Digital Medical Interview Assistant AnCha for Obtaining the Medical History in General Medicine: Case study (Preprint)

2021 ◽  
Author(s):  
Selina Florence Regli ◽  
Floriana Gashi ◽  
Kerstin Denecke
Keyword(s):  
Medical History ◽  
User Interfaces ◽  
Pilot Trial ◽  
Age Groups ◽  
General Medicine ◽  
Time Frame ◽  
Practical Implementation ◽  
Medical Interview ◽  
Digital Tool ◽  
Dialog System

BACKGROUND Collecting information on the medical history of a patient is an important step during the diagnosing process. Besides the interrogation by the physician, computerized questionnaires are used to collect the data. To facilitate interaction, implementation of digital medical interview assistants (DMIA) using conversational user interfaces (CUI) gain in interest. OBJECTIVE The aim of this research is to assess patient’s and physician’s perceptions towards a DMIA with CUI. Beyond, we want to understand how such DMIA can be used in real-world context, what issues and barriers exist in their usage. METHODS We developed a web-based DMIA with CUI (referred to as AnCha for anamnesis chatbot) as a research prototype in a participative and iterative development process. We conducted a pilot trial in a practice for general medicine. Patient perceptions were collected and physicians were interrogated regarding usefulness of collected information. RESULTS 31 patients were approached, and 9 participants were included in the pilot trial; 3 conversation protocols were used by the physicians to prepare for the encounter. Participants spanned all age groups from digital natives (n=5), and digital workers (n=3) to digital seniors (n=1). Patients can easily interact with AnCha and are willing to provide information to the digital tool. They recognize benefits while using the dialog system compared to the existing process. Important insights into practical implementation and integration into practice workflows could be gained. CONCLUSIONS Providing information on complaints and medical history before the actual encounter is considered useful. In order to be supportive for physicians, information has to be made available in a sufficient time frame before the encounter. Future work has to assess in particular whether AnCha is also well accessible for digital seniors.

scholarly journals Difference in the general medicine in-training examination score between community-based hospitals and university hospitals: a cross-sectional study based on 15,188 Japanese resident physicians

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yuji Nishizaki ◽  
Keigo Nozawa ◽  
Tomohiro Shinozaki ◽  
Taro Shimizu ◽  
Tomoya Okubo ◽  
...  
Keyword(s):  
Physical Examination ◽  
General Medicine ◽  
Cross Sectional Study ◽  
Medical Interview ◽  
Sectional Study ◽  
University Hospitals ◽  
Community Based ◽  
Cross Sectional ◽  
Clinical Competencies ◽  
Clinical Procedures

Abstract Background The general medicine in-training examination (GM-ITE) is designed to objectively evaluate the postgraduate clinical competencies (PGY) 1 and 2 residents in Japan. Although the total GM-ITE scores tended to be lower in PGY-1 and PGY-2 residents in university hospitals than those in community-based hospitals, the most divergent areas of essential clinical competencies have not yet been revealed. Methods We conducted a nationwide, multicenter, cross-sectional study in Japan, using the GM-ITE to compare university and community-based hospitals in the four areas of basic clinical knowledge“. Specifically, “medical interview and professionalism,” “symptomatology and clinical reasoning,” “physical examination and clinical procedures,” and “disease knowledge” were assessed. Results We found no significant difference in “medical interview and professionalism” scores between the community-based and university hospital residents. However, significant differences were found in the remaining three areas. A 1.28-point difference (95% confidence interval: 0.96–1.59) in “physical examination and clinical procedures” in PGY-1 residents was found; this area alone accounts for approximately half of the difference in total score. Conclusions The standardization of junior residency programs and the general clinical education programs in Japan should be promoted and will improve the overall training that our residents receive. This is especially needed in categories where university hospitals have low scores, such as “physical examination and clinical procedures.”

scholarly journals The Agile Approach with Doctoral Dissertation Supervision

2015 ◽  
Vol 8 (11) ◽  
pp. 139 ◽  
Author(s):  
Lars Göran Wallgren Tengberg
Keyword(s):  
Doctoral Students ◽  
Time Frame ◽  
Doctoral Dissertation ◽  
Doctoral Degrees ◽  
Practical Implementation ◽  
Doctoral Studies ◽  
Supervision Process ◽  
Agile Approach ◽  
Time Required ◽  
Teaching Learning

