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1. Introducing Artificial Intelligence Training in Medical Education

Author

Paranjape, Ketan, Schinkel, Michiel, Nannan Panday, Rishi, Car, Josip, and Nanayakkara, Prabath

Subjects
Special aspects of education, LC8-6691, Medicine (General), R5-920
Abstract

Health care is evolving and with it the need to reform medical education. As the practice of medicine enters the age of artificial intelligence (AI), the use of data to improve clinical decision making will grow, pushing the need for skillful medicine-machine interaction. As the rate of medical knowledge grows, technologies such as AI are needed to enable health care professionals to effectively use this knowledge to practice medicine. Medical professionals need to be adequately trained in this new technology, its advantages to improve cost, quality, and access to health care, and its shortfalls such as transparency and liability. AI needs to be seamlessly integrated across different aspects of the curriculum. In this paper, we have addressed the state of medical education at present and have recommended a framework on how to evolve the medical education curriculum to include AI.

Published
2019
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12. List of Contributors

Author

Ahmed, Ahsan, primary, Aisa, Tharwat, additional, Aleman, Maria Jimena, additional, Alvarado, Gabriela, additional, Gil Anton, Javier, additional, Aranda, Zulmi, additional, Arina, Pietro, additional, Atagi, Kazuaki, additional, Badia, Josep M., additional, Baldisseri, Marie, additional, Barrasa, Helena, additional, de Carlos, Juan Carlos, additional, Centeno, Clara, additional, Mishra, Rajesh Chandra, additional, Chiscano-Camón, Luis, additional, Coopersmith, Craig, additional, Crespo, Rafael Zaragoza, additional, Cruz, Luisa, additional, Escorza, Jeanette Zúñiga, additional, Esteban, Elisabeth, additional, Ferrer, Ricard, additional, Fonseca-Ferrer, Vanessa, additional, Fonseca, Fernando, additional, Gerena-Montano, Luis, additional, Gorordo-Delsol, Luis Antonio, additional, Gotur, Deepa, additional, Guirao, Xavier, additional, Hedjal, Jamila, additional, Hegazy, Ahmed F., additional, Hidalgo, Allyson, additional, Hidalgo, Jorge, additional, Jacobi, Judith, additional, Johnson, Laura S., additional, Juvany, Montserrat, additional, Ko, Ryoung-Eun, additional, Lai, Christopher, additional, Lopa, Ahsina Jahan, additional, Lyons, John, additional, Mahdy, Saad, additional, Malbrain, Manu L.N.G., additional, Martin, Alex, additional, Maynar, Javier, additional, Mazzei, Michael, additional, Mekeirele, Michaël, additional, Merinos-Sánchez, Graciela, additional, Morales-Colón, Sulimar, additional, Morazan, Gerhaldine, additional, Nanayakkara, Prabath W.B., additional, Sanchez Nava, Victor Manuel, additional, Ramirez Garcia, Hector Alejandro, additional, Nieves-Torres, Lucila, additional, Olivero, Lorenzo J., additional, Orellana Jimenez, Carlos Enrique A., additional, Paiva, José-Artur, additional, Paranjape, Ketan, additional, Perez-Fernandez, Javier, additional, Pérez-Nieto, Orlando, additional, Perez, Paola, additional, Plata Menchaca, Erika-Paola, additional, Reed, Mary Jane, additional, Rello, Jordi, additional, Rodríguez-Cintrón, William, additional, Rodríguez-Vega, Gloria M., additional, Rubio Mateo-Sidron, Jose Alfonso, additional, Ruiz-Rodríguez, Juan Carlos, additional, Sánchez, Carlos, additional, Sánchez, Juan Ignacio, additional, Sa, Marcio Borges, additional, Schinkel, Michiel, additional, Shah, Reena, additional, Sinclair De Frías, Jorge E., additional, Sinclair Avila, Jorge E., additional, Singer, Mervyn, additional, Sinha, Sharmili, additional, Suh, Gee Young, additional, Taha, Ahmed Reda, additional, Teboul, Jean-Louis, additional, Torres, Arlene C., additional, Usón, Elena, additional, Vanhonacker, Domien, additional, Wiersinga, W. Joost, additional, Zamarrón, Eder, additional, and Zimmerman, Janice L., additional

