BACKGROUND:To promote the shared decision-making(SDM)between patients and doctors in pediatric outpatient departments,this study was designed to validate artificial intelligence(AI)-initiated medical tests for childre...BACKGROUND:To promote the shared decision-making(SDM)between patients and doctors in pediatric outpatient departments,this study was designed to validate artificial intelligence(AI)-initiated medical tests for children with fever.METHODS:We designed an AI model,named Xiaoyi,to suggest necessary tests for a febrile child before visiting a pediatric outpatient clinic.We calculated the sensitivity,specificity,and F1 score to evaluate the efficacy of Xiaoyi’s recommendations.The patients were divided into the rejection and acceptance groups.Then we analyzed the rejected examination items in order to obtain the corresponding reasons.RESULTS:We recruited a total of 11,867 children with fever who had used Xiaoyi in outpatient clinics.The recommended examinations given by Xiaoyi for 10,636(89.6%)patients were qualified.The average F1 score reached 0.94.A total of 58.4%of the patients accepted Xiaoyi’s suggestions(acceptance group),and 41.6%refused(rejection group).Imaging examinations were rejected by most patients(46.7%).The tests being time-consuming were rejected by 2,133 patients(43.2%),including rejecting pathogen studies in 1,347 patients(68.5%)and image studies in 732 patients(31.8%).The difficulty of sampling was the main reason for rejecting routine tests(41.9%).CONCLUSION:Our model has high accuracy and acceptability in recommending medical tests to febrile pediatric patients,and is worth promoting in facilitating SDM.展开更多
An Outpatient Department is the first point of contact with the hospital, and good Doctor-Patient communication would improve the service quality of the hospital, so it is important to construct a harmonious Doctor-Pa...An Outpatient Department is the first point of contact with the hospital, and good Doctor-Patient communication would improve the service quality of the hospital, so it is important to construct a harmonious Doctor-Patient relationship. This article, from the perspective of psychology, investigates into the common psychological factors which affect the Doctor-Patient communication, the appearance of the communication problem, and make suggestions on possible solutions accordingly.展开更多
Background:Stable angina is one of the most common clinical types of coronary artery disease(CAD)and associated with poor health-related quality of life(HRQL).However,few studies have evaluated the risk factors associ...Background:Stable angina is one of the most common clinical types of coronary artery disease(CAD)and associated with poor health-related quality of life(HRQL).However,few studies have evaluated the risk factors associated with HRQL in patients with newly diagnosed stable angina.Methods:A cross-sectional survey was conducted with 342 consecutive outpatients with newly diagnosed stable angina from October 2017 to January 2018 at the Second Affiliated Hospital of Army Medical University,Chongqing,China.Eight dimensions of HRQL were evaluated via the 36-item Short-Form Health Survey,including physical functioning,role limitation due to physical problems,bodily pain,general health,vitality,social functioning,role limitation due to emotional problems,and mental health.Physical and mental component summaries were calculated.Multiple stepwise regression was performed to determine the factors associated with HRQL.Results:Patients who were older,were females,did not exercise,had lower educational levels,had lower monthly incomes,had smoking/drinking habits,and had diabetes,hypertension,or hyperlipemia showed lower physical HRQL scores,while those who were older with lower educational levels and lower monthly incomes showed lower mental HRQL scores.The results of the multiple stepwise regression analyses showed that physical and mental HRQL were positively correlated with exercise and monthly income and negatively associated with age.Patients with monthly income≥5000 Yuan showed higher HRQL scores than those with monthly income<5000 Yuan.Sleep quality and drinking were negatively associated with physical,but not mental HRQL.Conclusions:Our findings indicated that exercise and personal income level,both modifiable factors,were positively associated with physical and mental HRQL.These findings could have implications for clinical suggestions and strategies to improve HRQL in patients with stable angina.展开更多
Consultation-liaison psychiatry (CLP) was first established in China after liberation in 1949. It has developed more rapidly over the last two decades but, despite major regional differences in the level of CLP, the o...Consultation-liaison psychiatry (CLP) was first established in China after liberation in 1949. It has developed more rapidly over the last two decades but, despite major regional differences in the level of CLP, the overall practice of CLP in the country remains quite basic, largely limited to case-based consultation with other medical departments. There is little ongoing collaboration between departments of psychiatry and other departments, and medical students and non- psychiatric clinicians rarely get training in CLP.展开更多
基金This study was supported by the Science and Technology Innovation-Biomedical Supporting Program of Shanghai Science and Technology Committee(19441904400)Program for artificial intelligence innovation and development of Shanghai Municipal Commission of Economy and Informatization(2020-RGZN-02048).
