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Xu W, Li Q, Mao Y, He Y. Knowledge, attitude, and practice toward interstitial lung disease among patients: a cross-sectional study. Front Med (Lausanne) 2024; 11:1397659. [PMID: 38966525 PMCID: PMC11222668 DOI: 10.3389/fmed.2024.1397659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 06/10/2024] [Indexed: 07/06/2024] Open
Abstract
Objective To explore the knowledge, attitude, and practice (KAP) toward interstitial lung disease (ILD) among patients and analyze the factors affecting KAP. Methods This cross-sectional study enrolled patients with ILD treated at the Respiratory Department of Shanghai Pulmonary Hospital between January 2023 and June 2023. A self-administered questionnaire was developed to evaluate their KAP toward ILD through convenient sampling. Multivariate regression analysis and structural equation model (SEM) were used to analyze the factors influencing KAP and their interactions. Results A total of 397 patients were enrolled, with 61.71% male. The mean KAP scores were 4.60 ± 3.10 (possible range: 0-12), 16.97 ± 2.16 (possible range: 5-25), and 32.60 ± 7.16 (possible range: 9-45), respectively. Multivariate logistic regression analysis showed that junior high school [OR = 2.003, 95%CI: 1.056-3.798, p = 0.033], high school and above [OR = 2.629, 95%CI: 1.315-5.258, p = 0.006], and duration of disease ≥5 years [OR = 1.857, 95%CI: 1.132-3.046, p = 0.014] were independently associated with adequate knowledge. The knowledge [OR = 1.108, 95%CI: 1.032-1.189, p = 0.005] and duration of disease ≥5 years [OR = 0.525, 95%CI: 0.317-0.869, p = 0.012] were independently associated with a positive attitude. The knowledge [OR = 1.116, 95%CI: 1.036-1.202, p = 0.004], attitude [OR = 1.180, 95%CI: 1.061-1.312, p = 0.002], and the age of >70 years [OR = 0.447, 95%CI: 0.245-0.817, p = 0.009] were independently associated with the proactive practice. SEM showed that patients' knowledge of ILD directly affected their attitude (β = 0.842, p < 0.001) and practice (β = 0.363, p < 0.001), and their attitude also affected their practice (β = 0.347, p = 0.014). Conclusion Patients with ILD in China had poor knowledge, intermediate attitude, and proactive practice toward ILD, which suggests that the health education of patients should be further strengthened.
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Affiliation(s)
- Wenjie Xu
- Department of Respiratory and Critical Care Medicine No. 1, Shanghai Pulmonary Hospital, Shanghai, China
| | - Qiuhong Li
- Department of Respiratory and Critical Care Medicine No. 1, Shanghai Pulmonary Hospital, Shanghai, China
| | - Yanjun Mao
- Nursing Department, Shanghai Pulmonary Hospital, Shanghai, China
| | - Yan He
- Department of Respiratory and Critical Care Medicine No. 2, Shanghai Pulmonary Hospital, Shanghai, China
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Glenn LM, Troy LK, Corte TJ. Diagnosing interstitial lung disease by multidisciplinary discussion: A review. Front Med (Lausanne) 2022; 9:1017501. [PMID: 36213664 PMCID: PMC9532594 DOI: 10.3389/fmed.2022.1017501] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 09/05/2022] [Indexed: 11/13/2022] Open
Abstract
The multidisciplinary meeting (MDM) has been endorsed in current international consensus guidelines as the gold standard method for diagnosis of interstitial lung disease (ILD). In the absence of an accurate and reliable diagnostic test, the agreement between multidisciplinary meetings has been used as a surrogate marker for diagnostic accuracy. Although the ILD MDM has been shown to improve inter-clinician agreement on ILD diagnosis, result in a change in diagnosis in a significant proportion of patients and reduce unclassifiable diagnoses, the ideal form for an ILD MDM remains unclear, with constitution and processes of ILD MDMs varying greatly around the world. It is likely that this variation of practice contributes to the lack of agreement seen between MDMs, as well as suboptimal diagnostic accuracy. A recent Delphi study has confirmed the essential components required for the operation of an ILD MDM. The ILD MDM is a changing entity, as it incorporates new diagnostic tests and genetic markers, while also adapting in its form in response to the obstacles of the COVID-19 pandemic. The aim of this review was to evaluate the current evidence regarding ILD MDM and their role in the diagnosis of ILD, the practice of ILD MDM around the world, approaches to ILD MDM standardization and future directions to improve diagnostic accuracy in ILD.