<p class="apa">Several research findings conclude that many doctoral students fail to complete their studies within the allowable time frame, in part because of problems related to the research and supervision process. Surveys show that most doctoral students are generally satisfied with their dissertation supervision. However, these surveys also reveal some students think their supervisors meet with them too infrequently, lack interest in their dissertation topics, and provide insufficient practical assistance. Furthermore, many countries will soon witness a large turnover in the labour market as people near retirement. Because this is also the case at many universities and colleges, the expectation is that there will be many teaching and research vacancies. Therefore, many new doctoral students who plan to enter academia after earning their doctoral degrees are needed. In responding to these complaints, this conceptual paper examines the use of the agile approach–which has achieved recognition and approval in software development–in the doctoral dissertation process. In the teaching/learning sphere, the agile approach can be used in iterative meetings between doctoral student and supervisor for dissertation planning, direction, and evaluation. The focus of the iterations, the so-called Sprints, is on communication and feedback throughout the entire process. The paper is based in theories on teaching/learning and on the author’s personal experience with the agile approach. Use of the agile approach, which can decrease the time required for doctoral studies, may thus increase the number of graduates with doctoral degrees. The paper makes suggestions for practical implementation of the agile approach.</p>

scholarly journals ANALYSIS OF THE DETAILS OF THE IMPLEMENTATION OF APPLICATION PROGRAMMING INTERFACE AND USER INTERFACE FOR MANAGING MODELS OF NEUROMORPHIC COMPUTING SYSTEMS

2021 ◽  
Author(s):  
Vasily Scherbakov
Keyword(s):  
User Interface ◽  
User Interfaces ◽  
Application Programming Interface ◽  
Practical Implementation ◽  
Neuromorphic Computing ◽  
Computing Systems ◽  
Application Programming ◽  
Programming Interface

The paper discusses the main aspects of the practical implementation of software and user interfaces for managing models of neuromorphic computing systems.

Older Australians' Expectations of their Interactions with their GPs

2005 ◽  
Vol 11 (3) ◽  
pp. 38 ◽  
Author(s):  
Simone Pettigrew ◽  
Katherine Mizerski ◽  
Robert Donovan
Keyword(s):  
Older People ◽  
Focus Groups ◽  
Medical History ◽  
General Practitioners ◽  
Information Flow ◽  
Older Patients ◽  
Telephone Survey ◽  
General Medicine ◽  
Personal Relevance ◽  
New Developments

This article reports the findings of a study into older Australians' expectations when interacting with their general practitioners (GPs). Six focus groups and a national telephone survey (n=505) were conducted to identify those aspects of interactions with GPs considered to be the most important and relevant to older people. The results indicate that the three most important issues relate to ability of GPs to: (1) provide prompt referrals to specialists and ensure an ongoing information flow between GPs and specialists (2) remain abreast of new developments in geriatric and general medicine, and (3) demonstrate a familiarity with the patient's medical history. These issues were considered important to older patients in general and to be of personal relevance to the large majority of those sampled.

scholarly journals P0114BENEFITS AND CHALLENGES OF A RENAL BIOPSY REGISTRY AND NETWORK - FCGG EXPERIENCE

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Wim Laurens ◽  
Johan De Meester ◽  
Ben Sprangers ◽  
Steven Van Laecke ◽  
Dendooven Amélie ◽  
...  
Keyword(s):  
Renal Disease ◽  
Renal Biopsy ◽  
Iga Nephropathy ◽  
Clinical Care ◽  
Adult Population ◽  
Age Groups ◽  
Time Frame ◽  
Renal Pathology ◽  
Renal Diseases ◽  
Renal Biopsies