文摘BACKGROUND:To promote the shared decision-making(SDM)between patients and doctors in pediatric outpatient departments,this study was designed to validate artificial intelligence(AI)-initiated medical tests for children with fever.METHODS:We designed an AI model,named Xiaoyi,to suggest necessary tests for a febrile child before visiting a pediatric outpatient clinic.We calculated the sensitivity,specificity,and F1 score to evaluate the efficacy of Xiaoyi’s recommendations.The patients were divided into the rejection and acceptance groups.Then we analyzed the rejected examination items in order to obtain the corresponding reasons.RESULTS:We recruited a total of 11,867 children with fever who had used Xiaoyi in outpatient clinics.The recommended examinations given by Xiaoyi for 10,636(89.6%)patients were qualified.The average F1 score reached 0.94.A total of 58.4%of the patients accepted Xiaoyi’s suggestions(acceptance group),and 41.6%refused(rejection group).Imaging examinations were rejected by most patients(46.7%).The tests being time-consuming were rejected by 2,133 patients(43.2%),including rejecting pathogen studies in 1,347 patients(68.5%)and image studies in 732 patients(31.8%).The difficulty of sampling was the main reason for rejecting routine tests(41.9%).CONCLUSION:Our model has high accuracy and acceptability in recommending medical tests to febrile pediatric patients,and is worth promoting in facilitating SDM.
文摘An Outpatient Department is the first point of contact with the hospital, and good Doctor-Patient communication would improve the service quality of the hospital, so it is important to construct a harmonious Doctor-Patient relationship. This article, from the perspective of psychology, investigates into the common psychological factors which affect the Doctor-Patient communication, the appearance of the communication problem, and make suggestions on possible solutions accordingly.
基金supported by a grant from the special project of innovation and application of health management mode of the Chongqing Science and Technology Commission(Grant No:CSTC2015shms-ztzx10001,CSTC2017shmsA10006)。
文摘Background:Stable angina is one of the most common clinical types of coronary artery disease(CAD)and associated with poor health-related quality of life(HRQL).However,few studies have evaluated the risk factors associated with HRQL in patients with newly diagnosed stable angina.Methods:A cross-sectional survey was conducted with 342 consecutive outpatients with newly diagnosed stable angina from October 2017 to January 2018 at the Second Affiliated Hospital of Army Medical University,Chongqing,China.Eight dimensions of HRQL were evaluated via the 36-item Short-Form Health Survey,including physical functioning,role limitation due to physical problems,bodily pain,general health,vitality,social functioning,role limitation due to emotional problems,and mental health.Physical and mental component summaries were calculated.Multiple stepwise regression was performed to determine the factors associated with HRQL.Results:Patients who were older,were females,did not exercise,had lower educational levels,had lower monthly incomes,had smoking/drinking habits,and had diabetes,hypertension,or hyperlipemia showed lower physical HRQL scores,while those who were older with lower educational levels and lower monthly incomes showed lower mental HRQL scores.The results of the multiple stepwise regression analyses showed that physical and mental HRQL were positively correlated with exercise and monthly income and negatively associated with age.Patients with monthly income≥5000 Yuan showed higher HRQL scores than those with monthly income<5000 Yuan.Sleep quality and drinking were negatively associated with physical,but not mental HRQL.Conclusions:Our findings indicated that exercise and personal income level,both modifiable factors,were positively associated with physical and mental HRQL.These findings could have implications for clinical suggestions and strategies to improve HRQL in patients with stable angina.
文摘Consultation-liaison psychiatry (CLP) was first established in China after liberation in 1949. It has developed more rapidly over the last two decades but, despite major regional differences in the level of CLP, the overall practice of CLP in the country remains quite basic, largely limited to case-based consultation with other medical departments. There is little ongoing collaboration between departments of psychiatry and other departments, and medical students and non- psychiatric clinicians rarely get training in CLP.