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Affiliation(s)
- Laura M. Glenn
- Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
- The University of Sydney School of Medicine (Central Clinical School), Sydney, NSW, Australia
- National Health and Medical Research Council (NHMRC) Centre of Research Excellence in Pulmonary Fibrosis, Camperdown, NSW, Australia
- *Correspondence: Laura M. Glenn
| | - Lauren K. Troy
- Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
- The University of Sydney School of Medicine (Central Clinical School), Sydney, NSW, Australia
- National Health and Medical Research Council (NHMRC) Centre of Research Excellence in Pulmonary Fibrosis, Camperdown, NSW, Australia
| | - Tamera J. Corte
- Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
- The University of Sydney School of Medicine (Central Clinical School), Sydney, NSW, Australia
- National Health and Medical Research Council (NHMRC) Centre of Research Excellence in Pulmonary Fibrosis, Camperdown, NSW, Australia
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Thangaraj C, Easwaramoorthy D. Generalized fractal dimensions based comparison analysis of edge detection methods in CT images for estimating the infection of COVID-19 disease. THE EUROPEAN PHYSICAL JOURNAL. SPECIAL TOPICS 2022; 231:3717-3739. [PMID: 36090545 PMCID: PMC9443658 DOI: 10.1140/epjs/s11734-022-00651-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 07/26/2022] [Indexed: 06/15/2023]
Abstract
The coronavirus, also known as COVID-19, has become highly contagious and has been associated with one of the world's deadliest diseases. It also has direct effects on human lungs, causing significant damage. CT-scans are commonly employed in such circumstances to promptly evaluate, detect, and treat COVID-19 patients. Without any filtering, CT-scan images are more difficult to identify the damaged parts of the lungs and determine the severity of various diseases. In this paper, we use the multifractal theory to evaluate COVID-19 patient's CT-scan images to analyze the complexity of the various patient's original, filtered, and edge detected CT-scan images. To precisely characterize the severity of the disease, the original, noisy and denoised images are compared. Furthermore, the edge detection and filtered methods called Robert, Prewitt, and Sobel are applied to analyze the various patient's COVID-19 CT-scan images and examined by the multifractal measure in the proposed technique. All of the images are converted, filtered and edge detected using Robert, Prewitt, and Sobel edge detection algorithms, and compared by the Generalized Fractal Dimensions are compared. For the CT-scan images of COVID-19 patients, the various Qualitative Measures are also computed exactly for the filtered and edge detected images by Robert, Prewitt, and Sobel schemes. It is observed that Sobel method is performed well for classifying the COIVD-19 patients' CT-scans used in this research study, when compared to other algorithms. Since the image complexity of the Sobel method is very high for all the images and then more complexity of the images contains more clarity to confirm the COVID-19 images. Finally, the proposed method is supported by ANOVA test and box plots, and the same type of classification in experimental images is explored statistically.
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Affiliation(s)
- C. Thangaraj
- Department of Mathematics, School of Advanced Sciences, Vellore Institute of Technology, Vellore, Tamil Nadu India
| | - D. Easwaramoorthy
- Department of Mathematics, School of Advanced Sciences, Vellore Institute of Technology, Vellore, Tamil Nadu India
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Cherrez-Ojeda I, Cortés-Telles A, Gochicoa-Rangel L, Camacho-Leon G, Mautong H, Robles-Velasco K, Faytong-Haro M. Challenges in the Management of Post-COVID-19 Pulmonary Fibrosis for the Latin American Population. J Pers Med 2022; 12:jpm12091393. [PMID: 36143178 PMCID: PMC9501763 DOI: 10.3390/jpm12091393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 08/23/2022] [Accepted: 08/24/2022] [Indexed: 11/16/2022] Open
Abstract
This commentary aims to highlight some of the major issues (with possible solutions) that the Latin American region is currently dealing with in managing post-COVID-19 pulmonary fibrosis. Overall, there is little evidence for successful long-term COVID-19 follow-up treatment. The lack of knowledge regarding proper treatment is exacerbated in Latin America by a general lack of resources devoted to healthcare, and a lack of availability and access to multidisciplinary teams. The discussion suggests that better infrastructure (primarily multicenter cohorts of COVID-19 survivors) and well-designed studies are required to develop scientific knowledge to improve treatment for the increasing prevalence of pulmonary fibrosis in Latin America.
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Affiliation(s)
- Ivan Cherrez-Ojeda
- School of Health, Universidad de Especialidades Espíritu Santo, Samborondón 0901952, Guayas, Ecuador
- Respiralab Research Group, Guayaquil 090512, Guayas, Ecuador
- Correspondence: (I.C.-O.); (M.F.-H.)