Abstract Background and Aims End December 2016, a renal biopsy network in the Flemish region (Belgium) was founded as a collaboration between the renal pathologists and nephrologists. This FCGG network introduced a uniform renal biopsy request form, a well-structured report form of the renal pathology examination and a comprehensive list of renal pathology diagnoses. Method Following informed consent [99.5%] and in compliance with GDPR, the registration of the renal biopsies consists of basic categorical renal data, structured renal pathology information and the final clinical renal disease. Results In 2017 and 2018, 1385 renal biopsies were registered – 10.5 per million inhabitants per year; in addition, 28 patients had a repeat biopsy in the same time frame (2%). Of the pediatric patients ( age &lt; 18 years; N=92; 6.6%), 23 had IgA nephropathy, 20 a minimal change disease and 15 another type of glomerulonephritis. The biopsy was reported as normal or non-diagnostic in 15 patients (16%) – the majority was clinically considered as glomerulonephritis. The spectrum of the adult population was quite similar across gender and age groups: 56% glomerulonephritis [= IgA nephropathy [19%] + FSGS [8%] + pauci-immune glomerulonephritis [7%] + other GN [22%] ), 10% tubulo-interstitial nephritis, 7% acute tubular necrosis [ATN], 7% diabetes mellitus, and 7% nephroangiosclerosis. Exceptions are pauci-immune glomerulonephritis as the most important renal disease in women aged 65 years and older, and lupus nephritis as the second most important glomerulonephritis in women aged 18-44 years. Only a small percentage of adult renal biopsies yielded no result (7%), clinically interpreted as glomerulonephritis in 50% of the cases. Conclusion The FCGG network has provided a more intense collaboration between renal pathologists and nephrologists mainly by standardizing the renal biopsy reading and reporting across all centers. More precise estimates of the prevalent renal diseases were provided for the first time; however, in order to get full information, renal diseases diagnosed by other techniques ( serology, genetic analysis ) should also be collected in the future. Efforts will be done to coordinate the clinical care of renal diseases, particularly the more rare renal diseases, and to offer access to new therapeutic molecules or new schemes, through this super-regional network.

scholarly journals Illness duration and symptom profile in a large cohort of symptomatic UK school-aged children tested for SARS-CoV-2

2021 ◽  
Author(s):  
Erika Molteni ◽  
Carole Helene Sudre ◽  
Liane Santos Canas ◽  
Sunil S Bhopal ◽  
Robert C Hughes ◽  
...  
Keyword(s):  
Age Groups ◽  
Symptom Burden ◽  
Holistic Approach ◽  
Time Frame ◽  
Symptom Duration ◽  
Older Children ◽  
Illness Duration ◽  
School Aged Children ◽  
Symptom Profile ◽  
Using Data

Background In children, SARS-CoV-2 is usually asymptomatic or causes a mild illness of short duration. Persistent illness has been reported; however, its prevalence and characteristics are unclear. We aimed to determine illness duration and characteristics in symptomatic UK school-aged children tested for SARS-CoV-2 using data from the COVID Symptom Study, the largest citizen participatory epidemiological study to date. Methods Data from 258,790 children aged 5-17 years were reported by an adult proxy between 24 March 2020 and 22 February 2021. Illness duration and symptom profiles were analysed for all children testing positive for SARS-CoV-2 for whom illness duration could be determined, considered overall and within younger (5-11 years) and older (12-17 years) age groups. Data from symptomatic children testing negative for SARS-CoV-2, matched 1:1 for age, gender, and week of testing, were also assessed. Findings 1,734 children (588 younger children, 1,146 older children) had a positive SARS-CoV-2 test result and calculable duration of illness with the study time frame. The commonest symptoms were headache (62.2%) and fatigue (55.0%). Median illness duration was six days (vs. three days in children testing negative); and was positively associated with age (rs 0.19, p<1.e-4) with median duration seven days in older vs. five days in younger children. Seventy-seven (4.4%) children had illness duration =>28 days (LC28); LC28 was more common in older compared with younger children (59 (5.1%) vs. 18 (3.1%), p=0.046). The commonest symptoms experienced by children with LC28 were fatigue (84.4%), headache and anosmia (both 77.9%); however, by day 28 the median symptom burden was two. Only 25 (1.8%) of 1,379 children experienced symptoms for ≥56 days. Few children (15 children, 0.9%) in the negatively-tested cohort experienced prolonged symptom duration; however, these children experienced greater symptom burden (both throughout their illness and at day 28) than children positive for SARS-CoV-2. Interpretation Some children with COVID-19 experience prolonged illness duration; reassuringly, symptom burden in these children did not increase with time, and most recovered by day 56. Some children who tested negative for SARS-CoV-2 also had persistent and burdensome illness. Thus, a holistic approach for all children with persistent illness during the pandemic is required.