Published
2023
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18. The host response in different aetiologies of community-acquired pneumonia

Author

Schuurman, Alex R., Reijnders, Tom D.Y., van Engelen, Tjitske S.R., Léopold, Valentine, de Brabander, Justin, van Linge, Christine, Schinkel, Michiel, Pereverzeva, Liza, Haak, Bastiaan W., Brands, Xanthe, Kanglie, Maadrika M.N.P., van den Berk, Inge A.H., Douma, Renée A., Faber, Daniël R., Nanayakkara, Prabath W.B., Stoker, Jaap, Prins, Jan M., Scicluna, Brendon P., Wiersinga, W. Joost, and van der Poll, Tom

Published
2022
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23. Author Correction: Randomised feasibility study of prehospital recognition and antibiotics for emergency patients with sepsis (PhRASe)

Author

Jones, Jenna, Allen, Susan, Davies, Jan, Driscoll, Timothy, Ellis, Gemma, Fegan, Greg, Foster, Theresa, Francis, Nick, Islam, Saiful, Morgan, Matt, Nanayakkara, Prabath W. B., Perkins, Gavin D., Porter, Alison, Rainer, Timothy, Ricketts, Samuel, Sewell, Bernadette, Shanahan, Tracy, Smith, Fang Gao, Smyth, Michael A., Snooks, Helen, and Moore, Chris

Published
2022
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31. Patients' Perspectives and Feasibility of Home Monitoring in Acute Care: The AcuteCare@Home Flash Mob Study.

Author

Weijers, Jari, Prins, Manon L. M., van Dam, Davy G. H. A., van Nieuwkoop, Cees, Alsma, Jelmer, Haak, Harm R., v Uffen, Jan Willem, Kaasjager, Karin A. H., Kremers, Marjolein N. T., Nanayakkara, Prabath W. B., Stassen, Patricia M., and Groeneveld, Geert H.

Subjects
PATIENTS' attitudes, PHYSICIANS' attitudes, EARLY warning score, CAREGIVERS, HOSPITAL patients
Abstract

Objective: To determine patients' perspectives on home monitoring at emergency department (ED) presentation and shortly after admission and compare these with their physicians' perspectives. Methods: Forty Dutch hospitals participated in this prospective flash mob study. Adult patients with acute medical conditions, treated by internal medicine specialties, presenting at the ED or admitted at the admission ward within the previous 24 h were included. The primary outcome was the proportion of patients who were able and willing to undergo home monitoring. Secondary outcomes included identifying barriers to home monitoring, patient's prerequisites, and assessing the agreement between the perspectives of patients and treating physicians. Results: On February 2, 2023, in total 665 patients [median age 69 (interquartile range: 55–78) years; 95.5% community dwelling; 29.3% Modified Early Warning Score ≥3; 29.5% clinical frailty score ≥5] were included. In total, 19.6% of ED patients were admitted and 26% of ward patients preferred home monitoring as continuation of care. Guaranteed readmission (87.8%), ability to contact the hospital 24/7 (77.3%), and a family caregiver at home (55.7%) were the most often reported prerequisites. Barriers for home monitoring were feeling too severely ill (78.8%) and inability to receive the required treatment at home (64.4%). The agreement between patients and physicians was fair (Cohens kappa coefficient 0.26). Conclusions: A substantial proportion of acutely ill patients stated that they were willing and able to be monitored at home. Guaranteed readmission, availability of a treatment team (24/7), and a home support system are needed for successful implementation of home monitoring in acute care. [ABSTRACT FROM AUTHOR]

Published
2024
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35. Diagnostic and prognostic performance of neutrophil-to-lymphocyte ratio in acute coronary syndromes: A meta-analysis of 90 studies including 45 990 patients