| | - Arturo Cortés-Telles
- Departamento de Neumología y Cirugía de Tórax, Hospital Regional de Alta Especialidad de Yucatán, Mérida 97133, Mexico
| | - Laura Gochicoa-Rangel
- Department of Respiratory Physiology, National Institute of Respiratory Diseases “Ismael Cosío Villegas”, Mexico City 14080, Mexico
| | - Génesis Camacho-Leon
- Division of Clinical and Translational Research, Larkin Community Hospital, South Miami, FL 33143, USA
| | - Hans Mautong
- School of Health, Universidad de Especialidades Espíritu Santo, Samborondón 0901952, Guayas, Ecuador
- Respiralab Research Group, Guayaquil 090512, Guayas, Ecuador
| | - Karla Robles-Velasco
- School of Health, Universidad de Especialidades Espíritu Santo, Samborondón 0901952, Guayas, Ecuador
- Respiralab Research Group, Guayaquil 090512, Guayas, Ecuador
| | - Marco Faytong-Haro
- School of Health, Universidad de Especialidades Espíritu Santo, Samborondón 0901952, Guayas, Ecuador
- Sociology and Demography Department, The Pennsylvania State University, University Park, PA 16802, USA
- Ecuadorian Development Research Lab, Daule 090656, Guayas, Ecuador
- Correspondence: (I.C.-O.); (M.F.-H.)
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Fellowship Education in Interstitial Lung Disease. A National Survey of Program Directors and Trainees. ATS Sch 2020; 1:384-394. [PMID: 33870309 PMCID: PMC8015767 DOI: 10.34197/ats-scholar.2020-0065oc] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background: Whether graduating pulmonary and critical care medicine (PCCM) fellows feel adequately trained in interstitial lung disease (ILD) remains unknown. In addition, there are no published data describing the current approach to educating trainees about ILD. Objective: To characterize the present state of ILD training during fellowship and to determine graduating PCCM fellows' perceived abilities to diagnose and manage ILD. Methods: We surveyed PCCM fellowship program directors nationwide and compared their perceptions of graduating fellows' abilities to diagnose, provide initial management to, and offer longitudinal care to patients with ILD using a series of unpaired t tests. We also inquired about existing practices for educating fellows about ILD. We then surveyed graduating PCCM fellows from 19 different preselected programs to assess comfort level with ILD in comparison with other core clinical domains. Results: Program director respondents (n = 74, 40% response rate) rated graduating fellows' abilities to establish specific ILD diagnoses and to provide initial management similarly (4.3 ± 0.8 on five-point Likert scale), whereas the ability to provide longitudinal expert care was rated significantly lower (3.8 ± 0.9, P = 0.001). Most respondents (n = 52, 70.3%) reported having dedicated outpatient ILD specialists with whom fellows could rotate, but only half required this rotation. In addition, very few (n = 17, 23.0%) reported that a majority of patients with suspected or newly diagnosed ILD were scheduled in fellow clinics, many of whom received subsequent longitudinal care from dedicated ILD specialists. Among 71 third-year fellow respondents, confidence in managing ILD was rated poorly (3.2 ± 1.0 on a five-point Likert scale) in contrast to more common diseases like chronic obstructive pulmonary disease (4.4 ± 0.7, P < 0.001) and asthma (4.2 ± 0.8, P < 0.001). Conclusion: Trainee exposure to ILD in both clinical and educational settings varied across PCCM fellowships nationwide. Fellows nearing graduation were significantly less confident in their ability to manage ILD compared with other more common pulmonary diseases.
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Ramadurai D, Corder S, Churney T, Graney B, Harshman A, Meadows S, Swigris JJ. Idiopathic pulmonary fibrosis: Educational needs of health-care providers, patients, and caregivers. Chron Respir Dis 2020; 16:1479973119858961. [PMID: 31288534 PMCID: PMC6616062 DOI: 10.1177/1479973119858961] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Idiopathic pulmonary fibrosis (IPF) is a progressive disease associated with poor
quality of life. Debilitating symptoms and the reality of shortened survival
impact patients’ physical and emotional well-being and constrain the lives of
patients’ caregivers. This study assessed the informational needs of medical
providers who care for patients with IPF, IPF patients themselves, and their
caregivers. Tailored surveys were sent electronically to providers, patients
with IPF, and caregivers of patients with IPF collected on a rolling basis in
March of 2017. Providers answered questions regarding their own informational
needs and what information they believed patients needed. Patients and
caregivers identified their own informational needs and the perceived needs for
each other. About 2636 surveys were sent to providers, including 2041 to
physicians, of whom 156 completed it. One hundred sixty patients and 29
caregivers responded to the survey via a link on a website. Eighty-six percent
of providers described themselves as physicians who diagnose and treat IPF
patients themselves. Providers ranked information on “making the diagnosis of
IPF” as their top informational need. Patients and caregivers chose “disease
progression/what to expect” as the most important informational need for
themselves and for each other. Providers want to make a correct diagnosis when
IPF is in the differential diagnosis. Patients and caregivers desire clarity
around how IPF will behave over time and what their futures with IPF will look
like. Resources for patients and their caregivers should include information on
disease natural history in empathically worded, clear, and easily accessible
formats.