scholarly journals Prevalence and risk factors for pelvic organ prolapse in female citizens of Baku

2018 ◽  
Vol 99 (2) ◽  
pp. 187-194
Author(s):  
M Sh Askerova ◽  
L M Rzakulieva
Keyword(s):  
Risk Factors ◽  
Secondary Education ◽  
Pelvic Organ Prolapse ◽  
Family History ◽  
Medical History ◽  
Positive Family History ◽  
Age Groups ◽  
Pelvic Organ ◽  
Physical Work ◽  
Past Medical History

Aim. Study of prevalence and risk factors of pelvic organ prolapse in females in Baku. Methods. Statistical observation unit was a woman aged 45-74 years. The sample size (710 women) was determined taking into account probable prevalence of pelvic organ prolapse (20% according to literature) and margin of error (3%). All women were invited to maternity welfare centre, and a thorough examination was performed after their written consent was obtained. Results. The proportion of women aged 45-49, 50-54, 55-59, 60-64, 65-69, and 70-74 years was 26.5±1.7, 24.9±1.6, 23.1±1.6, 10.9±1.2, 8.2±1.0 and 6.4±0.9%, respectively. Prevalence of obesity in the named groups was 31.9, 34.5, 35.4, 36.4, 27.8 and 34.8%. Proportion of women with secondary and specialized secondary education was 58.5, 58.8, 53.7, 51.9, 51.7 and 67.4% resepctively. Among women of the corresponding age groups, physical work was recorded in 47.9, 53.7, 59.8, 58.4, 13.8 and 17.4% of cases, respectively. In past medical history, no surgeries were observed in 68.1, 77.4, 73.2, 77.9, 84.5 and 84.8% of cases, resepectively. Some women had no labour in past medical history (2.1, 2.3, 2.5, 2.6, 3.5 and 4.3% in the same age groups). Statistically significantly prevalence of pelvic organ prolapse increases among those aged 60 years and older (51.6±3.6% at age 45-49 years and ≥76.6±4.8% at age 60 years and older, р=0.001), with a body mass index less than 25.0 and more than 30 kg/м2 (69.7±3.3 and 66.7±3.0%, р=0.01), with high parity and remarkable family history (63.0±2.6, р=0.01), severe connective tissue dysplasia (72.6±2.5%, р=0.001), in postmenopausal period (63.8±2.0%, р=0.01), and depending on education level (88.0±2.4% among those with pre-secondary education: р=0.001). Relative risk of pelvic organ prolapse in the population of Baku is lower compared to the literature data in the background of obesity, but is higher in the background of positive family history and depending on the amount of deliveries (p=0.05). Conclusion. In Baku 59.9±1.8% of women aged 45-75 years have pelvic organ prolapse of different severity, incomplete uterine and vaginal prolapse are more prevalent (41.3±1.8 per 100 women); prevalence of pelvic organ prolapse is higher in women aged 60 years or older compared to those aged 45-49 (76.6±4.8% vs 51.6±3.6%, р=0.001).

scholarly journals Tolerance as a dominant social partnershih of intellectual education subjects

2019 ◽  
Vol 65 (2) ◽  
pp. 362-367
Author(s):  
Zhanna Shinkaryova
Keyword(s):  
Special Needs ◽  
Inclusive Education ◽  
Effective Interaction ◽  
Age Groups ◽  
Educational Needs ◽  
Point Of View ◽  
Practical Implementation ◽  
Special Role ◽  
Special Educational Needs ◽  
Social Partnership