Author

Pruc, Michal, primary, Kubica, Jacek, additional, Banach, Maciej, additional, Swieczkowski, Damian, additional, Rafique, Zubaid, additional, Peacock, William Frank, additional, Siudak, Zbigniew, additional, Kurek, Krzysztof, additional, Nanayakkara, Prabath, additional, and Szarpak, Lukasz, additional

Published
2024
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39. Can acutely ill patients predict their outcomes? A scoping review

Author

Mols, Elisabeth Margaretha, Haak, Harm, Holland, Mark, Schouten, Bo, Ibsen, Stine, Merten, Hanneke, Christensen, Erika Frischknecht, Nanayakkara, Prabath W B, Nickel, Christian Hans, Weichert, Immo, Kellett, John, Subbe, Christian Peter, Kremers, Marjolein N T, Safer@Home Research Consortium, Mols, Elisabeth Margaretha, Haak, Harm, Holland, Mark, Schouten, Bo, Ibsen, Stine, Merten, Hanneke, Christensen, Erika Frischknecht, Nanayakkara, Prabath W B, Nickel, Christian Hans, Weichert, Immo, Kellett, John, Subbe, Christian Peter, Kremers, Marjolein N T, and Safer@Home Research Consortium

Abstract

INTRODUCTION: The full impact of an acute illness on subsequent health is seldom explicitly discussed with patients. Patients' estimates of their likely prognosis have been explored in chronic care settings and can contribute to the improvement of clinical outcomes and patient satisfaction. This scoping review aimed to identify studies of acutely ill patients' estimates of their outcomes and potential benefits for their care. METHODS: A search was conducted in PubMed, Embase, Web of Science and Google Scholar, using terms related to prognostication and acute care. After removal of duplicates, all articles were assessed for relevance by six investigator pairs; disagreements were resolved by a third investigator. Risk of bias was assessed according to the Cochrane Handbook for Systematic Reviews of Interventions. RESULTS: Our search identified 3265 articles, of which 10 were included. The methods of assessing self-prognostication were very heterogeneous. Patients seem to be able to predict their need for hospital admission in certain settings, but not their length of stay. The severity of their symptoms and the burden of their disease are often overestimated or underestimated by patients. Patients with severe health conditions and their relatives tend to be overoptimistic about the likely outcome. CONCLUSION: The understanding of acutely ill patients of their likely outcomes and benefits of treatment has not been adequately studied and is a major knowledge gap. Limited published literature suggests patients may be able to predict their need for hospital admission. Illness perception may influence help-seeking behaviour, speed of recovery and subsequent quality of life. Knowledge of patients' self-prognosis may enhance communication between patients and their physicians, which improves patient-centred care.

Published
2024

40. The accuracy of predicting hospital admission by emergency medical service and emergency department personnel compared to the prehospital MEWS:a prospective multicenter study

Author

Veldhuis, Lars I., van der Weide, Laura, Nanayakkara, Prabath, Ludikhuize, Jeroen, Veldhuis, Lars I., van der Weide, Laura, Nanayakkara, Prabath, and Ludikhuize, Jeroen

Abstract

Introduction: Overcrowding in the emergency department (ED) is a global problem. Early and accurate recognition of a patient’s disposition could limit time spend at the ED and thus improve throughput and quality of care provided. This study aims to compare the accuracy among healthcare providers and the prehospital Modified Early Warning Score (MEWS) in predicting the requirement for hospital admission. Methods: A prospective, observational, multi-centre study was performed including adult patients brought to the ED by ambulance. Involved Emergency Medical Service (EMS) personnel, ED nurses and physicians were asked to predict the need for hospital admission using a structured questionnaire. Primary endpoint was the comparison between the accuracy of healthcare providers and prehospital MEWS in predicting patients’ need for hospital admission.Results: In total 798 patients were included of whom 393 (49.2%) were admitted to the hospital. Sensitivity of predicting hospital admission varied from 80.0 to 91.9%, with physicians predicting hospital admission significantly more accurately than EMS and ED nurses (p < 0.001). Specificity ranged from 56.4 to 67.0%. All healthcare providers outperformed MEWS ≥ 3 score on predicting hospital admission (sensitivity 80.0-91.9% versus 44.0%; all p < 0.001). Predictions for ward admissions specifically were significantly more accurate than MEWS (specificity 94.7–95.9% versus 60.6%, all p < 0.001). Conclusions: Healthcare providers can accurately predict the need for hospital admission, and all providers outperformed the MEWS score.

