifferentiated MESHD patients; triage and prognostication; monitoring progression and guiding interventions; persistence of residual LUS findings; inter-observer agreement; and the role of contrast-enhanced LUS.

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MeSH Disease
Human Phenotype

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