The article stresses the necessity of forming a tolerant attitude towards others in order to ensure effective interaction of all subjects of inclusive education, namely: pedagogical staff; children (both with special needs and ordinary pupils); parents, or persons who replace them. A comparative analysis of the content load of the concepts of «inclusive education» and «tolerance» is made. The ideology of social partnership and the establishment of «social peace» are defined. The compromise, as the leading method of solving social conflicts within the framework of social partnership, is emphasized. It has been determined that cooperation of all subjects in the context of inclusive education should be based on universal values, mutual respect and tolerance. It is proved that social partnership is a pledge of non-conflict tolerant interaction of children with special needs and their environment. The special role of the teacher from the point of view of tolerance is outlined, and the importance of possessing the technology of tolerant communication. It is emphasized that personal example and favorable environment help to establish and practical implementation of the value of tolerance. It is proved that one of the conditions for inclusion of a child in inclusive education is the ability of parents to consciously perceive the child’s condition, to be able to work with teachers, acting as their active assistants. It is stressed that the problem of education of tolerance for people with special educational needs should unite specialists of different directions and levels: philosophers, psychologists, teachers, managers, etc.; The representatives of different age groups are no exception. Tolerance, as the key value of the individual, has to become the dominant social partnership of all subjects of inclusive education, the uniting solution for a brick for the full development of children with special educational needs.

scholarly journals Asymmetric drift of Andromeda analogues in the IllustrisTNG simulation

2020 ◽  
Vol 497 (3) ◽  
pp. 2870-2882
Author(s):  
Amanda C N Quirk ◽  
Ekta Patel
Keyword(s):  
High Resolution ◽  
Rotation Curve ◽  
Age Groups ◽  
Time Frame ◽  
Centre Of Mass ◽  
Stellar Rotation ◽  
Internal Heating ◽  
Rotation Curves ◽  
Neutral Gas ◽  
Andromeda Galaxy

ABSTRACT We analyse the kinematics as a function of stellar age for Andromeda (M31) mass analogues from the IllustrisTNG cosmological simulation. We divide the star particles into four age groups: &lt;1, 1–5, 5–10, and &gt;10 Gyr, and compare the kinematics of these groups to that of the neutral gas cells. We calculate rotation curves for the stellar and gaseous components of each analogue from 2 to 20 kpc from the centre of mass. We find that the lag, or asymmetric drift (AD), between the gas rotation curve and the stellar rotation curve on average increases with stellar age. This finding is consistent with observational measurements of AD in the disc of the Andromeda galaxy. When the M31 analogues are separated into groups based on merger history, we find that there is a difference in the AD of the analogues that have had a 4:1 merger the last 4, 8, or 12 Gyr compared to analogues that have not experienced a 4:1 merger in the same time frame. The subset of analogues that have had a 4:1 merger within the last 4 Gyr are also similar to AD measurements of stars in M31’s disc, providing evidence that M31 may in fact have recently merged with a galaxy nearly one-fourth of its mass. Further work using high-resolution zoom-in simulations is required to explore the contribution of internal heating to AD.

Harvey (Williams) Cushing 1869-1939

1941 ◽  
Vol 3 (9) ◽  
pp. 277-290
Keyword(s):  
Medical History ◽  
General Medicine ◽  
Medical Sciences ◽  
Important Contributor ◽  
Harvey Cushing ◽  
The World ◽  
Learned Societies ◽  
Human Enterprise ◽  
Hard Labour

The habitual excellence of Harvey Cushing in a wide variety of achievements and the ease with which he appeared to attain his ends recall Goethe’s remark that for success in any venture ‘you need only to blow on your hands’. His eminence in various ranges of human enterprise, however, was attained only by eager and persistent striving, through hard labour, to realize an ideal of perfection which he carried to every activity in which he engaged. In all civilized countries he was renowned as a surgeon, and to that reputation was added recognition of his large acquaintance with general medicine and with the special field of neurology. He was an important contributor to medical sciences, both as an experimenter in the laboratory and as a studious observer in the hospital. He was a stimulating and a rigorously exacting teacher and trainer of young surgeons, who spread extensively his methods and his spirit. He was a lover and collector of the medical classics and an ardent student of medical history. He was a graceful and effective writer, not only on technical themes in the realm of his professional interests, but also on subjects of concern to the layman. Because of these excellences Dr Cushing was, during his busy life, honoured by universities and learned societies throughout the world. With regard to him, the words from Ecclesiasticus have been quoted: ‘The skill of the physician shall lift up his head: and in the sight of great men he shall be in admiration’.

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