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Affiliation(s)
- Deepa Ramadurai
- 1 Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Stephanie Corder
- 2 Office of Professional Education, National Jewish Health, Denver, CO, USA
| | - Tara Churney
- 3 Interstitial Lung Disease Program, National Jewish Health, Denver, CO, USA
| | - Bridget Graney
- 4 Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Andrea Harshman
- 2 Office of Professional Education, National Jewish Health, Denver, CO, USA
| | | | - Jeffrey J Swigris
- 3 Interstitial Lung Disease Program, National Jewish Health, Denver, CO, USA
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Galindo JL, Morales OMG, Sánchez DR, Celis-Preciado C, Arboleda AC. Barreras de acceso en la atención de las enfermedades pulmonares intersticiales en Colombia. SAUDE E SOCIEDADE 2019. [DOI: 10.1590/s0104-12902019190144] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumen Existe una creciente cantidad de información referente al manejo de las enfermedades pulmonares intersticiales en el mundo, sin embargo, las barreras en el acceso a los sistemas de salud afectan la adherencia a los estándares de tratamiento de estos pacientes. Este artículo busca explorar las perspectivas de los médicos neumólogos sobre las barreras en el diagnóstico y tratamiento de los pacientes con enfermedades pulmonares intersticiales en Colombia. Para este fin, realizamos un estudio cualitativo cuya aproximación metodológica fue la fenomenología. Se conformaron grupos focales con médicos neumólogos para explorar las barreras en el acceso a los servicios de salud. Los datos se analizaron usando un análisis temático inductivo. Los participantes manifestaron la existencia de barreras derivadas de la falta de capacitación en atención primaria, de la ausencia de integralidad en los servicios y de la escasez de grupos de discusión multidisciplinaria. La inequidad en la atención se encuentra relacionada con problemas estructurales del sistema de seguridad social colombiano. Como conclusiones identificamos que las características del sistema de salud establecen la mayoría de las barreras para la atención de los pacientes. Una mayor sensibilización al personal médico podría evitar retrasos en el acceso a la atención especializada.
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Affiliation(s)
| | | | | | - Carlos Celis-Preciado
- Hospital Universitario San Ignacio, Colombia; Pontificia Universidad Javeriana, Colombia
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Pereira CADC, Baddini-Martinez JA, Baldi BG, Jezler SFDO, Rubin AS, Alves RLR, Zonzin GA, Quaresma M, Trampisch M, Rabahi MF. Segurança e tolerabilidade de Nintedanibe em pacientes com fibrose pulmonar idiopática no Brasil. J Bras Pneumol 2019; 45:e20180414. [PMID: 31531619 PMCID: PMC8653976 DOI: 10.1590/1806-3713/e20180414] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 04/12/2019] [Indexed: 11/21/2022] Open
Abstract
RESUMO Objetivo Ensaios clínicos mostraram que 150 mg de Nintedanibe duas vezes ao dia reduzem a progressão da doença em pacientes com Fibrose Pulmonar Idiopática (FPI), com um perfil de efeitos adversos que é controlável para a maioria dos pacientes. Antes da aprovação do Nintedanibe como tratamento para a FPI no Brasil, um Programa de Acesso Expandido (PEA) foi iniciado para fornecer acesso precoce ao tratamento e avaliar a segurança e a tolerância do Nintedanibe para este grupo de pacientes. Métodos Foram elegíveis para participar da PEA pacientes com diagnóstico de FPI nos últimos 5 anos, com capacidade vital forçada (CVF) ≥ 50% do previsto e capacidade de difusão dos pulmões para monóxido de carbono (DLco) 30%-79% do previsto. Os pacientes receberam Nintedanibe 150 mg, 2 vezes ao dia (bid). As avaliações de segurança incluíram eventos adversos que levaram à suspensão permanente do Nintedanibe e eventos adversos graves. Resultados O PEA envolveu 57 pacientes em 8 centros. A maioria dos pacientes era do sexo masculino (77,2%) e brancos (87,7%). No início do estudo, a média de idade foi de 70,7 (7,5) anos e a CVF foi de 70,7 (12,5%) do previsto. A média de exposição ao Nintedanibe foi de 14,4 (6,2) meses; a exposição máxima foi de 22,0 meses. Os eventos adversos frequentemente relatados pelo pesquisador como relacionados ao tratamento com Nintedanibe foram diarreia (45 pacientes, 78,9%) e náusea (25 pacientes, 43,9%). Os eventos adversos levaram à suspensão permanente do Nintedanibe em 16 pacientes (28,1%) que passaram por um evento adverso grave. Conclusões No PEA brasileiro, o Nintedanibe apresentou um perfil aceitável de segurança e tolerância em pacientes com FPI, condizendo com dados de ensaios clínicos.
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