Published
2024

42. Randomised feasibility study of prehospital recognition and antibiotics for emergency patients with sepsis (PhRASe)

Author

Jones, Jenna, Allen, Susan, Davies, Jan, Driscoll, Timothy, Ellis, Gemma, Fegan, Greg, Foster, Theresa, Francis, Nick, Islam, Saiful, Morgan, Matt, Nanayakkara, Prabath W. B., Perkins, Gavin D., Porter, Alison, Rainer, Timothy, Ricketts, Samuel, Sewell, Bernadette, Shanahan, Tracy, Smith, Fang Gao, Smyth, Michael A., Snooks, Helen, and Moore, Chris

Published
2021
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44. Can acutely ill patients predict their outcomes? A scoping review

Author

Mols, Elisabeth Margaretha, primary, Haak, Harm, additional, Holland, Mark, additional, Schouten, Bo, additional, Ibsen, Stine, additional, Merten, Hanneke, additional, Christensen, Erika Frischknecht, additional, Nanayakkara, Prabath W B, additional, Nickel, Christian Hans, additional, Weichert, Immo, additional, Kellett, John, additional, Subbe, Christian Peter, additional, and Kremers, Marjolein N T, additional

Published
2024
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47. A Prospective Observational Clinical Cohort of Women with Suspected Breast Implant Illness.

Author

Spit, Karlinde A., Azahaf, Siham, de Blok, Christel J. M., and Nanayakkara, Prabath W. B.

Subjects
BREAST implants, CONTROL (Psychology), FATIGUE (Physiology), PHYSICIANS, SUSPICION
Abstract

Background: This study aims to describe a prospective clinical cohort of patients with silicone breast implants and suspected Breast Implant Illness (BII). Methods: Women were included in a specialized silicone outpatient clinic at Amsterdam UMC, the Netherlands. Baseline characteristics were collected including medical history, implant details, and symptoms. Experienced physicians categorized BII suspicion as high, moderate, or low, based on symptoms and after exclusion of other probable causes. Additionally, participants completed questionnaires assessing symptoms and daily life impact at baseline, 6 months, 1, 2, and 5 years. For this initial analysis, the results from the first three years of inclusions were collected. Results: Data from 353 women were collected from December 2020–December 2023. At baseline, the most reported symptoms were fatigue, arthralgia, myalgia, and morning stiffness, accompanied by local symptoms in 83.3% of patients. At the clinic, 112 women were categorized as having high suspicion of BII, 147 women as moderate, and 94 women as low. At follow-up, 182 women (51.6%) opted for explantation. Following explantation, women with a high or moderate suspicion of BII experienced more significant symptom improvement, accompanied by a decrease in anxiety and a greater sense of control over their illness, compared to women with a low suspicion of BII. Conclusions: Our study highlights a distinct interplay of systemic and local symptoms among women with suspicion of BII. Women with a high or moderate BII suspicion benefit significantly more from explantation than women with low suspicion. Experienced physicians are pivotal in effectively assessing and guiding this patient group, highlighting the need for tailored clinical approaches. [ABSTRACT FROM AUTHOR]

Published
2024
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50. Impact of Blood Culture Contamination on Antibiotic Use, Resource Utilization, and Clinical Outcomes: A Retrospective Cohort Study in Dutch and US Hospitals

Author

Schinkel, Michiel, primary, Boerman, Anneroos, additional, Carroll, Karen, additional, Cosgrove, Sara E, additional, Hsu, Yea-Jen, additional, Klein, Eili, additional, Nanayakkara, Prabath, additional, Schade, Rogier, additional, Wiersinga, W Joost, additional, and Fabre, Valeria, additional

Published
2023
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